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Improving Interoperability for More Effective Population Health with Nick Patel, Chief Digital Officer at Prisma Health was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text. Our automated transcription algorithms works with many of the popular audio file formats.
HP’s Population Health I.T. Solutions are creating convenience and choice for providers and patients. Building on over 50 years in health and life sciences, HP is delivering end to end solutions for remote care and in-home monitoring. Supporting the transition to home, chronic disease management, medication adherence, health education and remote clinical trial monitoring. HP Fit Solutions. Your single source for cost effective technology enabled remote care solutions and financing services. Visit www.hp.co/go/healthcare. That’s www.hp.co/go/healthcare. For more details.
Saul Marquez:
In today’s podcast on Population Health, sponsored by HP, I had the privilege of connecting with Dr. Nick Patel. He’s been a practicing internist for the past 16 years at Prisma Health’s Midland’s affiliate on mental health. It’s the largest, most comprehensive, locally owned nonprofit hospital system in South Carolina. Currently, he serves as the Chief Digital Officer at Prisma Health and Vice Chair for Innovation at USC Department of Medicine. Prior to his current role, he was the Executive Medical Director of Informatics at Palmetto Health USC Medical Group. He’s given multiple presentations around the country and topics ranging from health care, I.T., transformation, governance, workflow enhancements, health equity, telehealth and population health. He spearheaded the largest first of its kind Microsoft Surface pilot in the nation to improve physician workflow, published in the International Journal of Medical Informatics. He’s a subject matter expert for multiple Fortune 500 tech companies such as Hewlett Packard, Microsoft and Intel. He’s played an instrumental role in the acquisition of over twenty four million of venture capital funding for healthcare startup companies like Indeed and Excel Pixel. He developed the Bluetooth wireless transmitter and mobile application for the IOT connected EKG device, and he co-led the efforts in the optimization and integration of EPIC and Cerner at a major hospital system. He served as a leader in defining and articulating a unique vision on the utilization and development of technology and healthcare. And he currently serves on multiple advisory boards that are really focused on providing the best of healthcare and technology. It’s such a privilege to have held the discussion with him around population health and specifically around the category of remote patient monitoring. So without further ado, excited to showcase our conversation with Dr. Patel on this series on population health. So really appreciate you joining us today, Dr. Patel. So glad you’re here.
Nick Patel:
It’s a pleasure. Thanks for having me.
Saul Marquez:
As we mentioned in the in the intro, today’s conversation is really kind of broadly around value based care. Different ways of caring for patients, the chronically ill and beyond. And with that comes remote patient monitoring. We’ll dive into that today in this in this episode. But before we do, I’d love to learn more about you and what inspires your work in health care.
Nick Patel:
Sure. Yeah. It’s interesting. During I’ve kind of been on my path actually in health care, started from a patient perspective. I got sick a lot as a child and even had pneumonia requiring admission to a local hospital. And I remember the providers who took care of me there, as well as my local family doctor who took care of me on the outpatient side. And he was great. He spent a lot of time with me as explained the pathophysiology of why guys, when ear infections as strep throats consoles all these issues that I had and that really started my love for science and that led me to become a provider. And I think he’s one of the many providers I’ve met on my journey that inspired me to be an empathetic healer and to understand the science behind the decision making that’s required to treat someone.
Saul Marquez:
That’s really neat, you know, and I appreciate you sharing that. Nick, it’s inspiring to hear that your personal experience led you to want to heal others. So today you’re doing things on a patient basis, but also on a broader perspective at the system level. How are you and in your practice and business adding value to the health care ecosystem?
Nick Patel:
Yeah. There are so many changes occurring in health care industry in the 21st century. I’ve finished medical school in 2002 and I remember just that transition from going to paper chart, you know, electronic health records since the passage of the High Tech Act and now we’re about 10 plus years after that. And oh, we’ve gotten to a good stride with using this technology, but now we’re focusing on not just getting that tech out there, but we’re changing our mantra from just patient focus to more consumer focus. Although the two came from a care standpoint, as a consumer, we’re focusing a lot more on a holistic consumer experience when they need our care. Removing barriers such as to access with online scheduling, digitizing our checking process, offering virtual care services, giving remote patient monitoring devices so they can take home. We can monitor them all and aggregate that data and get insights so we can predict when they’re going to get sick and keep them healthy. You’ve probably heard in the media is moving out of that sick care to wellness. Yes, that’s a huge part of a lot of what we’re focusing on. A patient historically is met when you see a patient in your office. They become a you know, it’s a personal walks into your door, automatically turning to a patient either in the hospital, E.R. or wherever. And we treat them as a patient, as a subject of some illness that we have to fix versus a consumer that has needs outside of just sickness such as wellness, but also how to navigate that system when they really need it. And remove those barriers. Some of these tools there are standardized our workflows and trying to focus more on the outcomes, better outcomes and closing those care gaps. And a big one to really reach that remote patient monitoring. If you have a lot of chronic disease, if you look at South Carolina, we’re where top in diabetes, hypertension, congestive heart failure, COPD and our previous tools only allowed us to take care of them when they had an issue. They got admitted for congestive heart failure and then it got discharged to ambulatory setting. And then they try to maintain the medications. But after they leave your office, you have no idea what’s going on. You don’t know if they’re taking their meds. You don’t know if they’re watching their weight. They’re exercising, and then they get worried when they’re getting into trouble or if they’re congestive heart failure patients getting and retaining too much fluid weight. And that’s going to land them right back in the hospital. But where they connected weight scale, I can monitor that weight and using predictive analytics in the solutions that are out there. I can get a alert to the providers. Hey, wait a minute. Mr. Smith is getting into trouble. Just give me a call. Let’s get him to take an extra Lasix pill, which is a fluid pill to get some of this excess fluid out. And there’s studies over studies that show that early intervention significantly reduces hospitalization. And, you know, we’re working on multiple projects in this realm and we’re deploying a huge remote patient monitoring solution, as well as different devices that such as connected commoner’s weight scales, low pressure cuffs. We’re working on a great project with Hewlett Packard and welcome to study hypertension and monitor patients with uncontrolled hypertension at home and set up an algorithm so that we can intervene earlier and do a control versus connected patient per say, see which one does better have a feel connected patients going do better. I mean, at the end of the day, Prisma health as a whole. We hope to become better than 40 fourth in the nation when it comes to health, health care outcomes and cost.
Saul Marquez:
Love it, yeah. You know, in the in the direction that these programs are taken, you know, is leading to improved outcomes and wearing the the chief digital officer hat that you do. I’m sure you’re thinking several steps ahead. And one of the biggest challenges that comes with these programs is, is reimbursement for one and how it fits into an older model Right. that that doesn’t really account for these new technologies. What would you say is the the best way to to tackle some of those those hurdles to use these technologies?
Nick Patel:
Yeah, I mean, for me, I’ve been a clinician. You got to start with the problem first. Technology comes second. And we know that with value based care, we’re incentivized to keep them out of the hospital. And even our thirty two thousand employees who are at 100 percent risk for we want to keep them in mandatory setting. We want to keep them outside of hospital and getting sick. And so for us, even though there may not be any direct incentive from a payor standpoint, there are a whole bunch of indirect of downstream revenue Sables. When you keep people healthy as well, it’s just the right thing to do. And Medicare CMS has really kind of led the charge to start to have codes out there for reimbursement for remote patient monitoring based on time and how much data comes through and how much you intervene per annum. That allows you to remotely monitor patient and get reimbursed. And there’s even a they even cover some of the technology fees and overhead costs fired for that. So I think it’s going to move that way. And the payers are incentivized himself trying. I mean, if you look at Kaiser Permanente, fifty five percent of their inventory visits are done virtually because their payer provider organization, they know that it’s much better to keep patients at home. They also have better ability for not losing missing appointments and improved adherence. When you’re taking care of the patient at home. So I think that it’s going to move this direction. And that’s one of the major ways to reduce the cost of health care in this country.
Saul Marquez:
Yeah. And I think you hit the nail on the head there. And I’m just curious what you guys do different and better than than what’s available today. I mean, I think this stat that you mentioned with Kaiser is interesting. What are you guys doing that’s different? That’s working.
Nick Patel:
Yeah. So we’re working hard to make it a seamless journey for the consumer. They need our services, for example, for virtual care. We’re deploying one seamless digital continuum of services, using data to drive the patient to the right type of visit, from asynchronous visit to a synchronous visit using video to saying, you know, this person has certain X chronic disease state. We need to send a home remote patient monitoring device to manage that. And as we’re managing it, setting and thresholds to say, OK, Mr. Smith’s weight is going up. Let’s go ahead and call that person. Or better yet, let’s get on a video visit. I can see their legs. I could do a remote patient exam and assess that person at their house and bring in the caregivers. That’s something as a patient doesn’t know and a lot about what they’re doing, and so you have other caregivers that are helping navigate with them. And so with remote patient monitoring, it’s really meeting the patient where they are. And so we’re trying to seem it push it all together. So it’s not five different applications that you have to click through or the provider has to use it. We have to monitor and implement. We’re putting into all one seamless solution. We can switch between video versus asynchronous to just basic telephone and all that data being driven directly into our electronic health system. And we’re building in the ability if, for example, a care coordinator in the videos that, you know, you really need the office, you automatically have online scheduling setup so that we are able to get that patient to a visit and if needed, a higher level of care. One of the Keys things I think really changes what we’re doing and sets us apart. So we’re going to start using chat bots to serve as what I call automation glue in all these avenues of care because it’s all a disease based and it learns and understands and has content that’s around a lot of these RPM programs such as diabetes management, hypertension management and just about failure management and you marry that would just same program that you have someone enrolled in for RPO. And we’ve also deployed a Prisma Go app which has wayfinding with Gozo to help patients navigate the system. So it’s really a one stop shop for our Prisma health services.
Saul Marquez:
That’s pretty interesting. Sounds like you guys are really tackling it from the consumer perspective. And you’re very focused on that. Companies today, you know, with. I think about Amazon and JPM and and Brooke shared with that partnership and some of the other work that’s being done with these virtual care clinics. You guys are pretty ahead of the times with what you’re doing compared to a lot of other health systems.
Nick Patel:
Yeah, I think so. I mean, they’re different people. You know, one of the things as CDO like that to me, some great people in networking and they’re on their journey and we’re all helping each other and learning from that process. But it is a lot of work. There is no simple solution out there where you can click an executable and go, OK, it works now. Everything’s integrated, everything works. It is a significant amount of work and design on our part to link all the solutions together, as well as our I.T. and informatics team to marry that and bolted onto the EHR and our network infrastructure and everything else and making sure it has a wrapper security around it. Of course. So it’s a lot of work, but it’s going to be it’s going to get us to where we want to be. It’s got to really help our patients. So I think at the end of the day is not only going to improve outcomes for us, it’s going to drive patients to our organization because of what we’re trying to do. That’s different from our competitors. And hopefully it will make a dent in that. Forty fourth in the nation in regards to health care outcomes.
Saul Marquez:
Love it. Yeah, you know, and it’s it’s about it’s about easy Right.. I mean, we, I order something on Amazon. It’s easy. And it’s it’s creating that that frictionless experience. Right.
Nick Patel:
Well, you bring up a great point. So population has changed. Right. So this is the first time earlier actually it was the middle of last year, the first time ever where the millennials outnumber the baby boomer population. So our population…
Saul Marquez:
Is that right.
Nick Patel:
Yeah. Yeah, it probably is changing. They expect the easy button, right. they buy and online everything with their smartphones and their Amazons and everything else. And Netflix on demand. Everything’s on demand. So we have to be ready to provide. There’s always going to be our baby boomer population that’s gonna require more traditional on an onsite care. But even then, I see so many patients already ready to adopt this technology because if you think about it, you’re taking care of your parents and that you want that technology to help your parents. So it’s going to be it is needed that we have to start thinking different than what we’ve had for the last hundred to two hundred years with traditional a way of providing health care in this country.
Saul Marquez:
So I love it. And I think it’s a it’s a great call out for everybody listening. What are you doing with your business in this health care ecosystem? And if you’re a provider listening, what are you doing with your business? Same question. Right. And right now, you don’t want to be the blockbuster round that streaming has happened.
Nick Patel:
Exactly. It has happened. And you got to think in the end about that, too. I mean, moving away from hardware to cloud and making sure use data, it’s important that in health care, one of the significant issues that we have is 80 percent of our data is unstructured data. It’s not discrete data. It’s not something I can click and understand and drill down right away. But we’re moving towards that direction as we design these digital tools. We’re baking in data as one of the foundational principles of how we’re going to manage patients in the future. And we’re we’re gathering the right type of data. For example, if you were one of our patients and is using our solution, you might have engaged with us for a chronic issue. You might engage with us for an acute issue. But in that time, you’re going to answer a few questions. Let us know a lot about you. For example, if a female forty five, forty eight, whatever is Breast Cancer Awareness Month, all the sudden gets a push notification on her phone goes, you know, it’s breast cancer awareness. What did you know that? This is the rates of breast cancer and here’s how you can prevent it. And based on your GPS location, click here. I’ll show you everywhere within Prisma health. Or you can go get a mammogram today or schedule it for the near future. That person that clicks in, orders, it goes there, gets it. No paper, nothing to fill out, just walks in, gets it and then gets a report. And then on the back end we get data saying the patient’s doing well and it’s normal. And if it’s not normal, well, here’s what you do next. And you could do that was so many things, vaccinations, employment programs around wellness. There’s there’s a lot of stuff, mental health awareness, lots of things you can do.
Saul Marquez:
Love it. So, Nick, tell me about maybe a story you want to share of a way that you guys have improved outcomes or made business better or or more frictionless for the consumer?
Nick Patel:
Yeah. We already see improvement, our patient surveys. We see higher volumes of new patients seeking care at our practices. We are working on reducing our E.R. wait times. And overall, we’ve had more standardization, our workflow. We had a great project that we did actually in partnership with Hewlett Packard about a year ago, where we one of the things that we do not do well in health care is give good patient education. So we put their devices and we actually were giving education, right at that site using 3D modeling, using video, really sitting there having conversation with the patient. So you’re here for congestive heart failure. Did you know what that is? Here’s what it is. And showing that from a Pathaphysiology standpoint, I of like when I was a kid, my my family doc pulled out a know a 3-D model of a heart, a plastic one bag. Now I’m using 3-D video. I’m able to manipulate and I’m actually having the patient interact with my laptop because it’s touched touching the heart go, oh, that’s how the blood flows. That’s why my heart is weak on this side and that’s why I get fluid in my legs understanding that. And the survey showed significant patients expection. They also reported better that they would now they understand their disease state and that they’re more likely to adhere to their treatment plan. So that those those are just some of that some examples of what we’re trying to do and the outcomes we’ve had.
Saul Marquez:
And I would imagine, too, or maybe I might be wrong. Dr. Patel, but you educate a consumer patient at the bedside and then they go home on a remote patient monitoring plan. And now because they understand they might adhere even more after the program?
Nick Patel:
Absolutely. I mean, if you don’t know what you have and doctors are just coming pill pushers, no one’s going to listen to and you’re going to disenfranchise the patient. If you help them understand that you’re not just one of the thousand people you’ve seen a day, but yours, you’re an individual with a health care issue. And here’s your treatment plan and let’s work through it together. And there’s. And that’s the key here. Work through it together. It’s not a doctor. Push a pill. Do this. Do that. It needs to be a contractual agreement between patient and the provider. It cannot be just all provider telling the patient what to do. And this this is where when you give a tool, such a remote patient, monitor a patient, you get to see how that patient’s blood pressure is doing. You get to tell him, hey, look, your blood pressure is doing great. You give some positive reinforcement. And if it’s not doing well, here’s what we’re gonna do to make it better. And this is why, if you look at the industry, there’s so much going around right now in wearables. There’s you know, why can’t you have a remote patient market? We’re looking at more FDA approved wearable devices versus what you’d go just go pick up in a pharmacy or your Apple store or whatever, your Fitbit. These things are standardized and calibrated to what we’re looking for. But that doesn’t mean that the other tools that are consumer direct don’t have importance. For example, if I had someone in diabetes not really sick, you know, I’m going to give you a $10 gift card. If you do three thousand steps a day for a week, then that’s incentivized Right.. I am getting their activity monitoring. I’m getting that information and I get to use that data to kind of put that as part of their treatment plan. And so it is going to be a marriage of private consumer devices as well as FDA hospital devices that you need to take in all this data so you can give the patient more of a holistic view of where they’re doing.
Saul Marquez:
Very, very interesting. Appreciate you sharing that. And if you reflect on you’ve shared some of the successes, but if you reflect on some of the challenges, what would be one of the biggest setbacks you could recall? And what was the key learning from that?
Nick Patel:
Yeah, that’s you always have doing technology. You have to. What I call rinse and repeat all the time. Funding in I.T. resource is always a struggle, especially when you have a large care, a large health care system aggressively expanding and adding services. It’s a catch 22. You have to be able to learn. One of the things I’ve learned, you have to learn to be nimble and you have to be flexible, too. You have to design your systems to be and initiatives to scale. So from small to big. And with the limited amount of work effort. So if I take a ten thousand population and I won’t expand it to a hundred, though. Is that really gonna stress the system any more? Hopefully not. And so a transition to an agile organization is not easy one, but you have to be patient and flexible to make it happen. But luckily, we have a great set of folks that work at Prisma Health, a great team that keep their head down and keep working. But, you know, there’s always going to be setbacks. You know, there’s no perfect technology. You’ll have a technology that you’ve put a lot of effort in. And guess what? Two weeks later, they announce they’re gone bankrupt. And now you’re like, OK, what do we do now? So that happens. So it’s very important to pick a good strategic partner when you’re choosing different solutions that have good backing and that, you know, this is not a just two week startup that has a great idea. So that’s one of the things you have to really make sure is that you work with what’s true and true. You work with people who have data to back up what they’re selling. And if you are able to hopefully find good whitepapers Nairobi studies to support things that you’re trying to do.
Saul Marquez:
Love it. Some great call outs, Nick, appreciate it. You’re highlighting those definitely some of the pitfalls and risks that go along with implementing new programs, new technologies. What would you say you’re most excited about today?
Nick Patel:
Also, a practicing provider in health care. You’re constantly reminded how precious life is and how every day is gift. And I’m always excited every day when we tackle our spectrum of health care challenges. And I’m excited every day to get to work. A great team of folks dedicated to their tradecraft and seeing all our new innovations coming out, whether in the United States and around the world, to help us on our journey. And I’m excited that the fact that finally having a serious conversation about health care, how we all have to take a part in solving it is not going to be solved by government. It’s not going to be solved by health care system. It’s going to be really solved by the patient and provider and systems and the government. We’re all working together. But that’s what gets me up in the morning. And that’s why I love what I do.
Saul Marquez:
That’s great. Well, you know, it’s inspiring to hear your story. For one, going from a young man that, you know, had had health issues. You got entrenched and now you’re you’re paying it forward in a big way. So love that you’re doing what you’re doing and in a big way. One of the big things that we like to hear is, is the books the leaders we interview are our reading book. Would you recommend God?
Nick Patel:
There’s one that I just read that was actually is called Tribal Leadership. And then there’s another one called Trailblazer, who’s the CEO by Mark Petkoff, who’s the CEO of Salesforce. And I’m in the middle of right now. But it just I’m always inspired in this space by how much there is to learn. Always. That’s one thing I love by health care. You’ll never know everything in technology. Sure, we won’t know everything. But you get to meet people through events or their journey or their books that they put together. It is always amazing to me, their journey. And there’s usually a lot of overlap of what most of us go through. But just the out-of-the-box thinking and how do you adapt that sort of thinking to health care? Sometimes it’s not even maybe in a retail space. It may not be like you’ve read Steve Jobs book, which I love, how he started and what struggles he went through. People think of Steve Jobs as a billionaire, very successful Apple and all those things. But man, he went through a lot starting in this garage and going through corporate America politics around corporate America and the red tape he had to go through and the fact that he was eventually fired from his own company and then came back and took it to another level. So I think that you just have to keep that in mind. You’re gonna make mistakes. You’re going to trip over yourself. So it’s something a lot of these books and read, a lot of business, a Harvard Business Review Journal articles. You know, just learning about Toby Cosgrove and his journey and leadership at Cleveland Clinic and others. So there’s there’s definite enough literature to go around and just finding time to read it all. Now, I’m actually doing a lot of the books on tape, not so much tape, you know, on your app, on your phones. I listen to. Yeah, I love it. Now I listen to him. And in between meetings are driving to a meeting or things of that nature.
Saul Marquez:
Yeah. Now that’s so great. And I can group podcasts into that as well, you know, with my audio books and podcasts. I’m able to download it in a good way. Man, good recommendations. Dr. Patel – Tribal Leadership, Trail Blazers by Marc Benioff. Some outstanding reviews that followed. This has been fun and I’ve really enjoyed getting to hear your perspective on remote patient monitoring and just overall, you know, doing better for the consumer and health care. I’d love if you could just leave us with the closing thought and the best place where the listeners could continue the conversation with you.
Nick Patel:
Yeah, I mean, this has been great, Saul. I appreciate you inviting me to take part in this. Great talking to you. And hopefully listeners out there know that love what you do and do passion and Star Wars fan. So I asked my Yoda quote, which is do or do not there is no try and take an objective and hit it hard and do it passion. That’s what I recommend to anyone I meet.
Saul Marquez:
That’s outstanding. I love the Yoda quote. And if the listeners would want to get in touch with you or follow you. What would be the best place to do that, Nick?
Nick Patel:
Yeah, I I have a LinkedIn account under Nick Patel, M.D., as well as on Twitter. Nick Patel, M.D., that’s relatively new. Don’t have a bunch of followers. While we love to have loving new connections.
Saul Marquez:
There you have it, folks. Follow Nick Patel, M.D. on LinkedIn and also Twitter and be best placed to connect with him again. Dr Patel, just want to say thanks for your insights and looking forward to staying in touch.
Nick Patel:
Great. Thank you so much.
HP’s Population Health I.T. Solutions are creating convenience and choice for providers and patients. Building on over 50 years in health and life sciences, HP is delivering end to end solutions for remote care and in-home monitoring. Supporting the transition to home, chronic disease management, medication adherence, health, education and remote clinical trial monitoring. HP Fit Solutions. Your single source for cost effective technology enabled remote care solutions and financing services. Visit www.hp.com/go/healthcare. That’s www.hp.com/go/healthcare for more details.
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