Author: sanjith p

Virtual visits to our chatbots are 10-15 times more than pre-pandemic levels

Coronavirus conversations

Coronavirus conversations

Sara Vaezy, Chief Digital Strategy Officer Providence Health

"Virtual visits to our chatbots are 10-15 times more than pre-pandemic levels"

paddy Hosted by Paddy Padmanabhan
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In this episode, Sara Vaezy, Chief Digital Strategy Officer of Providence Health, the first health system to confirm a Covid-19 infection in the U.S., discusses how the organization has come together in a coordinated way in response to the crisis. Providence was one of the first health systems to enable patients with a set of FAQs and assessment tools by reconfiguring their chatbot Grace, which was developed over two years ago. In addition, the digital innovation group has helped Providence Health significantly scale up virtual visit capacity by redeploying and training clinicians in their same-day care operations to provide telehealth consults.

Providence Health has also successfully launched creative efforts to crowdsource PPE such as the 100 million mask challenge to ensure adequate availability of PPEs to protect the caregivers at the frontlines. Take a listen.

Sara Vaezy, Chief Digital Strategy Officer, Providence Health in conversation with Paddy Padmanabhan, CEO of Damo Consulting on the Big Unlock Podcast – “Virtual visits to our chatbots are 10-15 times more than pre-pandemic levels



PPWe are continuing with our series of conversations related to how technology is helping respond to the Coronavirus crisis. This week we have with us Sara Vaezy, Chief Digital Strategy Officer of Providence Health. So, Sara;Seattle has been ground zero for the Coronavirus epidemic in America. What’s life been like for the last few weeks? 

SVWe have been at the unfortunate leading edge of the pandemic for quite a while now. Providence Regional Medical Center in Everett, which is just outside of Seattle, had received the first coronavirus patient in the United States. We have been dealing with this for about a month now. We are coming together across every department, every function of the organization, under the leadership of Dr. Amy Compton Phillips, who is our Chief Clinical Officer. And in multiple times per day, emergency operations, command, huddles on various issues to tackle this. So, it’s been a busy month of doing whatever we can to help our patients, our caregivers, our broader communities, which include other community partners as well as other health systems. It’s been an extraordinarily busy time where a lot of the best has come out in folks in terms of the service that we provide. 

PPI have been following some of the extraordinary steps that you’ve taken at Providence Health to respond to this crisis and some extraordinary humanitarian stories, as well as.The stories related to how a large health system can come together to respond in a very coordinated way. What has been the single biggest challenge in your view in responding to the pandemic, how has Providence Health addressed it so far? 

SV:I think one thing that holds for everything is that things are changing. They’re so fluid and we’re learning a lot along the way. It’s a quickly evolving situation and it’s different for every city, county, and state. Each has diverse needs and manifestations of the situation. So, just dealing with that has been an interesting challenge. There’s also just basic stuff like we’re all bracing ourselves for the volumes that we’re afraid will result from this pandemic. There is quite a bit of sort of consternation out there about this. It’s sort of two sides of the same coin. Our biggest concern is supporting our frontline caregivers while they deliver high-quality care to patients in a very difficult situation. If I were to summarize it into one sentence, that would be it. 

PPWith a constantly evolving situation and all indications seem to be that we haven’t crested yet as far as the pandemic itself is concerned, as far as the United States is concerned. Everybody’s talking about the shortage of testing kits, PPE for frontline healthcare workers. And as you pointed out, that is a top priority for a health system to keep your healthcare workers, especially on the frontlines, safe so that they can deliver care and take care of themselves as wellYou’ve taken some very creative approaches to address some of the shortages in the near term. Can you talk about a couple of those just to help our listeners understand how you respond on the fly to these kinds of situations

SVAbsolutely. Thecredit goes to again our clinical teams who have been amazing. Our Chief Quality Officer, Jen Bayersdorfer, had an amazing idea for the hundred million mask challenge. Iresponse to the shortage of PPE, she pulled together this effort and engaged the public around making PPE and masks to protect our caregivers. They found a template and high-quality supplies. Then our digital team supported them by putting it on a website and asking for volunteers in getting engagement. We were so overwhelmed with the enthusiasm and outpouring of support from volunteers. We didn’t even need as many volunteers as we got. Part of that was due to some local companies coming out and working with us and saying, we’ll make masks for you, we were a furniture company before this, but we think it’s important and we’ll make surgical masks for you by using this template and these materials. So that was incredible and was very creative in terms of making the most out of available resources. Volunteers providing their time and organizations just stepping up and supporting us. That was by far one of the more uplifting experiences that we’ve had throughout this whole thing. 

PPIt’s an amazing story and I’m sure we’re going to see many more like that emerge in the coming weeks. There’s a lot of creative repurposing of our existing assets and resources across the country to deal with this. Hotels have been converted into hospitalsUnited Center, one of our biggest arenas, has been converted into a logistics hub for dealing with all the supplies and the logistics required to support this. You started a go funding program to help impacted residents. Tell us a little bit about that. 

SVThis was a volunteer-run effort between many of us and the digital innovation team as well as population health, where we really wanted to focus on homeless, shelters and services, and homeless individuals who received services from those organizations.With a situation like this, those places had significant challenges with getting disinfectants, enough funding for buying food, and other supplies for the folks. Thanks to the broader community and all those who participated.From around 80 donors, we received over $22,000 that we distributed to 56 shelters across three states. And those shelters provide services to almost 500000 people. And we were able to do that in just a matter of three days from start to finish. It was in the interest of supporting our most vulnerable populations. And it was the brainchild of Dr. Rhonda Medow’s, who is our Chief Population Health Officer at Providence. 

PP: I want to switch tracks a little bit and talk about the technology side of it. How your virtual care models have kicked in, in response to this crisis, especially telehealth, and anything else that you may have either built or repurposed from what you already have in responding to this crisis? What kind of adoption rates in terms of numbers you see and how is it the technology itself held up? 

SVI’ll focus primarily on what the digital innovation group has done. Before that, I want to mention that our IS colleagues have done a tremendous amount of work on a whole host of other technology-related things like standing up drive-through clinics, making iPads available to patients in the hospitals who are isolated, working closely with our physician enterprise to get thousands of providers who were providing care for established patients like chronic disease management care and things like that, getting them onboarded and ramped up on virtual visits. Our digital innovation group are absolutely at the forefront of everything happening from a technology standpoint and their efforts are running in parallel to everything else thatthe organization is doing.Froma patient-facing standpoint, we have stood up an assessment and FAQ chatbot, we call her Grace, and she does quick assessment by asking simple questions and triages patients to the appropriate next level of care, whether that just stay at home and rest or conducting a virtual visit with the provider. The second thing is really scaling up our virtual capacity for those same day use cases with folks who have concerns about Covid, whether they’ve been exposed, or they may have other risk factors. And that virtual visit capability has just seen tremendous ramping up over the course of the last few weeks. The third area is patient home monitoring. And for sub-acute patients who are either PUI patients under investigation or have tested positive but are not exhibiting the symptoms that would require them to be an inpatient in the hospital. We have sent them home and are monitoring their conditions remotely. And then we’ve done a lot of work around just a hub for consumer education and things like live locations for testing. So those are the primary activities that we’ve engaged in from a digital team standpointGrace is our chatbot, we call her Grace because we are a Catholic healthcare system. But Grace is a chatbot that we had made investments in for a couple of yearsWe could leverage those investmentsfortunately for Covid-19 specific use cases which means for patients essentially, we stood up a pathway that was with specific questions and workflow tied to Covid-19. So, things like have you traveled to a specific place that may have made you at higher risk for contracting the virus? And a whole host of other questions. We created the country’s first virtual assessment tool for quickly and safely assessing patients for Covid19. In the first few weeks, we helped over 70000 patients and had over a million messages exchanged between patients and the bot. It’s been a tremendous way to touch a lot of folks. In particular, keepthe worried one well, give them some peace of mind, and keep them in their homes, which we all know is very important, and then get folks who may need more sophisticated care. Care by talking with a provider live, get them triaged into virtual visits. 

PPI’ve talked to other health systems as well. And self-triaging bot serves two purposes. One is, it prevents an overwhelming of thehealthcare system when people start calling in such large numbers. And secondlyit triages into the right and the appropriate care. And I imagine that you have to put the clinical community through a new set of training or orientation to responding to what’s coming in through the triaging tool, and then appropriately responding to them. Have you had to invest quicklyhave a lot of training, are our providers comfortable with this mode of operation? Overnight you went from seeing patients to not seeing them anymore. What has been the challenge?

SV:When folks get triaged into virtual visits, they get triaged into what we call express care virtually. Express care is a clinical service that we have, and which is part of our ambulatory care network. We have over 50 providers who are just servicing express care. These folks are very specifically focused on express care. And in this case, they’ve been trained on those same-day use cases, particularly, virtualWe have been working with them really closely. Through our product team, they provide training like how to pull up the dashboards on your computer and just making that experience frictionless, not just for the patient who is accessing the virtual visit, but also for the provider who is delivering that care. So, they have stood up an entire customer success essentially team to be able to get our providers onboarded and trained for those same day’s virtual visits through Express Care Virtual. 

PPI want to share an anecdote with you, my daughter who lives in the city. She came down with a cold and a mild fever. The first thing that we told her to do was to schedule a virtual appointment. It took her a day to actually get to speak with a doctor even through a telehealth visit. So I imagine that even with a virtual model in place, even with the triaging in place, and the tools in place, there is still a feeling of maybe getting overwhelmed just because of the sheer volume of cases, all your routine cases which would have come in anyway. But then you layer on Covid-19 cases on top of that. How has the system responded in terms of Express care? Is it still same daycare, even though you switch to virtual or have the goalposts shifted a little bit? 

SV: There are significant challenges that the ambulatory care and the express care team rose to those challenges to findlarge number of providers to staff those visits. On the technology side of things, the volume that is coming through the platforms is 1015 times greater than what we had seen prior to the pandemic. We saw more volume in three weeks than we had in the entire previous year. And that has been a very interesting challenge in terms of the model. So previously it was on-demand telehealth and now what we’re seeing is almost like on-demand virtual visit. And lately, now what we’re seeing is like virtual urgent care or like a queuing model. And patients do wait in a waiting room in order to be able to access those visits. Now that it’s not a one day wait time, but they do sit in a waiting room in order to be able to access it. So, it’s almost a new model of care as compared to what we had previously. 

PPI’m hoping that, it’ll flatten out once we climb out of this crisis. And then hopefully when we go back to some level of normalcy, if you will, whatever, however, we may define normalcy going forward. 

SV:An interesting point, though there is a lot to be said for the adoption of technology potentially being accelerated through this process, given patients’ behavior is potentially different because they’ve now experienced a new form of care, a new modality of care that they otherwise wouldn’t have. And it’s unlikely that it will go back to completely the way it was and revert to the pre-pandemic days. This is alsobeen facilitated by a lot of regulatory and payment changes. And it’s also unlikely that it will willfully revert again just because we’re all getting used to engaging in a different way. And so the hope is actually that things like telehealth will be more ubiquitous in the future.We have this opportunity to meet patients and customers where they are with some of the enablers in place, too, like payment and like the regulatory environment has changed. 

PPOne of my previous guests said that with every crisis, a new opportunity arises. Maybe telehealth and virtual care models are what is going to be going forward. Switching to one more topic here, the dramatic jump in work from home employees. Solike every other business, every other enterprise across the land, you have seen remote workforce, double or triple. I know this is probably more or less function kind of responding to sit them all up remotely. What have been the challenges? Have there been more technological or cultural? 

SV:From a technological standpoint, Providence has a strategic alliance with Microsoft that is led by ourIS teamOur utilization of Microsoft Teams has just been through the roof. It has saved us in so many different ways. We’ve used it as a collaboration platform across the entire organization and it’s been tremendous. I’m sure that all of these collaboration platforms have been strained to the full extent that they possibly could be. But it has really served us well to have been up on Teams and be able to utilize all of its functionality from its video conferencing, but also to like collaboration spaces and SharePoint integration and things like that. So that’s been reallyhelpful for us. We also use things that are cultural in nature, like virtual social hours and happy hours and with the teams just to reconnect. And we’ve put some best practices in place, like actually having video when we are talking with each other and meetings so that we can ensure that folks are engaged and that we get to see each other’s faces. It’s not a requirement, but it is definitely something that we try to encourage. So, we maintain that closeness while we’re social distancing. 

PPI know the Providence Innovation Group has a significant portfolio of investments in digital health startups that have developed a range of innovative solutions. How this crisis has impacted them one way or another. And what are some of the things you’re seeing and how are they responding to it? Can you talk about a couple of your portfolio companies as illustrative examples?

SVAbsolutely. I think across the board they’ve all risen to the challenge with various creative solutions for how they can help and that’s been really heartening.I’ll talk about a couple of our portfolio companies, Xealth, which is a digital prescription platform and an integration mechanism into the EMR and Twistle, which is a digital pathway company that we’ve partnered with both of them, both in an investment capacity from a portfolio company standpoint. Providence was the home for Xealth when it was incubated. And we’ve worked with them for over two years prior to making an investment. They are working together to provide that core platform for the home monitoring that we just talked about. So,Twistle is the pathway that patients use to input their data. And that alerts our providers when a patient needs additional care and Xealth has been the mechanism by which Twistle has integrated into Epic for us. So, they’ve been tremendous partners and Xealth has also done some other separate innovative things. For instance, Kroger grocery delivery and making that available for patients directly. They are all doing really interesting and kind of creative things and have done them very quickly. I thinkthis crisis has focused on all of us. And just the sense of urgency has made things go 10 times faster than they ever did in the past. For all of us. 

PPThat is the sense I’m getting from digital health leaders, from other health systems as well as some of these programs and put them on a sense of urgency that may not have existed prior. And the part of the technology to dramatically change the way you deliver care and also do it in an efficient, cost-effective way is becoming more and more evident. As you’re aware, my second book was about to come out about digital transformation that I was co-authoring with Ed Marks, the former CEO of Cleveland Clinic. We have put it on hold for now. We are going to write a new chapter on how the digital health landscape is transformed as a consequence of this crisis. And I hope to come back to you and maybe request introductions to some of these portfolio companies of yours to really understand how they changed their product roadmap or turn on a dime, if you will, to respond to this crisis. Thank you for sharing those examples. Anything else you’d like to share with us Sara before we close the podcast.

SVThank you for having me and thank you for continuing to spread the word. We just want all of us to rally together, to marshal our resources, and manage the situation as much as possible. So, folks should feel free to reach out and learn more about how they can leverage what we’ve already done. 

PPThank you, that is indeed part of the purpose of these series of what I’m calling the Coronavirus conversations. I want to be able to spread the word of how health systems across the land are responding to the crisis. And our hope is that someone, somewhere is picking up something useful from these conversations

We hope you enjoyed this podcast. Subscribe to our podcast series at www.thebigunlock.com and write to us at [email protected]

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity.

About our guest

saraveazy-profile

Sara leads the development of the digital strategy and roadmap, digital partnerships with health systems and technology companies, new business commercialization and business development, technology evaluation and pilots, and digital thought leadership at PSJH.

Prior to PSJH, she worked for The Chartis Group, a healthcare management consulting firm, where she focused on enterprise strategic planning, payer-provider partnerships, and the development of population health companies.

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

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We’ve seen a 500% increase in telehealth visits

Coronavirus conversations

Coronavirus conversations

John M. Kravitz, Chief Information Officer Geisinger Health System

"We’ve seen a 500% increase in telehealth visits"

paddy Hosted by Paddy Padmanabhan
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In this episode, John Kravitz, CIO of Geisinger Health, one of the largest health systems in the country, speaks about how the organization’s leaders have been “blown away” by how technology has stepped up to help address the covid-19 crisis. Geisinger’s IT organization has kept up with a 500% increase in telehealth visits and a doubling of remote workers to 13,000 employees and minimized disruptions to operations. John believes this crisis has created a new awareness of the opportunities with digital transformation. It’s a remarkable story. Take a listen.

John M. Kravitz, Chief Information Officer of Geisinger Health Systemin conversation with Paddy Padmanabhan, CEO of Damo Consulting on the Big Unlock Podcast – We’ve seen a 500% increase in telehealth visits”

 
 

PPWe are starting a new series – coronavirus conversations – where we will feature healthcare leaders, especially those who are leading IT in large health systems and healthcare organizations on how they’re responding to the crisis. Today is March 20th and it’s my honor and privilege to introduce my first guest for these series, John Kravitz, CIO of Geisinger Health Plan and Health System. 

John can you tell us what is the situation at Geisinger? How many Covid-19 cases have come in and how are they being screened and tested? 

JKAt Geisinger Health System the number keeps changing by the hour. We’ve had several Covid-19 confirmed cases, some have come into our acute care system and others are being treated in ambulatory settings. The numbers have continued to increase in the state of Pennsylvania. My last count was 158 patients had tested positive for Covid-19. Most are in ambulatory, some very sick are in the acute setting, and some have expired. Unfortunately, happening all over the country. We, like others, have set up screening tents and treatment tents. Trying to keep those patients outside of our ED settings to avoid infection to other people. We’ve used a lot of technologies to support that, like iPads or FaceTime so that people can do work at their existing workstations. For example, registration people can get into communication with patients. Not everybody has to be in the tent and exposed to things. This minimizes for us the PPE because they are becoming in short supply, especially masks, even level 1 and level 3 masks, not include in the N-95 masks. We have 11 campuses and 13 hospitals in our system. We’ve set up these screening and treatment tents in every one of them with all the technology. They have got workstations on wheels, printers for lab labels, patient wristbands, everything you can imagine. It’s like a MASH unit and is well established. 

PPDo you develop your own test too?

JKYes, we were one of the two in the state of Pennsylvania to do our own testing. We got validation from the state and were cleared to begin our testing process. The challenge is the test kits. There aren’t enough test kits for all the requests coming through. We’ve been using a triage process. We use a bot that helps us considerably on our website and direct patients to that. Communication goes out through our patient portal as well to let people know what the process is. They can access that bot there. But it goes to a nurse triage hotline where they go through several questions with the patients and then set up appointments to be screened. 

PP: ChatBots have been introduced to respond to the crisis. Anything else for launching a new tool or reconfiguring any existing tool or technology in order to respond to the crisis? 

JKWe have a particular tool at the bot that is called SyllableWe have some in concept testing but haven’t had more fully deployed yet. Our main concern in responding to this crisis is getting people to have access to work from home so that we can do social distancing, so the disease doesn’t spread across our employee platform. Anyone who is a non-clinician can work from home in our environment. Clinicians can as well, when they don’t have to have direct patient care. Part of our process has been establishing remote connectivity for home workers. We use VMware’s VDI when people are in contact centers and need to make phone calls. We provide the Meraki type device; it’s an IP address mobile device that allows them to work at home effectively. We do not allow printers at home because of PHI or credit card processing machines at home because of PCI. But we take measures and provide access so that our employees can be separated. For example, in a contact center or a call center where we make appointment calls for our patients, if we have 300 people in a contact center we will move 100 those people to the home setting provided they have proper internet connectivity and speed and everything else to support that. We’ve created our own speed test and can run that for any of our potential people moving at home which has worked effectively. This allows us to spread people out more than 6-foot distance easily between contact center agents because we’ve taken people out of that mix. So those are some of the things that we’ve done. At this point time, we have 13000 remote workers at home on our systems and working well.  

PPSowhen your work is going from a campus-based workforce to a remote workforce, what have been some of the challenges you faced both from clinician standpoint as well as from a technology standpoint? 

JKWe have a lot of radiologists that do work from home with high-speed connectivity at their homes with high-resolution monitors. We call them broadband monitors,standard in the industry. We have a number of those people and we are doubling the size of the folks working from home. This adds new challenges to make sure they have adequate bandwidth, adequate facilities, and proper security at the devices at home. With our employees working from home, we still are cautious of PHI and making sure that the data is protected. And folks using Zen desktop or VDI, the work goes on back in your data center or in the cloud, where you’re connecting to, adding a layer of protection. That information isn’t sitting on someone’s home equipment. It’s easy to install that connectivity and in most cases, in a matter of minutes, people are functioning as long as they have adequate bandwidth. 

PPAre you seeing any increased threats from cyber-attacks in this current situation and are you being extra vigilant about any of that? 

JKWe do have surveillance systems that are in place. I have not received any through our Chief Information Security Officer about any new attack vectors that I’m aware of.Although I’ve been reading that there are increased attacks that are occurring. When there is a potential for vulnerability, the bad guys always want to look at new ways to attack and leverage their cause, unfortunately.We have not seen an uptick on that. We do have endpoint security, which is very strong to minimize or mitigate the spread of malware. I think it is the network surveillance that goes on all the time through MSSP. That’s a cloud-basedsolution and it’s worked well for us. Fortunately, we have not seen those increased attacksor are just not allowed to occur. So thankfully, that is the case for us so far. 

PPSwitching to the frontend technologies, the ones that you use for engaging with your patients. Telehealth is now front and center as you want to try and avoid in-person contact in the current situation unless it’s absolutely necessary. Have you seen an uptick in telehealth visits and how your platforms coping with that? 

JKWe’ve seen a tremendous increase, probably a 500% increase in telehealth visits. And our platforms and our physicians are all being trained as we speak now. It’s been happening all week, but they’ve been trained in proper technique. We have a thousand new providers that are going to be doing telehealth visits. Whether in the office or in their home settings, they will be able to do telehealth consultation visits. We pulled roughly a thousand iPads which can be used to do the telehealth visits. This is a crisis situation where good opportunities will come. I am hopeful of the relaxation of payments by commercial insurance as Medicare, Medicaid. In our state, Medicaid has paid for telehealth visits for a number of years in Pennsylvania as an in-person visit. But I would hope that the changing tipping pointfor people to really utilize telemedicineis seen in crisis, how it works. We can see it works effectively in daytoday settings. It’s a new opportunityOut of every crisis, a new opportunity arises. I believe telemedicine is a new opportunity for us and I am excited about it. We have patients in our ICU that may be nearing end of life because of this disease, we will utilize telemedicine. We will utilize links into our eICU so that they can talk to their loved ones. I hope there will not be any end of life and people do recover from this. 

PPHow is the technology itself holding up against this surge in usage? 

JKActually, very well, we’re using VDI in our cases where people may be using Zen desktop. It is really sending a minimal amount of data back and forth. When I looked at our internet pipes just yesterday to see the trendswe have not spiked up. We do have three major internet providers coming into our organization and we have the ability to burst and grow considerably higher if necessary. But honestly, I am surprised with 13,000 people at home, radiologists moving at home, and contact center agents, we have not spiked considerably. We may have gone up about 25 percent on our usage, but we still have a lot of capability. I expected more to be honest with you but seeing very pleasant results here and our systems have been doing very well.

PP:What about the IT organization itself John? These are new timeshas there been any impact to your daytoday operations in the data center? What kind of adjustments you had to maketo respond to the crisis and to support that with your capability? 

JKAs every other health systemwe have tried to minimize disruption in operations. Our service deskbeen doing very well. When we have information, we can communicate. Communication is the key for us and getting proper communication out to people. For example, when we started this telemedicine expansion, we’ve set up on our ACDour automated call distribution. We have a menu item that says if you are calling about telehealth problem there is a special small group of technology people supportthat will address those callsOur data center has been working very smooth. I think part of the challenge is because we’re looking at new and creative ways to tackle this problemWe have six enterprise implementation systems going simultaneously, including CRM and billing systems and everything else. We’ve not really stopped them, but we have reprioritized our work for this period and we’re going on two weeks now and I don’t see it stopping anytime soon. We have people working, unfortunately, in some cases 1617 hours nowadays. And we are not the only ones. At some point we’ve got to give our staff rest time and we want to do that. Butthe patient and our providers are top of mind for us. I am the CIO for the health plan and the health system and have been pulling resources from my health plan in augmenting for our health system, which is beneficial. 

PPHow do you think healthcare is going to get reshaped as a consequence of this crisis? Do you think that telehealth is going to become more and more mainstream?

JKWe’re all looking in digital. How do we do digital technology? How do we provide the best service for our customers? I think this is the opportunity and telehealth is one area. But, reach outs, capabilities make the process smoother to enable and get good care, whether it’s in the setting or in an ambulatory setting or an acute setting. Using technology to leverage that is going to be importantLeaders from all over our organizationare blown away by the level of support they’ve received from information technology and information services throughout this entire process. They never expect that we could respond like this and they are so thankful. I am sure every organization is hearing the same thing because we’re all hardworking, good people. As Winston Churchill said – never miss the opportunity.Do not miss the opportunity for innovation. That’s what we’re doing now, and I think it’s going to only continue. It’s an upward trajectory for us. Unfortunately, lives are at stake, but we’re doing what they can with technology to support that. 

PPJohn, I really appreciate you taking the time and I want to extend my deepest gratitude to healthcare workers all across the country for all that they’re doing in responding to this crisis. I think we’re going to be forever indebted to all of them. 

JKPaddy, if I could put in one plug for my fellow CIOs. I happen to be the chairman of CHIME. And I know there is a lot of work going on behind the scenes for policy and in communication to CHIME members. I think that the team works extremely hard to support our CHIME members. A lot of these initiatives, telehealth, national patient identifier, things that we’re going to need for the future. CHIME is really working hard to help support us to push that forward. I just wanted to give acknowledgment to them because the team, while it’s very small, is very agile and they’ve done fantastic work. I’m really honored to be the chairman of the board for that group. And I think this will help us as well for my fellow colleagues and members of IT. 

We hope you enjoyed this podcast. Subscribe to our podcast series at www.thebigunlock.com and write to us at [email protected]

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity.

About our guest

John brings more than 25 years of healthcare experience to Geisinger Health System. As the Senior Vice President and Chief Information Officer, John is responsible for IT Strategy, Digital Strategy, Cloud Migration Strategy, Governance and Operations and business growth through merger and acquisition or joint venture activities. John has the technical responsibility for the organization’s advanced analytics platforms, including two Big Data platforms to support innovation of the Integrated Delivery Network as well as the Population Health Platform. Responsible for the regional health information exchange, KeyHIE, which currently connects organizations throughout Pennsylvania & New Jersey.

He is responsible for all technology support for the enterprise. This is comprised of the Geisinger Health Clinical Enterprise, Geisinger Health Plan IT support of business operations as well as Geisinger Commonwealth School of Medicine.

John is Board Chairman of the College of Health Information Management Executives (CHIME). He is a member of Health Information Management System Society (HIMSS), has been a past CPHIMSS Board member (Central Pennsylvania HIMSS Chapter Board), and KINBER Board, which provides fiber optic connectivity throughout the Commonwealth of Pennsylvania.

John currently serves as the CHIME Board Chair and is very active in the CHIME Policy Steering Committee which advocates on behalf of its member organizations. His areas of focus in the past have been the Opioid Crisis, testifying to the House Energy and Commerce Committee on behalf of Geisinger’s work in reducing the impact of Opioid prescriptions by more than 66%. Other initiatives include interoperability, use of telemedicine services and 5G Broadband in rural communities.

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

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Digital front door is just the start for digital transformation

Episode #38

Podcast with Diana Nole, Chief Executive Officer, Wolters Kluwer Health

"Digital front door is just the start for digital transformation"

paddy Hosted by Paddy Padmanabhan
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In this episode, Diana Nole discusses Wolters Kluwer’s healthcare business and how they are building expert solutions for insights and evidence that are more deeply embedded into clinical workflows. She also discusses how digital transformation is much more than digital front doors.

Wolters Kluwer Health has invested significantly in digitizing their products and offerings over the past few years. They now use advanced technologies such as AI and NLP to enhance their heavily curated content to provide quick and easy-to-find answers for evidence-based clinical decisions. They are also enhancing the delivery of their content with emerging technologies such as voice-recognition. Additionally, they are also improving the user interface by delivering smaller nuggets of curated information customized for individual patients and caregivers. Diana and her team are using voice-enablement to enable clinicians to learn in a setting that’s more interactive and stay updated on the latest practices and clinical knowledge.

Diana believes in evidence-based data to enhance user experience with the latest available technology. Their focus now is on getting patients to engage more, especially those that need stay on very good pathways for their own health.

Wolters Kluwer Health, Chief Executive Officer, Diana Nole in conversation with Paddy Padmanabhan, CEO of Damo Consulting on the Big Unlock Podcast – “Digital front door is just the start for digital transformation”


PP: Can you tell us a little bit about your healthcare business for the benefit of our audiences?

DN: We like to think of ourselves as a very helpful business. Our focus is around making sure every patient has the opportunity to benefit from the best evidence and data. We really focus on what prevents that and what causes variation. We start with education. We have a suite of education tools that continually evolves. As you think about how students get educated today, it’s very different than in the past. But then when they go into practice, as soon as they walk out of the door, they need to keep learning and be updated on what’s the latest practice techniques. As they continue their research and education, we stay with them throughout that. Again, really focusing on what causes breakdowns in clinical care, really caused by variation. So that’s a little bit about who we are and our suite of solutions really tailors towards that.

PP: Would you care to share your thoughts on the final ruling on the interoperability question made recently by the HHS?

DN: I think all of us are trying to digest it as I understand it. I think it’s over like twelve hundred pages. So, we will learn a lot. But I think at the core of this, we really are a supporter of needing to have good strong interoperability without sacrificing any issues relative to privacy or security. So we believe for the long term, if you really want to have the benefits of a digital system and digital ecosystem and be able to support things like AI and its ability to really alter and augment the intelligence that our clinicians need, you have to be able to do this. And we still struggle with that in many cases. And so, the aspect of standards and procedures and interoperability is very important. So, I look forward to, as does my team, really understanding how this may help advance that. I think it’s early days, but certainly we are positive that a ruling has come out and helps to put guidelines for all of us that are kind of working within the system of how to operate best.

PP: Did anything leap out at you when you saw the initial press release, anything at all?

PP: Yeah, I think that the interesting thing is, there’s always been this aspect of who owns the data and whether they have to pay for the data; so they clearly are saying patients should be able to get access to their data without any issues and without having to pay any fees. I think for us working within the ecosystem, it helps to understand how this will actually work as we interface and integrate it into, like the EHR systems. For us the most important thing on our clinical practice side is really how can we do this and how can we do this as quickly and efficiently as possible. So, I think there have been some things written in the document that kind of talks about from a contractual arrangement, things you can and can’t do that would sort of define you being information blocking or not. So, we think that will maybe actually help us in our arrangements with our EHRs. We were very critical and important to us.

PP: What is the current state of maturity of digital transformation as it’s defined broadly in the healthcare ecosystem, in your perspective?

DN: It’s a big question. And obviously you’ll get lots of opinions. But from my perspective, I think we’re beyond sort of the foundation building. I mean, things really are in digital format. We did talk just briefly now about the interoperability issue. We still are plagued by the fact that we can’t probably get data in and out of the system for all the various use cases that could potentially use it. So, I think we’re beyond the foundation building. I do think you’re seeing some nice basic enhancements to experiences on the patient side. You know, there’s pretty basic things, but you can see what your lab results are. You sort of have a place where all of your data is. If you’re in a certain system, you have the ability to do electronic check-ins. We see telemedicine kind of coming up and we’re starting to see some ability to see sort of AI and its application where we have large data sets of labeled things.

I came from the world of radiology. I think there’s a lot of thought that now that we have all of this labeled data, we could apply AI and AI could augment a radiologist role and understanding where there are issues. So, we’re still I would say sort of early on. I think that is really where I think the hope is. If you go back to our focus around variations in care, you still have a lot of handoffs that aren’t managed well within the digital ecosystem. Once the doctor sees the patient and they kind of decide on a treatment path, is it all carried out even out to the patient? I mean, a customer told me, you know, a simple thing is now we can tell whether a patient has actually picked up their medication or not. It’s a simple thing, but obviously goes into a lot of parameters around, OK. They didn’t pick it up. Should we reach out? Can we have a discussion with them? Can we understand what happened? Is it a cost issue? Is it an access issue? What is it?

I think we’re also in that stage where we’re starting to better appreciate what the true connection of digital health could mean for us. And I think that’s still you know, that’s the vision that we’re all kind of working toward. So still in the basics. But, you know, moving through and got a lot of good foundations laid.

PP: In another podcast, the CEO of Wolters Kluwer, Nancy McKinstry, talked about the massive digital transformation that you folks have gone through as a company. Can you share a little bit about what that feels like for your business and share some learnings from that?

DN: Yeah. So, in health, we’ve gone through a similar transformation in our content-oriented business. It’s very heavily curated, just like the rest of our businesses within Wolters Kluwer. And so, the first step was taking everything from what used to be in a printed format and getting in a digital, and 90 percent of all of our solutions now are in digital. We still do have books. People do like hard books and hard journals.

But now, just like we talked about the transformation, the EHR kind of gets everything into digital. We have gotten everything into digital. But now what we’re really focused on is something we referred to as expert solutions and expert solutions or more deeply embedded into the workflow, take into context the use cases of how they’re used. I’ll use as an example UpToDate. We have now gone to something referred to as UpToDate Pathways, and that is more than augmented or guided decision-making tool for specific things that have evidence that’s very strong but wide areas of variation. So, we are really starting to see the move from just taking something that was in print and moving into digital and now moving it into expert solutions. And that’s really where our focus is, where I think we’ll unlock a lot more value and being able to serve exactly the content that our customers need. Having them have to rely on the questions to ask to serve up the content is not the long-term goal. We want to be able to take the patient information from the EHR and provide what we think is most relevant and help them kind of walk through, especially for complex situations. The best way that they could consider a treatment for their patients. So, we also are in a transformation. It’s very exciting, though, because I think that’s really where you see significant impact on patient outcomes if you can do that.

PP: I imagine you use a lot of natural language processing because you’re a content-heavy business in order to curate the content and to get to answers faster than you would through conventional or traditional news. Are you also changing the way you deliver this content?

DN: So, in terms of digitizing it and delivering it in different ways, we’ve been thinking about what’s the interface. We are working on voice because we think voice will be one element of how you might want to get the content and then serving it up. I think what you’ll find is instead of lengthy textual things, you’ll see something either in a curated order or much smaller. We also have, just recently, even in our more patient oriented space, videos that interact with the patient to help them get prepared or help educate them on things that they’re experiencing. We definitely have found in that world we need to have smaller nuggets and to be able to kind of customize it more for the patient and allow them a little bit more flexibility. So, I think you’re right in the fact that the way we serve up the content will be very different, and different types of content, whether it’s video, whether you do it by voice; those things will continue. It’s all about the user experience now and how can you best use the most available technology? So, you hit on a great point there.

PP: Based on what we are seeing, the focus of digital transformation is on digital front doors and the consumer interface.  Do you think that is too narrow and limiting a definition? What are your thoughts on what else health systems should be looking at as we transform the entire system really?

DN: I think the digital front door is just the start. If you use that analogy, there’s so much more in the house that you want to be able to use. I think that we obviously had to have that window and you have to have that be some kind of an enhanced experience. So, people want to open that door. But if you think about it, the type of information I mentioned before, you can now get your lab results. But the lab results, most of us as consumers of that information, we don’t really quite understand what it would be. So if you think about moving more into how are you going to actually manage your health and how do you really get the patients to engage, especially those that really do need to engage and stay on very good pathways for their own health. That’s why we saw so much value and made the investment in the acquisition we did a few years ago. Emmi was really beyond just patient engagement, but it was shared decision making as well as really helping patients as they move into their home healthcare in a transitional environment. So that’s more of how do you stay connected with them? Get things like, register your sugar levels, how is your pain level doing and then how do you really get to understand how that patient wants to interact? And do you see the ability to see when a patient is going into rising risk such that you will outbound and outreach to them to help keep them in their home healthcare environment, which is probably the best situation for them? So, I see it much more oriented towards true engagement with the patient on a much more sophisticated level. But it’s easy to interface with not just the portal, if you will.

PP: You’re kind of at the intersection of education and healthcare. Education itself is going through a dramatic transformation in its own way. What are you seeing there that’s comparable to the kind of transformation the health systems are going through? And how are you enabling that transformation?

DN: Yeah. And it’s really interesting because I called on an academic and I think the professor said people don’t really come to the lectures anymore. And so, it’s sort of indicative of what a student wants, and a student wants to kind of mimic what they’re going to be asked to do outside in the real world. So, we definitely see virtual simulation for things like nursing labs. The interface with the EHRs so they practice within sort of a version of that. But more importantly, what we’ve also done is we’ve integrated technology around adaptive testing where the student can self-test themselves. You can’t game the system. It’s based on AI so it constantly kind of thinks about how you answer something and then serves up additional things. But it really understands if you are getting to the core of clinical judgment. Can you actually understand in these various scenarios how you would react? And we believe and there’s evidence that shows that they’re much more ready. They have higher scores on their high-risk test exams and they really then get out into the world and are ready to go and practice right off the bat.

So, I think that that’s one aspect at the initial education and then the subsequent things, we do a lot of education. We obviously have the ability to do continuing medical education within UpToDate. And then we also have the aspects of our product called Audio Digest, where you can actually continue to learn along the way in a setting that’s more indicative again. Listen in the car, listen while you’re working out, how do you just continue to kind of have those? So, the way people stay updated on the latest practices and how they get their clinical knowledge and judgment at the beginning has definitely changed. It’s much more exciting, I think, as well. Students react much better about getting in and really kind of looking at real life situations.

PP: There is also a component of the infrastructure that is required to support digital front doors and patient engagement and so on. What is your sense of where health systems are, especially as it relates to your solutions? Are the infrastructural components that you expect health systems to have in place and are they ready for what you are providing to them?

DN: Yeah, that’s a really big broad question because I would probably say we all think that there’s still things to invest in. The EHR kind of is the big road, right? The big pipes around the hospital system. But what you’re tending to see, which is typical of where we’re at in the stages, is you see digital solutions popping up. And it’s unclear to us sometimes that as a vendor exactly who will own that. Some of our systems have put in place, like a Digital Health Officer, but we still find that projects and initiatives seem to be owned and influenced in a particular area. And so, will the Chief Nursing Officer still be overly responsible for things that deal with patient experience, patient education, patient interface. I don’t know that we see the need for additional infrastructure to be built. I do think people are still very worried about the aspects of security and privacy and all of those. So, I think that will continue to be an evolving state of affairs.

In terms of the infrastructure, I think most of that is in place. I do also think that you’ll see these naturally have different types of solutions. But ultimately our customers are recognizing that the way a patient is cared for is kind of shifting from various pieces of the solution, like a doctor, a nurse, and a pharmacist to actually seeing the whole ecosystem of the care team. And that’s where we’re trying to work on our own solutions, of how to make sure that we start wherever possible, can populate our solutions with each other’s data. So, as an example, if you’re in UpToDate as a doctor, we do populate drug information and access that we will put Emmi videos in there so you can see what the patient might be prescribed as far as patient engagement. We’re just trying to make the user interface is consistent. So, we are trying to make our own sort of clinical decision support suite look like a suite, act like a suite, have information accessible to it so it can support the movement to the care team approach.

PP: You may have a Chief Digital Officer who is making decisions on certain types of solutions, but then there are other solutions for which functional leaders like the CNIO, for instance, are making the decision. Are you seeing this all converging in some way to some kind of an org model which is becoming a defacto standard like a digital transformation office, for example? Are you seeing that happening? Or do you anticipate that it will continue to be the way it is, which is that decision making will remain fragmented based on the type of solution that people are buying?

DN: We definitely are seeing decisions become more solution, holistic enterprise wide. I think the org models specifically are continuing to evolve. So even when organizations have put in place a Digital Health Officer, they themselves are still getting the lay of the land in terms of how to bring in the right influential clinical people to get to a decision. But we definitely have seen more and more decisions being made sort of enterprise wide, and consolidation sort of more structure around how the decisions are made, which ultimately I think is going to be a very good outcome while not sacrificing any particulars that may need to happen at a particular site. So, I think they’re being very thoughtful about it.

PP: We’re in the middle of the Coronavirus. How is your business coping with the impact and how are you helping your customers cope with the impact?

DN: Yeah. I really do truly hope that we’re more in the middle than it’s still at the beginning. Obviously, we have our own employees that we want to make sure that we have good care around them. And so, we always continue to make sure they’re in a safe environment and have flexibility for them in terms of working from home. In terms of our customers, we’ve made readily available whatever information we have on the situation. We’ve just posted it out there. We’ve posted access for patients. If you as a consumer want to understand what’s real and what’s the facts. We’ve made that available so that we try to put that out there to kind of depict fact versus, you know, maybe not facts.

In terms of our customers obviously, our customers are bearing the biggest burden of all of this right now. And so, we’ve been very flexible. I’ll give you some examples. From a sales call perspective, a support call perspective, if we had planned onsite visits, we’ve automatically called them and said, would you prefer us to just do it virtually. About 50 percent are doing virtual kind of conversations with us right now. And then we have a lot of relationships with societies and many of the societies have had to cancel their conferences. And so, we’re working with them on how we can get there. Very valuable information was going to be presented at those conferences, how can we still get it out? So, we’re kind of working with them on flexibility of trying to still sort of in a virtual environment, get to the objectives that they had for those things. So those are some of the things that we are doing in this current state.

We hope you enjoyed this podcast. Subscribe to our podcast series at www.thebigunlock.com and write to us at [email protected]

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity.

About our guest

Diana Nole is the CEO of Wolters Kluwer Health, a leading global provider of trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers, students, and the next generation of healthcare providers with advanced clinical decision support, learning and research, and clinical intelligence.

Wolters Kluwer Health solutions support more than 2.5 million clinicians in 187 countries and educate over 1 million medical and nursing students under Diana’s direction. Research and development investments leverage the latest technologies including artificial intelligence to deliver innovative solutions that improve the quality and cost of healthcare, specifically focused on: user experience, decision support, disease detection, advanced workflows, and analytics. Her approach as CEO for Wolters Kluwer is to focus on the customer, drive a sense of urgency, and execute on plans.

Prior to joining Wolters Kluwer Health, Diana served as President of Carestream’s Medical Digital division, a global leader in medical imaging systems. Under Diana’s leadership, the breakthrough wireless x-ray detector, DRX-1, and mobile x-ray solution, DRX-Revolution were introduced and gained market leadership positions. During her tenure, Carestream’s healthcare IT solutions also received “Best in KLAS” designations and the company was chosen as vendor of choice by large, prestigious global healthcare providers across the globe. A nice recognition and acknowledgement by customers that these solutions had a true and meaningful impact. She has held a number of executive positions and is a passionate leader behind many healthcare technology innovations. Her view of the rapid evolution of technology is not one of a challenge but, rather, a chance to unlock new opportunities.

Diana holds an MBA from the William E. Simon Business School and a B.A. degree with Magna Cum Laude honors in Computer Science and Mathematics from the State University of New York. In addition, Diana is currently a Board Trustee of St. John Fisher College, recently appointed their first female Vice Chair, a Board Director of ESL Federal Credit Union, and a Board Director and Chair of the Audit committee of the life sciences company, Clinical Ink.

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

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Podcast Episode #1: “Patient first” with Ed Marx and Chris Donovan of Cleveland Clinic

Episode #1

Podcast with Ed Marx and Chris Donovan of Cleveland Clinic

"Patient first"

paddy Hosted by Paddy Padmanabhan
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In this episode, Ed Marx, CIO and Chris Donovan, Executive Director of Enterprise Information Management & Analytics at Cleveland Clinic discuss how the Clinic operates on the mantra of putting patients at the center of analytics and IT-led innovation programs.

This is Paddy, today our guests are Ed Marx, CIO of Cleveland Clinic and Chris Donovan, executive director of enterprise information management and analytics at the clinic. Cleveland Clinic as many of our listeners would know is one of the largest and most respected hospitals in the country and indeed in the world. Ed and Chris, it’s a real honor and privilege for me to have you as guests on the bigunlock podcast and welcome

Paddy thank you for having us. It’s a joy to be part of your first podcast

Yes, thank you very much

All right Ed, I am going to start with you, Your new role for a little under six months, right? You want to share some of your thoughts on what has been like? By the way, I read your blog on the first 90 days is great stuff there for leaders coming into new roles

Thank You Paddy yeah, it was very fresh on my mind obviously sort of the first 90 days. We all know how critical that can be to onboarding successfully in a new organization so as I went along that journey myself, Hopefully for the last time, I thought it might be good to write about it, and I had some other colleagues of mine who recently started new jobs also to contribute so hopefully it’ll help other people who make that transition and one of the things that I was really interested in coming on board was where we were with analytics and I’m pleased to say that of one of the many fine things that the Cleveland Clinic does is utilize data? To help us run our business and when I say a business of course. I’m talking about both the clinical and financial aspects of things and so we have a very robust enterprise analytic foundation and so that’s why I’m thrilled to share the stage the podcast stage with you today with Chris Donovan who leads that efforts on behalf of our organization, so it’s been very interesting to see all the different things that we have going on. It’s very progressive an innovative organization as you know? and analytics again one of the sort of highlights of my discoveries in my first six months.

That’s wonderful, it’s great that we’ve got Chris on the line as well. Chris, you’ve been at the clinic for a long time and now we are in the post EHR implementation era and analytics is center stage, right? Can you talk a little bit about you know where you’re seeing the highest value at the clinic for? Analytics, and maybe talker you know talked about a couple of successes that you’ve had

Sure, You know we’re really trying to drive in our organization or trying to drive analytics as an enterprise capability, So we’re looking at doing this work across a broad spectrum of domains, I think when you think about some of the top of mind certainly population health is a key component of our strategy right now, I think that’s something that’s in the forefront of most leaders and Health Care’s minds right now and we’ve been doing a lot of work in, The last year to try and apply some of these advanced analytic capabilities in that space, You know if you think about the transition that everyone’s going through and healthcare related to population health It’s really about that idea of how do we go from taking care of people who are already sick to keeping people from getting sick and in the space of analytics. There’s a ton of potential methodologies and approaches that we can apply to that so similarly things that we’ve done and if you think about analytics kind of broadly not just the advanced analytics meaning the math and the algorithms and that side of it, but also all the work that goes into making it successful, so building the right skill sets hiring the right people the data ensuring you have the right data you have good governance around it all that leads up to your ability to actually use that data to make better decisions and so we’ve been doing a lot of work around that partnering with payers try and get innovative in terms of how we collect data. How we share data How we move data back and forth between our organizations to understand the populations that we’re now at shared risk for Some very specific thing that we’ve been doing are trying to understand and forecast risk so what patients or? members and the plans that were at risk for Do we believe in the next 12 months are going to have a spike in their healthcare costs and what can we do then to intervene and actually stop that from happening, so we’ve done quite a bit of work with our clinical teams to identify algorithms that help us forecast patients who we believe are going to be those high spend or high utilization. Patients in the next year I’m using that information we can identify a risk score. That risk score allows us to feed that information back to our care coordination and care management teams and we’re just in the beginning stages of being able to utilize that to prioritize and highlight who we think our care coordination team should go after in their care coordination efforts and so that’s been a real success and even though we’ve we’re just in the beginning of actually utilizing it changing the way we deliver that care to our patients, I think that’s been a real success in terms of building momentum building excitement and building key partnerships in our organizations. We couldn’t do any of this without our clinical partners, and clinical leaders in our organization and this has been a great testing ground for us to really build some of those relationships understand how we can bring their clinical knowledge and apply that to. The math into the algorithms that we’re building so they can really be impactful when you roll them into production.

That’s awesome. That’s awesome, Let me touch on a couple of things that you mentioned, one of them is data now we are in an era where there’s newer sources of data that are available to us, right? Now we’ve done the EHR implementations of the electronic health records, but there’s also new data source. There are genomic data, just to name a couple, So can you talk a little bit about how you are social determinants of health people talk about that a lot? Can you talk a little bit about how you’re integrating these various data sources and what does it mean in terms of? Your IT infrastructure in order to be able to deal with these different types of data and also this increasing volumes of data?

Certainly, as we designed our analytics platform, which we’ve been working on for the last couple of years we had exactly that kind of capability and those challenges in mind, so we’ve been doing what we’ve traditionally called decision support, or business intelligence at the including clinic for a long time and has been very successful at it, but as we look forward a couple years ago. We recognized some of the challenges that you were raising here around volume and velocity and variety of data so if you think about certainly the EHR presents a huge source of star for data So just from a volume perspective we needed to be able to accommodate that also inside of that our notes and other kinds of data that are unstructured that we really have a desire to be able to access and understand and utilize The machines that we have in our patients room so kind of the Internet of Things Ecosystem we recognize that that data is going to be coming at us, and we have an opportunity to leverage that, increasingly patients will be bringing their own data. So whether it’s through a Fitbit or other kinds of health devices like that Also patient enter data, so what can we ask our patients? How can we do a survey with them and learn something about them that can help us design their care differently so as we built our platform. We knew we were going to have to have capabilities across a much wider array of data types and speed and all that stuff that we talked about so from a technology perspective we really built a platform that allows us to build a standardized enterprise approach to this and create a platform that we can leverage for our entire organization and inside of that we have some core, or key kind of foundations and building blocks that allow us to do that versus that data integration piece, So we need to be able to capture the data interact with it go out collect that data normalize it standardize it when appropriate and then store what pieces of that makes sense in a structured data warehouse or structured data environment Next to that and tied into that from a technical perspective. We also have a Hadoop file system which allows us to capture unstructured data allows us to bring data in that We’re not quite sure what we want to do is and we want to experiment with we want to Unleash it to people to kind of explore and see what kinds of connections they can find in it and it also allows us to capture data at much higher volume than typically our structured data warehouse would allow us to do so we have those those two pieces together along with that ETL or ELT depending on what particular use case you have on the front end of that and On top of all that is the analytics platform So that we can access it a couple of examples of that we did some work. We partner with our Lerner Research Institute here at the clinic around genomics and so genomics is a hot topic right now lots of possibilities there in terms of improving care and obviously one of the challenges of genomics is just the size of the data and how do you store that how do you use it so we partnered with our partners over in our Research Institute and we identified a process in our organization by which we store both components of the genomic data, So there’s the BAM files which are those the huge full sequence files that contain every single genome for each person that has been sequenced, and then there’s what they call the variant control files and that’s really what our team is interested in variant control files are where they compare your genome to the perfect human genome and they find just the places where there’s variances and so where there’s something different and so we identified a process where we’re just pulling those VCF files into our analytics platform and Leveraging those in it we did a research kind of a POC with this in 2017. We’re able to link that genotypic data up to the phenotypic data that we have in our EMR that we pulled into our analytics platform and do some really interesting stuff and and one of the things that we did just as a real-life use case was we identified a small cohort of patients who had a genomic indicator for an increased risk of colon cancer and We could cross-reference them with our EMR and identify a subset of patients who had that increased risk, but who had never had a scree colonoscopy and so it’s that kind of work that we believe is just the taste of what the potential of bringing together the disparate kinds of data that historically you were never able to link effectively.

That’s fascinating stuff now you know let me touch on what may have been some of the challenges right Chris, I’d love to if you’re and I’m sure our listeners would love to hear as well worse than the typical challenges you have to overcome Both from a technical standpoint because you’re looking at different kinds of structured and unstructured data coming at different velocities That’s one part of it. There’s a technical challenge, and then there are there other challenges such as you know privacy

I mean you know the stuff that you just talked about Do people want to know I mean what I want to know if how do you actually release that kind of information? Yeah, those are those are really good questions. In terms of technical yeah, there’s a big challenge there It’s um all the components of this kind of along the ecosystem of data that you know this new Accessing these new kinds of data at the velocity and the volume the variety of data present challenges for our historic model and that was really why we had to take a new approach and invest in What we’ve called our analytics platform that allows us to interact very differently It means a couple of different things it means we have to be able to capture data Differently we need to be able to collect data We need to be able to normalize it when it’s appropriate We also need to be able to capture data, and not make any changes to it Just store it use it. We need to think differently in terms of how we connect with different systems and Increasingly we may not need to actually move data out of source systems We may need to just connect to those systems and leverage that data where it sits so all of those different things present significant technical challenges to us, and that’s why we Tried to build an enterprise platform that provided enough flexibility and agility To you know address each of those different challenges, but bring it together into a common ecosystem that our organization could leverage in terms of the You know privacy issue is that something we’re definitely wrestling with I think that’s why? An equally important pillar of a program like this has to be around data Governance and so as part of this effort here at the clinic. We established a data governance office. Which is the first time? We’ve had that in our organization in a very formal manner and as part of that We’ve partnered that data governance office with our privacy officer and with our security officer to ensure that we’re building a best-in-class tool in terms of guarding patient privacy, so When people enter into our IIM in a platform we have You know what we’re building is best-in-class ensuring that we’re HIPAA compliant We’re exploring technologies such as data masking so do we have? Opportunities to build datasets that are completely masked so that we don’t have to worry about pH. I being Shared inappropriately where we do have pH. I building all the policies procedures guidelines Around that data to ensure that our folks at the clinic understand the appropriate use cases for that they understand the minimal use Requirements that we should all be thinking about constantly and that they’re very aware of the need to protect our patients private information And that’s a real challenge, and that’s really important going forward That’s something we spending quite a bit of time on right now because we’re trying to balance we want to build a platform that Makes it data available so because we have a very much a self-service bias And how we want to do this our goal is not to Centralize all the information and lock it down and make everybody come through a central team It’s how do we get that out into the hands of the folks are going to be using it to make decisions and improve? clinical care and drive quality improvements and outcomes and at the same time recognize that we have to do that in a way that is appropriately protecting the protein of the pH I that we have inside of these data sets so a lot of thought and effort here Around that and certainly our data governance office is taking the lead on helping us make sure we maintain that right, right I’m sure folks are going to be very reassured by the fact that there is a governance process And it’s all been you know properly handled the switching to the infrastructure piece From from your comments. I gather that your Changing the data from multiple sources and not necessarily bringing it all in-house So is it fair to say that you’ve given braised cloud infrastructure and cloud-based? Solutions For setting up this platform And is it also fair to say that the interoperability challenges that the industry has been talking about for you know for a while now Those are somewhat under control is it fair to say that Well we’re not we’re not in the cloud yet So we took that when we built this a couple years back and laid out our roadmap we started with an on-pre m traditional on-premise solution and The reason for that ties back to your last question was we were unsure at the time. We were making these decisions of the pahi, and the and the compliance of those cloud vendors to make sure that we keep that information safe and we understood how the whole process of how That whole process around privacy was going to work. We did Ensure that in our roadmap and when we talked with our partners that we you know the vendors that we partnered with in this space That we recognized that quad is where we’re going to be at some point and so we have a roadmap to move in that direction and we have technologies that allow us to Leverage a hybrid environment So what do we want to have on pre m and where and why does it make sense to leverage a more elastic and a cloud? Environment so in this space at least in our analytic space we’re not in the cloud today. We have other Approaches and strategies across the organization more broadly across IT that we’re moving probably more rapidly towards the cloud But in this space we were a little more conservative because of those concerns that I noted In terms of interoperability, you know there’s still a lot of challenges with that. That’s one of the key things as we think about if you think about building a digital platform for healthcare organization That’s got to be one of the keys so how do we build those ecosystems or we can connect out? You know in a population health world? We may have an app that we have in the hands of a patient and that patient might want to be able to access their chart access some clinical information on their own refill a prescription Maybe build an earth set an appointment by themselves and that at the same time they may be Providing us information that they’ve collected on that device you know a Fitbit or some other health device that they have at home We need to build this platform that allows us to interact with those devices interact with that patient That information has to pass back into our core applications so that they can actually you know schedule an appointment They may need to reach out to a partner a payer or maybe a provider partner and we have to be able to leverage that data that they’re capturing off that device so that’s the Ecosystem more broadly that we’re thinking of and we’re trying to design around and ensure We have that interoperability through direct connections or api’s or however we want to However, we think we’re going to best achieve that and then we also think about across that ecosystem What are the different ways that we want to partner with? vendors in the in this space so do we want to build like we did with our core analytics platform that we build in-house Do we want to buy applications? So people are delivering already You know purpose-built tools into the space can we partner someone there and leverage that get to something faster or more efficiently that we could and Where do we want to innovate and really kind of drive the edge and be on the leading edge? so kind of discovery exploration partners where maybe we bring in a Third-party vendor and we create something together And so I think it’s through those different strategies that we’re trying to address both the you know the interoperability challenges And also think about our infrastructure, and how we have to leverage those different ways of interacting with partners

That’s great stuff. I’m gonna come back to that in a second, but I was reminded Something that Ed told me what when I interviewed him for the for the book that I wrote At one of your quotes for my book was features ready, but the student is not I simply love that and what he was saying there was there’s a lot of innovative solutions out there But the health care system is not necessarily ready for all of it you want to Expand on there or comment on that Yeah, I think

We’ve been laggards in health care in terms of exploiting the data That we have access to as you address in your book the big unlock the harnessing data and growing digital health businesses in this you know value-based Era of care I think we’ve been slow and when we look at other industries We see them picking up on technologies much faster. They don’t have the same interoperability hurdles So I give ourselves a little bit of grace that we might have in our industry in healthcare and the complexities around that and like Chris was saying all the additional safeguards we put in place because of the sensitivity of the data that we’re dealing with and That said you know that those are those are real obstacles to deal with and challenges that we are that we work through But I think we’re still behind some other industries, and I’m glad to be serving alongside Chris and some other leading organizations that are Taking what we do have the capabilities available to us and doing some pretty innovative things like Chris already described And there’s certainly some some other things, but my hope is that? Organizations like the Cleveland Clinic and as I mentioned There’s other peers of Chris’s that he works with quite closely in Other parts of the country that they continue to demonstrate the leadership that they’re doing in terms of delivering outcomes utilizing data, and that others will also step up and bring the realities of the potential to healthcare because data is the new oil as you describe it and It’s a way to really Transform healthcare we’ve been talking about transformation for quite some time but I think the ability to harness the power of data is really gonna help us get there and So we continue to push and as Chris was describing You know again a little bit behind. What some other industries are but in terms of leveraging the technologies available? But I think we we’re beginning momentum making strong inroads And I think that you’ll see more and more examples of some of that innovation Taking place like what Chris was describing. We’re doing here at the clinic That’s really that’s really helpful You know as the head of the idea function and I imagine you have to make decisions all the time About allocating your resources right you know what gets funded. What doesn’t what gets your support What doesn’t so what kind of a framework or mental model? Will you do you use to decide? which initiatives you support and related to that is this whole innovation agenda right because the flip side of innovation is risk and So how do you balance those? Would you care to comment on that? sure, we approach it a couple of different ways but First and foremost is what are our objectives as the Cleveland Clinic, so we don’t create our own Sub objectives or objectives that are different within I T or within analytics so we really take where the organization is headed as put out by our board and our executive team and then really see ourselves as a catalyst to enabling the realization of those particular objectives so for instance I Think analytics relates to all six of our primary objectives for 2018, but let’s just take digitalization and high reliability Organization and of course we’re patient first is our mantra in terms of our culture And so when you take in the culture and you take in two of these six actually all six But I’m just highlighting two the six major objectives for our organization for the Year analytics is Deeply entrenched in each one of those and make those a reality and so it’s it’s not too hard then to to interpret the objectives of the organization and see how we leverage analytics and so when it comes to prioritization We have to look at where do we get the biggest bang for our buck and certainly analytics? Taking the harnessing all the data that we’d already collect and improving our clinical outcomes improving our financial outcomes Is is really how we’re we’re driven so I could and I could answer this in a multitude of different ways but we do have a governance structure and Chris alluded to that and in in terms of analytics it’s a very high-powered governance structure includes primarily members of the c-suite so our executive team as well as some of our we would call our most dominant power users and In there, it’s all about again going back to the objectives. I mentioned about high reliability organization all about digitalization you know taking data that we have and making it actionable and all wrapped around this concept of our patient first culture where we’ve made a promise that we’re going to deliver the best healthcare Anyplace and so in order to do that you get that robust analytics so when it comes down to going back I think to the heart of your question in terms of funding prioritization it we’re all about analytics and if you in fact if you look at from an IT centric point of view how we interpret things When we talk about our our? goals that flow directly from the organization goals We have a wraparound that in all of that and that wraparound is called analytics So it is front and center of everything we do It’s the core to digitalization to digital health, so it gets the recognition and that’s the funding that it deserves to get because it’s really probably our biggest single biggest lever for impacting patient outcomes That is that’s just fantastic I’m sure that’s music to the years of you know folks who are like-minded Analytics professionals or or those who are looking to work with you? Now a related question that that probably comes up in all your conversation certainly some of your Conversations is how do you compute the ROI on this is this more of? You know we know this is the right thing to do and therefore We’re going to do it or Is it that no we’re going to look at you know even if it’s important and the right thing to do is still going to? Look at the hard returns before we move forward with anything, or is it somewhere in between Well I’ll take a first stab at that and then maybe ask Chris to comment based on sort of a historical Point of view, but I think that the returns are pretty demonstrable, they’re they’re pretty Self-evident when you realize you need to become a data-driven Organization, and you need to have just like we asked for evidence-based medicine on behalf of our clinicians whenever we’re Delavan developing pathways We’ve we’re starting to embrace that sort of discipline or have embraced a discipline when it comes around data as well and that we need to be data-driven and the only way to be data-driven is to have the ability to collect and analyze data So we’ve seen a pure return even in in my first six months. Just looking at the work. That’s been done in Hearing use cases which I give giving Chris here time to maybe set one up for you It’s been pretty demonstrable and what’s nice is the more we do this It’s a repeatable cycle Then the more confidence that our executive team gains and what we can do and is more apt to continue investments in Analytics because they do see that return

Chris do you have an example that we might be able to share whether it’s a clinical return or a financial return?

Yeah absolutely, there’s a there’s a few that we can pick from and I just want to echo Ed’s comments that we really take that both sides of that approach so certainly we know that there’s Investments that we’re going to make that we want to have to return we do it because it’s the right thing to do But it’s equally important that we’re able to demonstrate Tangible value back to the organization so a couple of examples You know one that comes to mind is we had a third-party tool that we had in our organization that was focused around Some of our revenue cycle work and in the analytics that we were delivering out of that domain we were able to evaluate that tool and look at building that capability internally inside of our analytics platform and Deliver not only the functionality that we got out of that third-party tool But deliver actually new capabilities and exceed the capability that that organization delivered for us And that’s going to be somewhere around a seven million dollar return to the Cleveland Clinic over the the next four years So very easy to quantify that very easy to demonstrate. You know this is what we were spending This is a tool we were using we can in source it deliver more value at a lower cost That’s awesome fantastic. Yeah a couple. Oh, sorry good no bad No, no, there’s a couple other couple other examples. You know and this is really important crossings from in terms of delivering value We worked very closely with our folks on the clinical side and in our population health agreements You know making sure that we get accurate coding is really important, so we partnered with them on doing some work around HCC improvements, which is really a measure of how why you’re coding, and it’s important in your Medicare Advantage Agreements and we were able to achieve significant improvement and demonstrate that we are achieving approaching our 90% goal for compliance and that in that measure so Different different projects that we have across the organization tying a key metric that is measurable To those so that we could actually see the progress is really important to talking about the value that you’re delivering out of a program The only other thing I would say is that one of the ways that we try to do this is we’re very intentional about making Sure that While we have to deliver a platform And there’s you know like I said earlier that kind of data people process and technology we try to communicate the value of the program through What we call kind of these you know you know our product our product Product domains and so we talked about certainly the core things that we’re delivering That I talked about earlier across those four pillars, but we also talked about we’re delivering capability in Domains such as executive insights quality and outcomes making sure that we demonstrate how we’re doing stuff around physician and provider performance and those Those domains make it really tangible to the organization so when we talk to our executive team And our sponsors or we talk to people across the enterprise that’s a great way to translate from while we’re building a tool To we’re delivering value, and here’s how we’re delivering value, and here’s how we’re partnering with you to deliver that value That’s great, so that’s really helpful on inside so what $7,000,000 returned from one program That’s got to be that’s got to make people sit up and take notice I imagine Well, you know really yeah, and you know We can talk about analytics in today’s context without talking about some of the emerging technologies and the analytical tools and methods available out there So I’m going to throw a couple of terms out at you and you know add You know one of you can take a stab at what do you think of it one artificial intelligence? Can take a run at that ad I think artificial intelligence is a really exciting area right now. I think that term is Certainly surrounded by a lot of hype and a lot of different interpretations and definitions of what people mean by our official intelligence We’re applying a lot of capabilities that fit within that kind of large domain if you if you define it kind of the most in the most broad sense possible so a lot of those algorithms that we Were talking about earlier a leveraging machine learning capabilities to do forecasts for patient You know patient risk or rising risk patients. We’re building an all risk model for all of our patients leveraging those capabilities I think you know when I think of artificial intelligence I actually kind of prefer the term Augmented intelligence that you see more and more now as you do you know use your many different things on this Because I really believe that the opportunity that we’re going to have in healthcare especially Is to deliver on the promise of what we’ve always called clinical decision support And so I think we have the opportunity to go far beyond you know alerts And kind of rule based things that pop up in the EMR Which have a have their place and are important and certainly have driven value But also have a some sort of limit or a ceiling on how useful they can be And as you think about the ways You know the opportunity that we have to actually impact the way care is delivered I think there’s some fundamental things that are going to shift and AI is going to be at the center of that You know historically the way you deliver care and the way a physician or a clinician really drives that it was really dependent on their ability to kind of amass and to be able to access the store of knowledge right so the patients that they had seen the cases that they’d reviewed the journals that they’re keeping up with obviously their Education and medical school their ability to kind of look across all of that bring it together You know put it in context of the particular case they’re doing in brought arrive at a diagnosis, or a recommendation is really the key to be at your delivering successful clinical care and The fact is that today knowledge is largely becoming a commodity and so we need to think Differently about how can we take some of that? Need to do that off the shoulders or the clinicians and really free them up on that Diagnostic side and the gray they deliver care and to me That’s that augmented intelligence so can I provide to our clinicians in their clinical workflow the ability to? Access information and go through it and parse it and drive correlations that they would never be able to do on their own But we can deliver much more context to them so Can they see when they’re in the midst of making a clinical decision? What are the potential outcomes? What are the predictive models around cost and? Quality and how can we present to them not just an alert that says hey these two drugs have a bad interaction but information That helps them make a better clinical decision and provide them with options. I think we’re a long way from AI or a computer making clinical decisions I Still think that that you need that human in the middle of that or at the end of that process But I really think we can revolutionize the way that our caregivers provide that care through AI and to me that’s that augmented intelligence, so that’s what really excites me about that phrase and the potential of applying that in healthcare I think it’s so important to understand the distinction that you just made Cris between AI you know and this notion of AI as a job killer or replacing expert humans or whatever it is and really positioning it in a more nuanced way to really help people understand what it stands for today. I think I think you did you know you Did it you did a fantastic job of articulating that that difference in the distinction over there one more blockchain? Yeah blockchain is another one that has a whole bunch of hype around it now. I think there’s a ton of potential in this idea of kind of a distributed ledger in healthcare I think we’re really early in that, but if you think about you know one thing that kind of excites me in that space is the ability for were a patient to own their medical record and to own their clinical information and they would have the ability and the power to release that to caregivers that they wanted to share it with and to keep it from Folks that maybe they didn’t want to share with it for some reason so I think there’s a lot of potential uses for blockchain and that that kind of core technology of like I said that distributed ledger kind of technology But I think that that ability you know that that Healthcare record ability and being able to get a healthcare record in that technologists potentially the most exciting Maybe the maybe one of the hardest ones to actually get to but very exciting in terms of its potential This is a clinic doing any pilots one blockchain right now Where we’re not doing any active pilots with blockchain like Chris says we believe there’s great potential with The technology and we’re waiting to partner with one of our partners in terms of perhaps doing an application With them, but at this point we’re not going to do it for the sake of doing it So we’re waiting for the right use case to in which to apply the technology the only other thing I would add on our sort of approach to augmented intelligence is that We always talk about Having our providers operate at topic licensed well Augmented intelligence or artificial intelligence, however you want to couch it, but I appreciate Chris’s terminology and nuance is It’s weird rude. That’s how we’re driven so however we can make the clinicians processes that much more efficient and effective so they can focus on uncaring for the very sick and utilize all of their In you know collective experience, that’s that’s how we want to leverage that particular technology

Fantastic fantastic all right any final thoughts you’d like to share for the benefit of your peers in the industry Or for technology providers who may be listening to the podcast?

Chris you go ahead look go ahead, okay?

I was just going to share that I think this work is incredibly important, and I would just want to make sure that we Message that this is the work of a team that you’re you happen to be speaking with Ed and I but you know we have a lot of people that were working with And our clinical partners first and foremost we couldn’t do any of the work that we’re doing without The great clinical leadership that we have in partners such as Tim Crone is our medical director And well Morris is one of our associate CIOs You know that’s what makes the this really hum at the Cleveland Clinic is The ability to work hand in glove with our clinical leaders and get them engaged in this work and excited about this work So I just think it’s important that if you’re building these kinds of programs. You can’t do it in a vacuum You can’t do it in isolation You’ve got to get out and get key leaders in the organization and especially in a healthcare organization. You got to get those clinical leaders Engaged in the process early on My closing comments were very similar and Chris covered them quite eloquently and just to emphasize what he was saying Analytics doesn’t report to IT analytics doesn’t report to operations IT doesn’t report I mean analytics doesn’t report to Finance, but it’s embraced by everyone in such a way that through our unique governance structure We spoke about or spoke to a little bit earlier It is supported embraced and actualized as sort of this shared resource, and it works very well And it can only work that way in this Patient first type of culture and where everyone whether clinician or other type of care giver as we call ourselves Working together to doing the right thing for our patients, so that’s what that’s the real secret sauce if anything Patient first, I love that gentleman it’s been a real pleasure speaking with you.

Thank you once again

Thank you for the opportunity, thank you

We hope you enjoyed this podcast subscribe to our podcast series at www.thebigunlock.com and write to us at [email protected]

About our guest

Edward Marx is Chief Information Officer at Cleveland Clinic, an $8 billion medical system that includes a main campus, 10 regional hospitals, 18 family health centers, and facilities in Florida, Nevada, Toronto, Abu Dhabi and London. He is responsible for the development and execution of strategic planning and governance, driving optimal resource utilization, and team development and organizational support. Ultimately, he will develop leaders and leverage digital healthcare technologies to enable superior business and clinical outcomes.

Prior to joining Cleveland Clinic, Edward served as Senior Vice President/CIO of Texas Health. In 2015, he spent over two years as executive vice president of the Advisory Board, providing IT leadership and strategy for New York City Health & Hospital.

Edward began his career at Poudre Valley Health System. CIO roles have included Parkview Episcopal Medical Center, University Hospitals in Cleveland and Texas Health. Concurrent with his healthcare career, he served 15 years in the Army Reserve, first as a combat medic and then as a combat engineer officer.

Edward is a Fellow of the College of Healthcare Information Management Executives (CHIME) and Healthcare Information and Management Systems Society (HIMSS). He is on the CHIME Faculty for the CIO Boot Camp, training aspiring healthcare technology professionals. He has won numerous awards, including HIMSS/CHIME 2013 CIO of the Year, and has been recognized by both CIO and Computer World as one of the “Top 100 Leaders.” Becker’s named Marx as the 2015 “Top Healthcare IT Executive” and the 2016 “17 Most Influential People in Healthcare.”

Ed received his Bachelor of Science in psychology and a Master of Science in design, merchandising, and consumer sciences from Colorado State University.

Christopher Donovan is the Executive Director of Enterprise Information Management & Analytics at the Cleveland Clinic.

Chris joined the Clinic in 1992 and has worked across a wide range of healthcare financial performance management, decision support and analytics efforts during his career. In his current role, he is leading the development and implementation of the enterprise information management and analytics program for the Cleveland Clinic system to enable the organization to acquire, manage, and use information in the transition to a value-based healthcare model.

During his career, Chris has been responsible for multiple aspects of the operation across the Cleveland Clinic physician practice and hospital network. This work has included service line cost and profitability analysis, utilization and length of stay initiatives, financial planning and budgeting, decision support and enterprise business intelligence and charge master strategy and pricing. Chris has also been involved in operational and financial performance management and has a special interest in Lean and continuous improvement, for which he helped develop and pilot an enterprise wide application of Lean continuous improvement principles and practices across the Cleveland Clinic Health System.

Scholarship:
Chris has co-authored several articles and speaks both nationally and internationally on a variety of topics including analytics, information management, business intelligence and Lean continuous improvement applications in Healthcare.

Chris is currently a board member of the Healthcare Data and Analytics Association and participates as the Cleveland Clinic lead partner on the Analytics Leadership Consortium for the International Institute for Analytics.

Chris completed the Health Management Academy GE CFO Fellowship program in 2013.
He received a BS in Business Administration from Miami University in 1992 and an M.B.A. from Cleveland State University in 1997.

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

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The Healthcare Digital Transformation Leader

Stay informed on the latest in digital health innovation and digital transformation.

The Healthcare Digital Transformation Leader

Stay informed on the latest in digital health innovation and digital transformation

The Healthcare Digital Transformation Leader

Stay informed on the latest in digital health innovation and digital transformation.