Episode 30 : Enhancing Healthcare Efficiency:

SFTS-Thomas Bentley: Audio automatically transcribed by Sonix

SFTS-Thomas Bentley: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Intro/Outro:
Welcome to Smart From the Start, presented by Care.ai, the Smart Care Facility, platform company and leader in AI and ambient intelligence for healthcare. Join Steve Lieber, former CEO of HIMSS, as he interviews the brightest minds in the health provider space on truly transformative technologies that are modernizing healthcare.

Steve Lieber:
Hello, and welcome to Smart From the Start. I'm your host, Steve Lieber, and it is my pleasure to bring to you a series of conversations with some of the sharpest minds in health information technology. We'll discuss the smart directions healthcare companies and providers are pursuing to create smart care teams. Today, I'm joined by Tom Bentley. Tom is the Chief Information and Digital Transformation Officer for the Ohio State University Wexner Medical Center. Tom began his career with the Medical Center in 1994 as an analyst. Prior to serving as CIO, he led the Health System Informatics team responsible for patient care and administrative applications across Wexner's patient care, education, and research mission. He is also responsible for IT governance and strategic planning. Tom, welcome.

Thomas Bentley:
Welcome. Happy to be here, Steve.

Steve Lieber:
Great. Well, I'm looking forward to this conversation. Wexner is obviously a well-known, well-respected healthcare institution, and you guys are engaged in some stuff over there that I think will be quite interesting to our audience. So, let's start out by reading your background and bio. It does reference your role in the development and implementation of the electronic medical record there at Wexner. And certainly, from 1994 to now, you've lived the somewhat pre-EHR era and sort of the post-era as well. Let's look ahead. So you've lived with, and what's the major platform you operate on? Epic?

Thomas Bentley:
Yeah. Oh yes. We're an Epic shot.

Steve Lieber:
Yeah. So, as you look ahead, it's not like I'm looking forward to telling you whether or not you see yourself staying with Epic. It's not really the direction, but where is it going in terms of what we have always called the foundational technology of the EHR? Where is that headed?

Thomas Bentley:
Steve, I think it's a really interesting question. I think that the EHR traditionally meant basic physician order entry and documentation, and that certainly holds true. But I think now we see the boundaries pushing into so many other aspects of the business, even systems and operations that were always deemed maybe clinical engineering in nature or facilities in nature, whether it be a nurse call system or now RTLS. But those boundaries of what we consider clinical systems in an EHR are expanding to every facet of the business and the clinical operations.

Steve Lieber:
So, are those things? I'm really heading down a path here of point solutions versus integrated platforms and that sort of thing. Are you seeing a stronger emphasis on integrated applications into the platforms versus point solutions standalone? Is that a trend?

Thomas Bentley:
Well, I think it's a really good point, and I think it's something CIOs across the country and organizations all struggle with balancing really innovative point solutions but also making sure that it really integrates back in with the foundational platform systems of the organization. For us, it's Epic and a few others. But I think we see advancements in some of these point systems, and sometimes, it'll introduce an advantage for a period of time. But then the question is always, okay, how do we then incorporate it and make sure the information is integrated with our core systems? I think we hear that over and over from the physician and nursing communities in particular. Don't make me look at another system. Having an additional log-in makes me leave Epic to do the kinds of things I need to do.

Steve Lieber:
Yeah. So on that point of, you know, don't make me log into another one and such, at times, I think we've deployed technology which actually has made caregivers' work and lives harder, not easier. Are we solving that problem? Are we better today? Have we learned from a generation of IT installations? What's the readout on the floor in terms of what you do to them or with them?

Thomas Bentley:
Yeah, it's such a great point. I think for so long, the things that we were introducing into healthcare, yes, we were making the care safer. We were maybe making the entire care process more efficient, and more robust. But were we helping the physicians, the nurses, or others with their day going easier? I don't know that we were. I think we hear over and over from those folks that I didn't go to med school, or I didn't go to nursing school to spend 70% of my day on the computer and documenting and doing a lot of laborious tasks. And I think, for the first time, to the heart of your question, I think. Maybe in the last 12 months or so, and as we look toward the future, we can start to peel away a lot of those tasks that could be reduced by efficient clinical systems, by AI, by more mobile technologies, those kinds of things. Really, our goal in so many of the discussions is how we can return those minutes to the caregiver to be either with their patient or get home on time so they can have dinner with their family or they actually get that full lunch break. And I think, for the first time, the technologies are really starting to be able to address that.

Steve Lieber:
Yeah, that leads directly into the next area I wanted to go into. And sort of the broad terminology of virtual nursing. And absolutely, the whole idea here is how we create solutions and such, work processes, and workflow that allow machines to do things that aren't necessary for a person to do. It's so basic, so routine. It's certainly not at the top of licensure and that sort of thing. And so, you know, using ambient technology and such to free nurses up from their routine tasks, you indicated that that's in your thinking. Talk to us a little bit about where you see Wexner going in this sort of area.

Thomas Bentley:
Yeah, we're really invested in and aggressively pursuing the AI-based ambient technologies, specifically just because we see the workflow that clinicians are doing right now, whether it's a nurse on the inpatient side or a physician in the ambulatory setting, they're having the conversations with the patient, they're doing the clinical pieces they need to do. And then there's this whole extra step after that to document and record everything they just did, or they try to do them simultaneously. It's just not a great experience for the patient or the provider. So, we really believe that the ambient technology is going to bring those together and make it both a better experience and a more efficient experience for the clinician. I think that the technology is progressing a little faster for the ambulatory setting, and I think we'll see the benefits there first. But I think very soon to follow will be that inpatient impact whether it be virtual nursing or ambient listening for the nursing. I mean, I think it will take a number of forms as the technology advances, but I think the potential return for nursing could be very significant.

Steve Lieber:
Yeah. In these conversations that I've had, one of the things that comes up often is trying to address workforce issues through this technology. Yeah, you just articulated the clinical benefits and such, as well. But back to our earlier conversation about burnout, dissatisfaction, turnover, etc. And, you know, the idea of being able to bring in tools like this so that nursing can get to nursing. Physicians can get into medicine and have real opportunities there. One of the things that I have heard that a couple of people are trying and want to get your reaction because it may be a little farther along than where you are in setting up the ambient, monitoring, ambient listening types of technologies, having it in an integrated solution that works off of a command center, and people are putting those command centers in different places, could be on the floor but could be in a nurse's home because you don't need to be. That's the whole point of virtual care. You don't need to be on-site. What are your thoughts about those sorts of what I would call innovative approaches in terms of the monitoring and the human side of virtual care not being right there?

Thomas Bentley:
You know, it's such an interesting topic, and it has evolved, as you know, in various ways and paces and different aspects of healthcare. But, you know, at Ohio State, we're having discussions. We are taking a little step back and saying, what does effective patient surveillance look like? And it takes a lot of forms. In some ways, we look at our most acute patients and say, we want to be watching cardiac monitoring in a very acute way, in other less acute situations, we may be just monitoring pulse oximetry and some basic vital signs. And that's one area we feel that AI and trending and things like that can really help augment how that is done safely and effectively. But then, if you even take a step back from that, we certainly have populations we're monitoring that are doing various home biometric monitoring, whether it be blood pressure or many others. And that's certainly something you watch on a slightly different scale and acuteness. But, you know, we look at our cancer population and certainly have unique needs. But I think if we start to look at all of those use cases as a whole and say, how do we effectively surveil our patients in the right way with the right technologies? I do envision a type of a center that could be off-site from the medical center that deals with the most acute. Still, I think certainly there are a lot of scenarios where you suggest in your question where we have expert nurses or others that could be working from their home to help with either virtual nursing or maybe helping to surveil large populations of patients with AI, augmented alerts and things like that, to really keep an eye on broad numbers of populations based on the needs of the patient at the time.

Steve Lieber:
Yeah, you're absolutely right. And as I say in conversations I've had where a couple of places have put this in place, they're finding that they are able to retain nurses because they still want to stay engaged. They have expertise and want to contribute, but they simply don't want to be at the bedside in the hospital. And, you know, various other personal factors are playing in and are having some interesting success with those approaches. So you've mentioned a couple of times using AI, and certainly, there's a lot of conversation here. You know, exactly where on Gartner's hype cycle we are is maybe up for a little debate, but it's up there. So you've certainly referenced using AI-assisted tools when you're looking at trends and monitoring and that sort of thing, how are you identifying what, where, and who? You know, there are a lot of people out there claiming a lot of things. It has to be a lot of noise to pore through to figure out where, what, and who to do next.

Thomas Bentley:
It's such a good question, and I smile as you ask it, because I think the hype cycle is such an interesting component that all CIOs across the country are dealing with. I think the hype cycle is at an absolute peak and hard to describe, but at the same time, it's real.

Steve Lieber:
It's real. Yeah. This is not something that's not real and not going to happen. But will it do everything everybody's saying it's going to?

Thomas Bentley:
Exactly. And to do it safely and effectively, I think, is so important. I think we want to be aggressive but cautious. You know, I think one question or one thought that comes to mind as you ask is, if it really goes back to one of the earlier points you asked about the integration with the rest of our platform systems because there are some pretty advanced solutions that we've looked at that are very standalone, or they require you to sync all your data to them and work within those kinds of systems and platforms. There may be some advantages there, but in reality, our core platforms are epic and others, and that's where our physicians work and spend all of their time. So, if we're going to surveil our patients, that's one of the first questions we ask when we look at various AI opportunities. How well do you connect with our EMR? How seamless is it for those alerts to appear for the clinicians? Even as we look into advanced solutions that may be video or audio-based, it's really the same point. How well does it tie in with those core systems? And if it's innovative and doesn't do those types of things, it's not something we're typically interested in.

Steve Lieber:
That's a great insight. Tom, for a closing question, we asked the same thing. The people who listen to this are folks like you. So, what's your single most important practical piece of advice for other CIOs, CMIOs, CIOs, CNIOs, and the like?

Thomas Bentley:
I think it has a long-term vision, and in this business, maybe a 2—to 3-year vision of the clinical platforms that you want to have to work in a really robust way, get the maximum use out of those, and be careful of adding additional platforms, products, and complexities into your environment until you're really sure they're safe and can tie together with those other solutions.

Steve Lieber:
Yeah, that's a great insight. Certainly, following that is going to pay dividends in terms of your success of adoption and implementation and the reaction out in the care settings in terms of what you are doing as a partner with clinicians. That's a great insight. I appreciate that. Tom, it's great seeing you. I really do appreciate your time today. This has been a great conversation.

Thomas Bentley:
Great talking with you, Steve. Thanks for it.

Steve Lieber:
You bet. Thank you for joining us, and to our listeners, I hope this series helps you make healthcare smarter and move at the speed of tech. Be well.

Intro/Outro:
Thanks for listening to Smart From the Start. For best practices in AI and ambient intelligence, and ways your organization can help lead the era of smart hospitals. Visit us at SmartHospital.ai. And for information on the leading smart care facility platform, visit care.ai.

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