Digital Transformation in Healthcare: Dr Peter Y Hahn of University of Michigan Health-West On How Medical Practices Can Use Digital Transformation To Provide Better Care
Artificial intelligence can be the backbone to many technologies including predictive modeling, conversational and natural language processing, and automation. We are currently using artificial intelligence which allows us to have computer assisted detection of early breast and lung lesions. We are not looking for this technology to replace our providers. We are providing these technologies as tools to our providers, allowing them to render the most personalized care possible.
As part of our series about “How To Use Digital Transformation To Take Your Company To The Next Level”, I had the pleasure of interviewing Peter Hahn.
Dr. Peter Y. Hahn is President and CEO of University of Michigan Health-West. A noted healthcare executive and critical care physician, Dr. Hahn was previously on the faculty at Mayo Clinic. He is the recipient of numerous awards including the Mayo Brothers Distinguished Fellowship and attained his Masters of Business Administration from the University of Tennessee Haslam College of Business. Dr. Hahn lectures and publishes widely and serves as a trustee of the Committee for Economic Development. He plays an active role in the West Michigan community serving on the boards of the Grand Rapids Symphony, Opera Grand Rapids, the Economic Club of Grand Rapids and Davenport University.
Thank you so much for joining us in this interview series. Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?
I have always had an interest in leadership and a desire to make a difference. A career in healthcare came naturally growing up the son of a physician. I grew up watching my father spend a lifetime taking care of patients. As a clinician I was proud to make a difference in the lives of patients one at a time. I also saw the amazing potential to influence hundreds of lives at a time by becoming an effective healthcare leader. My time at Mayo instilled in me the mantra that the needs of the patients must come first. This is pivotal in how I approach leadership at UMH-West.
Can you share a story about the funniest mistake you made early in your career? Can you tell us what lessons or ‘take aways’ you learned from that?
When I was a resident at Mayo, I started a soccer team called Fellows United, made up of residents, fellows and staff physicians. Leading a team of extremely talented and highly educated physicians was a humbling experience and I learned a tremendous amount about leadership. The funny part was that we had players from around the world and players who played at very high levels in college and youth national teams. Yet we lost every single game our first season. Our team demonstrated many stereotypes; the surgeons always wanted to play forward and score the goals and get the glory etc. I learned a tremendous amount about team building during this time. In the following years, as we came together as a team, we consistently won championships. Over twenty years later, Fellow United continues to flourish and succeed as a team with world class physicians from around the world building camaraderie outside of the hospital.
None of us are able to achieve success without some help along the way. Is there a particular person you are grateful for, and/or who helped you in your career journey? Can you share a story?
Like most, I have been fortunate to have pivotal mentors along my journey. I have to give a lot of credit to my wife Sue. We got married when I was in my first year of residency after medical school. After 7 years of specialty training, 7 more years in academic medicine I told her I wanted to get an MBA and pursue a career in management. This entailed moving across the country to become Chief Medical Officer at the then Metro Health. Our children were still in high school and Suhwoo stayed behind in Portland, Oregon with them. Her sacrifices, encouragement and support during this career journey has allowed me to pursue my dreams.
Is there a particular book, podcast, or film that made a significant impact on you? Can you share a story or explain why it resonated with you so much?
I have always had a love for history. Reading about the past teaches you about the present and the future. A favorite book of mine is “The Fall of Constantinople 1453” by the great historian Steven Runciman. I remember first reading it on the beach in Barcelona. There are a number of important leadership lessons in the book that have influenced how I lead my teams and approach difficulties.
Extensive research suggests that “purpose driven businesses” are more successful in many areas. Can you share how University of Michigan Health-West is a purpose-driven business, what types of programs or initiatives are fulfilling this idea.
Our vision statement at UMHW is “Our innovations change care. Our care changes lives.”. We take this very seriously. Sometimes when people think of innovation, they think solely of discoveries in the lab or new technologies. We concentrate on how new technologies can change and improve the delivery of patient care. The size and nimbleness of our organization combined with the resources of being a part of one of the world’s great academic medical centers allows us unique advantages to achieve our vision. Two great examples of this is our nation leading breast cancer AI detection program and our widespread implementation of ambient voice recognition for physicians and advanced practice providers (APPs).
iCAD Medical and UMHW began collaborating on developing breast cancer detection workflows using artificial intelligence over three years ago. The partnership has given UMHW access to the most advanced breast cancer detection algorithms available. This makes the breast center at UMHW one of the most experienced in the country at using AI based algorithms along with human readings to detect more breast cancers while at the same time decreasing unnecessary workups for nonmalignant lesions. The breast center recently shared one of the first ever case studies showing the cancer prediction functionality of the amazing iCAD RISK algorithm which uses the patient’s mammogram to estimate the risk of cancer development. Current research at the center is focusing on applying RISK analysis to detect the most aggressive cancers in younger women at an early stage when there is still a chance for successful treatment. The breast center is proud to be an advisor, advocate, and educator for multiple high level academic and private breast centers across the US.
University of Michigan Health-West is a physician-led organization. We know that a physician and provider shortage is coming. There’s been a lot of issues with physician burnout already. For as helpful and essential as the EMR (electronic medical record) is, it’s likely contributed to that burnout. For every patient contact-hour, there’s another two hours of documentation that has to go into it. That physician-patient relationship has become a lot more transactional, and that predates COVID-19. One thing we’ve done to restore the intimacy of the physician-patient relationship is work with Nuance Communications to implement their Dragon Ambient eXperience (DAX) transcription service. Rather than type up two hours of notes, DAX records the doctor-patient visit using its voice transcription software, then turns it into a comprehensive note. This allows the doctor and patient to actually meet face to face during appointments and saves the physician hours afterward logging notes into an EMR.
Are you working on any new or exciting projects right now, and if so could you share how these new or exciting programs or projects will help your clients and customers.
We’ve mentioned a few times that we are emerging as one of the key leaders in implementing conversational AI to provide a better patient and provider experience. Over the last year, we have partnered with Nuance to implement their Dragon Ambient Speech conversational AI technology. This technology captures the conversation with the patient and provider, uses AI to structure the discussion in a compliant, high-quality progress note that the provider can review and edit as needed later on. This allows the provider and patient to have meaningful dialogue without the computer/documentation in the room being a barrier. The provider can be confident the AI is capturing all of the information needed for documentation and can focus all of their cognition on a personalized plan for the patient. Post visit, reducing the administrative burden documentation has on providers allows those individuals to focus even more on managing the care of their entire patient population, which is where we all expect our healthcare to be.
This technology is changing the way we provide care for our patients. We are looking to pivot this technology to assist in other clinical workflows, but a key focus will be on those conversational interactions we have with our patients pre and post visit. The conversational AI makes interactions with traditional voice response systems more personal and natural. We are looking to use this technology to assist patients in scheduling visits, answering key questions about our organization and help with flows such as patient prescription refills. Using this automation will allow our team members to spend less time on administrative tasks and more time with those patients who need our focus.
Let’s now turn to the main focus of our discussion about Digital Transformation. For the benefit of our readers, can you help explain what Digital Transformation means in regard to University of Michigan Health-West? On a practical level what does it look like for your organization to engage in a Digital Transformation?
University of Michigan Health-West prides itself on being an early adopter. Back in 2006–07, our organization was the first small- to mid-sized health system in the country to bring on Epic, which has since become the dominant EMR. That was very helpful. More recently, the speed of our digital transformation has been accelerated. I don’t know that any hospital system has built the number of innovative clinical programs that we have built over the last five years. In addition to adopting DAX about a year ago ― first via a pilot program, then expanding its use to our staff more broadly ― we’re implementing a number of remote patient monitoring tools. The hospital-at-home concept is the way things are headed, and not just here in Grand Rapids.
Which companies can most benefit from a Digital Transformation?
Digital Transformation in its simplest definition is taking paper and manual processes and leveraging technology to provide a digital efficient experience. With that definition in mind, every industry can benefit from digital transformation using key solutions such as voice assistance, automation, virtualization, data capture/sharing/reporting, and new emerging technology such as machine learning and artificial intelligence as essentials to the business plan.
How has the Digital Transformation with University of Michigan Health-West helped improve operations, processes and customer experiences? We’d love to hear some stories if possible.
We have many examples where our digital transformation has improved the operations, processes, and customer experience. We are intentional about the transformation we implement with a key focus on those technologies that will address those key improvements. These correlate with the healthcare industry’s concept of the quadruple aim: High Quality, Low Cost, Best Patient Experience, and Best Provider Experience. Some of our most recent examples of digital transformation are:
· Healthcare recovery solutions is a remote patient monitoring system which we were implementing prior to COVID for our congestive heart failure clinic. With the surge of COVID in November 2020 we pivoted and produced a COVID recovery program which allows patients to convalesce at home while still being monitored. Patients go home with a monitoring “kit” where we are able to monitor temperature, pulse ox, blood pressure, and weight remotely as well as do virtual visits and communication by texting. Patients are grateful to be able to convalesce at home where they have their own amenities but still have the watchful eye of a 24/7 care team. The program has served nearly 500 patients with almost 5000 patient hospital days saved.
· Tytocare is a remote physical exam and virtual visit tool. We were able to deploy this technology into an underserved area where patients were unable/unwilling to come to the hospital for specialty appointments. Patients can now be seen in their patient centered medical home and see a cardiologist remotely without the burden of travel, unknown territory, and the language barrier. We are in development of deploying these units into other underserved areas.
· Tavoca is a texting communication tool which allows us to remind patients about their upcoming appointments/procedures via multiple ways including texting, email, and phone calls. We are also able to give various instructions including arrival time and way finding through this solution. We have been able to reduce our no-show rate from as high as 8% to as low as 4%. When you consider the number of encounters, this improvement is quite beneficial on multiple levels.
· We are adopting automation tools to streamline our financial and billing practices. Processes that took a lot of paperwork or clicks on a computer are now being streamlined and automated. This allows for our Financial Representatives to spend more time focused on servicing our patients’ needs and less time on administrative burdens.
· Artificial intelligence is starting to become more and more useful in multiple areas of our institution. We are currently using artificial intelligence to help with our lung screening, mammograms, colonoscopy polyp detection rate as well as using it for ambient voice recognition for outpatient documentation. We will also be deploying conversational artificial intelligence using natural language processing to help automate the patient experience such as provider documentation, patient appointment scheduling, refill requests and care gap closures. Automating these tasks allows our colleagues to spend more quality time with patients.
Has integrating Digital Transformation been challenging for University of Michigan Health-West? How do you help resolve them?
University of Michigan Health-West has a long history of seeing the value technology and digital transformation can bring to healthcare. Many years ago, we started with a virtualized remote desktop which allows our colleagues to have a full desktop experience from any device with an internet connection. This allows our teams to access information in a safe and secure manner, from anywhere at any time. This was before the time of smartphones and mobile applications. Our providers are able to access pertinent information to advise on patient care from all areas of the globe and allows us to have a flexible workforce with full technical capabilities from their homes, on vacations and in the office. Essentially, we can access all the information we need whenever a patient needs us to, not just when the patient is in our four walls.
The transition from paper record to EMRs is another example of our history with digital transformation. We were one of the first small to midsized organizations in the country to roll out Epic, an industry leader in EMRs. This has allowed us better connectivity to our patients, more thorough access to information and collaboration with care teams, streamlined registration and billing practices. Finally, decision support tools such as drug/drug interactions, best practice alerts, and allergy interactions are allowing us to be safer with our decision making.
COVID did thrust us into a more focused digital health driven transformation. Within the COVID timeframe we operationalized video visits, dragon ambient experience for provider documentation, predictive modeling for sepsis detection, a deterioration index and remote patient monitoring. COVID has put a large spotlight on providing digital tools to patients allowing them more control of the care when not in our organization. We have always had a patient portal, but COVID forced a faster adoption of these tools. We implemented several online screening tools, a COVID chat bot, and online screening and scheduling for COVID immunizations. These transformations allowed us to continue to provide great care and services to our patients from outside our bricks and mortar.
Innovation and high paced work is not new to us, so although the pace was high, we were able to focus our efforts to accomplish the tasks that need to be done in such a short amount of time. We feel that prioritization and focus of time and energy are the keys to conquering any challenge.
Based on your experience and success, what are “Five Ways a Company Can Use Digital Transformation To Take It To The Next Level”? Please share a story or an example for each.
· Putting control back into the patient’s hands
o Broadening the patient’s ability to become more engaged into their healthcare leads to a deeper provider/patient relationship and we believe this improves compliance and, in the end, quality. Embracing and expanding the features of both patient portal and online services allows the patients to access care and information which helps them feel more a part of the team and in control.
· Virtualization:
o This concept can affect both staff members and patients. As mentioned with our virtual desktop solution our colleagues can log into any computer and use their personal virtualized desktop. We believe this improves the overall tolerance of using the computer as well as efficiencies of using our tools.
o Allowing the patients to do various types of virtual visits allows us to reach out to the patient and care for them at a mutually agreed-upon time and location. Virtual care allows easier access to care in non-traditional settings and in a manner where both patient and provider are comfortable.
· Ambient voice technology:
o We have implemented Nuance’s DAX technology which allows our patients and provider to have a meaningful uninterrupted conversation during an office visit while in the background that visit is being captured into appropriate documentation. This technology is in its infancy, however, will certainly explode and be available for many applications in the near future.
· Artificial intelligence:
o Artificial intelligence can be the backbone to many technologies including predictive modeling, conversational and natural language processing, and automation. We are currently using artificial intelligence which allows us to have computer assisted detection of early breast and lung lesions. We are not looking for this technology to replace our providers. We are providing these technologies as tools to our providers, allowing them to render the most personalized care possible.
· Techquity: While this appears to be a new emerging term for the industry, West has always been conscious to ensure our technical innovations are accessible to all of our patients. We are using our digital transformation to reach more patients where they need to be reached, in their homes, in the community. We are conscious that digital transformation is allowing us to connect more to individuals but we need to make sure every patient has access to the basic tools to make those connections happen. We are involved in community partnerships and our own programs that allow us to extend connections into underserved populations. Technology can have an inherent side effect where only those that can afford the technology will benefit from it. Our most purposeful innovations are aimed to bridge that gap, where in fact, our innovations benefit all patients and even more so in underserved populations. Some of the most recent programs are our implantation of the digital health kit Tytocare into underserved areas. During COVID, our mobile network technologies allowed us to stand up mobile vaccine clinics in neighborhoods where we were traditionally not present.
How can companies best create a “culture of innovation” in order to create new competitive advantages?
In our industry we believe that if you put the patient at the center of your decisions and look for innovative ways to wrap our digital arms around our patients, then we can help preserve the intimate relationship between providers/institutions and our patients. Leadership must set the tone for a culture of innovation which would start with the organization’s mission and vision. To place innovation at the center of your mission and vision tells the organization that this is the direction we are intending to move. In addition, you need to “walk the walk”; in other words actually producing workflows which will improve the employee experience and to keep the patient at the center of care. We like to say that our innovation should be “patient centered and provider/employee focused”. If you are unable to show that you are accomplishing your mission and vision, then confidence will wane with leadership. This will certainly affect your culture. At the basic level, Digital Transformation strategies need to be intentional, meaningful, equitable and measurable with constant checks and balances against those key principles. We are constantly asking ourselves, “what problems are we trying to solve?”, to ensure our strategies aren’t to implement for innovation’s sake but truly have the impact of bridging the gaps and improving the relationship between our organization and our patients.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
My favorite quote is, “I never lose, I either win or I learn.” by Nelson Mandela.
It’s taught me that I need to learn from every experience whether it’s good or bad, to stay positive and always progress and learn. It has been especially meaningful over the last two years as we faced the challenges of the pandemic.
How can our readers further follow your work?
Please follow me on Linkedin here: https://www.linkedin.com/in/hahnpy/ , and University of Michigan Health-West on Linkedin here: https://www.linkedin.com/company/university-of-michigan-health-west/
Thank you so much for sharing these important insights. We wish you continued success and good health!
About The Interviewer: David McNeil is the President of PatientPop, a Tebra company, a market leader in practice growth technology. McNeil is highly committed to helping the company build a modern go-to-market organization that delivers great value to practices in a time of rapid change in healthcare. McNeil’s business insights have been featured in publications such as Medical Economics and Los Angeles Business Journal.
