a063df5a-124c-428e-bb07-4da24531b175/20-0 00:00:03.130 --> 00:00:05.488 <v Jordan Cooper>Women and children service line for the system. Kendra,</v>

a063df5a-124c-428e-bb07-4da24531b175/20-1 00:00:05.488 --> 00:00:07.130 <v Jordan Cooper>thank you so much for joining us today.</v>

a063df5a-124c-428e-bb07-4da24531b175/24-0 00:00:07.200 --> 00:00:08.240 <v Kendra Folh>I'm very excited to be here.</v>

a063df5a-124c-428e-bb07-4da24531b175/28-0 00:00:08.240 --> 00:00:09.240 <v Kendra Folh>Thank you for having me.</v>

a063df5a-124c-428e-bb07-4da24531b175/51-0 00:00:09.610 --> 00:00:12.477 <v Jordan Cooper>Yeah. So we have a wide set of issues that</v>

a063df5a-124c-428e-bb07-4da24531b175/51-1 00:00:12.477 --> 00:00:17.144 <v Jordan Cooper>we're going to be discussing today, all pertaining to data surprises,</v>

a063df5a-124c-428e-bb07-4da24531b175/51-2 00:00:17.144 --> 00:00:18.610 <v Jordan Cooper>healthy data, podcast.</v>

a063df5a-124c-428e-bb07-4da24531b175/75-0 00:00:19.370 --> 00:00:25.219 <v Jordan Cooper>I'd like to ask you to start us off with a conversation or description of how data</v>

a063df5a-124c-428e-bb07-4da24531b175/75-1 00:00:25.219 --> 00:00:28.530 <v Jordan Cooper>the current state of data at Memorial Hermann.</v>

a063df5a-124c-428e-bb07-4da24531b175/90-0 00:00:28.690 --> 00:00:34.126 <v Jordan Cooper>What kind of issues are arising from clean or lack of clean data at Memorial</v>

a063df5a-124c-428e-bb07-4da24531b175/90-1 00:00:34.126 --> 00:00:34.690 <v Jordan Cooper>Hermann?</v>

a063df5a-124c-428e-bb07-4da24531b175/130-0 00:00:35.200 --> 00:00:37.452 <v Kendra Folh>Well, I think I could definitely speak to what</v>

a063df5a-124c-428e-bb07-4da24531b175/130-1 00:00:37.452 --> 00:00:40.327 <v Kendra Folh>is the state of Theta for all maternal health and you know,</v>

a063df5a-124c-428e-bb07-4da24531b175/130-2 00:00:40.327 --> 00:00:43.872 <v Kendra Folh>not just within my organization, but I also do a lot of work at the state</v>

a063df5a-124c-428e-bb07-4da24531b175/130-3 00:00:43.872 --> 00:00:47.417 <v Kendra Folh>of Texas level and so significant opportunity to really understand what's</v>

a063df5a-124c-428e-bb07-4da24531b175/130-4 00:00:47.417 --> 00:00:48.040 <v Kendra Folh>happening in.</v>

a063df5a-124c-428e-bb07-4da24531b175/174-0 00:00:48.150 --> 00:00:50.931 <v Kendra Folh>Population. We know maternal health is population</v>

a063df5a-124c-428e-bb07-4da24531b175/174-1 00:00:50.931 --> 00:00:53.546 <v Kendra Folh>health, so how do we get data that's relevant,</v>

a063df5a-124c-428e-bb07-4da24531b175/174-2 00:00:53.546 --> 00:00:56.660 <v Kendra Folh>actionable and timely, so we can really steer the ship.</v>

a063df5a-124c-428e-bb07-4da24531b175/174-3 00:00:56.660 --> 00:01:01.054 <v Kendra Folh>We know we have opportunities to improve our maternal mortality and morbidity,</v>

a063df5a-124c-428e-bb07-4da24531b175/174-4 00:01:01.054 --> 00:01:04.280 <v Kendra Folh>but where is the data that really helps us other than we?</v>

a063df5a-124c-428e-bb07-4da24531b175/180-0 00:01:04.280 --> 00:01:05.390 <v Kendra Folh>Have a problem.</v>

a063df5a-124c-428e-bb07-4da24531b175/186-0 00:01:05.510 --> 00:01:07.110 <v Kendra Folh>How do we fix this problem?</v>

a063df5a-124c-428e-bb07-4da24531b175/192-0 00:01:07.110 --> 00:01:08.870 <v Kendra Folh>And so how do we find the data?</v>

a063df5a-124c-428e-bb07-4da24531b175/195-0 00:01:08.910 --> 00:01:10.470 <v Kendra Folh>How do we clean that data?</v>

a063df5a-124c-428e-bb07-4da24531b175/200-0 00:01:10.590 --> 00:01:13.630 <v Kendra Folh>There's multiple different sources of this to really create.</v>

a063df5a-124c-428e-bb07-4da24531b175/207-0 00:01:14.320 --> 00:01:15.920 <v Kendra Folh>A story so we know where we can go and prove.</v>

a063df5a-124c-428e-bb07-4da24531b175/217-0 00:01:17.610 --> 00:01:19.930 <v Jordan Cooper>So what are some of I like to?</v>

a063df5a-124c-428e-bb07-4da24531b175/237-0 00:01:19.930 --> 00:01:23.040 <v Jordan Cooper>I think it's most helpful for our listeners if you walk us through a</v>

a063df5a-124c-428e-bb07-4da24531b175/237-1 00:01:23.040 --> 00:01:25.609 <v Jordan Cooper>particular use case, I think many listeners may say yes,</v>

a063df5a-124c-428e-bb07-4da24531b175/237-2 00:01:25.609 --> 00:01:26.690 <v Jordan Cooper>you know this resonates.</v>

a063df5a-124c-428e-bb07-4da24531b175/257-0 00:01:26.690 --> 00:01:31.426 <v Jordan Cooper>We do have an issue with mortality morbidity relating to maternal health,</v>

a063df5a-124c-428e-bb07-4da24531b175/257-1 00:01:31.426 --> 00:01:33.730 <v Jordan Cooper>but we don't really know what to do.</v>

a063df5a-124c-428e-bb07-4da24531b175/277-0 00:01:33.730 --> 00:01:37.860 <v Jordan Cooper>What are the different data sources you're trying to reconcile and what are</v>

a063df5a-124c-428e-bb07-4da24531b175/277-1 00:01:37.860 --> 00:01:42.370 <v Jordan Cooper>some of the challenges in trying to have actionable real time insights to improve?</v>

a063df5a-124c-428e-bb07-4da24531b175/279-0 00:01:43.060 --> 00:01:43.340 <v Jordan Cooper>Maternal health.</v>

a063df5a-124c-428e-bb07-4da24531b175/281-0 00:01:43.610 --> 00:01:43.730 <v Jordan Cooper>Off.</v>

a063df5a-124c-428e-bb07-4da24531b175/316-0 00:01:44.090 --> 00:01:46.634 <v Kendra Folh>Well, I think what the current state is and we</v>

a063df5a-124c-428e-bb07-4da24531b175/316-1 00:01:46.634 --> 00:01:50.639 <v Kendra Folh>think of what are our data sources and I think you know, Data's A1280 kg,</v>

a063df5a-124c-428e-bb07-4da24531b175/316-2 00:01:50.639 --> 00:01:54.210 <v Kendra Folh>like we say, a clinical side, I'm an L&amp;D nurse by background.</v>

a063df5a-124c-428e-bb07-4da24531b175/346-0 00:01:54.210 --> 00:01:56.854 <v Kendra Folh>So data is a newer place for us. As clinicians,</v>

a063df5a-124c-428e-bb07-4da24531b175/346-1 00:01:56.854 --> 00:02:01.370 <v Kendra Folh>we know we have our EMR which in Memorial Hermann we currently converted to EPIC.</v>

a063df5a-124c-428e-bb07-4da24531b175/369-0 00:02:01.610 --> 00:02:05.553 <v Kendra Folh>So we have EMR data, we have administrative coding data which</v>

a063df5a-124c-428e-bb07-4da24531b175/369-1 00:02:05.553 --> 00:02:09.050 <v Kendra Folh>is really where a lot of our reporting is coming from.</v>

a063df5a-124c-428e-bb07-4da24531b175/374-0 00:02:09.050 --> 00:02:11.050 <v Kendra Folh>So CMS is now really moving towards.</v>

a063df5a-124c-428e-bb07-4da24531b175/379-0 00:02:11.800 --> 00:02:12.920 <v Kendra Folh>Our severe maternal morbidity.</v>

a063df5a-124c-428e-bb07-4da24531b175/383-0 00:02:13.430 --> 00:02:14.910 <v Kendra Folh>Diagnostic codes.</v>

a063df5a-124c-428e-bb07-4da24531b175/406-0 00:02:14.990 --> 00:02:18.330 <v Kendra Folh>That's all claims data. There was just a recent article that came</v>

a063df5a-124c-428e-bb07-4da24531b175/388-0 00:02:15.080 --> 00:02:15.280 <v Jordan Cooper>Mm hmm.</v>

a063df5a-124c-428e-bb07-4da24531b175/406-1 00:02:18.330 --> 00:02:21.670 <v Kendra Folh>out by Popeue that said that really it's only about 65% accurate.</v>

a063df5a-124c-428e-bb07-4da24531b175/430-0 00:02:22.040 --> 00:02:26.871 <v Kendra Folh>So how did we take the ICD 10 code, which is really where all the claims data</v>

a063df5a-124c-428e-bb07-4da24531b175/430-1 00:02:26.871 --> 00:02:27.800 <v Kendra Folh>is coming from?</v>

a063df5a-124c-428e-bb07-4da24531b175/431-0 00:02:27.800 --> 00:02:28.560 <v Kendra Folh>The billing data.</v>

a063df5a-124c-428e-bb07-4da24531b175/448-0 00:02:28.560 --> 00:02:33.522 <v Kendra Folh>The reportable data is coming from, but then how do we use our epic to give</v>

a063df5a-124c-428e-bb07-4da24531b175/448-1 00:02:33.522 --> 00:02:34.240 <v Kendra Folh>us reports?</v>

a063df5a-124c-428e-bb07-4da24531b175/482-0 00:02:34.240 --> 00:02:38.323 <v Kendra Folh>That's gonna give us some good information and mix that together within</v>

a063df5a-124c-428e-bb07-4da24531b175/482-1 00:02:38.323 --> 00:02:42.461 <v Kendra Folh>the state of Texas and is coming to theaters near a lot of us across the</v>

a063df5a-124c-428e-bb07-4da24531b175/482-2 00:02:42.461 --> 00:02:45.807 <v Kendra Folh>nation as levels of care. And that's where we are gonna be</v>

a063df5a-124c-428e-bb07-4da24531b175/482-3 00:02:45.807 --> 00:02:46.600 <v Kendra Folh>designated as.</v>

a063df5a-124c-428e-bb07-4da24531b175/496-0 00:02:47.400 --> 00:02:51.266 <v Kendra Folh>Organization at what level of care and what is the acuity level of moms and</v>

a063df5a-124c-428e-bb07-4da24531b175/496-1 00:02:51.266 --> 00:02:52.080 <v Kendra Folh>neonatal babies?</v>

a063df5a-124c-428e-bb07-4da24531b175/512-0 00:02:52.630 --> 00:02:57.068 <v Kendra Folh>Even the NICU that you can take care of that requires a significant amount of</v>

a063df5a-124c-428e-bb07-4da24531b175/512-1 00:02:57.068 --> 00:02:57.750 <v Kendra Folh>case review.</v>

a063df5a-124c-428e-bb07-4da24531b175/527-0 00:02:58.110 --> 00:03:02.410 <v Kendra Folh>So that's another, you know, data source that is based on real</v>

a063df5a-124c-428e-bb07-4da24531b175/527-1 00:03:02.410 --> 00:03:05.960 <v Kendra Folh>obstruction, which I think as clinicians that's our</v>

a063df5a-124c-428e-bb07-4da24531b175/527-2 00:03:05.960 --> 00:03:06.710 <v Kendra Folh>preference.</v>

a063df5a-124c-428e-bb07-4da24531b175/535-0 00:03:06.710 --> 00:03:08.750 <v Kendra Folh>We really want to dig into that case.</v>

a063df5a-124c-428e-bb07-4da24531b175/544-0 00:03:08.750 --> 00:03:10.950 <v Kendra Folh>We want to understand all the variables.</v>

a063df5a-124c-428e-bb07-4da24531b175/545-0 00:03:11.110 --> 00:03:12.190 <v Kendra Folh>What happened?</v>

a063df5a-124c-428e-bb07-4da24531b175/552-0 00:03:12.430 --> 00:03:16.750 <v Kendra Folh>So how do we take the administrative data, the EMR data?</v>

a063df5a-124c-428e-bb07-4da24531b175/563-0 00:03:17.560 --> 00:03:22.600 <v Kendra Folh>And the abstracted data and create one source of truth that we can really guide.</v>

a063df5a-124c-428e-bb07-4da24531b175/571-0 00:03:23.110 --> 00:03:25.710 <v Kendra Folh>Our teams to move improvement.</v>

a063df5a-124c-428e-bb07-4da24531b175/576-0 00:03:25.710 --> 00:03:28.110 <v Kendra Folh>So that's the work that we're doing right now.</v>

a063df5a-124c-428e-bb07-4da24531b175/583-0 00:03:28.110 --> 00:03:31.190 <v Kendra Folh>It's really trying to pull that together to create one source.</v>

a063df5a-124c-428e-bb07-4da24531b175/620-0 00:03:31.800 --> 00:03:34.762 <v Jordan Cooper>Yeah. And I understand that it's been difficult</v>

a063df5a-124c-428e-bb07-4da24531b175/620-1 00:03:34.762 --> 00:03:39.267 <v Jordan Cooper>to get clinicians to buy into that administrative coding data and to get</v>

a063df5a-124c-428e-bb07-4da24531b175/620-2 00:03:39.267 --> 00:03:43.833 <v Jordan Cooper>them to trust the claims data because there may be a lack of trust in the</v>

a063df5a-124c-428e-bb07-4da24531b175/620-3 00:03:43.833 --> 00:03:45.560 <v Jordan Cooper>validity of that payer data.</v>

a063df5a-124c-428e-bb07-4da24531b175/633-0 00:03:45.560 --> 00:03:50.200 <v Jordan Cooper>How are you overcoming that kind of skepticism on the part of clinicians?</v>

a063df5a-124c-428e-bb07-4da24531b175/654-0 00:03:50.420 --> 00:03:53.219 <v Kendra Folh>We have to know our data and I think that's, you know,</v>

a063df5a-124c-428e-bb07-4da24531b175/654-1 00:03:53.219 --> 00:03:57.239 <v Kendra Folh>whether you're on the clinical side or you're on the on the tech side is we've</v>

a063df5a-124c-428e-bb07-4da24531b175/654-2 00:03:57.239 --> 00:03:58.460 <v Kendra Folh>really got to review it.</v>

a063df5a-124c-428e-bb07-4da24531b175/660-0 00:03:58.460 --> 00:03:59.700 <v Kendra Folh>We've got to get dirty with it.</v>

a063df5a-124c-428e-bb07-4da24531b175/665-0 00:03:59.700 --> 00:04:01.220 <v Kendra Folh>You got to get your hands in the data.</v>

a063df5a-124c-428e-bb07-4da24531b175/685-0 00:04:01.220 --> 00:04:04.603 <v Kendra Folh>So what we have found, we are seeing the same thing within our</v>

a063df5a-124c-428e-bb07-4da24531b175/685-1 00:04:04.603 --> 00:04:07.180 <v Kendra Folh>administrative data that's also being reported.</v>

a063df5a-124c-428e-bb07-4da24531b175/700-0 00:04:07.540 --> 00:04:10.470 <v Kendra Folh>Our validity is a little bit better as far as reliability,</v>

a063df5a-124c-428e-bb07-4da24531b175/700-1 00:04:10.470 --> 00:04:14.492 <v Kendra Folh>but I mean you're really looking at about 80% of that because the administrative</v>

a063df5a-124c-428e-bb07-4da24531b175/700-2 00:04:14.492 --> 00:04:14.740 <v Kendra Folh>data.</v>

a063df5a-124c-428e-bb07-4da24531b175/721-0 00:04:15.440 --> 00:04:19.150 <v Kendra Folh>Has a tendency to overcode history of, so that's what we're seeing is when we're</v>

a063df5a-124c-428e-bb07-4da24531b175/721-1 00:04:19.150 --> 00:04:22.080 <v Kendra Folh>getting triggered from mom that had a very severe complication.</v>

a063df5a-124c-428e-bb07-4da24531b175/767-0 00:04:22.750 --> 00:04:27.108 <v Kendra Folh>Based on a coding we're looking back and realizing she has a history of some</v>

a063df5a-124c-428e-bb07-4da24531b175/767-1 00:04:27.108 --> 00:04:31.862 <v Kendra Folh>cardiomyopathy or a history of stroke and then that pops up as a trigger and that's</v>

a063df5a-124c-428e-bb07-4da24531b175/767-2 00:04:31.862 --> 00:04:36.559 <v Kendra Folh>what we're publicly reporting and that's where we lose the trust of our clinicians</v>

a063df5a-124c-428e-bb07-4da24531b175/767-3 00:04:36.559 --> 00:04:38.200 <v Kendra Folh>and our program managers and.</v>

a063df5a-124c-428e-bb07-4da24531b175/791-0 00:04:38.200 --> 00:04:41.915 <v Kendra Folh>Our nursing abstractors at the site saying, hey, our data's not right.</v>

a063df5a-124c-428e-bb07-4da24531b175/791-1 00:04:41.915 --> 00:04:45.578 <v Kendra Folh>So we've got to take those triggers. We've got to abstract and really</v>

a063df5a-124c-428e-bb07-4da24531b175/791-2 00:04:45.578 --> 00:04:46.310 <v Kendra Folh>understand it.</v>

a063df5a-124c-428e-bb07-4da24531b175/808-0 00:04:46.310 --> 00:04:50.397 <v Kendra Folh>And then we have to visualize it, make it digestible and bring it back to</v>

a063df5a-124c-428e-bb07-4da24531b175/808-1 00:04:50.397 --> 00:04:52.550 <v Kendra Folh>the teams into a product that they can.</v>

a063df5a-124c-428e-bb07-4da24531b175/812-0 00:04:53.750 --> 00:04:54.230 <v Kendra Folh>Actually mute.</v>

a063df5a-124c-428e-bb07-4da24531b175/814-0 00:04:54.230 --> 00:04:54.830 <v Kendra Folh>So very labor intensive.</v>

a063df5a-124c-428e-bb07-4da24531b175/823-0 00:04:56.000 --> 00:04:56.560 <v Jordan Cooper>So.</v>

a063df5a-124c-428e-bb07-4da24531b175/832-0 00:04:57.160 --> 00:05:00.248 <v Kendra Folh>But to have the move forward to using our EMR to do some of that cleaning</v>

a063df5a-124c-428e-bb07-4da24531b175/832-1 00:05:00.248 --> 00:05:01.040 <v Kendra Folh>abstraction for us.</v>

a063df5a-124c-428e-bb07-4da24531b175/851-0 00:05:01.670 --> 00:05:06.435 <v Jordan Cooper>So as all of our listeners will know, there are two main buckets of analytic of</v>

a063df5a-124c-428e-bb07-4da24531b175/851-1 00:05:06.435 --> 00:05:07.030 <v Jordan Cooper>reporting.</v>

a063df5a-124c-428e-bb07-4da24531b175/860-0 00:05:07.030 --> 00:05:11.339 <v Jordan Cooper>There's analytical and operational. The analytical often people associate</v>

a063df5a-124c-428e-bb07-4da24531b175/860-1 00:05:11.339 --> 00:05:11.630 <v Jordan Cooper>with.</v>

a063df5a-124c-428e-bb07-4da24531b175/888-0 00:05:13.100 --> 00:05:17.316 <v Jordan Cooper>Historical chart reviews and claims reviews for something that happened</v>

a063df5a-124c-428e-bb07-4da24531b175/888-1 00:05:17.316 --> 00:05:21.707 <v Jordan Cooper>potentially months ago and operational something that happens real time is</v>

a063df5a-124c-428e-bb07-4da24531b175/888-2 00:05:21.707 --> 00:05:23.580 <v Jordan Cooper>actionable at the point of care.</v>

a063df5a-124c-428e-bb07-4da24531b175/900-0 00:05:25.260 --> 00:05:29.020 <v Jordan Cooper>Have you any experience working with fire or is that on your road map at all?</v>

a063df5a-124c-428e-bb07-4da24531b175/907-0 00:05:29.640 --> 00:05:30.560 <v Kendra Folh>Well, we definitely have.</v>

a063df5a-124c-428e-bb07-4da24531b175/928-0 00:05:30.560 --> 00:05:34.783 <v Kendra Folh>And so I think we we use fire more from an operational efficiency perspective</v>

a063df5a-124c-428e-bb07-4da24531b175/928-1 00:05:34.783 --> 00:05:38.680 <v Kendra Folh>where we're thinking, OK, hey, where do we have barriers for discharge?</v>

a063df5a-124c-428e-bb07-4da24531b175/955-0 00:05:38.680 --> 00:05:43.549 <v Kendra Folh>So how do we build that into our Emrs to flag a a mom that has already shown me</v>

a063df5a-124c-428e-bb07-4da24531b175/955-1 00:05:43.549 --> 00:05:45.800 <v Kendra Folh>some signs or changes in vital signs?</v>

a063df5a-124c-428e-bb07-4da24531b175/975-0 00:05:45.800 --> 00:05:49.781 <v Kendra Folh>Or maybe there's some delays that are already occurring so that way we can</v>

a063df5a-124c-428e-bb07-4da24531b175/975-1 00:05:49.781 --> 00:05:53.232 <v Kendra Folh>mitigate that quickly. Just really to ensure efficiency decrease</v>

a063df5a-124c-428e-bb07-4da24531b175/975-2 00:05:53.232 --> 00:05:54.240 <v Kendra Folh>our length of stay.</v>

a063df5a-124c-428e-bb07-4da24531b175/991-0 00:05:55.000 --> 00:05:58.592 <v Kendra Folh>But we're really wanting to do is how do we actually use fire and look at safe</v>

a063df5a-124c-428e-bb07-4da24531b175/991-1 00:05:58.592 --> 00:06:00.320 <v Kendra Folh>postpartum hemorrhage risk assessment.</v>

a063df5a-124c-428e-bb07-4da24531b175/1017-0 00:06:01.570 --> 00:06:06.882 <v Kendra Folh>How do we know a mom truly is at risk for hemorrhage and utilizing that technology</v>

a063df5a-124c-428e-bb07-4da24531b175/1017-1 00:06:06.882 --> 00:06:11.618 <v Kendra Folh>to alert these teams to increase the awareness to really monitor that mom</v>

a063df5a-124c-428e-bb07-4da24531b175/1017-2 00:06:11.618 --> 00:06:12.130 <v Kendra Folh>closely?</v>

a063df5a-124c-428e-bb07-4da24531b175/1020-0 00:06:13.730 --> 00:06:14.050 <v Jordan Cooper>Got it.</v>

a063df5a-124c-428e-bb07-4da24531b175/1044-0 00:06:14.050 --> 00:06:18.970 <v Jordan Cooper>So I think that there's a if there's a real time risk of hemorrhage,</v>

a063df5a-124c-428e-bb07-4da24531b175/1044-1 00:06:18.970 --> 00:06:24.530 <v Jordan Cooper>you're looking at using these reports to prevent bad outcomes and the target.</v>

a063df5a-124c-428e-bb07-4da24531b175/1072-0 00:06:25.940 --> 00:06:29.958 <v Jordan Cooper>You can't monitor every single woman who delivers for being at high risk for a</v>

a063df5a-124c-428e-bb07-4da24531b175/1072-1 00:06:29.958 --> 00:06:33.212 <v Jordan Cooper>postpartum hemorrhage, but you're kind of identifying the ideal</v>

a063df5a-124c-428e-bb07-4da24531b175/1072-2 00:06:33.212 --> 00:06:35.500 <v Jordan Cooper>target population where the care gap may be.</v>

a063df5a-124c-428e-bb07-4da24531b175/1089-0 00:06:35.500 --> 00:06:41.230 <v Jordan Cooper>Have you had any success in reducing the rates of postpartum hemorrhage because of</v>

a063df5a-124c-428e-bb07-4da24531b175/1089-1 00:06:41.230 --> 00:06:44.060 <v Jordan Cooper>these risk assessments and the analytics?</v>

a063df5a-124c-428e-bb07-4da24531b175/1094-0 00:06:44.450 --> 00:06:45.850 <v Jordan Cooper>Provided by fire in real time.</v>

a063df5a-124c-428e-bb07-4da24531b175/1125-0 00:06:46.250 --> 00:06:48.717 <v Kendra Folh>Not yet, but we are looking at is really the</v>

a063df5a-124c-428e-bb07-4da24531b175/1125-1 00:06:48.717 --> 00:06:53.102 <v Kendra Folh>maternal early warning and so that's the analysis that we're doing right now or</v>

a063df5a-124c-428e-bb07-4da24531b175/1125-2 00:06:53.102 --> 00:06:56.172 <v Kendra Folh>what are the signs, the vital signs that a mom has that</v>

a063df5a-124c-428e-bb07-4da24531b175/1125-3 00:06:56.172 --> 00:07:00.009 <v Kendra Folh>really has subtle changes that are increasing her risk for morbidity,</v>

a063df5a-124c-428e-bb07-4da24531b175/1125-4 00:07:00.009 --> 00:07:01.050 <v Kendra Folh>what we're looking.</v>

a063df5a-124c-428e-bb07-4da24531b175/1153-0 00:07:01.050 --> 00:07:03.518 <v Kendra Folh>At right now is. What is that impact on ICU?</v>

a063df5a-124c-428e-bb07-4da24531b175/1153-1 00:07:03.518 --> 00:07:06.479 <v Kendra Folh>So how soon can we identify a change in a vital sign,</v>

a063df5a-124c-428e-bb07-4da24531b175/1153-2 00:07:06.479 --> 00:07:10.153 <v Kendra Folh>whether it's a mom's heart rate, her mean arterial blood pressure,</v>

a063df5a-124c-428e-bb07-4da24531b175/1153-3 00:07:10.153 --> 00:07:12.730 <v Kendra Folh>or even just some of the hypertension disease?</v>

a063df5a-124c-428e-bb07-4da24531b175/1164-0 00:07:13.360 --> 00:07:15.742 <v Kendra Folh>What are those warnings that are going to prevent her from going to the ICU for</v>

a063df5a-124c-428e-bb07-4da24531b175/1164-1 00:07:15.742 --> 00:07:15.920 <v Kendra Folh>early?</v>

a063df5a-124c-428e-bb07-4da24531b175/1166-0 00:07:16.310 --> 00:07:16.470 <v Kendra Folh>OK.</v>

a063df5a-124c-428e-bb07-4da24531b175/1197-0 00:07:17.260 --> 00:07:22.104 <v Jordan Cooper>Hi Kendra I think you mentioned that you are A6 Sigma black belt and there have</v>

a063df5a-124c-428e-bb07-4da24531b175/1181-0 00:07:21.330 --> 00:07:21.690 <v Kendra Folh>Yeah.</v>

a063df5a-124c-428e-bb07-4da24531b175/1197-1 00:07:22.104 --> 00:07:26.706 <v Jordan Cooper>been different reports that have offer conflicting insights and you've been</v>

a063df5a-124c-428e-bb07-4da24531b175/1197-2 00:07:26.706 --> 00:07:28.340 <v Jordan Cooper>working to reconcile those.</v>

a063df5a-124c-428e-bb07-4da24531b175/1203-0 00:07:28.340 --> 00:07:31.260 <v Jordan Cooper>Would you mind elaborating upon your efforts there?</v>

a063df5a-124c-428e-bb07-4da24531b175/1210-0 00:07:32.550 --> 00:07:33.910 <v Kendra Folh>You know, we'll just stay with epic.</v>

a063df5a-124c-428e-bb07-4da24531b175/1238-0 00:07:33.910 --> 00:07:36.556 <v Kendra Folh>I mean, there's some really great product there</v>

a063df5a-124c-428e-bb07-4da24531b175/1238-1 00:07:36.556 --> 00:07:40.469 <v Kendra Folh>and there's some good reporting. I think what happens is if we have so</v>

a063df5a-124c-428e-bb07-4da24531b175/1238-2 00:07:40.469 --> 00:07:43.665 <v Kendra Folh>much data that's coming out and the definitions conflict,</v>

a063df5a-124c-428e-bb07-4da24531b175/1238-3 00:07:43.665 --> 00:07:46.310 <v Kendra Folh>So what populations are we actually looking at?</v>

a063df5a-124c-428e-bb07-4da24531b175/1245-0 00:07:46.310 --> 00:07:47.950 <v Kendra Folh>How are these reports written?</v>

a063df5a-124c-428e-bb07-4da24531b175/1264-0 00:07:48.390 --> 00:07:52.408 <v Kendra Folh>But how are we gonna use them? That is our biggest struggle is not only</v>

a063df5a-124c-428e-bb07-4da24531b175/1264-1 00:07:52.408 --> 00:07:56.761 <v Kendra Folh>just having the consistency and the cleanness of the data, but having to use,</v>

a063df5a-124c-428e-bb07-4da24531b175/1264-2 00:07:56.761 --> 00:07:57.430 <v Kendra Folh>for example.</v>

a063df5a-124c-428e-bb07-4da24531b175/1278-0 00:07:58.080 --> 00:08:00.480 <v Kendra Folh>With severe maternal morbidity, which is a very important measure and</v>

a063df5a-124c-428e-bb07-4da24531b175/1278-1 00:08:00.480 --> 00:08:01.920 <v Kendra Folh>definition for those severe complications.</v>

a063df5a-124c-428e-bb07-4da24531b175/1283-0 00:08:01.990 --> 00:08:02.990 <v Kendra Folh>It's her mom's.</v>

a063df5a-124c-428e-bb07-4da24531b175/1293-0 00:08:02.990 --> 00:08:07.503 <v Kendra Folh>There are three definitions that we have to report and have to educate our teams</v>

a063df5a-124c-428e-bb07-4da24531b175/1293-1 00:08:07.503 --> 00:08:07.670 <v Kendra Folh>on.</v>

a063df5a-124c-428e-bb07-4da24531b175/1313-0 00:08:08.070 --> 00:08:11.339 <v Kendra Folh>So you have three different reports coming out with three different</v>

a063df5a-124c-428e-bb07-4da24531b175/1313-1 00:08:11.339 --> 00:08:14.270 <v Kendra Folh>numerators, 3 different denominators, different definitions.</v>

a063df5a-124c-428e-bb07-4da24531b175/1318-0 00:08:14.270 --> 00:08:15.710 <v Kendra Folh>What do you do with that?</v>

a063df5a-124c-428e-bb07-4da24531b175/1322-0 00:08:15.750 --> 00:08:17.310 <v Kendra Folh>What do you act on that?</v>

a063df5a-124c-428e-bb07-4da24531b175/1338-0 00:08:17.310 --> 00:08:21.879 <v Kendra Folh>So it's taking a step back, aligning that up strategically to create</v>

a063df5a-124c-428e-bb07-4da24531b175/1338-1 00:08:21.879 --> 00:08:24.990 <v Kendra Folh>one system of truth that our teams can act on.</v>

a063df5a-124c-428e-bb07-4da24531b175/1341-0 00:08:25.980 --> 00:08:26.380 <v Jordan Cooper>Got it.</v>

a063df5a-124c-428e-bb07-4da24531b175/1388-0 00:08:26.380 --> 00:08:30.972 <v Jordan Cooper>So it sounds like there's an issue that we covered at the beginning of this</v>

a063df5a-124c-428e-bb07-4da24531b175/1388-1 00:08:30.972 --> 00:08:33.933 <v Jordan Cooper>discussion about whether data is clean or dirty,</v>

a063df5a-124c-428e-bb07-4da24531b175/1388-2 00:08:33.933 --> 00:08:38.645 <v Jordan Cooper>but it's also possible to have fully accurate data in three different reports</v>

a063df5a-124c-428e-bb07-4da24531b175/1388-3 00:08:38.645 --> 00:08:43.056 <v Jordan Cooper>that conflict with each other, because even though the data is accurate,</v>

a063df5a-124c-428e-bb07-4da24531b175/1388-4 00:08:43.056 --> 00:08:43.660 <v Jordan Cooper>the defin.</v>

a063df5a-124c-428e-bb07-4da24531b175/1395-0 00:08:43.780 --> 00:08:45.260 <v Jordan Cooper>'S conflicting aren't standardized.</v>

a063df5a-124c-428e-bb07-4da24531b175/1412-0 00:08:45.300 --> 00:08:49.679 <v Jordan Cooper>And so that presents a challenge for healthcare providers who are looking to</v>

a063df5a-124c-428e-bb07-4da24531b175/1412-1 00:08:49.679 --> 00:08:52.180 <v Jordan Cooper>have one golden record and source of truth.</v>

a063df5a-124c-428e-bb07-4da24531b175/1447-0 00:08:53.140 --> 00:08:55.926 <v Kendra Folh>Correct. And then if it was April 30 and then if</v>

a063df5a-124c-428e-bb07-4da24531b175/1419-0 00:08:53.770 --> 00:08:54.810 <v Jordan Cooper>Have you been?</v>

a063df5a-124c-428e-bb07-4da24531b175/1447-1 00:08:55.926 --> 00:08:59.507 <v Kendra Folh>you're having reporting issues or workflow entry issues or the</v>

a063df5a-124c-428e-bb07-4da24531b175/1447-2 00:08:59.507 --> 00:09:03.940 <v Kendra Folh>documentation's not done in the right place, it's not gonna feed your report.</v>

a063df5a-124c-428e-bb07-4da24531b175/1459-0 00:09:04.100 --> 00:09:09.803 <v Kendra Folh>So how are we're documenting the workload is so essential in the success and the</v>

a063df5a-124c-428e-bb07-4da24531b175/1459-1 00:09:09.803 --> 00:09:11.140 <v Kendra Folh>clean data process.</v>

a063df5a-124c-428e-bb07-4da24531b175/1461-0 00:09:12.770 --> 00:09:13.650 <v Jordan Cooper>Is there?</v>

a063df5a-124c-428e-bb07-4da24531b175/1481-0 00:09:15.420 --> 00:09:20.916 <v Jordan Cooper>Can you walk us through what the what kind of interventions you've been working</v>

a063df5a-124c-428e-bb07-4da24531b175/1481-1 00:09:20.916 --> 00:09:24.900 <v Jordan Cooper>on to improve documentation workflow at Memorial Hermann?</v>

a063df5a-124c-428e-bb07-4da24531b175/1511-0 00:09:25.540 --> 00:09:29.625 <v Kendra Folh>So as a six figure black belt, one of the projects we had as we did our</v>

a063df5a-124c-428e-bb07-4da24531b175/1511-1 00:09:29.625 --> 00:09:34.220 <v Kendra Folh>epic conversion is we've really had to analyze our data all across the spectrum.</v>

a063df5a-124c-428e-bb07-4da24531b175/1516-0 00:09:34.700 --> 00:09:37.740 <v Kendra Folh>What are the reports doing process mapping?</v>

a063df5a-124c-428e-bb07-4da24531b175/1537-0 00:09:38.020 --> 00:09:42.014 <v Kendra Folh>Understanding the data going, we call go to Gimba which is going and</v>

a063df5a-124c-428e-bb07-4da24531b175/1537-1 00:09:42.014 --> 00:09:46.180 <v Kendra Folh>working with those clinicians at the frontline to look at the workflow.</v>

a063df5a-124c-428e-bb07-4da24531b175/1539-0 00:09:46.700 --> 00:09:48.100 <v Kendra Folh>How are they documenting?</v>

a063df5a-124c-428e-bb07-4da24531b175/1543-0 00:09:48.220 --> 00:09:49.300 <v Kendra Folh>Where are they doing it?</v>

a063df5a-124c-428e-bb07-4da24531b175/1550-0 00:09:49.300 --> 00:09:52.060 <v Kendra Folh>What makes sense to workflow and how does that documentation?</v>

a063df5a-124c-428e-bb07-4da24531b175/1555-0 00:09:52.960 --> 00:09:54.320 <v Kendra Folh>Feed into the reporting.</v>

a063df5a-124c-428e-bb07-4da24531b175/1559-0 00:09:54.750 --> 00:09:55.550 <v Kendra Folh>The revenue.</v>

a063df5a-124c-428e-bb07-4da24531b175/1569-0 00:09:55.630 --> 00:09:59.270 <v Kendra Folh>The charge drops and all of the output that are required.</v>

a063df5a-124c-428e-bb07-4da24531b175/1574-0 00:09:59.310 --> 00:10:01.710 <v Kendra Folh>What we're finding is a significant amount of variation there.</v>

a063df5a-124c-428e-bb07-4da24531b175/1592-0 00:10:02.810 --> 00:10:08.170 <v Kendra Folh>So we've had to really do some work to standardize documentation.</v>

a063df5a-124c-428e-bb07-4da24531b175/1598-0 00:10:08.320 --> 00:10:09.680 <v Kendra Folh>Standardized template.</v>

a063df5a-124c-428e-bb07-4da24531b175/1623-0 00:10:09.750 --> 00:10:14.482 <v Kendra Folh>Standardized order sets and workflows and then kind of reconfigure how we're</v>

a063df5a-124c-428e-bb07-4da24531b175/1623-1 00:10:14.482 --> 00:10:18.476 <v Kendra Folh>working in the application, then going back to the reporting and</v>

a063df5a-124c-428e-bb07-4da24531b175/1623-2 00:10:18.476 --> 00:10:22.470 <v Kendra Folh>analytics to to redesign and reprogram what those workflows are.</v>

a063df5a-124c-428e-bb07-4da24531b175/1660-0 00:10:23.160 --> 00:10:25.615 <v Jordan Cooper>Many of our listeners may be thinking, you know,</v>

a063df5a-124c-428e-bb07-4da24531b175/1660-1 00:10:25.615 --> 00:10:29.523 <v Jordan Cooper>we've tried to implement standardized checklists and standardized procedures,</v>

a063df5a-124c-428e-bb07-4da24531b175/1660-2 00:10:29.523 --> 00:10:33.080 <v Jordan Cooper>but there's been a lot of pushback from different kinds of clinicians.</v>

a063df5a-124c-428e-bb07-4da24531b175/1677-0 00:10:33.080 --> 00:10:36.485 <v Jordan Cooper>The one physician says, well, this is the way we did it in residency</v>

a063df5a-124c-428e-bb07-4da24531b175/1677-1 00:10:36.485 --> 00:10:38.360 <v Jordan Cooper>and the other one does it differently.</v>

a063df5a-124c-428e-bb07-4da24531b175/1699-0 00:10:38.360 --> 00:10:42.142 <v Jordan Cooper>And then this nurse was trained on this for at that institution and then left and</v>

a063df5a-124c-428e-bb07-4da24531b175/1699-1 00:10:42.142 --> 00:10:45.970 <v Jordan Cooper>came to this institution and wants to do it that way because it worked over there.</v>

a063df5a-124c-428e-bb07-4da24531b175/1699-2 00:10:45.970 --> 00:10:46.800 <v Jordan Cooper>How do you handle?</v>

a063df5a-124c-428e-bb07-4da24531b175/1716-0 00:10:47.930 --> 00:10:51.846 <v Jordan Cooper>Cultural change as you're trying to make sure that you're following standard</v>

a063df5a-124c-428e-bb07-4da24531b175/1716-1 00:10:51.846 --> 00:10:53.930 <v Jordan Cooper>processes to improve the quality of data.</v>

a063df5a-124c-428e-bb07-4da24531b175/1727-0 00:10:54.560 --> 00:10:58.760 <v Jordan Cooper>And therefore improve patient health with actionable real time insights.</v>

a063df5a-124c-428e-bb07-4da24531b175/1756-0 00:10:59.100 --> 00:11:02.886 <v Kendra Folh>We would be very intentional with this as an organization with almost 32,</v>

a063df5a-124c-428e-bb07-4da24531b175/1756-1 00:11:02.886 --> 00:11:05.854 <v Kendra Folh>000 deliveries, we have 10 campuses and I always think of</v>

a063df5a-124c-428e-bb07-4da24531b175/1756-2 00:11:05.854 --> 00:11:07.900 <v Kendra Folh>us as a star track enterprise starships.</v>

a063df5a-124c-428e-bb07-4da24531b175/1765-0 00:11:07.900 --> 00:11:10.660 <v Kendra Folh>Everybody's got a different, different kind of ship.</v>

a063df5a-124c-428e-bb07-4da24531b175/1774-0 00:11:10.660 --> 00:11:12.500 <v Kendra Folh>They're running where a plurist model.</v>

a063df5a-124c-428e-bb07-4da24531b175/1782-0 00:11:12.500 --> 00:11:15.140 <v Kendra Folh>So we've got a global 4 academic facility.</v>

a063df5a-124c-428e-bb07-4da24531b175/1786-0 00:11:15.140 --> 00:11:16.140 <v Kendra Folh>We've got quite a physician.</v>

a063df5a-124c-428e-bb07-4da24531b175/1817-0 00:11:16.140 --> 00:11:18.961 <v Kendra Folh>We have employee positions, so we really had to create an</v>

a063df5a-124c-428e-bb07-4da24531b175/1817-1 00:11:18.961 --> 00:11:22.949 <v Kendra Folh>organizational structure and governance. That way we were collaboratively working</v>

a063df5a-124c-428e-bb07-4da24531b175/1817-2 00:11:22.949 --> 00:11:25.186 <v Kendra Folh>together. So we have what we call a perinatal</v>

a063df5a-124c-428e-bb07-4da24531b175/1817-3 00:11:25.186 --> 00:11:27.860 <v Kendra Folh>quality collaborative within the organization we have.</v>

a063df5a-124c-428e-bb07-4da24531b175/1819-0 00:11:27.860 --> 00:11:28.840 <v Kendra Folh>We meet every month.</v>

a063df5a-124c-428e-bb07-4da24531b175/1834-0 00:11:29.070 --> 00:11:33.102 <v Kendra Folh>Where we bring all of this together, we have work groups and so stakeholder</v>

a063df5a-124c-428e-bb07-4da24531b175/1834-1 00:11:33.102 --> 00:11:33.950 <v Kendra Folh>analysis is key.</v>

a063df5a-124c-428e-bb07-4da24531b175/1855-0 00:11:33.950 --> 00:11:38.933 <v Kendra Folh>We've got to have the right folks at the table and leading conversation and</v>

a063df5a-124c-428e-bb07-4da24531b175/1855-1 00:11:38.933 --> 00:11:42.670 <v Kendra Folh>collaborating, so we're not wanting to be authoritative.</v>

a063df5a-124c-428e-bb07-4da24531b175/1882-0 00:11:43.070 --> 00:11:47.021 <v Kendra Folh>We as the hospital organization, I'm not managing physician practice,</v>

a063df5a-124c-428e-bb07-4da24531b175/1882-1 00:11:47.021 --> 00:11:51.593 <v Kendra Folh>but we've got to come to some consensus. And so it's working to consensus in the</v>

a063df5a-124c-428e-bb07-4da24531b175/1882-2 00:11:51.593 --> 00:11:53.230 <v Kendra Folh>best evidence based practice.</v>

a063df5a-124c-428e-bb07-4da24531b175/1892-0 00:11:54.440 --> 00:11:57.480 <v Kendra Folh>And taking that to the right governance structures for approval.</v>

a063df5a-124c-428e-bb07-4da24531b175/1919-0 00:11:57.910 --> 00:12:00.640 <v Kendra Folh>Once those are approved, then we put those in place for</v>

a063df5a-124c-428e-bb07-4da24531b175/1919-1 00:12:00.640 --> 00:12:04.344 <v Kendra Folh>standardizing them and then doing that education, Pete as well as auditing.</v>

a063df5a-124c-428e-bb07-4da24531b175/1919-2 00:12:04.344 --> 00:12:05.270 <v Kendra Folh>We've got to audit.</v>

a063df5a-124c-428e-bb07-4da24531b175/1936-0 00:12:05.270 --> 00:12:07.886 <v Kendra Folh>We've got to bring that back to our quality and assurance performance</v>

a063df5a-124c-428e-bb07-4da24531b175/1936-1 00:12:07.886 --> 00:12:10.651 <v Kendra Folh>improvement committees or the quality committees to make sure that we are</v>

a063df5a-124c-428e-bb07-4da24531b175/1936-2 00:12:10.651 --> 00:12:11.510 <v Kendra Folh>managing that standard.</v>

a063df5a-124c-428e-bb07-4da24531b175/1969-0 00:12:12.100 --> 00:12:15.457 <v Jordan Cooper>As you mentioned Kendra, at the start of this discussion,</v>

a063df5a-124c-428e-bb07-4da24531b175/1969-1 00:12:15.457 --> 00:12:19.451 <v Jordan Cooper>you are the Chair of the data committee at the state level in Texas.</v>

a063df5a-124c-428e-bb07-4da24531b175/1969-2 00:12:19.451 --> 00:12:23.907 <v Jordan Cooper>And I think you have had some experience with reluctancy of different health</v>

a063df5a-124c-428e-bb07-4da24531b175/1969-3 00:12:23.907 --> 00:12:25.180 <v Jordan Cooper>systems to share data.</v>

a063df5a-124c-428e-bb07-4da24531b175/1986-0 00:12:26.610 --> 00:12:28.783 <v Jordan Cooper>At the, either with the state or with each other,</v>

a063df5a-124c-428e-bb07-4da24531b175/1986-1 00:12:28.783 --> 00:12:30.130 <v Jordan Cooper>would you care to elaborate on?</v>

a063df5a-124c-428e-bb07-4da24531b175/1994-0 00:12:30.210 --> 00:12:32.276 <v Jordan Cooper>Obviously, some patients are getting care well</v>

a063df5a-124c-428e-bb07-4da24531b175/1994-1 00:12:32.276 --> 00:12:34.210 <v Jordan Cooper>system and moving to another health system.</v>

a063df5a-124c-428e-bb07-4da24531b175/2008-0 00:12:34.450 --> 00:12:37.467 <v Jordan Cooper>Different. How do you how do you get kind of an</v>

a063df5a-124c-428e-bb07-4da24531b175/2008-1 00:12:37.467 --> 00:12:40.610 <v Jordan Cooper>accurate record of 1 mother coming in to deliver?</v>

a063df5a-124c-428e-bb07-4da24531b175/2010-0 00:12:42.250 --> 00:12:42.450 <v Jordan Cooper>And how?</v>

a063df5a-124c-428e-bb07-4da24531b175/2018-0 00:12:42.680 --> 00:12:45.360 <v Jordan Cooper>The different data sharing issues playing into that.</v>

a063df5a-124c-428e-bb07-4da24531b175/2032-0 00:12:45.570 --> 00:12:49.788 <v Kendra Folh>One, I think we're just not. I think we're not getting a good story of</v>

a063df5a-124c-428e-bb07-4da24531b175/2032-1 00:12:49.788 --> 00:12:51.570 <v Kendra Folh>moms working across the state.</v>

a063df5a-124c-428e-bb07-4da24531b175/2035-0 00:12:51.730 --> 00:12:54.050 <v Kendra Folh>I think we're also struggling.</v>

a063df5a-124c-428e-bb07-4da24531b175/2069-0 00:12:54.130 --> 00:12:58.173 <v Kendra Folh>I think Epic truly with the my chart have been the best interoperability that we've</v>

a063df5a-124c-428e-bb07-4da24531b175/2069-1 00:12:58.173 --> 00:13:01.447 <v Kendra Folh>been able to find so far. I think even just within Houston and some</v>

a063df5a-124c-428e-bb07-4da24531b175/2069-2 00:13:01.447 --> 00:13:05.297 <v Kendra Folh>of the work we're doing, to your point, women go to different organizations all</v>

a063df5a-124c-428e-bb07-4da24531b175/2069-3 00:13:05.297 --> 00:13:05.730 <v Kendra Folh>the time.</v>

a063df5a-124c-428e-bb07-4da24531b175/2075-0 00:13:05.810 --> 00:13:07.610 <v Kendra Folh>I'm going to go to what's ever easier.</v>

a063df5a-124c-428e-bb07-4da24531b175/2081-0 00:13:07.610 --> 00:13:08.530 <v Kendra Folh>I'm going to go to the Ed.</v>

a063df5a-124c-428e-bb07-4da24531b175/2082-0 00:13:08.530 --> 00:13:09.330 <v Kendra Folh>That's fastest.</v>

a063df5a-124c-428e-bb07-4da24531b175/2085-0 00:13:09.370 --> 00:13:10.570 <v Kendra Folh>Not necessarily the same.</v>

a063df5a-124c-428e-bb07-4da24531b175/2090-0 00:13:11.280 --> 00:13:14.000 <v Kendra Folh>It's changing that with, you know whether it's HIPAA.</v>

a063df5a-124c-428e-bb07-4da24531b175/2115-0 00:13:15.270 --> 00:13:20.402 <v Kendra Folh>Rules, whether it's organizational, reluctancy and protectivity of client</v>

a063df5a-124c-428e-bb07-4da24531b175/2115-1 00:13:20.402 --> 00:13:25.950 <v Kendra Folh>data as well as nobody wants to to to all the things nobody wants to have their</v>

a063df5a-124c-428e-bb07-4da24531b175/2115-2 00:13:25.950 --> 00:13:28.030 <v Kendra Folh>information used against them.</v>

a063df5a-124c-428e-bb07-4da24531b175/2126-0 00:13:28.390 --> 00:13:33.718 <v Kendra Folh>So even at the state level with the state is reluctant to have their data</v>

a063df5a-124c-428e-bb07-4da24531b175/2126-1 00:13:33.718 --> 00:13:34.510 <v Kendra Folh>publicized.</v>

a063df5a-124c-428e-bb07-4da24531b175/2151-0 00:13:34.510 --> 00:13:38.655 <v Kendra Folh>I know there was an article that just recently came out with Pro Publica that</v>

a063df5a-124c-428e-bb07-4da24531b175/2151-1 00:13:38.655 --> 00:13:41.950 <v Kendra Folh>there's just this reluctance to be being seen in a bad light.</v>

a063df5a-124c-428e-bb07-4da24531b175/2154-0 00:13:41.950 --> 00:13:43.550 <v Kendra Folh>So everybody's very protective.</v>

a063df5a-124c-428e-bb07-4da24531b175/2173-0 00:13:43.790 --> 00:13:46.955 <v Kendra Folh>Of the information and again adding in PIPA,</v>

a063df5a-124c-428e-bb07-4da24531b175/2173-1 00:13:46.955 --> 00:13:52.230 <v Kendra Folh>well it just adds a little bit more difficulty in exchange of information.</v>

a063df5a-124c-428e-bb07-4da24531b175/2182-0 00:13:52.630 --> 00:13:55.870 <v Jordan Cooper>So there's political barriers, economic barriers.</v>

a063df5a-124c-428e-bb07-4da24531b175/2190-0 00:13:57.370 --> 00:14:00.170 <v Jordan Cooper>To share to getting interoperability across health systems.</v>

a063df5a-124c-428e-bb07-4da24531b175/2214-0 00:14:01.730 --> 00:14:06.594 <v Jordan Cooper>And clinicians are just trying to provide care and it's difficult to exchange data</v>

a063df5a-124c-428e-bb07-4da24531b175/2214-1 00:14:06.594 --> 00:14:10.930 <v Jordan Cooper>in a way that is in the best interest of the patient is what I'm hearing.</v>

a063df5a-124c-428e-bb07-4da24531b175/2215-0 00:14:10.970 --> 00:14:12.530 <v Kendra Folh>Correct. Absolutely.</v>

a063df5a-124c-428e-bb07-4da24531b175/2245-0 00:14:12.690 --> 00:14:16.713 <v Jordan Cooper>Now you mentioned that automating data collection reporting would potentially</v>

a063df5a-124c-428e-bb07-4da24531b175/2245-1 00:14:16.713 --> 00:14:20.065 <v Jordan Cooper>add value and potentially if you could automate data collection,</v>

a063df5a-124c-428e-bb07-4da24531b175/2245-2 00:14:20.065 --> 00:14:22.850 <v Jordan Cooper>maybe you could overcome some of those interoperable.</v>

a063df5a-124c-428e-bb07-4da24531b175/2258-0 00:14:23.200 --> 00:14:26.653 <v Jordan Cooper>Ability challenges. Have you had any experience working on</v>

a063df5a-124c-428e-bb07-4da24531b175/2258-1 00:14:26.653 --> 00:14:29.520 <v Jordan Cooper>the automation of data collection and reporting?</v>

a063df5a-124c-428e-bb07-4da24531b175/2272-0 00:14:30.280 --> 00:14:32.320 <v Kendra Folh>Well, I think we're trying to I think just take</v>

a063df5a-124c-428e-bb07-4da24531b175/2272-1 00:14:32.320 --> 00:14:33.680 <v Kendra Folh>them within my own organization.</v>

a063df5a-124c-428e-bb07-4da24531b175/2307-0 00:14:33.680 --> 00:14:37.937 <v Kendra Folh>That's exactly what we're trying to do when we're looking at how do we automate</v>

a063df5a-124c-428e-bb07-4da24531b175/2307-1 00:14:37.937 --> 00:14:42.088 <v Kendra Folh>data collection and abstraction just for all of our state recording is that's</v>

a063df5a-124c-428e-bb07-4da24531b175/2307-2 00:14:42.088 --> 00:14:45.600 <v Kendra Folh>where we're really trying to do this at a pilot level internally.</v>

a063df5a-124c-428e-bb07-4da24531b175/2321-0 00:14:45.720 --> 00:14:48.840 <v Kendra Folh>How do we utilize the EMR with the claims data to audit?</v>

a063df5a-124c-428e-bb07-4da24531b175/2325-0 00:14:48.840 --> 00:14:50.800 <v Kendra Folh>We're building something we're calling the motherboard.</v>

a063df5a-124c-428e-bb07-4da24531b175/2350-0 00:14:51.240 --> 00:14:55.863 <v Kendra Folh>So how do we take this motherboard feeding automatically and doing some</v>

a063df5a-124c-428e-bb07-4da24531b175/2350-1 00:14:55.863 --> 00:14:58.560 <v Kendra Folh>minimal abstraction to complete the story?</v>

a063df5a-124c-428e-bb07-4da24531b175/2352-0 00:14:58.680 --> 00:15:00.080 <v Kendra Folh>And then we have a final.</v>

a063df5a-124c-428e-bb07-4da24531b175/2367-0 00:15:00.230 --> 00:15:02.444 <v Kendra Folh>Product. But we're also looking at how do we do</v>

a063df5a-124c-428e-bb07-4da24531b175/2367-1 00:15:02.444 --> 00:15:03.550 <v Kendra Folh>that at the state level?</v>

a063df5a-124c-428e-bb07-4da24531b175/2396-0 00:15:03.550 --> 00:15:08.302 <v Kendra Folh>Now California has done that well in this in this population where you like in the</v>

a063df5a-124c-428e-bb07-4da24531b175/2396-1 00:15:08.302 --> 00:15:12.652 <v Kendra Folh>Emrs are automatically reporting. There's some automation particularly with</v>

a063df5a-124c-428e-bb07-4da24531b175/2396-2 00:15:12.652 --> 00:15:15.285 <v Kendra Folh>epic, with the Vermont Oxford Network and the</v>

a063df5a-124c-428e-bb07-4da24531b175/2396-3 00:15:15.285 --> 00:15:16.430 <v Kendra Folh>neonatal population.</v>

a063df5a-124c-428e-bb07-4da24531b175/2421-0 00:15:16.550 --> 00:15:21.301 <v Kendra Folh>So I think there's pockets of it. The biggest opportunity in my perspective</v>

a063df5a-124c-428e-bb07-4da24531b175/2421-1 00:15:21.301 --> 00:15:26.490 <v Kendra Folh>is how do we take what the piloting that has been done and these piloting pilot in</v>

a063df5a-124c-428e-bb07-4da24531b175/2421-2 00:15:26.490 --> 00:15:26.990 <v Kendra Folh>pockets.</v>

a063df5a-124c-428e-bb07-4da24531b175/2426-0 00:15:27.760 --> 00:15:29.280 <v Kendra Folh>And how do we learn from those?</v>

a063df5a-124c-428e-bb07-4da24531b175/2432-0 00:15:29.790 --> 00:15:31.870 <v Kendra Folh>To see how can we fill that up.</v>

a063df5a-124c-428e-bb07-4da24531b175/2435-0 00:15:32.660 --> 00:15:33.020 <v Jordan Cooper>Got it.</v>

a063df5a-124c-428e-bb07-4da24531b175/2479-0 00:15:33.020 --> 00:15:35.248 <v Jordan Cooper>Yeah. The biggest opportunity is to scale</v>

a063df5a-124c-428e-bb07-4da24531b175/2479-1 00:15:35.248 --> 00:15:39.596 <v Jordan Cooper>little instances where it worked and see if you spread it across the organization</v>

a063df5a-124c-428e-bb07-4da24531b175/2479-2 00:15:39.596 --> 00:15:43.255 <v Jordan Cooper>and that's when you might use your position at the chair of the data</v>

a063df5a-124c-428e-bb07-4da24531b175/2479-3 00:15:43.255 --> 00:15:47.339 <v Jordan Cooper>committee at the state level or the difference governance committees at each</v>

a063df5a-124c-428e-bb07-4da24531b175/2479-4 00:15:47.339 --> 00:15:48.770 <v Jordan Cooper>individual healthcare deli.</v>

a063df5a-124c-428e-bb07-4da24531b175/2481-0 00:15:48.860 --> 00:15:49.260 <v Jordan Cooper>System.</v>

a063df5a-124c-428e-bb07-4da24531b175/2496-0 00:15:50.730 --> 00:15:54.208 <v Jordan Cooper>We've covered a lot of different topics, kind of approaching the end of this</v>

a063df5a-124c-428e-bb07-4da24531b175/2496-1 00:15:54.208 --> 00:15:54.930 <v Jordan Cooper>podcast episode.</v>

a063df5a-124c-428e-bb07-4da24531b175/2499-0 00:15:54.930 --> 00:15:56.730 <v Jordan Cooper>We've been moving quickly. We covered.</v>

a063df5a-124c-428e-bb07-4da24531b175/2506-0 00:15:58.970 --> 00:16:01.810 <v Jordan Cooper>Challenges with data being clean.</v>

a063df5a-124c-428e-bb07-4da24531b175/2545-0 00:16:02.200 --> 00:16:06.713 <v Jordan Cooper>Challenges with providers trusting the data challenges of trying to get the data</v>

a063df5a-124c-428e-bb07-4da24531b175/2545-1 00:16:06.713 --> 00:16:10.947 <v Jordan Cooper>in real time so it provides actionable insights and value to clinicians and</v>

a063df5a-124c-428e-bb07-4da24531b175/2545-2 00:16:10.947 --> 00:16:14.680 <v Jordan Cooper>patients when they're interacting with each other in an encounter.</v>

a063df5a-124c-428e-bb07-4da24531b175/2571-0 00:16:14.920 --> 00:16:19.733 <v Jordan Cooper>Challenges with try to reconcile different reports and then challenges and</v>

a063df5a-124c-428e-bb07-4da24531b175/2571-1 00:16:19.733 --> 00:16:24.931 <v Jordan Cooper>interoperability and automation for our listeners who are also experiencing some</v>

a063df5a-124c-428e-bb07-4da24531b175/2571-2 00:16:24.931 --> 00:16:26.920 <v Jordan Cooper>of these same challenges. What?</v>

a063df5a-124c-428e-bb07-4da24531b175/2582-0 00:16:28.210 --> 00:16:31.478 <v Jordan Cooper>Is one word of advice. If there you would potentially even give</v>

a063df5a-124c-428e-bb07-4da24531b175/2582-1 00:16:31.478 --> 00:16:32.090 <v Jordan Cooper>to yourself.</v>

a063df5a-124c-428e-bb07-4da24531b175/2589-0 00:16:32.720 --> 00:16:35.080 <v Jordan Cooper>A year ago or two years ago.</v>

a063df5a-124c-428e-bb07-4da24531b175/2607-0 00:16:35.080 --> 00:16:38.994 <v Jordan Cooper>What do you wish that you knew then that you know now that may help some of our</v>

a063df5a-124c-428e-bb07-4da24531b175/2607-1 00:16:38.994 --> 00:16:42.760 <v Jordan Cooper>listeners as they're beginning to go down the journey that you have been on.</v>

a063df5a-124c-428e-bb07-4da24531b175/2625-0 00:16:43.680 --> 00:16:45.837 <v Kendra Folh>The most important thing I have learned so far,</v>

a063df5a-124c-428e-bb07-4da24531b175/2625-1 00:16:45.837 --> 00:16:49.520 <v Kendra Folh>whether it's in my own organization and at the state level, if alignment is true.</v>

a063df5a-124c-428e-bb07-4da24531b175/2647-0 00:16:50.160 --> 00:16:55.269 <v Kendra Folh>So we've got to line up with Cnf and the external reporting measures and we're</v>

a063df5a-124c-428e-bb07-4da24531b175/2647-1 00:16:55.269 --> 00:16:58.760 <v Kendra Folh>financially impact us. We have to start from the top.</v>

a063df5a-124c-428e-bb07-4da24531b175/2665-0 00:16:58.760 --> 00:17:05.400 <v Kendra Folh>That is how we get the resources and the time to do this work and to get this data</v>

a063df5a-124c-428e-bb07-4da24531b175/2665-1 00:17:05.400 --> 00:17:05.880 <v Kendra Folh>clean.</v>

a063df5a-124c-428e-bb07-4da24531b175/2669-0 00:17:06.200 --> 00:17:08.320 <v Kendra Folh>It's very important. And So what we.</v>

a063df5a-124c-428e-bb07-4da24531b175/2681-0 00:17:09.200 --> 00:17:12.639 <v Kendra Folh>Have found the most valuable in these conversations is where we gonna make</v>

a063df5a-124c-428e-bb07-4da24531b175/2681-1 00:17:12.639 --> 00:17:12.960 <v Kendra Folh>impact.</v>

a063df5a-124c-428e-bb07-4da24531b175/2685-0 00:17:13.870 --> 00:17:15.870 <v Kendra Folh>Start very simple.</v>

a063df5a-124c-428e-bb07-4da24531b175/2688-0 00:17:16.070 --> 00:17:17.470 <v Kendra Folh>What are we trying to do?</v>

a063df5a-124c-428e-bb07-4da24531b175/2693-0 00:17:17.630 --> 00:17:18.750 <v Kendra Folh>What's our objective?</v>

a063df5a-124c-428e-bb07-4da24531b175/2697-0 00:17:18.790 --> 00:17:20.150 <v Kendra Folh>Let's focus on mortality.</v>

a063df5a-124c-428e-bb07-4da24531b175/2705-0 00:17:20.150 --> 00:17:23.150 <v Kendra Folh>Let's focus on morbidity decrease like the state.</v>

a063df5a-124c-428e-bb07-4da24531b175/2711-0 00:17:23.190 --> 00:17:25.030 <v Kendra Folh>How do we get the data to get there?</v>

a063df5a-124c-428e-bb07-4da24531b175/2743-0 00:17:25.030 --> 00:17:29.392 <v Kendra Folh>What does the story we need and what is the financial impact and that was the</v>

a063df5a-124c-428e-bb07-4da24531b175/2743-1 00:17:29.392 --> 00:17:33.977 <v Kendra Folh>biggest piece is when we lined that all the way up with our supplemental funding,</v>

a063df5a-124c-428e-bb07-4da24531b175/2743-2 00:17:33.977 --> 00:17:35.430 <v Kendra Folh>our CMS, our IQR measures.</v>

a063df5a-124c-428e-bb07-4da24531b175/2753-0 00:17:35.590 --> 00:17:39.430 <v Kendra Folh>Well, when you paint that picture, there's a lot of monetary impact here.</v>

a063df5a-124c-428e-bb07-4da24531b175/2758-0 00:17:39.510 --> 00:17:41.030 <v Kendra Folh>Not as well as just the impact of.</v>

a063df5a-124c-428e-bb07-4da24531b175/2766-0 00:17:42.040 --> 00:17:43.320 <v Kendra Folh>The the lives of these moms and these babies.</v>

a063df5a-124c-428e-bb07-4da24531b175/2783-0 00:17:44.230 --> 00:17:50.267 <v Kendra Folh>And that was how we were able to get the resources and the time to do this at a</v>

a063df5a-124c-428e-bb07-4da24531b175/2783-1 00:17:50.267 --> 00:17:51.550 <v Kendra Folh>meaningful level.</v>

a063df5a-124c-428e-bb07-4da24531b175/2836-0 00:17:52.160 --> 00:17:55.429 <v Jordan Cooper>Got this. So if you present a financial argument of</v>

a063df5a-124c-428e-bb07-4da24531b175/2836-1 00:17:55.429 --> 00:17:58.194 <v Jordan Cooper>return on investment to C-Suite executives,</v>

a063df5a-124c-428e-bb07-4da24531b175/2836-2 00:17:58.194 --> 00:18:02.908 <v Jordan Cooper>then there may be an opportunity to allocate resources in time in order to</v>

a063df5a-124c-428e-bb07-4da24531b175/2836-3 00:18:02.908 --> 00:18:07.873 <v Jordan Cooper>invest in these interventions to improve the quality of data where it's needed</v>

a063df5a-124c-428e-bb07-4da24531b175/2836-4 00:18:07.873 --> 00:18:10.010 <v Jordan Cooper>when it's needed, how it's needed.</v>

a063df5a-124c-428e-bb07-4da24531b175/2842-0 00:18:10.690 --> 00:18:12.970 <v Kendra Folh>And not just the speechwrit executive.</v>

a063df5a-124c-428e-bb07-4da24531b175/2847-0 00:18:12.970 --> 00:18:13.730 <v Kendra Folh>Also to our legislature.</v>

a063df5a-124c-428e-bb07-4da24531b175/2851-0 00:18:13.930 --> 00:18:15.730 <v Jordan Cooper>And legislative as well.</v>

a063df5a-124c-428e-bb07-4da24531b175/2881-0 00:18:15.770 --> 00:18:19.151 <v Jordan Cooper>All right. Well, for our listeners, this has been Kendra folh,</v>

a063df5a-124c-428e-bb07-4da24531b175/2881-1 00:18:19.151 --> 00:18:23.284 <v Jordan Cooper>the program director of Women's and children's servicen for Memorial Hermann</v>

a063df5a-124c-428e-bb07-4da24531b175/2881-2 00:18:23.284 --> 00:18:25.967 <v Jordan Cooper>Kendra. I'd like to thank you so much for joining</v>

a063df5a-124c-428e-bb07-4da24531b175/2881-3 00:18:25.967 --> 00:18:26.450 <v Jordan Cooper>us today.</v>

a063df5a-124c-428e-bb07-4da24531b175/2883-0 00:18:26.820 --> 00:18:28.100 <v Kendra Folh>Thank you so much for having me.</v>