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Episode Overview
LISTEN TO THE EPISODE:
Host:
Daniel J. Marino
Managing Partner, Lumina Health Partners
Guest:
Fred Goldstein
President of Accountable Health
Daniel Marino
Welcome to Value-Based Care Insights. I am your host Daniel Marino. In today's episode we're going to spend a little bit more time talking about the HIMSS conference that occurred a couple weeks back. If you recall on the last episode, I had two great interviews with Dr. Allen Young and Steve Overman when we talked about their specific technology that they had displayed at the HIMSS conference. Well I'm really pleased today to have a fellow podcast host with me. He is president of Accountable Care Health and host of his own show pop health week Fred Goldstein. Fred welcome!
Fred Goldstein:
Pleasure to be here Dan looking forward to today's discussion, Thanks.
Daniel Marino:
Fred it was interesting a couple of days at the HIMSS conference what was your impression?
Fred Goldstein:
I thought it was it was maybe a little more subdued than usual but still a very big crowd etcetera. I thought the focus areas were interesting obviously with AI and digital health, and digital tech. Workforce that I didn't spend a lot of time on and obviously cyber security is a big issue but really where do we get to these things actually impacting the patient that's sort of where I was looking at the digital tech and AI and we're using it to improve outcomes and really move into value-based care. And I'm not sure what were your thoughts on that from a value-based their perspective?
Daniel Marino:
Well I agree with you I think the artificial intelligence vendors and all the technology as well as the digital technology was quite impressive. I didn't see as much around specifics to value-based care. I was hoping there was going to be a little bit more solutions maybe around care management maybe around some of the performance analytics. And it was interesting because this isn't a major focus of HIMSS. And I did have an opportunity to actually talk to Hal Wolf and I asked him that question specifically. How was HIMSS going to be positioned to support value-based care in the future? Let's take a few minutes and listen to his response.
Hal Wolf:
Yeah I mean we we've always been a fan of value-based care. And I think that what value-based care in the state and goal is an efficient healthcare ecosystem that tries very hard to treat individual patients with the best outcomes for the least amount. Right? And that's really what sits behind it. Now that's an old expression it actually came out of intermountain. Intermountain, you know this right? Yeah and so that I always when I heard that mantra from intermountain 20 years ago I personally adopted it and I thought it was a fantastic statement. And I think that's what really is behind value-based care we've seen pieces of it and that's what Medicare Advantage is. So that's an expression of it. Globally we're hearing the same thing. So it's not just the US thing. It's a cultural issue. We're going to see how that comes together. But I don't think what we're trying to do is recognize and say this is the best way to squeeze the highest level of efficiency access quality through the use of these digital areas. There are other things that will contribute to that that's not in our space but when it gets in digital health transformation that's where we sit.
Daniel Marino:
An interesting response. Fred I'm really hopeful that HIMSS does focus a little bit more attention on value-based care performance. But let's dive into some of the specifics particularly around artificial intelligence were there a couple of things that really caught your eye as you were talking to any of the vendors?
Fred Goldstein:
Yeah, I think the key things we're seeing, and this has been talked about at a number of last couple of years, really is this use of AI to solve various issues that are not directly patient care issues but are workflow issues. And things like that, employees going out and gathering this data or these data and then bringing them in and adjusting them. And I think we're seeing some great progress in those areas. So it was really interesting to see that the clinical side obviously is touchy. And it'll take a while for some of those types of technologies to be accepted by physicians and other clinicians as augmented intelligence versus artificial intelligence. I think that's the key as we begin talking about those areas. And you, how did you see the whole AI spectrum there?
Daniel Marino:
I saw a lot more advancement on the business and the administrative side of artificial intelligence. I think to your point we're just starting to figure out how the, what the clinical impact is going to be of artificial intelligence. But the administrative side or the business side related to managing say the revenue cycle or pre authorizations, those type of things, I thought there was quite a bit of advancement. One thing that caught my eye though was the role of agents. Agents within artificial intelligence and how they would interact with patients.
Fred Goldstein:
Yeah I think the issue of using agents is really fascinating and I think this also gets back to a few years ago. I'd interviewed an individual who was the CEO of Cleveland Clinic at the time who made the comment I think we may lose 30% of our workforce at the hospital. Because it really is taking some of those workloads by using these agents off of people and allowing them to maybe at the very end take a look at it and validate it. But really whether it's interacting with a with a patient where I've seen these call centers show 14 to 20% more efficiency by using AI. To things like you talked about using it for prior authorization or documents scanning etcetera.
Daniel Marino:
Yeah I agree with you. There was 1 vendor that I had an opportunity to do a demo with and they started to incorporate agents within their care management services. And they bear they just started to scratch the surface on what potentially this can do. And I thought some of this was a little bit more of kind of a visionary technology because they were talking about how the agents could work with remote patient monitoring, interact with the physicians, and almost be that virtual care manager. I thought it was really interesting about how they would grab the data and incorporate into an agent and really use that as sort of a first line care manager on being able to drive some of those results.
Fred Goldstein:
Yeah absolutely and I think it's as we had discussed earlier you know I did a show for consensus with with mohana nagda who is at Athena health. And we talked about the use of AI for faxing ingesting that data putting it into the EHR and then actually using AI to then push it back out to the appropriate physician for referrals etcetera. and I really think you're going to see these workflow issues solved with some of these AI tools.
Daniel Marino:
Yeah I agree with you. And Athena had a pretty big booth there they were doing quite a bit of demonstrations on a lot of their technology. The other one that I had an opportunity to talk about another EHR vendor is eClinicalWorks. And eClinicalWorks has spent quite a bit of time working through a lot of their agents, even incorporating some bots that would allow them to provide some interaction there. Fred, I had an opportunity to interview the vice president of sales for eClinicalWorks his name is Sameer Bhat. I asked Sameer, goes by Sam, what are some of the new and interesting things that he's seeing related to technology that he's incorporating into his into eClinicalWorks that would really drive performance not only for the providers but also for the patients. An interesting conversation let's listen to this for a few minutes.
I am here with Sam Bhat, he is vice president of sales and marketing for eClinicalWorks, someone I've known for quite some time. Sam great to see you.
Sam Bhat:
Great to see Dan. It's always a pleasure talking to you.
Daniel Marino:
Thank you, thank you. All the conference has been fantastic. And I'll tell you there's such a great momentum push for artificial intelligence, and knowing the experience and my previous experience with eClinicalWorks, you are always at the top of the technology game. So what are some of the things that you're doing with artificial intelligence integrating into your solution?
Sam Bhat:
A lot of things. We see artificial intelligence as an integral part of the entire electronic health record and the revenue cycle management. We offer artificial intelligence in two flavors. 1 is called as AI assistant. AI assistant that can help in the front office in the mid office in the back office. But then there is this new concept called AI agents coming into play that can do autonomously multiple things for you both in the front and back office. It may not apply for clinical workflows yet.
Daniel Marino:
But for the business workflows, I think it's gotta be incredible. Everybody's looking at trying to get more efficient everybody's looking at trying to do more with less and bring down costs I would think the agent has just got to have some incredible outcomes to it
Sam Bhat:
I mean we just introduced this whole agentic revenue cycle management. Where essentially you are 90% of the tasks that you do today through agentic workflow. I mean I'll give you some examples think about sending appeals to payers when you have the insurance denials. it's a nightmare sometimes. An AI agent can actually pick up what the denial reason based on that it will assimilate all the information for you create a packet submit that for you and to an extent where the agent will start communicating with the insurance on the other side, because insurance companies on the other side are implementing agents of their side. The only way to fight that battle is you got to take advantage of the agent.
Daniel Marino:
Well I'll tell you for independent practices and I know that's a sweet spot of eClinicalWorks that is so important, right? It's all around efficiencies and it's all about maximizing your revenue potential.
Sam Bhat:
Exactly. I'll give you another example. Where you still receive faxes coming into these small practices, and they don't have time to look at those documents, and an AI agent can look at the information that has come in and create a quick summary for you. And think about an EOB coming into your office. As a printed form I mean that's still happens still 10% of the payments are still coming it printed EOBs. But they take 90% of your staff time to post the payment.
Daniel Marino:
Can you imagine the productivity that's once this really becomes part of our standard operating approach the productivity is going to be off the charts.
Sam Bhat:
Releasing these agents as part of our update this month and we'll be able to see the benefit of but this calendar year, not future.
Daniel Marino:
Well that is really exciting and I as I mentioned I mean eClinicalWorks has always been on the cutting edge of technology it's always been something that I've been extremely impressed with your organization and with your leaders so I wish you a lot of luck here. How's the conference going for you?
Sam Bhat:
The conference is going really great, and you're seeing a lot of momentum. And a lot of organizations looking for a change. Change not just for change just because they want to change but they want better efficiency and increase their productivity, cut down the physician burnout.
Daniel Marino:
And cutting edge technology. and that's what you guys have. Well thanks again Sam I really appreciate your time.
Sam Bhat:
Thank you, thank you.
Daniel Marino:
Interesting comments by Sam. Loves some of his thoughts on where artificial intelligence is going to go. And in particular some of the activities around the agent. Digital technology, Fred, was also a big focus of HIMSS and of course this was one of the four areas of pillars, if you will, that HIMSS was really focused on. Was there something related to digital technology that really caught your eye?
Fred Goldstein:
Yeah I think we're seeing this incredible growth in the potential. Now how much of it's actually being used in the market is less of this remote patient monitoring? And I think back to when I started my disease management care management company, you know typically someone see a doctor once twice maybe a Medicare person might seem 8 times a year and that's 1 little measuring point in this giant data set of what the individual's life is like. And by adding a care manager or somebody who called or talked to him you suddenly increased that data set. Now with remote patient monitoring we can really begin to understand the Natural History of disease of an individual's personalized condition and how it's impacting them. And I think remote patient monitoring has some incredible potential especially when linked up with AI because the data sets will be just gigantic.
Daniel Marino:
Yeah I agree with you there was another vendor that I was had a chance to talk to and they were focused on remote patient monitoring and really using that to help create some efficiencies in transitions of care. Going from patients who were in the hospital upon the discharge and care in the home. And it was fascinating for the for me to see how they were integrating remote patient monitoring based on the individual disease condition so those that had say cardiovascular issues or even diabetes or what have you what have you. But the interesting thing about that was how it integrated all of the data into a prioritization of information that was able to give to the care managers. I thought that was really fascinating. That that could potentially be a real game changer as to how we manage care um post you know post discharge or really care in the home.
Fred Goldstein:
Yeah and it's as you mentioned that area of transition is a huge drop point where you see real issues show up because the transition doesn't go smoothly. So if you have a system that can be monitoring that and then say in effect, hey here's a here's a warning we've got this going on that we need to address now, that's going to be a huge improvement in outcomes cost etcetera.
Daniel Marino:
Yeah and you know the part that I thought was interesting on this was it allows through this district advancement digital technology it allows us to get in front of some of these disease conditions, and to better understand some of these disease conditions. So you know another area that I found that was really interesting was how some of these technology vendors are helping to address issues of cancer and different cancers. So we can begin to not only use AI to identify diagnosis, but we're also then using digital technology to create more advanced therapies and working with the patients. I thought that was really fascinating. Was there anything out there that really caught your eye related to that?
Fred Goldstein:
I think the cancer area is really interesting obviously there have been incredible advancements with digital tech applied to image analysis. And when you can get down the pixel level you know you can really begin to understand what's going on. And identify things that may not show up to our normal eyes when we look at it. And so I think that that's going to be an area where we'll see some rapid integration of new technologies. Obviously the radiologists will still need to be involved, but it could take a huge workload off of those individuals so they can become more efficient as well.
Daniel Marino:
Well absolutely and you know it helps to as we're starting to think about the technology, I'm working through this with patients, not only is it going to help the cost but I could really see us thinking about having more personalized care and therapies that are really going to drive better outcomes for the patients. And frankly make the patients more comfortable as they're going through their treatments.
Fred Goldstein:
Yeah I think you ran on target with that. Whether it's the personalization of the messaging, because obviously I may react to some funny comment when I'm trying to lose weight and stand on the scale and it says what happened to you Fred? Where somebody else may need a different persona that's more gentle or something that helps them get motivated. So I think you can use it in that area obviously in the diagnosis area in looking at new treatment approaches developing. So there's incredible potential how and when we get there I think it's the big question. But we're beginning to see some progress.
Daniel Marino:
Absolutely, yeah I agree. So when I was talking to one of the vendors. I asked the question to him about you know how is this being received by physicians? And many of them, this one particular gentleman came back and said you know that's one of the biggest challenges because physicians have their approach and training page treating patients. They have their methodology that they incorporate into their care models. And to have them integrate that technology into the way that they practice is a bit of a is a bit of a challenge. It's almost relearning how to practice medicine. I thought that was really fascinating. Did that come across at all as you were starting to have your conversations as to the integration of that technology and the and the care plans?
Fred Goldstein:
Yeah I think there's definitely hesitancy and some of it is based upon reality. When we build these AI models and don't have a broad enough data set as we've seen in the past, we come up with issues where the model isn't correct. And so there needs to be the hesitancy there needs to be standard set, the physicians need to be comfortable with it, the patients need to be comfortable with it. and I think then including them as an augmented intelligence versus just artificial intelligence I think is going to be the key to solving that problem.
Daniel Marino:
So I had the opportunity to sit down with the gentleman Dr. Allen Young. He is a physician client executive with point B solutions. And I asked him just that. I asked him what that integration was going to be or how was going with physicians and how they were using that and incorporating it into their into their practice into the way that they deliver care. It was an interesting response. Let's listen to that for a few minutes.
Allen Young:
Yeah thanks for having me Dan and appreciate the time. One thing I've noticed is the growing trend and talk around AI agents. And the way agents are defined is that artificial intelligence powered workers that go and complete tasks on their own autonomously and then kind of bring the results or insights back. And what's exciting is to think about just the agents called the work they're doing but the oversight of agent representative or agent coordination. So you have multiple agents doing multiple things and then you have that step in between where someone will actually someone or AI will actually coordinate all of these different activities and hopefully bring the appropriate insights, recommendations, next steps, or even new content to clinicians right? As a physician it could be great if a number of agent I can go and go into a patient's record and come up with a number of different recommendations that kind of don't necessarily interrelate with each other but then have someone then oversee all of that and provide a meaningful recommendation or plan with context and also provide some of the shortcomings and things where they saw there wasn't enough information. Or areas where the clinician definitely needs to lean in more.
Daniel Marino:
Well and I think the agents, to your point, are definitely going to be that mechanism that's going to allows us to really not just operationalize but really realizing the benefits of AI pretty quick and pretty quick with patients now. Well thank you for your time I appreciate it, enjoy the rest of the conference.
Allen Young:
Thank you.
Daniel Marino:
Great response by Dr. Young, really appreciate that. Fred, this was a great conversation. I wanted to get your thoughts you've been going to HIMSS for a number of years. For many of our listeners who've not gone to HIMSS I'd highly recommend it, it's a it's a wonderful experience. As you reflect on this conference and past conferences, Fred, where do you feel like the greatest impact is for providers or for participants to either attend a conference like HIMSS or just participate in HIMSS?
Fred Goldsrtein:
Well I think HIMSS obviously is overwhelming and we talked about this before we recorded this show, and you had an incredible idea that I had never really thought about how physicians should approach this and you've been using it apparently for a couple years. So I'd love to hear that again.
Daniel Marino:
Yeah so given the fact that you know there's 1000 plus vendors there 28,000 participants it's hard to navigate through the different vendor communities that are there. Oftentimes what we've done on behalf of clients, is if clients wanted to see something specific say they were looking at analytics or they were looking at you know specific types of technology. We would then reach out on behalf of the clients and pre schedule a lot of these meetings. It was a great way to have a very focused approach with the conferences. And we found that that was really a great way to approach it because it is quite large. And to your point it is a little overwhelming if you're just going to show up there on day one.
Fred Goldstein:
Absolutely it's you've gotta sort of quickly map out the booths which rows you wanna hit and then kind of that's what I did. I just worked from the low numbers to the high numbers said ohh that ones in this row I gotta go left, I gotta go right, and I had some really fascinating conversations. I got a chance to interview some folks so it was really a great conference overall
Daniel Marino:
Yeah I agree I agree. Where do you think HIMSS is gonna go in the future?
Fred Goldstein:
Well it looks like they keep getting sort of more tech oriented. And you know as if and this worries me always the tech is the solution. Well tech is part of the solution. At the end of the day we still need people. People do respond better to people typically. So I think when it gets down to value-based care, as you focus on, that still gonna need a combination. And I don't know that we necessarily just solve it with tech. And sometimes I wonder if HIMSS goes a little bit too far in that direction.
Daniel Marino:
Yeah I agree with you. You know I I've said a long time the technology is important but it really comes down to the people process and how you use that technology. I think that's really key. It will be interesting to see where things go they clearly make big impact in the whole technology world and certainly the integration with healthcare. Well Fred I wanna I wanna thank you for coming on. I love having a fellow podcast host and again another you know big shout out to your show Pop Health Week, it's a great program, I've listened to it many many times.
Fred Goldstein:
Well fantastic it's been my pleasure thanks for having me on.
Daniel Marino:
And to you our listeners I want to thank you for tuning in. Until our next insight I am Daniel Marino bringing you 30 minutes of value to your day.
About Value-Based Care Insights Podcast
Value-Based Care Insights is a podcast that explores how to optimize the performance of programs to meet the demands of an increasingly value-based care payment environment. Hosted by Daniel J. Marino, the VBCI podcast highlights recognized experts in the field and within Lumina Health Partners
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