The Mindset of Digital: My Conversation with Amy Zolotow at Reuters Digital Health 2024

This past week, I had the privilege of joining the amazing Amy Zolotow on stage at Reuters Digital Health 2024 for a fireside chat about digital transformation and our experiences at Froedtert & the Medical College of Wisconsin. I’m excited to share some highlights from that conversation here:

Q: What is digital transformation?

Digital transformation begins with changing our mindset about what we do and what we are capable of doing. Traditionally, we think of treating one patient at a time. But what if we could do more? This digital transformation goes beyond consumerism — it’s about mission alignment. Are we a profession that is proactive? Are we here to promote and maintain health? Are we coordinated? To achieve these goals while maintaining the humanity in our profession, we need to embrace digital transformation.

The signs are clear: we must transform. The current model of one patient, one clinician in a clinic exam room under fluorescent lights is unsustainable. We face a significant clinician shortfall. A report from the Association of American Medical Colleges released this spring noted a projected shortage of over 80,000 physicians in the next decade, one of the more conservative estimates. Nurses and other team members are also becoming scarce and harder to hire. If we were to scale the general population-to-physician ratios to underserved areas, we would need five times as many clinicians. We can’t solve this without digital transformation. How can we do things differently to keep our workforce available for tasks requiring in-person, hands-on attention?

Internally, we refer to this as “superpowering our people.” Digital transformation is about augmenting human capabilities with technology. To drive this transformation, we must conceptualize the art of the possible and deliver on investments and promises.

Q: What challenges do you face integrating digital therapeutics into patient care, and how do you tackle them?

Digital therapeutics, which include software that augments aspects of the patient journey, present several challenges. Some are educational and connection-focused, while others are FDA-certified software as medical devices. Regardless, they share similar challenges.

In the clinic, it’s difficult to switch between in-person (analog) care and remote patient monitoring (digital) and virtual care. We need to consider data access, analysis, and review from a sociotechnical perspective, integrating these elements seamlessly into the overall care model and experience.

To address this, we have expanded our Virtual Care Team and integrated our virtual care program within our population health operations. Our goal is to adopt a population management approach, taking responsibility for digital therapeutics support and removing this burden from primary care teams. This mirrors our “Shared Responsibility Model” with AWS for cloud computing and should be documented formally between population health and in-person care.

For primary care and specialty clinicians, we use Xealth to enable monitoring of patient engagement and results with digital therapeutic tools, without placing the responsibility of monitoring on their shoulders.

Q: Can you give examples of innovative, scalable solutions by Inception Health to enhance patient care despite increasing challenges?

We are piloting alternative digital-first care models that start with chat, escalate to video, and then proceed to in-person care within our health network as needed. We’ve introduced more self-service tools into our digital ecosystem, starting with our mobile application. For example, we’ve made mental health a priority, enabling patients to begin with an assessment and access tools supported by our virtual care team, without needing to see a primary care provider first.

Q: How do you balance technology integration into patient care while maintaining a human-centered approach and patient trust?

We often focus on technology to solve problems, but if designed with the patient in mind, trust and patient-centeredness are inherent because the focus is on the humans. We are currently implementing artificial intelligence in our enterprise engagement center. The key is framing AI solutions to address patient problems, not just making our lives easier. This requires a different skill set than traditionally found in healthcare, despite being a patient-centered industry.

We often focus on technology to solve problems, but if designed with the patient in mind, trust and patient-centeredness are inherent because the focus is on the humans.

I’m proud to say that our Inception Health team has a dedicated UX team that conducts meticulous user research. They collaborate with a UX and experience team at Froedtert & MCW as well.

Q: What emerging trends or technologies do you think will significantly impact healthcare delivery soon, given your expertise in clinical informatics?

AI and large language models (LLMs) are rapidly maturing and could significantly impact healthcare. Our research team has been using transfer learning and early LLMs like GPT-2 to translate medical reports for patients. Since the “Attention is All You Need” paper, the field has evolved quickly, with medical-specific models now performing on par with, if not better than, humans. However, as my mentor Warner Slack said, any physician who can be replaced by a computer deserves to be replaced by one.

Any physician who can be replaced by a computer deserves to be replaced by one. — Warner Slack MD

Q: How does your role as Chief Medical Officer for Inception Health help form partnerships with external organizations for digital health transformation, and how do you choose promising initiatives to invest in?

Alignment and focus are crucial for our goals. We seek partners, not vendors, and look for those who can dive into technical details, aim for measurable improvements in care and experience, and are culturally compatible. We often have more initiatives than we can handle, so we prioritize and maintain relationships. When the timing is right, we move quickly with aligned partners.