All About Value Based Care, Cardiology in the ASC w/ Katherine Evans DNP

Erik Sunset: [00:00:00] Hello and welcome back. I’m Erik Sunset, your host of the DocBuddy Journal. Here at DocBuddy, we deliver healthcare solutions that take the pain and costs out of broken workflows. From the ASC to the clinic to on call at the hospital, DocBuddy helps providers access, create, and move data seamlessly, all from the point of care.

Erik Sunset: You can learn more about our solutions at DocBuddy.com. And today we’ve got a special guest and that is Katherine Evans. Katherine developed and implemented the value based care clinical model for Novocardia. She’s an expert in specialty value based care, working daily with interdisciplinary teams to change the landscape of clinical care and cardiology. She currently oversees the clinical model, including care teams and care model evolution for Novocardia. Katherine, thanks for joining us.

Katherine Evans: Thanks, Erik. So happy to be here.

Erik Sunset: It’s our pleasure to have you. Hopefully we did you justice with that short intro, but what else should listeners know about you?

Katherine Evans: Thanks, Erik. So I am a nurse practitioner by training, spent most of my [00:01:00] career in value based care models. I have practiced in cardiology as well as in geriatrics and then have spent the back half of my career in the past about 10 or 15 years really focused in the business of health care and how we can implement new and exciting models in order to take better care of patients.

Erik Sunset: Love it. And maybe that intro didn’t do you justice after all I wasn’t even close to the the full picture there So one of the things we’re really excited to have you on the show today to talk about is just that it’s it’s value based care We we need your help to shine a light on the topic. There’s a lot of opinions Good bad ignorance out there around value based care So for the listeners that maybe aren’t quite sure what we’re talking about, maybe start with a quick definition.

Katherine Evans: Sure. So the way I think about value based care is it really sits on a continuum where [00:02:00] you can have care that reimburses a provider For providing better outcomes, and I think that’s fundamentally the difference, right? So, if you think about fee for service care, and this is a doctor sees a patient, they get paid for the service.

Katherine Evans: What’s done is done whether the outcome was good or bad, they get paid. If we’re in a value based care model, the doctor provides a service and essentially. Incentives are aligned for that doctor to get paid for that service in a way that increases their incentive if the outcome is better. So it’s just a different way of practicing and thinking.

Katherine Evans: And it typically requires an interdisciplinary team approach. So, whether that’s, um. a nurse practitioner driven model, a physician driven model. If it’s a social worker at the forefront, it can be a lot of different ways in order to provide that outcome, but it typically involves a lot of different people working together.

Katherine Evans: So when you [00:03:00] look at this continuum, I think you start on, on one end of saying to a provider team, we will pay you the way we’ve always paid you for that fee for service. But if you get a little bit of a better outcome, then we will give you a bonus. So you still get paid the same, but you might get a little bit of extra, so it’s a pretty low risk entry into the value based care world, and then you move up the continuum a little bit, and you get to what you may call the shared savings arrangement.

Katherine Evans: So, that may be where you and the payer look at your performance over a period of time, call it 3 years and say, you know, you manage this population of patients for the past 3 years, and this is how much it cost. To manage that patient population and then when we’re going to move forward, we’re going to say, if you manage this patient population for less cost, and you create better quality outcomes, then we’re going to share in the savings with you.

Katherine Evans: [00:04:00] So you get 50 percent of. Of the money, we could keep 50 percent of the money. So that’s, you know, thinking of, um, and that those dollars can be what we call at risk. Meaning if you don’t save, you lose money, or they can be what we call upside only meaning you. You get the money if you do well, but if you don’t do well, you don’t lose anything.

Katherine Evans: Right? So, then you move into sort of the end of the continuum. And what we, you know, I think what we all talked about in the nineties capitation was it’s where the buzzword back then. Um, and I think we, we really moved away from that because the way value based care, when you move into what we think of as a total cost of care arrangement.

Katherine Evans: So you’re responsible for the entire. Panelist costs, you’re also responsible for the quality outcomes. So it’s not just saying you have to do well and you have to, you know, come under the cap dollars or you know, it’s sort of the old school way of thinking that. It’s more of thinking I have [00:05:00] this pool of patients and I’m responsible for their total cost of care.

Katherine Evans: And I’m also responsible for making sure they have good quality outcomes. So. It’s not as if there’s a pool of money that’s going to run out at the end of the day and the patients aren’t going to be managed. Right? It’s more thinking holistically about this population. And in order to do any of this, well, you have to have access to the data.

Katherine Evans: You have to know how your population is performing. So, if you can’t see that on a population level, if you can’t get things surface to you in your workforce. daily to know how is this patient performing on this quality open gap in care and how am I going to close that gap in care? Um, how, you know, this patient went to the hospital last week.

Katherine Evans: I need to make sure they get in for an appointment quick so I can, you know, do their medication reconciliation, make sure they have all their followup testing done, all the things that need to happen when someone’s very sick and vulnerable. If you don’t have visibility into that, then you can’t manage it.

Katherine Evans: [00:06:00] So the data, the, um, ability to see the outcomes and how to understand your population holistically are really critically important to the success in value based care.

Erik Sunset: Well, I definitely want to come back to the technology facet of this conversation, but you mentioned earlier on around interdisciplinary approaches, whether it’s physician led or nurse practitioner led and all the different team members that you need to pull off a successful value based care model.

Erik Sunset: Yeah, you’re obviously. Weighing in this equation, not only the care provided, but obviously the outcome, but that outcome can sometimes be dependent on patient actions, either actions that they undertake or that they don’t undertake. So how does that interdisciplinary approach help to manage, you know, what a patient’s doing when they’re not in your practice or not in your facility?

Katherine Evans: So there’s a lot of ways to approach that. One is It’s just having touch points with the patient and sometimes that can be as simple as a text message. [00:07:00] Sometimes it’s a phone call. Sometimes it’s a mailer. Um, but it’s also balancing what are the right touch points so that you don’t overwhelm a patient population.

Katherine Evans: And it’s having the right people outreach. So for someone who may be on the sicker side and need a lot of support. That person may need a registered nurse to outreach. If it’s someone who you really just want to check in on their blood pressure and make sure they’re taking their medication. That doesn’t, that could be a patient engagement specialist, a medical assistant, a care navigator.

Katherine Evans: So there’s different approaches I think depending upon how sick a population is in terms of how you want to get them that outreach. And then it’s giving patients the tools they need. So if you’re trying to get somebody to manage their blood pressure well and they don’t have a blood pressure cup at home, they’re never going to manage their blood pressure well.

Katherine Evans: So it’s getting them the cuff, whether that’s a remote patient monitoring tool where you can actually get all those blood pressures surfaced to you and then you can call them and check on them and get their [00:08:00] blood pressure. Say, wow, Ms. Smith, your blood pressure’s gotten really high lately. We’ve got to manage this medication better.

Katherine Evans: Or you can go low tech and have somebody that’s just writing their blood pressures down and bringing them to you or reading them to you over the phone. It’s important the patients know what their expectations are. I think one of the things we’ve also seen that’s been really helpful in some of our models and value based care is utilizing a health coach.

Katherine Evans: So the health coaches are trained to sit down with patients, create goals, Help them to learn how to be accountable to themselves and really to find goals that are achievable for them. So, oftentimes, I think, as providers, we know what patients should do and we know what we want them to achieve and the health coach does a really great job of breaking that down into achievable bites.

Katherine Evans: that the patient can find success with and really get there on a stepwise approach. So, um, there’s a lot of different ways to go about it. And I think it really starts with understanding your patient population.

Erik Sunset: [00:09:00] That all makes sense. And you mentioned something really interesting there around remote patient monitoring. That if you don’t have access to a blood pressure cuff, then you’re not going to know what it is. Obviously. What’s the, what’s the state of adoption? Um, and this is kind of through the lens that we have a never older adult.

Erik Sunset: American population, um, love our baby boomers. What’s, what’s the state of adoption for remote patient monitoring tech in the homes of, you know, the folks that need this type of care.

Katherine Evans: Yeah. So in our practices, we’ve seen it really upwards of 50 percent for the patients who need it. We find that when your provider says this is what you need to do, they tend to be receptive to it. And then it’s finding. really approachable tools that don’t overwhelm the patient population. Um, and it’s having people who can help onboard the patient when they get, so for example, if they get a box and there’s a blood pressure cuff and a scale in it, and having someone to just to pick up the phone and call and say, you should have gotten your box.

Katherine Evans: Let’s talk [00:10:00] about how to turn everything on, how to put the cuff on your arm appropriately, and you can also potentially send somebody into the home if that’s necessary, or you could train somebody, you know, train the patient and their family in the office as well. I think it’s just taking the time to have that quick extra step.

Katherine Evans: We found that More and more older adults are receptive to technology. Obviously, the pandemic caused a lot of force that forced a lot of people’s hands to understand it better. And you were reaching a place where the baby boomers are the older adults in the aging population. Many of these people. People have used email their entire careers.

Katherine Evans: They’ve been used to sitting on a computer and it’s not necessarily entirely overwhelming. That said, there are still a lot of people where it’s overwhelming. There’s still very real socioeconomic issues around technology and you have to be sensitive to that and think through all of those. pieces when you’re creating a remote patient monitoring strategy and thinking through, for [00:11:00] example, if there’s no Wi Fi in the area, if there’s no cell service in the area, is this going to work and how are we going to support that person if it doesn’t?

Erik Sunset: Sure. Yeah. The very, very real challenges. They’re a very real challenges. They’re coming back to the, uh, the technology of the facet. We don’t want to leave that on the back of the stove for too long. Um, before we started to record, we did a quick, you know, fly by meaningful use and all of its effects on provider workflow and, you know, Uh, certainly a lot of good did come from meaningful use, though, depending on who you ask.

Erik Sunset: They may not feel, uh, totally the same, those on the provider side. Um, What type of technologies or what I guess EHR workflows are the most valuable for practices and for facilities interested in either starting or optimizing their value based care strategy? What, what’s needed? During a normal workflow,

Katherine Evans: I think one of the things we see sometimes with value based care strategies is We ask for [00:12:00] another app to be filled out or another tool to be filled out. And that creates a second place for the provider to have to go in their workflow. And that’s where things start to break down. So when you’re thinking about a new value based care model, the more that you can put everything into the EHR workflow and the provider’s workflow directly, the better off you are.

Katherine Evans: Or if you can create a way where, if something needs to happen outside of that workflow, if there’s another staff member that can help support that along the way, the providers, when they have to step out of understanding what’s happening with that patient in that moment is very, very, very important.

Katherine Evans: Disjointed care and so bringing things all together so that it’s simpler and it flows is really important and I think it’s very challenging. It’s not simple and we know that there’s a lot of interoperability stressors and there’s a lot of [00:13:00] considerations that go into that. And it is, it is important work that needs to be done.

Katherine Evans: So if we can really continue to push on innovation in this space around making these EHRs and the tools that need to be overlaid more integrated and seamless for the provider, I think that if anytime somebody’s creating something the first thing that should come through that person’s mind is How is this going to help the provider’s workflow?

Katherine Evans: And I don’t think that’s how we currently think about most things when we add a new technology. And so we’ve really got to start rethinking and reframing our thinking around how we approach technology for healthcare providers.

Erik Sunset: truer words, never spoken. And the kind of the next thing I wanted to ask you is like the state of the EHR. And there’s really no EHR is that out of the box are going to work for a given practice, a given provider, just as it is. [00:14:00] That’s that’s a given, but state of the industry for some of these apps where you’re overlaying another window onto an EHR, like that’s like at that sentence for provider use cases, there’s already enough. Pick lists and windows to go through just in your core EHR. It sounds like there’s a little bit of work to be done there. What, what are you seeing on that front?

Katherine Evans: I agree. There’s work to be done there. I am seeing some companies that are doing a better job of integrating it into integrating some of these things into the actual EHR workflows. So they’re, they’re not sitting parallel to your point. They’re not another click. They’re not another window, or they may be even a side by side window versus having an extra place to EHR.

Katherine Evans: So I think any. The more we can surface things within that workflow, the better. And to your point, it has to be friendly visually and it has to make sense. So if we’re surfacing a lot of things that are noise, then it [00:15:00] just creates more frustration.

Erik Sunset: Yeah, and there’s certainly enough of that around technology and the provider and, and nurse side of the world right now. Well, if we can, let’s change gears a little bit to a specific care setting. That being the ASC, obviously cardiology and the ASC is a super hot topic with procedures coming off the IPO list, seemingly at a very regular cadence. Um, earlier today you mentioned that the ASC is a great lever that care teams can pull related to value based care. Let’s look at that. What are your thoughts there?

Katherine Evans: So I think the ASC is just a win all around for patients, for payers, for providers. It is a lower cost setting versus the hospital outpatient setting. Sometimes as much as 50 percent lower, depending upon the area. It is a better patient experience. It is what you avoid having to go to the hospital and park in the big deck and pay the 20 parking fee and all the things that go [00:16:00] along with having to go to a hospital outpatient setting versus an ASC setting.

Katherine Evans: And then you have providers who can really customize their workflow because it is a smaller setting where they have the ability to have more customizations and make their provider experience better as well. So from a value based care perspective, it’s a total win from a patient experience and a provider experience.

Katherine Evans: I think it’s a total win. I think that we are seeing, yes, and cardiology is huge for us, and we are seeing a lot of those procedures that had historically been done in the hospital setting. We can now do them very safely in ASC. At Cardiovascular Associates of America, we are advocating payers to look at all of those procedures that we think can safely be done in the ASC to allow us to do those in that setting as well.

Katherine Evans: Um, we feel very strongly it is a great lever. It really is the total package win from our perspective.[00:17:00]

Erik Sunset: And I would tend to agree listeners of the show know we fly the ASC flag very proudly here at DocBuddy. One of the questions I’m curious about your response on, obviously I’m just a spectator in this conversation, but it’s a, it’s a huge point of interest. That at least with Medicare, me Medicare reimbursements at the HOPD are better.

Erik Sunset: Uh, although it bears a higher cost to the patient in that HOPD versus the ASC. Um, and then I believe the study was in a fee for service model in a value-based care model. Is there a way to make up some of that grounds in reimbursement where it’s higher at the HOPD versus the ASC? Like what, how is that held in the balance or what types of conversations are happening there?

Katherine Evans: So when you think about the, from the physician perspective, If you are performing a procedure in the ASC versus the HOPD, the reimbursement is, is more favorable, uh, because of the way their technical [00:18:00] fees are reimbursed. So I think that that’s one thing, one consideration. If you are in a value based care arrangement and you’re responsible for cost of care for a population, the more procedures you’re doing in the ASC, the more you’re lowering the total cost of care for that population.

Katherine Evans: So it really creates. A more favorable outcome for that value based care arrangement because of those lower costs. I think you additionally are starting to see the payer community really latch on to the A. S. C. because of this delta in the reimbursement and. Are really creating very clear strategies on how they are want to drive patients to ASCs for procedures, um, either through prior authorizations, uh, or through, uh, other levers that they have as the payer in terms of what they’re going to pay for or not.

Katherine Evans: Right? So, I think that you’re seeing huge shifts in that regard as well, because of that, that [00:19:00] significant difference in reimbursement that said. There’s always going to be times when things need to be done in the hospital outpatient setting. There are always going to be patients who the outpatient setting at the hospital is the most appropriate place for them because of their comorbid conditions or whatever risk factors they may have.

Katherine Evans: So I don’t think that we will ever see the, I think it will remain appropriate for a subset of patients over, over time.

Erik Sunset: Sure, absolutely. And hopefully that wasn’t too, uh, too silly of a question from a lay person, but it is, it is interesting. Obviously economics are what make all of this work. We’d love to have a perfect utopia where people who need medical care can just go and get it, but that isn’t the reality. Somebody has to pay for it at some point. Um, so diving a little bit deeper into the, into cardiologic procedures in the ASC, can you speak to what’s on the horizon? What’s, what’s coming next? Are we going to see [00:20:00] a floodgates of, uh, cardio procedures come off the IPO list or are we going to hold steady for the rest of the year? What does that look like?

Katherine Evans: I think we’re seeing a very clear shift toward more procedures being approved for the ASC setting. And I think our next, uh, set of procedures will probably be ablations and, and, uh, having the opportunity to have more ablations in the hospital setting is coming. We’ve seen some recent statements from professional organizations and some, you know, recent signaling from payers and I think that CMS will probably more than likely be quickly coming on board as well.

Katherine Evans: So I do think that that momentum has not slowed. I think that it will continue to move toward getting these procedures that are safe to be done in the ASC setting moved there.

Erik Sunset: We can all, uh, we can all hope so, cause this is that, that rare alignment of patient provider and payer, uh, being the ASC and to kind of bounce around a little bit on you. Talk about interdisciplinary [00:21:00] teams for managing care. You got to have a care coordinator, maybe a remote patient monitoring specialist that can help set up equipment, but coming back to the nuts and bolts of procedures in the ASC, you know, tongue in cheek here as a patient, I’m not having any procedures done without anesthesia. What, what pressures are you seeing on cardiology procedures in the ASC with this lack of anesthesiologists, kind of a 10 part question here. If you had a magic wand, what would you do to fix that? What are the options for folks where anesthesia is tough to come by?

Katherine Evans: Yeah, it’s certainly a barrier, I think. I think that one of the, one of the very clear areas is the scope of practice for the CRNAs, the Certified Registered Nurse Anesthetist. I think that’s a role that has been clearly proven as a safe and effective way to provide anesthesia services. And I think that we can.

Katherine Evans: loosen the scope of practice in many states in order to [00:22:00] allow the independent practice for the CRNA. And I think that really frees up the workforce to provide that care in the ASC more readily. It is a, it is a huge issue. We are facing a physician shortage, a nursing shortage, and It’s not stopping much of that goes back to our earlier conversation around technology and burnout.

Katherine Evans: And we have to do a better job of making these professions more attractive and helping to retain the workforce. We have so. I think, you know, in order to get more of the proper specialist, especially anesthesiologists and we really have to think about all those workforce aspects. Uh, but I think if you want to think about it from a policy perspective and a practicality perspective, how could we quickly make changes?

Katherine Evans: I think that’s through policy.

Erik Sunset: Yeah, to your point, to enable CRNAs to practice, uh, independent of an [00:23:00] anesthesiologist, that’s a stroke of a pen, basically, um, that hopefully can ease some of the shortage and some of the, the crunch right now. Do you have any thoughts on getting more folks interested in medical school and going through the process of their residency and their fellowship and then becoming that? Provider that they went to medical school to be, because that, that seems to be like where the real fix is. The policy is one thing, and we should certainly, you know, take advantage of where the stroke prepend can fix a problem. There’s a lot bigger problem. So what do you do about that?

Katherine Evans: Right, so it’s interesting. My daughter’s in college now, and she wants to go to medical school. So I’m in the process of continuing to bolster her interest in that area because I think it’s really important that we have people who are passionate about health care who want to serve patients who go into the health care field, whether that’s.

Katherine Evans: Medicine or nursing or physical therapy. So many different areas that where patients need support. I think that we need to [00:24:00] really focus on helping these really smart people who are excited about healthcare, understand how they can be innovative and how they can bring their own thoughts and ideas into healthcare.

Katherine Evans: And I think we as providers need to continue to push the. Envelope on how we can continue to and how we can help innovate as well. So it’s that said, we need to also have clear focus and clear administrative support from our health care systems and from. Payers and everyone in the space on what it looks like to have a good provider experience.

Katherine Evans: So, but we have to advocate and we have to continue to have our voices heard. Um, I will say one of my frustrations though, is I tend to feel like anytime something goes wrong in the healthcare space, we say, well, let’s let the provider do this, or the provider should do more of this. And I think we often put that.

Katherine Evans: too much back on the provider. So I hesitate a [00:25:00] little bit when I say these things. Uh, that said, I don’t think we’re ever going to get changed without having a collective active voice together.

Erik Sunset: That makes sense. And when you, when you’ve looked at the data from years past, so excluding the present year data, which was reporting on 2023, the top drivers of burnout, and obviously burnout is driving physicians and providers and. Folks in healthcare altogether to retire early and pursue other interests, obviously.

Erik Sunset: So burnout’s a huge problem impacting us today. It was around a lack of autonomy in the role, lack of organizational alignment. Um, and this is in reverse order from three to one, and number one being technology. The current crop of data shows that it is staffing a lack of staff. I’m taking on too many administrative tasks and it’s killing me.

Erik Sunset: I didn’t go to medical school to be my own scribe. You know, all the things that you hear. It’s such a classic health care fix to both throw it back on the provider to figure out. And [00:26:00] when there’s frustration there at the provider level, it used to just be, we’ll just hire somebody, get an FTE in here, don’t care, warm body, they can do it. You can’t even do that anymore. That wasn’t the right way to solve a problem with all of the automation and technology that’s available to the rest of industry. But now you can’t even go back to that classic playbook of just hiring more headcount. So, again, a multi part question here. We gotta do better with workflows and automation and keeping people practicing at the top of their license, to turn the phrase. But then how do you make a hire? Like what’s going on? How come there is no one available to work in facility? Seemingly

Katherine Evans: I have this conversation every day with our practices and with my colleagues and other areas. It is, it is a phenomenal issue how we really are struggling to find the workforce and I think you have to create a setting that’s attractive to people you have to have I think we have to be a lot [00:27:00] more thoughtful than we ever did around culture and what a good employment environment looks like how do we retain the people we have.

Katherine Evans: And with recruitment, really understanding that we have to put together a job profile and a work environment that is conducive to someone feeling good about their day and feeling happy about the work. I do think value based care is a lever here and what you’re talking about, and it is, I think it’s a lever and provider burnout to give the.

Katherine Evans: Provider more control over the dollar and the ability to manage their patient population and create a way to create higher quality care and not have to churn through 35 patients a day. I do think there is a strong desire for providers to have that ability to spend more time with their patients and to.

Katherine Evans: I mean, every person who goes to nursing school or to medical school goes because they want to help these patients. They don’t, that’s really the ultimate [00:28:00] driver. No one is saying, I want to see, you know, it’s, it’s not because I want to make millions of dollars. It’s, I really want to make a, you know, provide the best possible care for the patient in front of me.

Katherine Evans: And I firmly believe that no one is. losing that. They, they really want, and I think that’s why they’re leaving is they’re feeling like the system is not set up so that they can take care of that person in front of them well. And if we can shift these payment models and create a way where the doctors and the nurses have more time to do this work and they can have more staff, interdisciplinary teams that can support it, I think that that really helps as we think about the provider burnout issue.

Erik Sunset: you, uh, you brought us back to the topic. I kind of let us wander off and took us down some, uh, some tangents there, but you, you mentioned culture and that’s, that’s all of it to be able to hire, entertain staff, and obviously with a value based care [00:29:00] approach, like if that is the, the core of what you’re doing, as opposed to fee for service, I would imagine there’s some inbuilt inbuilt. culture there too that we’re working towards a really big goal. To your point, not to see 35 patients every day until I retire, but we’re like actually trying to do some good here. How do you see that play out in practice?

Katherine Evans: Absolutely. I think when we look at value based care teams, they’re very mission driven and they get very focused on how do we come to work every day and create the best possible outcomes for this patient population. These interdisciplinary teams have the benefit of data. They have the benefit of seeing these outcomes very clearly in the population health dashboards and the work that comes in front of them each and every day.

Katherine Evans: And they have the benefit to have frankly, some great patient stories and the patients very clearly. are able to articulate the difference when they are being treated in a [00:30:00] value based care model. I’ll give you a very simple example. We have a heart failure program, and we had a patient in the heart failure program, and she said, I just appreciate that I know who I can call when I need help.

Katherine Evans: It was that simple. That one thing really made a huge difference in her life. She felt like, prior to being part of this program, she really didn’t know who to call when she needed something. So it’s small things that these value based care models create, and it creates a culture where people come to work and feel really good because they know that patients are getting the care that they need.

Erik Sunset: Yeah, that’s a, that’s a big difference from the production line, uh, of days past in terms of fee for service. Katherine, you, you can’t be a guest on the DocBuddy journal. If you don’t answer a question or two about AI and healthcare, I’m going to leave it really open ended. What are, what’s the current sentiment for you in terms of artificial intelligence [00:31:00] or so called artificial intelligence and healthcare?

Katherine Evans: So this is where I think about, That earlier conversation around the voice of the provider and we are in a very unique place and time where this technology is coming and we can figure out how we want to have our voices heard, understand how we want to create the direction for it and be clear and what we think it can provide as a value add versus a detractor and another place for noise.

Katherine Evans: And. I think without that clear voice saying, how will this make the provider experience better and how will this create better outcomes for patients? I think we have a very real risk of this being another meaningful use place where there’s just a lot more noise. And so. I think this is obviously up here to stay.

Katherine Evans: [00:32:00] I is not going away and we need to be thoughtful. We also need to make sure that when things are happening are implemented around that they’re safe and I don’t know that that’s entirely clear for everybody right now and. I’m hearing people coming to me every day saying, I can give you an AI nurse and the patient even never even knows that they’re not talking to a real person.

Katherine Evans: So, things like that scare me a little bit without a lot of safety checks behind that. And, um, I think we’re gonna need some very clear standards around how things like that can be implemented and how they are monitored and how we are clearly ensuring that these. strategies are safe for patients and that there’s clear oversight in these types of models.

Katherine Evans: But that said, I think there’s actually a lot of good that can come here and I think that the, the good can come [00:33:00] if we have the right people at the table, um, as things are developed.

Erik Sunset: It’s interesting that you, that you frame it that way. There’s. There’s very few consumer protection laws on the books for the use of AI, uh, in general. And there’s like next to nothing being proposed or drafted around patient safety in AI. And I’m, I’m hopeful it isn’t going to take something awful happening to end up with those laws. And I’m on the record saying this over the last year, you know, I’m not one to generally hope for any type of legislative guidance, but it almost seems like we were at a place where we could really use some of it. You know, from our perspective as a technology vendor in health care, there is a lot of noise to borrow your phrase.

Erik Sunset: There is a lot of noise. Hey, I can do this. Hey, I can do that. And maybe it can’t. But I think to your point, the best use cases will be those that reduce provider workload, what those are, what remains to be seen. But there’s, uh, there’s a [00:34:00] lot of a lot of reason to be excited and hopefully we can avoid that meaningful use. What would it be? Stage 5 now. We’re out of macro MIPS, uh, kind of on the tail end of those, uh, uh, integer versions of it. Um, but a lot of reason to be excited too, though.

Katherine Evans: I agree. I agree. I think it’s a huge opportunity and with the right care and thought that in people using the right clinicians at the table to help make these decisions, I think it can be very powerful to help patients and providers.

Erik Sunset: Well, Katherine, we’re kind of at the tail end of our conversation. Is there anything we didn’t cover that we should have?

Katherine Evans: I think that I would just love to put in a last plug for value based care in the specialty space. I think that, you know, 80 percent of disabilities. Spend in this country is specialty care spend and most of value based care has historically been in the primary care space. I’m very excited to see this trend [00:35:00] where we’re shifting more of these models into the specialist world.

Katherine Evans: I think it’s a great opportunity for providers and patients to improve quality of care and really have the best outcomes for patients and providers.

Erik Sunset: I love that. And I’m glad there’s folks like you working on this. Uh, there’s a lot wrong with healthcare in the U. S., but there’s still a lot that’s going right and that can go even more right. And I think value based care is one of those things.

Katherine Evans: I agree. Thanks so much, Erik.

Erik Sunset: You are so welcome. And before you go, are there, where can listeners find you online? Are you active on any social medias or your website?

Katherine Evans: Sure. So you can find, um, cardiovascular associates of America or cbausa. com. You can find me on LinkedIn, Katherine Abraham Evans, and on X at Katherine Abraham, I’m sorry, at K Abraham Evans.

Erik Sunset: We will be sure to include all of those handles and the link to the site in the [00:36:00] show notes. And on behalf of the entire DocBuddy team, thank you for listening. Be sure you’re subscribed on Apple podcasts, Spotify, and YouTube. So you always get the newest episodes of the show until next time. I’m your host, Erik.

Erik Sunset: Talk to you soon.