cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/6-0
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today with Akhil Chawla,
the Vice Chair of Surgery for Regional

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/6-1
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Integration at Northwestern Medicine and
an Associate Professor of Surgery at

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/6-2
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Northwestern University Feinberg School
of Medicine and a surgical oncologist at

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/6-3
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the Lurie Comprehensive Cancer Center.
Akhil, thank you for joining us today.

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Thank you for having me.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/8-0
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So for those listening,
Northwestern Medicine is a health system

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/8-1
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headquartered in Chicago, Illinois,
with 2,

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000 beds and 11 hospitals supported by 4,
000 physicians of whom Akhil is 1. Today,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/8-3
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Akhil,
we're going to be discussing system

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/8-4
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integration,
bringing clinical trials closer to home,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/9-0
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an example of that work specifically
grounded in your pancreatic cancer and

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/9-1
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early detection projects looking at
biomarkers like ctDNA. So please, Akhil,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/9-2
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welcome and tell us more about that
program.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/11-0
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Yeah,
thanks again for having me and it's a

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/11-1
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privilege to be here. You know,
as I think about integration,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/11-2
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it's a discussion that would certainly
surpass the time that we have,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/11-3
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but it's really unifying the patient
experience.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/11-4
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I think about it at the patient level.
What does a patient experience when they

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/10-0
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Mhm.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/11-5
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walk into

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/13-0
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one of our Northwestern Medicine
hospitals. What kind of access to care?

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And as a surgical oncologist thinking
about cancer,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/13-2
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what does a cancer patient feel,
for example?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/13-3
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What kind of doctors do they see?
What kind of familiarity with their

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/13-4
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disease process do they have?
And if a person has a need for a certain

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level of care or certain subspecialty
expertise,

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how does that patient get handed off?

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to the other physician.
I think the patient experience is not

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/14-1
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underrated because the patient experience
is very closely correlated, actually,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/14-2
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with how patients actually do from their
disease. And that's data-driven.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/14-3
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You think about, you know,
what makes patients go back and rate our

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/14-4
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hospital system, you know,
the best in Chicagoland.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/15-0
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It's actually what makes what makes
Northwestern Medicine special.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/15-1
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It's the ability to actually provide
high-level care close to home,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/15-2
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regardless of whether you present to
Kishwaukee Hospital, Palace Hospital, or,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/15-3
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you know, Northwestern Memorial Hospital.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/16-0
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So, Akhil,
I know you're building an integrated

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/16-1
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surgical program across a very large
health system that is Northwestern

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Medicine.
Can you tell our listeners about how

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/16-3
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you're thinking about standardizing care,
improving access to subspecialty

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/16-4
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expertise,
and determining the right site of care

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across academic and regional hospitals?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/17-0
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Yeah, so, you know,
within our 11 hospital system,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/17-1
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we have really two tertiary level
hospitals and one quaternary level

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/17-2
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hospital.
And we've kind of split it up by regions

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/17-3
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based off geography. But the reality is,
if there's a patient that's far out west,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/17-4
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they may not need to travel, you know,
an hour and a half.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/18-0
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to get to Northwest Memorial Hospital in
Streeterville.

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Those patients should be seen for a very
high level care at Central DuPage

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/18-2
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Hospital,
which is a 400 bed hospital with very

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strong, you know, vascular surgery,
cardiovascular surgery, thoracic,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/18-4
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surgical oncology.
So part of that experience is not just

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/18-5
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the fact that we can offer care at those
locations and operate on patients,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/19-0
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but the delivery of that care in a very
high quality manner.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/19-1
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So understanding that a patient comes in
and feels and understands that the

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/19-2
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outcomes are going to be very similar to
what they would be at our academic

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/19-3
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medical site. I think that's key.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/20-0
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So what are some of the technical
challenges that your team has had to

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/20-1
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overcome in order to facilitate this kind
of funneling of patients into the most

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/20-2
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appropriate and convenient site of care?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/22-0
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Yeah, great question. You know,
I think a problem that we deal with,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/22-1
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with I think,
which I think most health systems across

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/22-2
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the country are actively dealing with,
is capacity. You know,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/22-3
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how do we care for all patients that
present to our doors,

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regardless of where they are? I mean,
a patient doesn't know if a hospital is

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full.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/23-0
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So some of the things that we have
leveraged is technology and understanding,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/21-0
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Okay.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/23-1
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you know,
the OR capacity and the number of hours

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/23-2
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utilized for a certain type of case and
what could be done in potentially lower

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level of care,
potentially a hospital that's not a

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tertiary level hospital or an ambulatory
surgery center.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/24-0
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Understanding what could be done in those
areas and those locations and settings

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/24-1
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without compromising quality is one of
the areas that we're most focused on.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/24-2
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But that's a very matrixed type of
decision-making process where we really

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/24-3
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want to highlight also the programs that
we shine in, right, like cancer care,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/25-0
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cardiovascular care.
We want to be able to offer that to all

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/25-1
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the patients in Chicagoland if possible.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/26-0
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So I want to ground this conversation in
a concrete use case, right?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/26-1
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Because many of our listeners understand
that you're trying to provide the patient

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the most affordable,
like lowest level of care,

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while also allowing providers to practice
at the top of their license.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/26-4
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That's very familiar.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/27-0
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kind of mental construct in many health
systems.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/27-1
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But you're working with translating
innovation into clinical practice with

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/27-2
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your work with pancreatic cancer and
circulating tumor DNA and other precision

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/27-3
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oncology tools.
So when you have a cancer patient,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/27-4
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obviously some of those tools are only
going to be available in your tertiary

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/27-5
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and quaternary care centers.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/28-0
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Other oncology patients may be able to
get their chemo potentially administered

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/28-1
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in an ASC. So please,
let's use a pancreatic center use case.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/28-2
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What are you thinking here?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/30-0
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Yeah,
so I think pancreas cancer is a great

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/30-1
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example because it's something I work in
with every day.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/30-2
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So a patient presents to Kishwaukee
Hospital,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/30-3
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which is one of our far west hospitals.
We have great medical oncologists that

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/30-4
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are part of our broad GI tumor board that
we then are able to evaluate and

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/29-0
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Mhm.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/30-5
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determine the strategy of care.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/31-0
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During that tumor board, actually,
we're able to understand, you know,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/31-1
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what can be offered close to home,
for example,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/31-2
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the chemotherapy and if a patient needs
radiation. Well,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/31-3
00:06:20.872 --> 00:06:25.257
we know that their Whipple operation is
going to need to happen at Central DuPage

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/31-4
00:06:25.257 --> 00:06:28.787
Hospital, which is, you know,
probably the closest tertiary level

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/31-5
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hospital that patient has.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/32-0
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But one of the other areas that I focus
on is bringing clinical trials close to

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/32-1
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home.
It is not acceptable that that patient

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/32-2
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should not have access to the same
circulating tumor DNA trial that we have

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/32-3
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open in one of our other campuses.
In fact,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/32-4
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we have set up that infrastructure such
that our clinical trials office actually

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/32-5
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has purview and sends clinical research
coordinators to those sites to enroll

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/32-6
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those

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patients on trial. And actually,
we're able to then apply those results in

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/34-1
00:07:00.450 --> 00:07:04.471
a much more broad way. You know,
we're not only, you know,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/34-2
00:07:04.471 --> 00:07:09.856
examining or identifying patients that
can enroll on clinical trials that have

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/34-3
00:07:09.856 --> 00:07:14.218
the access to come to Streeterville to be
part of those trials.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/33-0
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Mhm.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/35-0
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It makes the results of those clinical
trials much more applicable when a

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/35-1
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patient who lives 30 minutes west of
Kishwaukee Hospital and two hours from

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/35-2
00:07:23.223 --> 00:07:27.848
Streeterville to be enrolled in a trial
to then have those results be applicable

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/35-3
00:07:27.848 --> 00:07:29.218
to a broader population.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/36-0
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So clearly,
patient access is a top priority for

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/36-1
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Northwestern.
And in order to kind of emphasize and

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/36-2
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facilitate improved patient access,
you're trying to bring clinical trials

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/36-3
00:07:41.952 --> 00:07:45.749
closer to the patient so it's more
convenient for them,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/36-4
00:07:45.749 --> 00:07:48.258
while also enabling care coordinators

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/37-0
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to ensure that when they do need,
for example, a Whipple operation,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/37-1
00:07:51.800 --> 00:07:54.193
that they're able to get to the tertiary
care.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/37-2
00:07:54.193 --> 00:07:57.858
But that doesn't mean that all their care
is at that tertiary hospital,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/37-3
00:07:57.858 --> 00:08:01.574
but that they can get some closer to
their own community. I'm wondering,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/37-4
00:08:01.574 --> 00:08:04.323
with care happening in all these
different locations,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/37-5
00:08:04.323 --> 00:08:08.600
what technical challenges are you seeking
to address or have you addressed in order

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/37-6
00:08:08.600 --> 00:08:09.058
to ensure

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/38-0
00:08:09.258 --> 00:08:13.486
that the record is comprehensive,
that the care provided in different

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/38-1
00:08:13.486 --> 00:08:17.955
settings is that all providers in the
care team are aware of all the care

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/38-2
00:08:17.955 --> 00:08:22.304
provided in different settings,
that the primary care provider is aware

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/38-3
00:08:22.304 --> 00:08:26.350
of what clinical trials the patient may
be eligible for, you know,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/38-4
00:08:26.350 --> 00:08:30.940
what sort of kind of infrastructure is
required in order to facilitate this

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/38-5
00:08:30.940 --> 00:08:33.658
improved patient access,
which is ultimately

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/39-0
00:08:33.738 --> 00:08:35.138
business outcome you're looking for.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/41-0
00:08:36.018 --> 00:08:39.343
Yeah, so, you know,
going back to the example of pancreas

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/41-1
00:08:39.343 --> 00:08:42.496
cancer care, you know,
I think navigating the patient,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/41-2
00:08:42.496 --> 00:08:45.993
navigation is key.
And many of our programs have navigators,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/41-3
00:08:45.993 --> 00:08:49.089
even in our Bloom Cardiovascular Center,
for example,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/41-4
00:08:49.089 --> 00:08:53.676
having a touch point for a patient to be
able to then be a warm transition such

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/41-5
00:08:53.676 --> 00:08:57.058
that they're meeting the surgeon at the
time of diagnosis,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/40-0
00:08:54.338 --> 00:08:54.818
Mhm.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/43-0
00:08:57.098 --> 00:09:01.009
but they're not going to meet them again
until they're done with their

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/43-1
00:09:01.009 --> 00:09:03.873
chemotherapy,
such that when it's time for surgery,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/43-2
00:09:03.873 --> 00:09:07.618
they then have to travel.
We have all the other resources in place,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/43-3
00:09:07.618 --> 00:09:11.088
such as social work,
other additional supportive services that

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/43-4
00:09:11.088 --> 00:09:14.337
can allow patients to help get to a place
if they need to.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/43-5
00:09:14.337 --> 00:09:18.248
But I do think that there's a huge
disparity that exists in the United

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/42-0
00:09:14.458 --> 00:09:14.978
Mhm.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/43-6
00:09:18.248 --> 00:09:21.938
States. That's no question about that.
And within our Northwestern

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/44-0
00:09:22.058 --> 00:09:25.571
medicine catchment,
we see that disparity every single day in

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/44-1
00:09:25.571 --> 00:09:28.630
the ability for patients to get routine
primary care.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/44-2
00:09:28.630 --> 00:09:33.333
And so one of the things that we've done
is really implemented the ability to have

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/44-3
00:09:33.333 --> 00:09:36.449
frequent touch points even after surgery
is completed,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/44-4
00:09:36.449 --> 00:09:40.698
such that it would reduce the chance of a
patient falling off or needing a

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/44-5
00:09:40.698 --> 00:09:41.378
readmission.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/45-0
00:09:42.018 --> 00:09:47.047
I think navigation in some of these very
extremely complex areas is key to

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/45-1
00:09:47.047 --> 00:09:51.138
allowing that patient to get all the care
that they deserve.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/46-0
00:09:51.778 --> 00:09:54.455
Now,
if a patient is looking to use a digital

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/46-1
00:09:54.455 --> 00:09:58.239
front door, for example,
MyChart or Northwestern specific app or

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/46-2
00:09:58.239 --> 00:10:02.080
the website or, you know,
there's various digital portals through

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/46-3
00:10:02.080 --> 00:10:06.446
which the patient is trying to access
this care and get this coordination.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/46-4
00:10:06.446 --> 00:10:09.181
It could be a phone call,
it could be the app,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/46-5
00:10:09.181 --> 00:10:10.578
it could be the website.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/47-0
00:10:10.738 --> 00:10:14.135
Are you leveraging artificial
intelligence at all?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/47-1
00:10:14.135 --> 00:10:18.930
Is there any kind of AI platform or
governance strategy that is helping

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/47-2
00:10:18.930 --> 00:10:24.058
facilitate and coordinate all these
different access points for the patient?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/49-0
00:10:25.458 --> 00:10:28.588
You know,
we really think at Northwestern Medicine

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/49-1
00:10:28.588 --> 00:10:33.559
that there's a space for technology to
help patients have high quality outcomes,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/49-2
00:10:33.559 --> 00:10:38.101
but nothing is really going to replace
the human touch and the ability to

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/49-3
00:10:38.101 --> 00:10:42.581
actually relate with a patient.
So we really leave a lot of our services

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/48-0
00:10:38.978 --> 00:10:39.538
Mhm.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/49-4
00:10:42.581 --> 00:10:45.343
for our,
particularly the more complex ones,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/49-5
00:10:45.343 --> 00:10:46.018
to actually

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/51-0
00:10:46.098 --> 00:10:49.628
have a touch point,
a navigator that could potentially help a

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/51-1
00:10:49.628 --> 00:10:52.189
patient to get where they needed to be.
Now,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/51-2
00:10:52.189 --> 00:10:56.743
as it relates to things like capacity and
understanding complexity in terms of,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/51-3
00:10:56.743 --> 00:11:01.468
you know, OR utilization and transfers,
certainly we're leveraging the technology,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/51-4
00:11:01.468 --> 00:11:05.510
machine learning to better understand
where the leverage points exist,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/51-5
00:11:05.510 --> 00:11:07.218
where the opportunities exist.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/52-0
00:11:07.578 --> 00:11:12.027
We're already under the same health
electronic medical record system

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/52-1
00:11:12.027 --> 00:11:16.540
throughout our entire health system.
That's been the case for a very,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/52-2
00:11:16.540 --> 00:11:20.086
very long time.
So we're leveraging the use of Epic to

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/52-3
00:11:20.086 --> 00:11:24.921
actually better understand that patient
flow so we can catch patients from

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/52-4
00:11:24.921 --> 00:11:28.338
presenting late for certain things.
So understanding

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/53-0
00:11:28.658 --> 00:11:30.728
you know,
potentially what the primary care is

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/53-1
00:11:30.728 --> 00:11:32.578
seeing and potentially intervening sooner.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/54-0
00:11:33.538 --> 00:11:39.313
So, Akhil, obviously you are a physician.
You're the vice chair of surgery for

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/54-1
00:11:39.313 --> 00:11:44.430
regional integration. Now,
if you were to be speaking to the C-suite,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/54-2
00:11:44.430 --> 00:11:48.962
particularly the CIO or CTO at
Northwestern, you know, maybe,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/54-3
00:11:48.962 --> 00:11:54.298
and I'm not sure about Northwestern
specifically, but many CIOs or CTOs,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/56-0
00:11:55.138 --> 00:12:00.631
do not spend the majority of their time
with frontline clinicians as you are and

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/56-1
00:12:00.631 --> 00:12:04.903
your colleagues are.
And I'm wondering if you have any message

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/56-2
00:12:04.903 --> 00:12:08.768
for a more technical audience listening
to this podcast,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/56-3
00:12:08.768 --> 00:12:12.768
potentially a CIO of your or a peer
organization or a CTO,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/56-4
00:12:12.768 --> 00:12:16.498
what kind of requests would you make of
that audience?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/57-0
00:12:16.778 --> 00:12:20.374
Because for them,
they may be considering their data center

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/57-1
00:12:20.374 --> 00:12:24.510
strategy, a cloud strategy,
may be figuring out where Epic is hosted

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/57-2
00:12:24.510 --> 00:12:29.005
and what kind of latency issues and how
to avoid downtime and what sort of

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/57-3
00:12:29.005 --> 00:12:33.920
vendors and AI applications could be most
useful in order to achieve, as you say,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/57-4
00:12:33.920 --> 00:12:35.778
the improved clinical outcomes.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/58-0
00:12:35.938 --> 00:12:38.896
the improved quality of care,
the improved access for patients.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/58-1
00:12:38.896 --> 00:12:41.808
That's the clinical and business outcomes
that you care about.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/58-2
00:12:41.808 --> 00:12:44.766
From a technical perspective,
when you're speaking to technical

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/58-3
00:12:44.766 --> 00:12:47.170
leadership,
what requests would you make of them or

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/58-4
00:12:47.170 --> 00:12:50.498
what would you want them to know as they
make those business decisions?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/59-0
00:12:51.938 --> 00:12:56.545
Yeah, no, that's a great question.
I think for somebody who sits with

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/59-1
00:12:56.545 --> 00:13:00.757
different hats as a clinician and
researcher and administrator,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/59-2
00:13:00.757 --> 00:13:05.561
I think that it's important to really
think about how we integrate care.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/59-3
00:13:05.561 --> 00:13:10.497
I think it's very easy to get lost in
spreadsheets and see that there's an

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/59-4
00:13:10.497 --> 00:13:13.458
opportunity in terms of utilizing
technology

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/60-0
00:13:13.778 --> 00:13:14.578
to fill a gap.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/61-0
00:13:15.618 --> 00:13:19.326
But there's also a patient behind that.
There's a program,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/61-1
00:13:19.326 --> 00:13:22.091
a program that has been built to,
you know,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/61-2
00:13:22.091 --> 00:13:27.118
really leverage the expertise that we
have with our physicians at Northwestern.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/61-3
00:13:27.118 --> 00:13:31.705
And I think aligning the strategic
component with the high quality care,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/61-4
00:13:31.705 --> 00:13:36.418
along with what we can leverage from a
technology standpoint and capacity,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/63-0
00:13:36.618 --> 00:13:39.985
I think bringing all three of those
things together is key.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/63-1
00:13:39.985 --> 00:13:44.588
And our individuals that sit on the tech
side within our leadership are very much

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/63-2
00:13:44.588 --> 00:13:47.955
in tune with that.
It's because we have leaders like myself

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/63-3
00:13:47.955 --> 00:13:52.389
that actually don't just sit in one lane.
We're actually purview to, you know,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/62-0
00:13:51.058 --> 00:13:51.538
Mhm.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/63-4
00:13:52.389 --> 00:13:57.047
what it looks like on the patient's side
and what the challenges are for a surgeon

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/63-5
00:13:57.047 --> 00:13:58.338
to get into the OR for,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/64-0
00:13:58.538 --> 00:14:01.247
you know,
booking a full day case and thinking

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/64-1
00:14:01.247 --> 00:14:04.416
about, you know,
where a patient should be in terms of

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/64-2
00:14:04.416 --> 00:14:08.854
getting high quality care. And also,
how do we leverage our health system to

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/64-3
00:14:08.854 --> 00:14:13.234
be able to get to more patients where
access to care may not be so easy for

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/64-4
00:14:13.234 --> 00:14:14.098
those patients?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/65-0
00:14:14.738 --> 00:14:18.512
A lot of times, Akhil,
when you speak about kind of improving

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/65-1
00:14:18.512 --> 00:14:21.981
patient access,
enabling clinical trials to be delivered

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/65-2
00:14:21.981 --> 00:14:26.668
in many different settings of care,
a lot of times there are challenges that

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/65-3
00:14:26.668 --> 00:14:30.442
are logistic challenges.
There are political, organizational,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/65-4
00:14:30.442 --> 00:14:34.338
governance challenges,
but also there are technical challenges.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/66-0
00:14:34.658 --> 00:14:38.546
As we wrap up this podcast,
are there any technical challenges that

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/66-1
00:14:38.546 --> 00:14:42.605
you've encountered in the past few years
while operating, for example,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/66-2
00:14:42.605 --> 00:14:46.665
the pancreatic cancer workflows that
we've been discussing? And if so,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/66-3
00:14:46.665 --> 00:14:50.953
how have you addressed any of those?
Or how would you recommend a listener

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/66-4
00:14:50.953 --> 00:14:54.498
encountering similar challenges might
address those technical

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/67-0
00:14:54.738 --> 00:14:56.818
obstacles that you are able to overcome.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/68-0
00:14:57.858 --> 00:15:00.289
Yeah,
I think one thing as we looked at the

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/68-1
00:15:00.289 --> 00:15:02.665
data,
we realized that there were clinical

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/68-2
00:15:02.665 --> 00:15:05.869
trials that are available to patients,
but in some sites,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/68-3
00:15:05.869 --> 00:15:09.460
there's lower enrollment.
And so we have a program called Cancer

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/68-4
00:15:09.460 --> 00:15:13.880
Insights where we utilize patient data to
better understand what trials they're

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/68-5
00:15:13.880 --> 00:15:16.919
eligible for.
So we are able to then cue the physician

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/68-6
00:15:16.919 --> 00:15:17.858
to then see, hey,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/69-0
00:15:18.058 --> 00:15:21.594
this patient may be eligible for trial A,
B, or C.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/69-1
00:15:21.594 --> 00:15:26.446
That's really using technology to
leverage the ability to get as many

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/69-2
00:15:26.446 --> 00:15:30.606
patients as possible to at least consider
a clinical trial.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/69-3
00:15:30.606 --> 00:15:33.795
And I think as we kind of exit the COVID
era,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/69-4
00:15:33.795 --> 00:15:37.538
we realize there's a lot of ability to
work remotely.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/71-0
00:15:38.418 --> 00:15:41.176
Certainly the workforce has always been a
challenge,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/71-1
00:15:41.176 --> 00:15:45.339
but the ability to potentially consent a
patient that lives or is in a hospital

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/71-2
00:15:45.339 --> 00:15:48.722
that's an hour from where we are at the
academic medical campus,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/71-3
00:15:48.722 --> 00:15:52.521
I think those are important things that
we need to continue to leverage.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/70-0
00:15:49.658 --> 00:15:50.138
Mmh.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/71-4
00:15:52.521 --> 00:15:56.215
It makes no sense to me that we
physically have to be in front of that

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/71-5
00:15:56.215 --> 00:15:59.858
patient in every circumstance to simply
go through a consent form. So

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/72-0
00:16:00.178 --> 00:16:04.056
That's how we get more out of our staff.
And I think those are important

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/72-1
00:16:04.056 --> 00:16:06.978
components of how we do that utilizing
the technology.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/73-0
00:16:07.218 --> 00:16:10.966
Two follow-up questions.
When you say that you queue the physician,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/73-1
00:16:10.966 --> 00:16:14.604
are you talking about a best practice
advisory alert within Epic?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/73-2
00:16:14.604 --> 00:16:16.258
Something like that, a pop-up?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/74-0
00:16:16.498 --> 00:16:18.881
Yeah, exactly.
So there's a couple of ways.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/74-1
00:16:18.881 --> 00:16:21.372
We're working to integrate that through
Epic,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/74-2
00:16:21.372 --> 00:16:23.863
and there is a workflow through that as
well.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/74-3
00:16:23.863 --> 00:16:28.141
But there's also a general place that a
physician, an oncologist, for example,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/74-4
00:16:28.141 --> 00:16:31.011
could go and look and see, hey,
I have this patient.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/74-5
00:16:31.011 --> 00:16:35.018
What are the trials that are available
for my patient at this site today?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/75-0
00:16:35.538 --> 00:16:38.356
And I think that's also key because as
you know,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/75-1
00:16:38.356 --> 00:16:41.749
those types of information change on a
daily basis, right?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/75-2
00:16:41.749 --> 00:16:45.775
There may be a trial open today,
but the accrual has filled tomorrow.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/75-3
00:16:45.775 --> 00:16:46.178
And so.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/77-0
00:16:45.938 --> 00:16:49.984
And so there's a database lookup that
physicians can go into that is separate

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/76-0
00:16:49.218 --> 00:16:50.018
That lives on.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/77-1
00:16:49.984 --> 00:16:50.658
from the EHR.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/78-0
00:16:51.178 --> 00:16:53.331
Correct,
and that and that lives on the cloud,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/78-1
00:16:53.331 --> 00:16:53.698
correct?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/79-0
00:16:54.258 --> 00:16:56.757
Okay,
and then the other thing I want to just

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/79-1
00:16:56.757 --> 00:16:59.255
talk about,
you did mention COVID and working

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/79-2
00:16:59.255 --> 00:17:02.623
remotely. I'm wondering,
as you're looking to improve access,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/79-3
00:17:02.623 --> 00:17:06.696
telemedicine is a topic that many health
systems have been grappling with.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/79-4
00:17:06.696 --> 00:17:10.987
People have been going one way and the
other with hospital at home and kind of

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/79-5
00:17:10.987 --> 00:17:14.898
trying to be creative about allowing
people to get care where they are.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/80-0
00:17:15.298 --> 00:17:20.137
I know that payer reimbursement codes
have changed and therefore health system

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/80-1
00:17:20.137 --> 00:17:23.935
practices have changed.
Are you also looking to leverage your

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/80-2
00:17:23.935 --> 00:17:28.774
telemedicine program to improve access?
Or is that something that Northwestern

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/80-3
00:17:28.774 --> 00:17:29.938
has been exploring?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/81-0
00:17:30.658 --> 00:17:35.403
Yeah, absolutely. I mean, for example,
the early detection program in pancreas

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/81-1
00:17:35.403 --> 00:17:38.886
cancer that I lead,
there's a lot of patients that we see

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/81-2
00:17:38.886 --> 00:17:41.890
that have lower risk lesions that can be
watched.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/81-3
00:17:41.890 --> 00:17:44.772
These are great patients for telemedicine.
Now,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/81-4
00:17:44.772 --> 00:17:48.376
hospital at home is another area that's
kind of next level.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/81-5
00:17:48.376 --> 00:17:50.178
And we're starting to do that.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/83-0
00:17:51.058 --> 00:17:54.993
in some of our medical subspecialties.
But what does that look like for a

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/83-1
00:17:54.993 --> 00:17:58.822
surgical patient that potentially doesn't
need very high level of care,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/83-2
00:17:58.822 --> 00:18:03.183
needs to be in the hospital for a couple
of days to just wait for their bowels to

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/83-3
00:18:03.183 --> 00:18:06.905
wake up, for example? I mean,
these are great examples of where we're

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/82-0
00:18:04.018 --> 00:18:04.898
Mmhm.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/83-4
00:18:06.905 --> 00:18:09.298
leveraging the technology to better
identify

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/84-0
00:18:09.418 --> 00:18:13.745
which patients are going to be right in
the post-operative setting for hospital

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/84-1
00:18:13.745 --> 00:18:14.178
to home.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/85-0
00:18:14.778 --> 00:18:18.270
And then,
when you mention that the database lookup

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/85-1
00:18:18.270 --> 00:18:22.636
is separate in the cloud,
is that is that what kind of decisions

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/85-2
00:18:22.636 --> 00:18:26.061
went into,
or what kind of benefits are there with

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/85-3
00:18:26.061 --> 00:18:29.554
it being in the cloud,
or how does it interoperate?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/85-4
00:18:29.554 --> 00:18:34.658
Is there what kind of interoperability is
there with the Epic EHR instance?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/86-0
00:18:34.938 --> 00:18:39.464
kind of what are the implications of
having that database look up in the cloud

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/86-1
00:18:39.464 --> 00:18:41.698
for the organization and for providers.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/87-0
00:18:42.258 --> 00:18:45.971
For providers, it's huge.
It's kind of going back to what I said

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/87-1
00:18:45.971 --> 00:18:48.883
earlier.
It's really a live understanding of where

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/87-2
00:18:48.883 --> 00:18:52.767
trials exist, what's open,
and can I accrue a patient on that trial

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/87-3
00:18:52.767 --> 00:18:56.023
today? Are there slots open?
So some of our drug trials,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/87-4
00:18:56.023 --> 00:19:00.649
that's really crucial to understand at
that very moment as a patient could be in

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/87-5
00:19:00.649 --> 00:19:04.647
the next room ready to be seen.
So A clinician could be ready to then

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/87-6
00:19:04.647 --> 00:19:06.418
enroll that patient onto trial.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/88-0
00:19:06.658 --> 00:19:09.165
But yes,
that we're integrating that with Epic

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/88-1
00:19:09.165 --> 00:19:12.791
such that we're able to then look and see
within a patient's chart,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/88-2
00:19:12.791 --> 00:19:16.525
these are the trials that a patient could
potentially be enrolled in,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/88-3
00:19:16.525 --> 00:19:18.498
and then we can have that discussion.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/89-0
00:19:19.138 --> 00:19:21.687
Well, Akhil,
I certainly appreciate your time.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/89-1
00:19:21.687 --> 00:19:25.700
Any final thoughts to our listeners about
bringing trials closer to home,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/89-2
00:19:25.700 --> 00:19:27.218
enabling system integration?

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/90-0
00:19:28.098 --> 00:19:30.211
Yeah,
I think this is integration is an

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/90-1
00:19:30.211 --> 00:19:34.437
important area probably for every major
health system across the United States.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/90-2
00:19:34.437 --> 00:19:38.451
I like to think that in Northwestern
Medicine, we're one of the best at it,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/90-3
00:19:38.451 --> 00:19:41.409
but certainly a lot of room for
improvement and growth.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/90-4
00:19:41.409 --> 00:19:44.262
I think leveraging the technology is
going to be key.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/90-5
00:19:44.262 --> 00:19:47.378
How do we look at this in a very highly
matrix system with

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/91-0
00:19:47.578 --> 00:19:52.709
lot of variables to then understand where
we can care for patients as close to home

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/91-1
00:19:52.709 --> 00:19:55.458
as possible,
but in the highest quality way.

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/92-0
00:19:56.418 --> 00:20:00.454
Well, this has been Dr. Akhil Chawla,
the Vice Chair of Surgery for Regional

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/92-1
00:20:00.454 --> 00:20:04.385
Integration at Northwestern Medicine and
Associate Professor of Surgery at

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/92-2
00:20:04.385 --> 00:20:08.630
Northwestern University Feinberg School
of Medicine and a surgical oncologist at

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/92-3
00:20:08.630 --> 00:20:11.041
the Lurie Comprehensive Cancer Center.
Akhil,

cd090ce0-e9b8-4cc8-9c51-f14283e52ff0/92-4
00:20:11.041 --> 00:20:14.658
I'd like you to thank you to thank you so
much for joining us today.