Jeff DiLullo, Executive Vice President and Chief Region Leader, Philips North America, David Entwistle, President and Chief Executive Officer, Sandford Health Care, Fritz Francois, Executive Vice President and Vice Dean, Chief of Hospital Operations, NYU Langone Health, Diane Brady, Executive Editorial Director, Fortune,
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TechTranscript
00:00I want to start because so many of the people at the table are interested in what many of
00:06which you we've talked about in the call which is that whole realm of innovation,
00:13what's in the pilot stage, how do we get things out there in the marketplace. I want to ask each
00:17of you first of all what's most exciting on your radar right now that you put on ours and then we
00:22can get to the challenges but let's just start with that and give give us some teaser content
00:29to start the conversation. I'll start with you Jeff. My teaser I learned early on in the army
00:33that blunt trauma is a good motivator for change and I feel since the pandemic we've seen an
00:40acceleration of traumatic events in the industry mainly around staffing and burnout and access to
00:45care actually going down and so as a med tech provider to hospital systems I have an opportunity
00:54that I see to use what's on the truck today to work together to innovate in care model deliveries
00:59that we may not have even expected four years ago and leveraging what we have today to really build
01:04upon that we can't have the big bang but there's a lot today we can do. Yes and thank you for your
01:09service that's very important so thank you for that. Dave what excites you? Well as I think about
01:15kind of where we're at in the healthcare industry right now there's some challenges that are ahead
01:19of us that again I'm not perhaps maybe as excited about now we can take each individual state and
01:26look at our own unique differences and woes that we have. There's a lot that we're worrying about
01:31right now whether it's staffing simply getting enough individuals that want to go into health
01:36care whether we're looking at inflation whether we're looking at inpatient beds whether looking
01:40at clinics whether our physicians will use digital whether we can use AI and employ it in a real way
01:45there's so many exciting things that are going on right now the question is is what do we focus on
01:51and I think that's going to be the challenge and also the excitement and I hope we talk a little
01:56more about some of the things that we're doing to try to narrow in and see some of the
02:02advantages and really benefits to what we're doing but I'm excited about what we're in front
02:06there is always something woeful in health care whether it's the balanced budget act whether it's
02:12DRGs whether it's Obamacare there's always the next thing COVID. If we think about some of the
02:18challenges and we are such a resilient industry and we are here for what our patients need that's
02:24what excites me. Okay good and I love the fact you immediately hone in on priorities ROI what's going
02:30to make a difference I think that makes for rich conversation how about you? Well you know for me
02:35thinking about something that we mentioned earlier which is that we're all getting older
02:39and the ability to address aging and think about you know the optimal aging and how do you do that
02:46how do you think about individuals and providing care from that perspective and it's not just the
02:52typical way in which we've done it but innovating in terms of again optimizing aging and one example
02:59and I'll leave you there with this teaser that we know that as individuals age obviously like you
03:03can develop like organ failure and this whole notion of xenotransplantation beyond just a
03:10typical way that we do it now and just really thinking about the how that will serve a variety
03:17of immunities as well as addressing aging in a different way so that excites me I think we're
03:23very very close. Is that an aura ring on your hand? That is a wearable. You know I've counted
03:3017 aura rings on CEO hands in the past month so that which is kind of a big deal well it's also
03:37because sleep they're recognizing sleep as a sort of a strategic advantage and maybe it's maybe it's
03:42just fad but it does say something about our attitudes. I'll tell you the other reason that
03:47I absolutely love this I am fascinated with data and this thing gives you a lot of data.
03:54What's your sleep score today coming into this conversation? You don't want to know that's a
03:57different idea. We'll get to that. Well let me go ahead. I want to ask about the challenges
04:04so let's start with that but you're going to add something. I wanted to just in try to make it
04:10very real and tangible your thought about aging. Tonight as I'm sitting here my wife is in
04:16south Alabama with her parents. Her father's dealing with congestive heart failure. Her
04:20mother is dealing with some serious memory issues. She has been driving five hours every week to go
04:24care for them. Can't do it anymore. They're finally at the point they need to move to Nashville
04:30with us so she's bringing them up. I'm helping them move in next week so I'm thankful that this
04:34was this week not next week. Yeah. But they don't have access. I mean these are these are well-off
04:40people. They've worked really hard their whole lives and they just don't have access to the kind
04:44of care they need despite all the telehealth things that they've been doing. So we have we
04:48got to help people everywhere in the in life journey. I was really moved by your statement
04:53there so I just kind of wanted to share that. Well it does get to the challenge doesn't it
04:57because it we get very excited about some of the advanced you know capabilities that we see in
05:02technology but so much of the challenge of the health care system is that kind of meat and
05:09potatoes you know I need care. It's not you know the latest advance in heart surgery. It's can I
05:15get to my doctor's appointment etc. So what would you say are some of the challenges that you're
05:20thinking about. Well I was sitting with the CIO several months ago and he said he was talking
05:26about technology and kind of general terms. He's talking about various things that were coming at
05:30him and different vendors that have solutions. It's like it's death by a thousand cuts. I need
05:35someone to help me orchestrate this. So the challenges that we get by the way we're here
05:39because of the future health index that we're all going to give you a sneak peek about 12 hours
05:43before we go public. So yes. And we'll talk about that because it's actually quite interesting to
05:48see the U.S. in the context of other countries too. How about yourself? You talked about some
05:52of the challenges. Are there particular problems that are most critical to solve that you think
05:58are the most perhaps far off? Well again when we think about some of the things that we're worried
06:06about right now care at the end of the day comes down to the individual interaction between the
06:10patient. I loved your comment about thinking about how do we better enable our nurses,
06:15our physicians, our caregivers. The use and employment of technology I hope and as I spoke
06:21about should be an enabler but at the end of the day it doesn't take place of the relationship
06:26between the caregiver and what will actually be provided. Again I think about something that
06:31happened this week. We've got something that was new program at Stanford which is called TILS,
06:35Temporary Infiltrating Lymphocytes, which again is a new way of caring for patients in a different
06:41way. I can talk about Atropos which is our latest AI technology that allows you to get a second
06:46opinion with a million different data sets but quite frankly TILS has more of an opportunity to
06:52make real pieces. So if we're going to employ technology in a way how do we identify what we
06:57need from being able to do that and I think that's where some of the challenges lie and have we done
07:02a good job of identifying what we could actually be better enabled with and what we're using and
07:08started to identify those. We talk about our again one of the things we talk about all the
07:14little shiny things that are out there that grab our attention. There's a lot of them and I would
07:19say probably the leaders around the table here are probably getting inundated with a lot of
07:23different ideas and the question is how do we go back to really saying what makes the difference
07:28for our patients who's really going to be able to make an impact. There's a lot of things here
07:33and those opportunities it's just honing in on what those are. Yeah and we'll talk more about
07:36that. How about for you Fritz? Yeah you know we talked about the you know the challenges for
07:42organizations but as I think about the you know the challenges and how we adapt. I mean we are a
07:47very large academic integrated academic medical center and we thought about the quite this
07:54question of access from the perspective of what are the challenges for patients and communities
07:59and should we really think about this in the context of bringing the care to them as opposed
08:05to assuming that patients will always come to us. So here's a question for all of you to think
08:10about the problem that we face was that is it possible to literally take a failing community
08:17hospital that is in an area with the highest Medicaid population in the country and transform
08:25it? Well you know immediately you might say well no that's that's crazy. Why would you want to?
08:30So we actually thought about this because again we wanted to bring the care to patients and
08:35communities and the hospital I'm talking about used to be known as Lutheran in Brooklyn and we
08:41did that with the idea that it was going to be the same standard and focusing on quality and safety
08:48and believe it or not we've been at this since 2016. Believe it or not they have the lowest
08:54mortality rates in the country and not only that is the only hospital in Brooklyn to have an A
09:02safety rating by leapfrog. So that transformation in terms of what is possible when you think about
09:07bringing the care and making investments in the communities as opposed to and the transformation
09:12was moving kind of that inpatient experience out to absolutely not only in terms of the hospital
09:19but also school-based clinics as well as working with communities and community health workers
09:25to think about the needs of the patients if they get admitted and they're discharged well what
09:30happens thereafter. So that's been kind of the type of investments that we have made with the
09:36idea that we know that not all patients are going to come into Manhattan. We want to go out to those
09:40communities. Well I want to talk about the future health index but let's let's pause on this for a
09:45second see if any of the two of you have comments on what is the future of that kind of
09:51inpatient hospital experience so much of the technology we're talking about enables in-home
09:58enables new centers but yet it creates new challenges around you know the payment models the
10:04the control models. How is that playing out from where you sit either of you? I'll take a first
10:11stab and the first of all I was in in with Fritz's team just a few weeks ago and watching what they
10:20do in the ward. It is mind-blowing the innovation they have to save minutes off a nurse's hour
10:26minutes. What they can do on a phone from the beginning of their shift to the end of the shift
10:31they've changed they've taken all the menial activity out the redundant the hand typing all
10:35those things that you say well that's not that's probably you get a 10% bang on that but the value
10:40to the nurses because you that's 10 minutes more an hour they're spending with their patients and
10:45that's really what they want to do so there's a human I saw the human satisfaction in in approaching
10:51that and the reason I bring this up is because it's digital capability that exists today and
10:55you all have invested in that and the same way David with Stanford in so many of the ways with
11:00digital pathology and and and and some of the AI work that you're doing that we get to participate
11:06in with you because we know it takes a team to do it it can't just be providers it can't just be
11:10technology it can't just be the reimbursements a part of it but a lot of things that happen in
11:14the walls of the hospital we can really make pretty slick and make a better patient experience
11:18yeah and and improve staffing satisfaction and lower the burnout as well which is you know if
11:24you get to the report it's a pretty pretty big freaking deal here in the U.S. yeah what's
11:29happening to our health care workers and and that's absolutely correct Jeff you know what
11:32it was a was referring to is that we have paid a lot of attention to not only how every one of our
11:40rooms are designed to save time for nurses where instead of having to go back to an area for
11:45instance to get medications there is a literally a digital medication drawer right at the door
11:54that is where you can put your fingerprint as a nurse it opens it up because the medications
11:57were already delivered saves time you're not going back and forth you also reduce error in terms of
12:03you know like thinking about how you're giving that insulin medication to our patients moreover
12:07the entire focus think about the design is to bring the care to the patient we don't move patients
12:14so what am I talking about well think about the acuity of the patient whether they're on acute
12:19versus ICU but you don't move the patient so we have acuity flexible beds we come to the patient
12:25the team comes to the patient saves time and reduces a lot of waste when it comes to workload
12:32and and yes you're right the the the that the devices that the nurses use allows for better
12:38communication we deliver information to their devices even alert them when a lab is ready
12:44they'll get that notification right there they don't have to go to another computer again it's
12:49all about efficiency about safety so is there anything you want to add David well what's
12:54interesting I remember going through grad school which was quite a few years ago who everybody said
12:58the inpatient hospital is going away that it's it's dead we'll not have it what we have seen in
13:03every organization of the four places I've been I've built a new inpatient facility and so it
13:07continues to grow the question is and I like what Fritz said and Jeff as well how do you scale the
13:13technology that we put into these spaces so that it we have the ability to actually treat the
13:19patient in the area that they're at for example we can now do an online e-consult for our patients
13:26because not all the time do we have the ophthalmologist the nephrologist all immediately
13:30available because of the technology you now have in the room you can do that e-consult right there
13:36immediately so that you don't have a patient waiting same with the ability to do the pharmacy
13:41the meds those pieces that allow that so how do we start to pull in some of these technologies
13:47the EMR is just a great data resource right now how do we start to use that to actually in part
13:52of the decision making process and that's what we're doing and I love that you brought up what
13:56we're doing with you with digital pathology we've now everything in the hospital is digitized and so
14:03you can bring those films up or slides up real time so that patients and doctors can see them
14:08right there so a lot of scaling of the technology enablement in the areas so it's exciting to think
14:13of some of the devices to now where doctors can perhaps not look up but get so much of it served
14:18up to them I want to ask about the your latest future health index it's your ninth year I think
14:26putting the U.S. also in the context of other countries is interesting like because sometimes
14:32we don't get out much with these things because we it's a big country there's lots to talk about
14:37what are some of the findings this year you think are interesting and germane to this well I'll draw
14:42out the first one which I think really paints U.S. healthcare in quite a different light you think
14:47about the the nature of this it's the ninth survey it's fairly well known 3,000 of your
14:52compatriots globally do this in 14 countries many of which are kind of economically mature countries
14:58and so 90 percent nine out of ten practitioners that took the survey said that mental health and
15:04well-being and burnout was actually impacting their ability to deliver care at a rate because
15:10of staffing shortages that that's remarkable think about one out of ten is like it's pretty good
15:15nine out of ten have a have a concern about the the long-term burnout effect
15:20we're not having people add to the ranks as much as we're having them leave the ranks right so
15:24the second big thing eight out of ten have said they feel a direct tie to the ability to deliver
15:28quality care as a result of that staffing shortage 50 said we made 50 of the respondents said we
15:36actually are reducing our capability to reach underserved communities I it's a passion of ours
15:40it's a passion made around the table we're actually lowering that capability when I look
15:44as a technology provider what we can do I think gosh there's got to be a way to work closer
15:49together now Diane to your point and the last one I'll make on the sort of the challenges
15:54the the U.S. that 90 percent I referenced is twice as much as anywhere else in the world
15:58so we're experiencing burnout in our ecosystem twice as more twice as much by our own respondents
16:04our own people than why do you think that is or why do you think that is you should ask these guys
16:10why do you think that is why why are we sort of uniquely ill-placed I think part of it quite
16:16frankly is there's a little bit of an overwhelming aspect of the technology that we're using a little
16:20bit overwhelming aspect of the care that's being provided a lot of the intensity the volume the
16:26things that are there but I think you know it's something that we've got to be focused on in a
16:31very different way that we haven't before yeah I want to ask I know that we want to I feel like
16:37we could be talking all evening and I want to give a chance if anybody has any questions too but
16:44I want to go to both of you and whether it's the levers that you think have are proving especially
16:50effective but maybe more from an advice perspective what have you found actually moves the needle
16:57you know in terms of you talked a little bit about some of the innovations that you're doing but if
17:02you were to sit back what problems are you solving that you think would be relevant to the
17:08problems that the people at this table also have or what problems you know are on the horizon that
17:14we can solve I know it's a big question but do you want to weigh in rich you want me to start
17:20I'm happy to start I mean I think we touched on this notion that that the the volume is increasing
17:26and we we made the assumption post pandemic we were talking about this that perhaps the eds would
17:32be quieter nothing could be further from the truth that we're busier and yet the pressures of being
17:38more efficient are there and so from the perspective of thinking about you know how do we do this
17:45better in some in some ways and the use of technology right can be overwhelming and so
17:51what we're doing is rethinking the way that we're using this and give you a concrete example of what
17:55I'm talking about think about the the work what the bedside nurse will do and all the various
18:02steps that they have to do and we've thought about this in terms of we're about to roll out
18:08what we're calling a virtual nurse who essentially is a live nurse that is going to be able to do the
18:14initial assessment and saves the time from that bedside nurse to do something else frees up
18:21sometimes makes it a little bit more efficient reduces that that pressure on that individual
18:26sounds simple and yes it's an investment but if you're that bedside nurse think about what that
18:32means for you of having that kind of support so it's one example in which in terms of how are we
18:37taking a bite out of all excellent and and we're talking a lot about staff it's a multi-stakeholder
18:41environment obviously we've got insurers we've got employees we've got patients are there any um let
18:47me go to USEC also doctors um how is the technology we haven't talked about all of the stakeholders
18:53and I know we have to I want to give it's funny we're going to have a chance to sum up here and
18:58then move the conversation to the table to hear from all of you but what about some of the other
19:02stakeholders you think about in terms of the impact of technology and the levers that you're
19:07looking at well again I'll use that since you brought it up I mean the faculty or the physicians
19:12at Stanford on average before COVID used telehealth two percent of the time of course during COVID we
19:20were up to 79 percent of the time and now we're settled in about 34 percent of our visits are
19:26again we are probably one of the highest still in the country so how long does a telehealth visit on
19:31average take 21 minutes how long does an in-person visit take 67 minutes we are two-thirds more
19:39likely to be able to have a higher patient experience score quite frankly if they have a
19:44telehealth visit because of the fact that you don't have to go find parking and all the other
19:48things that go along with that we then employ other technologies like voice automation like
19:55what we've been doing with some of the technologies that actually then can scribe a note for the
19:58physician if you look at some of the things that we're doing with we use DAX with Microsoft the
20:05reality is about 20 of all the notes that are scribed coming out of the inbox are actually used
20:11so that means 80 or not so the reality is the physicians are saying this is still better than
20:18I don't have to use the cognitive load actually draft the node so in terms of enabling the
20:23physicians whether it's telehealth allowing them more time and access to the patients
20:27that they can't get to whether it's the technologies that actually can save them time
20:31I think there's a lot in the pipeline that allow us to improve that now I know from experience that
20:36well-fed people make for a better conversation so I'm going to give each of you a chance to give
20:40some very quick closing thoughts and then we'll move this conversation to the table where we'll
20:45have a wider discussion I'm going to start with you sure you know I think quickly you know AI
20:51is amazing I think that the what the potential to do and make to do things for our physicians
20:56as an example improve quality and safety is something that we are absolutely committed to
21:01and looking forward to transformative nature David yeah same thing I think technology is something
21:07that's on the future it's on the horizon how do we make sure that we take advantage of it and pick
21:12those things that are going to best enable our physicians staff the ability to do better work
21:17I do think I'm excited about and very bullish on what we have in front of us and as a technology
21:22service provider to all of you and the innovation you're trying to do for that people and patient
21:27centric design and delivery systems we're wanting to walk that journey with you end to end because
21:33technology of itself is not enough your network is insufficient by itself just with the providers
21:38because we think there's a multiplicative effect everything we're designing today in in Phillips
21:45is to take a piece of technology that you can use and extend the care or the highest level of
21:49licensure of a human being of a care provider into communities with maybe a lower level but
21:55that you can have that collaboration live and meet the requirements and the and the quality
21:58that you want and keep extending that care at a lower price exciting stuff we're going to continue
22:03the conversation the table we want to hear from all of you it's the daughter of a nurse I also
22:08thank you because I know full well oh boy did I hear stories from my mom so thank you very much
22:13Fritz David Jeff and look forward to a great meal thanks everyone