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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. Have you missed our live show?

It is only available on our YouTube channel. What a fantastic conversation we had with, uh, direct for David Mutz S Shade. Around what's next in health. It, uh, you can view it on our website with our new menu item appropriately named live. Or just jump over to the YouTube channel. And while you're at it, you might as well subscribe to our YouTube channel and click on Get Notifications to get access to a bunch of content only available on our YouTube channel.

Uh, live will be a new monthly feature only available on YouTube. How many times did I say YouTube in that paragraph? Subscribe to YouTube. We're gonna have some great stuff over there. This episode in every episode since we started the Covid 19 series has been sponsored by Sirius Healthcare. Uh, they reached out to me to see how we might partner during this time, and that is how we've been able to support producing daily shows.

Special thanks to Sirius for supporting the show's efforts during the crisis now onto today's show. All right. Today's conversation is with Josh Saul, director of Innovation and, uh, uh, uh, director of Innovation and Ambulatory Clinical Systems at Houston Methodist. You have a really long title, Josh. I'm sorry.

I, I messed that up a little bit. Not a problem. It happens. Well, welcome to the show. You're, you're really in charge of innovation around the, uh, outpatient, uh, patient interoperability, all that Methodist is, that's. Fantastic. So you said Methodist, obviously the, the name tells us where you're at. Um, but isn't that where like President Bush was there?

Is that Yes. That he was, he was, he was treated with us. Uh, uh, we're, we're about an eight hospital system. Uh, we are have an integrated academic, uh.

Uh.

Wow, that's big. And by the way, I didn't violate any hipaa. That was in the, in the news that, that's right. President Bush was at Houston Methodist. So, uh, thanks for taking a few minutes to meet with me today. I really appreciate it. Uh, so give us a little background on your organization as it progressed through the pandemic.

You know, what, what kind of things did you experience? What kind of things did you roll out? I think, um, you know, our leadership, um, had some really great foresight looking at Covid and, uh, in my world, uh, we took.

Um, we kicked off right around the March 6th, the ninth timeframe. Uh, we started training our physicians prepping for virtual medicine. Uh, we started with about 66 MDs that were doing virtual, uh, treating virtual urgent care, or doing primary care. But quickly, within about three weeks, we hit about 900 MDs.

Uh, this was a huge undertaking to be able to train it. And, uh, for those of you who dunno, Houston Methodist, we actually developed what's called our, uh, center for Innovation Technology Hub. That's where it is really focused in on, uh, uh, tools, digital health tools that our end users, whether it be patients, consumers, come in and trial out these technologies.

We Technology Hub 30.

Support treating patients when they're in isolation. So we, we had a, uh, a huge influx of training and our, our technology hub was able to, uh, support that as the, uh, pandemic started to really hit our teams focused in on more and more virtual, uh, we were doing about a thousand virtual visits a week prior to, we now average

recently hit our visit mark.

15 questions. Focus, bill. Let's see. So the hardest part of the training, it sounds like you just, you already had the, the virtual, uh, workflows in place. You already had the, uh, telehealth solution platform in place, so you just scaled that up a little bit. You had to train the doctors. The workflow was already baked.

Is that pretty accurate? Yeah, that is actually, uh, the training was the hard part. Uh, but we also experienced issues like many other telemedicine groups are, are seeing where you just couldn't anticipate the growth. And so we had to add licenses to be able to do concurrent connections. Um, and, and we continued to add them up, uh, so that we could keep the movement, uh, of the video exchange occurring.

Uh, we, like many others, were just kind of continuing to ramp up and up so that we hit, uh, and had enough of those licensing. So that was a struggle from an IT perspective. The other per the other struggle was establishing support. So now that you have more physicians doing telemedicine, how do you support that?

So we had a couple strategies. We actually developed a telemed Rapid. Were originally two individuals, then it turned into eight. Um, we focused in on Epic Tools, KU Canto, making sure that they were video applicable. Um, that way we could support that. We also had, uh, Amwell as a group that we was our virtual urgent care.

We had team members that were able to support that through our My Methodist app. Um, developing that support was really important. Operations.

Job of supporting their physicians.

We instituted a thing called tele rounding, and I'm sure many of your other organizations have done that as well. But our tele rounding, uh, our, our CMIO, Dr. Nicholas Desai had a vision to create what was called tele lounges in certain conference rooms inside of the hospital so that our physicians could go into those tele lounges and beam into a.

Our tele rounding experience, we think that is gonna continue to grow and expand. I don't see that stopping. Um, it helped us to save on PPE and created a good positive experience for our patients. Wow. Uh, you know, I had, uh, Nicholas s was on the show a while back, uh, with uh, CEO of notable, uh.

Sophisticated innovation and, and digital capability, you guys to be pretty, pretty advanced in how you solving problems. Is there a framework or methodology you have in for, uh, for innovation at. At your organization? Yeah, so we, we certainly, we certainly have, uh, strategic goals that we're working to hit and we continue to develop a solid framework of reviewing technology, developing the strong business case with our operational partners.

And then developing success metrics to say whether or not this project was successful. Um, if it was successful, fantastic. We move forward. If it wasn't, then we would succeed fast or fail fast, and we'll fail that project and we actually, we actually highlight those because that's an opportunity for us to learn.

Uh, and so by learning that we, we can grow the mission of innovation going forward. The other big thing that we did was we, as I mentioned before, is we developed that technology hub. That technology hub is where we're trialing breakthrough technologies like ambient listening in outpatient clinic rooms to be able to capture sound, uh, from a physician and differentiate that.

Wave files and using automated intelligence robots to type up the note for physicians and create actions on it. Saved our orthopedic physicians a tremendous amount of clicks. Um, as you guys know, EMR is a really task oriented click heavy. Our goal in the technology hub and center for innovation is to reduce the amount of clicks and to create that physician to patient eye contact.

When you integrate an EMR and a screen right in the middle, you kind of break that. So our goal is to really break that barrier into not have that anymore. Alright. So we're, we're entering a different phase here. So you're, you're in Texas, I'm in Florida. These are two markets that are starting to open back up.

So how is, how is digital gonna help in the process of reopening the hospitals? I, I think we're gonna continue marching down the same paths that we are doing. We're focusing on patient experience, um, and clinical accurate clinical documentation in interoperability. So we, as part of our efforts with Covid, we deployed 250 Alexas into the room.

So our patients who were isolated could feel less isolated. They could play music, they could chime into, uh, break into their, uh, echo. Echo, loved. We also deployed patient engagement iPads where our patients could play games, Netflix, Hulu type approach, where they're actually have it in the room. Uh, we see that expanding.

Uh, we see the patient experience, um, focus, you know, continuing to expand across the organization. Now we have started to open up for surgeries, um, elective surgeries, and we have started to do diagnostic imaging, and we see that volume ramping up. Uh, our clinics have opened up and we're starting to see patients, um, uh, in, in a measured way, very measured way.

Uh, we're also continuing to leverage telemedicine, so we see that being as a constant. Um, and, and so we're, we're trying to grow all that together. Where we see digital is, is creating that positive patient journey that, um, one of.

We're not actually passing, uh, questionnaires back and forth or collecting money. It's all done via mobile check-in. Yeah, it's interesting. I have my, my daughter who's gonna Baylor, um, I'm not wearing the Baylor hat this morning, but she's gonna Baylor and she was asking me, you know, do you think this will be the advent of, um, essentially, you know, the mobile pay and those kind is.

And, uh, I, this will change our behaviors in, in a lot of different areas. I mean, you mentioned you put Alexa in all the rooms. I assume you're not gonna, uh, take those echoes outta those rooms. You probably put cameras in a lot of rooms that didn't have cameras before. Uh, to facilitate the, uh, physician lounge, that's probably not gonna go away.

There's probably not gonna be as much paper. What, what other behaviors are you looking at and what other things are you looking at that potentially might change as a result of.

Have to come up with different types of solutions. Well, we're, we are heavily invested into a virtual ICU. Um, so we started that deployment this year. Uh, it was, uh, about an 18 month plan to deploy, and now we've, uh, we've accelerated that ramp up, uh, to do our entire system with virtual ICU by the end of the year.

So we see that as being a big win. So creating a foundation of virtual care is gonna be a continued focus for. Yeah. So when you think about long-term impact, it's, it's, uh, you know, we've changed behaviors, we've changed so many behaviors over these couple of months, um, that really does catapult things forward.

Is the, is the challenge just integrating all these things. I mean, okay, so we have an echo, we have a camera, we have a virtual.

Our goal has been to develop on a solid foundation foundational platform. So when we're on the same platform and talking the same language as an organization, um, we can really start to innovate. So, uh, our goal for virtual, for example, we had a couple of virtual vendors, uh, maybe three to four. We're now consolidating down to just two.

And that's when our innovation really started to flourish. Because we're all speaking the same language, we're no longer worried about master patient, index of multiple systems. We now have one patient, one record. We're able to have different conversations around experience. So I think to your point, developing that common architecture so that we can support our business leaders has been a mission of ours and we continue to, to push on that.

My pleasure. Thank you for your time. Thank you. That's all for this week. Special thanks to our sponsors, VMware Starbridge Advisors, Galen Healthcare Health lyrics, Sirius Healthcare and Pro Talent Advisors for choosing to invest in developing the next generation of health leaders. If you wanna support the fastest growing podcast in the health IT space, the best way to do that is to share it with the peer.

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