Episode Overview
LISTEN TO THE EPISODE:
Dan Marino:
Welcome to Value-Based Care Insights, I'm your host Daniel Marino. In today's episode I'm going to spend some time reflecting on the hymns meeting that I went to a couple of weeks back. The theme of this last meeting was really I think twofold. One, talked a lot about digital health technology. But of course artificial intelligence was really a big theme. As part of my work there at HIMSS I had an opportunity to do 2 live interviews. I'm going to broadcast those for you today. The first interview was with Stephen overman. He's CEO and founder of standpoint solutions. Stephen has a really interesting software technology that overlays in perioperative services and really what it sells for is the communication gap that often exists as many providers start to come together to provide the surgery for patients. His technology is sort of like a social media application for perioperative services just a really a great solution. The second interview is with Dr. Alan Young. Dr. Young is client executive for point B solutions or technologies. He has a tremendous amount of experience in artificial intelligence and he and I just have a wonderful conversation where we talk about how artificial intelligence and the advancement of that is going to really change the way physicians are going to take care of patients. And in particular in that conversation he reflected on the use of agents and how agents are going to drive a lot of those outcomes. So why don't we dive into this and listen to Stephen Overman and Dr. Alan Young. Stephen welcome excited to talk with you today.
Stephen Overman:
Thank you Dan, it's very exciting to be here at a very large conference with you.
Dan Marino:
So I know Standpoint works with a lot of hospitals and focuses a lot on perioperative care, and in particular what I'm what I'm interested in is a lot of the work that you've done in supporting and improving perioperative services and in particular surgical services. And for any of our listeners out there surgical revenue from surgical services accounts for 65 to 70% of overall revenue, right? For a hospital and health system. So one of the areas that I know you're particularly interested in or your solution focuses on is a lot of the value-based outcomes associated with perioperative care. Can you speak to that a little bit?
Stephen Overman:
I sure can. It has a lot to do, first of all the term perioperative care was invented in 1966.
Daniel Marino:
Yeah, most people don't even understand what that means
Stephen Overman:
They don't. All the teams that surround a patient as they go through a surgery and OR room as you can imagine it requires a lot of people a lot of teaming. And they are existing at different times of the day and different teams perpendicular type of surgery and so it's that teaming which excites us to focus our technologies on to improve the team, which creates a better patient experience a better clinical team and a better economic outcome.
Daniel Marino:
Well I think what a lot of people unless you're really involved in the OR or you know involved in surgical services you don't really understand the complexity of that. And two things that are particularly important aside from being able to generate the revenues that come from surgical services, it's efficiency and it's managing the cost of care. Right? And both of those are tied very closely. So if there are inefficiencies that occur that that occurs within the surgical setting it increases costs right? Yes clinical variation is one of those things that drives costs. How is your solution helped to identify maybe streamline clinical variation that occurs in sort of in the surgery room?
Stephen Overman:
That's a good question because the cost result a lot of times in a change of patient condition as they're in the pre the intro the surgery phase and then specifically in in the post-surgery, the PACU. This is where a lot of problems can arise in both clinically and cost sensitive. So most leaders of the perioperative care episode typically the surgeon and more importantly the anesthesiologist today and some of the nurses, they need clinical and cost feedback right now to the condition of the patient compared to a community of patients of the past. So they can make a comparison of what's driving towards a target that's looking more negative such as length of stay or possibly returning to the hospital in 28 days. Or the cost factor so they can adjust the care pathway adjust the orders toward the patient.
Daniel Marino:
Well and I'll tell you so efficiency in the OR is very important right? So how we manage surgical block time, how we manage flip rooms making sure we start and stop on time. But understanding that variation and the efficiency around it to your point is so key. There's so many components that are as a result of inefficiencies that occur in the OR. One in particular is readmission rates you know as you mentioned the length of stay and when you think about it from a value-based care standpoint hospitals are held responsible right? and if patients aren't if you don't understand that post operative rehab service correctly if you don't manage it correctly and you have the right transitions of care what ends up happening is a patient show up in the emergency room and then they're readmitted.
Stephen Overman:
Exactly you're starting all over again
Daniel Marino:
Yeah, absolutely. So let's talk a little bit about one of the areas in your solution the communication, right? It's complicated from that standpoint because you've got the surgeon you've got the anesthesiologists you may have the OR nursing you know leader and the OR nurses. How does your solution help to streamline improve communication?
Stephen Overman:
Well it comes back to that teaming concept. They are a team and we provide them with a interface both mobile and desktop that allows them to interface around that patient. Patients always at the center of the care for that episode. But it looks very much like a social network.
Daniel Marino:
Yes.
Stephen Overman:
Because it's been found to be we're all used to social networks. It's a great way to formally and informally communicate to share data share thoughts share more importantly feedback a nurse give feedback to a physician that comes out of the PACU. So we chose a very simple very uncomplex social network interface for our platform we call ethos. Which is a a perioperative risk stratification and performance platform. It very easy to use it's centered and secure around the patient, but more importantly 1/3 component or major feature of our of our platform is to measure the teaming effectivity.
Daniel Marino:
Ohh wow so you're actually measuring how well the different groups are performing in the teams?
Stephen Overman:
Exactly. It comes back out of that social Network World again.
Daniel Marino:
Ohh my gosh see that's unusual because I'll tell you a lot of people talk about communication to talk about establishing the team but it's very difficult to be able to measure that. I would think that the contributing challenges in terms of the lack of communication, you probably know the statistics off the top of your head, I would think it would be quite great. So I was working with one organization and what we determined was they didn't not have a very strong pre surgical evaluation structure. So in this scenario patients were evaluated by the primary care physician before they went into surgery. There was also some evaluation that was done by the surgeon of course. But what we found was that that information actually never got into the anesthesiologist. It didn't get shared. And when we were starting to really look at what some of the challenges were and the byproduct of that was they had a large cancellation rate. So when we were looking at the kind of the root cause of those cancellation, which what we found was there were instances with the patient some conditions with the patients that were never communicated to the anesthesiologist. And not only was it disruptive to the scheduling of the surgical schedule but it was extremely disruptive patient right? I mean if you're getting yourself prompted for surgery and then all of a sudden it's cancelled you know that's the last thing you want to experience. So how is your system then connecting those dots? How do you inform particularly the anesthesiologists, who in many organizations you know they're sort of that champion of the surgery activities.
Stephen Overman:
Yeah we believe they're one of the leaders. We go back to our first feature in ethos and we calculate that risk stratification.
Daniel Marino:
So are you risk scoring patients to a certain extent?
Stephen Overman:
We're not scoring we're actually running some very accurate machine learning that gives you what factors clinically and cost and experience related such as the patient or the clinical team that is driving a particular targeted outcome. For instance a total hip replacement length of stay, probability returning the hospital in 30 sixty 90 days, and team effectivity. Those are kinds of risk stratification analysis that we allow the leaders, such surgeon or anesthesiologist, to simply click a button around that patient and have that very accurate incredible deep information. We call it clinical insight. But they also are exposed to cost so they can make cost decisions through that council care pathway. 77% of physicians prefer to see cost data when they see predicted clinical data so they can make a better decision through that flow.
Daniel Marino:
And that is so important. A lot of organizations as they're shifting into value-based care are looking at these episode based models right? And they're pricing out these models and they're assuming a level of risk for a lot of these procedures that are occurring. So I would think just having this cost information and just being able to share this information with the with the surgeons with the anesthesiologists to create that awareness.
Stephen Overman:
Doctors do want to see it, they are just not given exposure to it.
Daniel Marino:
Yeah absolutely. How have you seen organizations take that improved communication, that data, how have they built it into maybe some of their process improvements? Has it been more of a governance issue? Have there been process improvement initiatives? What have you seen?
Stephen Overman:
Well, care pathway an episode of care for a patient goes into order sets into the EHR system EMR system. They see inefficiencies with respect to the choices of cost care products that they can better maintain if they're if they're given that kind of relevant data. They can understand if a team is being better communicated too there's less questions. And so you're saving a lot of time of going off channel to texting emails in notes whatever it might be to communicate with each other. And not everybody's on the same time scale and that's where mistakes start happening. So when a in a single social network like environment that's highly secure, they can see all of that data and simply yeah give comment right to how to better optimize the care pathway. Which typically saves costs saves time.
Daniel Marino:
Well I'll tell you there's here at HIMSS there's a lot of technology and a lot of folks are focusing on providing information at the point of care and so forth. I think what excites me about what you're describing because it's really it's moving towards proactive care right? You're giving information to the surgical team that's allowing them to be proactive to anticipate some challenge and to communicate about it. And I think when you when you focus when hospitals and health systems focus on moving towards value based care those elements are critically important.
Stephen Overman:
Yes it's that's one of the reasons why we've chosen an ROI based revenue model for when we license our application and hospital.
Daniel Marino:
So even your financial model is value-based?
Stephen Overman:
Yes, if we're doing good, you’re doing good. If we are adding features you find a value because we're learning from our clients. You get that.
Daniel Marino:
Well they're aligning incentives right?
Stephen Overman:
Exactly.
Daniel Marino:
Well Stephen this has been fantastic I really appreciate you joining me. And for anybody that's interested in finding out a little bit more around standpoint please visit https://www.standpointdsoftware.com. If folks are interested in getting a hold of you, can you share your information?
Stephen Overman:
I sure can. On our website there is a 1-800 number and this actually gets directed to me and I will be happy to explain and even show you an explainer video and point you to a link that you can watch and see a video of what our application platform does.
Daniel Marino:
Wow that's fantastic well I would assume that there's a lot of hospital and health executives out there that would be very interested in your program. You know there's not a great communication tool there's not a great system that really provides a lot of support for perioperative services. Well Stephen I want to thank you for joining me today this has been fantastic I wish you a lot of success that standpoint and please enjoy the rest of the conference.
Stephen Overman:
I will thank you so much Dan it's been a pleasure.
Daniel Marino:
Welcome back to our live recording of HIMSS25 in Las Vegas, NV. I am your host Daniel Marino, on Value-Based Care Insights. My next guest is Dr Alan Young. Dr. Young is a client solution executive for Point B Solutions. Dr. Young thanks for joining me today.
Alan Young:
No problem Daniel, thanks for having me.
Daniel Marino:
So I know, Dr. Young, you know one of the areas that you're really focused on is digital health technology. And here at the conference there's been so much information sharing around artificial intelligence. What I find interesting is how digital technology and artificial intelligence will start to come together. And in particular how we're going to start to see that impact for patients. Now I know we're still early in our in our sort of journey into artificial intelligence, well what are you seeing now as some of the biggest impacts that the collaboration of digital technology and artificial intelligence what do you see that having on patients?
Alan Young:
Yeah great question. I think since the advent of the electronic health record we've been faced with this challenge of having too much data that keeps growing exponentially every day. Patient data, clinical data, research data, and I see digital health solutions artificial intelligence as potentially closing the gap between what we need at the bedside what patients need at their homes and what we want behavior change and modification to take place in order to kind of achieve better outcomes.
Daniel Marino:
Do you think, just kind of building on that for a second, do you think that layering on artificial intelligence is going to help to better organize the data so providers have sort of a stronger picture or a clear direction on the care that's going to be provided to patients?
Alan Young:
Yeah I don't want to think about layering it on. I think it needs to be appropriately implemented in the right situation in the right contacts with the right stakeholders involved.
Daniel Marino:
We really have to move towards more proactive care as we start to anticipate what's occurring with patients maybe on their different risk conditions and so forth. How do you see AI being able to support that?
Alan Young:
I think as clinicians we always wanted to do what's best for our patient and we hope that with patients there'll be two things that happen. They come in to see a doctor and the optimal condition that they had, and that's usually not the case, and when they leave they actually follow our instructions. Or know what to do. And I think that's doesn't happen very often right? So I think artificial intelligence especially some of the applications we have through machine learning and generative AI can now help us to be proactive to look at patient data and the vast sources and multiple sources that we have in order to give a clinician or the healthcare team some insight into what this patient needs as they arrive for their visit or start a telemedicine consultation or even get on the phone. That gives us insights that previously physician would have to go into a record and read on their own they just don't have the time. They have so many administrative and clinical and other possibilities but we need to do that we need to take advantage of the power within the data.
Daniel Marino:
Well and I think to be able to aggregate all those data sources I see that as a huge value of artificial intelligence. I mean if you think about it you've got the clinical data you may have some financial data you have the social determinant data and a lot of people would argue and I would be one of these that the social determinant aspect of that that a person is involved in does really influence their clinical outcomes right? Their care or and even their conditions. So as we start to think about that and we pull that together I think that's really where the driver comes in. Is there some immediate solutions that you think may help? For instance remote patient monitoring and how we're interacting with patients taking all those things into consideration or maybe it's just the telehealth visit.
Alan Young:
Yeah I think there's one exciting advancement I've seen recently is really focused in the area of patient engagement and education, using digital health driven by AI. So if you think about remote patient monitoring you have you're getting data about a patient they know what their blood pressure is they know what their cholesterol is they know what their you know diabetes continuous glucose monitoring readings are, but they don't know how to react to it in real time.
Daniel Marino:
And they really don't truly understand it. So they're saying these are as indicators but I don't understand what it really means.
Alan Young:
We have a kind of asset that you can deploy that will be there as a companion and help guide them. And I've seen one company called acolyte health they use digital avatars of celebrities or athletes that then accompany the patient home and help walk them through their care journey. This is what you need to do, this is how you should, this is why it's important to do you're screening, why you should eat exercise and change your diet. It helps empower them to think about who else is motivating them. And so taking that ability to create a digital persona using data that we have and then relying on the patients RPM data or their EHR data to then drive the right messaging through that educational tool, hopefully we'll improve better patient compliance adherence to physician recommendations and even knowing what to do when something is not going well.
Daniel Marino:
Right, I mean what you're describing to me just sounds so powerful. When you're when you think about artificial intelligence and you think about then digital health technology we're moving very fast right? What do you see as some of our biggest challenges?
Alan Young:
I think the movement and the interest and also the investments focus attention paid on artificial intelligence has caused a lot of organizations to adopt point solutions or boltons to existing systems or even you know legacy IT solutions because they don't they don't know how to use it and there's a demand on them to get it in. One example would be Ambien AI and there's plenty of those vendors around.
Daniel Marino:
Yes, a lot of vendors around.
Alan Young:
A lot of thought has to go into are you picking the right vendor, does integrate into your system? And so that has been a big challenge to think about what's going to happen down the road when you IT organization looks at their number of solutions or applications sees hundreds of AI tools. So I think where the opportunity is, and I had the chance to meet a few companies during HIMSS, was really to be a platform based company and an AI first company. And build everything from the ground up and then go to market with those solutions. And one of them was focused predominantly on value-based care which I found to be really refreshing, given the timing of our conversation. So much of the platform that's using all the AI tools and capabilities to enforce all of the value-based care activities such as scheduling and you know gap closure analysis and patient engagement.
Daniel Marino:
Really you integrate that into whatever that end game would be whether it's going to be for service or value-based care I think would be key. Do you feel that given the speed and and the pace that we're moving at, do you feel that many CIO's of hospitals health systems should they put together a strategy plan as to how we need to integrate this technology? How we need to integrate our data into some type of an artificial intelligence road map if you will?
Alan Young:
Right. I think you hit on a very sensitive point because this we're in a decade now halfway through we're in 2025 years of unprecedented change in healthcare and a lot of unknowns and new entrance of technology and processes. And I think there needs to be a thoughtful perspective to say hey my organization is going through this change. I should rely or reach out to someone that has experience doing this or can bring a different perspective. And I think that's the biggest thing. I don't think there's any experts out there that can say ohh you know we've survived the AI boom and we know what to do. No one knows we want to be thought partners to help CIO, CTO, chief medical officers think through do they need a new strategy? What is their data approach to data? Are they investing all into value-based care? Are they moving into a more home based hospital at home model?
Daniel Marino:
Well if anything just to share the insights right? And to understand what's occurring and you know to your point earlier and I love that. If you can learn from other people's successes and learn from the challenges that people had wrapped it into your strategy, I mean that makes all the sense in the world. I've said time and time again and we practice this a lot of in the work that we do form follows function you have to understand where you're going. One other item I want to talk a little bit about are some of the real opportunities that are out there, but then some of the challenges around these standalone applications. You know as we look around HIMSS here and we see all of the vendors there's a lot of folks who are building these standalone applications, which may not necessarily integrate with EHR's is that a problem is that a challenge? Or do we feel like that's going to fix itself?
Alan Young:
I think the biggest challenge here is that yes there's a myriad of new technology and a large number of entrants into the solution space. For multiple reasons. A) Healthcare is a big industry. It generates 20 plus percent of this country's GDP and it's very personal. B) I think the technology has advanced so quickly and has the cost has dropped dramatically that new companies can be spun up quickly.
Daniel Marino:
Ohh and there's private equity dollars that are being funneled right?
Alan Young:
And you don't need a team of 10 to 20 engineers overseas anymore. You can spin it up with the Gen. AI applications and you have one or two people manage shop that took months to build it can be done in weeks or days. So that's created a large number of entrances. And then you have the resistance of the industry professionals and I think I recall my experience trying to convince doctors that the HER was going to be the next greatest thing ever, and we see how that went. And the same thing is happening now doctors are not as forthright with admitting they're going to accept and adopt technology that they don't understand or they don't not have sufficient training or education on. No one can tell me they understand all the coding languages the data science, very few of my friends and mentors were physicians can do that but the majority aren't. They're busy seeing patients they go home to their families they just want to do the day-to-day work.
Daniel Marino:
Well and I think the underlying message there is there's exciting opportunities as we see these new applications emerge these new organizations emerge but there's also a lot of challenges. So a couple of things for any of our listeners that are out there who are interested in learning a little bit more your organization or maybe about you or just some thoughts that are coming down the pike regarding artificial intelligence, can you share some of your information maybe you know how they can get a hold of you?
Alan Young:
Yeah, I work for point B our website is pointb.com. I think the biggest thing that you know take away for the audience is we really thrive building an ecosystem of partners and collaborators. I think talking to physicians executives technology companies from the big ones to the small ones to the middle market ones we can't do it alone. We're not going to be able to solve all these problems and challenges we need partners that understand the tech in a deep you know very focused way. But then we also need people that are more broad based and thinking holistically about the long term impact of accessing care and population health.
Daniel Marino:
Well and the fact that you know you've started to kind of build this capability and this knowledge base is as we talked about absolutely invaluable. I think as we as we move forward. Well Dr. Young this has been fantastic conversation. I really appreciate it and I know this isn't going to be the last time we talked about artificial intelligence and digital health technology. I fully expect a lot of movement happening very quick in terms of the integration with AI and digital technology so thank you for spending some time today.
Alan Young:
Thank you Daniel.
Daniel Marino:
And enjoy the rest of the conference. And to our listeners I'm Daniel Marino I want to thank you for tuning into this episode of Value-Based Care Insights live at HIMSS25 in Las Vegas. And until our next insight I'm bringing you 30 minutes of value to your day. Thanks, and take care.