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 Today, on this week in health it, we started looking at what were those things that we needed to do to allow our consumers and patients to access healthcare the way they wanted to. Not the way that we felt that they should, but how could they begin to be able to get healthcare services through their phones or through virtual visits?

Thanks for joining us on this week in Health IT Influence. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in Health. IT a channel dedicated to keeping health IT staff current. And engaged. Special thanks to our influence show sponsors Sirius Healthcare and Health lyrics for choosing to invest in our mission to develop the next generation of health IT leaders.

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Good afternoon, Michelle. Welcome to the show. Welcome. Thank you very much for having me, bill. Well, I'm looking forward to the conversation. We've actually never met, this is the first time we're meeting per se, but I was talking to somebody about their different innovation things and they said, if you haven't talked to Michelle, you have to talk to Michelle about what they're doing down at Houston Methodist.

And so we connected via phone and now we're connecting, uh, to share this with the community 'cause it was a great conversation. So I'm looking forward to hearing about what's going on at Houston Methodist. But let's start highlight, how does Houston Methodist approach. Innovation I, I realize that's a a 45 minute PowerPoint presentation, but let's just start with the basics and then we'll boil it down from there.

Well, I wanna kind of take it back to the basics of why we even created our Center for Innovation. I mean, innovation is not new to Houston Methodist, of course, we have a research institute, so most people are very familiar with Dr. Michael DeBakey and all of the innovations in heart that he has done. So clinically, we've done a lot, but what happened about four years ago?

Which I'm sure you're very familiar with, bill, is these disruptors that were coming into healthcare that were never had, never even had healthcare experience thinking that they could solve the world of healthcare. And we sat down and there was a small group of us that was kind of trying to pay attention to what was going on.

And it quickly became obvious to us that we were either gonna let these outside influencers disrupt our business. We were going to do it to ourselves. And so that was the decision that we made and we created this kind of small group and it really kind of started off almost like a small book club of us just meeting and really connecting and, and talking about the stories and the things that people were doing without, with these disruptors.

And it's like any group we love. We named ourselves the Diop Group, and it was the Digital Innovation Obsessed People group, and that has kind of stuck with our CEO and he will always know, know us as the Diop group. But so we started looking at what were those things that we needed to do to allow our consumers and patients to access healthcare the way they wanted to.

Not the way that we felt that they should, which is if you think about the old traditional ways of phone calls and seeing your doctor. But how could they begin to be able to get healthcare services through their phones or through virtual visit, and how could we make it easier for them to be able to get those services?

So that's kind of how we started off And . Really, and within this core group that we have now known as our Center for Innovation, we all kind of hold dual roles and we represent the entire organization. So it is there, hospital operations is there, our physician group, marketing, hr, everyone that you can think of.

Is sitting in within this group, and what we tended to look at were how could we create efficiencies with providing healthcare services, but also how could we create efficiencies for our clinicians in house? Because we know EMRs have been great, but they tended to really get people focused on computers and not in front of the patients.

And then also, how could we really attract and retain top talent? So that was our other constituent group that we looked at, which was our employees, our potential employees, and when it came down to what do we look at, we kind of broke it out into very specific areas for our patients or consumers, our employees and our physicians.

What could we do within hospital services that could be easier and to access or easier to be used? And then ultimately, we now are kind of focused in on this kind of remote monitoring, and I think everybody has, is kind of gone down in this path. But way back in the very beginning, it was really about how are we allowing patients to get easier access to this?

Big, huge health system that was giving traditional care, if you could think of it in that aspect, it's interesting. I'm looking at this slide deck and you shared with me the slide deck that you just presented to another organization and one of the things that strikes me that the Diop group, thank you for giving us another acronym.

We were hoping we would get another acronym in healthcare, but the representation in the center for innovation I think is fascinating. It obviously. Physicians and the physician organizations. Maybe not as obvious, but makes sense. Finance, supply chain, clinical operations, hr, marketing. You have the foundation, which I assume is philanthropy and, and fundraising.

Legal global operations and, and research institute as well. That is really well-rounded. I'm not sure I've seen another organization that has all of that represented, and so I would imagine when you're having the conversations, you get a lot of really good. Different perspectives and, and different lenses on various problems we do, and that's the beauty of it.

And we meet weekly. We meet weekly for an hour and a half, and we bring in most individuals who have certain issues that they're looking at. And so the thing I find interesting about that is you have a very diverse group and you get a very, uh, a lot of different lenses on similar problems. Do you find that.

Helps to define the problem really well and to define what solutions make the most sense. It does. I will tell you what the diversity that we have in this group, the good news is, is that we're looking across the entire organization on potential solutions to problems. And I will tell you that's what we focus on.

'cause I tell people all the time with all of these innovative companies that are out there and they're great, is that you can kind of get the starry eyed of Oh wow. That solution, can't we do something with it? But we wanna make sure that we're focused on the problems that we have at Houston Methodist.

And so we meet weekly for an hour and a half, this entire group, and we're all looking, we're all looking for those solutions that are out there, that we know are problems in the various specific areas that you talked about. And if they find a specific solution that they're interested in and they want to pilot now I want to kind of clarify.

What we do in the Center for Innovation is we pilot different solutions. We don't operationalize solutions across the organization. What we do is pilot and in order for you to pilot a solution, it has to have what problem you're solving. What's the ROI? And that's very key. We don't do pilots unless they have a solid ROI for us.

And then once we pilot that solution. Whether it be within our technology hub, and I'll talk about that in a little bit, or within one of our units at the hospital or within our physician organization. If it's successful, then we will graduate it. It has to have a very specific business owner and someone within it to move forward to make sure that it gets operationalized quickly.

So it's the, the beauty of that group is that we have representation across our organization. And know exactly what problems that we're trying to solve. Now, we do have key level areas that we're very focused in on, but it does not mean that we won't consider something that someone else is bringing if it doesn't quite fit in one of those key areas.

And you talked about, you have some of these categories here, patient oriented technologies, a marketing new patient acquisition, clinician operations, and whatnot. The thing I like about this chart is it's so clean. You have the pipeline. This is stuff that people have come in and said, Hey. Take a look at this.

This is really good, but I love the fact that you have Pilot and Rust in Peace, , the, the r and p. It has a little, little tombstone there. Yes. And, and I, I'm often saying to people, moving something into that column is a win. And it is. It very much so. It, it is one of the things that was very, I, I will tell you for, for old ways of thinking, calling a project a failure.

Was almost just never heard of. Nobody wanted to do that. Let's just keep trying and trying and trying until we can make it work for us. We want to very quickly and we've, we've got this motto, it's either Succeed fast or fail fast, and if it's not working, we're gonna fail it, but we need to make sure that we're learning why did it fail?

Because it doesn't mean that we won't go out and search for another solution. Whatever other solution that we find it, it ha we have to make sure that we learned our lessons from the other one. But I will tell you, that's been one of the key things that I think for any healthcare institution that is really trying to innovate, don't be afraid to, to fail, because that's all part of innovating.

The thing I find interesting is this chart that you have, it has your pipeline, your pilots, your failures, has your graduates. And it's actually one of the cleaner ones I've seen. I mean, I've seen these things so gunked up with projects 'cause they don't move, they tend to like sit for a long period of time.

I'm curious on your graduates. I I, I mean you could comment on that if you want, but I'm curious on your graduates, do they go into a holding pattern or do they immediately do, do people like pick 'em up and run with them almost immediately? Oh, no. They, they, it's almost immediately when we graduate them.

That's what we, that's as I said, they have to have an operational owner identified and their IT partner in order to make sure that they can operationalize them very quickly. And I will tell you, that's what really helped us as part of overall when the pandemic hit, because we had many of these solutions that were already in place.

I mean, I'll be honest with you, when. We very first had our community spread patient. We'd been hearing about the pandemic kind of going on in others, but when Houston very first, this community spread patient, we called everybody in that was part of the Center for Innovation and said, okay. I. What solutions do we have now that will be able to help us, that we can quickly roll out?

Maybe we were just kind of finishing in them in the pilot phase so that we can quickly roll out that will be able to help us to be able to take care of these patients as we know it's gonna quickly ramp up in our organization. So that's what I will tell you. The reason why, and I know some people have asked us, will you, because you've done so well in the Center for Renovation, have you ever really considered.

Taking everybody out and separating them and creating this own nucleus group without their dual roles. And I will be honest, our CEO and everyone, his, no, we will not, because that is what we believe has made us so successful, um, is because we each do, now, I will tell you I have a full-time role in IT is managing, if you can imagine all of the IT applications within overall our health system.

And then I also have half a part of my job is spent on center for innovation. So does it make for a busy life? Yes, it does. But it's very, very rewarding to be able to see that we can get out and get these solutions and bring them in very quickly to bring value to our organization. You know, the, the other thing, and I, I want to talk about the pandemic 'cause I want to talk about what are some of the things you did specifically in the pandemic.

But before we get there, there are the, the UPMCs, the Jeffersons, the providence that are focused on commercializing a lot of these things. Mm-Hmm. , what? What's your focus? But that's not our focus. And, and we've had other individuals that ask us about that. For us, it's really about our patients, our clinicians, our health system.

That's what we wanna remain focused on. There's been this piece, well, should we venture out? Should we start to becoming more. Doing these joint ventures and some of the other things. And we believe that's going to take away from what we're trying to accomplish for our health system. And it's been great.

And I will tell you, we work a lot with Providence. We work a lot with some of these other organizations and just kind of comparing notes, but we just don't believe that's the right thing for us. We wanna stay focused in on our health system and not so much trying to create products to go off and sell.

And, and it's not to say that's a very worthwhile cause and I really appreciate some of the things that Providence is doing, but it's just not for Houston Methodist. Yeah. So you're, you're focused on internal innovation and innovating around your clinicians, your patients, your community. We believe that's where our success lies and, and what was our whole main purpose.

Our main purpose was doing this, so these disruptors out there couldn't come and really disrupt and kind of like chip away at some of our own business. And I mean, we've been very successful at that. And I will say our, our overall brand within the Houston and surrounding community. Is very high. We're not out to be the cheapest hospital, but we are out to provide the best quality, safety, care, and innovative services to our community and our patients.

We serve. Yeah, I, I, I did another interview with Josh Sol and Yes. And notable. And so notable is one of the technologies that has graduated. Mm-Hmm. from your plan. I, the thing I like about this is when you're focused in on your community, when pandemic hits and. It is very clear what the group is about.

It's a, okay, we've got this pandemic. Did you narrow down your focus from these seven or eight categories down to a handful as a result of the pandemic? And then what innovations did you, did you move through to address the pandemic? Well, I would tell you one of the key, there was probably two key areas that really helped us immediately during the pandemic, and that was

We were just starting to do virtual medicine. It was really working well within our primary care group. A lot of our specialty physicians weren't really doing it. I think they believed it wasn't really going to be necessary. And then our other was our virtual ICU. And so we had set up our virtual ICU in our main hospital, but really hadn't expanded across to our community-based hospitals.

We had plans to, and we were gonna do that within the next year and a half, kind of as an overall project. But I'll tell you, when the pandemic hit, we knew that virtual medicine was going to be absolutely necessary, especially when we shut down all of our clinics. And so our technology hub, and it's something that we hadn't gotten to talk about yet, but we created an innovation technology hub.

It's within our hospital within one of the, our old units that was b and d commissioned. So our chief innovation officer is also our CEO of our largest hospital. So she was, we were talking about doing this. We were thinking about looking offsite and she was like, no, I'm gonna let you all have this. So what we did was we took this nursing unit and created what we called our r and d space, and basically it has a, a home of the future clinic of the future hospital, inpatient room of the future.

Virtual reality room plus has co-development space within there so that we can work with other outside organizations if we're doing a true co-development project. But what we had to do when the pandemic hit, we had to quickly train. All of our physicians to be able to do virtual visits. Well, we already had it set up within our technology hub, so what we did within over a two week period, we trained over about 600 physicians to be able, how could they do virtual visits with their patients?

What did the technology look like? How would they be able to launch those virtual visits? How would they document overall within our EMR on those visits as well? Then the other piece that we had to do was our virtual ICUI told you we were planning on expanding it across our organization within a year and a half.

Within six months, we had it up all over with all in our community hospitals, everything else, plus a virtualized command center where we had hospitalists and, and different groups who were maintaining and watching over these patients. The other thing that we had to do very quickly was when in our covid units to be able to help our clinicians not always have to go into those rooms.

We put iPads in every single one of those rooms so that a virtual visit could be done with that patient if need be, instead of them having to gown up and everything else to get to be able to just look, get basic information from the patients at the time. But also too, because patient family members could not visit those covid units, we actually made it possible for family members to dial in and have face-to-face virtual conversations with their families.

And so it became just this really nice opportunity so that family members could still communicate with their families that were in the Covid unit if that was possible. We all know if they were intubated or whatever it would be, but before that happened, they could at least have some sort of communication or at a time when if maybe the nurse was just in the room and wanted to be able to communicate with the family, with their patient, with their family members.

You guys did so much and the stats are. Pretty impressive from a virtual care standpoint. Did a lot around vaccine tracking. When the pandemic hit, we really redefined what it meant not to deliver care, but to access care and it, it happened in a lot of different methods. I assume. I'm looking at your fully customized MyChart.

You gave people a lot of different ways that they could interact with you, not only virtually. They could schedule an appointment, they can. They could do a lot of things. And talk to me a little bit about your customized MyChart. Why did you decide to go down that fully customized route, and how does that differ from what you had before?

Well, I will tell you, and that's a project we're working on right now, but I'm gonna back up and tell you what did help us tremendously was, what we found was that patients, patients don't like to log into MyChart. What they prefer is their preferred mode of communication. Is texting, and in that presentation that I gave to you, it's a company that we worked with, Caldwell Health.

And I'm gonna tell you, it's become our preferred mode of communication with our patients. We do bidirectional communication with them as well. So it's a reminder of your appointment. It allows you to text back if you want to reschedule that appointment. It will give you directions to where you need to go.

We used it heavily for our vaccines to be able to, one, remind patients they could sign up for their vaccines, and then also of. Sending out the questionnaire that they needed to complete prior to coming in. But I will tell you we've we're really expanding upon that. Now, there's two products that we will use.

One, I will tell you, Iswell Health, but the other one is on care sets that we found, and this is where we work with. I will tell you kind of newer companies that are out there, they've got a product. They maybe have implemented at a small institution, but they're looking for a big health system to really help them further develop their product.

So Care Sense was another one that we used. And what Care allows It's Care Pathways, I'm sure you're familiar with that, but the Pathways that allows you to send communication by that patient's preference. For what they need to do before they get into the hospital and what they need to do after they leave the hospital.

So in it's little bite-sized pieces of information, you should be taking this medication. You should be looking at your dressing, changing your dressing, what this is, what you should be eating or, and so forth. And what we found by these little bite-sized chunks of information, whether it be through well through care sense.

Is that we got really great adherence to what people should be doing. And I will tell you, high patient satisfaction rate dramatically decreased. Our readmissions and length of stay for that care sense for the pathways that we have that we're using them on, but then on, well, we're now expanding that. So that whenever you're discharged from the hosp discharge order is placed, we're getting ready to do, um, a pilot that will send you a text notification.

It. It's given your discharge bite-sized chunks, discharge information in that text base. But it will allow you, the patient also to ask questions if you didn't quite understand something. And so this is where we're finding, as I said, people don't wanna log into MyChart. They don't wanna have to log into other pieces.

They want their information the way that they're used to using. And how much do we text today? All the time. So that's what we have found has been beneficial for our patients. And I will tell you, we're even looking at a potential solution with an organization that provides text-based healthcare. So minor things.

Right, but hey, you're able to, I've got a sore throat, or I've got a headache, or I've got whatever. And you have a physician on the other end that is texting you specific information. And of course if it ever gets to a point, he or she feels you need to come to the doctor for an in-person or virtual, they can offer that to you as you're having that text-based interaction.

So it's reducing the friction. So as I'm, I'm thinking about this texting with patients. I, I assume there's a lot of data that goes into this. So you're looking at the data, you're looking at the engagement rates, you're looking at the, the no-show rates, the people showing up through appointments and those kind of things.

The data has to drive how you're thinking about these things. When you step into a pilot, like say, with, well. Do you have all that data or is it one of those you do the pilot and you just, the, the data's overwhelming and you realize, Hey, you know what, they're telling us something with this overwhelming response.

Well, I will tell you, we already, we had had another solution that we were using for appointment reminders. I. And that's what we started off with. So we kind of had baseline information, right, of our no-show rates, cancellations, all of that. So I do recommend if there's any way possible when you go into a pilot, if you have some sort of baseline information to compare it to, but remember.

We always have what's our ROI that we're looking for when we go into these, just the ones that you mentioned there. Substantial, substantial, you know, reduction in no show, substantial reduction in cancellations by the solution that we had. Hence the reason why we are still continuing to expand it across our organization and things that we're trying to do.

When you're, when you're dealing with consumers, is it. , just make it as easy as possible. Is that what they're looking for? Easy in their, I wanna say workflow. It's not really their workflow, it's in their life flow healthcare. Yeah. Yeah. I want you to stop and go back and think. I keep telling everybody the CVSs, the Walmarts, the Walgreens, and some of the others, they're not trying to build hospitals.

That's not what they're trying to do, and they never will. Yeah. I mean, what are they trying to do? It's the outpatient business, which we all know for a healthcare system is very important. And so why does that CVS, Walgreens, why, why is it that they would attract those consumers to go there? Convenient.

It's all about convenience. We are a society that is so busy that we cram so much in our daily lives that to stop and think about having to make a phone call to make a doctor's appointment, now I have to travel down to that doctor's appointment. And then what if I have to get referred to somebody else and then end up having to have a hospital stay?

Well think about the length of time that you're spending to do that. So how can we reduce that down to make it more convenient and easy so that yes, you will wanna continue to come to Houston Methodist and not Well, I'm just gonna go over here 'cause it, it's, it's just easier for me and I'll think about it.

If it's more detailed healthcare, I'll, I'll maybe think about it. So easier for consumers. Talk to me about the clinicians. What kind of things have you found and where are you focusing those innovations? Well, I'll tell you, it's one of the biggest areas that we believe is kind of the future of healthcare is voice.

We use voice in our daily lives. We use it in our homes. We use it in our cars. We do a lot. And so. One of the things and, and I know there are different voice vendors that are out there that have products, but when we were looking at it on the full spectrum of care, we didn't believe that it fully met everything that we wanted to do.

And so kind of our two first pilot initiatives was on one ambient listening. And so we've got a pilot within eight of our clinics right now. And the product, it's learning itself. It's learning the, the clinician's voices and what modifications we need to make, but we couldn't do it ourselves. And so who's the leading kind of voice vendor that's out there?

So we partnered with AWS Amazon and to do this co-development with them. And then the other piece, not only for our. Physicians and where I will tell you that our ambient listening product, it goes from the very first to the full spectrum down to even coding of the case. So when you're finished with seeing that patient, all you have to do is then look at the physician, just has to look at the record, make sure all the notes were captured, all of the codes were captured correctly for that visit.

If it's done, he signs off and it's done. It's ready to go and be sent out for a claim. So versus your other vendors, I know they're not there yet. They may get there, but that's where it is that our product, that we wanted to make it as easy, simple as possible and have it be done with. The other piece is within our ORs.

And when you're looking at a surgery case, stop and think about all of your clinical staff, not just your surgeon in there that are having to do something on that computer. And whether it's starting the case, starting the tourniquet, and you're having to document all of these things within the EMO and plus, maybe during the case you need to see labs or you need to see PAX images or what else?

So we said, wouldn't it be nice. If you're in the OR and the surgeon or the staff are needing to do something, wouldn't it be nice if they could just voice it and it be done? And so that's what we have created. We've got it going in. Um, a couple of pilots in our ORs right now. Again, it's in learning mode.

Um, but the ultimate goal is really just to increase the efficiencies over all of our clinicians. And we've done well with these kind of. PO physicians and our surgeons, so much so that our nurses are now, they're like, wait a minute. We need some efficiencies in our workload as well. So it's something that we're now exploring.

What are their potential use cases that we can use voice with our nurses on top of something else that we're already doing, because we've got voice now within every patient. Not only do we have iPads in every one of our rooms, but we've got echo devices in every room. I will tell you, a lot of it's just been used for music, but one skill that we have developed is if you have discharge medications that you're going home with and you have a question, you can get in touch with a pharmacist directly on that echo.to go through your discharge medications.

Wow. My gosh. You say so much in a short period of time. I have like 55 questions. Let me start with. The, one of the challenges with ambient listening is the amount of medical jargon, medical terminologies, and the medical terminology is different from field to field. And so it, it's, it's been hard for anybody to really develop all those dictionaries and, and all those vocabularies, and so they have to really focus it down.

Is that the purpose of just going into the or? 'cause you can just focus in on certain phrases and certain activities. It is. And that's where you can take off you, you can look at these projects, think about nursing, think about the full nursing workflow. It's huge, right? So we're really trying to narrow it down is where are the two or three use cases that we believe brings high impact and efficiencies to the nursing?

And let's start off with those. And if you can start off with those and get those done right, then all you're doing is just continuing to keep add on. It's kind of like in the ORs in some of the other areas. If you get the technology down and you get to where you've got the right foundation, then it's easier to add Instead of trying to break off the mountain and crawl up it, and then you're looking at a two to three year project selecting.

A partner in AWS and AWS obviously is very good with voice, with commands, like place music and, and do those kind of thing. Mm-Hmm. . But they're, they're also good with dialects. They're good with multiple languages. They're good with, so there, there is a baseline to start with as you are creating that, if you select a partner and, and go that route, and I assume their

Really happy to work with you. 'cause they're trying to figure out where can I play in this healthcare space. They are, and this is where I would tell you, it's a true partnership and we have really appreciated the executives and the people that we've been working with at Amazon. They know some of the spaces that we're working in is not.

Something everyone has heard of Amazon Care and AWS trying to get into healthcare and everything else. This isn't a space they're trying, that they're gonna, oh, we're gonna develop it with you and then we'll take it away from you. No, that is not within their mindset, but they are very interested in working with healthcare organizations to, one, does it increase?

I will tell you from them, the business case has to be right. In order to, for them to even do co-development with us. I mean, I'll tell you, they have told us it was, many systems have come up and just said, Hey, we wanna do a joint project with you. Okay, what do you wanna do? We're like, I don't know, just something that would be really cool for our institution.

And the one thing that we have done that Amazon very much appreciates is we really drill it down. We drill it down to these two to three use cases, it makes it easier for us to work on with them. And Amazon kind of has this lifecycle. I mean, they'll develop it up to a point with you and then they wanna hand it off.

They don't wanna just continue to keep going on. And that's what's good for us. It is helps us build that foundation, build the skill sets that we need so that we're we're gonna be made Self-sufficient. On. So you still have a team internally that works with them to build these things out? Or is it more they're developing it and you are utilizing it?

Or is it more They're a platform and once you develop a skill, you've developed a skill that could be deployed to any. Echo across the entire ecosystem. Okay, this is, again, I want you to stop and think about you're integrating this information into the EMR. So in essence, they're also working with Epic because we're an Epic client and it, so you can't, it's not just Amazon.

It is Amazon and Houston. Methodist and Epic. So that as our clinicians are utilizing voice in their daily workflow, it's being captured within our EMR. And so it is as, that's why I talked about, it's building the foundation. So yes, they're working with our staff as well. They're utilizing their expertise to help us with this development.

But ultimately, Amazon's not there to be your long-term development partner. They're there to help develop the solution and then we're done. You take it, you support it and continue on the development if that is what you so, you know, desire. So it's the one thing I do appreciate about working with them.

Is you're getting that knowledge and expertise in kind of these short sprints to be able to help you get these use cases developed and in a working model. So let me ask the two questions to, to close with one, I. Uh, it just came back from the health conference and one of the questions that was often posed to larger organizations, it was posed to CVS post to Walmart and others.

It's, we're an innovative startup and we want to work with you. What, what's that look like at Houston Methodist? It's a very good question, and I will tell you, we're always looking for newer organizations. There's a small core group of us, and it's probably about . Five, six of us that are really out looking for new, innovative companies that are there.

But the one thing that it has to do is what problem is it solving for us? And I'll tell you, I get a lot of interest from a lot of organizations. Let me show you our product. Can I show you our product? Can I show you what we're doing? I try to at least get some information about it because while I continue to wanna see new potential solutions.

Is that it really has to solve a problem for us, and if it doesn't, what we do is we call it, we put it on the shelf. We put it on the shelf here of this is a company we looked at very promising, but not something that we're interested in really doing anything with right now. And maybe later on, as I said, this core group coming up with what problems we're trying to solve.

We'll, remember we've got a list of these companies that we'll go back and look at, but when you've got a hundred companies that's at you all the time, it's very hard to kind of keep up. I could spend a full-time job of doing nothing but looking at, at new innovative companies that are out there, and I just have, we all have to remember, we need to stay focused.

What are those things that we wanna solve for? Houston Methodist. Yeah. I wanna, I want to ask you about, because this seems to be, I wanna ask you about labor shortages. So this seems to be a problem that is starting to be exacerbated and we're seeing numbers like a shortage of 500,000 nurses across the US by the year.

And so that's the reason why we're doing multiple things to be able to, to work with overall our nursing staff. But I will tell you one of the other key items that they're looking at is how. With the solutions that we're creating, create these efficiencies and create us as a differentiator to attract and retain those nursing staff.

So why would they wanna come to Houston Methodist? Look at all of the things that we have to decrease the burden of your workload that you have as being a nurse. I think that's part of, you're gonna hear nurses are tired. Physicians are tired. Everyone's just tired these days from having to deal with the pandemic.

And so if there's anything that we can do to create those efficiencies within overall our EMR, whether it be through voice, whether it be through some other technology, that's, yes. One of the main reasons that we're doing it is because of the burden that the EMR has put with on overall clinicians. Are, but it is tied them to all the data that you have to put in, in order to make them work appropriately, is what you're saying now that is causing the burnout.

I, I think it was a nurse. It might have been a doctor, explained it to me once. He said, all right, here's what I want you to do for the next week. Every time you talk to a person, I want you to pull up your phone. I want you to log that conversation. I want you to log the topic. I want you to log what you told that person to do.

And then I would like you to text them in, uh, a week to let them know that you're following up to see how they're doing. 'cause now do that with every conversation you have. , he goes, now you have an idea of what my life is like. And I thought. Yeah, that makes sense. Everything you do within that hospital has to be documented.

That in and of itself is, is pretty overwhelming. And I guess that's part of the ambient listening, the promise of ambient listening, even if it's just picking up. Portions of that. But if you get a whole, the whole note typed up and just approve it, I would assume that's, that's the holy grail right there.

That's the ultimate goal. And the other thing I would tell you in looking at innovative solutions is don't always just think it's going to solve one problem. I will tell you in some of the things that we've done, it has solved multiple problems for us. We didn't realize it in the beginning, and we don't always just look in healthcare.

You can learn a lot from other industries on. Maybe it's patient movement, maybe it's other things, but there's so much opportunity that's out there. As I said, it's just how do you keep yourself focused and as you kind of referenced the spreadsheet almost what it looks like. That's how we do. And one of the things that I will tell you, you kind of said on looking at these new vendors, I challenge my team all the time.

What are the vendor solutions that we don't have that for problems that we're trying to solve that are on this sheet. If we don't, those are the ones you should be focused on. Not bringing in, looking at all of these other innovative companies that are reaching out to you on a daily basis. If you're not getting solutions for those, those are the ones that you better be focused on.

Do you miss the conferences, the, the big box conferences? I do. The only thing that I will tell you, there's two things that I miss about the conferences. Is one of getting out to be able to look at the different vendor solutions, because I love the exhibit halls. That's where I probably, I spend the majority of my time because it kind of gives you the idea of what's new that's out there.

But the other thing that I truly miss is just the after session conversations or dinner conversations. You tend to learn so much from other people who are attending of things that maybe you haven't even thought of. So I'm hopeful. I'm hopeful now that things. Seem to be on the downward trend, and I hope it stays that way, that with these conferences that we'll be able to start attending them.

Michelle, thank you very much for your time. It's really exciting what you're doing at Houston Methodist. You and the team, uh, are doing some great things. I hope to catch up with you again next year and, and hear about some of the progress you guys are making. Sure. Would love to. Thank you very much for having me.

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