f5f294d6-871f-405c-9c09-fa25d142839b/5-0
00:00:03.513 --> 00:00:07.291
Chief Nursing Officer of Memorial Hermann,
The Woodlands. John,

f5f294d6-871f-405c-9c09-fa25d142839b/5-1
00:00:07.291 --> 00:00:09.593
thank you so much for joining us today.

f5f294d6-871f-405c-9c09-fa25d142839b/6-0
00:00:08.873 --> 00:00:10.993
Thank you so much. Glad to be here.

f5f294d6-871f-405c-9c09-fa25d142839b/8-0
00:00:10.593 --> 00:00:14.629
So for those who don't know,
Memorial Hermann Health System is a 19

f5f294d6-871f-405c-9c09-fa25d142839b/8-1
00:00:14.629 --> 00:00:17.596
hospital,
4300 bed health system headquartered in

f5f294d6-871f-405c-9c09-fa25d142839b/8-2
00:00:17.596 --> 00:00:21.097
Houston, TX. John,
I understand that there are a number of

f5f294d6-871f-405c-9c09-fa25d142839b/8-3
00:00:21.097 --> 00:00:25.073
projects that you're working on today
that we'll be able to cover.

f5f294d6-871f-405c-9c09-fa25d142839b/9-0
00:00:25.633 --> 00:00:28.579
These include virtual smart rooms,
workplace violence,

f5f294d6-871f-405c-9c09-fa25d142839b/9-1
00:00:28.579 --> 00:00:32.541
and a community paramedicine program to
reduce heart failure readmission.

f5f294d6-871f-405c-9c09-fa25d142839b/9-2
00:00:32.541 --> 00:00:34.951
So I'd love to get started and just ask
you,

f5f294d6-871f-405c-9c09-fa25d142839b/9-3
00:00:34.951 --> 00:00:39.020
what's the genesis of the virtual smart
room program? But more importantly,

f5f294d6-871f-405c-9c09-fa25d142839b/9-4
00:00:39.020 --> 00:00:42.822
you know, from a data perspective,
what have been some of the greatest

f5f294d6-871f-405c-9c09-fa25d142839b/9-5
00:00:42.822 --> 00:00:45.553
challenges and how have you been
addressing those?

f5f294d6-871f-405c-9c09-fa25d142839b/10-0
00:00:46.153 --> 00:00:50.366
Yeah, it's a great point.
I think that the the genesis is we're

f5f294d6-871f-405c-9c09-fa25d142839b/10-1
00:00:50.366 --> 00:00:55.631
always looking to see how we can improve
the care delivery model and one of the

f5f294d6-871f-405c-9c09-fa25d142839b/10-2
00:00:55.631 --> 00:01:00.304
the drivers is obviously AI.
There's a I in healthcare and we use that

f5f294d6-871f-405c-9c09-fa25d142839b/10-3
00:01:00.304 --> 00:01:00.633
word.

f5f294d6-871f-405c-9c09-fa25d142839b/12-0
00:01:01.273 --> 00:01:06.487
And healthcare somewhat generically
because there's so much of it and it's

f5f294d6-871f-405c-9c09-fa25d142839b/12-1
00:01:06.487 --> 00:01:11.980
coming at such a rapid pace that it's
hard to really articulate what a I is in

f5f294d6-871f-405c-9c09-fa25d142839b/12-2
00:01:11.980 --> 00:01:16.151
the healthcare industry.
One of those avenues is smart room

f5f294d6-871f-405c-9c09-fa25d142839b/12-3
00:01:16.151 --> 00:01:20.113
technology and that's the use of
installing cameras and.

f5f294d6-871f-405c-9c09-fa25d142839b/13-0
00:01:21.073 --> 00:01:25.817
Specific TV's in the rooms for patients
and in our context,

f5f294d6-871f-405c-9c09-fa25d142839b/13-1
00:01:25.817 --> 00:01:32.220
we're going to be using virtual nursing
as the foray into smart room technology,

f5f294d6-871f-405c-9c09-fa25d142839b/13-2
00:01:32.220 --> 00:01:37.833
really focusing on admissions and
discharges and improving throughput.

f5f294d6-871f-405c-9c09-fa25d142839b/14-0
00:01:38.353 --> 00:01:43.352
Really also trying to offload the burden
of the bedside nurse.

f5f294d6-871f-405c-9c09-fa25d142839b/14-1
00:01:43.352 --> 00:01:49.303
One of the strategies is to really
enhance the opportunities for nurses to

f5f294d6-871f-405c-9c09-fa25d142839b/14-2
00:01:49.303 --> 00:01:52.953
practice at the top of their license and
and.

f5f294d6-871f-405c-9c09-fa25d142839b/16-0
00:01:53.033 --> 00:01:57.755
Being able to offload some of the
documentation requirements that exist so

f5f294d6-871f-405c-9c09-fa25d142839b/16-1
00:01:57.755 --> 00:02:02.162
nurses can be at the bedside providing
that care is really important.

f5f294d6-871f-405c-9c09-fa25d142839b/16-2
00:02:02.162 --> 00:02:07.324
We think that there's all kinds of data
points that we'll be able to capture that

f5f294d6-871f-405c-9c09-fa25d142839b/16-3
00:02:07.324 --> 00:02:11.793
we don't currently capture either with
the use of the cameras or with.

f5f294d6-871f-405c-9c09-fa25d142839b/15-0
00:02:08.793 --> 00:02:09.273
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/17-0
00:02:12.353 --> 00:02:15.010
You know,
improving efficiencies around that

f5f294d6-871f-405c-9c09-fa25d142839b/17-1
00:02:15.010 --> 00:02:18.139
documentation.
If you have a virtual nurse doing the

f5f294d6-871f-405c-9c09-fa25d142839b/17-2
00:02:18.139 --> 00:02:21.032
documentation of your admissions and
discharges,

f5f294d6-871f-405c-9c09-fa25d142839b/17-3
00:02:21.032 --> 00:02:25.459
you can you can create efficiencies
because they become content experts at

f5f294d6-871f-405c-9c09-fa25d142839b/17-4
00:02:25.459 --> 00:02:29.710
that. We're going to be, you know,
the the smart technology has lots of

f5f294d6-871f-405c-9c09-fa25d142839b/17-5
00:02:29.710 --> 00:02:31.953
capability. It has room sensors, RTLI.

f5f294d6-871f-405c-9c09-fa25d142839b/18-0
00:02:32.153 --> 00:02:36.023
Class capability.
It can it can track equipment when it

f5f294d6-871f-405c-9c09-fa25d142839b/18-1
00:02:36.023 --> 00:02:40.999
enters the room or exits the room.
It can help with fall prevention and

f5f294d6-871f-405c-9c09-fa25d142839b/18-2
00:02:40.999 --> 00:02:46.044
reminding patients to get back in bed so
that they don't get up and fall

f5f294d6-871f-405c-9c09-fa25d142839b/18-3
00:02:46.044 --> 00:02:49.153
accidentally and we can aggregate that
data.

f5f294d6-871f-405c-9c09-fa25d142839b/19-0
00:02:49.553 --> 00:02:53.647
And find out how often did a patient try
and get out of bed?

f5f294d6-871f-405c-9c09-fa25d142839b/19-1
00:02:53.647 --> 00:02:57.741
How often did the the staff enter the
room or exit the room?

f5f294d6-871f-405c-9c09-fa25d142839b/19-2
00:02:57.741 --> 00:03:01.499
How often was a certain piece of
equipment in the room?

f5f294d6-871f-405c-9c09-fa25d142839b/19-3
00:03:01.499 --> 00:03:07.069
And I think those things are going to be
valuable to us in how we actually deliver

f5f294d6-871f-405c-9c09-fa25d142839b/19-4
00:03:07.069 --> 00:03:07.673
the care.

f5f294d6-871f-405c-9c09-fa25d142839b/20-0
00:03:07.673 --> 00:03:11.488
And I didn't mention the admissions and
discharges.

f5f294d6-871f-405c-9c09-fa25d142839b/20-1
00:03:11.488 --> 00:03:17.504
It also gives us insight and to be able
to determine or measure how efficient are

f5f294d6-871f-405c-9c09-fa25d142839b/20-2
00:03:17.504 --> 00:03:22.713
we at getting those admissions and
discharge documentations completed.

f5f294d6-871f-405c-9c09-fa25d142839b/21-0
00:03:23.273 --> 00:03:28.656
And other things I think we get from that
is we get real-time data such as vital

f5f294d6-871f-405c-9c09-fa25d142839b/21-1
00:03:28.656 --> 00:03:31.579
sign trends, mobility status,
other things,

f5f294d6-871f-405c-9c09-fa25d142839b/21-2
00:03:31.579 --> 00:03:36.696
early warning systems that we can we can
implement and tie to the smart room

f5f294d6-871f-405c-9c09-fa25d142839b/21-3
00:03:36.696 --> 00:03:39.353
technology to enhance nursing workflows.

f5f294d6-871f-405c-9c09-fa25d142839b/22-0
00:03:40.273 --> 00:03:42.982
I appreciate you going into detail there,
John,

f5f294d6-871f-405c-9c09-fa25d142839b/22-1
00:03:42.982 --> 00:03:45.861
on how you're implementing the virtual
smart room.

f5f294d6-871f-405c-9c09-fa25d142839b/22-2
00:03:45.861 --> 00:03:50.488
I want to dive in to a number of topics,
but first we'll start with something you

f5f294d6-871f-405c-9c09-fa25d142839b/22-3
00:03:50.488 --> 00:03:53.028
said,
offload documentation requirements and

f5f294d6-871f-405c-9c09-fa25d142839b/22-4
00:03:53.028 --> 00:03:56.245
allowing nurses to practice at the top of
their license.

f5f294d6-871f-405c-9c09-fa25d142839b/22-5
00:03:56.245 --> 00:03:59.913
I think that's something that many
organizations are looking at.

f5f294d6-871f-405c-9c09-fa25d142839b/24-0
00:04:00.273 --> 00:04:05.502
Not only for increasing revenue capture,
but also for decreasing burnout.

f5f294d6-871f-405c-9c09-fa25d142839b/23-0
00:04:03.913 --> 00:04:04.633
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/24-1
00:04:05.502 --> 00:04:10.801
Can you speak about how this smart room
implementation is offloading these

f5f294d6-871f-405c-9c09-fa25d142839b/24-2
00:04:10.801 --> 00:04:15.818
documentation requirements?
How is there ambient listening technology?

f5f294d6-871f-405c-9c09-fa25d142839b/24-3
00:04:15.818 --> 00:04:17.513
What are you guys doing?

f5f294d6-871f-405c-9c09-fa25d142839b/25-0
00:04:18.233 --> 00:04:21.828
Yeah.
So it's a great point and I'll focus on

f5f294d6-871f-405c-9c09-fa25d142839b/25-1
00:04:21.828 --> 00:04:26.282
burnout and well-being specifically from
a nursing lens.

f5f294d6-871f-405c-9c09-fa25d142839b/25-2
00:04:26.282 --> 00:04:32.221
I think that while every organization
wants to to become more efficient and

f5f294d6-871f-405c-9c09-fa25d142839b/25-3
00:04:32.221 --> 00:04:33.393
cost conscious.

f5f294d6-871f-405c-9c09-fa25d142839b/26-0
00:04:33.833 --> 00:04:39.279
I think that from a clinical perspective,
we always focus on, you know,

f5f294d6-871f-405c-9c09-fa25d142839b/26-1
00:04:39.279 --> 00:04:45.178
if we can keep the turnover down of
nurses and keep them more engaged and and

f5f294d6-871f-405c-9c09-fa25d142839b/26-2
00:04:45.178 --> 00:04:51.304
feeling more valued in their profession,
then that's also a cost saving strategy

f5f294d6-871f-405c-9c09-fa25d142839b/26-3
00:04:51.304 --> 00:04:51.833
and so.

f5f294d6-871f-405c-9c09-fa25d142839b/29-0
00:04:51.993 --> 00:04:56.783
The the benefit is multimodal.
I think that initially we're focusing on

f5f294d6-871f-405c-9c09-fa25d142839b/29-1
00:04:56.783 --> 00:05:02.172
having a virtual nurse who will beam into
the room on the camera and the monitor

f5f294d6-871f-405c-9c09-fa25d142839b/29-2
00:05:02.172 --> 00:05:07.295
and talk to the patient and or the family
member to do that somewhat lengthy

f5f294d6-871f-405c-9c09-fa25d142839b/27-0
00:05:06.393 --> 00:05:06.713
Mm.

f5f294d6-871f-405c-9c09-fa25d142839b/29-3
00:05:07.295 --> 00:05:11.353
admission process that normally takes a
bedside nurse about.

f5f294d6-871f-405c-9c09-fa25d142839b/28-0
00:05:09.113 --> 00:05:09.153
I.

f5f294d6-871f-405c-9c09-fa25d142839b/30-0
00:05:11.833 --> 00:05:16.509
An average of 40 minutes to do an
admission in the chart. And if we can,

f5f294d6-871f-405c-9c09-fa25d142839b/30-1
00:05:16.509 --> 00:05:21.697
if we can designate that to someone else
who actually improves at the efficiency

f5f294d6-871f-405c-9c09-fa25d142839b/30-2
00:05:21.697 --> 00:05:26.309
and doesn't have the constant
interruptions with other call bells going

f5f294d6-871f-405c-9c09-fa25d142839b/30-3
00:05:26.309 --> 00:05:30.665
off or bed alarms going off or
interruptions from providers who are

f5f294d6-871f-405c-9c09-fa25d142839b/30-4
00:05:30.665 --> 00:05:31.753
asking questions.

f5f294d6-871f-405c-9c09-fa25d142839b/32-0
00:05:31.873 --> 00:05:34.977
Phone calls,
then that Virtual nurse has the attention

f5f294d6-871f-405c-9c09-fa25d142839b/32-1
00:05:34.977 --> 00:05:39.492
of the patient and or family member for
the duration of that admission process.

f5f294d6-871f-405c-9c09-fa25d142839b/32-2
00:05:39.492 --> 00:05:43.443
So we can probably get it down to
anywhere between 15 and 20 minutes.

f5f294d6-871f-405c-9c09-fa25d142839b/32-3
00:05:43.443 --> 00:05:47.224
So there's some significant efficiencies
gained from that process.

f5f294d6-871f-405c-9c09-fa25d142839b/32-4
00:05:47.224 --> 00:05:51.513
There will still be other documentation
that has to be done by the bedside.

f5f294d6-871f-405c-9c09-fa25d142839b/31-0
00:05:48.273 --> 00:05:48.393
you.

f5f294d6-871f-405c-9c09-fa25d142839b/33-0
00:05:51.713 --> 00:05:56.456
Nurse as they're providing care and there
will be the addition of ambient

f5f294d6-871f-405c-9c09-fa25d142839b/33-1
00:05:56.456 --> 00:06:00.174
technology added for nursing at some
point in the future.

f5f294d6-871f-405c-9c09-fa25d142839b/33-2
00:06:00.174 --> 00:06:04.019
The smart room technology gives us that
capability as well.

f5f294d6-871f-405c-9c09-fa25d142839b/33-3
00:06:04.019 --> 00:06:08.313
So we're not going to do it from the
beginning, but at some point.

f5f294d6-871f-405c-9c09-fa25d142839b/34-0
00:06:08.393 --> 00:06:12.473
Maybe it's a year from now.
We'll add the ambient listening and and

f5f294d6-871f-405c-9c09-fa25d142839b/34-1
00:06:12.473 --> 00:06:17.453
be able to capture the the documentation
that's essential for the bedside nurse to

f5f294d6-871f-405c-9c09-fa25d142839b/35-0
00:06:17.153 --> 00:06:20.547
So I know that this is Healthy Data
podcast,

f5f294d6-871f-405c-9c09-fa25d142839b/34-2
00:06:17.453 --> 00:06:18.113
do as well.

f5f294d6-871f-405c-9c09-fa25d142839b/35-1
00:06:20.547 --> 00:06:26.732
but we can't forget that there's a human
relationship between the patient and the

f5f294d6-871f-405c-9c09-fa25d142839b/35-2
00:06:26.732 --> 00:06:30.050
provider. I'm wondering, are there,
I mean,

f5f294d6-871f-405c-9c09-fa25d142839b/35-3
00:06:30.050 --> 00:06:36.235
to what extent are in-person interactions
between floor nurses and patients being

f5f294d6-871f-405c-9c09-fa25d142839b/35-4
00:06:36.235 --> 00:06:36.913
replaced?

f5f294d6-871f-405c-9c09-fa25d142839b/36-0
00:06:38.473 --> 00:06:43.219
With the video nurse and how is that
affecting the relationship and the

f5f294d6-871f-405c-9c09-fa25d142839b/36-1
00:06:43.219 --> 00:06:44.273
quality of care?

f5f294d6-871f-405c-9c09-fa25d142839b/38-0
00:06:44.633 --> 00:06:48.179
Yeah, it's a great point. Yeah,
it's a great point.

f5f294d6-871f-405c-9c09-fa25d142839b/37-0
00:06:45.633 --> 00:06:46.433
How are you tracking that?

f5f294d6-871f-405c-9c09-fa25d142839b/38-1
00:06:48.179 --> 00:06:53.770
And I would say that it actually enhances
the time at the bedside while the video

f5f294d6-871f-405c-9c09-fa25d142839b/38-2
00:06:53.770 --> 00:06:58.542
nurse, the virtual nurse is doing that,
that admission and discharge,

f5f294d6-871f-405c-9c09-fa25d142839b/38-3
00:06:58.542 --> 00:07:02.633
the paperwork component of it,
the collection of that data.

f5f294d6-871f-405c-9c09-fa25d142839b/41-0
00:07:02.713 --> 00:07:08.105
To enter into the record is not what is
one of the favorite things that nurses

f5f294d6-871f-405c-9c09-fa25d142839b/41-1
00:07:08.105 --> 00:07:12.064
like to do, right?
They they never did it in the old days

f5f294d6-871f-405c-9c09-fa25d142839b/39-0
00:07:10.393 --> 00:07:10.553
Right.

f5f294d6-871f-405c-9c09-fa25d142839b/41-2
00:07:12.064 --> 00:07:17.593
and and So what they really prefer to do
is to be there to provide that comfort,

f5f294d6-871f-405c-9c09-fa25d142839b/40-0
00:07:12.753 --> 00:07:12.913
8.

f5f294d6-871f-405c-9c09-fa25d142839b/41-3
00:07:17.593 --> 00:07:19.913
the compassionate, connected care.

f5f294d6-871f-405c-9c09-fa25d142839b/43-0
00:07:19.913 --> 00:07:24.991
To patients and families holding hands
while also doing the technical aspects of

f5f294d6-871f-405c-9c09-fa25d142839b/42-0
00:07:22.633 --> 00:07:23.113
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/43-1
00:07:24.991 --> 00:07:28.376
nursing, right?
Making sure that your medications are

f5f294d6-871f-405c-9c09-fa25d142839b/43-2
00:07:28.376 --> 00:07:32.827
infusing correctly and making sure that
patients don't have, you know,

f5f294d6-871f-405c-9c09-fa25d142839b/43-3
00:07:32.827 --> 00:07:36.713
skin breakdown and and all the other
complexities of nursing.

f5f294d6-871f-405c-9c09-fa25d142839b/44-0
00:07:36.713 --> 00:07:41.057
I I think that offloading that from the
bedside nurse gives more time for the

f5f294d6-871f-405c-9c09-fa25d142839b/44-1
00:07:41.057 --> 00:07:45.568
bedside nurse to be in the room and to be
interacting with patients and families

f5f294d6-871f-405c-9c09-fa25d142839b/44-2
00:07:45.568 --> 00:07:49.801
and providing real-time education and
doing some of these other assessments

f5f294d6-871f-405c-9c09-fa25d142839b/44-3
00:07:49.801 --> 00:07:54.033
that are more meaningful and valuable
both to the patient and to the nurse.

f5f294d6-871f-405c-9c09-fa25d142839b/45-0
00:07:54.753 --> 00:07:59.571
Just to understand the impact of FT E's
per bed, prior to the virtual room,

f5f294d6-871f-405c-9c09-fa25d142839b/45-1
00:07:59.571 --> 00:08:02.994
did you have two nurses assigned to the
same patient?

f5f294d6-871f-405c-9c09-fa25d142839b/45-2
00:08:02.994 --> 00:08:07.748
Cause it sounds like there's one nurse
who's ensuring that the infusion is

f5f294d6-871f-405c-9c09-fa25d142839b/45-3
00:08:07.748 --> 00:08:12.755
correct and there aren't decubitus ulcers
underneath the patient and doing the

f5f294d6-871f-405c-9c09-fa25d142839b/45-4
00:08:12.755 --> 00:08:14.593
compassionate care in person.

f5f294d6-871f-405c-9c09-fa25d142839b/46-0
00:08:14.593 --> 00:08:19.555
And there's a second person on the other
end of the video screen at the same time

f5f294d6-871f-405c-9c09-fa25d142839b/46-1
00:08:19.555 --> 00:08:23.366
who's maybe doing the ADT stuff.
So prior to the virtual room,

f5f294d6-871f-405c-9c09-fa25d142839b/46-2
00:08:23.366 --> 00:08:26.089
were there also two nurses or was it on
one?

f5f294d6-871f-405c-9c09-fa25d142839b/46-3
00:08:26.089 --> 00:08:31.171
Like what's the financial impact there of
having potentially two people at the same

f5f294d6-871f-405c-9c09-fa25d142839b/48-0
00:08:30.873 --> 00:08:36.142
Yeah. So it's a great point.
And this really goes to to the thought

f5f294d6-871f-405c-9c09-fa25d142839b/46-4
00:08:31.171 --> 00:08:31.473
time?

f5f294d6-871f-405c-9c09-fa25d142839b/48-1
00:08:36.142 --> 00:08:40.093
process around when you add smart room
technology,

f5f294d6-871f-405c-9c09-fa25d142839b/48-2
00:08:40.093 --> 00:08:45.904
do you just layer it on top of your
existing care delivery model or do you

f5f294d6-871f-405c-9c09-fa25d142839b/47-0
00:08:41.553 --> 00:08:42.633
Mm-hmm.

f5f294d6-871f-405c-9c09-fa25d142839b/48-3
00:08:45.904 --> 00:08:49.313
have to transform your care delivery
model?

f5f294d6-871f-405c-9c09-fa25d142839b/51-0
00:08:49.593 --> 00:08:54.563
To produce a different outcome and we're
going about it a little differently.

f5f294d6-871f-405c-9c09-fa25d142839b/49-0
00:08:50.753 --> 00:08:51.033
Cortana.

f5f294d6-871f-405c-9c09-fa25d142839b/51-1
00:08:54.563 --> 00:08:59.596
We're taking the approach that we're
going to redesign the care delivery model

f5f294d6-871f-405c-9c09-fa25d142839b/51-2
00:08:59.596 --> 00:09:03.993
right now before we go live,
we're operating under a primary nursing

f5f294d6-871f-405c-9c09-fa25d142839b/51-3
00:09:03.993 --> 00:09:07.115
model,
which means it's one RN who takes care of

f5f294d6-871f-405c-9c09-fa25d142839b/50-0
00:09:04.593 --> 00:09:05.233
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/51-4
00:09:07.115 --> 00:09:09.153
four to five patients at a time.

f5f294d6-871f-405c-9c09-fa25d142839b/54-0
00:09:09.353 --> 00:09:13.763
And then we have a patient care tech on
the floor that takes care of up to 12

f5f294d6-871f-405c-9c09-fa25d142839b/54-1
00:09:13.763 --> 00:09:17.098
patients at a time.
So that patient care tech is a support

f5f294d6-871f-405c-9c09-fa25d142839b/54-2
00:09:17.098 --> 00:09:20.377
role for nursing.
They do the vital signs and the bathing

f5f294d6-871f-405c-9c09-fa25d142839b/52-0
00:09:19.113 --> 00:09:19.593
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/54-3
00:09:20.377 --> 00:09:23.599
and the ambulation to the bathroom and
things like that.

f5f294d6-871f-405c-9c09-fa25d142839b/53-0
00:09:23.233 --> 00:09:23.753
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/54-4
00:09:23.599 --> 00:09:27.839
We're going to change that dynamic
because we're going to change it from a

f5f294d6-871f-405c-9c09-fa25d142839b/54-5
00:09:27.839 --> 00:09:28.913
four to one to A63.

f5f294d6-871f-405c-9c09-fa25d142839b/55-0
00:09:29.193 --> 00:09:35.132
Model and that 63 model is 6 patients per
RN with the addition of a virtual nurse

f5f294d6-871f-405c-9c09-fa25d142839b/55-1
00:09:35.132 --> 00:09:40.128
and also decreasing that PCT model from a
12 to one to a six to one.

f5f294d6-871f-405c-9c09-fa25d142839b/55-2
00:09:40.128 --> 00:09:46.066
So essentially you as a nurse will have a
PCT that's assigned with you to be able

f5f294d6-871f-405c-9c09-fa25d142839b/55-3
00:09:46.066 --> 00:09:48.673
to deliver that care at the bedside.

f5f294d6-871f-405c-9c09-fa25d142839b/57-0
00:09:48.873 --> 00:09:53.623
Side and then the virtual nurse will be
the addition to supplement and make sure

f5f294d6-871f-405c-9c09-fa25d142839b/57-1
00:09:53.623 --> 00:09:58.021
that they're doing as much of that
documentation as possible when you talk

f5f294d6-871f-405c-9c09-fa25d142839b/57-2
00:09:58.021 --> 00:10:02.477
about the financial impact on the
organization by changing that four to one

f5f294d6-871f-405c-9c09-fa25d142839b/56-0
00:10:00.233 --> 00:10:00.713
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/57-3
00:10:02.477 --> 00:10:04.353
model and going to a six to one.

f5f294d6-871f-405c-9c09-fa25d142839b/58-0
00:10:04.633 --> 00:10:08.968
And then increasing the tech coverage
with the virtual nurse.

f5f294d6-871f-405c-9c09-fa25d142839b/58-1
00:10:08.968 --> 00:10:13.233
It's not an additional cost,
it's essentially the same cost.

f5f294d6-871f-405c-9c09-fa25d142839b/60-0
00:10:13.033 --> 00:10:16.836
Interesting. All right.
I appreciate you explaining the financial

f5f294d6-871f-405c-9c09-fa25d142839b/60-1
00:10:16.836 --> 00:10:20.870
impact. I'd like to go back to data.
We spoke about aggregating data.

f5f294d6-871f-405c-9c09-fa25d142839b/60-2
00:10:20.870 --> 00:10:23.694
For example,
you had KPIs about patients getting

f5f294d6-871f-405c-9c09-fa25d142839b/60-3
00:10:23.694 --> 00:10:28.246
frequency of patients getting out of bed,
staff entering and exiting the room,

f5f294d6-871f-405c-9c09-fa25d142839b/60-4
00:10:28.246 --> 00:10:29.513
equipment in the room.

f5f294d6-871f-405c-9c09-fa25d142839b/61-0
00:10:29.513 --> 00:10:34.145
What sort of mechanisms are you using,
or what sort of challenges did you

f5f294d6-871f-405c-9c09-fa25d142839b/61-1
00:10:34.145 --> 00:10:38.965
encounter in aggregating, normalizing,
deduplicating this data and making it

f5f294d6-871f-405c-9c09-fa25d142839b/61-2
00:10:38.965 --> 00:10:44.223
available, as you mentioned, in real time?
Have you been able to set up a fire repo

f5f294d6-871f-405c-9c09-fa25d142839b/61-3
00:10:44.223 --> 00:10:45.913
in a commercial cloud VCPU?

f5f294d6-871f-405c-9c09-fa25d142839b/62-0
00:10:46.633 --> 00:10:49.459
You know,
what sort of different data have you been

f5f294d6-871f-405c-9c09-fa25d142839b/62-1
00:10:49.459 --> 00:10:53.262
able to do most of this within the EHR
and enterprise data warehouse?

f5f294d6-871f-405c-9c09-fa25d142839b/62-2
00:10:53.262 --> 00:10:56.033
How are you doing this aggregate data
aggregation?

f5f294d6-871f-405c-9c09-fa25d142839b/65-0
00:10:56.513 --> 00:11:00.423
Well, you know, we've implemented Epic,
which is our, you know,

f5f294d6-871f-405c-9c09-fa25d142839b/65-1
00:11:00.423 --> 00:11:05.127
it's a nationally accepted electronic
health record and we have all kinds of

f5f294d6-871f-405c-9c09-fa25d142839b/63-0
00:11:00.473 --> 00:11:00.993
Yeah.

f5f294d6-871f-405c-9c09-fa25d142839b/64-0
00:11:05.073 --> 00:11:05.233
And.

f5f294d6-871f-405c-9c09-fa25d142839b/65-2
00:11:05.127 --> 00:11:09.831
dashboards and data reports in that
system that are formulated and tabulated

f5f294d6-871f-405c-9c09-fa25d142839b/65-3
00:11:09.831 --> 00:11:13.313
automatically based on on, you know,
how they're set up.

f5f294d6-871f-405c-9c09-fa25d142839b/68-0
00:11:13.513 --> 00:11:20.213
Artisite has some reporting functionality
as well. And then we also have Pilrom,

f5f294d6-871f-405c-9c09-fa25d142839b/68-1
00:11:20.213 --> 00:11:26.333
which is made by Baxter for our bed data.
So I think it's the, as I said,

f5f294d6-871f-405c-9c09-fa25d142839b/68-2
00:11:26.333 --> 00:11:30.633
we haven't implemented our virtual smart
rooms yet.

f5f294d6-871f-405c-9c09-fa25d142839b/67-0
00:11:31.073 --> 00:11:31.553
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/70-0
00:11:31.473 --> 00:11:35.807
But that is part of the process is to
look at how are we going to collate all

f5f294d6-871f-405c-9c09-fa25d142839b/70-1
00:11:35.807 --> 00:11:39.308
of that data into meaningful,
actionable reporting structures,

f5f294d6-871f-405c-9c09-fa25d142839b/70-2
00:11:39.308 --> 00:11:43.086
whether that's dashboards or daily
reports or whatever it might be,

f5f294d6-871f-405c-9c09-fa25d142839b/70-3
00:11:43.086 --> 00:11:47.086
where we can look at it and say, OK,
here's what we see with this data.

f5f294d6-871f-405c-9c09-fa25d142839b/70-4
00:11:47.086 --> 00:11:50.753
What are we going to do next?
How are we going to transform this?

f5f294d6-871f-405c-9c09-fa25d142839b/71-0
00:11:51.193 --> 00:11:54.753
And and are we on the right track or do
we need to regroup?

f5f294d6-871f-405c-9c09-fa25d142839b/69-0
00:11:51.393 --> 00:11:51.873
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/72-0
00:11:55.553 --> 00:11:58.202
Yeah,
sounds like many questions that are

f5f294d6-871f-405c-9c09-fa25d142839b/72-1
00:11:58.202 --> 00:12:02.869
before you right now are the very
questions before many of your peers and

f5f294d6-871f-405c-9c09-fa25d142839b/72-2
00:12:02.869 --> 00:12:06.274
listeners to this podcast episode across
the country.

f5f294d6-871f-405c-9c09-fa25d142839b/72-3
00:12:06.274 --> 00:12:11.193
I'd like to pivot to two of the other
topics that we're going to cover today.

f5f294d6-871f-405c-9c09-fa25d142839b/73-0
00:12:11.593 --> 00:12:16.965
One is a community paramedic program
pilot to reduce readmissions for heart

f5f294d6-871f-405c-9c09-fa25d142839b/73-1
00:12:16.965 --> 00:12:20.569
failure.
Would you please tell me a bit about that

f5f294d6-871f-405c-9c09-fa25d142839b/73-2
00:12:20.569 --> 00:12:20.993
pilot?

f5f294d6-871f-405c-9c09-fa25d142839b/75-0
00:12:21.273 --> 00:12:25.947
Absolutely. You know,
one of the challenges that we have in a

f5f294d6-871f-405c-9c09-fa25d142839b/75-1
00:12:25.947 --> 00:12:31.675
acute care is that our heart failure
patients that are readmitted within 30

f5f294d6-871f-405c-9c09-fa25d142839b/75-2
00:12:31.675 --> 00:12:36.273
days, CMS has, you know,
take back money for those patients.

f5f294d6-871f-405c-9c09-fa25d142839b/74-0
00:12:36.473 --> 00:12:37.153
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/77-0
00:12:36.873 --> 00:12:42.613
The claw back so to speak and so if they
come back within 30 days after discharge

f5f294d6-871f-405c-9c09-fa25d142839b/77-1
00:12:42.613 --> 00:12:45.693
then we get penalized for that
financially.

f5f294d6-871f-405c-9c09-fa25d142839b/76-0
00:12:43.193 --> 00:12:43.833
Mm-hmm.

f5f294d6-871f-405c-9c09-fa25d142839b/77-2
00:12:45.693 --> 00:12:51.573
So the the goal is to how is to think how
do we keep these patients that tend to be

f5f294d6-871f-405c-9c09-fa25d142839b/77-3
00:12:51.573 --> 00:12:53.673
chronically ill patients that.

f5f294d6-871f-405c-9c09-fa25d142839b/79-0
00:12:53.673 --> 00:12:58.177
Can be non-compliant, you know,
for the ones that tend to be readmitted.

f5f294d6-871f-405c-9c09-fa25d142839b/79-1
00:12:58.177 --> 00:13:00.952
How do we manage the care of those
patients?

f5f294d6-871f-405c-9c09-fa25d142839b/78-0
00:12:59.593 --> 00:13:00.313
Mm-hmm.

f5f294d6-871f-405c-9c09-fa25d142839b/79-2
00:13:00.952 --> 00:13:05.887
Because we've tried phone calls and we've
tried all kinds of strategies to keep

f5f294d6-871f-405c-9c09-fa25d142839b/79-3
00:13:05.887 --> 00:13:09.033
them out of the hospital with very little
success.

f5f294d6-871f-405c-9c09-fa25d142839b/80-0
00:13:09.833 --> 00:13:16.001
So we we decided last year that we were
going to pilot a community paramedicine

f5f294d6-871f-405c-9c09-fa25d142839b/80-1
00:13:16.001 --> 00:13:20.550
program and it's hospital-based,
which is somewhat unique.

f5f294d6-871f-405c-9c09-fa25d142839b/80-2
00:13:20.550 --> 00:13:26.101
And maybe to your point about data,
one of the things that we wanted to

f5f294d6-871f-405c-9c09-fa25d142839b/80-3
00:13:26.101 --> 00:13:28.953
insist on was that this was actually.

f5f294d6-871f-405c-9c09-fa25d142839b/84-0
00:13:28.953 --> 00:13:36.096
Captured in our Epic platform.
So we built out the documentation for the

f5f294d6-871f-405c-9c09-fa25d142839b/81-0
00:13:32.833 --> 00:13:32.953
OK.

f5f294d6-871f-405c-9c09-fa25d142839b/84-1
00:13:36.096 --> 00:13:44.217
paramedics to be done in Epic instead of
some EMS agency platform and we feel that

f5f294d6-871f-405c-9c09-fa25d142839b/82-0
00:13:44.113 --> 00:13:44.433
Good.

f5f294d6-871f-405c-9c09-fa25d142839b/84-2
00:13:44.217 --> 00:13:48.033
that's super beneficial for us because.

f5f294d6-871f-405c-9c09-fa25d142839b/83-0
00:13:47.273 --> 00:13:47.993
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/85-0
00:13:48.233 --> 00:13:51.733
We'll be able to tap into the data and
see what we're actually doing.

f5f294d6-871f-405c-9c09-fa25d142839b/85-1
00:13:51.733 --> 00:13:55.833
So when they're when they're doing this,
they're pre-visits and they round in the

f5f294d6-871f-405c-9c09-fa25d142839b/85-2
00:13:55.833 --> 00:13:59.883
hospital and they meet with the patients
before they're discharged and they talk

f5f294d6-871f-405c-9c09-fa25d142839b/85-3
00:13:59.883 --> 00:14:02.783
about what we're going to be doing over
the next 30 days.

f5f294d6-871f-405c-9c09-fa25d142839b/85-4
00:14:02.783 --> 00:14:06.783
We make sure that we help get their meds
to the bedside so that they have their

f5f294d6-871f-405c-9c09-fa25d142839b/85-5
00:14:06.783 --> 00:14:08.033
meds before they go home.

f5f294d6-871f-405c-9c09-fa25d142839b/86-0
00:14:08.513 --> 00:14:13.792
And then that information is captured in
the Compass Rose module in Epic,

f5f294d6-871f-405c-9c09-fa25d142839b/86-1
00:14:13.792 --> 00:14:18.214
which is really for community care and
and population health.

f5f294d6-871f-405c-9c09-fa25d142839b/86-2
00:14:18.214 --> 00:14:22.993
And then when they go out to the house
and they make a home visit.

f5f294d6-871f-405c-9c09-fa25d142839b/87-0
00:14:23.193 --> 00:14:28.175
Which we know is a big driver of keeping
patients out of the hospital.

f5f294d6-871f-405c-9c09-fa25d142839b/87-1
00:14:28.175 --> 00:14:33.928
They document any of their interventions
at the home in the outpatient module and

f5f294d6-871f-405c-9c09-fa25d142839b/87-2
00:14:33.928 --> 00:14:38.629
the benefit of that is that that goes
directly to into the record,

f5f294d6-871f-405c-9c09-fa25d142839b/87-3
00:14:38.629 --> 00:14:40.313
so the primary care and.

f5f294d6-871f-405c-9c09-fa25d142839b/89-0
00:14:40.393 --> 00:14:44.681
The cardiologists all get to see that
information when they're making these

f5f294d6-871f-405c-9c09-fa25d142839b/89-1
00:14:44.681 --> 00:14:48.857
home visits and how is their patient
progressing outside of the hospital?

f5f294d6-871f-405c-9c09-fa25d142839b/88-0
00:14:46.193 --> 00:14:46.433
U OK,

f5f294d6-871f-405c-9c09-fa25d142839b/89-2
00:14:48.857 --> 00:14:53.596
And do they need to be seen sooner in the
clinic or do they need to be brought back

f5f294d6-871f-405c-9c09-fa25d142839b/89-3
00:14:53.596 --> 00:14:56.473
into the hospital or are they maintaining
at home?

f5f294d6-871f-405c-9c09-fa25d142839b/91-0
00:14:56.553 --> 00:15:00.699
Our paramedics are doing great because
they actually have protocols that they

f5f294d6-871f-405c-9c09-fa25d142839b/91-1
00:15:00.699 --> 00:15:03.038
can go out and they can assess the
patient.

f5f294d6-871f-405c-9c09-fa25d142839b/91-2
00:15:03.038 --> 00:15:05.801
And if the patient's not significantly
exacerbated,

f5f294d6-871f-405c-9c09-fa25d142839b/91-3
00:15:05.801 --> 00:15:09.788
if they've gained 4 lbs or whatever,
they can give them some medication to

f5f294d6-871f-405c-9c09-fa25d142839b/91-4
00:15:09.788 --> 00:15:13.774
manage them in the home setting.
So we're preventing them from coming back

f5f294d6-871f-405c-9c09-fa25d142839b/91-5
00:15:13.774 --> 00:15:15.793
into the hospital as much as possible.

f5f294d6-871f-405c-9c09-fa25d142839b/92-0
00:15:16.153 --> 00:15:19.864
The goal is knowing that we're not going
to keep all these patients out of the

f5f294d6-871f-405c-9c09-fa25d142839b/90-0
00:15:16.593 --> 00:15:17.353
Is this the?

f5f294d6-871f-405c-9c09-fa25d142839b/92-1
00:15:19.864 --> 00:15:22.212
hospital,
but if we can at least start addressing

f5f294d6-871f-405c-9c09-fa25d142839b/92-2
00:15:22.212 --> 00:15:25.593
maybe a third of them or a little bit
more, then we're making progress.

f5f294d6-871f-405c-9c09-fa25d142839b/93-0
00:15:25.313 --> 00:15:25.473
OK.

f5f294d6-871f-405c-9c09-fa25d142839b/94-0
00:15:26.193 --> 00:15:29.313
So are you?
I'm not sure how long has this has been

f5f294d6-871f-405c-9c09-fa25d142839b/94-1
00:15:29.313 --> 00:15:33.093
going on and how you're calculating your
return on investment,

f5f294d6-871f-405c-9c09-fa25d142839b/94-2
00:15:33.093 --> 00:15:37.713
but it it seems like this is the kind of
program that may be able to pay for

f5f294d6-871f-405c-9c09-fa25d142839b/94-3
00:15:37.713 --> 00:15:40.653
itself.
If you can offset the penalties from the

f5f294d6-871f-405c-9c09-fa25d142839b/94-4
00:15:40.653 --> 00:15:45.093
public and private payers in your
risk-based shared value delivery model,

f5f294d6-871f-405c-9c09-fa25d142839b/94-5
00:15:45.093 --> 00:15:45.873
then I think.

f5f294d6-871f-405c-9c09-fa25d142839b/95-0
00:15:46.153 --> 00:15:51.686
Those penalties may exceed the costs of
the paramedic pilot program,

f5f294d6-871f-405c-9c09-fa25d142839b/95-1
00:15:51.686 --> 00:15:58.180
therefore leaving the organization in the
black within this particular use case.

f5f294d6-871f-405c-9c09-fa25d142839b/95-2
00:15:58.180 --> 00:16:04.273
Is that has that borne out in with the
over the course of the intervention?

f5f294d6-871f-405c-9c09-fa25d142839b/98-0
00:16:04.473 --> 00:16:09.210
It's a great thought. Unfortunately,
we get paid for the readmissions, right?

f5f294d6-871f-405c-9c09-fa25d142839b/96-0
00:16:09.033 --> 00:16:09.713
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/98-1
00:16:09.210 --> 00:16:12.551
But you know,
if you if you figure you're going to get

f5f294d6-871f-405c-9c09-fa25d142839b/98-2
00:16:12.551 --> 00:16:15.284
paid,
but you're also going to have to pay a

f5f294d6-871f-405c-9c09-fa25d142839b/98-3
00:16:15.284 --> 00:16:18.320
penalty on the back end,
it's not a full payment.

f5f294d6-871f-405c-9c09-fa25d142839b/97-0
00:16:18.113 --> 00:16:18.273
OK.

f5f294d6-871f-405c-9c09-fa25d142839b/98-4
00:16:18.320 --> 00:16:22.025
But at the same time,
one of the things that we built as our

f5f294d6-871f-405c-9c09-fa25d142839b/98-5
00:16:22.025 --> 00:16:24.393
KPI was to decrease the length of stay.

f5f294d6-871f-405c-9c09-fa25d142839b/99-0
00:16:24.393 --> 00:16:29.327
Half a day for the CHF population,
we've been able to do that already and

f5f294d6-871f-405c-9c09-fa25d142839b/99-1
00:16:29.327 --> 00:16:34.460
some of the strategies we've taken to
impact that is that we're working with

f5f294d6-871f-405c-9c09-fa25d142839b/99-2
00:16:34.460 --> 00:16:39.727
our Ed partners to make sure when these
mildly to moderately exacerbated heart

f5f294d6-871f-405c-9c09-fa25d142839b/99-3
00:16:39.727 --> 00:16:41.993
failure patients come into the Ed.

f5f294d6-871f-405c-9c09-fa25d142839b/100-0
00:16:41.993 --> 00:16:44.755
We admit them to the OBS unit for 24
hours,

f5f294d6-871f-405c-9c09-fa25d142839b/100-1
00:16:44.755 --> 00:16:49.776
we tune them up and then we discharge
them and and they know that the paramedic

f5f294d6-871f-405c-9c09-fa25d142839b/100-2
00:16:49.776 --> 00:16:54.797
will go out there the next day to assess
them and maintain a close eye on them.

f5f294d6-871f-405c-9c09-fa25d142839b/100-3
00:16:54.797 --> 00:16:59.379
So by doing that we prevented the
readmission into the hospital which is

f5f294d6-871f-405c-9c09-fa25d142839b/100-4
00:16:59.379 --> 00:17:01.073
definitely contributing to.

f5f294d6-871f-405c-9c09-fa25d142839b/101-0
00:17:02.033 --> 00:17:02.433
Cost savings.

f5f294d6-871f-405c-9c09-fa25d142839b/102-0
00:17:03.513 --> 00:17:06.256
I see.
And are there any challenges with

f5f294d6-871f-405c-9c09-fa25d142839b/102-1
00:17:06.256 --> 00:17:09.734
facilitating?
I guess the paramedics are working on

f5f294d6-871f-405c-9c09-fa25d142839b/102-2
00:17:09.734 --> 00:17:13.881
iPads or some sort of digital input data,
maybe a smartphone.

f5f294d6-871f-405c-9c09-fa25d142839b/102-3
00:17:13.881 --> 00:17:18.229
Are there any challenges?
You said you're leveraging the Compass

f5f294d6-871f-405c-9c09-fa25d142839b/102-4
00:17:18.229 --> 00:17:19.633
Rose module and Epic.

f5f294d6-871f-405c-9c09-fa25d142839b/103-0
00:17:20.153 --> 00:17:26.595
Are there any challenges to incorporating
the data that is obtained in the patients

f5f294d6-871f-405c-9c09-fa25d142839b/103-1
00:17:26.595 --> 00:17:32.806
homes by the paramedics into the EHR and
making it available at the time of care

f5f294d6-871f-405c-9c09-fa25d142839b/103-2
00:17:32.806 --> 00:17:36.793
when a patient returns to the emergency
department?

f5f294d6-871f-405c-9c09-fa25d142839b/104-0
00:17:37.633 --> 00:17:43.358
Yeah. No, there's no issue with it now.
When we first started this back in

f5f294d6-871f-405c-9c09-fa25d142839b/104-1
00:17:43.358 --> 00:17:46.945
September,
there was no documentation in Epic.

f5f294d6-871f-405c-9c09-fa25d142839b/104-2
00:17:46.945 --> 00:17:52.899
So we had to start from scratch and our
Epic partners and our folks at at our

f5f294d6-871f-405c-9c09-fa25d142839b/104-3
00:17:52.899 --> 00:17:53.433
system.

f5f294d6-871f-405c-9c09-fa25d142839b/105-0
00:17:53.793 --> 00:17:58.501
ISD team really worked hard at helping us
create it and and it was interesting

f5f294d6-871f-405c-9c09-fa25d142839b/105-1
00:17:58.501 --> 00:18:02.255
because we talked about which is the best
module to put it in.

f5f294d6-871f-405c-9c09-fa25d142839b/105-2
00:18:02.255 --> 00:18:06.725
Is it Compass Rose population health?
Is it is it the outpatient platform?

f5f294d6-871f-405c-9c09-fa25d142839b/105-3
00:18:06.725 --> 00:18:11.313
We wanted to make sure that we captured
those social determinants of health.

f5f294d6-871f-405c-9c09-fa25d142839b/106-0
00:18:11.433 --> 00:18:16.460
And and the interventions that we were
doing before we actually went out to the

f5f294d6-871f-405c-9c09-fa25d142839b/106-1
00:18:16.460 --> 00:18:21.425
house and the appropriate tools so that
our community partners could see those

f5f294d6-871f-405c-9c09-fa25d142839b/106-2
00:18:21.425 --> 00:18:26.263
kind of interventions and and that's
helped us because now we've got some of

f5f294d6-871f-405c-9c09-fa25d142839b/106-3
00:18:26.263 --> 00:18:30.473
these patients that are tapping into the
community health workers.

f5f294d6-871f-405c-9c09-fa25d142839b/107-0
00:18:30.473 --> 00:18:34.781
They can go out and help them with other
tasks at home to keep them out of the

f5f294d6-871f-405c-9c09-fa25d142839b/107-1
00:18:34.781 --> 00:18:37.562
hospital.
But we also wanted to make sure that the

f5f294d6-871f-405c-9c09-fa25d142839b/107-2
00:18:37.562 --> 00:18:41.051
primary care physician and the
cardiologist could see it on the

f5f294d6-871f-405c-9c09-fa25d142839b/107-3
00:18:41.051 --> 00:18:44.159
outpatient side.
So we we built two different, you know,

f5f294d6-871f-405c-9c09-fa25d142839b/107-4
00:18:44.159 --> 00:18:48.194
structures within Epic to be able to
accommodate that and right now we're

f5f294d6-871f-405c-9c09-fa25d142839b/107-5
00:18:48.194 --> 00:18:49.993
working with our partners at ISD.

f5f294d6-871f-405c-9c09-fa25d142839b/108-0
00:18:50.153 --> 00:18:53.130
To help us build a dashboard for that
purpose.

f5f294d6-871f-405c-9c09-fa25d142839b/108-1
00:18:53.130 --> 00:18:58.385
And so we've we've got I think maybe the
second iteration of that dashboard that's

f5f294d6-871f-405c-9c09-fa25d142839b/108-2
00:18:58.385 --> 00:19:01.995
been completed.
Now we've got more things we're going to

f5f294d6-871f-405c-9c09-fa25d142839b/108-3
00:19:01.995 --> 00:19:05.287
add to it,
but I think it's important for us one of

f5f294d6-871f-405c-9c09-fa25d142839b/108-4
00:19:05.287 --> 00:19:08.073
the things that we recognize to your
point.

f5f294d6-871f-405c-9c09-fa25d142839b/110-0
00:19:08.713 --> 00:19:13.740
We started this and I I would say the
first quarter of data that we got was

f5f294d6-871f-405c-9c09-fa25d142839b/110-1
00:19:13.740 --> 00:19:18.567
just the beginning of February.
And one of the things we noticed is that

f5f294d6-871f-405c-9c09-fa25d142839b/109-0
00:19:16.553 --> 00:19:16.793
Hmm.

f5f294d6-871f-405c-9c09-fa25d142839b/110-2
00:19:18.567 --> 00:19:23.858
we weren't having as significant of an
impact as we wanted to with going out to

f5f294d6-871f-405c-9c09-fa25d142839b/110-3
00:19:23.858 --> 00:19:28.553
the home or with reducing readmission.
So when I went back and looked.

f5f294d6-871f-405c-9c09-fa25d142839b/112-0
00:19:28.553 --> 00:19:32.828
Notice that we had a lot of phone calls
we were making and a few house visits.

f5f294d6-871f-405c-9c09-fa25d142839b/112-1
00:19:32.828 --> 00:19:36.237
When I looked at the patients that
actually had a house visit,

f5f294d6-871f-405c-9c09-fa25d142839b/112-2
00:19:36.237 --> 00:19:40.403
only 6% of those patients came back in.
So we pivoted and we said, OK, well,

f5f294d6-871f-405c-9c09-fa25d142839b/112-3
00:19:40.403 --> 00:19:44.353
we need to stop all the phone calls and
we need to get out to the house.

f5f294d6-871f-405c-9c09-fa25d142839b/111-0
00:19:44.513 --> 00:19:45.273
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/114-0
00:19:44.593 --> 00:19:49.334
So we're curious to see what the new data
is going to show us and the upcoming,

f5f294d6-871f-405c-9c09-fa25d142839b/114-1
00:19:49.334 --> 00:19:53.600
you know, weeks. We anecdotally,
we feel that we're making a difference

f5f294d6-871f-405c-9c09-fa25d142839b/113-0
00:19:53.193 --> 00:19:53.713
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/114-2
00:19:53.600 --> 00:19:57.511
and it's already paying off,
but I want to see what the real data

f5f294d6-871f-405c-9c09-fa25d142839b/114-3
00:19:57.511 --> 00:20:00.473
shows us in that regard with home visit
increase.

f5f294d6-871f-405c-9c09-fa25d142839b/116-0
00:20:01.353 --> 00:20:04.768
Well, John,
we're approaching the end of this podcast

f5f294d6-871f-405c-9c09-fa25d142839b/116-1
00:20:04.768 --> 00:20:09.511
episode and I appreciate your last
comment just there about looking to not

f5f294d6-871f-405c-9c09-fa25d142839b/116-2
00:20:09.511 --> 00:20:14.570
to to create an intervention and then to
evaluate it ex post facto with data in

f5f294d6-871f-405c-9c09-fa25d142839b/116-3
00:20:14.570 --> 00:20:17.479
order to make decisions about how to
proceed.

f5f294d6-871f-405c-9c09-fa25d142839b/116-4
00:20:17.479 --> 00:20:21.273
I like how you pivoted from more calls
and fewer visits to.

f5f294d6-871f-405c-9c09-fa25d142839b/117-0
00:20:21.353 --> 00:20:26.213
More visits and fewer calls based on the
data that you looked at.

f5f294d6-871f-405c-9c09-fa25d142839b/117-1
00:20:26.213 --> 00:20:29.748
As we wrap up this episode,
just to recap here,

f5f294d6-871f-405c-9c09-fa25d142839b/117-2
00:20:29.748 --> 00:20:35.418
we've spoken about the smart rooms,
about the dedicated nurse and offloading

f5f294d6-871f-405c-9c09-fa25d142839b/117-3
00:20:35.418 --> 00:20:40.793
documentation to reduce burnout.
Actually the offsite nurse was able to.

f5f294d6-871f-405c-9c09-fa25d142839b/119-0
00:20:41.113 --> 00:20:47.180
To by reduce by half the amount of time
required for admission or discharge.

f5f294d6-871f-405c-9c09-fa25d142839b/119-1
00:20:47.180 --> 00:20:53.009
We spoke about the community paramedicine
program to reduce heart failure

f5f294d6-871f-405c-9c09-fa25d142839b/119-2
00:20:53.009 --> 00:20:56.633
readmissions.
I'd like to ask you to wrap up.

f5f294d6-871f-405c-9c09-fa25d142839b/120-0
00:20:56.793 --> 00:21:00.142
What would you advise yourself a few
years ago,

f5f294d6-871f-405c-9c09-fa25d142839b/120-1
00:21:00.142 --> 00:21:05.374
before you engaged in either of these
programs, knowing what you know now,

f5f294d6-871f-405c-9c09-fa25d142839b/120-2
00:21:05.374 --> 00:21:09.141
how would you,
what would you say to yourself to make

f5f294d6-871f-405c-9c09-fa25d142839b/120-3
00:21:09.141 --> 00:21:11.233
this process go more smoothly?

f5f294d6-871f-405c-9c09-fa25d142839b/121-0
00:21:11.673 --> 00:21:18.336
I I think as as leaders, as executives,
I think it's imperative that that you're

f5f294d6-871f-405c-9c09-fa25d142839b/121-1
00:21:18.336 --> 00:21:22.860
receptive to change.
I think you have to be, you know,

f5f294d6-871f-405c-9c09-fa25d142839b/121-2
00:21:22.860 --> 00:21:29.193
we never predicted three years ago or
five years ago that we would have a I.

f5f294d6-871f-405c-9c09-fa25d142839b/124-0
00:21:29.233 --> 00:21:33.157
And the the rapid pace at which AI is now
evolving,

f5f294d6-871f-405c-9c09-fa25d142839b/124-1
00:21:33.157 --> 00:21:39.043
I mean daily literally and and I don't
think we ever could have predicted the

f5f294d6-871f-405c-9c09-fa25d142839b/123-0
00:21:35.713 --> 00:21:36.193
Mhm.

f5f294d6-871f-405c-9c09-fa25d142839b/124-2
00:21:39.043 --> 00:21:45.005
kinds of capabilities that we have now or
what's going to come in another five

f5f294d6-871f-405c-9c09-fa25d142839b/124-3
00:21:45.005 --> 00:21:47.193
years and I I would say that.

f5f294d6-871f-405c-9c09-fa25d142839b/125-0
00:21:47.193 --> 00:21:51.521
It's imperative that as executives,
even old timers like me,

f5f294d6-871f-405c-9c09-fa25d142839b/125-1
00:21:51.521 --> 00:21:57.125
that we recognize that times are changing
and we shouldn't be fearful of those

f5f294d6-871f-405c-9c09-fa25d142839b/125-2
00:21:57.125 --> 00:22:00.602
changes.
We need to use those changes as much as

f5f294d6-871f-405c-9c09-fa25d142839b/125-3
00:22:00.602 --> 00:22:02.233
we can to improve care.

f5f294d6-871f-405c-9c09-fa25d142839b/126-0
00:22:02.313 --> 00:22:06.820
In the healthcare market to make sure
that we're giving the best care we

f5f294d6-871f-405c-9c09-fa25d142839b/126-1
00:22:06.820 --> 00:22:11.511
possibly can and to improve outcomes and
if you embrace the changes and you

f5f294d6-871f-405c-9c09-fa25d142839b/126-2
00:22:11.511 --> 00:22:15.832
embrace the technology and the
opportunities that exist and certainly

f5f294d6-871f-405c-9c09-fa25d142839b/126-3
00:22:15.832 --> 00:22:17.313
using the data to drive.

f5f294d6-871f-405c-9c09-fa25d142839b/128-0
00:22:17.753 --> 00:22:21.715
Whether you're actually making the
difference you anticipate you're making,

f5f294d6-871f-405c-9c09-fa25d142839b/127-0
00:22:21.713 --> 00:22:21.953
Hmm.

f5f294d6-871f-405c-9c09-fa25d142839b/128-1
00:22:21.715 --> 00:22:24.113
I think you'll be,
you'll be well positioned.

f5f294d6-871f-405c-9c09-fa25d142839b/129-0
00:22:27.513 --> 00:22:29.673
Absolutely. Thank you so much.

f5f294d6-871f-405c-9c09-fa25d142839b/130-0
00:22:37.633 --> 00:22:38.153
Thank you.