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Using A.I. to Achieve the Quadruple Aim

Episode 406

Recommended Book:

Blue Ocean Shift

Best Way to Contact Alan:

Linkedin

Mentioned Link:

Healthcare Pittstop

 

Using A.I. to Achieve the Quadruple Aim with Alan Pitt, CMO at CloudMedx transcript powered by Sonix—the best audio to text transcription service

Using A.I. to Achieve the Quadruple Aim with Alan Pitt, CMO at CloudMedx 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 in 2019.

Welcome to the Outcomes Rocket podcast, where we inspire collaborative thinking, improved outcomes and business success with today’s most successful and inspiring health care leaders and influencers. And now your host, Saul Marquez.

Saul Marquez:
Welcome back to the podcast. I have the privilege of hosting Dr. Alan Pitt. He’s a professor of Neuroradiology at Barrow Neurological Institute and also the Chief Medical Officer at CloudMedx Health. At the Barrow Neurological Institute, they are one of the country’s premiere centers of excellence for neuroscience. He has degrees from Stanford and University of Arizona. He did postgraduate training in internal medicine, neurology, radiology and neuroradiology. Over the past two decades, Dr. Pitt has worked at the nexus of computers and medicine, looking for better ways to stitch together our fragmented care system. We talked a lot about the siloed nature of health care, and he passionately believes that by putting the patient in the front of the right person, fear and anxiety for the patient, the loved one, the nurse or generalist can be replaced by reassurance. This avoids needless tests, transfers and worry. He focuses on cloud based solutions, as he is doing with his experience at CloudMedx, which he’ll dive into a little bit further today and collaborating with sustainable business models to create better outcomes in healthcare. So in addition to that, Alan is also a podcaster. The name of this podcast is Healthcare Pittstop curating conversations for better care. We’ll be leaving links to his podcast as well as his work in the show notes. But for now, I just want to give you a warm welcome, Alan, to the podcast. Thanks for joining us.

Alan Pitt:
Thanks for having me. Glad to be here.

Saul Marquez:
It’s a privilege to have you carve out time for us. Now, did I miss anything in the intro that you’d like to fill in?

Alan Pitt:
I think you’ve got it all. I don’t think you put my birthday and what I like to get for gifts. But other than that, we’re good.

Saul Marquez:
Love it. That’s great. And so what got you into the health care sector?

Alan Pitt:
Well, so health care is really a family business for me. My father’s a physician. I call myself probably the stupidest person to ever go to Stanford because all I thought about getting into med school while I was at Stanford rather than looking at the opportunities there. But pretty much, you know, you often follow in the things that you’re familiar with. My father had a very successful career in health care and I went into health care with that as a model. My wife is actually a physician. Half of all women physicians meet and marry other physicians. And actually my daughter and her fiancee are both. So it really is the family business for us.

Saul Marquez:
It sure is. That’s amazing. So you guys are truly at the core. You know, a physician family?

Alan Pitt:
I would say so, yeah. For good or for bad? I had a lot of conversations with my daughter about, you know, why she wanted to do this. If this was a good choice for her and she, of course, as all children do, didn’t really listen to me and gave me reasons why I didn’t understand. And she’s now at the University of Colorado in obstetrics and gynecology.

Saul Marquez:
Wow. Good for her. Good for her. You guys. You guys have done wow. Raised her well, and she’s following your footsteps. So you’ve also taken an entrepreneurial pursuit and sort of gone into the business side of things. So, you know, overall, you know, you have a really well-rounded experience. What would you say? A hot topic Alan, that needs to be on health leaders agenda today is. And how are you and your organizations approaching it?

Alan Pitt:
Yeah. So I’m well, so when I say my organization, I have many different hats that I wear when I speak about my organization. I have the Barrow Institute, which is an institute inside a large organization called Dignity Health, now called Common Spirit, which is roughly a hundred and fifty hospitals here in the US. Barrow and Dignity don’t necessarily align with what their mission is. Barrow is really focused on serving the most complex patients in the country where dignity has a broader mission of I want to serve the underserved and take care of everybody. And that’s a perhaps a separate topic. And then I have my entrepreneurial had one where I look out on the world, I see problems. And I want to find solutions. And so you kind of have to couch it in those terms. More broadly, I would tell you that, you know, I’m now in my late 50s and I’ve lived through multiple iterations of health care that are gonna have some major influences. And so when I was in med school, of course, we did everything on paper and we lamented how bad the paper was. If you wanted to do research, you had to go to the medical records place, which was kind of like the dungeon where they had all these charts and you get these big carts full of charts and you try to read through the charts and these illegible notes and you’d lament how they were illegible and you couldn’t do your research as a medical student. Now we have everything electronic and now we lament how bad the electronic user interfaces and how we can’t find stuff there and how it doesn’t talk to different systems. I think we’ve gone through this process of going from paper to digital, but the digital really is not in a format that either providers or patients can use to help them better understand their health care. And I think we’re about to hit this kind of paper was the first wave. Digital is the second wave. The third wave is, you know, how is digital actually going to interact with humans in a way that is much more fluid and friendly than I think matters.

Saul Marquez:
So the third iteration would be how do we humanize digital?

Alan Pitt:
Correct. Right. So you have all this data now Right.. We’ve gone from paper to digital. You have all this data. But from a patient perspective, for instance, if you go to use Google to search about your health care, you get an overwhelming amount of information which basically dilutes its value to a patient. And you as a provider at the bedside, you’re really sitting there documenting almost a slave, if you will, to the revenue cycle side that the billing side of health care. How we get paid as opposed to the technology is really adding as an assistant to you to help you better understand that patient. And what are next steps? What would be best best practice? Next steps? We’re not there yet. We talk about clinical decision support. We’re really at the very beginning of that. And I think it’s important to point that out because that’s actually a real opportunity for people who want to be entrepreneurial. How do I how do I take all this data and make it much more approachable for both patients and physicians?

Saul Marquez:
Yeah, there’s some great, great insights there, Alan. And so maybe you could dive into some of the work either at Barrow or CloudMedx. Tell us about how you’ve created results and improve things by doing them differently.

Alan Pitt:
Yes. So it’s funny. Healthcare, healthcare at the bedside. Hospitals, I think really somewhat lag behind entrepreneurs. But I’m going to just give you a brief example of what the bureau is trying to do. And it kind of points back to some of the earlier work I did prior to working with cloud medics. I was the Chief Medical Officer of a large telemedicine company of Visio, which then exited to American. Well, the idea of telemedicine, the ability to bring the right person in at the right time really offers an opportunity to save patients a lot of angst and expense. So a small example of something that we’re starting to do and obviously there’s a lot of opportunity to do this is this idea of a network seeing information about the patient before a patient is sent to our hospital. We often get patients sent to us from hospitals around Arizona as well as around the country. Often these are felt to be emergencies. Many times they’re not emergencies. And if we had only been able to see the patient or see their MRI scan or C.T. scan, we’d have been able to avert that transfer. Either the patient isn’t as sick as is being proposed or they’re so sick that moving them to the barrow really isn’t going to help very much. And so now we’re basically and this sounds kind of almost old school in today’s day and age, we’re allowing our residents and attendings to see some of those images before the patient gets in the health evac. Realize, of course, that many patients have to pay for that transport and that can bankrupt a lot of families. That really upsets me when we receive somebody who didn’t need to be here from a cloud, from a cloud medical perspective. I feel very blessed. You know, I’ve reached this point. I’ve helped a whole bunch of startups and I have somewhat the luxury of being able to engage in companies that I really believe in. CloudMedx was started by two co-founders with advanced degrees in computer science Tashfeen Suleman. The CEO was with Microsoft for quite a while. He had his own personal experience with a family member where the physicians did not have the information necessary to make the right diagnosis and he thought he could build something different. But unlike a lot of tech entrepreneurs, I really applaud Tashfeen because he learned a lot of the lexicon and workflows of health care almost before he built his business. And now he’s built a very interesting company that really acts to support both providers and patients leveraging artificial intelligence. And he really tries to fit that artificial intelligence to the workflow of patients and providers in ways that are very pragmatic.

Saul Marquez:
I love the approach you’re taking, right, because from from the bedside, your implementing process, innovation and you know, hey, risk stratification, who’s ill, who’s not? How can we prevent 60? The 60? The number is 66 percent of bankruptcies to health care reasons.

Alan Pitt:
Yeah.

Saul Marquez:
And I love your passion about that. You’re complete disgust with that happening if it doesn’t have to happen. And then on the other side, it’s technology, innovation, leveraging your experiences. So I’d love to hear from you through these these insights that you’ve made, maybe something that didn’t work out so well and what you learned from that made you stronger and better because of it.

Alan Pitt:
Yeah. Yeah. That’s interesting. So, you know, I’ll tell you some mistakes I’ve made as a physician. Right.. And I tell you this story only to give your listeners a sense of some of the struggles in health care at the bedside. So when I was an intern in medicine, gosh, almost 35 years ago, now. Yeah. There are two patients that I was not completely but partially responsible for their deaths. And as I looked at both of those experiences, there were things, checks and balances, process issues that were broken that allowed the wrong patient to get the wrong medication. And I participated in that. And I I still see their faces. Not on a daily basis, certainly on a weekly basis, and certainly when other providers have a less than optimal outcome. I always think back to those times. That being said, those experiences I think have made me a little bit better when I see other people or I see issues that pop up. It’s given me some perspective on what can happen in healthcare. I should tell some of your listeners who are not physicians that, you know, whenever you think to go to a hospital, there’s no free lunch. I think Americans believe that they can consume healthcare with no risks and it’ll all be fine. Anytime somebody comes at you with a sharp object or a drug that you haven’t taken before, you really want to ask yourself, ask your provider, are there any other options? Because there’s always risks involved. So you want to think about them.

Saul Marquez:
It’s a good call out, Alan, and appreciate you sharing that.

Alan Pitt:
From an entrepreneur’s perspective. I think there there have been also some lessons. I’m an entrepreneur. I’ve also been an investor at times. I would tell you as an investor, I give talks to my residents and fellows on health care investing. And I have a rule now that I tell them if there’s no revenue, you don’t invest. Yeah, you can help. But certainly my mistakes in healthcare have been about I think of expression is felt no fear of missing out Right.. You’re presented with a problem and a solution that you understand. And certainly as physicians, we you know, we think we’re really smart. We can gauge stuff, but execution matters more than anything else. And revenue means other people are willing to pay literally pay for that solution. And so I’m very reluctant now to invest in solutions where other people have not elected to pay for things.

Saul Marquez:
I think that’s a that’s a great call out, especially with the slow selling cycle in healthcare from you have an idea to hospitals, practices, are going to be purchasing it. Is this definitely a great call out? So as you as you’ve made mistakes, you’ve also had a ton of successes. I love to hear one of your most proud moments has been.

Alan Pitt:
It’s been one of my in terms of entrepreneurism and it’s probably one of my proudest things, but it’s also one of my greatest disappointments and a real learning experience.

Saul Marquez:
Huh?

Alan Pitt:
So I posted some of this on the Web. So it is not private information, but my my mother in law was a patient here at this hospital and they had some issues with her and she got transferred to another hospital. But my hospital forgot to kind of tell the other hospital that she was coming. And so I got this call from my father in law is a Korean War vet. I can hear my mother in law kind of yelling at him and like near tears. And I call up the chief nursing officer at the hospital at the time, at the time. And, you know, I was a fairly well-known physician and I said, you created this problem. You will fix this problem. And so they got my mother in law back in the hospital that night. And I went to them the next day and I said, look, I don’t care if this problem happened. I just want to know what you’re going to do to change things. I’ve had things that have gone sideways and they said, sure, we’ll get back to you. But they never did. And I kept going after the person. Finally, the person was responsible to get back to me. I said, you know, what ways do you have to communicate with patients when things go sideways? And he looked at me straight in the eye and said, Doc, I really have nothing. I have no tools to remind me to go back and touch that patient that we didn’t do a great job on. And in that moment, I came up with a technology strategy, which I called my hospital and I partnered with the chief nursing officer to allow nurses on their 48 hour follow up call to record or at least note what patients were saying about their experience and if there was something that was not ideal to basically pass that message forward into other sectors in the hospital. The chief nursing officer actually won something called the Green Light Award. It was an innovation award offered by Dignity Health.

Saul Marquez:
That’s great

Alan Pitt:
We won one hundred thousand dollars to build the technology. We deployed that technology. The nurses, who were very skeptical at first became some of the biggest advocates. They sang songs about it and they got T-shirts and.

Saul Marquez:
They literally sang songs about it.

Alan Pitt:
I can send you a YouTube. One of the nurses.

Saul Marquez:
I want to see that.

Alan Pitt:
All the I.T. platform I am aware of ever. I have nurses literally. They made up a poem and singing a song about it.

Saul Marquez:
If you share the link, I’ll definitely put it in the show notes.

Alan Pitt:
I will absolutely find… So, you know, the nurses were all in and then really the leadership of dignity who had given all this money couldn’t figure out how to scale this opportunity. And the institution kind of through privacy and legal and everything else kind of blocked it. So it became one of my proudest moments. I created something that I thought could really add to care. But also one of my saddest moments to see that we couldn’t figure out how to get out of our own way. So it was that was kind of interesting.

Saul Marquez:
It’s a great story. And, well, you know, also a testament to how you could you get lemons. Make some lemonade. And you know, you truly did that with this situation, created something awesome. People rallied behind it. Differences make being made. And the thing that that, you know, I guess I’ll highlight to the listeners is, wow, even as an insider Doctor Pitt, Allen. You know, it’s hard to get these things stick to move. So if you’re struggling right now, it’s a solution that you believe in is hard. So don’t get down on yourself. Keep working on that. There’s a way. There’s a way if you really believe that there’s a way if you connect with the right people. But sometimes there isn’t. And you gotta learn how to.

Alan Pitt:
It’s tougher than you think.

Saul Marquez:
Yeah. Yeah.

Alan Pitt:
It’s really tougher than you think.

Saul Marquez:
Now, this is a great, great example. And definitely appreciate you sharing that. How about an exciting project you’re working on today?

Alan Pitt:
So I would say that the majority of my time now outside my clinical practice is being taken up by CloudMedx. I’m super engaged with cloud medics and really believe in their mission moving forward. Really, we’re being overwhelmed by data as providers. It’s leading to a lot of provider burnout and the application of A.I. as a board, if you will, to help physicians provide other providers get through their workflow, I think is a really big deal. The founders actually had an interesting idea. So I think their first software to pass a modified version of the medical boards that came to me and they said, look, you know, we’d like to have our software take the medical boards and compare it to UCSF residents. And I said, don’t do that. That’s not really the opportunity. The opportunity is. Have the residents take this exam. Have the software take this exam and then have the residents with the software take the exam. And almost as expected, what you saw were residents got about the 70 percent range, a little higher in software, gotten the 80 percent range. And then the residents with the software got in the 90 percent range.

Saul Marquez:
Nice.

Alan Pitt:
The whole thing there is that there’s a lot of fear about A.I. displacing people. It’s not about displacing people. We’re not going to take your job away. We’re going to change your tasks, what your job involves. And in this role, when you interview those residents after they took the exam with the software, they said, you know, initially I didn’t trust it. But then I started to lean in because I recognized that it was really helping me understand. And it’s taking the medical boards that usually problem sets. That’s you know, if a patient is this, then that I think that’s really about the future of health care and what it looks like.

Saul Marquez:
I love that. You know, and when whenever I get into discussions about A.I. and health care with folks, I always just say it’s augmented intelligence.

Alan Pitt:
Yeah, that’s right. But somebody has to be augmented.

Saul Marquez:
That’s right.

Alan Pitt:
And somebody has to be augmented.

Saul Marquez:
That’s right. Wow. So cool. I think that’s neat. And I think, gosh, we could do another podcast. And I’d really like the behind the scenes of cloud medics. So the hook is in listeners. You know, check out what CloudMedx is up to and what Dr. Alan Pitt is doing there. We’ll leave a link to that in the show notes as well. We’re here at the Lightning Round. So we’ve got a couple of questions for you. Followed by a book you recommend to the listeners. You ready?

Alan Pitt:
You betcha.

Saul Marquez:
All right. What’s the best way to improve health care outcomes?

Saul Marquez:
Data transparency. Basically pointing out to people where they sit relative to their peers in terms of how they’re performing.

Saul Marquez:
What’s the biggest mistake or pitfall to avoid? Well, I’m not sure how we’re going to tell you whether it’s really two outcomes or starting a business, but a pitfall in terms of starting a business. I would recommend that you find a partner in it. I don’t think you can build a business without a peer, without somebody to help you when times get tough. I think you need to find that other person who you know, it’s the Jerry Maguire line who completes you. I would definitely find someone else to go through that rough road.

Saul Marquez:
Love that. How do you stay relevant despite constant change?

Alan Pitt:
I don’t know. That’s that’s a tough one. I think from an organizational point of view, from a large health care point of view, we’re really struggling to figure out how to to not so much stay relevant, but stay afloat. But I think that for me personally, you know, I tell people, you reach midlife and you start drinking. You have an affair or you start a new job. I think if you’re always curious and always looking for solutions, there are problems waiting to be solved all around you. All you have to do is look and try to think about that problem a little bit harder.

Saul Marquez:
Right. a great, great insight there. And what does one area of focus that drives everything in your work?

Alan Pitt:
I know it’s funny. I think from a personal perspective, I’m looking to make a difference. You know, I want to get to the end of the road and feel like I mattered somehow. I think sometimes that’s an empty you know, it’s an endless cup that needs to be filled. But I’d like to look back. And by the way, it’s never I think what other people think about your work and what you’re doing, it’s what you think about that work and is it adding value? Unfortunately, for many of us, we often become our harshest critic.

Saul Marquez:
And I think that’s a great, great insight there. And so these next two are more on a personal note for less years to get to know you. What is your number one health habit?

Alan Pitt:
So my number one health habit is that I have an extra reclining exercise bike, not a sitting one reclining exercise bike, because for the guys out there, some of them may struggle, as I did with when you sit on those bikes for too long. In areas of numbness that are not appreciate it. So I have a reclining bike that I read or do some work or watch TV, but I pretty much get 30 minutes of exercise, get it, you know, get into sweat almost every day.

Saul Marquez:
That’s great.

Alan Pitt:
Yeah. So it’s have to go anywhere. It’s sitting in my bedroom. I can do that.

Saul Marquez:
That’s awesome. And how about your number one success, haven’t you?

Alan Pitt:
My kids will hate this, but my probably my number one success at it is that I talk to strangers.

Saul Marquez:
I love it.

Alan Pitt:
You never know if you turn to the person that you’re waiting to get on the airplane with or you’re out to dinner, if you just turn it them and go, you know, what do you do? What are you up to? Yeah. And I think it drives my my kids kind of nuts. We went to Australia once as a family on a trip. And I did a… I started talking all these young women about. Have you ever thought about living in America? We’re looking for an au pair. And I drove my children nuts, but we ended up having a great au pair on a great friend on a trip. Yeah. She finally said, yeah, I’ll do that.

Saul Marquez:
That is awesome. Yeah. That’s great. That’s a good habit. Alan, what book would you recommend to the listeners?

Alan Pitt:
You know, I would strongly recommend Blue Ocean Strategy. They have a new book called Blue Ocean Shift that just came out.

Saul Marquez:
How do you like that one?

Alan Pitt:
I you know, on the new one is it sounds like you’ve read it. It’s a little dense. But I think if you can get through shift, blue ocean shift, there’s a lot there. Oh, help you really rethink how you want to build that business. I think we need a lot more entrepreneurs who are looking for a blue ocean strategy. For those who don’t know what blue ocean is. Blue ocean, there’s two oceans. There’s the Red Ocean, there’s the commodities where we are, ocean of defined customers, zero sum game, zero sum game, Right. businesses all competing for the same customer. And then there’s a blue ocean strategy which is really coming up with novel mashups to create additional value, not necessarily margins for the business, but value for the customer, which ultimately results in higher margins. And it looks to enlist people who are not using the solution, the product today in that new world. And I think there’s a lot to be gained about, Lou, ocean strategies as we think about it from a health care perspective, from, you know, across the spectrum for startups.

Saul Marquez:
Great recommendation again, folks. You could find all of our show notes at outcomesrocket.health in the search bar type in Alan Pitt, that’s PITT and you’ll find the show notes, full transcript as well as links to all of the resources we’ve discussed. Before I conclude, Alan and Love, if you could just share a closing thought and then the best place for the listeners could connect with you or follow your work.

Alan Pitt:
Sure. Yeah. Yeah. Well, I’ll be you know, I’m trying to make a difference. And to do that, I really need to bring along a community. I do share my own blog podcast on both LinkedIn as well as my own blog site, Healthcare Pittstop. And, you know, I recommend. You know, I would certainly be happy if anyone would not only listen in, but critique it. If you have thoughts around what I’m missing, I would be very appreciative of that. And for, frankly, you know, health care is one of those spaces, very hard space to work in. But it’s one of those few spaces where you can do well by doing good. You can really make a difference. As my Jewish grandmother used to say, may you be healthy, wealthy and wise. Well, without your health, you don’t have anything. And so it’s really incumbent on all of us to try to stand that up.

Saul Marquez:
Love it, Alan. It’s a great closing thought and a great invitation to everybody listening. Check out Alan’s work. It’s worthwhile. I respect what you do, Alan. I admire the things that you’ve been up to. And really thank you for for spending time with us.

Alan Pitt:
It’s been a pleasure. Thanks for having me.

Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration and so much more.

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