3ce2362b-63af-4cc8-982c-935076f3ff7f/6-0
00:00:03.416 --> 00:00:06.127
with Stephen Estime.
He's the Associate Professor of

3ce2362b-63af-4cc8-982c-935076f3ff7f/6-1
00:00:06.127 --> 00:00:09.964
Anesthesia and Critical Care at the
University of Chicago Medicine and the

3ce2362b-63af-4cc8-982c-935076f3ff7f/6-2
00:00:09.964 --> 00:00:13.954
Associate Chair of Strategy and Finance
in the University of Chicago Medicine

3ce2362b-63af-4cc8-982c-935076f3ff7f/6-3
00:00:13.954 --> 00:00:16.870
Department of Anesthesiology and Critical
Care. Stephen,

3ce2362b-63af-4cc8-982c-935076f3ff7f/6-4
00:00:16.870 --> 00:00:18.456
thank you for joining us today.

3ce2362b-63af-4cc8-982c-935076f3ff7f/5-0
00:00:18.816 --> 00:00:20.136
Thank you, Jordan, for having me.

3ce2362b-63af-4cc8-982c-935076f3ff7f/8-0
00:00:20.696 --> 00:00:24.276
As background,
the University of Chicago Medicine Health

3ce2362b-63af-4cc8-982c-935076f3ff7f/8-1
00:00:24.276 --> 00:00:27.604
System is headquartered in Chicago,
Illinois, has 2,

3ce2362b-63af-4cc8-982c-935076f3ff7f/8-2
00:00:27.604 --> 00:00:32.126
000 beds across 10 hospitals serviced by
3,000 providers. Now, Stephen,

3ce2362b-63af-4cc8-982c-935076f3ff7f/8-3
00:00:32.126 --> 00:00:37.088
today we're going to be speaking about
using data to shape staff behaviors and

3ce2362b-63af-4cc8-982c-935076f3ff7f/8-4
00:00:37.088 --> 00:00:40.416
design incentives across a complex work
environment.

3ce2362b-63af-4cc8-982c-935076f3ff7f/9-0
00:00:40.856 --> 00:00:43.176
In particular,
I understand you've been using

3ce2362b-63af-4cc8-982c-935076f3ff7f/9-1
00:00:43.176 --> 00:00:47.312
operational data to improve staffing and
incentives in the anesthesia department.

3ce2362b-63af-4cc8-982c-935076f3ff7f/9-2
00:00:47.312 --> 00:00:51.498
Can you please elaborate on the genesis
of this project, what the intervention is,

3ce2362b-63af-4cc8-982c-935076f3ff7f/9-3
00:00:51.498 --> 00:00:52.456
and how it's going?

3ce2362b-63af-4cc8-982c-935076f3ff7f/10-0
00:00:53.576 --> 00:00:56.533
Yeah, for sure.
So I think it's helpful to sort of

3ce2362b-63af-4cc8-982c-935076f3ff7f/10-1
00:00:56.533 --> 00:01:01.114
provide a little bit of a groundwork in
what's happening. So as you mentioned,

3ce2362b-63af-4cc8-982c-935076f3ff7f/10-2
00:01:01.114 --> 00:01:05.346
I'm a clinical anesthesiologist.
I also work in the intensive care units

3ce2362b-63af-4cc8-982c-935076f3ff7f/10-3
00:01:05.346 --> 00:01:09.695
at the University of Chicago. I,
another hat, I sort of wear several hats,

3ce2362b-63af-4cc8-982c-935076f3ff7f/10-4
00:01:09.695 --> 00:01:14.391
but as a day-to-day clinical operations
leader in the operating room, I do that,

3ce2362b-63af-4cc8-982c-935076f3ff7f/10-5
00:01:14.391 --> 00:01:16.536
I do that several times a month, just

3ce2362b-63af-4cc8-982c-935076f3ff7f/11-0
00:01:16.856 --> 00:01:19.975
sort of coordinating cases, scheduling,
you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/11-1
00:01:19.975 --> 00:01:23.280
resources and staff to cover said
operational cases.

3ce2362b-63af-4cc8-982c-935076f3ff7f/11-2
00:01:23.280 --> 00:01:27.334
And then on the back end,
thinking about high level strategy and

3ce2362b-63af-4cc8-982c-935076f3ff7f/11-3
00:01:27.334 --> 00:01:30.702
finance with respect to the Department of
Anesthesia,

3ce2362b-63af-4cc8-982c-935076f3ff7f/11-4
00:01:30.702 --> 00:01:35.629
how we're staffing things and trying to
maintain as best as we can operational

3ce2362b-63af-4cc8-982c-935076f3ff7f/11-5
00:01:35.629 --> 00:01:35.816
and

3ce2362b-63af-4cc8-982c-935076f3ff7f/13-0
00:01:36.056 --> 00:01:40.291
and fiscal sustainability and
responsibility. So, you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/13-1
00:01:40.291 --> 00:01:46.080
the one interesting part with the field
of anesthesia is that it's sort of unlike

3ce2362b-63af-4cc8-982c-935076f3ff7f/13-2
00:01:46.080 --> 00:01:50.597
other fields in that a lot of our
workflow is captured in time.

3ce2362b-63af-4cc8-982c-935076f3ff7f/13-3
00:01:50.597 --> 00:01:54.268
There are other,
if you're a surgeon or if you're a

3ce2362b-63af-4cc8-982c-935076f3ff7f/13-4
00:01:54.268 --> 00:01:55.256
proceduralist,

3ce2362b-63af-4cc8-982c-935076f3ff7f/14-0
00:01:55.496 --> 00:02:00.649
a lot of their workflow and the way that
they are compensated is going to be based

3ce2362b-63af-4cc8-982c-935076f3ff7f/14-1
00:02:00.649 --> 00:02:03.877
on how many cases they do. Their RBUs,
if you will.

3ce2362b-63af-4cc8-982c-935076f3ff7f/14-2
00:02:03.877 --> 00:02:08.595
If you're in a medicine-based specialty,
a lot of that is determined by the

3ce2362b-63af-4cc8-982c-935076f3ff7f/14-3
00:02:08.595 --> 00:02:11.698
complexity of patients that you see,
the medical,

3ce2362b-63af-4cc8-982c-935076f3ff7f/14-4
00:02:11.698 --> 00:02:14.616
the complexity of the medical decision
making,

3ce2362b-63af-4cc8-982c-935076f3ff7f/15-0
00:02:14.736 --> 00:02:19.893
that you're doing for said patients and
basically the volume of patients that are

3ce2362b-63af-4cc8-982c-935076f3ff7f/15-1
00:02:19.893 --> 00:02:22.723
coming across your, you know,
your workflow.

3ce2362b-63af-4cc8-982c-935076f3ff7f/15-2
00:02:22.723 --> 00:02:27.817
So the fact that anesthesia is time-based,
meaning that, you know, we basically,

3ce2362b-63af-4cc8-982c-935076f3ff7f/15-3
00:02:27.817 --> 00:02:33.100
we bill and many times we're incentivized
based on how long is the anesthesia team,

3ce2362b-63af-4cc8-982c-935076f3ff7f/15-4
00:02:33.100 --> 00:02:36.936
the anesthesiologist and by extension the
nurse anesthetist,

3ce2362b-63af-4cc8-982c-935076f3ff7f/16-0
00:02:37.336 --> 00:02:41.828
in the room during a surgical procedure,
start to finish.

3ce2362b-63af-4cc8-982c-935076f3ff7f/16-1
00:02:41.828 --> 00:02:47.094
That's sort of how the anesthesia is sort
of done. What this means,

3ce2362b-63af-4cc8-982c-935076f3ff7f/16-2
00:02:47.094 --> 00:02:53.289
and sort of the problem that I wanted to
highlight and talk about is, you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/16-3
00:02:53.289 --> 00:02:56.696
trying to account for the work that's
done.

3ce2362b-63af-4cc8-982c-935076f3ff7f/17-0
00:02:56.856 --> 00:03:01.936
by your frontline clinicians. You know,
we in the past were using,

3ce2362b-63af-4cc8-982c-935076f3ff7f/17-1
00:03:01.936 --> 00:03:05.576
I'll call it a legacy system where we use
Epic,

3ce2362b-63af-4cc8-982c-935076f3ff7f/17-2
00:03:05.576 --> 00:03:11.642
which is our electronic health record.
And we were basically reverse extracting

3ce2362b-63af-4cc8-982c-935076f3ff7f/17-3
00:03:11.642 --> 00:03:15.736
data for surgical cases that were being
complete. And

3ce2362b-63af-4cc8-982c-935076f3ff7f/18-0
00:03:15.896 --> 00:03:21.965
looking then to try to identify how much
time our clinicians were spending in the

3ce2362b-63af-4cc8-982c-935076f3ff7f/18-1
00:03:21.965 --> 00:03:27.591
hospital and by extension, you know,
how much we should be compensating our

3ce2362b-63af-4cc8-982c-935076f3ff7f/18-2
00:03:27.591 --> 00:03:32.994
faculty based on those numbers.
That led to a number of different issues

3ce2362b-63af-4cc8-982c-935076f3ff7f/18-3
00:03:32.994 --> 00:03:34.696
because one of which is

3ce2362b-63af-4cc8-982c-935076f3ff7f/19-0
00:03:34.776 --> 00:03:37.916
you know,
our time as anesthesiologists aren't

3ce2362b-63af-4cc8-982c-935076f3ff7f/19-1
00:03:37.916 --> 00:03:41.791
always cleanly defined by time done in an
operating room,

3ce2362b-63af-4cc8-982c-935076f3ff7f/19-2
00:03:41.791 --> 00:03:47.202
which means that things like emergencies,
so if you're responding to a trauma in

3ce2362b-63af-4cc8-982c-935076f3ff7f/19-3
00:03:47.202 --> 00:03:50.676
the trauma bay,
if you're responding to emergencies

3ce2362b-63af-4cc8-982c-935076f3ff7f/19-4
00:03:50.676 --> 00:03:53.816
throughout the hospital,
if there was waits or

3ce2362b-63af-4cc8-982c-935076f3ff7f/20-0
00:03:53.936 --> 00:03:57.610
delays either between cases or to start
cases,

3ce2362b-63af-4cc8-982c-935076f3ff7f/20-1
00:03:57.610 --> 00:04:03.316
that's time that we're in the hospital,
but that's not time that's being

3ce2362b-63af-4cc8-982c-935076f3ff7f/20-2
00:04:03.316 --> 00:04:07.459
recognized.
And so what that led to was us adapting,

3ce2362b-63af-4cc8-982c-935076f3ff7f/20-3
00:04:07.459 --> 00:04:12.696
well actually what that led to then was
multiple systems trying to

3ce2362b-63af-4cc8-982c-935076f3ff7f/21-0
00:04:12.736 --> 00:04:15.848
capture this time outside of the
operating room.

3ce2362b-63af-4cc8-982c-935076f3ff7f/21-1
00:04:15.848 --> 00:04:20.612
And it sort of kind of blew up into
having three to four different systems

3ce2362b-63af-4cc8-982c-935076f3ff7f/21-2
00:04:20.612 --> 00:04:25.883
trying to track and account for our time,
which led to a pretty heavy lift from an

3ce2362b-63af-4cc8-982c-935076f3ff7f/21-3
00:04:25.883 --> 00:04:30.456
IT perspective and from a data analytics
support personnel perspective.

3ce2362b-63af-4cc8-982c-935076f3ff7f/22-0
00:04:31.616 --> 00:04:36.355
And that's difficult in an environment
like this. And so instead,

3ce2362b-63af-4cc8-982c-935076f3ff7f/22-1
00:04:36.355 --> 00:04:42.314
we decided to transition and implement a
more clinician-facing time and attendance

3ce2362b-63af-4cc8-982c-935076f3ff7f/22-2
00:04:42.314 --> 00:04:47.914
platform to better make some of this
information user-generated and hopefully

3ce2362b-63af-4cc8-982c-935076f3ff7f/22-3
00:04:47.914 --> 00:04:51.576
increase some reliability in the data
that we were

3ce2362b-63af-4cc8-982c-935076f3ff7f/23-0
00:04:51.696 --> 00:04:55.096
Capturing, and then,
and then also you making decisions on.

3ce2362b-63af-4cc8-982c-935076f3ff7f/24-0
00:04:55.936 --> 00:04:59.491
What kind of,
you said you're trying to create

3ce2362b-63af-4cc8-982c-935076f3ff7f/24-1
00:04:59.491 --> 00:05:04.105
user-generated data.
What kind of platform did you implement

3ce2362b-63af-4cc8-982c-935076f3ff7f/24-2
00:05:04.105 --> 00:05:07.736
in order to enable that user-generated
content?

3ce2362b-63af-4cc8-982c-935076f3ff7f/25-0
00:05:08.456 --> 00:05:11.673
Yeah, you know,
it's a third-party platform that we're

3ce2362b-63af-4cc8-982c-935076f3ff7f/25-1
00:05:11.673 --> 00:05:14.421
using,
so it's not something that's homegrown.

3ce2362b-63af-4cc8-982c-935076f3ff7f/25-2
00:05:14.421 --> 00:05:17.462
It's not something that, you know,
that we created.

3ce2362b-63af-4cc8-982c-935076f3ff7f/25-3
00:05:17.462 --> 00:05:21.673
It was basically a scheduling software
that we've been using for years,

3ce2362b-63af-4cc8-982c-935076f3ff7f/25-4
00:05:21.673 --> 00:05:26.234
although the scheduling platform had
recently released a time and attendance,

3ce2362b-63af-4cc8-982c-935076f3ff7f/25-5
00:05:26.234 --> 00:05:26.936
meaning that

3ce2362b-63af-4cc8-982c-935076f3ff7f/26-0
00:05:27.256 --> 00:05:30.784
clinicians could sort of self-document
their own time,

3ce2362b-63af-4cc8-982c-935076f3ff7f/26-1
00:05:30.784 --> 00:05:36.044
meaning that they could sort of own that.
And so when they were doing work for us

3ce2362b-63af-4cc8-982c-935076f3ff7f/26-2
00:05:36.044 --> 00:05:39.765
with anesthesia,
that work that's particularly costly are

3ce2362b-63af-4cc8-982c-935076f3ff7f/26-3
00:05:39.765 --> 00:05:44.063
our night and weekend work.
And so when clinicians were doing said

3ce2362b-63af-4cc8-982c-935076f3ff7f/26-4
00:05:44.063 --> 00:05:47.976
night and weekend work,
they could capture that time. It's a

3ce2362b-63af-4cc8-982c-935076f3ff7f/27-0
00:05:48.536 --> 00:05:51.062
You know,
it's a platform that you can also use

3ce2362b-63af-4cc8-982c-935076f3ff7f/27-1
00:05:51.062 --> 00:05:54.535
both desktop and on a phone,
and you can capture the work when it

3ce2362b-63af-4cc8-982c-935076f3ff7f/27-2
00:05:54.535 --> 00:05:58.797
starts and then the work that it that
when it finishes. And it's user generated,

3ce2362b-63af-4cc8-982c-935076f3ff7f/27-3
00:05:58.797 --> 00:06:01.428
meaning it's coming directly from our
clinicians.

3ce2362b-63af-4cc8-982c-935076f3ff7f/27-4
00:06:01.428 --> 00:06:04.164
It's not something that we're extracting,
you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/27-5
00:06:04.164 --> 00:06:07.216
sort of in the background and then trying
to extrapolate.

3ce2362b-63af-4cc8-982c-935076f3ff7f/28-0
00:06:07.296 --> 00:06:13.192
the work that our clinicians are doing.
And so I think it does a couple of things.

3ce2362b-63af-4cc8-982c-935076f3ff7f/28-1
00:06:13.192 --> 00:06:18.946
It creates a little bit more integrity in
the data because it's the work that is

3ce2362b-63af-4cc8-982c-935076f3ff7f/28-2
00:06:18.946 --> 00:06:22.569
physically being done by our frontline
clinicians.

3ce2362b-63af-4cc8-982c-935076f3ff7f/28-3
00:06:22.569 --> 00:06:27.896
And it also helped us because we were
able to whittle it down to sort of 1

3ce2362b-63af-4cc8-982c-935076f3ff7f/30-0
00:06:28.296 --> 00:06:32.838
source of truth, if you will.
One data source where we could then take

3ce2362b-63af-4cc8-982c-935076f3ff7f/30-1
00:06:32.838 --> 00:06:37.700
that data and actually start looking at
things and looking at trends versus

3ce2362b-63af-4cc8-982c-935076f3ff7f/30-2
00:06:37.700 --> 00:06:41.730
trying to parse data out from three to
four disparate systems.

3ce2362b-63af-4cc8-982c-935076f3ff7f/30-3
00:06:41.730 --> 00:06:46.656
So it sort of helps to make things a
little bit smoother and more efficient.

3ce2362b-63af-4cc8-982c-935076f3ff7f/29-0
00:06:43.016 --> 00:06:43.296
Sure.

3ce2362b-63af-4cc8-982c-935076f3ff7f/32-0
00:06:47.336 --> 00:06:51.974
So what are the data sources for this
staffing, scheduling,

3ce2362b-63af-4cc8-982c-935076f3ff7f/31-0
00:06:48.176 --> 00:06:48.296
Yeah.

3ce2362b-63af-4cc8-982c-935076f3ff7f/32-1
00:06:51.974 --> 00:06:54.216
user-generated data platform?

3ce2362b-63af-4cc8-982c-935076f3ff7f/33-0
00:06:55.416 --> 00:06:59.473
Is it just, I mean,
to what extent is it integrated with Epic

3ce2362b-63af-4cc8-982c-935076f3ff7f/33-1
00:06:59.473 --> 00:07:04.641
and does it have any other external data
sources other than kind of clinicians

3ce2362b-63af-4cc8-982c-935076f3ff7f/33-2
00:07:04.641 --> 00:07:09.614
going directly into this third party
staffing system and entering when they

3ce2362b-63af-4cc8-982c-935076f3ff7f/33-3
00:07:09.614 --> 00:07:12.296
are in the hospital and when they aren't?

3ce2362b-63af-4cc8-982c-935076f3ff7f/36-0
00:07:13.016 --> 00:07:16.003
You know,
there are other there are other sort of

3ce2362b-63af-4cc8-982c-935076f3ff7f/36-1
00:07:16.003 --> 00:07:19.050
functionalities that this that this
platform does,

3ce2362b-63af-4cc8-982c-935076f3ff7f/34-0
00:07:16.616 --> 00:07:17.096
Mhm.

3ce2362b-63af-4cc8-982c-935076f3ff7f/36-2
00:07:19.050 --> 00:07:23.651
and so there is some data integration
between Epic and between this platform

3ce2362b-63af-4cc8-982c-935076f3ff7f/36-3
00:07:23.651 --> 00:07:26.757
where there's sort of bi-directional
communication.

3ce2362b-63af-4cc8-982c-935076f3ff7f/36-4
00:07:26.757 --> 00:07:31.238
Those are other sorts of use cases that
there will be some back and forth,

3ce2362b-63af-4cc8-982c-935076f3ff7f/36-5
00:07:31.238 --> 00:07:34.345
you know,
but but I think specifically for the time

3ce2362b-63af-4cc8-982c-935076f3ff7f/36-6
00:07:34.345 --> 00:07:36.376
and attendance of better capturing

3ce2362b-63af-4cc8-982c-935076f3ff7f/35-0
00:07:34.936 --> 00:07:35.496
Mhm.

3ce2362b-63af-4cc8-982c-935076f3ff7f/37-0
00:07:37.256 --> 00:07:42.001
user generated time, this one,
there isn't really bidirectionality. And,

3ce2362b-63af-4cc8-982c-935076f3ff7f/37-1
00:07:42.001 --> 00:07:45.251
you know,
part of that was intentional by design,

3ce2362b-63af-4cc8-982c-935076f3ff7f/37-2
00:07:45.251 --> 00:07:49.606
because I think that, again,
the data that we're getting from Epic

3ce2362b-63af-4cc8-982c-935076f3ff7f/37-3
00:07:49.606 --> 00:07:55.131
with respect to this particular issue was
incomplete. And I think in many instances,

3ce2362b-63af-4cc8-982c-935076f3ff7f/37-4
00:07:55.131 --> 00:07:57.016
probably caused a little more

3ce2362b-63af-4cc8-982c-935076f3ff7f/38-0
00:07:57.256 --> 00:08:01.561
confusion and it was probably less
helpful than just getting this stuff

3ce2362b-63af-4cc8-982c-935076f3ff7f/38-1
00:08:01.561 --> 00:08:02.936
directly from the user.

3ce2362b-63af-4cc8-982c-935076f3ff7f/39-0
00:08:03.416 --> 00:08:06.616
So how is a user-generated data validated?

3ce2362b-63af-4cc8-982c-935076f3ff7f/41-0
00:08:08.136 --> 00:08:12.612
I mean, we basically do audits.
So we'll take a look and we'll do audits

3ce2362b-63af-4cc8-982c-935076f3ff7f/41-1
00:08:12.612 --> 00:08:16.413
on the times. You know,
it's helpful because I am a frontline

3ce2362b-63af-4cc8-982c-935076f3ff7f/41-2
00:08:16.413 --> 00:08:21.440
clinician and so I sort of understand the
work patterns and I can actually see it

3ce2362b-63af-4cc8-982c-935076f3ff7f/40-0
00:08:16.536 --> 00:08:16.736
Yeah.

3ce2362b-63af-4cc8-982c-935076f3ff7f/41-3
00:08:21.440 --> 00:08:24.383
in Epic as well too,
how many cases were going,

3ce2362b-63af-4cc8-982c-935076f3ff7f/41-4
00:08:24.383 --> 00:08:26.896
what was happening on any particular day.

3ce2362b-63af-4cc8-982c-935076f3ff7f/42-0
00:08:27.176 --> 00:08:32.635
And it's pretty easy to just sort of take
a look at a day by day and a month by

3ce2362b-63af-4cc8-982c-935076f3ff7f/42-1
00:08:32.635 --> 00:08:37.957
month basis to sort of scan and look
where these things accurately placed in.

3ce2362b-63af-4cc8-982c-935076f3ff7f/42-2
00:08:37.957 --> 00:08:43.075
There's also a free text option that's in
this platform so that if there's

3ce2362b-63af-4cc8-982c-935076f3ff7f/42-3
00:08:43.075 --> 00:08:45.736
discrepancies or if there's areas where

3ce2362b-63af-4cc8-982c-935076f3ff7f/43-0
00:08:46.936 --> 00:08:51.420
things don't completely line up,
then that can be an explanation that the

3ce2362b-63af-4cc8-982c-935076f3ff7f/43-1
00:08:51.420 --> 00:08:54.752
user can create.
And so it makes that process a little

3ce2362b-63af-4cc8-982c-935076f3ff7f/43-2
00:08:54.752 --> 00:08:55.176
easier.

3ce2362b-63af-4cc8-982c-935076f3ff7f/44-0
00:08:55.816 --> 00:09:01.339
What percentage of cases are subject to
this spot checking manual auditing

3ce2362b-63af-4cc8-982c-935076f3ff7f/44-1
00:09:01.339 --> 00:09:02.296
against Epic?

3ce2362b-63af-4cc8-982c-935076f3ff7f/46-0
00:09:03.936 --> 00:09:07.668
I don't know if I can,
I don't know if I can peg down a specific

3ce2362b-63af-4cc8-982c-935076f3ff7f/46-1
00:09:07.668 --> 00:09:10.883
number, but I would say that, you know,
me and my team,

3ce2362b-63af-4cc8-982c-935076f3ff7f/46-2
00:09:10.883 --> 00:09:14.500
we will review every single every single
data point. You know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/45-0
00:09:12.616 --> 00:09:13.176
Mhm.

3ce2362b-63af-4cc8-982c-935076f3ff7f/46-3
00:09:14.500 --> 00:09:19.208
so we'll take a look at a high level and
just and and and look through what those

3ce2362b-63af-4cc8-982c-935076f3ff7f/46-4
00:09:19.208 --> 00:09:21.735
time punches are,
how the hours were spent,

3ce2362b-63af-4cc8-982c-935076f3ff7f/46-5
00:09:21.735 --> 00:09:25.696
and really we sort of flag areas where
there seems to be an outlier.

3ce2362b-63af-4cc8-982c-935076f3ff7f/48-0
00:09:26.016 --> 00:09:30.708
And if there seems to be an outlier where
there seems to be a time where, wow,

3ce2362b-63af-4cc8-982c-935076f3ff7f/48-1
00:09:30.708 --> 00:09:35.638
this certain clinician spent significant
amounts of time either in this case or in

3ce2362b-63af-4cc8-982c-935076f3ff7f/48-2
00:09:35.638 --> 00:09:38.608
the hospital this day,
we can dig more into that.

3ce2362b-63af-4cc8-982c-935076f3ff7f/48-3
00:09:38.608 --> 00:09:41.518
So we're really flagging for outliers,
you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/47-0
00:09:41.376 --> 00:09:41.856
Mhm.

3ce2362b-63af-4cc8-982c-935076f3ff7f/48-4
00:09:41.518 --> 00:09:43.656
when we're doing these audit checks.

3ce2362b-63af-4cc8-982c-935076f3ff7f/49-0
00:09:44.056 --> 00:09:46.662
It sounds like when you're flagging for
outliers,

3ce2362b-63af-4cc8-982c-935076f3ff7f/49-1
00:09:46.662 --> 00:09:49.685
you're trying to identify trends or as
you say, outliers,

3ce2362b-63af-4cc8-982c-935076f3ff7f/49-2
00:09:49.685 --> 00:09:52.708
that seems like a perfect opportunity to
leverage Gen AI.

3ce2362b-63af-4cc8-982c-935076f3ff7f/49-3
00:09:52.708 --> 00:09:54.376
Have you thought about doing so?

3ce2362b-63af-4cc8-982c-935076f3ff7f/50-0
00:10:13.696 --> 00:10:14.176
Mhm.

3ce2362b-63af-4cc8-982c-935076f3ff7f/52-0
00:10:14.216 --> 00:10:18.133
I think we're going to need more time
with this data before we do it.

3ce2362b-63af-4cc8-982c-935076f3ff7f/51-0
00:10:17.336 --> 00:10:17.576
Hmm.

3ce2362b-63af-4cc8-982c-935076f3ff7f/52-1
00:10:18.133 --> 00:10:21.490
And then also, you know,
the questions with respect to data

3ce2362b-63af-4cc8-982c-935076f3ff7f/52-2
00:10:21.490 --> 00:10:24.567
security. You know,
we want to make sure that if we're

3ce2362b-63af-4cc8-982c-935076f3ff7f/52-3
00:10:24.567 --> 00:10:27.532
feeding this into some kind of, you know,
AI system,

3ce2362b-63af-4cc8-982c-935076f3ff7f/52-4
00:10:27.532 --> 00:10:31.169
that we're doing it with a lot of
responsibility with respect to

3ce2362b-63af-4cc8-982c-935076f3ff7f/52-5
00:10:31.169 --> 00:10:32.176
confidential data.

3ce2362b-63af-4cc8-982c-935076f3ff7f/53-0
00:10:32.816 --> 00:10:37.716
Just to go to back up at a high level for
our listeners who don't work closely with

3ce2362b-63af-4cc8-982c-935076f3ff7f/53-1
00:10:37.716 --> 00:10:40.807
anesthesia,
you did mention it's a different kind of

3ce2362b-63af-4cc8-982c-935076f3ff7f/53-2
00:10:40.807 --> 00:10:43.840
specialty.
It's measured and reimbursed differently

3ce2362b-63af-4cc8-982c-935076f3ff7f/53-3
00:10:43.840 --> 00:10:46.932
than the other specialties.
So just at a high level,

3ce2362b-63af-4cc8-982c-935076f3ff7f/53-4
00:10:46.932 --> 00:10:50.665
is all time spent in the hospital or
another care setting by an

3ce2362b-63af-4cc8-982c-935076f3ff7f/53-5
00:10:50.665 --> 00:10:54.923
anesthesiologist or nurse anesthetist or
someone involved in delivery of

3ce2362b-63af-4cc8-982c-935076f3ff7f/53-6
00:10:54.923 --> 00:10:55.856
anesthesia care?

3ce2362b-63af-4cc8-982c-935076f3ff7f/55-0
00:10:56.176 --> 00:10:59.259
equated with reimbursable time delivering
care?

3ce2362b-63af-4cc8-982c-935076f3ff7f/55-1
00:10:59.259 --> 00:11:04.011
Or is there any time where the provider
is at risk and is not meant to be

3ce2362b-63af-4cc8-982c-935076f3ff7f/55-2
00:11:04.011 --> 00:11:05.616
reimbursed for that time?

3ce2362b-63af-4cc8-982c-935076f3ff7f/56-0
00:11:06.296 --> 00:11:09.344
That's a great, you know, Jordan,
that is a,

3ce2362b-63af-4cc8-982c-935076f3ff7f/56-1
00:11:09.344 --> 00:11:12.933
that is a very perceptive question.
You know, so no,

3ce2362b-63af-4cc8-982c-935076f3ff7f/56-2
00:11:12.933 --> 00:11:17.809
I think that the way by and large that
anesthesiologists are reimbursed

3ce2362b-63af-4cc8-982c-935076f3ff7f/56-3
00:11:17.809 --> 00:11:21.873
physically by their time,
by third party payers, et cetera,

3ce2362b-63af-4cc8-982c-935076f3ff7f/56-4
00:11:21.873 --> 00:11:25.056
is by that time that's spent in and
operating.

3ce2362b-63af-4cc8-982c-935076f3ff7f/59-0
00:11:25.216 --> 00:11:30.008
when you're actually doing said procedure.
You know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/59-1
00:11:30.008 --> 00:11:37.061
when that makes it tricky because,
you know, I think, as I alluded to before,

3ce2362b-63af-4cc8-982c-935076f3ff7f/59-2
00:11:37.061 --> 00:11:44.385
while that time is the reimbursable time,
and it's really the highest value time

3ce2362b-63af-4cc8-982c-935076f3ff7f/58-0
00:11:43.856 --> 00:11:44.096
Hmm.

3ce2362b-63af-4cc8-982c-935076f3ff7f/59-3
00:11:44.385 --> 00:11:44.656
for

3ce2362b-63af-4cc8-982c-935076f3ff7f/60-0
00:11:44.816 --> 00:11:48.149
what you're doing and how we're going to
be paid.

3ce2362b-63af-4cc8-982c-935076f3ff7f/60-1
00:11:48.149 --> 00:11:53.616
It's difficult when you're trying to sort
of build a department where the reality

3ce2362b-63af-4cc8-982c-935076f3ff7f/60-2
00:11:53.616 --> 00:11:59.016
is that anesthesiologists have to do work
that is beyond just work that's in the

3ce2362b-63af-4cc8-982c-935076f3ff7f/60-3
00:11:59.016 --> 00:12:02.816
operating room.
And so how do you account for that time?

3ce2362b-63af-4cc8-982c-935076f3ff7f/60-4
00:12:02.816 --> 00:12:05.216
How do you show value for that time?

3ce2362b-63af-4cc8-982c-935076f3ff7f/61-0
00:12:05.456 --> 00:12:10.159
how do you sort of build commitment with
the other things that just have to happen

3ce2362b-63af-4cc8-982c-935076f3ff7f/61-1
00:12:10.159 --> 00:12:13.105
in a hospital,
like responding to emergencies that,

3ce2362b-63af-4cc8-982c-935076f3ff7f/61-2
00:12:13.105 --> 00:12:15.938
you know,
when you're responding to an emergency.

3ce2362b-63af-4cc8-982c-935076f3ff7f/61-3
00:12:15.938 --> 00:12:20.187
So, you know, part of my happen, you know,
working as an anesthesiologist,

3ce2362b-63af-4cc8-982c-935076f3ff7f/61-4
00:12:20.187 --> 00:12:24.096
I got to respond to codes in the hospital.
Technically, those codes,

3ce2362b-63af-4cc8-982c-935076f3ff7f/62-0
00:12:24.656 --> 00:12:28.112
You know, being reimbursed very,
very little for those for those codes,

3ce2362b-63af-4cc8-982c-935076f3ff7f/62-1
00:12:28.112 --> 00:12:28.736
if if at all.

3ce2362b-63af-4cc8-982c-935076f3ff7f/64-0
00:12:29.696 --> 00:12:35.025
Why wouldn't a claims payment be issued
for care provided in response to an

3ce2362b-63af-4cc8-982c-935076f3ff7f/64-1
00:12:35.025 --> 00:12:38.390
urgency,
to an emergency in another part of the

3ce2362b-63af-4cc8-982c-935076f3ff7f/64-2
00:12:38.390 --> 00:12:42.176
hospital? Or would it,
and it's just not translating?

3ce2362b-63af-4cc8-982c-935076f3ff7f/63-0
00:12:40.496 --> 00:12:40.976
You know.

3ce2362b-63af-4cc8-982c-935076f3ff7f/66-0
00:12:42.896 --> 00:12:45.691
I mean, I think sometimes,
sometimes you can,

3ce2362b-63af-4cc8-982c-935076f3ff7f/66-1
00:12:45.691 --> 00:12:48.972
but it's pennies on a dollar.
And so it's incredibly,

3ce2362b-63af-4cc8-982c-935076f3ff7f/66-2
00:12:48.972 --> 00:12:53.468
it's incredibly low. Plus, you know,
that would assume that everything is

3ce2362b-63af-4cc8-982c-935076f3ff7f/66-3
00:12:53.468 --> 00:12:57.782
documented in the right way to actually
get that going to claims data.

3ce2362b-63af-4cc8-982c-935076f3ff7f/66-4
00:12:57.782 --> 00:13:00.456
So like we do,
I think we do generate bill,

3ce2362b-63af-4cc8-982c-935076f3ff7f/66-5
00:13:00.456 --> 00:13:02.096
we do generate revenue from

3ce2362b-63af-4cc8-982c-935076f3ff7f/65-0
00:13:02.336 --> 00:13:02.896
Mhm.

3ce2362b-63af-4cc8-982c-935076f3ff7f/67-0
00:13:02.736 --> 00:13:07.124
set emergencies. It's just, you know,
it can be difficult to capture.

3ce2362b-63af-4cc8-982c-935076f3ff7f/67-1
00:13:07.124 --> 00:13:11.825
And it certainly doesn't capture the
entirety of the preparatory work that

3ce2362b-63af-4cc8-982c-935076f3ff7f/67-2
00:13:11.825 --> 00:13:15.836
happens when, you know,
I'm thinking sort of doing an emergency

3ce2362b-63af-4cc8-982c-935076f3ff7f/67-3
00:13:15.836 --> 00:13:19.660
airway, for example.
It doesn't account for that preparatory

3ce2362b-63af-4cc8-982c-935076f3ff7f/67-4
00:13:19.660 --> 00:13:20.976
work. Sure, maybe the

3ce2362b-63af-4cc8-982c-935076f3ff7f/69-0
00:13:22.656 --> 00:13:26.999
the intubation or the airway itself might
be accounted for where, yes,

3ce2362b-63af-4cc8-982c-935076f3ff7f/69-1
00:13:26.999 --> 00:13:30.546
said procedure was done,
but all the time that sort of is

3ce2362b-63af-4cc8-982c-935076f3ff7f/68-0
00:13:28.336 --> 00:13:28.496
Mm.

3ce2362b-63af-4cc8-982c-935076f3ff7f/69-2
00:13:30.546 --> 00:13:34.583
associated with that isn't always neatly
captured. And, you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/69-3
00:13:34.583 --> 00:13:39.292
one of the struggles of trying to manage
a department where it's a sprawling

3ce2362b-63af-4cc8-982c-935076f3ff7f/69-4
00:13:39.292 --> 00:13:42.656
enterprise or a lot of moving parts is
how do you keep

3ce2362b-63af-4cc8-982c-935076f3ff7f/70-0
00:13:43.216 --> 00:13:48.845
How do you retain your faculty, you know?
And I think sort of thinking about all

3ce2362b-63af-4cc8-982c-935076f3ff7f/70-1
00:13:48.845 --> 00:13:54.056
the important work that they do,
trying to capture the important work that

3ce2362b-63af-4cc8-982c-935076f3ff7f/70-2
00:13:54.056 --> 00:13:57.322
they do,
and then trying to figure out how you

3ce2362b-63af-4cc8-982c-935076f3ff7f/70-3
00:13:57.322 --> 00:14:02.256
reimburse in a responsible way for that
work sort of goes in line with

3ce2362b-63af-4cc8-982c-935076f3ff7f/72-0
00:14:02.496 --> 00:14:07.462
how to keep a department functioning,
especially at a place as complex as the

3ce2362b-63af-4cc8-982c-935076f3ff7f/72-1
00:14:07.462 --> 00:14:12.300
University of Chicago. Because, you know,
in a lot of ways, this, you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/72-2
00:14:12.300 --> 00:14:16.119
I think there's a morale component to it
because, you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/72-3
00:14:16.119 --> 00:14:20.766
when you're working with hardworking
clinicians frontline, there's this,

3ce2362b-63af-4cc8-982c-935076f3ff7f/72-4
00:14:20.766 --> 00:14:23.376
at times it feels this insatiable demand.

3ce2362b-63af-4cc8-982c-935076f3ff7f/71-0
00:14:23.856 --> 00:14:24.256
Yeah.

3ce2362b-63af-4cc8-982c-935076f3ff7f/74-0
00:14:23.936 --> 00:14:27.006
for expanding service lines and doing
procedures,

3ce2362b-63af-4cc8-982c-935076f3ff7f/74-1
00:14:27.006 --> 00:14:32.103
making sure that you've got the, you know,
making sure that you can actually get a

3ce2362b-63af-4cc8-982c-935076f3ff7f/74-2
00:14:32.103 --> 00:14:36.831
supply of providers there to keep pace
with that demand is really important.

3ce2362b-63af-4cc8-982c-935076f3ff7f/74-3
00:14:36.831 --> 00:14:41.682
And I think recognizing the time and
effort that clinicians are putting in for

3ce2362b-63af-4cc8-982c-935076f3ff7f/74-4
00:14:41.682 --> 00:14:42.296
their work

3ce2362b-63af-4cc8-982c-935076f3ff7f/75-0
00:14:42.496 --> 00:14:45.643
is an important part.
And that's where this tool has really,

3ce2362b-63af-4cc8-982c-935076f3ff7f/73-0
00:14:42.776 --> 00:14:42.896
Yeah.

3ce2362b-63af-4cc8-982c-935076f3ff7f/75-1
00:14:45.643 --> 00:14:48.016
I think,
helped us in some regards with that.

3ce2362b-63af-4cc8-982c-935076f3ff7f/76-0
00:14:48.496 --> 00:14:53.150
So where is additional revenue being
drawn from when more reimbursable hours

3ce2362b-63af-4cc8-982c-935076f3ff7f/76-1
00:14:53.150 --> 00:14:54.056
are identified?

3ce2362b-63af-4cc8-982c-935076f3ff7f/77-0
00:14:55.456 --> 00:14:59.409
Well, I mean,
I think that's a multifaceted question.

3ce2362b-63af-4cc8-982c-935076f3ff7f/77-1
00:14:59.409 --> 00:15:04.315
Some of that is a little bit beyond me,
but I know that, you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/77-2
00:15:04.315 --> 00:15:09.366
I think the reality is increasing
surgical revenue and providing and

3ce2362b-63af-4cc8-982c-935076f3ff7f/77-3
00:15:09.366 --> 00:15:13.100
expanding surgical services is that
pop-off lever.

3ce2362b-63af-4cc8-982c-935076f3ff7f/77-4
00:15:13.100 --> 00:15:15.296
I think certainly trying to be

3ce2362b-63af-4cc8-982c-935076f3ff7f/78-0
00:15:15.616 --> 00:15:18.861
really responsible with these high cost
personnel,

3ce2362b-63af-4cc8-982c-935076f3ff7f/78-1
00:15:18.861 --> 00:15:23.951
the high cost services that you have.
You've got to be responsible on that end.

3ce2362b-63af-4cc8-982c-935076f3ff7f/78-2
00:15:23.951 --> 00:15:28.787
But I think it's really led by health
system growth and trying to make sure

3ce2362b-63af-4cc8-982c-935076f3ff7f/81-0
00:15:28.256 --> 00:15:33.171
So it's coming from payers, essentially.
You're saying that you were going to get

3ce2362b-63af-4cc8-982c-935076f3ff7f/78-3
00:15:28.787 --> 00:15:29.296
that you

3ce2362b-63af-4cc8-982c-935076f3ff7f/81-1
00:15:33.171 --> 00:15:37.606
reimbursed $30,000 for this procedure,
but now that you're able to better

3ce2362b-63af-4cc8-982c-935076f3ff7f/81-2
00:15:37.606 --> 00:15:41.143
account for anesthesia care delivered,
maybe it's $34,000.

3ce2362b-63af-4cc8-982c-935076f3ff7f/81-3
00:15:41.143 --> 00:15:45.338
I'm just making up numbers. Right. Okay,
great. So you mentioned, oh,

3ce2362b-63af-4cc8-982c-935076f3ff7f/79-0
00:15:42.336 --> 00:15:42.656
Sure.

3ce2362b-63af-4cc8-982c-935076f3ff7f/80-0
00:15:43.616 --> 00:15:43.936
Yeah.

3ce2362b-63af-4cc8-982c-935076f3ff7f/81-4
00:15:45.338 --> 00:15:47.616
actually one last thing on this topic.

3ce2362b-63af-4cc8-982c-935076f3ff7f/82-0
00:15:48.496 --> 00:15:51.696
Admin time.
I'm just trying to wonder where pushback

3ce2362b-63af-4cc8-982c-935076f3ff7f/82-1
00:15:51.696 --> 00:15:55.138
could be. Obviously,
you have other providers across the

3ce2362b-63af-4cc8-982c-935076f3ff7f/82-2
00:15:55.138 --> 00:15:59.183
health system, not anesthesiologists,
I wouldn't imagine too much,

3ce2362b-63af-4cc8-982c-935076f3ff7f/82-3
00:15:59.183 --> 00:16:02.383
but other kinds of specialists who have
pajama time.

3ce2362b-63af-4cc8-982c-935076f3ff7f/82-4
00:16:02.383 --> 00:16:06.851
And they often are doing in-basket
messages after their kids go to bed at

3ce2362b-63af-4cc8-982c-935076f3ff7f/82-5
00:16:06.851 --> 00:16:07.696
night at home.

3ce2362b-63af-4cc8-982c-935076f3ff7f/83-0
00:16:08.096 --> 00:16:13.022
And that isn't directly reimbursable.
There's no charge associated with that.

3ce2362b-63af-4cc8-982c-935076f3ff7f/83-1
00:16:13.022 --> 00:16:17.128
And as you're seeing more,
as you're seeing anesthesiology being

3ce2362b-63af-4cc8-982c-935076f3ff7f/83-2
00:16:17.128 --> 00:16:20.159
able to capture more time that is
reimbursable,

3ce2362b-63af-4cc8-982c-935076f3ff7f/83-3
00:16:20.159 --> 00:16:25.338
are you seeing other departments say, hey,
I want my time to be also reimbursable

3ce2362b-63af-4cc8-982c-935076f3ff7f/83-4
00:16:25.338 --> 00:16:29.696
when I'm not doing an actual procedure
associated with the CPT code?

3ce2362b-63af-4cc8-982c-935076f3ff7f/85-0
00:16:31.256 --> 00:16:33.911
You know,
I'm going to pause with respect to the

3ce2362b-63af-4cc8-982c-935076f3ff7f/85-1
00:16:33.911 --> 00:16:37.000
other departments,
just because I don't work in a lot of

3ce2362b-63af-4cc8-982c-935076f3ff7f/85-2
00:16:37.000 --> 00:16:40.685
these other departments.
I will say that my friends that, you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/84-0
00:16:37.456 --> 00:16:37.776
Good.

3ce2362b-63af-4cc8-982c-935076f3ff7f/85-3
00:16:40.685 --> 00:16:44.749
are gastroenterologists and, you know,
even in primary care who, you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/85-4
00:16:44.749 --> 00:16:48.759
a lot of their time, you're right,
is now spent with doing things like in

3ce2362b-63af-4cc8-982c-935076f3ff7f/85-5
00:16:48.759 --> 00:16:50.656
baskets and doing times that aren't

3ce2362b-63af-4cc8-982c-935076f3ff7f/87-0
00:16:50.896 --> 00:16:54.715
directly reimbursable.
I think those questions are coming up

3ce2362b-63af-4cc8-982c-935076f3ff7f/87-1
00:16:54.715 --> 00:16:57.533
more and more.
And I think in a lot of ways,

3ce2362b-63af-4cc8-982c-935076f3ff7f/87-2
00:16:57.533 --> 00:17:02.479
it's probably contributing to some of the
morale and wellness and perhaps lack

3ce2362b-63af-4cc8-982c-935076f3ff7f/87-3
00:17:02.479 --> 00:17:05.484
thereof,
the burnout that we're starting to see

3ce2362b-63af-4cc8-982c-935076f3ff7f/87-4
00:17:05.484 --> 00:17:09.616
across medicine because of these tasks
that are being done aren't

3ce2362b-63af-4cc8-982c-935076f3ff7f/86-0
00:17:05.936 --> 00:17:06.536
Mm-hmm.

3ce2362b-63af-4cc8-982c-935076f3ff7f/89-0
00:17:09.736 --> 00:17:13.576
directly reimbursable.
It's hard to figure out how you account

3ce2362b-63af-4cc8-982c-935076f3ff7f/89-1
00:17:13.576 --> 00:17:17.050
for that time and how that translates
into compensation.

3ce2362b-63af-4cc8-982c-935076f3ff7f/89-2
00:17:17.050 --> 00:17:21.621
I think it highlights a real struggle and
a real challenge with, you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/89-3
00:17:21.621 --> 00:17:26.496
how do we account for that, you know,
and how do we do it in a responsible way?

3ce2362b-63af-4cc8-982c-935076f3ff7f/88-0
00:17:25.456 --> 00:17:25.816
This.

3ce2362b-63af-4cc8-982c-935076f3ff7f/90-0
00:17:26.896 --> 00:17:30.976
So you mentioned that now you're able to
more accurately capture.

3ce2362b-63af-4cc8-982c-935076f3ff7f/91-0
00:17:31.936 --> 00:17:35.823
time that is spent by anesthesiologists
delivering care,

3ce2362b-63af-4cc8-982c-935076f3ff7f/91-1
00:17:35.823 --> 00:17:41.142
you want to avoid reinforcing the wrong
behaviors and incentivize the correct

3ce2362b-63af-4cc8-982c-935076f3ff7f/91-2
00:17:41.142 --> 00:17:45.575
behaviors in a complex work environment.
Can you speak to which,

3ce2362b-63af-4cc8-982c-935076f3ff7f/91-3
00:17:45.575 --> 00:17:49.120
how the intervention,
the scheduling system and the

3ce2362b-63af-4cc8-982c-935076f3ff7f/91-4
00:17:49.120 --> 00:17:50.416
user-generated data

3ce2362b-63af-4cc8-982c-935076f3ff7f/92-0
00:17:50.656 --> 00:17:55.610
has been reinforcing the behaviors that
you want to see and incentivizing them to

3ce2362b-63af-4cc8-982c-935076f3ff7f/92-1
00:17:55.610 --> 00:18:00.444
work in the way that you want them to
work and how have they it moved providers

3ce2362b-63af-4cc8-982c-935076f3ff7f/92-2
00:18:00.444 --> 00:18:02.256
away from the wrong behaviors.

3ce2362b-63af-4cc8-982c-935076f3ff7f/93-0
00:18:03.376 --> 00:18:06.111
Yeah, and I think I think that's,
you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/93-1
00:18:06.111 --> 00:18:10.898
one of the things because OR time is the
time that is reimbursable, I think,

3ce2362b-63af-4cc8-982c-935076f3ff7f/93-2
00:18:10.898 --> 00:18:14.068
you know,
we make it pretty clear that documenting

3ce2362b-63af-4cc8-982c-935076f3ff7f/93-3
00:18:14.068 --> 00:18:18.917
time that can be collaborated with what
you're doing in the operating room is

3ce2362b-63af-4cc8-982c-935076f3ff7f/93-4
00:18:18.917 --> 00:18:22.336
where we want the majority of that of
that time spent.

3ce2362b-63af-4cc8-982c-935076f3ff7f/94-0
00:18:22.416 --> 00:18:25.428
You know,
and so if you are doing procedures or

3ce2362b-63af-4cc8-982c-935076f3ff7f/94-1
00:18:25.428 --> 00:18:30.323
you're doing work that is quote unquote
unreimbursable by third party payers,

3ce2362b-63af-4cc8-982c-935076f3ff7f/94-2
00:18:30.323 --> 00:18:33.523
then that stuff has to be documented,
adjudicated,

3ce2362b-63af-4cc8-982c-935076f3ff7f/94-3
00:18:33.523 --> 00:18:38.167
and discussed to see whether that's the
best way to spend your, you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/94-4
00:18:38.167 --> 00:18:41.179
set time.
So I think that's probably one way of

3ce2362b-63af-4cc8-982c-935076f3ff7f/94-5
00:18:41.179 --> 00:18:42.936
aligning some of that stuff.

3ce2362b-63af-4cc8-982c-935076f3ff7f/95-0
00:18:44.496 --> 00:18:48.615
I think also just, honestly,
a lot of this data has been nice just

3ce2362b-63af-4cc8-982c-935076f3ff7f/95-1
00:18:48.615 --> 00:18:52.672
from a conversation starter.
And I think having data isn't magic.

3ce2362b-63af-4cc8-982c-935076f3ff7f/95-2
00:18:52.672 --> 00:18:57.220
It doesn't make everything better.
But I know that one of the issues that

3ce2362b-63af-4cc8-982c-935076f3ff7f/95-3
00:18:57.220 --> 00:19:01.646
oftentimes comes up in our group is this
concept of fairness, you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/95-4
00:19:01.646 --> 00:19:03.736
and is fairness being distributed?

3ce2362b-63af-4cc8-982c-935076f3ff7f/96-0
00:19:03.896 --> 00:19:08.862
across with respect to work with
individuals or with certain subsections

3ce2362b-63af-4cc8-982c-935076f3ff7f/96-1
00:19:08.862 --> 00:19:12.264
within departments.
I think people want fairness.

3ce2362b-63af-4cc8-982c-935076f3ff7f/96-2
00:19:12.264 --> 00:19:17.638
That's something that also builds morale.
And I think by having tangible data,

3ce2362b-63af-4cc8-982c-935076f3ff7f/96-3
00:19:17.638 --> 00:19:21.856
it helps us to better identify whether
these are just sort of

3ce2362b-63af-4cc8-982c-935076f3ff7f/97-0
00:19:22.976 --> 00:19:26.929
gut feelings, like if we've got,
if we have clinicians that are coming in

3ce2362b-63af-4cc8-982c-935076f3ff7f/97-1
00:19:26.929 --> 00:19:29.975
and saying, hey,
I feel like I'm working too much or one

3ce2362b-63af-4cc8-982c-935076f3ff7f/97-2
00:19:29.975 --> 00:19:32.539
section is working harder than another
section.

3ce2362b-63af-4cc8-982c-935076f3ff7f/97-3
00:19:32.539 --> 00:19:36.759
I think being able to have this helps us
in these conversations and, you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/97-4
00:19:36.759 --> 00:19:38.896
sort of ground level and ground sets it.

3ce2362b-63af-4cc8-982c-935076f3ff7f/99-0
00:19:39.376 --> 00:19:44.093
From a data integration perspective,
you mentioned that there's just one

3ce2362b-63af-4cc8-982c-935076f3ff7f/99-1
00:19:44.093 --> 00:19:46.872
platform,
the scheduling platform with the

3ce2362b-63af-4cc8-982c-935076f3ff7f/99-2
00:19:46.872 --> 00:19:50.684
user-generated data,
and that's where you can capture more

3ce2362b-63af-4cc8-982c-935076f3ff7f/99-3
00:19:50.684 --> 00:19:54.625
areas where anesthesiology,
anesthesiologists are performing

3ce2362b-63af-4cc8-982c-935076f3ff7f/98-0
00:19:52.096 --> 00:19:52.176
The.

3ce2362b-63af-4cc8-982c-935076f3ff7f/99-4
00:19:54.625 --> 00:19:58.373
reimbursable work,
or you said sometimes non-reimbursable

3ce2362b-63af-4cc8-982c-935076f3ff7f/99-5
00:19:58.373 --> 00:19:58.696
work.

3ce2362b-63af-4cc8-982c-935076f3ff7f/100-0
00:19:58.936 --> 00:20:02.896
You also mentioned that you manually
review the Epic,

3ce2362b-63af-4cc8-982c-935076f3ff7f/100-1
00:20:02.896 --> 00:20:08.909
the clinical records in Epic to see what
care actually was delivered and you kind

3ce2362b-63af-4cc8-982c-935076f3ff7f/100-2
00:20:08.909 --> 00:20:13.603
of try to reconcile those.
Is there any other data that's being

3ce2362b-63af-4cc8-982c-935076f3ff7f/100-3
00:20:13.603 --> 00:20:17.856
integrated or reconciled?
Are you pulling in claims data?

3ce2362b-63af-4cc8-982c-935076f3ff7f/101-0
00:20:18.096 --> 00:20:22.749
Are you using Epic Payer Platform?
Are you using external data sources to

3ce2362b-63af-4cc8-982c-935076f3ff7f/101-1
00:20:22.749 --> 00:20:26.961
accomplish any of this work?
Or is it really just there's this one

3ce2362b-63af-4cc8-982c-935076f3ff7f/101-2
00:20:26.961 --> 00:20:32.054
standalone solution and there's periodic
manual review between that and Epic and

3ce2362b-63af-4cc8-982c-935076f3ff7f/101-3
00:20:32.054 --> 00:20:35.512
side-by-side screens,
but there's no data integration.

3ce2362b-63af-4cc8-982c-935076f3ff7f/101-4
00:20:35.512 --> 00:20:38.656
What are you looking at in terms of data
sources?

3ce2362b-63af-4cc8-982c-935076f3ff7f/102-0
00:20:39.216 --> 00:20:41.390
Yeah,
I think those are I think those are

3ce2362b-63af-4cc8-982c-935076f3ff7f/102-1
00:20:41.390 --> 00:20:43.875
important next steps. I think right now,
again,

3ce2362b-63af-4cc8-982c-935076f3ff7f/102-2
00:20:43.875 --> 00:20:46.567
because we launched this platform about a
year ago,

3ce2362b-63af-4cc8-982c-935076f3ff7f/102-3
00:20:46.567 --> 00:20:49.621
and we've got six months worth of worth
of data right now,

3ce2362b-63af-4cc8-982c-935076f3ff7f/102-4
00:20:49.621 --> 00:20:53.400
it's sort of manual side-by-side
integration or side-by-side comparison.

3ce2362b-63af-4cc8-982c-935076f3ff7f/102-5
00:20:53.400 --> 00:20:55.677
But I think certainly the future,
you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/102-6
00:20:55.677 --> 00:20:58.576
the future to try to figure out how to
better integrate

3ce2362b-63af-4cc8-982c-935076f3ff7f/103-0
00:20:58.976 --> 00:21:01.023
Yeah,
some of this payer information is there.

3ce2362b-63af-4cc8-982c-935076f3ff7f/103-1
00:21:01.023 --> 00:21:02.416
We haven't implemented that yet.

3ce2362b-63af-4cc8-982c-935076f3ff7f/104-0
00:21:03.856 --> 00:21:06.851
Got it.
And what would be the business

3ce2362b-63af-4cc8-982c-935076f3ff7f/104-1
00:21:06.851 --> 00:21:13.226
justification for finding a way to better
integrate claims data and clinicals data

3ce2362b-63af-4cc8-982c-935076f3ff7f/104-2
00:21:13.226 --> 00:21:18.909
and the time entry data together in one
cohesive, normalized, aggregated,

3ce2362b-63af-4cc8-982c-935076f3ff7f/104-3
00:21:18.909 --> 00:21:21.136
and deduplicated data stream?

3ce2362b-63af-4cc8-982c-935076f3ff7f/105-0
00:21:21.976 --> 00:21:27.416
Yeah, I mean, I think that's, you know,
tying all these things to reimbursable

3ce2362b-63af-4cc8-982c-935076f3ff7f/105-1
00:21:27.416 --> 00:21:32.788
behavior and making sure that that you
have a better understanding of sort of

3ce2362b-63af-4cc8-982c-935076f3ff7f/105-2
00:21:32.788 --> 00:21:38.228
how time is spent that will that will
sort of lead to and increase revenue and

3ce2362b-63af-4cc8-982c-935076f3ff7f/105-3
00:21:38.228 --> 00:21:40.776
where time that doesn't reflect that.

3ce2362b-63af-4cc8-982c-935076f3ff7f/107-0
00:21:41.696 --> 00:21:44.036
you know,
sort of how to account for that time.

3ce2362b-63af-4cc8-982c-935076f3ff7f/107-1
00:21:44.036 --> 00:21:47.692
I think I think that can, you know,
I think that there's opportunities for

3ce2362b-63af-4cc8-982c-935076f3ff7f/107-2
00:21:47.692 --> 00:21:47.936
that.

3ce2362b-63af-4cc8-982c-935076f3ff7f/109-0
00:21:48.336 --> 00:21:51.580
So we've approached the end of this
podcast episode.

3ce2362b-63af-4cc8-982c-935076f3ff7f/109-1
00:21:51.580 --> 00:21:55.313
I'd like to pose a final question to you,
Stephen, which is,

3ce2362b-63af-4cc8-982c-935076f3ff7f/109-2
00:21:55.313 --> 00:21:58.556
what advice would you have for yourself
in May 2025,

3ce2362b-63af-4cc8-982c-935076f3ff7f/108-0
00:21:56.816 --> 00:21:56.896
The.

3ce2362b-63af-4cc8-982c-935076f3ff7f/109-3
00:21:58.556 --> 00:22:01.616
one year ago when you were starting this
program?

3ce2362b-63af-4cc8-982c-935076f3ff7f/110-0
00:22:02.976 --> 00:22:07.267
Yeah, I think, you know,
one of the things that I think I learned

3ce2362b-63af-4cc8-982c-935076f3ff7f/110-1
00:22:07.267 --> 00:22:10.128
is that I think data and systems are
great.

3ce2362b-63af-4cc8-982c-935076f3ff7f/110-2
00:22:10.128 --> 00:22:15.199
And I think that using more and more
powerful data is the wave of the future.

3ce2362b-63af-4cc8-982c-935076f3ff7f/110-3
00:22:15.199 --> 00:22:18.905
It's something that we've got to
increasingly recognize.

3ce2362b-63af-4cc8-982c-935076f3ff7f/110-4
00:22:18.905 --> 00:22:22.416
But I think at the end of the day,
it's people first.

3ce2362b-63af-4cc8-982c-935076f3ff7f/111-0
00:22:22.576 --> 00:22:25.366
You know,
and one of the things I don't think we

3ce2362b-63af-4cc8-982c-935076f3ff7f/111-1
00:22:25.366 --> 00:22:28.839
talked much about here,
but one of the things that I really,

3ce2362b-63af-4cc8-982c-935076f3ff7f/111-2
00:22:28.839 --> 00:22:33.223
that I struggled with and that I learned
was this stuff doesn't work without

3ce2362b-63af-4cc8-982c-935076f3ff7f/111-3
00:22:33.223 --> 00:22:36.981
buy-in from your people.
And I think taking the time to empathize

3ce2362b-63af-4cc8-982c-935076f3ff7f/111-4
00:22:36.981 --> 00:22:41.536
and sort of understand where your users
are coming from, and that helped A lot.

3ce2362b-63af-4cc8-982c-935076f3ff7f/112-0
00:22:41.776 --> 00:22:44.933
for myself as a clinician in this,
you know,

3ce2362b-63af-4cc8-982c-935076f3ff7f/112-1
00:22:44.933 --> 00:22:50.334
working in this complex environment,
I think starting with trust and empathy

3ce2362b-63af-4cc8-982c-935076f3ff7f/112-2
00:22:50.334 --> 00:22:54.262
can ultimately,
I think it does a lot of the hard work,

3ce2362b-63af-4cc8-982c-935076f3ff7f/112-3
00:22:54.262 --> 00:22:56.016
the hard lifting for you.

3ce2362b-63af-4cc8-982c-935076f3ff7f/113-0
00:22:56.896 --> 00:23:01.256
All right. Well, thank you, Stephen.
I appreciate you joining us for this

3ce2362b-63af-4cc8-982c-935076f3ff7f/113-1
00:23:01.256 --> 00:23:05.381
episode of Healthy Data Podcast.
For our listeners, this has been Dr.

3ce2362b-63af-4cc8-982c-935076f3ff7f/113-2
00:23:05.381 --> 00:23:08.739
Stephen Estime,
an Associate Professor of Anesthesia and

3ce2362b-63af-4cc8-982c-935076f3ff7f/113-3
00:23:08.739 --> 00:23:11.744
Critical Care,
and Associate Chair of Strategy and

3ce2362b-63af-4cc8-982c-935076f3ff7f/113-4
00:23:11.744 --> 00:23:15.456
Finance in the Department of
Anesthesiology and Critical Care.

3ce2362b-63af-4cc8-982c-935076f3ff7f/114-0
00:23:15.696 --> 00:23:20.016
at UChicago Medicine. Stephen,
thank you so much for joining us today.

3ce2362b-63af-4cc8-982c-935076f3ff7f/115-0
00:23:20.256 --> 00:23:21.296
Thanks for having me, Jordan.