TownHall: Hospital at Home, Digital Patient Access, and AI Enhancements with Jane Moran
Episode 3419th March 2024 • This Week Health: Conference • This Week Health
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Today on Town Hall

it's so easy in other areas of your life.

Think, ordering from Amazon. to cancel an order, to add to an order. You can't do that, I'd say, in almost all healthcare systems.

We're working through that right now

and I think that's going to be transformational for our patients.

My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health.

Where we are dedicated to transforming healthcare, one connection at a time. Our town hall show is designed to bring insights from practitioners and leaders. on the front lines of healthcare. Today's episode is sponsored by ARMIS, First Health Advisory, Meditech, Optimum Health IT, and uPerform. Alright, let's jump right into today's episode.

Hello. I'm Sue Shade, Principal at Starbridge Advisors and one of the hosts for the Town Hall Show at This Week Health. Today, my guest again is Jane Moran, Chief Information and Digital Officer at Mass General Brigham. Jane joined the organization in 21 after serving as CIO for global organizations outside of healthcare for over 20 years.

Jane and I did a Part 1 interview last fall, and we had so much more to cover that Jane graciously agreed that we could do a Part 2, so here we are today. Looking forward to talking with Jane again and getting into some new areas we didn't cover before. So welcome, Jane. Nice to be here, Sue. Thanks for having me back.

All right. Thank you. Let's start by having you briefly introduce yourself and tell us about Mass General Brigham, or MGB, as we know in the Boston area, for those who might have missed the Part 1 interview. Yeah, sure. Hi, everyone. I'm Jane Moran. As Sue said, I'm the Chief Information and Digital Officer at Mass General Brigham.

is the largest employer and actually the largest health system in Massachusetts. It's an academic medical center associated with with Harvard Medical School and the academic piece are two academic medical centers, Mass General Hospital and Brigham Women's Hospital. And we have a dozen or so other community hospitals and hundreds of practices that we support throughout Massachusetts and into New Hampshire.

scope of it. So what are your:

of our priorities going into:

And then just the general care and feeding of a big healthcare system in terms of technology, really kind of putting those, modernizing our infrastructure, our technology processes, improving the relationships with the tech companies, and really bringing up the level of technology. So that we can, you know, better support our ecosystem and make it better for not just our patients and our care teams, but for our employees.

And I should have mentioned this earlier, but Mass General Brigham has on any given day about 15, 000 researchers. So really helping our researchers to manage data, And compute easier. So, really kind of focused on, people and their experiences.

Excellent. And trying to reduce some of the burdens.

Yes, absolutely. Okay, great. Great. So I want to get into Hospital at Home. I know that MGE is one of the largest Hospital at Home programs in the country. And when we closed our part one interview and talked about the fact that we hadn't gotten to it, you said you could spend a whole half hour on that.

Which we won't do, but tell me about some of the biggest challenges in terms of supporting those programs from a technology perspective. Sure. Yeah,

I mean, listen, there's some really great technology and we will all have experienced this in our personal lives with, wearable devices and the integration of like, even for, your scales at home into, your healthcare, your health apps.

So many people already experienced this. During the pandemic, though, I think that was the real growth of the hospital at home programs for us. And I think this is a trend, especially across the United States, is only going to grow. Our hospital at home programs are currently expanding rapidly at MGB.

And, we now offer home hospital at five of our hospitals. But you mentioned the challenges. First of all the first has to be, just some of our patients are super tech savvy, and some of our patients are less tech savvy, and some patients don't have the means to actually own some of the technology that would be required For a patient to have.

So we need to figure that out. And what gets even more difficult in this space is Medicare and the private insurers may not continue to offer the same reimbursement rates for our patients receiving care at home. So we're trying to figure out how we can actually use digital technology. To disrupt this space, and many of our digital solutions are less expensive.

And so we're trying to, sort that out. So that's probably the biggest thing. And we have some partnerships that we're working on. With tech companies and other companies to see how we can offer patients in home the right technology so that they can have the best, equitable technology to support their at home experience.

But I really see this as this is going to be, I think this is going to have to be the future. We're never going to be able to keep up with building hospitals and beds. And I think that this whole concept of at home is a big one. And there's a lot of innovation in this space as well.

So there's a lot of companies. I think that's the other challenge is just to figure out who's doing some of this, work and to partner with them and start trialing and piloting some of their innovations.

You started by talking about patients not being always that tech savvy and trying to figure out how to support them.

You talked about some of the partnerships. I know that you have one with Best Buy. You probably have others. There's been a lot of press around that one. Can you talk a little bit about how you're working with them? I mean, we know them with the Geek Squad, right? Right. Okay. They can come into a home and help figure out the technology, right?

Yes, and that's really all that there is to share at this point. They have a lot of great technology products and They work with a lot of partners out there. So if you go into a Best Buy, you'll certainly see a lot of wearables, a lot of, like I mentioned, the scales that integrate into apps.

And so they're starting to sell a lot more healthcare devices at a Best Buy. And what we're working on is actually the integration then From that, if you consider it a platform into an integration into our electronic health record, so that a patient can easily, take their blood pressure or weigh themselves, and then that gets automatically easy through an app uploaded into our electronic health record.

So that is that innovation is, how can we help the patient and make it super easy for them and then we get the benefit of automating that integration into their patient record.

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 are there particular changes that you've had to make with EPIC as your EHR to support the hospital home program?

Are there modules there that are helping support?

Yeah, and I would say we're working directly with EPIC and there's just a generalized point around the technology companies in particular working directly with them in terms of, think we have, if not the single biggest instance, one of the biggest instances of EPIC out there.

So we spent a lot of time giving EPIC feedback. And they're very interested in leaning into supporting our home hospital. Program, but like I said, right now, it's mostly focused on integration with the tools that we're able to place in the home today. And that's no small feat is managing through that.

Okay. Great. Well, let's pivot on and talk about AI. Okay, we talked about some in our part one of the interview. I've been seeing more press on MGB initiatives in that space. So can you share with us some of that work that's going on and what some of those maybe pilot projects are with


Yeah. I mean, so we're doing a lot of AI and I think I talked a little bit about what we're doing externally today. I'm going to talk a little bit more about what we're doing internally within the organization. So internally to support the processes that I just spoke about alleviating our care team, their administrative burden.

And the first thing we're working on is a program around automating clinical documentation. So, our providers are going into visits and many people will have experienced this. You go see your primary care physician and they spend more time behind the computer screen than they're spending actually talking to you.

So we're working on a program right now to summarize patient visits into clinical documentation. And the program is, it's ambient documentation. Basically what it does is it transcribes the entire conversation, 20, 30 minute conversation, but it actually creates a new data set which is a clinical note.

. That note then needs to be reviewed and edited by the clinician, but the time savings on that is really significant. So that seems to be. A very popular program. We're on our second pilot. We have 200 doctors subscribed into this pilot, and I really feel like that's something that will really help our clinicians sort of improve the interaction.

They can spend more time actually talking to the patient and it makes it easier for them then to write up their notes at the end. The second thing we're doing is we're improving search and synthesis of scientific literature. So, like I mentioned before, at the beginning, we have 15, 000 researchers.

So one of the things we're working on is, working with a company actually called System, And platform ingests articles from PubMed every day and leverages AI to synthesize and contextualize scientific literature. And so, this will, our researchers spend hours and hours searching and digging through primary literature.

For their analysis, and this really sort of helps give them step up in, in synthesizing their literature and at the beginning of their research program. And then the 3rd area, I would say. That is, we're really leaning into is just the generalized improving patient access and engagement. So, it's so easy in other areas of your life.

Think, ordering from Amazon. to cancel an order, to add to an order. You can't do that, I'd say, in almost all healthcare systems. To schedule your appointment, mostly you have to, call, and then if you need to change your appointment time, or you want to schedule a follow up appointment, You need to call back.

We're now building out the technology so that if you've established a relationship with a primary care physician or a specialty care physician, you can actually go online and schedule those appointments. And we're working through that right now by each different specialty department and with our primary care physicians.

And I think that's going to be transformational for our patients. We've already. Sort of crack the code, if you will, and doing urgent care online but, this is something I think that's going to make it much easier. And we're automating things like. Making it easier to understand your insurance and pay your bill and those are things that were just unnecessarily complicated.

for this. We have:

And we're working on improving all of the technology and the business processes underneath this, so we're not dropping any patient calls. We're returning calls back if the patient ends up hanging up on us. So a lot of innovation in this space and a lot of different types of technology, depending on how our patients can utilize that technology.


that was a lot. And I like to hear these

things, especially when No, I know, there's so much, but there's so much we're doing in AI. But it's really, like I said, and just to kind of, for our listeners to repeat, those three areas that I mentioned the ambient documentation on, the automating clinical documentation, The second was around searching and synthesis of scientific literature, and then the third is around improving patient access engagement.

If we can do these three over the course of the next sort of two years, two to three years, I think this is really going to make a huge difference for patients, our clinicians, and our researchers at MGB. That's

great. It sounds like you have pilots in the first two areas with the ambient documentation and

we, and the third, we're actually on the patient access.

we actually have that now. We're not trying to publicize it because we've got nearly 3 million active patients out there. So I don't want all of our patients running to the portal, trying to do online scheduling. But, if a patient is using. Our app called Patient Gateway, they will be notified if their PCP is enrolled in online appointments and then be able to do online appointments or one of their specialty care providers.

So, we're rolling this out slowly and we're not doing a big bag in terms of advertising. Because we want our patients to have a good experience, so that's, that's why at the same time we're improving the technology on our phone systems, so their phone systems will work better, and I think that's just, like I said, going to be a win for everyone.

That's great. And I totally understand with that many patients and actually Matthew and I are two of them need to go slow and you need to make sure that you have the operational issues addressed behind the scenes. I get that. Excellent. So is there any other areas in terms of where you think you and your team are pushing the envelope right now in terms of technology that you want to touch on?

There's so many, I'd say, I mean, one of the things that we're doing with the rapid rise of. artificial intelligence, it's causing a lot of disruption to every industry. And for good and for not good. And so I think we need to deploy these AI tools carefully. so one of the things that we're doing is we're really looking at the impact of artificial intelligence.

We put together this AI governance committee across MGB. And we're also looking at are we baking in bias? What are the ethics around the AI that we're using? And we're developing guidelines. So, we need to make sure that we're doing this in a way that first and foremost is safe.

for our patients. so we're being very careful about how we use AI internally in our organization. And there's some really wonderful use cases. There's a lot of heavy administrative processes, all the forms that you need to fill out. And one of the things as a patient, and I'm sure there's a lot of listeners here, every single time you go to see a doctor, they ask you the same list.

And that is because most of our electronic health record platforms require that for every clinical interaction, you need to fill this out. And so, using technology to eliminate that kind of stuff and make it easier or make it easier for billing and that kind of thing.

We can really help take costs out of the administrative and put that back into for our patients. And so that's what we're working on, but it does worry me. ChatGPT, we've got a lot of sort of guidance around what we can use ChatGPT for and crucially what we can't. So more to, come on that.

And I think people will be reading more and more about. The rapid rise of AI. I think it's good, but it does need to be governed.

Absolutely. Absolutely. And you have guidelines internal to MGB around

chat GP? We definitely have guidelines we've published across our organization. So, so I think that hopefully it's been helpful for folks.

Good great. Well, in the time we have remaining, Jane, I want to get into one other topic, and that's a little bit about you and your experience coming from outside of healthcare. So, how did that experience help you to transition into healthcare, a whole new industry? And is there any advice you'd give to an executive who might be skeptical of bringing someone in at this level, if you've not had healthcare experience before.

Oh my gosh, I had just for everyone, I, and I don't know if this makes some people nervous, but I do actually highlight the fact my only background in healthcare was me as a patient or, with my family as patients. So, I think healthcare is in a period of massive disruption, so certainly my background was mostly, I spent the majority of my career In fintech and banking technology and then I did 7 years at Unilever.

So consumer products good. I think that created a real basis for actually the technology required. If you think about it, there's no better industry for that real time aspect that's required in healthcare than banking, right? We're looking at transactions and, feeds from one system to another in milliseconds or nanoseconds.

And, I think that is what is required. And also in banking, there's a real need for continuous innovation. Same as healthcare, right? Managing large files, large data files, healthcare is exactly the same. So I think there's a lot of similarities. And then with my consumer products goods experience, that focus on the patient as a consumer.

And I don't think we focus enough on that, making it easier for our patients to consume health care and get access to what they need, and crucially have Like a wonderful end to end experience, right? We put a lot of that responsibility today back on the patient to manage their own journey through their healthcare.

And I think that, healthcare systems, not just MGB, but all of the healthcare systems out there could be doing a much better job for our patients as consumers and making that whole experience, getting access to their files or reviewing. or creating follow ups for next visits. That can all be done better.

And I'm really drawing on my background from consumer products there as well. I think that's, really helping to specifically improve the patient experience. And finally, I'll say both of the companies, big companies I work for, Thomson Reuters and Unilever, were very disciplined in terms of managing effectively and efficiently.

And I think. We definitely could do a better job. And so, using technology to help take costs out and make things more efficient, I think, is really important. And I think that's something that we're focused on here is number one, delivering quality health care. Number two, doing it in an efficient and equitable way.

Great. Well, I look forward to hearing more. about the great work that you and your team are doing. And I appreciate that perspective in terms of what you've been able to bring into this industry. Is there anything else that you want to highlight before we close today?

Not today, Sue.

I'll be happy to come back one day. So I'll

keep you posted. Okay, great. Thank you so much, Jane. Yeah. Stay

warm. Okay. Okay.

Bye. Bye.

Thanks for listening to this week's Town Hall. A big thanks to our hosts and content creators. We really couldn't do it without them. We hope that you're going to share this podcast with a peer or a friend. It's a great chance to discuss and even establish a mentoring relationship along the way.

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