November 20, 2025: What if transforming your operating rooms started in the parking lot? Dr. Sarah Pletcher, Chief Digital Health Officer at Houston Methodist, is joined by Joseph Seliski, Director of Technology Strategy and Digital Health at Allegheny Health Network, to discuss why surgical innovation requires thinking far beyond the OR itself. From ambient cameras tracking efficiency to AI that reads 8,000-page charts instantly, she shares how Houston Methodist is reimagining the entire surgical journey. Discover why AI is "like glitter at a craft party"—it's everywhere now—and learn the surprisingly simple strategy for getting started: start small, but plan big. Plus, Sarah shares career advice that's guided her through decades of healthcare innovation. 

Key Points:

• 03:09 Innovations in Surgical Care
• 09:17 Balancing Technology and Human Touch
• 13:28 Advice for Health Systems: Starting Small
• 15:06 Lightning Round

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Flourish Sound Bytes: Ambient Operations and Hidden Waste with Sarah Pletcher and Joseph Seliski

Sarah Richardson: I'm Sarah Richardson, a principal here at this week Health where our mission is healthcare transformation, powered by community. This is Flourish Soundbites, unfiltered Conversations with healthcare leaders. Let's get real,

Sarah Richardson : .Welcome back to Flourish Soundbites. I am Sarah Richardson, and I am joined by two special guests, Sarah Pletcher and Joey Leski. Sarah is the Chief Digital Health Officer at Houston Methodist, and she's a pioneer in telehealth and connected care.

Dr. Pletcher brings over 25 years of experience driving healthcare innovation. From founding Dartmouth Hitchcock Centers for Connected Care to scaling national telemedicine programs over 100 hospitals. She's helped shape the future of digital health. She's also a trusted advisor to many health systems, policymakers and investors on disruptive technologies and new care models.

Joey Seliski: Yeah, thanks for having us, Sarah. We're, you know, we're really excited for that. The warm welcome.

Look forward to you learning from the expert. You know, Dr. Sarah Cher here from Houston Methodist. And how we're thinking about the surgical patient journey, you know, for patients, clinicians and operators and sort of ideas that health systems can think through at their organization from pre-surgery to maybe during the procedure to engagement with families and how we can cover that whole spectrum with different technology aspects, people and process ideas.

How that can really truly change, you know, the downstream outcomes and the best care for patients. So again thanks for having us and we're thrilled to be here to talk through it today. Sarah, I'm gonna open up with let's start with the why. You know, why operating rooms.

From your perspective, what opportunities might be there for health systems to think about from the whole surgical journey and how you all start thinking about that at Houston Method.

Sarah Pletcher: I mean certainly we think about leveraging innovation really across all settings of care. And we don't just think about the clinical side, we think about the backend side, the cafeteria, supply chain, parking, whatever it is.

And high cost. We need to really lean in to deliver highest safety, best outcomes, but also be thinking about the best experience we can deliver to patients and their families, to the care teams all at the same time trying to build towards a sustainable, financially healthy health system. So anytime you find a lot of complexity, a lot of risk, potential cost, and an opportunity to deliver a better experience you know, that's really where.

As innovators, we wanna try to lean in and try to scale some innovation.

Just the operating room, but it's so much more than that and it's a really great lens that you all think of at Houston Methodist. So how about from the technology now perspective, connecting to that? You hit on the journey, the different areas that I'll feed into it that lead to that best experience for our patients.

Like what are different technology stacks that health system leaders should be thinking about to get to that lens or that mindset? You know, I think a lot focus on the EHR, but there's EHR plus too and other things that compliment it that I think really do solve and get to that experience you hit on.

So maybe you can give us, you know, some insights into, to how you think through that.

Sarah Pletcher: there's so many and you know, you can kind of slice and dice it different ways. You can slice and dice it in terms of tech stacks and you know, on that front, just in the hospital we've invested in having virtual care.

But if you kind of go back to thinking about it more from a patient journey in chronological terms. Before you get into the operating room you have to make sure that you are able to get access to the specialists that are going to work out whether you would benefit from surgery, and make sure it's the right surgery, and make sure that your care and your health is as optimized as possible before you go into surgery.

So lots of innovation just in getting patients in to clinic close to their home. To get them the right expertise, to get the right pre-admission testing and care on the day of surgery to make sure they followed the pre-op guidelines appropriately to get them admitted using our virtual teams where possible to monitor them after the surgery.

Getting the right medication. So a lot of it is really orchestration and coordination along that whole patient journey with the time in the operating theater. Yes, it's important, but it's really just a piece in that whole journey so you can really see the investments in innovation all along that pathway.

Sarah Richardson : So Sarah, I have to ask, what I wanna say is the obvious question in that patient persona, that entire journey that you just shared, in addition, I mean you're orchestrating the components of the patient experience, then plugging it into the clinician experience as well. How did you help bring those pieces together?

Sarah Pletcher: I think one thing, there was a time for Houston Methodist when there was a relatively small group of people who were really interested in leaning in and trying to drive innovation.

But over the years, I would say that now every employee, every physician, every executive. Is innovating. And I think that's been a key to our success to drive it from a central group, our die out group, but to then really get to a point where everyone felt they were part of implementing care redesign and some of these innovations.

So it certainly was not all me. I'm just one. Of many people who help to lean in on some of these care technologies. But I think that is a piece of it is if you keep innovation siloed over in an area, it's hard to really get this sort of scaled transformation. So it really does involve embedding that culture of innovation throughout everyone in the organization.

Joey Seliski: I love that last note uh, Sarah and like the clinical and the operational role and research role combined that, that's something I've never heard that's really unique and I think that really does drive that culture to your point of innovation and always thinking about how do we change our, you know, workforce or experience in different ways maybe we haven't thought about.

So that's amazing. How about in the world of just artificial intelligence? I know that's a topic we all hear now, and like, how do you think that impacts the journey for pre-surgery again, from the patient when they said you have to have it to the post post-op care? Like where do you think the biggest things are shifting?

For leaders to think about?

We have a number of AI solutions that help us understand patients and their. History and the 8,000 pages of chart information that no doctor has time to go through. Risk scoring them, predicting which patients are going to need more support when they're in the hospital, using AI as part of our monitoring algorithms for our vital sign monitoring program.

So it's really everywhere. It's in our imaging solutions using AI to help make us even better in terms of interpreting. Imaging findings quicker and certainly in the OR lots of AI predicting how long certain cases are going to take and what instruments is each surgeon going to use and which approach is going to be best for any particular patient.

Joey Seliski: that's great. The glitter at the craft party reference. That's great. I like that. Go to that one. That was good.

Sarah Pletcher: It feels that way, right? Like everything is smart. Yeah.

You know, you're like, wow, I didn't realize I needed a smart stapler, but, okay. I guess. I guess my stapler is smart now.

Sarah Richardson : Sarah, are you finding that when it comes to things like AI or even advancements from some of your partners, is it a push or a pull? Are you finding your organization says, these are the problems we want fixed, or is it also a hybrid relationship with your partners where they say, these are some of the problems we've solved from organizations we've seen like your, how are you bringing those two together?

Sarah Pletcher: I mean, it's definitely both. I think we do go out with specific problems and look to find someone who can source the solution. And, you know, often vendors or partners will bring us a solution and we'll see if it matches up to a problem. And sometimes we have to look to see if we have a problem that fits that solution.

So we try to kind of go out and find someone who's really equipped to solve a problem. We know we have now. If that's what we're doing, or to kind of be open to test and develop something that a vendor brings forward. It's a mix. It's always going to be a mix.

Joey Seliski: Sometimes it, it's brought to you and you say, do we have this problem? Maybe you just haven't heard of it when you go in source, so you find, oh wow. Like we do have it and it's maybe bigger than I thought. And they didn't know technology could solve that. So I agree with that, exactly what you said.

So something, you know, we worked on was behind the scenes like supply chain inventory management. So when our a FC stock comes in, scanning it, so we always know our inventory across all hospitals. Auto reordering when it gets near a car level or so that the clinicians can free up their time from having to remember that, write it on a spreadsheet and do that process.

And we sort of worked with that from the people and the process and the technology perspective to align that, you know, over the last year. And I'm curious, do you all think about on the supply chain side, in your operating rooms and that journey and any technology or insights or folks that you guys have thought through?

The preferences are different, and so you sort of have to look at trying to find that balance of standardizing where that's the best approach, but also giving individual surgeons some latitude who may have been trained in different techniques to kind of have that individuality. But I think the key is data and insight.

And so if you're able to say to a surgeon, Hey, you've been having these three instruments in your tray for this case for the last 15 years, and you never use those instruments, are you okay if we take them off your tray? We'll still keep them in central supply if you should need them. But really being able to serve up that data and insight at the individual surgeon level to the surgical division, you know, to the, or really, he helps you make informed decisions.

But again, finding that balance where you want to, you wanna preserve individual physician choice where that makes most sense for the patient.

Joey Seliski: Yeah data plus insight to help drive the conversation. That's great. Couldn't agree more. All right, so let's end with our, one of our last topics for our audience and listeners is, you know, if they haven't thought about the operating room yet, that they don't know where to start, where do you think is best to view, or maybe even from a people process perspective, how should they start?

It might not even be technology. What would your recommendation be for health systems?

Sarah Pletcher: it's a little bit of a cop out answer because it really is very specific around that hospital health systems needs and opportunities and what problems they're trying to solve for to kind of know where they need to start.

So just understanding movement in and out of the operating rooms to be able to communicate to the families what the status of the case. And that gave us a lot of insight around how we're using our OR time. We didn't tackle everything at once. We didn't boil the ocean. We focused on. Are we using our operating time efficiently?

Sarah Richardson : That's great advice. Yeah. Now, the most important question for you, Sarah, are you ready for speed

[Mic bleed]

Sarah Pletcher: I hope so. I will see what you guys have to throw at me.

Sarah Richardson : Oh, we've got some fun ones. Okay. If we were gonna go to karaoke tonight, what would you be singing?

Sarah Pletcher: I mean, the honest answer is probably nothing.

I'd be wall flowering in the corner, but I'll be a Nepo mom and say, I sing something written by my singer songwriter daughter. So how about that? Watch this.

Sarah Richardson : Love that and you should share that with us too. Is it on Spotify or any of the other

Sarah Pletcher: spaces? Soon. Soon. Her debut album is coming out end of the year, so

Sarah Richardson : Okay.

We will help you market that.

Sarah Pletcher: All right. Appreciate it.

Sarah Richardson : Yes. I don't know if we'll get to be as good as karaoke on it, but we'll definitely help you promote that album. What's your favorite productivity hack?

Saves me dozens of hours every week. So I'm a big fan of meal prepping.

Sarah Richardson : I love that you said that because we have, at our household do what we call loud budgeting, and if we go how much for something, so like we don't go out to dinner that much anymore because why spend $200 when we can make it at home for like 27 and we just make it more like a restaurant experience.

So your point meal prep break and the health factor that goes into it too. That yes, that sodium and that salt, and that is the same thing, the sugar aspect. We'll throw that in there. Yes. Great one. All right, joy what do you wanna ask Sarah? Yeah.

Joey Seliski: You, so, so if you weren't in your current career, if there was something you would be doing, what would that be?

Or have your interests of yours from a career perspective?

So, I don't have a single thing. Any number of things might've been. What I ended up doing. So I'm just glad I've had the opportunity to do something so fun and challenging and rewarding and tormenting all at the same time.

Joey Seliski: Yeah, I love the curiosity there too. You know, always, what could you know, what could we change or what's going on in this area that can learn more about that aspect of growth?

So I agree with you on that. And the last point is just for our listeners, is just the best piece of career advice that you've received from a mentor of yours over the years at your current role that you'd like to share with folks.

Sarah Pletcher: Again, so many. And it's like, how do you choose which one? I'll just I'll cop out and do two.

Think of you and want your take on a difficult problem or some exciting opportunity, then don't sweat. A lot of the other details. Don't worry about title or reporting lines or worry about job security. Just focus on that somebody wants your take whenever there's something difficult or fun or exciting.

And I think that's kind of a good grounding point in a complex market.

Sarah Richardson : Awesome answers, man. I love that. Don't do it by yourself. And by the way, people care what you think. Then you've got a good toehold. So many amazing pieces of information shared today from my biggest takeaway is that starting small to create something really big and impactful.

And lasting. And that can be anywhere in the continuum, whether it's cafeteria, whether it's operating room. They both matter and the journey and the experience for the patients, the providers, and the overall ecosystem and mission and vision and values you bring to your organization. So thank you for sharing your views with us Joey.

Sarah Pletcher: I feel like we, we should have interrogated Joey more. He's been up to all sorts of good stuff in his organization too, so he's next up on the hot seat, I think.

Sarah Richardson : Yeah, don't worry. I can, yes I will set up an interview with Joey and we can cover some great things at Allegheny, but both of you, just so much fun information.

Always love spending time, even if it's virtual with one another. And again, to our listeners, thank you for tuning into Flourish Soundbites. And that's all for now.

Sarah Pletcher: All right. Thank you so much for having me.

Joey Seliski: Thank you all.

Sarah Richardson: that's flourish soundbites, find your community at this week, health.com/subscribe. Every healthcare leader needs a community to learn from and lean on. Share the wisdom.

That's all for now.