5b16d8ba-4328-4834-b106-0d6caf58f4ba/5-0
00:00:03.494 --> 00:00:06.249
Health.
Kathy is a senior advisor of Population

5b16d8ba-4328-4834-b106-0d6caf58f4ba/5-1
00:00:06.249 --> 00:00:09.980
Health Analytics. Kathy,
thank you so much for joining us today.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/5-2
00:00:09.980 --> 00:00:11.014
How are you doing?

5b16d8ba-4328-4834-b106-0d6caf58f4ba/6-0
00:00:10.414 --> 00:00:13.334
My pleasure. Very well.
Thank you for having me.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/8-0
00:00:13.734 --> 00:00:18.822
Perfect. So for those who don't know,
Northwell Health is a health system

5b16d8ba-4328-4834-b106-0d6caf58f4ba/8-1
00:00:18.822 --> 00:00:21.985
headquartered in Hyde Park, New York,
with 8,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/8-2
00:00:21.985 --> 00:00:26.730
000 beds and 29 hospitals serviced by 16,
000 providers. Now, Kathy,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/8-3
00:00:26.730 --> 00:00:31.268
today you and I are going to be
discussing a variety of, I guess,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/8-4
00:00:31.268 --> 00:00:32.094
Northwell of

5b16d8ba-4328-4834-b106-0d6caf58f4ba/9-0
00:00:32.254 --> 00:00:37.291
of avenues through which Northwell Health
has been approaching AI and Gen. AI.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/9-1
00:00:37.291 --> 00:00:40.990
And to start it off,
we'll be talking about incorporating

5b16d8ba-4328-4834-b106-0d6caf58f4ba/9-2
00:00:40.990 --> 00:00:45.708
patient generated health data into
provider workflows for the purposes of

5b16d8ba-4328-4834-b106-0d6caf58f4ba/9-3
00:00:45.708 --> 00:00:49.853
supporting population health management
at Northwell. So please,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/9-4
00:00:49.853 --> 00:00:51.894
what are you doing in this area?

5b16d8ba-4328-4834-b106-0d6caf58f4ba/10-0
00:00:52.454 --> 00:00:56.617
Sure. You know,
Northwell's been at this for a while in

5b16d8ba-4328-4834-b106-0d6caf58f4ba/10-1
00:00:56.617 --> 00:01:00.409
this arena,
really heavy focus on value-based care

5b16d8ba-4328-4834-b106-0d6caf58f4ba/10-2
00:01:00.409 --> 00:01:05.539
initiatives, quality initiatives,
you know, changing payment models,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/10-3
00:01:05.539 --> 00:01:10.074
all those things that we're all
challenged by in healthcare.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/10-4
00:01:10.074 --> 00:01:13.494
But understanding how we might use
technology

5b16d8ba-4328-4834-b106-0d6caf58f4ba/14-0
00:01:14.294 --> 00:01:18.127
is,
it's not new here with this AI kind of

5b16d8ba-4328-4834-b106-0d6caf58f4ba/11-0
00:01:17.214 --> 00:01:17.414
Mm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/14-1
00:01:18.127 --> 00:01:23.119
evolution happening.
We started with chat bots in 2018,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/14-2
00:01:23.119 --> 00:01:29.983
and they were used for a population
health initiative to reduce readmissions

5b16d8ba-4328-4834-b106-0d6caf58f4ba/14-3
00:01:29.983 --> 00:01:36.134
and avoidable emergency room visits in
recently discharged patients.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/13-0
00:01:36.414 --> 00:01:36.934
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/15-0
00:01:36.454 --> 00:01:40.320
So people may be familiar that the
Medicare star ratings,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/15-1
00:01:40.320 --> 00:01:45.654
you get quality dings if your patients
are readmitted within 30 days. You know,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/15-2
00:01:45.654 --> 00:01:49.387
it's expensive. You know,
you're not getting additional

5b16d8ba-4328-4834-b106-0d6caf58f4ba/15-3
00:01:49.387 --> 00:01:53.187
reimbursement.
You're kind of giving a warranty for that

5b16d8ba-4328-4834-b106-0d6caf58f4ba/15-4
00:01:53.187 --> 00:01:57.254
30 days to the payer.
And so we have a really robust program

5b16d8ba-4328-4834-b106-0d6caf58f4ba/15-5
00:01:57.254 --> 00:01:58.454
for managing that.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/17-0
00:01:59.014 --> 00:02:03.202
And, but it's expensive.
It's a large team of nurse practitioners,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/17-1
00:02:03.202 --> 00:02:06.078
physician assistants,
administrative support,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/17-2
00:02:06.078 --> 00:02:09.517
and figuring out who really needs
attention, you know,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/17-3
00:02:09.517 --> 00:02:14.581
and who needs level one attention and who
maybe could be reached less frequently

5b16d8ba-4328-4834-b106-0d6caf58f4ba/17-4
00:02:14.581 --> 00:02:17.770
and is probably going to be okay in the
community.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/16-0
00:02:16.854 --> 00:02:17.334
Okay.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/17-5
00:02:17.770 --> 00:02:21.334
We started using chat bots to communicate
with patients.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/19-0
00:02:22.134 --> 00:02:25.976
to determine were their symptoms the same,
improving, worse?

5b16d8ba-4328-4834-b106-0d6caf58f4ba/19-1
00:02:25.976 --> 00:02:30.511
Did they have a follow-up appointment?
Did they fill the prescriptions,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/19-2
00:02:30.511 --> 00:02:34.165
things like that?
And depending on their replies to that,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/19-3
00:02:34.165 --> 00:02:38.637
it was determined, you know,
this one needed a call within 15 minutes,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/19-4
00:02:38.637 --> 00:02:40.464
could be the, you know, for a

5b16d8ba-4328-4834-b106-0d6caf58f4ba/18-0
00:02:39.574 --> 00:02:40.054
Oh, wow.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/22-0
00:02:40.534 --> 00:02:44.686
a red or, you know, a high alert,
a heart failure patient who was having

5b16d8ba-4328-4834-b106-0d6caf58f4ba/20-0
00:02:42.854 --> 00:02:43.334
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/22-1
00:02:44.686 --> 00:02:47.928
worsening symptoms,
didn't have a follow up appointment,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/22-2
00:02:47.928 --> 00:02:51.228
all those kind of red flags may perhaps
gain some weight.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/21-0
00:02:51.054 --> 00:02:51.174
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/22-3
00:02:51.228 --> 00:02:55.778
And we could reach them quickly where
patients who had all those things kind of

5b16d8ba-4328-4834-b106-0d6caf58f4ba/22-4
00:02:55.778 --> 00:02:59.590
covered and were improving,
we might wait till tomorrow to call so

5b16d8ba-4328-4834-b106-0d6caf58f4ba/22-5
00:02:59.590 --> 00:03:00.614
that you used your

5b16d8ba-4328-4834-b106-0d6caf58f4ba/26-0
00:03:01.014 --> 00:03:04.297
expensive human resources more
efficiently.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/23-0
00:03:03.214 --> 00:03:03.454
Hmm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/26-1
00:03:04.297 --> 00:03:09.894
The product we were working with there,
we're not currently involved with.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/26-2
00:03:09.894 --> 00:03:15.640
We've recently begun our Epic transition.
We started in November, and we're,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/24-0
00:03:12.694 --> 00:03:13.294
Mm-hmm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/25-0
00:03:14.534 --> 00:03:14.934
Right.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/26-3
00:03:15.640 --> 00:03:18.924
you know,
with a very large implementation,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/26-4
00:03:18.924 --> 00:03:21.014
as you might imagine, across

5b16d8ba-4328-4834-b106-0d6caf58f4ba/28-0
00:03:21.054 --> 00:03:24.648
over 100,
000 employees and almost 30 hospitals.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/28-1
00:03:24.648 --> 00:03:29.196
So we're learning now what Epic
capabilities we purchased and

5b16d8ba-4328-4834-b106-0d6caf58f4ba/28-2
00:03:29.196 --> 00:03:34.918
understanding how we might use some of
that and also looking at some external

5b16d8ba-4328-4834-b106-0d6caf58f4ba/28-3
00:03:34.918 --> 00:03:39.099
ones because this is a space that's
exploded since 2018.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/27-0
00:03:37.814 --> 00:03:38.014
The.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/28-4
00:03:39.099 --> 00:03:41.374
What we used was really kind of

5b16d8ba-4328-4834-b106-0d6caf58f4ba/30-0
00:03:42.934 --> 00:03:47.575
It was called conversational AI,
but I would say it was more algorithmic,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/30-1
00:03:47.575 --> 00:03:52.153
more clinical decision tree of if the
patient says yes to this question,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/30-2
00:03:52.153 --> 00:03:56.104
ask them this question,
where if these newer models that we're

5b16d8ba-4328-4834-b106-0d6caf58f4ba/29-0
00:03:53.614 --> 00:03:54.094
Mmh.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/30-3
00:03:56.104 --> 00:04:00.808
evaluating really can be, you know,
do you have a ride to the appointment?

5b16d8ba-4328-4834-b106-0d6caf58f4ba/30-4
00:04:00.808 --> 00:04:03.254
And instead of yes, no, the patient can

5b16d8ba-4328-4834-b106-0d6caf58f4ba/33-0
00:04:03.894 --> 00:04:07.324
free text or speak their reply that my
sister's taking me.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/31-0
00:04:05.654 --> 00:04:05.974
Right.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/33-1
00:04:07.324 --> 00:04:12.093
That's great that your sister helps you
like that. You know, it may snow Tuesday.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/33-2
00:04:12.093 --> 00:04:15.407
You know, understand, you know,
understanding, you know,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/32-0
00:04:13.334 --> 00:04:13.894
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/33-3
00:04:15.407 --> 00:04:18.838
is that going to be a problem? You know,
things like that.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/33-4
00:04:18.838 --> 00:04:23.374
So the generation that's coming right now
is really exciting what's possible.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/36-0
00:04:23.974 --> 00:04:29.744
So I think that Northwell's journey with
these chatbots is maybe of great interest

5b16d8ba-4328-4834-b106-0d6caf58f4ba/36-1
00:04:29.744 --> 00:04:35.515
to listeners because many health systems
across the United States have begun their

5b16d8ba-4328-4834-b106-0d6caf58f4ba/36-2
00:04:35.515 --> 00:04:38.922
journey much more recently.
And instead of 2018,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/34-0
00:04:36.294 --> 00:04:36.694
Uh-huh.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/36-3
00:04:38.922 --> 00:04:43.094
some have started incorporating Gen.
AI tools in the 2020s.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/35-0
00:04:43.334 --> 00:04:43.814
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/37-0
00:04:43.414 --> 00:04:47.197
I'm wondering,
so as you've seen kind of more of an

5b16d8ba-4328-4834-b106-0d6caf58f4ba/37-1
00:04:47.197 --> 00:04:51.780
algorithmic AI tool evolve and then the
array of tools evolve,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/37-2
00:04:51.780 --> 00:04:56.728
what kind of reactions have you seen from
patients, from providers?

5b16d8ba-4328-4834-b106-0d6caf58f4ba/37-3
00:04:56.728 --> 00:05:02.694
And then how have you been adapting this
sort of kind of resource allocation tool

5b16d8ba-4328-4834-b106-0d6caf58f4ba/38-0
00:05:02.934 --> 00:05:07.014
As you've been getting more advanced AI
resources.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/42-0
00:05:08.054 --> 00:05:12.972
you know, you're spot on there.
We were early and nobody really,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/39-0
00:05:10.694 --> 00:05:10.814
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/42-1
00:05:12.972 --> 00:05:18.647
I did a research project on our pilot for
dissertation. It was my project.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/40-0
00:05:16.534 --> 00:05:17.014
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/42-2
00:05:18.647 --> 00:05:22.733
And it was,
I couldn't find articles about the use of

5b16d8ba-4328-4834-b106-0d6caf58f4ba/42-3
00:05:22.733 --> 00:05:29.014
chatbots in healthcare. It just, you know,
it was a very innovative thing in 2018.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/41-0
00:05:24.214 --> 00:05:24.614
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/44-0
00:05:29.494 --> 00:05:35.473
We were really fortunate that we did that
because when the COVID surge hit in New

5b16d8ba-4328-4834-b106-0d6caf58f4ba/43-0
00:05:34.894 --> 00:05:35.494
Mm-hmm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/44-1
00:05:35.473 --> 00:05:39.119
York in 2020,
we had this tool up and ready and a

5b16d8ba-4328-4834-b106-0d6caf58f4ba/44-2
00:05:39.119 --> 00:05:44.516
crisis that frankly delayed the
implementation of some of these tools for

5b16d8ba-4328-4834-b106-0d6caf58f4ba/44-3
00:05:44.516 --> 00:05:48.454
many health systems because budgets were
constrained.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/47-0
00:05:48.614 --> 00:05:52.310
resources were constrained.
It was not the time to be introducing

5b16d8ba-4328-4834-b106-0d6caf58f4ba/47-1
00:05:52.310 --> 00:05:55.446
something new.
We would probably never have kicked that

5b16d8ba-4328-4834-b106-0d6caf58f4ba/47-2
00:05:55.446 --> 00:05:58.582
pilot off in 2020.
But because we already had the tool,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/45-0
00:05:57.094 --> 00:05:57.574
Right.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/47-3
00:05:58.582 --> 00:06:02.166
we used it. Honestly,
we used it to send patients home from the

5b16d8ba-4328-4834-b106-0d6caf58f4ba/47-4
00:06:02.166 --> 00:06:05.974
emergency room who might have been
admitted under other conditions,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/47-5
00:06:05.974 --> 00:06:08.214
but they were sent home with a chat bot.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/52-0
00:06:08.614 --> 00:06:12.497
a pulse oximeter, a thermometer,
and we monitored them and we could

5b16d8ba-4328-4834-b106-0d6caf58f4ba/46-0
00:06:08.974 --> 00:06:09.454
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/48-0
00:06:11.614 --> 00:06:12.134
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/52-1
00:06:12.497 --> 00:06:16.438
dispatch an ambulance if we thought we
needed somebody to come back,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/52-2
00:06:16.438 --> 00:06:20.378
or we could know that they were safe in
the community. And honestly,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/52-3
00:06:20.378 --> 00:06:24.833
those chat bot questions included things
like, do you have food in the house?

5b16d8ba-4328-4834-b106-0d6caf58f4ba/49-0
00:06:24.614 --> 00:06:25.094
No.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/52-4
00:06:24.833 --> 00:06:27.803
You know,
do you need a delivery from the pharmacy?

5b16d8ba-4328-4834-b106-0d6caf58f4ba/50-0
00:06:27.494 --> 00:06:27.974
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/52-5
00:06:27.803 --> 00:06:29.174
How can we help you stay

5b16d8ba-4328-4834-b106-0d6caf58f4ba/53-0
00:06:29.334 --> 00:06:33.468
home in that.
So getting a head start really positioned

5b16d8ba-4328-4834-b106-0d6caf58f4ba/51-0
00:06:30.454 --> 00:06:30.854
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/53-1
00:06:33.468 --> 00:06:37.380
us well in that crisis.
And what I think what we've,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/53-2
00:06:37.380 --> 00:06:41.145
some of the lessons we've learned from
that pilot,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/53-3
00:06:41.145 --> 00:06:45.574
and it recruited thousands of patients,
when I say a pilot,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/53-4
00:06:45.574 --> 00:06:47.494
it was a very large pilot.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/56-0
00:06:50.904 --> 00:06:54.835
We now,
we're much more discerning consumers now.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/54-0
00:06:54.454 --> 00:06:54.614
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/56-1
00:06:54.835 --> 00:06:58.610
We have,
we know what we want from this product

5b16d8ba-4328-4834-b106-0d6caf58f4ba/56-2
00:06:58.610 --> 00:07:04.271
now. The Medicare population is,
by definition, generally 65 and older,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/56-3
00:07:04.271 --> 00:07:09.304
except for some, you know,
other unique circumstances. I don't,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/55-0
00:07:04.974 --> 00:07:05.494
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/59-0
00:07:10.614 --> 00:07:15.954
I don't find that patients 65,
75 are at all reluctant to use technology

5b16d8ba-4328-4834-b106-0d6caf58f4ba/59-1
00:07:15.954 --> 00:07:21.074
specifically to support their health.
The literature shows they will.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/57-0
00:07:17.574 --> 00:07:18.054
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/59-2
00:07:21.074 --> 00:07:25.024
But when you start getting to a patient
who's 90, 95,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/59-3
00:07:25.024 --> 00:07:29.414
there can be challenges in some of this
kind of technology.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/58-0
00:07:25.494 --> 00:07:25.974
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/62-0
00:07:30.134 --> 00:07:33.700
adoption.
And so now some of the models that we're

5b16d8ba-4328-4834-b106-0d6caf58f4ba/62-1
00:07:33.700 --> 00:07:38.175
looking at are more voice activated
rather than text activated.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/60-0
00:07:37.894 --> 00:07:38.374
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/62-2
00:07:38.175 --> 00:07:43.979
We'd like to explore that where it comes
in sounding quite natural where the phone

5b16d8ba-4328-4834-b106-0d6caf58f4ba/61-0
00:07:43.894 --> 00:07:44.294
Yes.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/62-3
00:07:43.979 --> 00:07:49.574
call comes in and it may say, you know,
this is a Northwell chat agent calling.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/64-0
00:07:50.214 --> 00:07:54.736
you know, identifying it,
but asking the questions and taking

5b16d8ba-4328-4834-b106-0d6caf58f4ba/64-1
00:07:54.736 --> 00:08:00.572
advantage of some of the natural language
processing that we really didn't find

5b16d8ba-4328-4834-b106-0d6caf58f4ba/64-2
00:08:00.572 --> 00:08:04.950
effective in 2018.
You specifically asked about our patient

5b16d8ba-4328-4834-b106-0d6caf58f4ba/64-3
00:08:04.950 --> 00:08:09.254
experience. And, you know,
I have one anecdote I've shared

5b16d8ba-4328-4834-b106-0d6caf58f4ba/63-0
00:08:05.414 --> 00:08:05.894
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/67-0
00:08:10.214 --> 00:08:13.359
before,
but we had one rather high-powered

5b16d8ba-4328-4834-b106-0d6caf58f4ba/67-1
00:08:13.359 --> 00:08:17.310
executive. You know,
it's New York City is our metro,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/65-0
00:08:15.734 --> 00:08:16.214
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/67-2
00:08:17.310 --> 00:08:22.065
where that's where we are.
And he was used to a certain level of

5b16d8ba-4328-4834-b106-0d6caf58f4ba/67-3
00:08:22.065 --> 00:08:27.845
performance from everything around him.
And he had been discharged home with a

5b16d8ba-4328-4834-b106-0d6caf58f4ba/66-0
00:08:24.254 --> 00:08:24.854
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/67-4
00:08:27.845 --> 00:08:29.894
heart failure diagnosis. And

5b16d8ba-4328-4834-b106-0d6caf58f4ba/71-0
00:08:30.774 --> 00:08:34.345
in the chat bot,
he put in his weight and he had gained a

5b16d8ba-4328-4834-b106-0d6caf58f4ba/71-1
00:08:34.345 --> 00:08:37.854
few pounds from discharge to the time he
was doing this.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/68-0
00:08:35.294 --> 00:08:35.774
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/71-2
00:08:37.854 --> 00:08:42.349
And a couple of minutes later,
a nurse called and he was confused by the

5b16d8ba-4328-4834-b106-0d6caf58f4ba/71-3
00:08:42.349 --> 00:08:45.613
phone call.
He was not understanding why someone was

5b16d8ba-4328-4834-b106-0d6caf58f4ba/71-4
00:08:45.613 --> 00:08:49.800
reaching out to him. And when she said,
well, I see that, you know,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/69-0
00:08:47.254 --> 00:08:47.494
Hmm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/71-5
00:08:49.800 --> 00:08:52.694
your weight is 203 and you were 199 on
Friday,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/73-0
00:08:52.934 --> 00:08:56.414
and I'm concerned that we may need to
adjust your medications or is there

5b16d8ba-4328-4834-b106-0d6caf58f4ba/70-0
00:08:53.174 --> 00:08:53.294
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/72-0
00:08:56.214 --> 00:08:56.734
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/73-1
00:08:56.414 --> 00:08:59.565
something going on with your diet?
How's your shortness of breath?

5b16d8ba-4328-4834-b106-0d6caf58f4ba/73-2
00:08:59.565 --> 00:09:01.494
And he kind of got flustered and he said,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/76-0
00:09:02.614 --> 00:09:06.358
wait a minute,
you're calling me because of the weight I

5b16d8ba-4328-4834-b106-0d6caf58f4ba/76-1
00:09:06.358 --> 00:09:10.299
put in my phone 5 minutes ago?
And she said, yeah, he goes,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/74-0
00:09:07.854 --> 00:09:08.054
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/76-2
00:09:10.299 --> 00:09:15.291
I was in the hospital last week and I
rang a call bell and I couldn't get a

5b16d8ba-4328-4834-b106-0d6caf58f4ba/75-0
00:09:13.894 --> 00:09:14.694
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/76-3
00:09:15.291 --> 00:09:19.823
nurse that fast. And so, you know,
patients can be delighted by this

5b16d8ba-4328-4834-b106-0d6caf58f4ba/76-4
00:09:19.823 --> 00:09:22.254
technology if you make it meaningful.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/80-0
00:09:23.014 --> 00:09:28.342
If you send somebody a 40 question
questionnaire every morning and nobody

5b16d8ba-4328-4834-b106-0d6caf58f4ba/77-0
00:09:27.574 --> 00:09:28.054
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/80-1
00:09:28.342 --> 00:09:33.238
does anything with it, they drop out.
After one week, they're done.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/78-0
00:09:29.174 --> 00:09:29.654
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/80-2
00:09:33.238 --> 00:09:38.926
But when they feel that it really impacts
their care or somebody takes action,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/79-0
00:09:34.134 --> 00:09:34.614
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/80-3
00:09:38.926 --> 00:09:41.014
or even if the chat bot says,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/82-0
00:09:41.334 --> 00:09:46.060
You're doing great. Keep it up.
Would you like to see some education

5b16d8ba-4328-4834-b106-0d6caf58f4ba/82-1
00:09:46.060 --> 00:09:51.265
about cardiac rehab or about, you know,
and take them down paths that maybe

5b16d8ba-4328-4834-b106-0d6caf58f4ba/81-0
00:09:48.854 --> 00:09:49.254
Right.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/82-2
00:09:51.265 --> 00:09:56.745
they've expressed an interest in learning
how to exercise with heart disease or

5b16d8ba-4328-4834-b106-0d6caf58f4ba/82-3
00:09:56.745 --> 00:10:01.814
better nutrition with heart failure?
And you can use these opportunities.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/84-0
00:10:02.054 --> 00:10:07.691
I don't know if you used the V-safe chat
bot that the CDC had in COVID. It was a,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/84-1
00:10:07.691 --> 00:10:11.954
if you got vaccinated,
you could answer a few questions about

5b16d8ba-4328-4834-b106-0d6caf58f4ba/84-2
00:10:11.954 --> 00:10:16.836
how you were tolerating the vaccine,
what symptoms did you have to it,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/83-0
00:10:15.334 --> 00:10:15.814
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/84-3
00:10:16.836 --> 00:10:21.098
any reactions to it.
And I did it every day when they sent it

5b16d8ba-4328-4834-b106-0d6caf58f4ba/84-4
00:10:21.098 --> 00:10:23.574
to me because it was so easy. It was

5b16d8ba-4328-4834-b106-0d6caf58f4ba/89-0
00:10:24.734 --> 00:10:27.226
a minute, less than a minute.
I never like said, oh,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/85-0
00:10:26.254 --> 00:10:26.854
Mm-hmm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/89-1
00:10:27.226 --> 00:10:30.893
this thing's going to take a while.
I'll do that later and put my phone down.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/89-2
00:10:30.893 --> 00:10:34.373
I knew I could answer two or three
questions and they would have the data

5b16d8ba-4328-4834-b106-0d6caf58f4ba/89-3
00:10:34.373 --> 00:10:36.912
they needed.
And I think that's where we have to find

5b16d8ba-4328-4834-b106-0d6caf58f4ba/89-4
00:10:36.912 --> 00:10:39.545
the sweet spot.
It's very tempting to ask patients lots

5b16d8ba-4328-4834-b106-0d6caf58f4ba/89-5
00:10:39.545 --> 00:10:43.212
of things. But if you're never going,
if no one's going to take action on it,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/87-0
00:10:40.454 --> 00:10:40.854
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/89-6
00:10:43.212 --> 00:10:44.294
don't waste their time.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/90-0
00:10:44.734 --> 00:10:47.254
It would be a tidbit I would offer to
others.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/88-0
00:10:44.774 --> 00:10:45.334
So...

5b16d8ba-4328-4834-b106-0d6caf58f4ba/95-0
00:10:47.974 --> 00:10:53.040
It sounds like there are a lot of
different data sources feeding into this

5b16d8ba-4328-4834-b106-0d6caf58f4ba/95-1
00:10:53.040 --> 00:10:58.377
tool. Obviously, there's clinical record,
there's patient-generated responses.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/92-0
00:10:53.054 --> 00:10:53.534
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/95-2
00:10:58.377 --> 00:11:03.917
What other sort of data sources did you
need to integrate in order to enable this

5b16d8ba-4328-4834-b106-0d6caf58f4ba/93-0
00:10:58.694 --> 00:10:59.174
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/95-3
00:11:03.917 --> 00:11:08.308
tool to not only be a data ingestion
mechanism from the patient,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/94-0
00:11:07.294 --> 00:11:07.774
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/95-4
00:11:08.308 --> 00:11:09.254
but also to be

5b16d8ba-4328-4834-b106-0d6caf58f4ba/96-0
00:11:09.494 --> 00:11:13.581
a data provision mechanism to send
resources and information and direct

5b16d8ba-4328-4834-b106-0d6caf58f4ba/96-1
00:11:13.581 --> 00:11:14.774
calls to the patient.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/99-0
00:11:15.294 --> 00:11:19.522
So the vendor that we worked with had a
dashboard,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/97-0
00:11:19.494 --> 00:11:20.054
It is.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/99-1
00:11:19.522 --> 00:11:25.658
but we integrated fully into our
ambulatory EMR. So that the, and to the,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/98-0
00:11:24.974 --> 00:11:25.534
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/99-2
00:11:25.658 --> 00:11:31.627
we had a homegrown platform for care
navigation for that group of nurse

5b16d8ba-4328-4834-b106-0d6caf58f4ba/99-3
00:11:31.627 --> 00:11:36.104
practitioners, PAs,
nurses that were doing these care

5b16d8ba-4328-4834-b106-0d6caf58f4ba/99-4
00:11:36.104 --> 00:11:36.934
navigation

5b16d8ba-4328-4834-b106-0d6caf58f4ba/101-0
00:11:37.254 --> 00:11:42.412
models post-discharge specifically,
but also for our own employee plan for

5b16d8ba-4328-4834-b106-0d6caf58f4ba/100-0
00:11:41.854 --> 00:11:42.334
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/101-1
00:11:42.412 --> 00:11:47.777
chronic diseases like diabetes or COPD.
We provide those kind of programs for

5b16d8ba-4328-4834-b106-0d6caf58f4ba/101-2
00:11:47.777 --> 00:11:53.280
employers, for lots of different groups.
And so they all documented in this one

5b16d8ba-4328-4834-b106-0d6caf58f4ba/101-3
00:11:53.280 --> 00:11:55.894
platform. And we made it very visually

5b16d8ba-4328-4834-b106-0d6caf58f4ba/105-0
00:11:58.534 --> 00:12:02.580
there were color,
it was color-coded and they could look

5b16d8ba-4328-4834-b106-0d6caf58f4ba/105-1
00:12:02.580 --> 00:12:07.976
very easily to see who had a red reply
today, who was all green, who had a,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/105-2
00:12:07.976 --> 00:12:11.809
it was green,
red and yellow were our color levels of

5b16d8ba-4328-4834-b106-0d6caf58f4ba/102-0
00:12:11.254 --> 00:12:11.894
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/105-3
00:12:11.809 --> 00:12:16.140
alert. And you know,
who was green moving into yellow looked

5b16d8ba-4328-4834-b106-0d6caf58f4ba/103-0
00:12:13.094 --> 00:12:13.574
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/105-4
00:12:16.140 --> 00:12:19.974
different than who was red moving into
yellow because

5b16d8ba-4328-4834-b106-0d6caf58f4ba/108-0
00:12:20.254 --> 00:12:24.363
That's a very different message.
If somebody's doing great and now they're

5b16d8ba-4328-4834-b106-0d6caf58f4ba/104-0
00:12:21.814 --> 00:12:22.294
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/108-1
00:12:24.363 --> 00:12:28.035
moving into a medium zone,
it's very different than somebody who's

5b16d8ba-4328-4834-b106-0d6caf58f4ba/106-0
00:12:26.094 --> 00:12:26.574
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/108-2
00:12:28.035 --> 00:12:30.830
really been in trouble,
but now they're in medium.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/108-3
00:12:30.830 --> 00:12:33.405
They're kind of moving in the right
direction.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/108-4
00:12:33.405 --> 00:12:37.954
And so putting that in the user workflow
that they got their alerts in their usual

5b16d8ba-4328-4834-b106-0d6caf58f4ba/108-5
00:12:37.954 --> 00:12:40.694
electronic medical record,
they didn't have to go

5b16d8ba-4328-4834-b106-0d6caf58f4ba/107-0
00:12:39.934 --> 00:12:40.534
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/111-0
00:12:40.894 --> 00:12:46.562
remember a password to log into another
place, because that is a real barrier.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/109-0
00:12:45.094 --> 00:12:45.574
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/111-1
00:12:46.562 --> 00:12:49.862
People change departments,
change employment,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/111-2
00:12:49.862 --> 00:12:54.884
somebody else has to get access.
You really want to make sure that if

5b16d8ba-4328-4834-b106-0d6caf58f4ba/111-3
00:12:54.884 --> 00:12:58.687
there's potentially a dangerous situation
out there,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/111-4
00:12:58.687 --> 00:13:03.494
that someone is monitoring and can see
this very quickly, not even

5b16d8ba-4328-4834-b106-0d6caf58f4ba/110-0
00:12:58.934 --> 00:12:59.414
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/114-0
00:13:04.214 --> 00:13:08.245
a few times a day,
depending on the use case. Now,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/112-0
00:13:05.894 --> 00:13:06.374
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/114-1
00:13:08.245 --> 00:13:12.434
if it's about, you know,
a rather low risk use case,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/114-2
00:13:12.434 --> 00:13:17.018
that may be fine.
But we used some of this for OB-GYN and

5b16d8ba-4328-4834-b106-0d6caf58f4ba/114-3
00:13:17.018 --> 00:13:22.393
postpartum depression screening was part
of it. One other anecdote,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/113-0
00:13:20.694 --> 00:13:21.174
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/114-4
00:13:22.393 --> 00:13:23.974
we had a patient who

5b16d8ba-4328-4834-b106-0d6caf58f4ba/117-0
00:13:24.294 --> 00:13:29.391
had her first postpartum visit with the
doctor, brought the baby into the visit.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/117-1
00:13:29.391 --> 00:13:33.797
Everybody was ooing, ahhing off the baby,
you know, checked out fine,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/115-0
00:13:31.134 --> 00:13:31.654
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/117-2
00:13:33.797 --> 00:13:38.768
went home and answered the questions in
her postpartum screening and expressed

5b16d8ba-4328-4834-b106-0d6caf58f4ba/117-3
00:13:38.768 --> 00:13:42.230
suicidality.
She was really struggling with postpartum

5b16d8ba-4328-4834-b106-0d6caf58f4ba/116-0
00:13:41.254 --> 00:13:41.454
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/117-4
00:13:42.230 --> 00:13:43.174
depression. And

5b16d8ba-4328-4834-b106-0d6caf58f4ba/118-0
00:13:43.974 --> 00:13:48.054
In conversation later with the doctor,
the doctor said, you know, I...

5b16d8ba-4328-4834-b106-0d6caf58f4ba/123-0
00:13:49.334 --> 00:13:52.619
I thought you were okay.
I'm so sorry I had missed it.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/123-1
00:13:52.619 --> 00:13:56.919
And she said, well, you know,
I was embarrassed to say anything because

5b16d8ba-4328-4834-b106-0d6caf58f4ba/119-0
00:13:52.774 --> 00:13:52.934
Mm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/123-2
00:13:56.919 --> 00:14:00.025
everybody,
I know the baby's a blessing and lots to

5b16d8ba-4328-4834-b106-0d6caf58f4ba/123-3
00:14:00.025 --> 00:14:03.608
be thankful for and a healthy baby is a
gift. But she said,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/120-0
00:14:01.974 --> 00:14:02.454
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/123-4
00:14:03.608 --> 00:14:08.446
when I got home and then the chat bot was
there, it was a little more anonymous.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/123-5
00:14:08.446 --> 00:14:11.254
It felt easier to have the conversation
there.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/121-0
00:14:09.334 --> 00:14:09.934
Mm-hmm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/122-0
00:14:11.334 --> 00:14:11.814
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/126-0
00:14:11.574 --> 00:14:15.637
And that was a real eye-opener to us that
for certain use cases,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/126-1
00:14:15.637 --> 00:14:19.138
patients actually prefer this. And listen,
we all know,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/126-2
00:14:19.138 --> 00:14:24.202
like if my dentist office calls me to
remind me I have an appointment, I'm like,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/126-3
00:14:24.202 --> 00:14:27.328
oh, I'm in a meeting.
Can you just text me? Like,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/124-0
00:14:26.854 --> 00:14:27.254
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/126-4
00:14:27.328 --> 00:14:30.454
can't we just do this more easily?
And so I think

5b16d8ba-4328-4834-b106-0d6caf58f4ba/125-0
00:14:29.814 --> 00:14:30.214
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/128-0
00:14:30.494 --> 00:14:35.461
where we're coming to now is the chat
bots are becoming more sophisticated to

5b16d8ba-4328-4834-b106-0d6caf58f4ba/128-1
00:14:35.461 --> 00:14:40.365
where they can know how do I prefer to be
addressed? When do I prefer? Well,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/128-2
00:14:40.365 --> 00:14:43.421
you know,
some patients will answer at 7 in the

5b16d8ba-4328-4834-b106-0d6caf58f4ba/128-3
00:14:43.421 --> 00:14:46.415
morning.
Some will answer at 7 in the evening.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/127-0
00:14:46.294 --> 00:14:46.774
Right.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/128-4
00:14:46.415 --> 00:14:49.854
Some want natural language processing.
Some want just

5b16d8ba-4328-4834-b106-0d6caf58f4ba/130-0
00:14:50.014 --> 00:14:53.437
a couple of questions with multiple
choice.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/130-1
00:14:53.437 --> 00:14:58.260
How do we target to get rich data from
all of them? You know,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/130-2
00:14:58.260 --> 00:15:04.173
and now the addition of devices,
wearables, sensors, medical devices, it's,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/129-0
00:15:02.374 --> 00:15:02.854
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/130-3
00:15:04.173 --> 00:15:08.374
you know, it's unlimited.
It's a little overwhelming.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/132-0
00:15:08.934 --> 00:15:13.565
Let's talk about those devices.
I know that you've integrated apps and

5b16d8ba-4328-4834-b106-0d6caf58f4ba/132-1
00:15:13.565 --> 00:15:18.978
medical devices and wireless devices. How,
and I guess all of that is into this AI

5b16d8ba-4328-4834-b106-0d6caf58f4ba/132-2
00:15:18.978 --> 00:15:24.197
chatbot type workflow. Can you explain,
can you elaborate on what kind of apps,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/131-0
00:15:19.814 --> 00:15:20.294
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/132-3
00:15:24.197 --> 00:15:27.458
device,
and wireless devices have been integrated

5b16d8ba-4328-4834-b106-0d6caf58f4ba/132-4
00:15:27.458 --> 00:15:27.654
and

5b16d8ba-4328-4834-b106-0d6caf58f4ba/134-0
00:15:28.214 --> 00:15:32.105
how have that,
how has that affected workflows for

5b16d8ba-4328-4834-b106-0d6caf58f4ba/134-1
00:15:32.105 --> 00:15:36.454
providers and just the general experience
for Northwell.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/133-0
00:15:35.894 --> 00:15:36.454
Sure.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/137-0
00:15:38.214 --> 00:15:43.305
Interestingly, with our initial vendor,
we did a pilot just to do hypertension

5b16d8ba-4328-4834-b106-0d6caf58f4ba/137-1
00:15:43.305 --> 00:15:46.399
monitoring.
We didn't really want to start with

5b16d8ba-4328-4834-b106-0d6caf58f4ba/135-0
00:15:45.014 --> 00:15:46.294
Mhm, mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/137-2
00:15:46.399 --> 00:15:51.168
something like glucose monitoring or any
kind of obstetrical application,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/137-3
00:15:51.168 --> 00:15:56.582
like some high risk things where somebody
could really be in a dangerous situation.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/137-4
00:15:56.582 --> 00:15:59.740
We said,
let's do this with blood pressure where

5b16d8ba-4328-4834-b106-0d6caf58f4ba/137-5
00:15:59.740 --> 00:16:01.094
we can kind of have a

5b16d8ba-4328-4834-b106-0d6caf58f4ba/136-0
00:16:01.174 --> 00:16:01.214
I.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/139-0
00:16:02.054 --> 00:16:06.598
you know, an explanation at the beginning,
like when you call your doctor's office

5b16d8ba-4328-4834-b106-0d6caf58f4ba/139-1
00:16:06.598 --> 00:16:09.939
and they say, if this is an emergency,
hang up and dial 911.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/138-0
00:16:09.734 --> 00:16:10.214
Right.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/139-2
00:16:09.939 --> 00:16:13.334
We felt with blood pressure,
we could provide some, you know,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/141-0
00:16:14.414 --> 00:16:18.612
grow barriers to people and say,
beyond this, call us.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/141-1
00:16:18.612 --> 00:16:23.726
Don't wait for us to call you.
Make sure you get in touch with us.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/140-0
00:16:20.454 --> 00:16:20.774
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/141-2
00:16:23.726 --> 00:16:28.612
And so, but that pilot,
we learned a lot about how data did not

5b16d8ba-4328-4834-b106-0d6caf58f4ba/141-3
00:16:28.612 --> 00:16:33.574
flow well on the internet through the
blood pressure cuff to the

5b16d8ba-4328-4834-b106-0d6caf58f4ba/143-0
00:16:34.054 --> 00:16:39.356
manufacturer of the blood pressure cuff
on their app and then over through

5b16d8ba-4328-4834-b106-0d6caf58f4ba/143-1
00:16:39.356 --> 00:16:43.881
Validic and into the vendor.
And so we actually put it on pause

5b16d8ba-4328-4834-b106-0d6caf58f4ba/143-2
00:16:43.881 --> 00:16:49.748
because we felt we were going to create a
patient safety issue where patients were

5b16d8ba-4328-4834-b106-0d6caf58f4ba/142-0
00:16:48.614 --> 00:16:48.774
Mm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/143-3
00:16:49.748 --> 00:16:52.294
safer with their notebook and a pen.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/145-0
00:16:53.094 --> 00:16:59.147
in 2021 that was. And so, you know,
we're now that we're then shortly after

5b16d8ba-4328-4834-b106-0d6caf58f4ba/144-0
00:16:55.654 --> 00:16:55.814
Mm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/145-1
00:16:59.147 --> 00:17:04.484
that, Epic was announced.
And so now we're beginning to understand

5b16d8ba-4328-4834-b106-0d6caf58f4ba/145-2
00:17:04.484 --> 00:17:09.741
what are what are their capabilities for
incorporating this data.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/145-3
00:17:09.741 --> 00:17:11.494
But we have physicians

5b16d8ba-4328-4834-b106-0d6caf58f4ba/146-0
00:17:12.534 --> 00:17:18.500
whole specialties lined up waiting for us
to offer glucometer monitoring.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/146-1
00:17:18.500 --> 00:17:22.531
Hypertension is, you know,
such a common problem.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/146-2
00:17:22.531 --> 00:17:29.142
And there's revenue tied there for remote
monitoring if it's done effectively and

5b16d8ba-4328-4834-b106-0d6caf58f4ba/146-3
00:17:29.142 --> 00:17:33.174
you meet certain qualifications with
patients. So

5b16d8ba-4328-4834-b106-0d6caf58f4ba/148-0
00:17:33.374 --> 00:17:38.342
There's lots of potential there.
The thing I will say about providers that

5b16d8ba-4328-4834-b106-0d6caf58f4ba/147-0
00:17:35.974 --> 00:17:36.454
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/148-1
00:17:38.342 --> 00:17:43.708
we need to be mindful of is they don't
want to know every blood glucose and they

5b16d8ba-4328-4834-b106-0d6caf58f4ba/148-2
00:17:43.708 --> 00:17:48.941
don't want to know every blood pressure.
The volumes of data are way too much.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/148-3
00:17:48.941 --> 00:17:52.254
And so what we need to be careful is not
to alert

5b16d8ba-4328-4834-b106-0d6caf58f4ba/152-0
00:17:52.334 --> 00:17:57.679
them with every blood pressure that's
over 140 over 90 because my goodness,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/152-1
00:17:57.679 --> 00:18:02.251
like that's why somebody is on
hypertension monitoring. They're,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/149-0
00:18:01.814 --> 00:18:02.534
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/152-2
00:18:02.251 --> 00:18:05.697
you know,
and somebody who's 140 over 90 who was

5b16d8ba-4328-4834-b106-0d6caf58f4ba/152-3
00:18:05.697 --> 00:18:11.254
160 over 100 last week is very different
than somebody who was 120 over 80. So

5b16d8ba-4328-4834-b106-0d6caf58f4ba/150-0
00:18:08.454 --> 00:18:09.094
That's great.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/151-0
00:18:11.974 --> 00:18:12.534
Right.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/154-0
00:18:12.214 --> 00:18:15.380
There's a lot to be learned from small
pilots.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/154-1
00:18:15.380 --> 00:18:20.231
And what I tell people is don't do
nothing. It's a little overwhelming.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/154-2
00:18:20.231 --> 00:18:24.880
Nobody's really sure what to do.
But if you just do one small thing,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/153-0
00:18:22.414 --> 00:18:22.934
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/154-3
00:18:24.880 --> 00:18:29.934
you really will learn more than you might
imagine from that small project.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/156-0
00:18:31.014 --> 00:18:37.518
And so what we're trying to say with the
projects we're planning now is how do we

5b16d8ba-4328-4834-b106-0d6caf58f4ba/156-1
00:18:37.518 --> 00:18:42.911
let a doctor know that this patient who's
diabetic is, there is 6%,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/156-2
00:18:42.911 --> 00:18:48.860
has better blood glucose control within,
you know, 6% better this quarter.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/156-3
00:18:48.860 --> 00:18:49.574
This one,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/155-0
00:18:49.374 --> 00:18:49.854
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/159-0
00:18:49.734 --> 00:18:54.029
spikes on Fridays,
their blood glucose goes up Fridays at

5b16d8ba-4328-4834-b106-0d6caf58f4ba/159-1
00:18:54.029 --> 00:18:57.435
530.
Maybe we have a conversation about happy

5b16d8ba-4328-4834-b106-0d6caf58f4ba/157-0
00:18:55.014 --> 00:18:55.494
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/159-2
00:18:57.435 --> 00:19:02.249
hour. What's happening on Fridays?
You know, and this, you know,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/158-0
00:18:57.494 --> 00:18:57.734
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/159-3
00:19:02.249 --> 00:19:07.803
this hypertension patient, you know,
is trending this much better or is it

5b16d8ba-4328-4834-b106-0d6caf58f4ba/159-4
00:19:07.803 --> 00:19:13.654
within range 80% of the time where it was
only 50% of the time six months ago?

5b16d8ba-4328-4834-b106-0d6caf58f4ba/160-0
00:19:13.974 --> 00:19:19.534
so that we give them insight, not numbers.
If we don't help them manage the volumes

5b16d8ba-4328-4834-b106-0d6caf58f4ba/160-1
00:19:19.534 --> 00:19:24.301
of data that are coming at them,
they'll never buy into these projects.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/160-2
00:19:24.301 --> 00:19:25.294
But I wouldn't.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/163-0
00:19:24.974 --> 00:19:28.450
So Kathy, I love the anecdotes.
I love the illustration.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/163-1
00:19:28.450 --> 00:19:31.621
We are approaching the end of this
podcast episode.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/163-2
00:19:31.621 --> 00:19:36.622
And I think I'd like to ask you one final
question about your outcomes over time.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/161-0
00:19:34.214 --> 00:19:34.774
Certainly.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/163-3
00:19:36.622 --> 00:19:40.038
As we mentioned,
Northwell got started with AI pilots a

5b16d8ba-4328-4834-b106-0d6caf58f4ba/163-4
00:19:40.038 --> 00:19:45.100
little bit before the rest of the country.
And one of the things that AI does very

5b16d8ba-4328-4834-b106-0d6caf58f4ba/162-0
00:19:42.054 --> 00:19:42.534
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/163-5
00:19:45.100 --> 00:19:47.174
well is identify trends over time.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/164-0
00:19:47.374 --> 00:19:52.573
You're mentioning these meaningless
alerts and how to identify what is a

5b16d8ba-4328-4834-b106-0d6caf58f4ba/164-1
00:19:52.573 --> 00:19:58.341
meaningful alert and when to notify that,
embed it within the provider workflow.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/164-2
00:19:58.341 --> 00:20:01.475
So the question I'd like to pose to you
is,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/164-3
00:20:01.475 --> 00:20:06.745
what has been kind of the result over
time of what has been the impact of

5b16d8ba-4328-4834-b106-0d6caf58f4ba/164-4
00:20:06.745 --> 00:20:07.814
having these AI

5b16d8ba-4328-4834-b106-0d6caf58f4ba/165-0
00:20:07.854 --> 00:20:13.284
chat bots and new iterations of
manifestations of AI at Northwell Health

5b16d8ba-4328-4834-b106-0d6caf58f4ba/165-1
00:20:13.284 --> 00:20:18.491
and any words of advice to other
organizations who are earlier in the

5b16d8ba-4328-4834-b106-0d6caf58f4ba/165-2
00:20:18.491 --> 00:20:20.054
process in Northwell.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/167-0
00:20:20.454 --> 00:20:24.455
Sure. So we, you know,
I've mentioned this robust care

5b16d8ba-4328-4834-b106-0d6caf58f4ba/167-1
00:20:24.455 --> 00:20:28.093
navigation post discharge that Northwell
offered.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/167-2
00:20:28.093 --> 00:20:33.476
Our readmission rates were already good.
Like in 2018, we were, you know,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/166-0
00:20:30.854 --> 00:20:31.334
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/167-3
00:20:33.476 --> 00:20:37.914
doing pretty well on that measure.
And with this technology,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/167-4
00:20:37.914 --> 00:20:40.534
the patients who participated in it,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/172-0
00:20:40.774 --> 00:20:44.935
had a reduction.
And I remember my academic advisor at the

5b16d8ba-4328-4834-b106-0d6caf58f4ba/172-1
00:20:44.935 --> 00:20:48.886
time saying to me,
looking at the numbers of my data to

5b16d8ba-4328-4834-b106-0d6caf58f4ba/169-0
00:20:48.454 --> 00:20:49.014
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/172-2
00:20:48.886 --> 00:20:52.695
start and saying, boy,
if you can impact this number,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/172-3
00:20:52.695 --> 00:20:58.056
you're really getting blood from a stone
at this point because it's really,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/170-0
00:20:55.734 --> 00:20:55.894
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/172-4
00:20:58.056 --> 00:21:01.654
you already have good reduction of
readmission. So

5b16d8ba-4328-4834-b106-0d6caf58f4ba/171-0
00:20:59.574 --> 00:21:00.054
Right.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/174-0
00:21:01.974 --> 00:21:09.318
this technology would have to really do
something special to make it a measurable

5b16d8ba-4328-4834-b106-0d6caf58f4ba/173-0
00:21:06.854 --> 00:21:07.414
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/174-1
00:21:09.318 --> 00:21:15.140
difference. And it did.
So I think that what I would tell people

5b16d8ba-4328-4834-b106-0d6caf58f4ba/174-2
00:21:15.140 --> 00:21:19.529
is that, you know,
these technologies are there.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/174-3
00:21:19.529 --> 00:21:20.694
Be careful in

5b16d8ba-4328-4834-b106-0d6caf58f4ba/175-0
00:21:21.334 --> 00:21:25.722
setting your thresholds.
If you create a lot of false alarms,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/175-1
00:21:25.722 --> 00:21:29.757
you really reduce the effectiveness of
them, ironically.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/175-2
00:21:29.757 --> 00:21:35.561
You can use that data certainly to know
that somebody is trending 10% higher over

5b16d8ba-4328-4834-b106-0d6caf58f4ba/175-3
00:21:35.561 --> 00:21:39.454
a month or in a value that you want lower
or whatever.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/178-0
00:21:39.614 --> 00:21:44.278
But if you alert nurses and doctors,
it just becomes alarm fatigue and it

5b16d8ba-4328-4834-b106-0d6caf58f4ba/178-1
00:21:44.278 --> 00:21:48.374
becomes less meaningful.
So working with providers to understand

5b16d8ba-4328-4834-b106-0d6caf58f4ba/178-2
00:21:48.374 --> 00:21:51.967
when would you,
what could we tell you at your patient's

5b16d8ba-4328-4834-b106-0d6caf58f4ba/178-3
00:21:51.967 --> 00:21:57.072
office visit that would be helpful for
you to know versus when do you want us to

5b16d8ba-4328-4834-b106-0d6caf58f4ba/176-0
00:21:54.214 --> 00:21:54.334
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/178-4
00:21:57.072 --> 00:21:58.774
call you on Sunday morning?

5b16d8ba-4328-4834-b106-0d6caf58f4ba/180-0
00:21:59.094 --> 00:22:03.024
for about your patient and let you know
that.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/177-0
00:21:59.334 --> 00:21:59.894
Mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/180-1
00:22:03.024 --> 00:22:09.946
Because if you trigger them constantly,
and we found we pretty quickly reset our

5b16d8ba-4328-4834-b106-0d6caf58f4ba/180-2
00:22:09.946 --> 00:22:16.099
yellow alerts because, you know,
one patient said within a few weeks of

5b16d8ba-4328-4834-b106-0d6caf58f4ba/179-0
00:22:11.094 --> 00:22:12.374
Mhm, mhm.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/180-3
00:22:16.099 --> 00:22:17.894
going on the program,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/183-0
00:22:18.654 --> 00:22:23.100
When he got a call from the nurse,
he was like, oh, am I yellow again?

5b16d8ba-4328-4834-b106-0d6caf58f4ba/181-0
00:22:22.374 --> 00:22:23.094
Yeah.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/183-1
00:22:23.100 --> 00:22:26.732
And so, you know, just understanding that,
wait a minute,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/183-2
00:22:26.732 --> 00:22:31.805
we're starting to over monitor in some
ways because you have so much ability and

5b16d8ba-4328-4834-b106-0d6caf58f4ba/183-3
00:22:31.805 --> 00:22:36.439
such scalability. So, you know,
set the thresholds where you really would

5b16d8ba-4328-4834-b106-0d6caf58f4ba/183-4
00:22:36.439 --> 00:22:37.254
do something.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/184-0
00:22:37.294 --> 00:22:42.454
thing, not just to know.
And then use the data about that you know

5b16d8ba-4328-4834-b106-0d6caf58f4ba/182-0
00:22:37.974 --> 00:22:38.374
Right.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/184-1
00:22:42.454 --> 00:22:47.691
to identify the trends for the provider
so that they can say, okay,

5b16d8ba-4328-4834-b106-0d6caf58f4ba/184-2
00:22:47.691 --> 00:22:51.619
you've really been in good control on
this number.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/184-3
00:22:51.619 --> 00:22:56.934
Let's look at this other thing now and
get insight rather than data.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/185-0
00:22:57.414 --> 00:22:59.951
Well, Kathy,
I appreciate everything that you've given

5b16d8ba-4328-4834-b106-0d6caf58f4ba/185-1
00:22:59.951 --> 00:23:02.165
to us today.
Thank you for joining Healthy Data

5b16d8ba-4328-4834-b106-0d6caf58f4ba/185-2
00:23:02.165 --> 00:23:02.534
Podcast.

5b16d8ba-4328-4834-b106-0d6caf58f4ba/186-0
00:23:02.854 --> 00:23:03.574
My pleasure.