ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/5-0
00:00:03.351 --> 00:00:07.078
with Lewis Marshall,
the Chief Medical Officer of New York

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/5-1
00:00:07.078 --> 00:00:12.257
City Health and Hospital Lincoln Hospital.
He is also on the board of trustees of

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/5-2
00:00:12.257 --> 00:00:16.551
One Brooklyn Health. Lewis,
thank you so much for joining us today.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/6-0
00:00:17.031 --> 00:00:19.671
Jordan, thank you for having me.
It's a pleasure to be here.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/8-0
00:00:20.391 --> 00:00:23.987
So for our listeners,
New York City's Health and Hospitals,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/8-1
00:00:23.987 --> 00:00:27.403
or NYCH&H,
is the largest municipal health system in

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/8-2
00:00:27.403 --> 00:00:30.760
the United States,
headquartered in New York, New York,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/8-3
00:00:30.760 --> 00:00:33.696
with 4,
500 beds across 11 acute care hospitals,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/8-4
00:00:33.696 --> 00:00:38.311
supported by 9,400 physicians. So, Louis,
today we're going to be discussing

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/9-0
00:00:38.831 --> 00:00:43.560
What else could we be discussing?
But artificial intelligence,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/9-1
00:00:43.560 --> 00:00:48.663
particularly ambient AI and the
intersection of IT and clinical AI.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/9-2
00:00:48.663 --> 00:00:53.917
AI is the acronym of the year.
So I think a lot of organizations have

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/9-3
00:00:53.917 --> 00:00:59.471
been grappling with what to do in terms
of governance strategies. I think

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/10-0
00:00:59.591 --> 00:01:04.876
Ambient AI has been the most popular
technology that I've seen health systems

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/10-1
00:01:04.876 --> 00:01:08.197
adopt in the last,
certainly in the last decade.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/10-2
00:01:08.197 --> 00:01:12.465
What is NYC H&H doing with ambient AI?
And then, you know,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/10-3
00:01:12.465 --> 00:01:18.021
we'll review your strategies for how you
selected and implemented and scaled your

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/10-4
00:01:18.021 --> 00:01:18.631
solution.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/11-0
00:01:18.951 --> 00:01:23.004
on how it's improving efficiency,
accuracy, and care quality. But please,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/11-1
00:01:23.004 --> 00:01:26.071
tell me what's going on with ambient AI
and NYCH&H.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/12-0
00:01:26.551 --> 00:01:29.700
Sure.
So we took a long time to develop a

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/12-1
00:01:29.700 --> 00:01:34.272
governance structure, right?
Because any organization that's

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/12-2
00:01:34.272 --> 00:01:40.044
implementing AI needs a very strong
governance structure to make sure the AI

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/12-3
00:01:40.044 --> 00:01:44.391
is 1 selected appropriately,
2 implemented appropriately,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/15-0
00:01:44.551 --> 00:01:49.617
three managed appropriately,
and that we monitor it going forward to

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/15-1
00:01:49.617 --> 00:01:54.389
make sure that it's doing what we expect
it to do. And so H&

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/14-0
00:01:52.631 --> 00:01:53.191
Okay.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/15-2
00:01:54.389 --> 00:01:59.307
H has a team that has looked at
developing a governance structure,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/15-3
00:01:59.307 --> 00:02:02.538
which has now been in place for many
years.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/15-4
00:02:02.538 --> 00:02:08.484
And it's really served us very well in
terms of identifying any AI tools that we

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/15-5
00:02:08.484 --> 00:02:09.071
may want

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/16-0
00:02:09.071 --> 00:02:12.414
to use,
whether they are independent vendor tools

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/16-1
00:02:12.414 --> 00:02:16.626
or they're embedded within an electronic
health record, right?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/16-2
00:02:16.626 --> 00:02:21.172
So even those that are embedded within an
electronic health record,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/16-3
00:02:21.172 --> 00:02:26.119
we still need to make sure that we're
using them correctly and then we're

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/16-4
00:02:26.119 --> 00:02:28.191
monitoring them and that the...

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/17-0
00:02:29.111 --> 00:02:35.204
relevance of the AI tool is not changing
as our patient demographics may change.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/17-1
00:02:35.204 --> 00:02:40.769
And I think that that's something that we
all need to consider, you know,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/17-2
00:02:40.769 --> 00:02:45.658
as we move forward with this.
We have developed an enterprise AI

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/17-3
00:02:45.658 --> 00:02:46.711
roadmap, which

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/18-0
00:02:47.591 --> 00:02:54.234
gives us a roadmap of how and what we are
going to look at and how and what we're

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/18-1
00:02:54.234 --> 00:02:59.662
going to implement, right?
So that's been very telling in terms of

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/18-2
00:02:59.662 --> 00:03:05.818
how we've moved forward with different AI
tools. As many systems, you know,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/18-3
00:03:05.818 --> 00:03:06.871
Epic is a big

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/19-0
00:03:08.151 --> 00:03:11.918
EHR, and as many systems have that,
so do we.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/19-1
00:03:11.918 --> 00:03:16.748
And so we've implemented some of the AI
tools within Epic,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/19-2
00:03:16.748 --> 00:03:20.924
such as the inpatient summary,
outpatient summary,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/19-3
00:03:20.924 --> 00:03:24.608
and a few other tools available within
Epic.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/19-4
00:03:24.608 --> 00:03:29.111
But looking and talking specifically
about ambient AI,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/20-0
00:03:29.991 --> 00:03:30.551
And.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/23-0
00:03:32.031 --> 00:03:37.652
What I would say is the, you know,
that's the new shiny object in the room

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/23-1
00:03:37.652 --> 00:03:43.123
and everybody has the shiny object
syndrome. And it's like, I want that.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/21-0
00:03:40.311 --> 00:03:40.791
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/23-2
00:03:43.123 --> 00:03:46.570
So we did a long review of different
vendors.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/23-3
00:03:46.570 --> 00:03:51.591
This was before Epic actually came out
with their ambient AI tool.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/22-0
00:03:52.151 --> 00:03:52.631
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/24-0
00:03:52.151 --> 00:03:57.261
which was just recently.
And so we had selected a vendor and we

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/24-1
00:03:57.261 --> 00:04:01.732
implemented it.
Most recently it was implemented across

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/24-2
00:04:01.732 --> 00:04:06.043
the system.
And so the way we decided to implement it

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/24-3
00:04:06.043 --> 00:04:11.791
was first we only put it in primary care
offices where the attending is

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/26-0
00:04:11.871 --> 00:04:16.803
the primary caregiver, right?
Because we all have residency training

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/26-1
00:04:16.803 --> 00:04:20.448
programs.
And so initially we did not want to roll

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/25-0
00:04:17.031 --> 00:04:17.511
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/26-2
00:04:20.448 --> 00:04:24.522
it out to the residents.
We wanted the attendings to get

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/26-3
00:04:24.522 --> 00:04:27.952
comfortable with the tool,
with using the tool,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/26-4
00:04:27.952 --> 00:04:31.311
with evaluating the tool,
and learning how to.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/27-0
00:04:31.431 --> 00:04:32.671
to trust it, right?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/29-0
00:04:33.431 --> 00:04:38.183
Louis, just to jump in there,
this was a paid pilot limited to

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/29-1
00:04:38.183 --> 00:04:42.860
particular practices,
or was it for all primary care provider

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/29-2
00:04:42.860 --> 00:04:48.819
offices and attendings in those offices,
or would you not characterize it as a

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/29-3
00:04:48.819 --> 00:04:49.271
pilot?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/28-0
00:04:49.911 --> 00:04:50.311
Um...

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/30-0
00:04:51.591 --> 00:04:53.991
I would characterize it as...

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/32-0
00:04:55.591 --> 00:05:00.304
A pilot at scale, right?
So we did implement it across the system

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/31-0
00:04:57.431 --> 00:04:57.911
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/32-1
00:05:00.304 --> 00:05:05.873
in primary care where the attending is
the primary caregiver for the patient.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/32-2
00:05:05.873 --> 00:05:10.513
So every institution selected initial
people, they were trained,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/32-3
00:05:10.513 --> 00:05:15.511
and then the tool was implemented and
moved forward. And we have some

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/33-0
00:05:15.551 --> 00:05:22.675
data, which I can mention in a little bit.
But so this is something that we are

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/33-1
00:05:22.675 --> 00:05:27.929
continuing to look at now.
We have started to expand it to

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/33-2
00:05:27.929 --> 00:05:35.231
sub-specialists, surgeons, ENT doctors,
you know, and some other sub-specialists.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/34-0
00:05:35.351 --> 00:05:36.391
Neurologist.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/35-0
00:05:37.351 --> 00:05:42.919
And we're also going to be expanding to
allow the residents in training as well

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/35-1
00:05:42.919 --> 00:05:44.311
to utilize the tool.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/36-0
00:05:44.791 --> 00:05:48.294
So I've had,
and I know a lot of our listeners will be

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/36-1
00:05:48.294 --> 00:05:51.606
somewhat,
will be somewhat familiar with ambient AI

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/36-2
00:05:51.606 --> 00:05:56.191
tools and its great popularity.
I've spoken to other healthcare leaders

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/36-3
00:05:56.191 --> 00:05:59.184
at other systems previously,
and they've said,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/36-4
00:05:59.184 --> 00:06:02.623
despite it being popular,
another health system said,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/36-5
00:06:02.623 --> 00:06:06.699
the greatest ROI is the perception that
it reduces pajama time,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/36-6
00:06:06.699 --> 00:06:08.991
but when you actually run analytics,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/37-0
00:06:09.271 --> 00:06:14.698
there's not a statistically significant
difference at that organization in the

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/37-1
00:06:14.698 --> 00:06:19.782
amount of time that providers are
spending after hours in their in-basket

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/37-2
00:06:19.782 --> 00:06:24.178
or other kind of chores.
Are you finding that to be true at NYC

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/37-3
00:06:24.178 --> 00:06:27.270
and H&H,
or are you finding real kind of

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/37-4
00:06:27.270 --> 00:06:31.391
measurable ROI beyond the definitive
improvement in morale?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/38-0
00:06:32.231 --> 00:06:35.720
Well, you know,
hopefully you want all of those things,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/38-1
00:06:35.720 --> 00:06:39.022
including improvement in morale. You want,
you know,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/38-2
00:06:39.022 --> 00:06:43.758
to reduce pajama time for caregivers.
But one of the things that we saw was

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/38-3
00:06:43.758 --> 00:06:45.751
that we saw a difference between

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/40-0
00:06:46.991 --> 00:06:50.996
those providers who are using an MB AI
tool and those who are not.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/40-1
00:06:50.996 --> 00:06:55.718
And the difference was that those who
were using it were actually spending one

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/40-2
00:06:55.718 --> 00:06:59.722
to two more minutes in the record than
those who weren't using it,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/39-0
00:06:57.471 --> 00:06:58.071
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/40-3
00:06:59.722 --> 00:07:03.607
which is not necessarily a bad thing,
right? Because that means,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/40-4
00:07:03.607 --> 00:07:07.671
hopefully what that means is that the
providers are using the tool.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/41-0
00:07:07.871 --> 00:07:10.631
but then they're spending time to review
the output.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/42-0
00:07:11.231 --> 00:07:11.711
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/44-0
00:07:11.671 --> 00:07:15.069
right,
to make sure that the output from the

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/44-1
00:07:15.069 --> 00:07:19.750
ambient AI is correct.
There's no hallucinations and that the

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/44-2
00:07:19.750 --> 00:07:25.187
outcomes of that are appropriate.
And so I think that that's one of the

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/44-3
00:07:25.187 --> 00:07:30.623
things that we've been seeing. I mean,
it's not a whole big difference,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/44-4
00:07:30.623 --> 00:07:31.831
but I think over

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/43-0
00:07:31.271 --> 00:07:31.431
Mm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/46-0
00:07:32.071 --> 00:07:38.444
10s of thousands of visits, you know,
that can account for a lot of time for a

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/45-0
00:07:34.231 --> 00:07:34.711
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/46-1
00:07:38.444 --> 00:07:43.607
provider. So I think in time,
we will start to see the numbers,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/46-2
00:07:43.607 --> 00:07:50.141
the minutes within the record for those
who are using ambient AI come down as we

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/46-3
00:07:50.141 --> 00:07:51.351
learn to trust.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/48-0
00:07:51.431 --> 00:07:56.723
the tool and we realize or we monitor the
outcome, right? And again,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/47-0
00:07:53.431 --> 00:07:53.911
Mmh.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/48-1
00:07:56.723 --> 00:08:02.474
if our population starts to change,
we want to make sure that that doesn't

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/48-2
00:08:02.474 --> 00:08:06.231
affect, you know,
the outcome of the ambient AI.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/49-0
00:08:06.951 --> 00:08:11.237
So can you explain to our listeners,
so you have a pilot,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/49-1
00:08:11.237 --> 00:08:17.074
you've scaled it across the enterprise to
every primary care provider who's an

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/49-2
00:08:17.074 --> 00:08:21.582
attending, and then you,
how do you make the decision, okay,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/49-3
00:08:21.582 --> 00:08:27.271
we see that these physicians are spending
one or two minutes more in the EHR

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/51-0
00:08:27.511 --> 00:08:30.197
than Dr.
than the control group of providers who

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/51-1
00:08:30.197 --> 00:08:34.143
are not using ambient listening.
How do you make the decision to expand

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/51-2
00:08:34.143 --> 00:08:37.925
the pilot to roll it out to all the other
specialty groups? Are you,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/51-3
00:08:37.925 --> 00:08:40.830
because you know, if you're spending,
like you said,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/51-4
00:08:40.830 --> 00:08:45.051
over 10s of thousands of doctors,
it could be fewer visits, fewer, you know,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/51-5
00:08:45.051 --> 00:08:46.311
reimbursable CBT codes.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/50-0
00:08:47.351 --> 00:08:48.951
So, I, I think, I think...

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/52-0
00:08:50.031 --> 00:08:54.588
One of the reasons that we've done that,
and this is just my thought process,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/52-1
00:08:54.588 --> 00:08:57.684
not the system's thought process, is that,
you know,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/52-2
00:08:57.684 --> 00:09:02.590
by rolling this out to other specialties,
we'll get a greater return on investment.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/52-3
00:09:02.590 --> 00:09:06.972
So even though we're spending a few more
minutes within a chart, you know,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/52-4
00:09:06.972 --> 00:09:09.191
reviewing the outcome from Ambient AI.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/53-0
00:09:09.591 --> 00:09:15.885
we think in time that this will come down
and we'll really start saving time on the

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/53-1
00:09:15.885 --> 00:09:21.429
provider side. And then I think about,
well, what might that mean, right?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/53-2
00:09:21.429 --> 00:09:25.624
And so a lot of reports that I've seen,
not at H&H,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/53-3
00:09:25.624 --> 00:09:28.471
but outside other organization is that

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/55-0
00:09:29.111 --> 00:09:32.276
you know,
we look to utilize ambient AI in hopes

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/55-1
00:09:32.276 --> 00:09:35.118
that we reduce work time for the
providers,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/55-2
00:09:35.118 --> 00:09:40.350
and then that will allow the providers to
increase their templates by one or two

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/55-3
00:09:40.350 --> 00:09:44.612
patients a day, right,
to increase their volume, which, you know,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/54-0
00:09:43.991 --> 00:09:44.471
Right.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/55-4
00:09:44.612 --> 00:09:49.134
may or may not be a good thing. I mean,
from a financial perspective,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/55-5
00:09:49.134 --> 00:09:51.071
it might be a great thing, but

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/57-0
00:09:52.391 --> 00:09:57.062
One of the things that I think about when
we talk about expanding access and

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/57-1
00:09:57.062 --> 00:10:01.793
expanding A physician's template and the
number of patients they may see in a

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/56-0
00:09:58.071 --> 00:09:58.231
Yeah.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/57-2
00:10:01.793 --> 00:10:06.706
session or a day is what type of support
are we providing that clinician, right?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/57-3
00:10:06.706 --> 00:10:09.618
So we can't,
if we're going to see more people,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/57-4
00:10:09.618 --> 00:10:12.711
we need more support for the doctor.
We can't just

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/58-0
00:10:12.791 --> 00:10:19.191
expect the doctor to pick up where the
lack of support staff doesn't help them.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/59-0
00:10:19.671 --> 00:10:23.314
So just to clarify,
you are seeing an expansion of doctors'

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/59-1
00:10:23.314 --> 00:10:27.808
templates and the increase in the
quantity of patients they're seeing per

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/59-2
00:10:27.808 --> 00:10:31.511
day when using ambient AI,
or that's where you'd like to be?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/62-0
00:10:31.311 --> 00:10:35.823
That's where we'd like to be.
I don't think we have not,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/60-0
00:10:33.711 --> 00:10:34.191
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/62-1
00:10:35.823 --> 00:10:40.334
as far as I know,
we have not as a system looked at that

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/61-0
00:10:38.711 --> 00:10:39.191
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/62-2
00:10:40.334 --> 00:10:43.975
yet.
We're still in the process of looking at

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/62-3
00:10:43.975 --> 00:10:49.831
ambient AI usage and how that affects,
you know, charting, documentation.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/66-0
00:10:50.631 --> 00:10:54.379
coding and other aspects of the visit
itself,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/63-0
00:10:52.151 --> 00:10:52.631
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/66-1
00:10:54.379 --> 00:10:59.431
and improving patient satisfaction and
provider satisfaction.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/65-0
00:10:55.871 --> 00:10:56.311
And then...

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/68-0
00:11:00.231 --> 00:11:03.538
Could you speak about the patient and
provider satisfaction with ambient

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/68-1
00:11:03.538 --> 00:11:03.991
listening?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/72-0
00:11:05.351 --> 00:11:08.524
So I think everybody's hope is that with
ambient AI,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/72-1
00:11:08.524 --> 00:11:11.458
that when you're in the room with the
physician,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/69-0
00:11:10.151 --> 00:11:10.631
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/72-2
00:11:11.458 --> 00:11:15.948
they're looking at you and they're
speaking to you and they're not sitting

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/70-0
00:11:14.271 --> 00:11:14.751
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/72-3
00:11:15.948 --> 00:11:20.858
with their back to you and on a computer
trying to type in the things that you're

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/72-4
00:11:20.858 --> 00:11:23.911
telling them,
the patient's telling the doctor. So

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/71-0
00:11:22.391 --> 00:11:22.711
Okay.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/74-0
00:11:24.951 --> 00:11:28.122
You know,
I think it's going to take some time for

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/74-1
00:11:28.122 --> 00:11:31.355
us to get there.
I think it's going to take us some

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/74-2
00:11:31.355 --> 00:11:36.266
remodeling of our exam rooms and placing
computers in the right place and exam

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/74-3
00:11:36.266 --> 00:11:40.369
tables in the right place,
because it may not be the same, right,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/74-4
00:11:40.369 --> 00:11:44.037
using ambient AI,
because you may not necessarily need the

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/73-0
00:11:40.551 --> 00:11:41.031
Okay.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/74-5
00:11:44.037 --> 00:11:45.031
computer, right.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/75-0
00:11:45.591 --> 00:11:48.702
at the desks where you're facing in the
wall.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/75-1
00:11:48.702 --> 00:11:51.271
So I think from a provider standpoint.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/76-0
00:11:52.351 --> 00:11:57.567
what we're going to see is an improvement
in provider satisfaction because they'll

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/76-1
00:11:57.567 --> 00:12:02.155
actually get to talk to the patient and
spend the time with the patient,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/76-2
00:12:02.155 --> 00:12:06.051
not necessarily typing.
I think from a patient perspective as

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/76-3
00:12:06.051 --> 00:12:09.130
well, patient satisfaction as we know,
you know,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/76-4
00:12:09.130 --> 00:12:13.969
if you go into a room and sit down in a
chair and have a conversation with a

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/76-5
00:12:13.969 --> 00:12:14.471
patient,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/78-0
00:12:14.551 --> 00:12:18.724
even if it's only for a few minutes,
the patient's perception is that you

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/78-1
00:12:18.724 --> 00:12:22.108
spent more time with them.
So I think that this ambient AI,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/78-2
00:12:22.108 --> 00:12:26.225
and if we use it in the correct way,
will definitely help us improve our

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/77-0
00:12:24.391 --> 00:12:24.871
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/78-3
00:12:26.225 --> 00:12:30.285
patient satisfaction and give us more
time with the patients, you know,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/78-4
00:12:30.285 --> 00:12:31.751
to have that conversation.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/79-0
00:12:30.551 --> 00:12:35.524
So even though you mentioned earlier that
your AI governance committee and

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/79-1
00:12:35.524 --> 00:12:40.629
structure has been in place for years,
it sounds like some of your goals are

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/79-2
00:12:40.629 --> 00:12:44.607
still aspirational.
You don't yet have quantitative data on

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/79-3
00:12:44.607 --> 00:12:48.386
whether patients and providers do have
more eye contact,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/79-4
00:12:48.386 --> 00:12:52.231
less doctors behind the screens,
and more improvements in

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/80-0
00:12:52.551 --> 00:12:56.425
patient reported health outcomes or at
least patient reported satisfaction

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/80-1
00:12:56.425 --> 00:12:59.111
scores. Is that true?
It's still more aspirational?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/82-0
00:12:59.511 --> 00:13:04.822
A lot of it is still aspirational,
but we do have teams at central office

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/82-1
00:13:04.822 --> 00:13:09.845
that are looking at those metrics.
But we just don't have, I haven't,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/82-2
00:13:09.845 --> 00:13:14.725
they have not been shared as of yet,
other than the time, you know,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/81-0
00:13:11.311 --> 00:13:11.791
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/82-3
00:13:14.725 --> 00:13:18.671
time in the chart based upon using it or
not using it.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/83-0
00:13:20.231 --> 00:13:25.496
Would you say that there's a few kind of
leaders in the field of ambient AI?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/83-1
00:13:25.496 --> 00:13:31.239
Would you say that there are significant
differences or that they're more fungible?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/83-2
00:13:31.239 --> 00:13:36.367
And what led you to selecting the vendor
that you ended up, that NYCH&

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/83-3
00:13:36.367 --> 00:13:37.871
H ended up going with?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/85-0
00:13:38.791 --> 00:13:44.962
So I can't comment on how we selected the
vendor because I was not involved in that

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/84-0
00:13:43.831 --> 00:13:44.231
Yeah.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/85-1
00:13:44.962 --> 00:13:49.148
process directly,
but I know that we did look at several

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/85-2
00:13:49.148 --> 00:13:54.217
major vendors in this field.
And then the one that they selected was

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/85-3
00:13:54.217 --> 00:13:54.951
based upon

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/86-0
00:13:56.311 --> 00:14:00.044
you know, quality, history,
how long the system had,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/86-1
00:14:00.044 --> 00:14:03.214
how long the tool has been available,
right?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/86-2
00:14:03.214 --> 00:14:08.637
Because that's one of the things that I
think we look at in general is like,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/86-3
00:14:08.637 --> 00:14:14.131
how long has this been available and out
there and how many other systems are

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/86-4
00:14:14.131 --> 00:14:15.751
using it as opposed to.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/89-0
00:14:15.911 --> 00:14:19.513
you know,
being on the bleeding edge of technology

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/89-1
00:14:19.513 --> 00:14:23.255
and really just being the first one out
of the gate.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/87-0
00:14:19.911 --> 00:14:20.391
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/89-2
00:14:23.255 --> 00:14:28.551
But I think we've taken a more cautious
route, which has, I think, for us,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/89-3
00:14:28.551 --> 00:14:33.423
especially here at Lincoln,
paid off in terms of how we've rolled it

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/88-0
00:14:31.391 --> 00:14:31.911
Mmh.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/89-4
00:14:33.423 --> 00:14:36.671
out,
how we've gotten buy-in from clinicians.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/90-0
00:14:37.751 --> 00:14:41.591
including clinicians who weren't really
sure that they would like it, right?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/90-1
00:14:41.591 --> 00:14:45.031
Because not everybody necessarily likes
all this new technology. So.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/91-0
00:14:46.391 --> 00:14:53.156
So I know that we mentioned a broader AI
strategy through an AI governance board,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/91-1
00:14:53.156 --> 00:14:58.022
and I'm sure there are many AI
initiatives and priorities.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/91-2
00:14:58.022 --> 00:15:04.622
Is there any way in which ambient AI is
integrated with any other AI initiative

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/91-3
00:15:04.622 --> 00:15:07.591
or as part of a broader AI strategy?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/92-0
00:15:11.591 --> 00:15:14.471
I don't know the answer to that question.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/94-0
00:15:15.031 --> 00:15:19.378
Well, okay, let's go to the next topic.
As I know that we don't have too much

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/93-0
00:15:15.831 --> 00:15:16.151
Yeah.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/94-1
00:15:19.378 --> 00:15:22.777
more time on this episode,
but we wanted to also discuss the

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/94-2
00:15:22.777 --> 00:15:27.123
intersection of IT and clinical AI.
And that's kind of where I was going with

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/94-3
00:15:27.123 --> 00:15:30.188
that question.
So ambient listening AI is clinical AI,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/94-4
00:15:30.188 --> 00:15:32.918
right?
It's capturing a conversation between the

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/94-5
00:15:32.918 --> 00:15:37.431
provider and the patient and documenting
it within the electronic health record.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/95-0
00:15:38.391 --> 00:15:43.123
I'd like to ask if you could elaborate
upon what intelligent infrastructure

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/95-1
00:15:43.123 --> 00:15:48.103
might look like and how technologists and
clinicians have been collaborating at

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/95-2
00:15:48.103 --> 00:15:51.340
NYCH&
H in such a way as to fuel innovation and

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/95-3
00:15:51.340 --> 00:15:56.071
accelerate that adoption and unlocking
new possibilities for care delivery.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/97-0
00:15:57.591 --> 00:16:03.850
Those are all great questions.
I think a lot of it is really for us

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/97-1
00:16:03.850 --> 00:16:08.084
depends upon our leadership,
like our system,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/97-2
00:16:08.084 --> 00:16:15.631
CMIO is very much interested in making
sure that whatever tools that we roll out,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/99-0
00:16:15.831 --> 00:16:20.899
have a clinical impact and not just roll
it out because it looks good.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/96-0
00:16:16.071 --> 00:16:16.631
Okay.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/99-1
00:16:20.899 --> 00:16:26.537
So he's looking to make sure that it's
one has an impact clinically and two is

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/98-0
00:16:21.591 --> 00:16:22.151
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/99-2
00:16:26.537 --> 00:16:30.748
scalable, right?
That's the other issue that we're looking

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/99-3
00:16:30.748 --> 00:16:34.958
at is whether something is scalable or
not and if so, how.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/99-4
00:16:34.958 --> 00:16:36.671
And then also looking at

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/100-0
00:16:36.791 --> 00:16:37.351
Um...

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/101-0
00:16:38.791 --> 00:16:43.204
you know,
how we use the IT and the ambient AI

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/101-1
00:16:43.204 --> 00:16:47.805
together in terms of decision support,
you know,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/101-2
00:16:47.805 --> 00:16:55.693
autonomous decision making by ambient AI
or by AI in general, and making sure that,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/101-3
00:16:55.693 --> 00:16:58.791
you know, there's always a human.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/103-0
00:16:58.991 --> 00:17:05.565
joking with somebody the other day that
we're going to start seeing ads for jobs.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/103-1
00:17:05.565 --> 00:17:11.097
They're going to say human needed to
monitor AI tools. So, but it's,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/102-0
00:17:07.351 --> 00:17:08.231
Yeah.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/103-2
00:17:11.097 --> 00:17:14.705
I think that, you know,
overall as a system,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/103-3
00:17:14.705 --> 00:17:17.751
I think we have a great plan. I think.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/104-0
00:17:18.631 --> 00:17:22.187
Like I said,
we're probably a little more cautious

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/104-1
00:17:22.187 --> 00:17:26.719
than some other systems,
probably because we are a public health

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/104-2
00:17:26.719 --> 00:17:32.505
system and we don't necessarily have the
resources that other large health systems

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/104-3
00:17:32.505 --> 00:17:35.991
may have, right,
to develop their own technology.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/105-0
00:17:37.591 --> 00:17:41.746
I guess two more wrap up questions. One,
is there, how,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/105-1
00:17:41.746 --> 00:17:47.828
while you're considering your AI strategy
and intersection of IT and clinical AI,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/105-2
00:17:47.828 --> 00:17:52.873
everything we've been discussing today,
is any of that affected by,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/105-3
00:17:52.873 --> 00:17:57.991
or does any of that affect the direction
NYCH&H is going towards

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/106-0
00:17:58.551 --> 00:18:04.001
migrating to cloud managed services or
your data center strategy in general.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/106-1
00:18:04.001 --> 00:18:07.893
As you know,
there's a lot of costs associated with AI

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/106-2
00:18:07.893 --> 00:18:10.794
tokens.
I'm just wondering from a system

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/106-3
00:18:10.794 --> 00:18:14.757
perspective, kind of is,
how is AI affecting, you know,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/106-4
00:18:14.757 --> 00:18:17.871
where the data is being held and
processed?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/108-0
00:18:19.111 --> 00:18:22.539
So I know,
I think from a systems perspective,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/108-1
00:18:22.539 --> 00:18:27.643
they are looking at where this
information is stored. We've recently,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/107-0
00:18:25.831 --> 00:18:25.991
Mm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/108-2
00:18:27.643 --> 00:18:31.217
I believe,
gone to a cloud system and using data

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/108-3
00:18:31.217 --> 00:18:36.905
centers to house all of this information.
And that's been an ongoing process,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/108-4
00:18:36.905 --> 00:18:38.071
I think, from...

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/109-0
00:18:38.111 --> 00:18:41.932
My perspective,
as I've seen things develop over the last

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/109-1
00:18:41.932 --> 00:18:46.609
couple of years, we've moved things from,
you know, servers to clouds.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/109-2
00:18:46.609 --> 00:18:51.154
And so that's really, I think,
given us a better access at the front

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/109-3
00:18:51.154 --> 00:18:53.987
line.
So clinicians have better and easier

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/109-4
00:18:53.987 --> 00:18:55.831
access to a lot of the data.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/110-0
00:18:57.111 --> 00:19:02.481
So it's been very helpful for us as a
hospital and I think for us as a system

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/110-1
00:19:02.481 --> 00:19:03.031
as well.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/111-0
00:19:03.871 --> 00:19:10.363
And the last question I'd like to pose to
you is if you could presume that I and

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/111-1
00:19:10.363 --> 00:19:15.813
the listeners of Healthy Uptime Podcast
are the CEO of NYC H&H.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/111-2
00:19:15.813 --> 00:19:21.824
And we would like to pose the following
question to you. So, you know, Dr.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/111-3
00:19:21.824 --> 00:19:25.591
Marshall,
you've been working with Ambient AI.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/112-0
00:19:26.071 --> 00:19:30.474
at Lincoln Hospital. And, you know,
it's been a great pilot.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/112-1
00:19:30.474 --> 00:19:35.599
You've even seen you scale from primary
care providers to specialists.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/112-2
00:19:35.599 --> 00:19:40.796
Could you please justify for us why you
think we should be expanding it

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/112-3
00:19:40.796 --> 00:19:45.271
system-wide and we should be continuing
to support ambient AI

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/113-0
00:19:45.511 --> 00:19:49.793
given that, you know,
we don't have the data right now to say

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/113-1
00:19:49.793 --> 00:19:55.525
that we've actually had a hard financial,
you know, it hasn't paid for itself yet.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/113-2
00:19:55.525 --> 00:20:00.151
Can you justify why we should expand
ambient AI across the system?

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/115-0
00:20:01.431 --> 00:20:05.084
So in my view,
I think we should expand ambient AI

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/115-1
00:20:05.084 --> 00:20:09.740
across the system to all specialists and
all types of providers.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/115-2
00:20:09.740 --> 00:20:14.539
I think that the benefit,
one of the major benefits is going to be

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/115-3
00:20:14.539 --> 00:20:19.840
improved documentation, right?
Having ambient AI available allows us to..

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/115-4
00:20:19.840 --> 00:20:19.911
.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/116-0
00:20:22.311 --> 00:20:23.191
To.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/118-0
00:20:25.111 --> 00:20:31.632
develop a visit or record a visit and
then have that visit summarized with the

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/118-1
00:20:31.632 --> 00:20:36.998
correct medical information.
And it will allow us to have better

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/118-2
00:20:36.998 --> 00:20:40.960
medical records,
more complete medical records.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/118-3
00:20:40.960 --> 00:20:43.271
And it will also allow us to

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/120-0
00:20:43.591 --> 00:20:48.764
at some point in the future,
allow us to improve our coding so that we

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/120-1
00:20:48.764 --> 00:20:52.844
can, you know,
generate the revenue based upon the care

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/120-2
00:20:52.844 --> 00:20:57.798
that we're providing, right?
I find clinicians are terrible coders,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/119-0
00:20:52.951 --> 00:20:53.431
Hello.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/120-3
00:20:57.798 --> 00:21:02.607
and we probably should never code a chart.
So I think ambient AI,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/120-4
00:21:02.607 --> 00:21:03.991
as it develops more

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/122-0
00:21:04.311 --> 00:21:09.541
will help us with completion of the notes.
Chart hygiene will be improved.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/122-1
00:21:09.541 --> 00:21:14.631
Some of the new systems coming out that
will actually pick up, you know,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/122-2
00:21:14.631 --> 00:21:19.861
orders and place orders, you know,
during the visit for the doctor to sign

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/121-0
00:21:18.231 --> 00:21:18.711
Mhm.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/122-3
00:21:19.861 --> 00:21:24.045
off on, you know,
will all help to reduce the time that the

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/122-4
00:21:24.045 --> 00:21:24.951
doctor spends

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/123-0
00:21:25.351 --> 00:21:28.630
in the chart and give the doctor more
time with the patient.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/123-1
00:21:28.630 --> 00:21:32.338
And I think overall that's just going to
be a benefit for all of us.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/123-2
00:21:32.338 --> 00:21:35.831
And then I think in the bottom line is
going to improve as well.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/124-0
00:21:36.791 --> 00:21:40.781
Well, Lewis,
I do appreciate you joining us today.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/124-1
00:21:40.781 --> 00:21:46.726
For our listeners, this has been Dr.
Lewis Marshall, and I'll just add his,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/124-2
00:21:46.726 --> 00:21:52.514
there's an incredible array of
qualifications. So he is a medical doctor.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/124-3
00:21:52.514 --> 00:21:54.391
He's also a JD, MBA, Ms.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/126-0
00:21:55.271 --> 00:21:58.427
health policy and management. So Dr.
Marshall,

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/126-1
00:21:58.427 --> 00:22:03.933
we've covered a lot of ground today on AI
and how it's expanded and scaled across

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/126-2
00:22:03.933 --> 00:22:08.164
the organization. It's ROI,
how it's improved patient provider

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/126-3
00:22:08.164 --> 00:22:11.588
satisfaction.
I'd like to thank you for joining us

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/126-4
00:22:11.588 --> 00:22:11.991
today.

ebd98a77-7c28-4c1d-aaf7-570c9d8c61dc/127-0
00:22:12.711 --> 00:22:15.351
Oh, thank you. It's a pleasure being here.
Thank you, Jordan.