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 Welcome to this week in Health It where we amplify great thinking to Propel Healthcare forward. My name is Bill Russell Healthcare, CIO, coach and creator of this week in health. It. A set of podcast videos and collaboration events dedicated to developing the next generation of health leaders. This episode, every episode since we started the c Ovid 19 series has been sponsored by Sirius Healthcare.

Now we're exiting the series, and Sirius has stepped up to be a weekly sponsor through the end of the year, and we want to give a special thanks to Sirius for supporting the show's efforts during the crisis and beyond. Don't forget, we've gone to three shows a week now. Tuesday we cover the news.

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I. So I, I did this show a little while ago. I recorded this probably about, almost eight weeks ago now, and didn't get a chance to air it. We had so many shows recorded and so much in the, in the pipeline that I didn't get a chance to, to, to release it. But I wanted to get it out there for you and for the community.

Uh, I had a discussion with, with partners of the show around what is gonna be next within the hospital. What is, what is the patient room next? Going to look like and we had a good conversation and recorded it here for you. Hope you enjoy, um, the patient room. Next is what we're calling this, this conversation.

Our panel for today is Fred Holson, ed Ricks and Eli Tarlow from Sirius Healthcare. Gentlemen, welcome to the show. Thank you, bill. Thank you. All right. So you know, I've been reading a lot and I'm sure you guys have been reading a lot on the impact of Covid 19 on healthcare, but some of it is, has really accelerated the move to digital at an amazing speed.

Fantastic. So you'll represent the the CIO perspective on this show, which is great. Ed, do you want to introduce yourself? Yeah. Thanks Bill. Appreciate it. So, uh, prior to joining Sirius, I've been with Sirius for, uh, gosh, just about two years now. But before that, about 20 years primarily as a health system, CIO around the Midwest and the Northeast and Southeast.

Uh, but the last nine years in a town called, uh, Bufort in South Carolina, where I spent probably the last three and a half years as the, um, COO there and sort of still had it, but led operations of all the ancillary departments and service departments and our population health, uh, initiatives. Great. So we're, we're gonna have you take the COO perspective and, and Fred, give us a little bit of your background.

Sure. Fred Holston, I'm Director of Healthcare here at Sirius. Been with Sirius for, uh, just a hair over five, five years, excuse me. Came from Intermountain Healthcare as their Chief Technology Officer. I also left as the creator and executive director of the Innovation Lab, which we call the Transformation Lab there at Intermountain.

Fantastic. Uh, so there's your CTO's perspective, so C-I-O-C-O-C-T-O. And what we're gonna talk about is the, the changing landscape of the patient room and, and really the hospital just in general. You know, the number of digital initiatives as we touched on earlier and the pace at which we just accomplished it is pretty staggering.

Jonathan managed the CIO for Christus, wrote in Modern Healthcare just today. That, that, you know, the cat is really outta the bag and we are likely never going back to that digital. We, we've experienced digital and our consumers have experienced digital and it will change things for good is what he believes.

And you know, I guess my first question is why is that a good thing? And you know, let's start with Ed. Let's start with the COO's perspective. Why is that a good thing that digital. Is, is going to take hold for the, for the business of healthcare or for the operations of healthcare, you know, moving forward.

Yeah, I think if, if you remove the clinical benefit, which it's gonna be huge in that probably above anything else, we're gonna create some of the efficiencies that other industries have been working with for 15 years. You know, the way they've used digital and sort of input it into their business, from buildings to operations to people and the way they actually manage what's going on.

So to me that's gonna be one of the biggest gains, certainly because there's so much technology available that we've underutilized from an operational perspective for years that will be integrated into our day-to-Day lives probably. Yeah, it is, it, it will be interesting to see, and we, and we'll go into more detail of, of where that sort of integrates and what that looks like in the hospital.

And you, Eli, from ACIO perspective, digital's taking hold. Why is that a good thing? Well, first of all, why digital hasn't taken hold, um, historically in healthcare. And, you know, we can spend hours talking about why the healthcare industry lags behind . Others in, in, uh, as it relates to technology. You know, for one reason, healthcare, we have to be more risk, um, adverse or risk balanced.

It is human life. It's more, it's science as well as art. But with every crisis that comes opportunity, and with most recently with the coronavirus, a lot of the things that we're seeing in the last two weeks are things that we not, we haven't been able to progress on, whether it was for funding reasons, legal reasons, et cetera, that have now.

Really propelled and, and has gone far in the last couple weeks. I'm personally excited about a lot of the things we'll be able to accomplish, and I, um, really, uh, excited about the fact that that'll be sticking, as you pointed out. Yeah. It will be interesting, you know, Fred, from, from your perspective, you know, we, we've talked about, you know, patient room now, next in future, and the technology foundation for that, you know.

Why is it a good thing that the digital technologies will be coming in? You know, was there, were there challenges with the existing technology? Were there things we were unable to do that now we're going to be able to do? Well, I think so. Uh, part of it was that we, I. Wanted digital technology or technologies, I won't necessarily say they're all digital to influence healthcare, whether that's decision support, protocol support, whether that's the EHR, regardless of what it is.

But we kept layering those on without figuring out the workflows. And the workflows now have gotten, we used to call it, we needed a tool belt for a nurse 'cause there were so many things they needed to carry around or do. So many computers to . To type on, so there's two pieces of the digital side. One is that we're going to hopefully create better workflows and that the computer does more, but actually gets outta the way.

But the other is, is that in many of our healthcare patient rooms, we can't do the surveillance or monitoring of patients like we really would like to. If you hook 'em up to heart monitor, that's one thing. Ventilator, that's one thing. A pump, that's one thing. But when they're just in the patient room, who's watching 'em?

The nurse can't be there all the time. The family may or may not be there all the time. The digital influence on what we're gonna be able to watch going forward and what we're gonna be able to learn about people and how we change their care minute to minute and then as they go home with what we're gonna be able to watch, I think will be a huge impact in the future.

Yeah, I agree. So the, the, you know, the Covid 19, you know, pandemic that we're currently dealing with, we've seen organizations revamp those workflows on the fly. I. And so we've, we've put some things in place and we revamped some of the workflows. And obviously some of that stuff will have to be thought about when we're not in a moment of crisis.

So let's, let's assume, let's, let's fast forward a little bit 'cause we could talk about now, but right now people are still sort of battling through crisis mode and, and you know, it's amazing that we stood these things up. They're, they're filling gaps. But if we were to step back and start to think about.

Um, setting this up in a, in a way that is, you know, is purpose built, planned thought through in order to, in order to get the, you know, the best outcomes for the health system. And, you know, ed, we will start with you. You know, what, what kind of outcomes are we looking for? What kind of workflows and what kind of outcomes would we be looking for from the.

Really transitioning from brick and mortar to more technology enabled, uh, workflows and processes. I mean, I think the word that always comes to mind for me, bill, is flexibility, right? So Eli mentioned sort of necessity is the mother of invention, and so people are accelerating what they're doing today, which is incredible.

When I'm talking to friends in the industry, what they've done on the last two or three weeks, it probably is more than they've done from a change perspective in the last two or three years, really, when you think about their clinical workflow and everything through the organization. So building flexibility, using, uh, thinking more virtually.

Beyond the bricks and mortar 'cause we're sort of stuck with the bricks and mortar that we have, you know, from a room perspective, and I know we'll get into some other concepts in, in a little bit, but today we have what we have, right? So you're seeing the popup tents, you're seeing people, um, converting recovery rooms to temporary ICUs and things like that really quickly.

And the plans were probably already in, always in place for that. But now it's going in action and, and you learn from that, which is the other good thing really from this. Is everything that people are gonna learn, what they can improve on. So, you know, most organizations over the last 15 years or so have adopted some sort of maybe lean technology for performance improvement.

And this is really accelerating that even. And so it is like, make a change. Is it better? Good if it's not better, make a different change and keep going on. And that is the stuff that sort of really excites me and energizes me on what people are doing. Yeah, absolutely. Eli and Fred, I'd like to really hear both of you sort of weigh in on, you know, what does it look like?

So we want to build agility in, and we've seen some of this play out, right? So the health, it really has been kind of the, you know, the support best supporting actor in this whole thing of ramping things up. Uh, with a certain amount of agility. So we had some systems in place to, to make the transition for rooms and those kind of things.

Is that gonna be the design criteria moving forward? Agility, being able to respond in, in a crisis and being able to build new workflows and those kind of things. And, and, you know, Eli, I guess we'll start with you. You know, how are we thinking about the technology at this point? . Sure. Thanks Bill. So I would answer that in two ways.

The first is that, as Ed mentioned, it's about having flexibility or, or making so that they're module, uh, modular. 'cause we don't know what the next crisis will be and we need that kind of flexibility or the ability to just change purpose. But the second thing I wanna really focus in on is that what, what, what coronavirus and repurposing of space.

Has really amplified something that we've all been, we've known for a while, is that hospitals are really, really becoming more care centers for the highest level of acuity. You know, previously, over decades, people went to hospitals for many things that are now being taken care of in ambulatory care settings.

It's moving to home health, it's moving to telehealth, it's moving outside long-term care, post-acute, et cetera, and hospitals, the brick and mortar buildings are becoming more and more. Where patients have no other place to go. Now with this latest epidemic, that's exactly what we're seeing. People are making choices.

They're saying, okay, I'm going to go to the hospital if, God forbid, I not, not if I have a virus, I'll go to my, you know, my primary care physician, I'll go to a, to a pop-up. I hate to use that term, but, you know, a, um, a clinic, ACVS, just if I think I have the symptoms and I'll only go to the, to the brick and mortar hospital if I, if it's, if it's lifesaving.

And I think that's really. A, what the hospitals are going to become, and B, and how we design it from a technology standpoint, that has to really become our true north. If it isn't there already, we have to start to think about the patient rooms, not just how can I turn a Med-surg bed into an EICU, but how can I continue to turn the hospital into the higher level of care place?

So. I think a, we have to look at those rooms, the wards, the units, the services, and how do we, how do we kind of align the technology strategies for that, but, and keeping it somewhat flexible 'cause we won't get there overnight. But b is, that's really what those buildings are gonna become. So how do we make sure that whatever our investments are, that they make sense in a decade from now.

Uh, and, and Fred, I'm just gonna ask you to build on that, but Eli, I'm not sure we can say that anymore. We can't build it overnight 'cause we just did , we built a ton of stuff overnight. It's unbelievable. Absolutely. Uh, Fred, do you wanna build on on what Eli's talking about? Yeah, I mean, I think we were headed there anyway, I think is the shift to.

Community care, more outpatient care, as Eli was talking about shifts and really that hospital becomes this, it ebb and flows between, well, if I've got room, I'll keep people for observation. If I don't have room, people for observation may go home and be centered up, you know, as they go home. And so that room was always needing to change for the future so that we could ebb and flow it.

What's really needing though, to change in situations like this is how do you help . Clinical equipment is one issue, staffing is another. Well, they've always been staff on the floor for those rooms, but they're not always necessarily, uh, fully trained on the protocols for certain critical or ICU, uh, situations.

So how do, how can you now have the room rise to help them with those protocols, those step by steps, the, the distance, uh, specialists, those kinds of things. And so it's always been on that path, but I think now we have a reason to. Expedite that path. You know, one of the things that I'm struck as I hear you guys talking is just how, how integrated the, the technology tool set's going to be and the physical design and, and plant and how we sort of plan these things.

And you guys have probably been through building projects. I've been through building projects. It's amazing to me how much of an afterthought it was. In those building projects way back in the day. I mean, it was essentially, yeah, we set aside this much money, just make sure that the room can do what it needs to do.

Was sort of the conversation. But it sounds like what you're saying is you we're, we're gonna have to think about the workflows. It's almost like we're completely. Changing how we think about how we provide care, what the set, what's the proper setting, getting them to the right setting, providing, you know, a higher level of acuity care in certain instances, maybe even, maybe a certain higher level of acuity care out of the home with remote monitoring and those kinds of things.

Are we gonna be rethinking the whole paradigm of what goes on in the hospital and in the workflows across the board? Is that what I hear you guys saying? If I can jump in, bill, uh, Fred will smile. Fred and I spent a big part of last week actually, we were asked by a hospital in the Tri-state area in Connecticut actually, and they were, they're, they're building new brick and mortar property, and they asked us, actually before they stick a shovel in the ground to help them design their technology stack for that building and a lot of what we're talking about today, so they haven't even begun.

Construction on it, and they're really asking us to help them think about these things. So that's a forward-thinking, um, organization. I, I wish all were the same, but we're starting to see that more and more where our clients for hospitals are starting to say, hold on a second. How do we, we have an opportunity, whether it's a new building, it's whether or it's repurposing something different.

Types of opportunities come to us and it's stopping to say, hold on a second before we do anything, how do we prepare this to be something that makes sense for a long time? So Ed, what kind of business questions are we asking? Are we, are we rethinking some of our, some of our normal business practices?

You, you have to. And I think it does start with the technology though, and it's sort of that thought leadership to be in advance of the building. So Fred nailed it. In the future, I think that acute care hospitals will be for extremely acute patients. And that's it. That's all we're gonna do are procedural things.

You know, everyone else is gonna be treated some other step down way or at home or whatever, whatever it could be. And the technology brings the clinical process together to that. So I think the business questions are, can we make . Any place flexible enough to be a very high level of acuity may not always use it that way.

Right? But you gotta plan ahead. And I think if you're not planning ahead, then you're sort of short shifting yourself later. So to me it's looking at that it is how do we use technology not to be in the way to be, but to be invisible to the clinicians, you know, as also ACIO for 20 years. I know I was a very big part of the problem of sort of screwing up the clinicians.

Life and workflow, all for the right reasons, you know, and we can say what, whatever drove us, if it was to be meaningful use, if it was to be, you know, compliant with some regulation, whatever, whatever it was, we were still glorifying EHRs as billing systems and letting the clinicians pay the price for that.

And I think that the effort now is, let's look ahead, how can we. Get the most advantage out of those clinicians who are fewer and fewer, by the way. And I think the workforce in the future is gonna be an issue. And, and we may talk about that later, but how can we get the most out of their skillset without invading or, you know, being in the way, being a barrier to what they do.

And, you know, making that technology more invisible from thinking of it in advance, not as an add-on, which is what we've historically done. All right, so we've talked about the why. We've even talked about somewhat the, the, the what that we're gonna do. We're gonna remap these, we're gonna remap our care settings.

We're gonna raise acuity and do those things. Let's start to talk about the how and, and Fred, I think we're gonna start with you on the how, which is, you know, how do we do this? What does it look like? You know, the same, is it the, the same way we put in a foundation. For the build physical building, we're gonna put in a, a technology foundation to support this and a business process foundation and a, a staffing foundation.

I mean, what does, what does it look like to do this? Yeah, so we're, we're viewing it as in the foundation side of, of your comment, what are all the sensors we could be putting in the room to make the room. And collect data. I mean, part of this is knowing what's going on, collecting the data, everything from touch, and we're looking at touchless.

How do you do touchless vitals? How do you do. Touchless proof of life. How do you do touchless, um, movement? How do you, and then how do you model the data that you're getting to say an action's happening? If you look at one of our goals when we look at patient room next, we really want the actions of what nurses and doctors are doing to create documentation to get out of pecking on the computer.

Do what you do, do it well, and while you're doing it we'll create the documentation. And by the way, when you're not there physically around the patient. We'll look at what's going on and be able to alert you ahead of something going wrong ahead of a code blue or ahead of a fall or ahead of whatever it happens to be.

Those all start with putting the right types of sensors. There's thousands of sensors out there you can imagine, column 'em, IoT, call 'em whatever you want. But there is a subset of those that are really good at what they do, and we can put those in. Make them part of the infrastructure, take the data from that, build models.

And as we get smarter over time, we'll build more models. We'll load those models and we'll get smarter. Over time, we'll load those models and continue this evolution. And then for staff, uh, hopefully we will be changing their workflows in such a way that they become more efficient, they're doing the things that number one, they like to do.

Most nurses get into it. Because they like to take care of people. It's not just a job. They like to take care of people. My brother's a physician. He got into it because he likes to take care of and, and help people. Let him get back to doing that and doing it well. But the other piece I think that'll change is the satisfaction of, of our patients, whether that's family members that we're trying to deal with, or satisfaction and mental.

I won't say mental health necessarily, but the mental attitude of people in the hospital. Are they satisfied? Are they distracted and do they feel like they're being taken care of? Can we provide digital companions that allow them to feel like they're, uh, being taken care of? And then when they transition out of the health traditional brick and mortar back home, can those companions go and continue that that cares?

We move them from one look, you know. Care, uh, environment to another. So there are a lot of things that'll, that'll come along and it starts with kind of this fundamental foundation of let's get the right sensors in there and start this process of getting data and modeling that Wow. That's in, that is interesting to me in that, first of all, you mentioned a lot of technologies that are already out there.

I think we're talking about the, the next iteration of this. Some people might think, oh, that's, that's way off what you're talking about. But we've already had nuance and others on the show talking about ambient clinical listening. IoT. We've seen things from a lot of different vendors. Some of 'em are really sophisticated.

The amount of data and the things that they can actually monitor that are going on in the room as, as you said, you know that the technical jargon for it would be IoT, but there are thousands of IoT devices. So is this another one of those cases where there's a ton of technologies and, and we really have to figure out a way.

To, again, we don't want the technology to lead the business problem, right? This is how we get in . This is how we get in trouble, how we've gotten in trouble over the years. We really want to step back and understand the business and then start to put those things in. Uh, are we seeing business models start to move in this direction?

I mean, uh, Intermountain was one as the EI as as the EICU, or actually they have the digital hospital, right? It's Mercy in St. Louis that has the EICU. And others, do we think that that's going to be, you know, one of the more prevalent business models that, that we're gonna see start to people are gonna rethink the hospital and, and start to provide those digital services for their community?

I can add, no, go ahead, Fred. No, I just think the, there's, there's no doubt there's, there's, there's zero doubt in my mind. They're gonna be rethinking that. You know, one of the things that, that occurred in, in all the healthcare legislation for the past, in number of years. Patients feel empowered and patients wanna work a certain way with their health system, and that is now driving how they, how we, I, I'm a patient.

How do I want care? And it's driving that and it's not just a cool digital app that's out on your phone, it's the entire process. So I think this entire rethinking of what do we provide, but the good news about that is it isn't just, oh, we have to do this because that's what customer service of our patients and satisfaction they want.

It really can be a game changer of how we can lower our costs, improve patient outcomes, and actually make our physicians and nurses more happy in what they do. And at the end of the day, collect more data that will help us in the long-term research of, you know, how we solve bigger, bigger medical and healthcare problems.

Yeah. And that's one of the things I, I'm wanna come back to the how in a minute, but that's one of the things I want to touch on with you guys. And I'm sorry I'm throwing you curve balls. I'm just throwing a question out there to all three of you and letting you jump on each other, uh, each other. So I apologize.

I, it's, uh, , but I, I don't, I'd almost rather have that, you know, whoever feels, whoever can jump in, feel free to jump in. But I wanna talk about the, the customer experience. Because, you know, we've seen these, you know, we've had people come in and say, you know, why aren't you more like these customer service organizations who have, you know, thought through this and put in digital tools and all that other stuff?

I need a, I need a ride to somewhere. I need someone to bring me my drugs. I need someone to monitor me for falls, not only in the hospital room, but in my home. I need somebody to, you know, check my te I mean, literally we could set up. Out of the home if that's what people require of us as a health system.

So talk about the patient experience. What, what do you think is going to change as a result of this, the the Covid 19 situation we're going through right now, that patients are gonna go, Hey, you know what? This is, this is my new expectation from healthcare. And again, I'll throw it out to all three of you.

Whoever wants to go, just raise your hand. So I, so sorry. Next time I'm gonna raise my hands quicker. . So, um, it gets the call. So a lot of what you just talked about Bill was, um, traditional, I, you know, IT organizations or, or manufacturers of EHRs, et cetera. The way they, um, attacked the patient experience was by building on their existing tool set.

So you mentioned the patient portal, right? So a manufacturer, an EHR company that has AEHR can now open it up and say, okay, I wanna, you know, cut out this, this section of data, make it patient facing, and now voila, you have patient experience, right? What we're seeing more and more now are things that are coming totally from left field.

So things that are . Being manufactured or created by companies that have not been in the healthcare arena. And it's not, this is nothing new. This has been going on for a while now, and they're modeling it after. Um, other industries. It could be any, even loyalty programs. It doesn't have to even be patient experience.

Doesn't necessarily have to be, you know, a way to see their vitals. It could be like, you know, . Modeling after the gaming industry and loyalty. It could be modeling, you know, you mentioned now they're sending cars, you know, taking Uber or whatever to send cars to lower, um, patient cancellations and improve access.

So I think the genesis of patient experience was, okay, what can we do with the tools we have? And it's completely turned around. We're saying what's available out there and how can we benefit from that? Fred and I and Ed actually the three of us, we heard about a manufacturer that's using Alexa, which ties into C Ovid 19, which is moving towards using an Alexa to detect abnormalities in breathing patterns.

You know, one of the early symptoms of C Ovid 19 was, was shallow breathing. You know, imagine an elderly in a house. Who, um, is having difficulty breathing and ambient listening can now detect that against algorithms and other signatures of that person and set off alerts that's not building on an EHR. So I think a lot, and that's obviously patient experience.

So I think what we're seeing now is that ideas are coming from everywhere and it, it is a little bit of a tsunami. Hospitals are gonna be challenged with saying, okay, what makes sense? What can we adopt? What do we have to push off? What do we gotta wait to see others, how they deal with it? Um, that's gonna be the challenge.

I think it's gonna be, there's just, we're going from so little to so much. Yeah. I think another one of the problems that we're seeing as part of this is the evolution of how it's happening. I walked into one of our, it was one of our customers not too long ago, and when I walked in the lobby, there were four banners and one banner said, Hey, if you wanna figure out where you're going inside of our hospital, download our wayfinding app.

There's one app. Then it said, Hey, if you want to be your patient, whatever, download our portal app. Oh, and if you want to be part of this education thing, download this thing. And there was one other one. But, but the point being, our evolution is we're, we're evolving by looking at, oh, we think people want this.

We think people want this. And we're, we're buying a solution, which is what we've done for the last. 25, 30 plus years, we buy a solution that solves a very specific problem, and then we're looking at our patients, our doctors, and our nurses to try to figure out how to use all those too many applications where the shift is really gonna occur.

If you talk about the experience component of this is we're gonna have to create this. One organization experience, call it digital front door. It's overused, but this idea that you can create a relationship with somebody long before they become your patient, you can use them for. For, uh, goodness, you know, and trying to keep them healthy and all those other things.

But then when the day comes that they need something, whether that's MI minor or major, they have a, a relationship. That relationship leads them where they need to go. It helps along that way, and then ultimately it sends them back home, but keeps that ongoing relationship. And that's, I think, how we'll create an experience.

So we lead them along that it's kind of a one view of that world and we feel like. Even though we're multiple departments and specialties and people, and maybe even different organizations within the same organization, that it feels more like one, and I feel like I'm being taken care of. From a, from a clinical perspective, it becomes a branding issue.

It becomes a satisfaction issue. It becomes a health issue as well as that's really the way I. We need this to work going forward. And the room as we talk about that is one piece of that, right? We've got the, the pieces that occur before you ever get there, and then we've got what occurs in the room. But those are all part of the same ultimate conversation.

How do we take care of people in that continuum of care when it's cheaper and most appropriate to take care of 'em, and before it gets to most expensive and it becomes more difficult. Right. And it's, oh, go ahead, ed, please. I was just gonna say, I think that part of this whole thing is what's gonna probably lead us there.

It's kind of funny. So for the last 10 years probably, we've been talking about the shift to consumerism and the fact that you are not gonna remain financially viable if you can't figure out patient experience and you're gonna lose anything profitable in your system to the businesses that understand how to do that well, you know, and there's a lot of them that are retail and.

Really know how to connect to patients. And yet I still don't think we've done a great job, you know, in healthcare in general. But you know what? We do really good in healthcare. We respond to crisis. And I think that's the interesting thing right now. It's like, here's the real expectation that patients have.

So yes, they are consumers now. Yes, they want all these things to improve the patient experience, and I know that we've gotta get to that point, but they also want . Good care and they wanna make sure that they feel comfortable, they're gonna, wherever they go, that they're gonna get taken care of, they're gonna save their lives.

I mean, right now it's a real crisis and you're seeing that response and I think that's why you're seeing such a monumental shift so quickly. Like, let's throw up the popup 10. So let's bring in the mobile units, let's find a unused dorm room, whatever, or you know, whatever it might be to get these temporary hospitals.

'cause I think healthcare does that really well. We'll recover from this and then go on and as if you are already starting to put the building blocks in place for the shift to consumerism and how do you fix that? Not only patient experience, but Fred will mention, you know, clinician experience. That's a big piece of this.

I think that you'll be better suited for the future regardless of the way reimbursement works. 'cause that's a big piece of it, but really because that's what people have an expectation next for on everything. Yeah, and actually, you know, one of the things I think is really fascinating to me is we were sort of as a health, as a industry, we were sort of plotting along, waiting for big tech or somebody to come in and completely upset us.

I mean, literally we were not responding as quickly in any one area, especially around the, you know, a unified experience. And we were sort of waiting for it to happen to us. And it's really interesting 'cause I think this has caused us to do just some of the things that we've, we've really needed to do.

And the, and the, I keep coming back to telehealth just 'cause it's the best example. Telehealth had a net promoter score of like 85 to 90%. There's almost nothing else that healthcare does that gets a 90% net promoter score, and we just implemented it across the board. Okay. That's great. That's one example.

That's one piece of really being responsive to the consumer. But there's now a whole host of other things that we can do if we focus in and do these things. And what it, it's, I think it's changed the trajectory. I. It used to be, Hey, you know what, uh, CVS is gonna come along and eventually get in between us and our consumer and way it goes.

But we, the healthcare systems just jumped over. C-V-S-C-V-S was gonna be convenient 'cause it was down the street. We're now going into the home. Right. So, so that's fundamentally changing things. But any, I'm sorry. I, but I digress. I'm gonna, I'm gonna go back to interviewing. Talk to me about the clinician experience.

I and Fred, you touched on this earlier, you know, why is it gonna be fundamentally better? We've been saying it's gonna be fundamentally better for a while, but you know, it seems like we put technology in and it doesn't make their life better. Why is this fundamentally gonna be better? Well, let's put it this way.

I certainly hope it's fundamentally better. The way we've done technology in the past is we've gone based on clinical workflows. We've not always looked at how nurses actually work in their wherever environment they are, and how doctors actually want to work, and what do they need when at the most appropriate time.

And as they're moving, you know, not going in and saying, well, I gotta review this chart. What can we tell them right here, right now as they come in to see Bill? In order to, to have the best conversation or, or make the best recommendation on Bill right now. And I think that's where we have the opportunity to make it better.

Look, there are lots of systems. There's EHRs, there's the there labs, there are many other systems that they interact with that have information. They potentially have to put information in, but we have new and interesting opportunities to make it more like their workflow and they just wanna know what do they need to know when they need to know it at the time.

They need to know it so they can do their job the best and spend more time with the patient, less looking again, which you see the nuance solution, right? What part of what that's for? Great documentation while spending more time directly with the patient. That's a great, great use of technology in order to.

To create a better patient, you know, uh, doctor, physician relationship in that mode. But there are other things that we can bring along. So that will be one machine vision, machine audio. Content delivery, distraction, right. Are all pieces of this grant, I think future that we have, bill, I'll add to what Fred said.

There's, you know, there's the component of patient experience where the, where the provider has more time. A lot of that, like Fred mentioned, is ability to use technology to have more time when they're in the room. Telehealth and other forms of technology. Means that patients don't necessarily have to interact with the provider unless it's absolutely necessary, which gives the provider more time back in their day.

But another thing that Fred alluded to earlier, which is from a clinician or provider satisfaction, are all the things that we're seeing technology that such as sensors. You know, I remember when the Ebola patient was at Bellevue Hospital. I know that everybody knows that story and I was the CI there at the time.

One of the big challenges we. Was entering the room. It was a long procedure to Don and D. The PPE. It was an airborne pathogen, said it was inherent risk to the provider. And now one of the things that Fred is, I know is building on with the patient. Who next is the ability to care for the patient without even entering that, that perimeter, whether it's the sensors, all those types of touchless technology that's available, physicians don't have to enter that area, the perimeter where they can expose themselves to unnecessary risk.

So I mean that if there's no, I can't think of a better clinician satisfier than their own health. Yeah, absolutely. Ed, should we give you the last word on this, or who would like the last word on this? I. We all would Fred deserves it because this has been his vision for a long time. And, and, and, you know, it's a big part of why actually I joined this team just because of the way I think we think, and we're very pragmatic.

We wanna solve problems. We don't wanna sell parts, we don't wanna do that. We're looking to the future, trying to tie it all together. I do think, you know, so my piece of this is, I would say being pragmatic. We can solve a lot of clinical efficiencies, a lot of workflow efficiencies. Think about space differently, think about digital differently in the way you tie things together.

I love this concept of the future because that means maybe a greenfield, you know, you building things away from a design process on up, thinking about digital instead of the retrofit. But I'd love to hear Fred's final thoughts. No, I think I agree. And I think the other thing I also want to just make sure that we get across is that while we are a technology company, while we are looking at technology, I'm certainly a technologist by history.

We are really taking two approaches to this and they're, they're being done at the same time. One is. How do we curate the technology and find the right pieces that, you know, will give us the kind of data that we need in order to answer a lot of these questions in the future. But the second piece is we're asking our customers what are the most important things we could be doing if we could check this box and take that off your plate, or make this easier or solve this particular type of problem.

Do we impact cost? Do we impact satisfaction? Do we impact outcome of care? What are those clinical things that we could be doing? And how do we then marry those two? How do we take the data we're getting from all the technology and the capability we've put in and marry that to what the real needs out there and try to check those in some kind of order That, and, and by the way, I don't know what that order is.

It's different by organization, so we'll have to figure that out. It's different by doctors versus nurses versus patients and, and even the, the administrative side of the organization. But we're asking the questions as to what can we really and should we be solving so that we, we do this in some kind of, again, pragmatic and useful way that people actually want to use.

And then how do we sell it and install it in such a way that they can use just what they need. 'cause that's what they need now. They're not ready for all the other. Cool whiz bank stuff that might, could be done. Let that come as, as it's appropriate for it to come or for the next pandemic kind of situation that says, I need that.

And it'll be more prepared maybe to, to move those things a little faster. Well guys, this is an exciting future. I, I think, and I, I think there is a positive that comes outta this as we talked about. Earlier, just the uh, and the positive is a healthcare that is more designed around the clinician and more designed around the patient and the patient experience.

And hopefully some of the regulatory things that have kept us from doing some of this stuff in the past will open up as well. And I think the thing I've heard from you guys, the exciting thing is. The technology has progressed in such a way that we can do things today that we haven't even thought about before, which gives us the ability to create some of these, some of these new processes supported by technology that gives people the, the joy of practicing clinical work again, and the efficiencies that we need to give them the time that they really want to spend with each one of the patients.

Gentlemen, thank you very much. I appreciate your time. Thank you, bill. Thanks, bill. That's all for this week. Special thanks to our sponsors, VMware Starbridge Advisors, Galen Healthcare Health lyrics and pro talent advisors for choosing to invest in developing the next generation of health leaders. This show is a production of this week in Health It.

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