63 – At the Intersection of Healthcare & Technology: A Conversation w/ Steve Lieber

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Marcus: All right, welcome back to our guest series here at Health Further. Vic and I, we’re very glad to introduce to our audience, Steve Lieber. Steve has a storied history. We’re going to get into it, but, um, he’s currently has a podcast called smart from the start that he does with a care. ai. So, um, definitely go check that out on a Apple podcast, Spotify podcast, wherever you get podcasts.

Marcus: Um, but Steve, thanks so much for joining the show.

Steve Lieber: I’m looking forward to the conversation guys. Thank you.

Vic: So Steve, I want to give you a chance to give, uh, your background. So the audience has some frame of reference, but, uh, just in summary, you, you spent a lot of years at hymns. Through that really [00:01:00] helped shape the.

Vic: The industry and the association, uh, segments of the industry, but, but talk about the back, like, how do you, uh, describe your career? Give it, give us like the quick bio for the listeners.

Steve Lieber: Sure. Uh, quite honestly, my entire career has been in healthcare. And almost exclusively from the association standpoint, I was the CEO of the Emergency Nurses Association.

Steve Lieber: I worked at the American Hospital Association. And then, as you mentioned, I was the CEO at HIMSS for nearly 18 years. So, you know, a lot of territory covered, a lot of different disciplines. Um, and, and quite honestly, over a time period where I have really enjoyed seeing what has occurred in healthcare, um, and particularly these last 20, 25 years as, as technology has really become, uh, a significant force in healthcare and [00:02:00] how it operates.

Steve Lieber: And, you know, hitting hymns in, in 2000, Um, I, I do, I kind of pinch myself even still of, of being so fortunate to be in the place I was at the time I was, because it was, and still is in my opinion, a golden age of technology and healthcare.

Vic: Yeah. I mean, the first, the place I wanted to start is HIMSS really, uh, under your leadership, I think, I’m sure there are lots of other people involved, but under your leadership grew from a membership organization to really a First of all, global organization and very influential in, um, thought leadership and direction of how the industry should Think about where technology and information systems fits into the delivery of care.

Vic: Maybe just reflect back on some of the strategic decisions you made and some of the things you’re most proud of during that time. Sure.

Steve Lieber: Um, I’ll go back to [00:03:00] late 1999 when I was interviewing for the position of CEO there. And that was a Only a few years after the, the major legislative activities, uh, around HIPAA, uh, moved through Congress.

Steve Lieber: And people today think of HIMSS as being big and influential. Well, in 1999, it wasn’t. It was a trade show. Uh, and, and I made the comment to the search committee as I had done my research on this. You weren’t at the table when HIPAA was put through Congress. HEMS really wasn’t there and wasn’t influential in helping to shape a very significant piece of, of legislation and regulation.

Steve Lieber: And I said, I don’t care who you hire, don’t let that happen again. And well, they hired me. And, and so as I followed up with the board on, on that line of thought, I said to him, I said, you got to grow at the time. Hims was, [00:04:00] uh, had an annual budget of about 10 million. It was mostly that trade show. And I said, you’ve got to be doing more things.

Steve Lieber: You’ve got to grow. If you’re going to truly. Um, drive health care in terms of its adoption and use of technology. And so we did. We embarked on a number of major initiatives in growing the organization. Uh, we started up HIMSS Media, which became, started out in the print world and evolved into a diversified digital media company.

Steve Lieber: We started HIMSS Analytics and the EMR adoption, uh, model, EMRAM. Uh, that, uh, became a, a significant standalone initiative of the organization, while at the same time growing membership, growing the conference, growing the trade show, uh, doing things. And as you mentioned, going overseas. Uh, we were operating in about 40, 45 countries when I, when I retired at the end of, of 17.

Steve Lieber: [00:05:00] All of that was really around the strategy of you’ve got to have size and scope to be influential. And that was the way that I did it. And we played it out in Washington all the time because we had the numbers behind us. We had the people behind us, we had the companies behind us. And as a result, uh, you know, kind of going back to 2005, 6, 7, with the launch of Meaningful Use, we were there.

Steve Lieber: We were at the table. Uh, a lot of other people besides myself were very instrumental in shaping the policies at that time, and it was because we had positioned ourselves to be in, in that kind of role. Um, Quite honestly, it was a lot of fun. Uh, we really and and as I have said many times, uh, even as recently as this week when I was talking with someone, I recognize the benefit I had of being in the right place [00:06:00] at the right time.

Steve Lieber: I could have embarked upon that same strategy in another period of time and not realize nearly the successes that we did. Um, and so, you know, by the time I retired, we had a annual budget of a hundred million dollars, I had 400 employees, we were all over the world. Uh, and, and really felt like we were being, uh, instrumental.

Steve Lieber: And in helping to shape the direction of not only technology adoption in the U. S. But worldwide,

Marcus: that that’s a great story, Steve. Um, so I have, I think, come to come to develop an appreciation for the power of associations over the course of the last Let’s call it three to four years really sort of coming out of the pandemic, uh, actually, um, and I’ll tell you why.

Marcus: And then, then I want to sort of ask your, your thoughts on, on the future of associations and, and particularly in the healthcare space. So, um, two real big things happened. One, uh, I, I became friends with a couple of, uh, folks in [00:07:00] leadership, uh, at HFMA, uh, specifically. Uh, Joe Pfeiffer and Mary, Mary, Mary, Mary’s a, you know, good friend of, of, of jumpstart.

Marcus: And, um, they invited me sort of in the middle of the pandemic to join the board, uh, the national board of HFMA. Um, and I was like, well, why do you want a VC sort of, you know, on the board? And obviously it was the pandemic and conferences and all this other kind of stuff. And they were like, listen, you know, we believe we’re going to have to totally reinvent and rethink.

Marcus: You know, the way that that that this organization, um, you know, lives inside of the world and inside of healthcare and, you know, we want other perspectives. So I joined the board. It’s been an incredible learning experience. Now it’s under the leadership of Van Jordan, who’s doing a great job. But obviously, just through the last sort of three years in that role, I’ve learned a lot.

Marcus: The other thing is, um, I picked up quite a bit of keynote speaking and have done quite quite a bit of keynote speaking across the association circuit. You know, [00:08:00] these would be state hospital associations. America’s essential hospitals, a Hema. So, you know, lots of different groups sort of even in the in the health care space.

Marcus: Um, the American Hospital Association is a limited partner in our fund. And so speaking at all these different conferences, sort of really understanding that an association is not an organization. Association. You know, it’s like some of them are totally focused on lobbying. Some of them are totally focused on, on, uh, you know, trade and economic development.

Marcus: Some of them are totally focused on thought leadership. Some of them are totally focused on, uh, building the workforce. Right. Um, and then, and then sort of the, the, the capstone to this would be that I got to speak at ASAE and then understand the entire profession of association executives. Right. And the fact that.

Marcus: That you guys are a tribe, you know, right? And, and, and so, you know, for someone who didn’t know anything about associations, really, I would say five years ago, uh, I, I understand a lot better now, and I think with that, uh, the perspective of [00:09:00] what you and your team over the course of, you know, two decades accomplished at him.

Marcus: Um, is really, really powerful. Not just the scale and the growth, but like you said, being at the table, being able to be a multifaceted player in the space, right? Um, we’re in an age, and we’re, we’re going to get into talking about AI and sort of how, what a big role technology is going to play in healthcare.

Marcus: But we’re in this age and we’re in this space where, The dynamics of the industry have changed dramatically, right? Like a payer is not necessarily a payer. A provider is not necessarily a provider anymore. Uh, technology companies, you know, are, are, are taking this very, very seriously at the highest levels, you know, fortune 10 levels, um, in terms of their, their view into healthcare.

Marcus: And, and so, You know, how do you see the future of associations, uh, in, in health care today? You know, it’s not the same as when you joined, uh, in 97, right? I mean, it’s a, it is, it is a different time, more dynamic, more, more energy, more [00:10:00] capital. The tech is more purposeful, you know, do you see associations having that same, uh, you know, potential impact that they had back when you started?

Steve Lieber: I do, and it’s because of the one thing that hasn’t changed. And that is, the association is the unbiased, trusted source. They’re not out to sell a product. I mean, yes they are. They’re selling membership, and they’re selling Right conferences and such, but you know, it’s in the space that you’re operating in and we’ll just stick with health care technology.

Steve Lieber: I’m not selling a technology product and in fact, this is 1 of my problems that I’ve got with what I perceive is kind of the direction is gone, which is more into consulting and you lose. That, um, position of being unbiased, uh, objective, [00:11:00] neutral, um, not taking sides among, uh, competing vendors and, and that sort of thing.

Steve Lieber: Um, and, and so as long as associations stay true to their roots. I think there is a very bright future because the world is always looking for that trusted source. Who can I get the strip straight scoop from, you know, is there a a lens that it goes through? Of course. I mean, nobody is perfect in that regard.

Steve Lieber: Um, but but as long as the association adopts those principles of being, uh, Um, you know, the trusted source, the unbiased source, uh, the neutral, uh, you know, not trying to pick winners, not trying to pick sides, and, and stays true to its mission. Absolutely. When you start heading into some other directions, where you, you start playing in, in, you know, for example, has, uh, an investment fund [00:12:00] as well.

Steve Lieber: Okay. Now you’re starting to, um. Confused the market, quite honestly. Who are you? You know, what are you up to? What, that sort of thing. And so, uh, as I say, and, and again, you know, I’m, I’m old at this point. I’m, I’m, you know, kind of old school, um, although in the healthcare and the, uh, association profession, even today, a lot of my peers consider me not to be particularly traditional in, in my approach.

Steve Lieber: Um, but you know, as I say, if you, if you stick to your knitting, um, yeah, there’s a bright future for association.

Vic: Steve, I’m interested to learn about the, I think after you left HIMSS, you joined, I believe you joined TIME, um, and I’m interested to hear the origin story of the conference VIVE, which is a huge success from my point of view, really Came out of, you know, non existence to be one of the best, uh, venues for innovation and new [00:13:00] technologies for the entire healthcare industry, certainly the health systems.

Vic: Um, what was the origin story there? Chime came together with, uh, HLTH, Health. Uh, but that was not a marriage that I would have predicted. Health was not very well established. They’d done one or two conferences, but, uh, were you there at the time? Maybe tell us some of that origin story if you can, or, um, how did it evolve, uh, to be the, the incredible platform it is right now?

Steve Lieber: Yeah. Um, after I left HIMSS, uh, you know, I, I was done with operations. I really didn’t want to run anything. I mean, I was, I was out of gas. And I needed to take a break and for about six months, I did, and then I started just dabbling in working on projects for people. And quite honestly, it was always someone calling me up and saying, Steve, would you help us on a B or C or whatever?

Steve Lieber: I really have never gone out looking for [00:14:00] consulting gigs. And Russ Branzell was same way. He called me up and said, Steve, um, you If I’m doing my calculations right, your non compete period with HIMSS is just about up. Um, would you come in and bring some of the entrepreneurial approaches that you have to our organization?

Steve Lieber: And I said, sure. Um, Russ and I had developed a great relationship. Um, it was probably And it was unfortunately a very short golden age of relationship between him and China. Um, Russ and I traveled the world, uh, speaking at conferences and, and, and working on things together. Uh, and I felt there was huge compliment between him, which was very focused on how to middle management type of work and China, which was focused on leadership and executives.

Steve Lieber: So anyway, he reached out to him and I said, sure. Um, I am in a position now where I [00:15:00] can can work with you guys. And so we set out on a couple of strategic, um, projects, one of which was this conference, uh, and what had happened is Hems had canceled. An agreement between themselves and chime, which had been in place for, oh, by that time, probably 25 years.

Steve Lieber: Um, and it was an agreement in terms of working together. Uh, collaborating on a spring conference chime would bring in its executive program into the conference and, uh. HEMS decided we don’t want to do that anymore, uh, for whatever reason. And you’d have to ask Hal Wolf. I have my opinions, but ask him in terms of why I did it.

Vic: Well, with hindsight, you know, which is always 2020, maybe not the best choice, but,

Steve Lieber: uh, I think that’s probably a safe statement to make, but quite honestly, [00:16:00] I would have thought you’d have seen it with foresight, not just hindsight. Uh, because it, it locked up the market. In the spring time shot slot there, I never had competition and I worked very hard to make sure I never had competition.

Steve Lieber: And so I made sure I brought in players so they wouldn’t create something else that would compete with me.

Vic: Yeah. Just to be clear, when you were at hims, you were working to maintain that and make sure that. That combination really dominated the spring calendar.

Steve Lieber: Absolutely. Along with other relationships or acquisitions that we made to take, uh, place, they’d take activities out of the market.

Steve Lieber: Uh, it was a very straightforward business, uh, strategy in terms of protecting what at the time was the crown jewel of, of hims. So the conference, the agreement gets [00:17:00] canceled and the opportunity now exists for Chime to do something else. And so myself and Russ Branzell and, um, uh, the folks at, uh, uh, Health, uh, John Wainer and, and, uh, Rich Garfoe started a conversation.

Steve Lieber: About doing, because, because China was without a home for its executive program in the spring time slot. And so the, I mean, it just came together and, you know, and, and, you know, relationships have a lot to do with it. Rich Garfield, who’s a president of health used to work for me. Russ and I had been on the road around the world together.

Steve Lieber: I mean, we, we knew each other. We were comfortable with each other. And so it, it, it came together. And the, the combination of the health, um, event mentality with the, [00:18:00] the QIIME executive audience and the technology approach and such, it was natural and it was relatively easy to differentiate it from HIMSS.

Steve Lieber: The objective was and I think remains not to create something of that scale. It has really nothing to do with. Sessions on how to’s and implementations and that sort of thing. It’s much more about culture, leadership, innovation, those sorts of things. And so, you know, we worked hard at differentiating it.

Steve Lieber: And, um, you know, at the same time, uh, you know, we were just coming out of the pandemic. Hems, unfortunately, it kind of fumbled a little bit in the way it, it’s customer relationship with how it handled the cancellation of the 20 conference. Uh, people weren’t happy. Um, it was in, in some respects, you know, perfect opportunity for a new entry into the market and it [00:19:00] has, I think, done pretty well.

Vic: Yeah. I mean, to me, to me, it’s the one. Like, don’t miss events. I go to lots of events, and I’ll pick and choose, maybe one year I’ll go to JPM, the next year I’ll go to health, but, but Vive has sort of emerged from, from nothing three years, three years ago? I don’t know how many years it’s been going on, but it’s really, uh, no mess to make, yeah.

Marcus: Yeah, I mean, it came to Nashville, so it made it really easy for us. Uh, and, and we actually built a series of events around it and it was, it was fantastic. Everybody was in town, you know, for it. So, um, And

Vic: then LA was, was good again. Not, not as easy for me, but also great.

Marcus: Okay. So I think that’s a pretty good segue into the work with, uh, with smart hospitals.

Marcus: So the way this, this whole podcast got booked is our mutual friend, Bruce Brandis, uh, who is a listener of our show, uh, has been, has been feeding us conversations. I think it really kind of [00:20:00] started when we, we, uh, found an article that was talking about Virtua Health. And, uh, their implementation of Wobot.

Marcus: And so Vic and I, we, every week, we just kind of talk about new stories. And we were talking about that one and he was like, Hey guys, you should probably talk to TK, who is at Virtua and doing that. And then TK has now come on the show and he’s become a really great friend of the show. Um, and then, you know, Bruce reached out to both myself and, and, and Dave Johnson, uh, from Foresight Health.

Marcus: Dave and I are both on the board of, uh, HFMA and, and kind of want to make us aware of the smart hospital initiative. Um, and said, you guys should talk. Steve Lieber, have him on the show to talk about what you’re doing there. We talk about AI every single show. Um, it’s, it’s the way we end our shows because we believe that it’s, uh, it’s the most transformative, uh, you know, technology of at least the last, you know, 20 years.

Marcus: And um, you know, it’s, it’s, uh, it’s great to see recently standards and also, Um, dedicated organizations emerge to try to get its [00:21:00] arms around how A. I. Is going to be effectively implemented into health care. It feels like both the coalition for health care A. I. As well as the smart hospital initiative, both kind of sprung on the scene and around the same time.

Marcus: Uh, and so it’s great to have you here to share a little bit about the smart hospital initiative. So what can you tell us about it?

Steve Lieber: Yeah, and again, you know, especially like I described in the last story, you know, relationships drive so much of what goes on in health care. Bruce and I had worked together a few years ago on on another project.

Steve Lieber: And so when he landed at care, AI, and I started. Thinking about how ambient monitoring and listening was evolving with the introduction of AI and, and, you know, the, the move into virtual care, virtual nursing in particular, um, you know, he, he reached out to me and he said, you know, there is something here that I think.

Steve Lieber: We ought to work on in terms of trying to bring some sense to [00:22:00] this area. It’s, it’s, um, it’s new. It’s emerging. And, and, you know, there’s, there’s, there’s a need to help people navigate through it. So, uh, about a year. And a half ago, um, I was at a conference with CARE AI’s founder and CEO, uh, Chakri Taleti.

Steve Lieber: And Chakri knows my background as well, and he was talking about the work we had done in creating the EMR adoption model, which became industry standard for EHRs, uh, with a major, uh, defining force around meaningful use. And he said, you know, Steve, Have you thought about building a model that will help us measure smart care teams and smart care facilities?

Steve Lieber: So, and this is in my early days in terms of doing a little consulting work with Care AI, and I said, okay, talk to me about this. Let me, help me understand. And, and so, you [00:23:00] know, it, it is a convergence of multiple technologies, AI only being one of them. So, if we think about. Automobiles, you know, the first elements of smart technology and automobiles were the sensors.

Steve Lieber: You’re about to bump into something or whatever. Now we’ve got lane departure warnings. We’ve got, I mean, on and on in terms of the things that have evolved and other technologies being brought in. Well, that’s what’s happening around this broader subject of smart care facilities. Thanks. You do have the AI, you’ve got robotics, you’ve got ambient monitoring, ambient listening, you’ve got wearables, sensors, a whole bunch of things.

Steve Lieber: You’ve got the concept that you can monitor patients, even in the inpatient setting, without somebody being right there. Now, we’ve, we’ve thought about that with telemedicine and, uh, monitoring at home, that [00:24:00] sort of stuff. But in the facility, you don’t have to have somebody who has to walk into that room every four hours to take vitals and, and that sort of thing.

Steve Lieber: So I said, Put some thought into this and go back to your experience with MRAM and, and see what you can, can create. So we’ve done that. We’re in the midst, I’d say kind of in the, the second third of, of the project’s development. We created a national blue ribbon advisory panel, uh, about 60 different individuals from administration, nursing, medicine, technology, uh, medical records, finance, all areas that we could to serve as advisors.

Steve Lieber: We started out with, let’s define what it, what does a smart care facility involve? We came up with three major components, people, places, and [00:25:00] processes. So, in the people part of the, the SMART hospital, that is patients and the patient family care circle, as well as the second group is care and support teams.

Steve Lieber: So, the obvious people that are involved in healthcare. Places have to do with infrastructure, actual locations of care. Emergency department, inpatient, ambulatory, residential, not only at home, but, uh, rehab, uh, post acute, uh, those kinds of places. Um, and so we’ve got locations or places that are part of the equation.

Steve Lieber: And then the third part of the equation or processes, you’ve got strategy, governance, finance, materials, all of those things are critical. For the delivery of care. It’s more on the administrative side, but you can’t have successful, uh, [00:26:00] activities, whether it’s in business or patient care without having the infrastructure of strategy and culture and governance and that sort of thing.

Steve Lieber: So we define the scope and then we started. Breaking it down into greater detail of, okay, what are the pieces underneath those broad areas of people, places, and things? And that’s how we came up with patients as well as caregivers, intelligence as well as optimization, um, those, those different things. And then, you know, the next stage in building a model like this is, okay, what are the subjects that fall into each of those categories?

Steve Lieber: So website, uh, Uh, infrastructure like bandwidth, um, the actual technologies of AI robotics and that sort of thing. Um, I mean, it, there are probably about 150 to 200 topics within this broad area of smart care facilities and smart care teams. [00:27:00] So, I say, when, when we talk about it, we actually don’t start with AI, but we get to it.

Steve Lieber: So, I say, when, when we talk about it, we actually don’t start with AI, but we get to it. It’s not the entry point in the conversation, but it is a critical part because as we’ve developed, and we haven’t released this yet, and I can talk a little bit about it as we’ve developed the levels, am I a level 1, level 2, level 3 of the smart care facility?

Steve Lieber: It is obviously based upon the growing sophistication of the tools that you use. And as you guys know, you know, there are about 5 different levels of analytics and AI from, you know, descriptive to prescriptive and, and, and such, um, and, and so we are trying to build a model here, which 1, it’s credible. So that’s the important part about having the national advisory panel.

Steve Lieber: 2, it’s got to be objective. This is not a model that’s [00:28:00] built around any single product or vendor or anything like that. And 3, it’s got to have value. Not only is our objective here to be able to determine. Where somebody is in their smart care journey, but give them information back for them to help understand where their gaps where their opportunities are.

Steve Lieber: So those are guiding principles around the model that that we’re building. And as they were. Coming up on the last, uh, of the second of three stages here, which is actually building the survey instrument. So, for the past, oh, 2 months, we’ve been circulating questions among our national panel, getting their feedback.

Steve Lieber: Are these the right questions to ask? Are the, um. Options, the answer options, the right ones. And are there questions in here that nobody can say yes, or they are doing. But what are those questions about the [00:29:00] next generation? Because we want to be able to build a model here that facilities can grow into not be a model that at the 1st.

Steve Lieber: Uh, release. There are facilities at the top. We want this to include an aspirational component as well to help define a road map. of where facilities might go as they are looking at the adoption of these various technologies, including AI, as well as ambient monitoring and listening and such. So that, that’s a pretty high level overview of the scope.

Steve Lieber: We’re going to be doing some beta testing of the entire survey, uh, by late June. Uh, and then launch the full survey, uh, to the national panel. They’ll get the first crack at it in, in August. And we’re kind of aiming for, uh, just [00:30:00] after Labor Day for, uh, a broad launch, uh, an invitation for others to, um, take the model, uh, take the survey to, to see how they rack up, uh, in terms of, of what we’ve developed.

Vic: Yeah. What are the things that I wanted to. Asked further about you kind of touched on it, but, um, one of the challenges with health care is we have to continue to treat patients every day in all these facilities as we are. making changes and upgrading and hopefully bringing more, more technology to bear to make the the entire process more efficient for caregivers and better for the patients.

Vic: And one of the things about naming it a maturity model and allowing that stage one, stage two, stage three, wherever, if you’re the best run hospital in the country or the worst, everyone can make small improvements today and continue to grow along this trajectory. Is that, is that sort of how it’s being designed or is that?

Vic: Would you frame it differently? [00:31:00]

Steve Lieber: Yeah, absolutely. And it’s not designed to show that one is better than the other, or you’re penalized, or you’re falling behind, or it’s just where you are. And we saw this in MRM as well, when we first launched it back in about 2000 and. 5, 6, 6 probably is when it was launched, um, hospitals move at different speeds and different ways.

Steve Lieber: There is not, and there wasn’t around EHR adoption either, there is no single path. You can bring in this person, Technology before someone else does and somebody else leaps over that, bring something else in and then comes back and drops the other piece in. So it really is the value really is being able to understand where you are, what you’re able to accomplish with what you have and then look for your opportunities.

Steve Lieber: As to, [00:32:00] okay, where are our weaknesses if we want to even go that far? Because again, we want to be careful in terms of of how we express this in the language we use. But, you know, where are the places that other organizations have found success and have positive impacts on on patient care and outcomes and such?

Steve Lieber: And how does that fit within our, you know, Business strategy, um, and so it very much is much more about assessment than it is a merit badge or anything like that. It really is being designed as a building tool to help healthcare facilities understand really what is new for all of us. I mean, this, this is the types of things we’re talking about.

Steve Lieber: a coordinated comprehensive way is new. Have we talked about pieces of [00:33:00] this stuff? Yeah, but what we want to make sure is we’re bringing it all together. We want to try to make sure we don’t replicate some of the problems we created in the past, which was keep bringing things in and not putting them together.

Steve Lieber: This very much is about how things hang together and how they Um, are, are coordinated and, and that there is logic in how things are brought together and moved forward with.

Marcus: I hope I’m able to articulate this because I feel like I’ve got a complex question brewing in my head. So, uh, and, and if, and if you disagree with the premise of the question, please feel free to, to, to do that.

Marcus: Um, you know, one of the observations that. I’ve made, uh, right or wrong as I’ve been walking through the Healthcare Association world is that there is an association for everything, right? And for everybody, right? So certainly at HFMA, it’s it’s kind of the CFOs organization, right? I mean, you know, it’s [00:34:00] it’s it represents the CFOs on down through their organization.

Marcus: Now, do you have other You You know, members of the the health system that are that are present and that are engaged. Of course, of course you do, right? You know, but obviously, healthcare finance management, it’s kind of in the name, right? Uh, you know, with with HIMSS, uh, I didn’t have as much exposure nationally, but there was a very robust, you know, sort of Tennessee chapter here.

Marcus: And the people who really were flying that flag, The CIOs here, you know, um, good friend of ours, Eric Threlkelf, who was at AmSurg, you know, he was like, you know, leading the charge, but he always had a bunch of other CIOs around him and, you know, were other people involved? Of course, but like the CIOs really felt like this was their thing, you know, and so I, what I’m wondering is, you know, you were talking about.

Marcus: Value, um, and you were talking about bringing it all together. And one of the things that we found just running a portfolio of companies to try to sell into healthcare [00:35:00] is it’s not just fragmented from a, you know, topical industry perspective, it’s, it’s fragmented inside of organizations, right? Like different people control different aspects of it.

Marcus: And so that culture, whereas this AI thing is truly a holistic transformation. It’s going to touch, you know, the members of the AMA, the Nurses Association, the HFMA, the HIMSS, it’s going to touch all of these people, right? What, how does culture fit into this model, um, from a maturity perspective? And then the second piece is, how do you articulate the value?

Marcus: Right, because, uh, I think there are different values and sometimes those values can be a little bit in competition, um, you know, amongst the different stakeholders. So those to me seem like two potential difficulties, uh, in, in getting a model adopted, uh, not to say the model isn’t needed. I think, I think what you articulated is very much needed, sort of a scaffolding for people to sort [00:36:00] of say, I am here and I’m trying to get there.

Marcus: Um, but it also sort of calls out to me, there’s a great opportunity for this model to sort of call out the elephants in the room, right, which is health care has generally had historically an innovation adoption culture issue problem, right? Um, and then it’s also had a value alignment problem. Um, and so how, how do you think about that in the context of this model?

Steve Lieber: Yeah, there are several elements that you’ve brought up here that are very. valid and ones that we’ve been thinking about. So in terms of multiple disciplines within the healthcare setting, as a result, we have a representative from HFMA. We have a representative from, uh, AONL, the nursing leaders, uh, group.

Steve Lieber: Um, we have, we have, uh, CHINE involved. So we are trying to position this not [00:37:00] as a single discipline model. Unlike MRAM, for example, I mean, that was him. That was the CIOs. Actually, the CFOs were interested in it because they learned that if you were in a stage 7, you had a greater likelihood of improving your bond rating.

Steve Lieber: And so they became more interested in it, but only from their perspective, not said at all. So, you know, it really does, because of the nature of what we’re talking about here. It crosses disciplines, and it does make it more difficult. Another reason why we’ve got as many people as we have serving as advisors, because they cross all disciplines from the CEO’s office on across, uh, to all the other, um, C suite offices and, and throughout, um, you know, and, and so the, one of the questions that has been asked by some of our, our members of our, uh, advisory panel is, um, Who do we expect to complete the survey?[00:38:00]

Steve Lieber: And it’s a good question because there are questions the CIO can’t answer. There are questions the, uh, CNOs, Chief Nursing Officer, can’t answer and that sort of thing. It’s going to have to be a collaboration. So it wasn’t necessarily that we started out with this as an objective, but it’s evolving into something that forces Different areas to work together to understand what’s going on and the value getting back to the last part of your question there.

Steve Lieber: The value is getting all of them on the same page and understanding. where they are and how it all fits together. How does smart technology that helps, um, finance in terms of real time insurance checks and validation and those sorts of things, how does that impact Patient [00:39:00] care. Well, you know, if it’s real time, we’re able to move a whole lot faster instead of someone saying we have to wait.

Steve Lieber: We don’t know if we have, um, approval, you know, those sorts of things. And so it actually is. I hope going to help create those lines of communication across the different disciplines. And then when the report comes back to the facility, again, it’s crossing areas and it will, I think, go and our objective will be to ensure that it’s distributed across multiple disciplines.

Steve Lieber: I think it will give Insights into some of those very issues you’re talking about where silos and, and, uh, discipline barriers actually hinder advancement in, in adoption of, of technologies and, and improvement in, in some aspects of patient care. That’s those are some of the things that when we 1st started out.

Steve Lieber: I wasn’t [00:40:00] really thinking about those sorts of things, but you’ve really hit on something that we have learned through this process.

Vic: Steve, talk to us about how, I mean, through your career, through associations, and even in this latest with the maturity model of smart hospitals, I think I was reading about some of your writings this weekend, but you, you talked a few times about getting everyone in the room, getting all the key, um, minds, the key people that have the information in the same room and talking to each other.

Vic: And how does that manifest in this really fast paced AI world where things are changing pretty quickly to gather together all the key opinions? And then, like, re re circulate that information so that it is, maybe not constantly updated, but updated quickly enough so that you can be effective. There’s a balance there, I assume.

Steve Lieber: Yeah. You know, it’s it’s just, it’s a lot easier today, because this is the way we communicate now. [00:41:00] I I don’t travel nearly as much as I used to. As a matter of fact, if if if I were at HIMSS today, I probably could have lasted longer, because I wouldn’t have been on the road so much. Because With with zoom and teams and all that sort of thing.

Steve Lieber: It’s just a whole lot quicker to connect and have a conversation and we become so comfortable with it that this. I don’t feel any less of a connection than if we were in the same room. And I think we’ve all gotten that way. And so the ability to connect people. Uh is is just so much easier and as you guys I’m sure know a lot of executives in health care Facility settings aren’t always at the hospital anymore They are in other places or they come in for a few days a week and then live elsewhere.

Steve Lieber: Whatever. I mean the the remote uh work environment [00:42:00] You know, it’s, it’s top down. It’s, it’s, you know, it, it, it plays out in, in virtually all, all levels. Um, and example of this is, is 1 sort of surprise me. It’s a little bit off the topic for your question, but the creation of virtual command centers where you’re bringing.

Steve Lieber: Uh, all of the smart technology together in one display and and so you’ve got a smart room and you’ve got sensors going, you’ve got cameras going and all that and all that’s feeding into a command center while the command center is no longer down the hall at the nurse’s station. It could be elsewhere in the facility, or it could be in a nurse’s home, in a secure location in his or her home, because they don’t want to come into the hospital anymore.

Steve Lieber: They’re really comfortable working in this kind of environment, and, and, and being virtual, you know, why do you have to be down the hall or even on the next floor? You can be across town, across country, and it really is having a. [00:43:00] Significant impact on, uh, nurse satisfaction and, and, uh, burnout and, and issues like that.

Steve Lieber: So, I, I think really the main point I’m making about, uh, related to your question is, this becomes an easier conversation because we can get on these kinds of technologies and have these conversations. And, you know, It’s, I think the, the world is becoming, um, better documented in terms of what’s going on.

Steve Lieber: And so it’s more visible and hiding behind things is less of an option. Um, and, and just in, in terms of, uh, conversations I have on, on my podcast, um, Most of my, my, uh, guests are, are out of the technology space in, in healthcare settings. They’re talking about the other peers outside of, of [00:44:00] information systems that they’re talking to all the time.

Steve Lieber: So I think it’s just a matter of routine course of doing business now.

Marcus: What do you think is the over under on, uh, you know, AI being at. Visible penetration to the patient in health care in 24 months, you know, to where, like right now we all know the EMR every time I go in, I see my doc, not looking at me, you know, looking at the screen.

Marcus: What do you kind of think is going to be the point where patients will feel AI in their health care experience?

Steve Lieber: You know, it’s probably going to be longer than 24 months. Yeah. And this, this may be a little controversial in terms of, of what I’m going to say as to why that is, um, healthcare [00:45:00] enjoys maintaining a bit of mystique about what we do, and you don’t always want to let the patient in on all of the things that you know how to do it.

Steve Lieber: Medicine is probably more guilty of that than anybody else, you know, the mystique of, of, of medicine and such. And so I think I will be driving decision making, um, in a more significant way than the typical patient will know. So, I do believe, you know, every 12, 24 months, we will be moving into more and more.

Steve Lieber: Um, scenarios where AI is becoming more and more influential. I’m not gonna say it’s the decision maker, but more and more influential in the decisions that are made. Um, how much of that is repeated to the patient [00:46:00] of a doctor saying, well, my AI is telling me I ought to, and I just don’t hear a doctor saying that.

Steve Lieber: Sorry. Right. I’m just going to turn your question a little bit and say, in 24 months, it’s going to be even more impactful on health care than it is today. How evident that is to the patient, perhaps a little less so.

Marcus: Probably the patient would refer it would prefer it that way.

Steve Lieber: Um, well, you know, probably the average base patient.

Steve Lieber: Yeah, the average. Some of us that do a lot of reading and all it’s like, I really want you to have AI take a look at this. For sure. I trust you and I trust your judgment, but your judgment will be so much better if you use all of the tools that are available to you.

Marcus: Amen. Amen. So, so Steve, before we, before we do wrap up, we definitely want to give you a chance to talk a little bit about your podcast.

Marcus: [00:47:00] Uh, you know, educate us. You’re, we, we’ve got it up here on the screen. You’re, you’re 29 episodes in so smart from the start. So, so what, what was the genesis of this? I mean, obviously you, you ran a media company at him, so this, this is not new to you. Um, but you know, you’re, you’re back out, uh, doing it again.

Marcus: Talk about why you’re, you’re creating this, this show and sort of what it adds to the landscape of healthcare podcasts.

Steve Lieber: You know, it’s, it’s, it’s part of a Steve playbook that you can find elements of through, throughout my career. Things you do, you do several things all focused in the same general strategic direction.

Steve Lieber: So smart from the start really is a part of this broader effort around smart care. Um, as I look at it from a personal standpoint, um, It’s, it’s a place where I feel not at a disadvantage. It’s new to all of us. You guys are learning it at the same time I am, and so, you know, the, the people that are at a disadvantage are the ones that aren’t doing the reading and, and following along.

Steve Lieber: So [00:48:00] creating an environment in the podcast where I can talk to Folks about what they’re doing around smart technologies. And so we do, we talk a lot about ambient technologies, virtual nursing, AI, robotics, and that sort of thing. That’s sort of the common theme running through and it’s as much educational for me as it is for the audience that I’m trying to bring this to and it very much is part of.

Steve Lieber: The smart hospital maturity model initiative and all. So, you know, all of these pieces driving together. Uh, just trying to be a part of the conversation, um, and part of the thinking that goes into what will be, you know, the next turn of the crank in, in healthcare.

Marcus: Mm hmm.

Vic: Vic, any final questions? Yeah, I’m interested to, I mean, I think we’re all watching the early adoption of AI in, uh, ambient scribing and things in the revenue cycle, the various pieces of revenue cycle, or on the, on the [00:49:00] payer side, the opposite side.

Vic: Um, what, what other part of the health system would you say to keep an eye on because you’re starting to hear early things of maybe a new application that we haven’t seen or that’s less, less well understood?

Steve Lieber: Yeah, there are a couple of things that come to my mind in relation to that question, and I’m going to kind of vary from it just a little bit.

Steve Lieber: One of the things that is different that I’m seeing this time than the adoption of electronic health record is the for profits are leading the direction this time, not the academic medical centers. And so, you know, well, wait a minute. Why is that? Well, back for early adoption of EHRs, there was no money in it.

Steve Lieber: It was just an expense. Well, who had money at that time? Academic medical centers had huge endowments, and so they could afford to do it. And the value proposition, the business case came later. [00:50:00] Well, around smart technology, so in particular, things like virtual nursing. There is an obvious and immediate business case and the for profits are all over it.

Steve Lieber: So this is something I’ve, I’ve learned coming through through my podcast is those folks have such an attention to the bottom line. They’re looking for ways to make sure that they can reduce turnover, help deal with the workforce shortages. And at the same time, create more effective as well as efficient patient care.

Steve Lieber: Um, I think that whole area of, and the terminology I’m using these days is virtual care versus telemedicine. Telemedicine carries too much baggage of something else. Um, and I think that’s the space, um, that I’d be paying attention to. Um, it, it. Doesn’t carry the overhead that you’ve got in other kinds of [00:51:00] care.

Steve Lieber: You’ve got the opportunity of really embracing remote working and all of the benefits that that can bring the technology is getting to the point where, um, you can have confidence in the readings that you’re getting. And that’s the thing. And I think the patient population. is getting there. So if we think about chronic conditions, especially like diabetes, those folks have been all over technology for a long time because they had to and to stay alive.

Steve Lieber: And it was introduced to them early. One We’re our generations are turning over and in the last of the non technological generation, there’s not many left my crowd. You know, we were adults when technology came in, but we had to learn it and learn it fast and we’re comfortable with it. So, you know, the, the virtual care at home.

Steve Lieber: [00:52:00] Uh, and as well as in other residential settings and all of the technologies, whether it’s monitors, um, medication and remote medication administration. I mean, all of those things. If I were looking at a place to play, I’d be looking for that remote virtual aspect as the thing that would make a lot of sense.

Steve Lieber: Um, we continue to try to get care outside of the hospital. We all know the hospitals probably the. last place you really want to go if you have a health care issue. Because, you know, there’s so much else that you can catch while you’re there, too. Um, and so it’s all a matter of what’s the least invasive place where you can get care and what’s the technology you need in order to deliver it.

Steve Lieber: That’s great.

Marcus: Yeah. Yeah. Awesome. This is a great episode, Steve. Thanks for making time. Uh, For the listeners smart from the start is the podcast. You can find it on Apple. You can find it on Spotify, um, and the smart hospital initiative. Uh, you can Google that and we’ll have [00:53:00] links to all this stuff in our show notes.

Marcus: So Steve, again, thanks so much for your contribution to the industry and continuing to do really cool stuff, man. We appreciate it.

Steve Lieber: Uh, thank you guys really enjoyed the conversation today.