103 – The Future of Smart Hospitals, AI, Innovation, and the Path to Smarter Care

Marcus: 0:00

If you enjoy this content, please take a moment to rate and review it. Your feedback will greatly impact our ability to reach more people. Thank you. All right. Uh, welcome back to help further. This is our guest series and, uh, we've got a returning guest and a new guest, but the new guest is a good friend of the pod. So, uh, returning, we have Steve Lieber and, uh, our friend Bruce Brandes. And, uh, we've been talking to Bruce. Pretty much since the inception of the show around artificial intelligence and how it will play out, uh, I think maybe, maybe most specifically in hospitals, um, and behind the scenes, Bruce and Steve have been working on, uh, some, some really cool things and, and we were able to get them in to talk about it sort of on the, uh, not the Eve, but the dawn of a new press release that they just put out, right.

Vic: 0:55

Yeah, excited to hear what you guys have got going on. So, um, there's been a lot of changes with the acquisition and with, of course, new roles. Maybe, um, can y'all sort of tell us where you're sitting now, what your roles are, and then we'll dive into it.

Bruce Brandes: 1:11

Sure. First of all, Marcus, Vic, thank you so much for having us. Um, this is Bruce. I am a long time healthcare guy in technology. Most recently, I've served as president at Care AI. As you mentioned, we are now part of Striker. I am part of the organization going forward. Uh, and as part of, um, what I will be spending my time on going forward, uh, I am also a board member of the newly found, uh, Alliance for Healthcare, uh, Smart Healthcare Excellence, uh, which Steve, uh, will introduce.

Steve Lieber: 1:48

Great. Thanks, guys. Appreciate being back on with you and, and catching up from our conversation back at the beginning of the, the summer. Uh, I am Steve Lieber, uh, and I've got a new role. Uh, so I'll introduce that first and then, uh, step back to, to the past a little bit. Uh, along with Bruce, he and I have founded, uh, the Alliance for Smart Healthcare Excellence and I will be serving as Chief Executive Officer. Of that new not for profit, uh, previously I served for a very long time as the CEO of HEMS, uh, retired from there at the end of 17, and over the past seven years been working at a variety of consulting roles, um, in both Industry as well as the association world spent a little time as the chief analytics officer at chime, uh, and, and it was really about, oh, Bruce, what a year plus ago, year and a half ago, you and I started talking again, Bruce and I, our paths have crossed off and on over the past. 15 years or so, uh, or longer. And, and, uh, he said, you know, here at CARE AI, we're really focused on, uh, the, the advancement of technologies that leverage, uh, smart concepts and smart technology. And so it was working with CARE AI over the last year and a half, One in terms of doing a podcast, bringing on people to talk about, uh, ambient technology and smart care technologies, virtual nursing, those types of things. And it led to a conversation with the Care AI's founder, Chakri Taleti, uh, who said, Steve, you know, think about what you and, and hims did, uh, now 20 years ago, uh, in the creation of the EMR adoption model. And how that set the standard for electronic medical records, and in fact, was, uh, sort of the foundation of meaningful use and how the monies from meaningful use were going to be doled out to, uh, healthcare organizations. And so, um, along with Bruce and, and about 65 other executives from, uh, From around the country, from, uh, the executive suite from finance, from materials, management, security, nursing, medicine, you know, across the board. We had a lot of people who were advising us on this concept of. Okay, let's figure out if we can measure, uh, the journey hospitals are on in moving towards, uh, a smart care concept. And, and we really started this out as, say, a year ago. And there wasn't and maybe still isn't a great definition of what is smart care. Uh, and so we're sort of doing that as well as we go down this path. And so we have completed and announced, uh, the model. And, and we're out there starting to, uh, initiate, uh, some, some inquiries and some surveys to, to see what we can find out, out in the industry.

Bruce Brandes: 5:06

If I could just add a little background in color as to what was going on behind the scenes that kind of inspired The ask of Steve to think about this. There's so much noise in the industry right now around AI in particular, but around Whatever the buzzwords are about smart hospitals, you know smart technologies ambient monitoring, you know, there there's no lack of vendors that are now jumping onto those buzzwords, uh, and, and incorporating into whatever legacy product that they had. They're now, you know, a smart technology company. And what, what I found and what we found was the market was really confused. Um, and so working closely with health system executives, they were basically scratching their head saying, how do we make sense of all this? And at the same time, Several of the health system executives that we were working with actually were in the process, are in the process of opening what they call their smart hospital, um, Hospital of the Future. And they've been building it, they announced it, it was getting a lot of attention in their markets, and they would have board members or community members come up to them and say, Hey, what does that actually mean? And it was funny, our whole leadership team, Really couldn't answer that question in a consistent way and there and that led us to realizing there is no definition or there was no definition or clarity on what is that destination that we're all aspiring to much less how do we figure out based on these point solutions that we've invested in so far for this and that does that mean we're smart or and how are we doing compared to others and how do we get from where we are to where we want to go. And so that was really the market asking us for, can you help with this? And being on the leading edge of defining smart hospitals, we thought the best way of doing it would be to aggregate the voices of some of the smartest people across the industry that we knew.

Vic: 6:54

Yeah. So I want to spend a minute just defining what the smart hospital maturity model is. And then, uh, maybe Bruce, it's good for you to touch on, um, kind of the origin of how, why it made sense to spin it out post the, post the acquisition of care. ai. Um, but the way I think about the smart hospital maturity model is that it's maybe a measuring stick or, or, uh, a set of activities and outcomes and states of delivering care. Uh, that would indicate that you are along the path towards a smart hospital, uh, and then there, there are gradations, you, you call them leaps where you are, you have successfully completed leap one, leap two, leap three, but maybe, uh, correct me where that's wrong or, or define for the audience what this is, what this framework is. And then Bruce, maybe talk about why it made sense to spin it out into a nonprofit.

Steve Lieber: 7:49

Sure. And you're right on target. There's nothing to correct. I can only elaborate. So let's, let's go with that. So the model itself is built around three fundamental domains, people, Places and processes. We talked about this last summer when we talked about the model and I introduced the general concepts back then. And since then, obviously, we filled it out. And so what we're recognizing here is three major drivers in health care. First, we start with people. So you got patients and you got staff. So obviously we know health care has a people component. Uh, the second places so places really is, uh, representation of several concept. One is location. So obviously care is people. provided in a variety of places ranging from common and entry areas into the facility, all the way through and out to ambulatory care. Uh, places also can be interpreted or defined as environments. And so infrastructure, security, quality, all of those things that are not people and not necessarily processes. come under this domain of places or environments. And then the final domain area, the final big driver in healthcare, of course, is processes. And so you've got strategy and culture, you've got governance, uh, innovation, financial processes, clinical processes, material processes, all of those are ways in which we do things. And, and so, All of these aspects, people, places, and processes have components that can be driven by smart technology or smart practices. And so underneath those three major domains, we've got a bunch of topics and subheadings and areas that are covered by the underlying survey. That drives the results of the model. So the survey is an 89 question survey, which you know, on the surface, that doesn't sound bad. Well, actually there's some 560 data points or places where you would enter information. And so it's a very extensive survey that asks a lot about all of these areas. And then based upon the scoring algorithm, it then translates, as you described, into the gradation. or what we call leaps. And we got six of those, um, starting out at leap zero, which, you know, quite honestly, I'm going to be surprised if we find anybody at that level. Because we designed these from where the world really was maybe five years ago to where the world might be 10 years from now. So we're not expecting to find anybody at level five. And I'm really not expecting to find anybody at level zero because the level of technology adoption would have to be so low. One, nobody would want me to tell anybody else that they were level zero. And two, in reality, I don't think so. You know, we're going to find most of the world at level five. Leap one and and leap two and and what that translates into what's that mean? A leap one is an institution that's largely defined by point solutions. Now there are a whole lot of other aspects the way you answer questions that'll bring you to that level versus another, but sort of the shorthand is, you know, a lot of one offs. When you get to level, uh, to leap two, you're starting to work with functional platforms. In other words, things are starting to be pulled together. And what really moves you up the scale here is not whether you have it or not, But how much you use it. So this is a very much a model that is about both adoption and use. And from that, yes, you will get, um, a, a, a snapshot in terms of where you are and how you fit on the leap schedule. It'll identify where your gaps are. What are you not doing in terms of adoption of technologies? Or where are you not doing it? You might have a lot of back office, like financial insurance, those sorts of places where you're doing real time eligibility checking, things like that, that will score you some, but you don't have much going on in clinical processes, for example, whatever. So there are a variety of ways that you move up on the scale. And so it is not, intended to produce the way to reach level five. There are multiple ways to get there based upon the strategic imperatives of an individual hospital or system, but it, the, the design is such where it will show you where you are and where your opportunities or challenges

Bruce Brandes: 13:08

might be. And if I could add a little color to that, um, if you think about what MRAM was for the, for EMR adoption, it was pretty well a straight line of these are the checkboxes you have to go through. And it was a direct roadmap. I think of this really more as how you would use Google Maps, uh, where there are multiple ways to get to the destination. And I may want to say. I want to avoid toll roads, or, um, I want to go on the highway, or I want to take the scenic route, or I want to get there by this date. And, and, you know, it'll, it'll give you different guidance. So I think that that's kind of how this works. And I think another important note that was baked into the design here that's different than MRAM. MRAM was really an IT project, right? It was driven by by the CIO and and their teams to define a smart hospital and the way in which we approach this was to define a smart hospital. Yes, it needs to be involved, but it really should be defined by all the other key stakeholders. So as we approach this, not only do we have chime involved, we have representatives from HFMA to make sure that it's Marcus, as we've talked about somebody with a financial hat that this is how do you cost justify these kinds of investments that we were thinking about that, um, that A. O. N. L. From a nursing leadership standpoint that the voice of nursing was very much at the table, um, the head of leapfrog to make sure quality and safety was incorporated. We had somebody from the Joint Commission thinking about regulatory compliance. Uh, and so when you start defining it more broadly, um, it also helps that the survey Really becomes a collaboration tool to provoke thinking across the entire leadership team of a health system because it's not just a matter of completing the survey. Um, it, it really kind of requires some discussion and some strategy. Um, and so it really becomes a framework to help people think about where do we want to go and who needs to be involved in this, who should be answering these questions. And more often than not, it may be, you know, facilitating the completion of the survey. But it's really bringing all of the other stakeholders to the table and the points of view that they may have on, uh, what that destination and what the journey to that destination should look like.

Vic: 15:19

Yeah, I mean, that's one of the big areas that I love about the models. It's really a holistic view to how you should. Kind of orient your people, environments, places, and processes to deliver the best care and, um, with technology, with AI, with tools. One of the things I want y'all to talk to just explicitly is, people is one of the three main, um, categories. And one of the things that I found really, um, helpful is the goal of getting to leap five, getting to the finish line 10 years from now, we will still have a lot of people delivering care because that is part and parcel of treating patients, both actually interfacing with the human body and also the empathetic care and, and helping them understand what's going on. And that, so talk about that aspect of the model. This is not getting rid of all the people and automating, although certainly repetitive things that humans don't need to do can be automated. But talk about that balance.

Bruce Brandes: 16:19

I'd say a big part of the inspiration of this was recognizing that a lot of what our caregivers are spending their time doing today are not things that were what inspired them to go to nursing school or medical school in the first place. And so we've layered in, you know, regulatory and administrative, um, burdens, uh, on top of them, which is atypical of how any other People with their educational background, you know, would be asked to do, you know, clerical types of things. And so this technology and a smart hospital, you know, one of the definitions that I think will come out of being a smart hospital is empowering human beings to do the things that only human beings can do. And that to me is to hold someone's hand and to listen and, and, you know, show compassion. And so, um, you know, how do we focus on You know, the technologies that can take the things that clearly should be off their plates, as well as how do you empower those caregivers at that moment of caring to have the information that they need to know what they need to know to be, you know, at the top of their game. And so what we're finding is, you know, When you talk about AI and healthcare in particular, you know, you have on one extreme, this irrational exuberance on how it's going to create this utopia. And on the other end, you have this, you know, paralyzing fear. Uh, and, and the truth is this is somewhere in between. And, and I think this model, what, what, what it will flesh out is the practical path to applying this technology in ways that just make common sense.

Steve Lieber: 17:50

Yeah, and just to elaborate on on that point, you know, the future of health care is not an environment where there are no caregivers and it's all done by machine. That's that's not the environment. It's when is it. The right time for artificial intelligence or human intelligence or combination to, to plug in at what point and basic and act upon what information. And so when we look at leap 5, I mean, sort of the sub heading of it is called supervised autonomy. So that clearly indicates that people are definitely engaged and they are making those critical decisions, but utilizing to a great extent technology and machine and machine learning in order to achieve certain things. And so it very much is about how people will be used versus will they be used or not.

Vic: 18:53

As you proceed through 1, 2, The care should get better and cost to deliver should come down, but more importantly on this point is the people in will get to practice more at the top of their calling or the top where they really got into medicine, whether they're a nurse or a doctor or a specialist or they get to do what they love to do more often than not as you proceed through the steps. Right. Yeah.

Steve Lieber: 19:18

And not only that, we're also. Seeing in the survey as also and also through anecdotal conversations, satisfaction has a very positive correlation as you move up in the adoption of smart technologies, both satisfaction by patients as well as by the clinical and support teams. Because as Bruce talked earlier, you're removing some of that drudgery of Administrative tasks or tasks that are better performed, um, automatically or ambiently. Uh, and, and so what we're seeing is that there is a very positive impact on satisfaction scores as we see people at higher levels of, of adoption of this technology. And that kind of highlights one of the things that we're going to be looking for. You alluded to, to another one as well. So one, we're going to be looking for correlations. Are there correlations and what are they between things like ambient technology and staff satisfaction? Are there correlations between cost savings and, and financial efficiencies and levels or leaps within, in the models? Those are all things that come out of this process over time as we collect more data. As we start to get multiple data points for the same institution and then start running cross tabulations against other data,

Marcus: 20:49

Steve, it strikes me and I want to kind of continue on on this point, Steve, it strikes me that you are certainly one of the best people to lead this kind of initiative because of not just your, uh, your time at him's, but maybe the overlap of your time at him's with the high tech act and you know how that would have been the dawn of a new world and having to sort of look to the future and and to some degree. Be the convener that is helping people to, to consistently figure out what that new world might look like. I think a lot of people are now looking at the, the, the Post High Tech Act world and saying, you know, a lot of this tech ha has burdened us more, uh, than, than necessarily helped us more. At least that's, that's a lot of the narrative that comes from the, the pH, the physicians groups. I am, I, I'm wondering, you know, leap one and LEAP two. Seem fairly straightforward and leap five to me seems like the best we can do is have a theory, but really what we have to be effective at doing is convening to consistently track closely and be willing to consistently modify. What leap five looks like. And I think we can say things and look, I think there's probably 99%. Uh, today, you know, market confidence that, uh, supervised, uh, I'm not sure that the term you came up with there, but autonomy, autonomy, a supervised autonomy, okay, is, is what it looks like. And, uh, You know, this morning I was looking on perplexity and Sam Waltman's talking about AGI next year, right? So I, I only just say that to say that we are in this new world and not just a new world of technology, but we're in a, you know, a new political regime. We're in a new sort of, you know, multipolar world regime. There's, there's all sorts of stuff that's, that's sort of on the landscape. And I guess I'm circling back to why you're You're a great person to be at the helm of this, because this is not just about to me. It's about more than the model. Like the model is good, but there's the convening of people around this specific topic to map and chart the future, uh, that I think to me feels more practical. That actually feels more practical, uh, than, than saying today, here's where it's all going to go. And this is how we're all going to do it. Cause nobody knows right now. Right.

Steve Lieber: 23:07

Yeah, yeah, let's let's be careful on that point. Exactly. I am not sitting here saying, okay, in 10 years, leap five is what health care is going to look like. It's an idea or theory, as you said, as to what we think today. It ought to elements concepts that ought to be. Is it going to change? Absolutely. Because one technology may move faster or slower, in which case there's got to be adjustments. We will be looking at the model at the leaps and at the survey questions every year. So based upon what people are responding. It tells us, is this commonplace? And so, therefore, it's of lesser value getting you to a higher level because it's table stakes now, or, you know, things like that. You know, I, I, I, I, I, I, I call myself this although I have not had hands on at this level for a long time, but I'm a data guy from way back. That's actually where I started out my career in an era when it was a whole lot harder to get data and such, a lot less computerized. And so working with numbers and, and looking for trends and working and, and trying to figure out correlations and that sort of stuff, that's in my DNA. And, and so having had the experience at HEMS where we did a lot of that across multiple models and such, it gives me a background and, uh, you know, quite honestly, I'm, I'm not that arrogant where I believe I've got the answer and that's why we brought 65 other experts in here and really pummeled them with questions about. What are you doing? What do you think should be doing? What's important? What's not important? You know, that sort of thing. And that's how we'll continue to operate in the new alliance. And just to kind of, you may have more questions about the model, but just to throw in a comment about the new alliance for smart healthcare excellence. We really wanted to create an environment where everybody felt. Like they were on an even plane. There is no one company, no one set of products that's driving the agenda. It wasn't before. Care. AI provided the funding and then stayed out of the way and said, Steve, use your experts and build the right model. And when you look at the survey, you'll see we don't ask a single question of what technology, what company do you use? It's more about how you are doing things, where you are applying concepts like AI, or looking at analytics from descriptive to generative, and where are you using which one of those, uh, five different levels of analytics and that sort of thing. Not. Who's your vendor? And so in the alliance, it's a safe place for everybody to engage. Very much, we'll be pulling people together for these conversations. And we do envision that we will be doing various, uh, forums like this at conferences, like at Vive. We just wrapped up a session at Chimes Fall Forum. Where we are engaging the audience and having this conversation, sharing what we know, and then listening to them to find out what else do we need to know?

Vic: 26:33

Yeah, excellent. So maybe let's dive into that a little bit more. So if I'm managing and my team is managing, say, a small to medium sized health system, maybe like eight to ten, A 10 locations in a midsize metro area that they come in and fill out this this survey 89 questions, but 400 plus data points that takes some time group of other leadership has to contribute to it and they get a score. Uh, placed on the maturity model, is there a road map or, I mean, Bruce, back to your, like, Google maps thing, we want to head towards the next. Maybe I'm, I'm a leap one system or two. Do you have advice or guidance on how you might then move forward? Make progress in getting towards the next leap.

Steve Lieber: 27:22

Sure. So advice on how to get there. No, it's going to take a little bit of analysis on your part, because I don't know what your strategic, uh, plans are in terms of what's important and what's next. So the adoption of, um, Analytics, uh, a higher level predictive or prescriptive analytics in the operating room may not be on your. roadmap in the next 12 months, but something else is what you'll be able to do is look at each of the question and each of the 560 data points and see where you are versus your peer group. So what it will tell you is I'm in the same place as everybody else. I'm behind others. I'm ahead of, um, and, and even if you're in the same place as everybody else, but it's very low level of use. It'll clearly illustrate what your opportunity is as to where you can add on new technologies or technologies. You may be piloting on General Medical Ward, but you want to expand that system wide or across surgical suite or whatever, because it's divided up into those various locations. So again, it will show you where your gaps and opportunities are, but it's not going to tell you where to go next, because that's a that is a system by system decision based upon the resources you have. What the strategic imperatives are that, that you have, and, and, you know, what, uh, what sort of problems are really the most critical that you're having to solve for? You know, is it the bottom line? You know, is that really the thing you're trying to solve for first? Okay, there are certain technologies that'll drive you that way. Is it staff satisfaction, staff turnover, all of the headaches that we're hearing from so many people regarding workforce? Okay, different sets of technologies that you might pursue. So in your situation, you might head down this path, but it'll show you what those opportunities are and, and really it, it, it does take a level of analysis on your part as the recipient of our peer comparison reports to sort of figure out what does this tell us about our organization?

Vic: 29:52

Yeah, it seems like it really becomes a. Incredibly valuable component. into the three, five year strategic plan, which has, of course, other inputs as well as what our financial position, what our leadership team is already good at, what our culture is like. Maybe what our expansion plans are. And then you put all that into a plan to make improvements and hopefully move up the, the leap structure as part and parcel with building your entire strategy. Right? Yeah.

Bruce Brandes: 30:23

And, and, you know, the other, uh, point that you've made earlier around. The collaboration of the people taking the survey. That's one of the reasons why it's important for us under this new not for profit to really lean in in a meaningful way with a number of the industry associations because we expect that we can partner in a line with them at their convenings to facilitate these types of conversations and sharing. Of best practices and lessons learned and you know, hey, we made this mistake and hey, we went on this path and this was why and this is what we learned from that. And so I think the more that we can combine the data and the insights and the reports that come from it with helping connect. People who really want to learn from it. Uh, I think that's real where this really starts to amplify its impact on the industry.

Marcus: 31:11

Yeah, I think that's really smart to kind of be, uh, uh, like a, like a meta org. Uh, Steve, you talked about, you know, having convenings at Vive. I mean, you know, you talked about including HFMA. I mean, I think that is very smart strategy. Um, I want to ask you more sort of around, around strategy and tactics here. I'm, I'm sort of thinking through, okay. Um, this is an emerging topic and certainly, you know, not all health systems, uh, are created equal in terms of their bandwidth and or resources to staff, um, this overall initiative, right? Like maybe they, they can muster up the effort to get the survey done, uh, and they can sort of have a meeting internally to review that. But I'm wondering, what is your view on how this, this, um, this gets activated? Are you anticipating, because you've been able to successfully aggregate, uh, the industry around this idea that the industry says it wants an independent standard for this road map through, uh, through, through the pathways to become a smart hospital. Are you anticipating that, um, Consulting firms will maybe come to get certified by this, this new nonprofit. And that way they can then partner with health systems on, on the prioritization and the execution of different initiatives that will. Move them, you know, through the through the different, um, stages or like, how are you seeing? Because I, I just wonder about some hospitals will have the ability to say, okay, I'm gonna put, I'm gonna stick this with so and so, and they can sort of run with it. Maybe it's their head of innovation or something like that. But not all hospitals and health systems sort of have that have that set up. So I'm just thinking more about how this gets actualized and where the consultants fit where the vendors fit. You know, just practically, if I'm looking three years down the road, how do you envision this playing out?

Bruce Brandes: 33:09

If I could make a quick observation, Steve, I'll have you elaborate. If you think about what happened with MRAM, uh, around Meaningful Use, you know, there were a lot of, once the survey was created, there then became an ecosystem of leading in with our vendor partners to help us to understand their roadmaps and how they can help us with it. And they became a resource as well as consulting organizations saw an opportunity to build a practice around it. We're still very early in this. You know, we just, we just formally announced it last week. That said, I, I would hope that this becomes a movement across the industry that others and, and this is intended that this goes back to Vic, your question early on, you know, why spin it out as a not for profit? First of all, when we started at Cary I, this was always our intention, and we were just then fortunate that in partnering with Stryker, uh, they were aligned with that, and they were willing to provide grant funding to help stand this up, uh, for, for the next, uh, few years, and, and so we know, we now know that we can you. Endure, we can, we can have this model evolve over time. We can invest the resources that it's going to take, um, to hopefully fuel that movement because it really needs to be something. It's not going to be Steve and Bruce, uh, you know, putting out a survey and now all of a sudden everybody's a smart hospital. It's going to be giving them information and helping them to, to, you know, Think a little bit differently about where they are, where they may want to go and then bring in all the other stakeholders. You know, we mentioned associations the other the rest of the vendor community to have peers from other health systems collaborate. There's there's a lot if we do this right that this becomes a resource for everyone. And that's really the goal.

Steve Lieber: 34:50

So, you know, basically the question you're, you're asking, uh, is what's the business model? And, and so if we sort of, um, contrast this with the business model that I had at HEMS analytics, we're not selling this data. So let's start there that this is something that's not going to be built upon a market research model and here's data to help vendors better understand the marketplace and hone their focus in terms of sales. Will it be a resource to companies? Absolutely. And so what we will do, as well as other consultants will do, is we'd be happy to sit down with an executive team at a striker or whatever and talk through our findings and what the trends are showing us for them to then take into their organization and figure out what they're going to do. Same with provider organizations. I fully envision us doing, um, teleconferences and, and webinars and such with, uh, executive teams at a system. Again, uh, elaborating on the findings from their survey and drawing some comparisons and some contrasts with the data that we're also collecting. Acting on it though will entail the consulting crowd. And as Bruce said, there certainly was a, even more than a cottage industry that grew up around MRAM in the consulting world. And there will be here as, as well, just because of the kind of, the breadth of technology that we're talking about and how it impacts so much of, of healthcare delivery. There will be consulting organizations who specialize in helping people move down the path of smart, uh, care adoption and use. I don't envision us going in. And teaching systems about what and how they ought to do it. Ours is, I view our role as an informational resource for them to take and act upon themselves or bring in someone who has boots on the ground that can actually work with them in building their enterprise strategic plan and and and such. So, you know, there are ways in which we're going to be an informational resource both to industry as well as the provider

Bruce Brandes: 37:24

or to use that as a way to lean in with your vendor partners to align on what the expectations could or should be with the customer. The roadmap and how do we leverage what we've already invested in to do more?

Vic: 37:36

Yeah, I think Steve, one of the real advantages of the business model you laid out is you're providing the information, um, not selling it, but giving people updates on, on how they're performing compared to their peers and also how vendors perform or don't perform compared to their peers. And what I think could be really interesting is you talked about it a few minutes ago, as you start seeing. correlations with other key data points that health systems really care about, whether that's outcomes or costs or satisfaction or others. And you can then start thinking about, well, maybe there's some causation there, or maybe it's an order of operations. If you do a, then that opens up B, C and D. It could be really valuable to have this third party who is not doing a lot of the consulting, not doing the work, keeping score for lack of a better word. Here, here's what we're seeing out here. We're You're having an impact on these metrics in this way and the range of outcomes. I mean, some people might do very well. Others might implement slightly differently and do less well. Do you see, is that part of the role going forward?

Steve Lieber: 38:44

Yeah, yeah, you're nailing it because again, going in and working with the system to actually Develop and execute on a plan requires a deep dive into that system, not only the model and where you stand in the model, but what's going on in the rest of the organization and that sort of thing. And that requires the resources of a consult and the expertise of a consulting firm. What we can do is provide the information upon which those actors can act.

Marcus: 39:14

Well, first of all, thank you so much for being willing to talk through things like the business model. Uh, you know, I'm, I'm, I don't know, I'm an amateur association nerd. I, I, I spent a lot of my time with, with associations, but, but I, I think they're really valuable and really important. And there's a reason why, um, they aggregate so much mindshare in, in the, in, in any industry when they're done correctly. Right. So that, that's why I'm kind of curious about these things. Um, I, I think I'm pretty clear on the. On the business model, I think we'd be remiss if we didn't ask for our own benefit, but also for the benefit of our listeners. You know, on our weekly roll ups, we track AI and I realized that not everything you're doing here in the smart hospital paradigm is AI, but certainly AI is a major fulcrum of smart hospitals. Right? Um, And, you know, there is another organization, at least one other organization, but chai is one of the organizations that has shown up on our weekly roll up a couple of times. Can you just, uh, help us a little bit to talk about the ecosystem that's developing, AI is developing the ecosystem that's developing around the AI. A. I. adjacent or A. I. centered associations in health care and how your organization fits relative to a chi. Obviously, you, you know, you've been able to aggregate significant, um, you know, thought leaders from well respected organizations. So you've got your own differentiated position, but I'm just wondering, can you help help us understand it a little bit?

Steve Lieber: 40:39

Sure. There's both a look back on this question as well as a look forward. So the look back is I spent a lot of hours delving into anything that these organizations have published, uh, in understanding and educating myself about, um, the technologies, uh, their, their evolution, their adoption and this sort of thing. So these associations have been a Unknowing to many of them, a great resource to meet. Uh, and that's the nature of the not for profit world, and, and I've spent my entire career there. Um, we're all really happy to share with each other our insights and our learnings. And, and it's like, if you can build off of what I've done, and, and bring more value to the audience you're serving as a result of that, go for it. And, and that's the way I, I treated the, the publicly available information from these organizations in, in. informing our group on what this ought to look like. The look forward to your question is, we're going to be reaching out to those organizations and looking for ways in which we can collaborate because we think there are things that they're working on that we're not, and we're working on things that they're not. And so again, thinking about Just sort of the, the fundamental premise of an association, which is bringing multiple stakeholders together to discuss common problems or issues. That's, that's where we are here. And so we will be reaching out to those organizations and looking for those opportunities for us to come into their events and share what we are doing. The findings that are coming out of our surveys and that sort of thing, uh, as well as looking for them to engage with us and add value to the pieces we're doing. Because again, all of these organizations have pieces. Nobody's got the absolute full picture and a lock on the intel around these subjects.

Bruce Brandes: 42:39

You know, we're, we're all in a really early innings as it relates to this. So I think the most important thing we can do is be open and honest and collaborate, which again goes back to why it was important to us when we started this within care AI to make sure that it became an independent, not for profit, because that's, that's the best way for it to, to be non threatening to everyone.

Vic: 43:02

Yeah. Well, we will certainly give a link to folks to be able to hit the website and, and, uh, Take the survey and and sign up and begin, but Steve and Bruce get give people a sense of what they should expect, like when they when they begin this, is it a one day project? Is it a month project? What? What does it involve to really get all the information put in? What's realistic? And what should people be expecting? It sounds, it's really valuable. I think a lot of people listening will want to do it. What do they need to aggregate ahead of time, if anything, to be successful at

Bruce Brandes: 43:36

it? And Steve, let me just give a quick cover to you diving into that. First of all, you can go to smarthospital. ai As the website where you can request a survey, and we partnered with chime to be able to deliver the survey and you're probably your audience is probably familiar with chime and their most wired survey so that a lot of the approach and questions will feel very familiar to them. We're using, you know, the system that they use. Uh, and over time you'll start to see us be able to, um, you know, while the purpose of most wired and the purpose of this are different, you know, we, we want to be able to make sure that the people completing the survey don't have to answer the same question twice. Uh, yeah, some of the inputs can be certainly lots of surveys out there. So, you know, the goal of this is not to be another survey that everybody has to take. Uh, it's really designed to be an asset. To help collaboration across the organization again beyond it to all the other clinical and operational and financial stakeholders that need to be involved to have this important conversation about what is the future of how we're going to operate as a hospital.

Steve Lieber: 44:45

So in in terms of process, there is. I'm pausing for a moment thinking, just make sure I don't speak out of turn here, but I don't think it's possible for any one person to have all of the knowledge to be able to sit down with this survey and answer all the questions you're going to have to engage, uh, other, other folks, because as I say, the CIO might be the initial point of contact, just because, you know, Technology and technological processes generally flow through IT. If not starting there, it certainly has to connect there and that sort of thing. Um, and, and so, you know, it is something that, that you're going to have to engage nursing leadership in, um, medicine, executive office, uh, finance, and IT. The survey is designed where you have an, uh, an online portal. and you have a unique identity, uh, access to it, but you can share that within your institution. And so it, you know, someone from, um, finance department can go in and answer those questions around how we're doing, um, insurance reviews and eligibility and that sort of thing. Somebody else can come in and look at it in terms of, of how we're using, uh, data analytics. Another person can come in and answer different questions about. Uh, other processes or what? And so it is possible for, uh, and in fact I would encourage it to be a a survey process that engages multiple people to answer it. Watching, uh, the first 175 that have completed it, uh, recognizing nobody sits down and says, okay, I'm going to spend the next eight hours doing the smart hospital maturity model. You do pieces and then something comes up. It's like, Oh, I got to close that screen and go do something else. I mean, it generally will take someone working, you know, here and there to three weeks for you to complete the whole survey. Um, not that it. Absolutely takes that long to compile all of it and then enter the responses and all, but just because there's so many things that crop up in a person's day, uh, as well as, uh, you know, there are some questions about, um, the emergency department, and then there are questions about the medical wards. And so, you know, There may be completely different people that you need to go to. It's like, okay, what are you doing down there? How are you using some of these? Because that may not be known by I. T. for example, um, and so, as I say, they're just a variety of things. And certainly you're going to be. pulling in the executive suite because there's certainly strategy, culture, and governance issues, uh, questions that are part of the survey. So I'd say a lot of, a lot of moving pieces to this, but you know, you, you got to plan on two, three weeks of part time to, to get this done.

Bruce Brandes: 47:53

I think that's a key piece of the value is not only the output that you'll get as a result, but actually going through the exercise. With your colleagues, I think is, uh, really the most initially illuminating part is so that you can start that conversation internally and get alignment around where you're going.

Vic: 48:10

Yeah, yeah, exactly. I agree. So just directionally, it's a couple weeks, 2, 3, 4 weeks, but I agree, Bruce. Exactly. The survey itself will help you begin to think about, Oh, I need to go down to the ED or I need to think of my medical wards in this light. And who should I go ask for that? You, you probably know these people, of course, you know, these people, but, but you may not have thought of them in this, uh, how do I make my hospital smart setting. And it sounds like the survey is going to direct the initial responder to go find these resources in the system and then almost creates like an ad hoc team around these initiatives. Is that fair?

Steve Lieber: 48:51

Yeah, absolutely. And you can, in fact, even divide the survey up into its segments and send those segments out. And so send, send the emergency department segment down to the ED manager. You know, send send the perioperative section over to to the OR manager, you know, that sort of thing. So it is easily divided up. And as Bruce highlighted, you know, it will be there, there will be a positive effect of just simply engaging your clinical and administrative colleagues in this conversation in pulling all this together. And more than likely, it's also going to trigger some, well, what about? Or why aren't we and things like that, which is exactly what you want to have happen with something like this. It's not just, oh, let's get a score and see what we see what it is. It's about what it means

Marcus: 49:47

guys. I just want to say, I'm perusing the website while we're talking right now. I think it's really impressive the way that you put this together. Um, I know you've been working on it for a while, but to. You know, launch a press release after you've got, you know, 40 episodes of the podcast already done 150 plus surveys already filled out, you know, a completely undeniable list of executives from top hospitals across the country. I don't think anyone's missing from that list that are already in your advisory group. It's, uh, it's a really strong first showing, um, and it gives me a lot of confidence that you all will, will be here to stay. And, uh, it, I think it's something Vic and I are going to have to study more and make sure that our companies that are targeting, uh, supporting health systems are up to speed on. Cause I think it's, it's, it's likely that this will be a, a pretty big player in the future of the way that hospitals look at developing, uh, how they, how they become more innovative and become more smart.

Vic: 50:47

Yeah, yeah, I think it's really smart to be able to kind of collect this disparate information and frame it for people so they can Get an understanding of, okay, what do we mean by the smart hospital maturity model? How do we tell our board? How do we tell our community stakeholders? How do we tell our employees? We're on this journey to where, you know, we want to be smart. Everyone wants to be smart. What does that mean? Right. And then the, the, the real power is sort of creating this index of peer institutions or similarly situated institutions. So you can have a frame of reference because, you know, knowing where I am on the journey is one thing, but knowing where everyone else is may make me go to my stakeholders and try to find some more money because we got to catch up or make me feel okay. Like we're, we're, we're alongside people. We need to make more improvements, but we're in, we're in good shape. Knowing that I think is. You know, a lot, a lot of the challenge

Marcus: 51:46

really valuable right now when there's so much, you know, headlines flying around and Hey, did you hear about this? Did you hear about that? You have something that grounds you in, in where you stand relative to the rest of the industry, um, with your own submitted data that, that informs it in a way that you sort of understand, you know, where we are across all these different areas and the focus on people and I just think it's, it's, uh, it's well done. It's thoughtful. So, so congratulations. And, uh, you know, hopefully we will be, uh, you know, one of your check in partners as you continue to advance this, we can reach out to you and see if there are any meaningful updates, but, you know, we, we always appreciate your willingness to come on health further and share the information with our audience and with Vic and myself.

Steve Lieber: 52:27

Absolutely. You know, this has been a great conversation and you're absolutely right there. There is value here, both for the companies as well as provider organizations, uh, and executives that are your listeners here. Uh, and you know, we're, we're trying to bring structure. Bruce said this early in the conversation, a lot of noise in this space, um, in, in terms of, of what is it, you know, and we're not even really there yet in terms of, of creating. perfect structure, but we're starting to bring some, uh, order to the marketplace around these

Bruce Brandes: 53:02

topics. And, and we're just getting started. I think what's, what's most exciting is we've got the conversation started, uh, and we're getting the right people in the boat together to figure this out. So I, I think this should be thought of as a journey ahead and we're really excited about what we've started with and where we are now, but we're really just getting started and we look forward to collaborating with you. Across the industry to make this a valuable resource for everyone. Awesome.

Marcus: 53:31

Excellent. Yeah, no better way to end it. So both Bruce and Steve, thank you so much. And we'll, we'll be keeping track of you guys. Thank you.

Steve Lieber: 53:37

Thank you so much.