How AI Orchestration Changes Care Delivery

[00:00:00] Erik Sunset: Inside America’s hospitals and healthcare facilities where critical patient information is still moving by fax machine and by pager, doctors and nurses are forced to play telephone while patients wait for care that should already be there. Today, we sat down with the man trying to fix it, 25 years as a physician, now leading the AI orchestration revolution at TigerConnect, Dr.

Pete Stetson. The burnout, the bottlenecks, and the billions on the line. I’m Erik Sunset. This is the DocBuddy Journal, and our conversation starts right now

Erik Sunset: Okay. Hello and welcome back. I’m Erik Sunset, your host of the DocBuddy Journal, and today we’re joined by Dr. Pete Stetson. Dr. Stetson is the chief medical information officer at TigerConnect, TigerConnect is the AI-powered healthcare orchestration platform. Dr. Stetson, thanks for joining us.

Dr. Pete Stetson, MD: Thanks so much for having me on, Erik. I really appreciate the opportunity[00:01:00]

Erik Sunset: This is gonna be a great chat, very juicy. AI remains, you know, one of the hottest topics in healthcare. We finally moved past the days of COVID-19 dominating all headlines, although that is still out there. before we dive into the, to the bones of the show, to get started, what do listeners need to know about you and your work at Tigerconnect?

Dr. Pete Stetson, MD: Oh, thanks. So I’m a physician by background. I’m trained in internal medicine. I practiced as a primary care provider and as a hospitalist, uh, all through my career, twenty-five plus years as a clinician. And, uh, I also am trained in informatics, so I, uh, you know, did a NIH postdoc in that area and, uh, starting in the early 2000s, uh, really did a ton of work in informatics, um, around healthcare communication, around decision support.

Dr. Pete Stetson, MD: Uh, I came up through the, you know, [00:02:00] leadership ranks and, uh, was CMIO at Columbia Doctors for a bunch of years. Uh, built their quality program with digital stuff, became their chief medical officer, and then I joined Memorial Sloan Kettering as the chief health informatics officer in 2015, so I was there for about ten years.

Dr. Pete Stetson, MD: Um, there I ran the EHR. I helped install our, uh, new EHR. We did two smart building installs while I was there. A lot of patient engagement and patient-reported outcome work. Um, uh, led, uh, business insights functions and, uh, lots of digital initiatives around AI. I oversaw the responsible AI governance work at Memorial Sloan Kettering, and at the time that I left, we had about a hundred models in play in various stages of their life cycle there.

Dr. Pete Stetson, MD: I joined Tigerconnect because, uh, there is still this unsolved problem out there of [00:03:00] orchestrating the care team to communicate effectively to help patients get the care they need. Uh, I was drawn to it, uh, because of the mission, and our mission is, uh, uh, improving the lives of patients and the, and, and the care teams that care for them.

Dr. Pete Stetson, MD: And, uh, so I’ve been with Tigerconnect for about a year now.

Erik Sunset: That’s great. And one of the things I’m most excited about, uh, about our discussion, Dr. Stetson, is that none of this is theoretical for you. It’s all practical. You’re, you’re a physician. You’ve got the bona fides on the data and the AI side and the informatics, uh, work that you’ve done. And I think one of the places that would be really useful to start for our listeners is what is AI orchestration as it relates to healthcare?

Dr. Pete Stetson, MD: Yeah. So, uh, there’s two parts to that. There’s, uh, the concept of orchestration, and then there’s the concept of AI to power that orchestration. And, uh, as you know, and I’m sure many of your listeners [00:04:00] know, they’ve been a patient, they’ve had a, a parent who’s gone through a healthcare journey, they’ve got kids who’ve gone through healthcare journeys.

Dr. Pete Stetson, MD: You feel it when we in the healthcare system are disorganized and not communicating with each other effectively. Uh, as you know, medical errors are very commonly caused by communication problems. And then there’s some really, uh, y- you know, insidious communication challenges that really block effective care.

Dr. Pete Stetson, MD: Uh, you know, if you’re trying to coordinate visits, uh, and get to the hospital, and if you have to devote a whole day to get to the doc, the last thing you wanna hear is, “Oh, we don’t have the records yet from the cardiologist that we consulted,” or, “We don’t have the results necessary. You, you gotta go across town, go and get a r- a, a CT scan and then come back.”

Dr. Pete Stetson, MD: Uh, like that kind of [00:05:00] disorganization Still is a persistent problem in healthcare. You guys all feel it. Um, so orchestrating that, meaning knowing who’s supposed to do what when, and activating the right members of the care team at the right time, making sure that the stuff that the nurse needs to do goes to the nurse but not to the doc, and the stuff that the doc is supposed to do goes to the doc, not to the nurse.

Dr. Pete Stetson, MD: And there are many other people on the care team, uh, medical assistants, schedulers, pharmacists, supply chain people that are delivering the drug to the floor or to the pharmacy. All of this needs to be orchestrated, not just connected, but orchestrated so that there’s a system of activation behind the care team, behind the scenes, enabling the care team, not putting the members of the care team into being in the middle of a [00:06:00] huge game of telephone.

Dr. Pete Stetson, MD: We call that the, the middleware condition. We do not want our doctors and nurses and care team members serving as middleware. Uh, we have a whole, uh, concept that we need to fix in healthcare about clinicians should not be middleware. The AI piece is adding on top of that orchestration capability, agentification that takes the, uh, work of connecting the digital switchboard out of the hands of the clinicians and the care team members so that that work flows at scale across the entire health organization.

Dr. Pete Stetson, MD: The result is faster time to diagnosis, faster time to interception of alarm conditions, better patient experience, improved ROI for healthcare systems, uh, and, uh, frankly, a better, uh, clinician [00:07:00] experience and reduced burnout. And, uh, the technology is here today. The orchestration of it is the challenge.

Dr. Pete Stetson, MD: And so that’s what we refer to

Erik Sunset: Uh, uh, th-that, that hits my ear and it, it sounds in a way, and maybe the, those with their textbooks open and the academics can correct me on this, but this really sounds like the final mile of access to healthcare for patients in, in a lot of ways. I mean, you may, you may have a great insurance plan, you may be able to afford the care, uh, but to your example, if the records aren’t in front of the provider, “Oh, you had imaging done.

Erik Sunset: We don’t have it. Come back when you have it, or we’ll let you know when we get it.” That’s brutal as a patient, and especially if you’re caring for a parent or a child, that’s just not the way that it should be, right?

Dr. Pete Stetson, MD: Yeah, exactly that. And, you know, the expertise of healthcare is divvied up. You know, the cardiologists are over here, the surgeons are over there, the oncologists are over there, the anesthesiologists are over here. Uh, they… [00:08:00] For an effective care journey for a patient, those different members of the care team need to be talking to each other at the right time, so not scrambling when the patient shows up in the emergency room or not scrambling when the patient shows up in clinic.

Dr. Pete Stetson, MD: That should all be– That communication should be orchestrated. And by the way, most health systems are very fractured on this. Um, it’s a, you know, they’re- they’ve got Microsoft Teams, they’ve got Zoom, they’ve got, uh, pagers, still pagers from 1970s. They’re still out there. They’re, uh, you know, fax machines.

Dr. Pete Stetson, MD: You know, like the, the… This is very fractured still and merits a consolidation, a technology consolidation, harmonization, and application rationalization. And, uh, this is a new frontier. And in doing that, we get to that last mile of activating the right person at the right time with the right patient context in the right [00:09:00] setting with the right recommendation.

Dr. Pete Stetson, MD: And that’s what I think you were referring to with the last mile.

Erik Sunset: It is. It is. And if we can go down memory lane here to 2009 when, uh, the HITECH Act came into law as part of ARRA 2009. I mean, this sounds to me like AI orchestration at this level is making good on that promise of interoperability. And I’m, I’m an EHR absolutist. I think, I think we need them. I think they could be better.

Erik Sunset: Spent a long time in the space. I’m not here to apologize for them because there’s a lot to, to… that remains to be worked on. with what you just said, this, uh, this fractured ecosystem, and you took the words out of my mouth about facts. Maybe I’d add in smoke signal as well for going all the way. Uh, but this is something that we were supposed to have

Dr. Pete Stetson, MD: Carrier pigeon. I mean, it’s, you know, there’s a lot of, uh, legacy tech out there. Yeah

Erik Sunset: But this is something we were supposed to have had, you know, 15 years ago, and we just don’t. We don’t need to get into the nuts and bolts of, uh, you know, private vendors building their own softwares, and [00:10:00] of course, they’re gonna have difficulty talking to each other. But as a cohesive system, it’s a shame that we don’t already have this, and it doesn’t seem that there’s one silver bullet to fix it, though, either

Dr. Pete Stetson, MD: Yeah. So, um, there are, uh, efforts, uh, certainly within our company to build a, a platform-based approach so that there’s a core hub on which you can enable these workflows, uh, and get the, you know, the ability to go very quick from idea for workflow improvement to workflow deployment and activation of the, the right roles and teams to do this.

Dr. Pete Stetson, MD: And, uh, that’s something we’ve been investing in, and a number of other companies have been as well. And let me take this one step further for you. Imagine, um, you know, hospital A is building a new tower, a new pavilion. Guaranteed that that organization is thinking to themselves: How do we make [00:11:00] this new tower a differentiating capability with our competition across the street?

Dr. Pete Stetson, MD: Uh, how do we make this a destination for our patients? How do we make this building and the rooms within it part of the care team, as opposed to a shell that the patient has to survive being transported around? You know, h- so if you actually go into a patient’s room these days and you look around, you’ll see physiologic monitors.

Dr. Pete Stetson, MD: You’ll see the bed, which is a smart bed. You will see a video that in some cases is monitoring patients that are high fall risk. You’re gonna see microphones, uh, where the patients could actually activate the nurse to come without having to fumble around with buttons, you know. So the rooms themselves are now becoming part of the care team, and [00:12:00] they are sending signal.

Dr. Pete Stetson, MD: So our docs and nurses are getting not only, you know, human-to-human beeps and boops, but the room is creating beeps and boops, and that all has to be orchestrated. Um, there’s a huge opportunity there to consolidate and streamline when those signals, uh, go. And, uh, take that step one step further, that r- that actually, uh…

Dr. Pete Stetson, MD: We have a risk in our industry of creating additional cognitive burden for our nurses and our doctors because of all this tech that’s in the room. Um, so, uh, what I like to say is we should be in the business of anti-spamming, not spamming. And, uh, so that’s… We actually need to take down nuisance alarms and nuisance alerts, build some quiet, so that, uh, nurses and docs can be at top of license and patients are experiencing the best [00:13:00] care journey that they can.

Erik Sunset: Everything you just said is, uh, is, is pulling a parallel out of my brain with what we’re, uh, the conversations we have with prospective customers at DocBuddy, and I would imagine it’s some of the same at Tiger Connect. Uh, we obviously offer vastly different, uh, solutions to healthcare, but what we’re, what we talk about is that your status quo, the thing that you’ve always known, and it, it works okay, and maybe you wanna throw more people at the problem, if you can hire them, if you can retain them.

Erik Sunset: That doesn’t really work anymore. But your status quo is actually the very old way. To our earlier points on fax and, and beepers still being in use, I mean, you’re in, you’re in good company with, like, the federal government on that, and I’m not sure that that’s the shining city on the hill you wanna be compared to. So when you’re bringing this discussion to, um, to market, are you getting a similar reaction of, “Oh my gosh, I didn’t even know you could do that”? Like, “That’s possible?”

Dr. Pete Stetson, MD: Yeah. Um, we are, and, uh, and some of the observations [00:14:00] that we encounter when we talk to our customers is that there’s a lot of communication tech in their ecosystem. Uh, uh, and there are some roles that you might not actually think of initially as part of a rapid response function. So we specialize in, you know, uh, stroke activation, heart attack activation, sepsis activation, as well as non-emergent communication.

Dr. Pete Stetson, MD: But the… Even the operator, the hospital operator has a very key role in get– when, you know, a nurse goes into a room and a patient is having a heart attack or a stroke or a code blue, you know, cardiac arrest, most hosp- lot of hospitals route that through a page operator still or an operator function.

Dr. Pete Stetson, MD: That means the operator is part of the care team. So when you think of it that way, uh, you really need modern tech that connects people [00:15:00] in their role at that time. Uh, it means you need to know who’s on call. It means you need to know who fills the neurointensivist care team, uh, roles and, uh, responsibilities.

Dr. Pete Stetson, MD: Who’s on on the weekends, who’s on at night. Like you, you, you have to orchestrate all that stuff to really deliver right care at the right time

Erik Sunset: Talk about being at the, at the switchboard, you know, without modern tech, how are, how is somebody looking all that up? You know, the, the pager operator as part of the care team, either they probably have a lot of it committed to memory, and I know they serve a really important role, but

Dr. Pete Stetson, MD: Ja

Erik Sunset: that’s a critical failure point potentially

Dr. Pete Stetson, MD: And today, if you go around to hospitals, you’ll see some pretty antiquated tech in that context of a lot of what we call swivel chair work. So the operator is hitting, uh, you know, they get, they got the phone system on one screen. They’ve got, uh, like a protocol of who to activate in emergency situations on screen number two, and they have four different [00:16:00] schedules up on the other four screens of, you know, the, uh, the cardiology depart- division and the surgery department.

Dr. Pete Stetson, MD: And, you know, it’s just a lot of swivel chair stuff that’s still out there. And, uh, so we, you know, at least in our organization, are enrolling that role onto the care team and building unified communication capabilities. We call it operator console, but, um, you know, contact center is another way to think about it.

Dr. Pete Stetson, MD: But as such, it, yeah, actually, that took me a while in my progression of my career to understand how broad the care team actually is when you’re talking about an urgent or emergent situation that needs to be activated right away. Um, the other place, you know, to your question, that we see ahas is in the smart room space.

Dr. Pete Stetson, MD: So hospitals typically have a plethora of, uh, vendors [00:17:00] and applications in rooms of the future. And, uh, so the nurse call system, which, uh, you know, is the stuff… It’s activated by the pillow speaker buttons, for example, or the pull cord. That’s one set of vendors. There’s the physiologic monitors for the, you know, cardiac monitors that you might put a patient on.

Dr. Pete Stetson, MD: There’s the bed alarms in the smart beds that warn when a patient who’s high fall risk and on falls precautions are starting to wiggle and get out of the bed. Those don’t talk to each other un- uh, unless you have a solution that orchestrates them, um, and with AI rules knows, “Okay, hey, man, uh, this patient’s on high fall risk.

Dr. Pete Stetson, MD: They’re moving around. They, you know, two weeks ago, they had a fall with injury,” [00:18:00] so you need to know a little patient context. Uh, “They’re on a antiplatelet med, so they’re high risk if they fall to bleed. Uh, so injury, uh, you know, the likelihood of injury is pretty high for this person, and they are on the edge of the bed, uh, because five minutes ago they pressed the button that they needed to go to the bathroom.”

Dr. Pete Stetson, MD: Like, that should be intercepted right away, you know? So th- when we talk with our customers about the possibility that that kind of stuff could be orchestrated, noise like, uh, “Hey, I want, you know, to order my food for tomorrow- can come off the nurse’s plate and go straight to the, um, you know, the nutrition service.

Dr. Pete Stetson, MD: Uh, and then you have this they’re about to fall event that can be boosted. Like, when you talk about integrating this and orchestrating this in the smart room, people start to think, “Oh, yeah, our smart building investment could actually [00:19:00] be, uh, an agent of improved care.”

Erik Sunset: Totally. Th-this is more of a point of interest than anything, and obviously the, the types of procedures are vastly different between a surgery center or an HOPD versus inpatient like we’re, we’re talking about. When it comes to smart rooms, are you seeing that surgery centers are adopting what they need?

Erik Sunset: Obviously, it’d be a different set of criteria. Or are they lagging a little bit behind these true smart rooms that you’re describing?

Dr. Pete Stetson, MD: Well, so we see actually, uh, a lot of, um, interest and avidity in early uptake actually in the operative theater and in the periop space.

Erik Sunset: Mm.

Dr. Pete Stetson, MD: at least in our experience, my experience, both in my prior job at Memorial Sloan Kettering and in my, in my role at, uh, TigerConnect now, working with lots of different customers.

Dr. Pete Stetson, MD: There, uh, the OR and getting patients into the OR, getting the surgeon there, but not too early before the patient’s really ready. [00:20:00] Uh, surgical supply, making sure you have the right supplies in the OR. Our, our healthcare organizations are particularly interested in, uh, quality and throughput. And, uh, so this technology that, that, uh, we’re talking about here today, this orchestration capability, has very strong positive ROI proof points in the periop space.

Dr. Pete Stetson, MD: So kinds of metrics that we’re seeing improvement with this orchestration around our first case on time starts. Uh,

Erik Sunset: Huge

Dr. Pete Stetson, MD: as you know, it’s huge. I’m sure you talked about this with other, uh, folks who’ve joined you on this call, and your listeners know, you get behind on the first case, the whole day goes downhill, right?

Dr. Pete Stetson, MD: Um, it’s not recoverable. And, uh, what else you want to avoid? You want to avoid having to have your surgeons come in on Saturday mornings and Saturday nights. Like you wanna fill those ORs. Um, you wanna build capacity. [00:21:00] Uh, surgery is a, uh, is a financial driver, uh, for organizations. So the… You cannot tolerate delays in the periop space.

Dr. Pete Stetson, MD: So, um, what kinds of things that we work on are getting all that stuff orchestrated and then notifying the surgeon that, you know, “Patient ready, come on down,” but not before, right? So that they can do what they need to do, like round or do administrative work or some of their research work or what have you.

Dr. Pete Stetson, MD: So their time is, you know, respected and more valued, uh, both in and out of the operating theater. Um- You know, like, uh, so there’s so much opportunity, and we are seeing a lot of positive ROI proof points in the periop space. This is true for our customers that are same-day surgery as well, where they’re ambulatory surgery centers.

Dr. Pete Stetson, MD: Um, we did something like this, uh, in my prior job as well, where, uh, activating the [00:22:00] patient on the care team and knowing through, uh, RTLS technology, uh, location technology, are the patients up and moving around as a measure of discharge readiness. If they’re still in the bed, they’re probably not ready for discharge.

Dr. Pete Stetson, MD: Uh, and if you have a twenty-four-hour window to get them up and home safely, you gotta know that they’re up and moving around post-op, right? So, like, you can orchestrate all of this. You can use these signals to identify opportunities for throughput improvement in the periop space. There’s a, uh, our– There’s a huge opportunity in this space, and we are seeing our operative and perioperative customers adopt and, uh, seeing really strong ROI, uh, that comes out of it

Erik Sunset: Believe it. I mean, you said the magic word a moment ago, time. Time, time, time. And I, I wanna– We’ve kind of danced around it. We’ve, we’ve been adjacent to it. But this physician does middleware piece, the, the impact on, [00:23:00] uh, not only operational efficiency, so surgical throughput, whether you’re inpatient or outpatient, same-day surgery. then the impact on, uh, providers, care teams, everybody involved in healthcare, like burnout is such a major factor. when you see, uh, orchestration at, at this level, what is the impact on providers’ feelings of burnout?

Dr. Pete Stetson, MD: Yeah

Dr. Pete Stetson, MD: it’s significant. Um, we, uh, we deploy a number of tools for measuring this with our customers, uh, as part of the, uh, value and ROI program that I’ve been leading in the organization. And, um, uh, so one of our customers, um, w- the, the major effort was focused on reducing nuisance alarms. Uh, in the literature, in the scientific literature, it’s well established that nurses suffer from a large volume of [00:24:00] nuisance alarms.

Dr. Pete Stetson, MD: Um, it could be the battery on the smart pump is running down, and it starts beeping in the room. It could be that this old defibrillator down the hall is not charged. Uh, who’s supposed to, you know, who’s supposed to fix that? Is the nurse really supposed to fix that? Like, that should go to, you know, biomed and facilities team, right?

Dr. Pete Stetson, MD: Um, so there’s a lot of, uh, cognitive burden, and we’re making it worse by adding more devices that beep and boop. So, uh, there’s a quantifiable benefit to de-noising. Um, and, uh, so we believe that a core part of measuring ROI for customers should and must, must include, uh, assessing the impact that this technology has on burnout, cognitive load With the goal of actually improving workforce [00:25:00] resilience.

Dr. Pete Stetson, MD: One of the ways that we measure this, for example, is how much extra time does a nurse or a doc have to spend at the end of a shift reconciling and communicating all of the undone to-dos that, you know, uh, that actually adds up for overtime for health systems, for nurses. So the hard ROI on that is reducing overtime.

Dr. Pete Stetson, MD: Another hard ROI for this, uh, around this is, um, you know, avoiding nurse burnout. Um, staff assist is a key emergent, you know, like, uh, the unruly patient, uh, and s- the uncivil patient. The, the rates on this have been skyrocketing over the last few years. That really contributes to a sense of, um, burnout among nurses, for example.

Dr. Pete Stetson, MD: So being able to orchestrate rapid response for staff assist requests is a core use case that, uh, we s- we support. And, um, you know, [00:26:00] the money, the money shot is there. Like, if you lose docs, you lose nurses, or if you have to pay nurses overtime, the, uh… This, this is, uh, this is quantifiable cost for organizations due to the churn of staff.

Dr. Pete Stetson, MD: Like, you lose expertise, and then it takes three to six months to hire a replacement. That’s all quantifiable ROI these days. Um, so this is a huge area, um, and, uh, uh, one that merits a lot of focus. Um, we measure, um, satisfaction and ease of use, and increasingly we’re measuring cognitive burden as part of our deployments with our customer partners.

Dr. Pete Stetson, MD: There are standardized instruments to do this, and, um, we use them

Erik Sunset: That seems to be sort of the unspoken factor, and I haven’t looked at any recently, but going back to pre-COVID, a lot of the key self-reported drivers of burnout from [00:27:00] physicians was around bad tech, legacy tech that doesn’t work, um, administrative headwinds, lack of autonomy. all carried forward post-COVID, but it is that lack of staffing that is the number one reported driver right now. not sure that I’ve ever seen cognitive load listed on these reports. I know that’s a major factor, and I’m not, I’m not disputing anything that you’re saying. But I would imagine that makes an asymmetric difference because when you look at some of the, the newer reports about what healthcare organizations, namely hospital systems, are doing to reduce sentiments of burnout, the solution that I saw, I kind of rolled my eyes at this, and you’re the perfect person to ask, but it was health system-sponsored, like, not group therapy, but discussion sessions and roundtables about how bad your burnout feels.

Erik Sunset: And they have gotten results with this, just talking it out, evidently. Uh, I would imagine lifting that cognitive load or lightening it or de-alarming, as you say, uh, plays a huge [00:28:00] role in just your day-to-day wellness, though. What do you

Dr. Pete Stetson, MD: Yeah. So I, I agree with that, and many organizations have established, uh, you know, uh, clinical staff, uh, wellness programs. Um, the evidence shows that digital technology, uh, is a part of what drives burnout, at least among physicians. But you made the point earlier about how important time is. Uh, one of the…

Dr. Pete Stetson, MD: Actually, um, a predominant driver in the literature for physician burnout is lack of autonomy and control over one’s time. So what our company, uh, really focuses and drills in on is time savings. Um, and, you know, with our capabilities, what we’re seeing is roughly a twenty-five percent reduction in the amount of time it takes to do the activities of care team communication and orchestration.

Dr. Pete Stetson, MD: And, uh, you know, there’s– [00:29:00] Overall, when you add, uh, time savings, uh, throughput, quality improvements that can be traced to hard ROI dollars or incentive dollars, uh, we’re averaging about one point five million dollars of true return on investment for our healthcare organizations for roughly an average five hundred-bed hospital.

Dr. Pete Stetson, MD: So time given back and reallocated or time given back for managing your work or work-life balance is probably the central, um, the central, uh, deliverable to effect change around burnout. Um, cognitive burden is part of that, but ultimately that’s because it takes you longer to do something than it really should.

Dr. Pete Stetson, MD: It really comes back to that time piece that you were just talking about, and we’re all about time savings.

Erik Sunset: You’re preaching [00:30:00] to the choir there, and what, what we found and what, uh, what sort of the new health tech vendors are seeing across the space, you know, we talked to, talked to a lot of them, is if you can improve the use of physician and nurse and overall care team time, that’s a, that’s a net benefit, obviously.

Erik Sunset: Less burnout being one of the core factors there.

Dr. Pete Stetson, MD: Yeah

Erik Sunset: there’s a really cool second order effect that generally, and depending on what you’re talking about, but generally the facility’s revenue cycle accelerates as a result of that as well. More time for patient care. There’s, there’s no reason not to address physician time. You know, if you’re a new entrant to the health tech space, that would be the place to look. You can make the most impact and deliver the most value in ROI just by addressing the use of physician time. At least from my seat, that’s what it seems like.

Dr. Pete Stetson, MD: That and, uh, the evidence is starting to show that, um, technologies like Ambient is helping, uh, with efficiency. Uh, it’s also helping in adequately documenting the complexity of care that our providers [00:31:00] provide, truly recognizing how complex some of these multi-morbid, multi chronic patients are to manage, and it helps us track that complexity.

Dr. Pete Stetson, MD: That’s where some of the benefit of Ambient comes in. For nurses, um, in our experience with the smart room capabilities that we support with our customers, you know, documentation is a huge burden for nurses, and it is different than physicians. So physicians, you know, we have our soap note. Nurses document on flow sheets, very structured, different workflow.

Dr. Pete Stetson, MD: Uh, Ambient has been a little bit slower on the nursing side to develop capability, but we are starting to see how that works. For us, uh, one of the core components of managing patients for through their hospital stay and getting them home safe with a plan to prevent readmission is providing [00:32:00] good patient education, starting at admission, all the way through to, “Hey, here’s what you do with all your tubes and drains that you got installed, and this is when you come back to clinic, and this is what to watch for, and these are the side effects of your medications.”

Dr. Pete Stetson, MD: Enabling, uh, patient education documentation automatically by what the nurses are talking about with the patient is a new workflow that we support. Don’t have to hit the keyboard. It goes back into the system of record. But the system of activation, the one that is connecting the patient and the nurse, the, the kind of stuff that my company supports Can write back to the system of record and, uh, we’re seeing that that’s saving upwards of ten minutes per shift per nurse every day, all day, thousands of nurses in a 500-bed hospital, you know.

Dr. Pete Stetson, MD: Like, that is huge, uh, capital [00:33:00] that you can redeploy, uh, you can avoid overtime, so there’s real hard ROI. And what we’re seeing with modern smart room technology, which again, we support, is integrating the virtual nursing experience. So a lot of that patient ed can be handled by virtual nurse, uh, so the primary nurse can hand that off and, uh, take the next admission, deal with the unstable patient down the hall.

Dr. Pete Stetson, MD: Uh, that has a huge ROI on, uh… And that itself has an anti-burnout effect because a lot of more senior nurses are, you know, looking for a little bit of time that’s a little bit less stressful with their high acuity patients, and this is a huge benefit. We orchestrate all of that, so the virtual nurse turking– ta-talking to the primary nurse and, um, that’s a huge, huge domain of ROI, uh, impact, and improved experience.

Dr. Pete Stetson, MD: Better for the patients too.[00:34:00]

Erik Sunset: We can’t forget that. That’s the,

Dr. Pete Stetson, MD: Ja

Erik Sunset: center of the universe. But that, that amount of time savings adds up very, very

Dr. Pete Stetson, MD: Very fast with a very strong hard ROI proof point. Yep

Erik Sunset: So I think we’ve got time to, to turn our focus to one sort of last meaty topic here, Dr. Stetson, and that revolves around, uh, AI orchestration readiness. What we talked about before we started to record. Not every solution needs an AI solution, although sometimes the best solution is an AI solution. are your words to the wise there? If there’s a healthcare organization out there listening, and we, we know they are, you know there’s a better way. You see it’s all disjointed, faxes, carrier pigeons, all this information flowing. Team members don’t know what to do. So there’s a problem that’s recognized, but again, that’s their status quo. What’s the first step somebody should take to look at this the right way?

Dr. Pete Stetson, MD: Yeah, that’s a great question. So, um, you know, there’s a long tradition [00:35:00] of, uh, digital interventions dying at the pilot stage. Uh, I call this pi– this condition, it could be called pilotitis. Uh, you know, and the treatment for that is, um, a couple things. One, evaluating your pilots with exit criteria that you specify up front for when you would take a pilot to full scale.

Dr. Pete Stetson, MD: Another, uh, is having the members of the team that are experienced in scaling technologies, uh, because it’s people, process, and tech. Tech’s last. It’s the change readiness, the change management. It’s the new workflow process mapping, uh, because you’re changing something in the environment for the busy clinicians, and they don’t like change.

Dr. Pete Stetson, MD: And so people, process, and then the tech flows. [00:36:00] But having a scaling function for transformation of a pilot into a full, uh, a full deployment is absolutely critical. Um, the… You know, in my experience working on, uh, responsible AI governance, uh, you know, our, our concepts, the, the concepts we employ, uh, both in my prior organization and in my current organization are, uh, what we call promoting responsible AI.

Dr. Pete Stetson, MD: So– And there’s– those two words are very consciously chosen. One is you gotta be responsible with the AI Um, the model needs to be monitored. You know, whatever model you’re using needs to be built well, make transparent recommendations, and then also monitored. But at the same time, you don’t wanna slow down innovation.

Dr. Pete Stetson, MD: You want to promote the use of the wise, uh, wisely deployed AI, and they really do have benefits. Uh, for example, [00:37:00] uh, we have a scheduling function, as you may imagine, to know who the right person to contact for, uh, “Hey, this patient’s having a stroke.” You gotta know who’s on the schedule for the stroke team, uh, in order to act– for the system of activation to activate the right person.

Dr. Pete Stetson, MD: Um, but if you look one lens out, there are probably hundreds to thousands of people creating all sorts of different schedules across your organization. Some in Excel, some in an application, some on a whiteboard, grease board, what have you. Um, digitizing that is critical so that you have the information available.

Dr. Pete Stetson, MD: But what we’ve also learned is it actually takes a long time to build those schedules. If you have a hundred-person department and you gotta equitably allocate holidays and weekends and, uh, make sure that there are no coverage gaps for the [00:38:00] cardiology team and the stroke team and what have you, it’s a complex build of those schedules.

Dr. Pete Stetson, MD: So we invested in AI to take down the pain of building the schedule, and we’re seeing a seventy– sixty to seventy-five percent reduction in the amount of time that it takes to build a whole year’s schedule for, uh, you know, twenty different specialty, uh, divisions. Um, that’s a huge time savings ’cause that person, instead of spending time building a schedule, can work on, “Hey, how could we make access for patients a little easier, uh, by getting their outside records in before the first visit?”

Dr. Pete Stetson, MD: Instead of working on the s-back-office stuff of scheduling the doctors that are gonna be in clinic that day, you know. So, um, uh, there’s– So getting AI, uh, [00:39:00] into front of office, back office use cases that hit on throughput, efficiency and quality and don’t get stuck in a pilot phase because of lack of attention on exit criteria and change management is the way to go on that promotion word.

Dr. Pete Stetson, MD: You know, promoting the responsible use of AI. Pick the right problems. That’s the responsible part. Promote it is the second part, which means have a way to pull it forward out of the pilot stage. Don’t get stuck in pilotitis. 80% plus of AI projects today currently die on the vine. The workflows are not durable.

Dr. Pete Stetson, MD: Uh, so another really critical piece is having some clinical informatics folks in there that can help make sure the workflows work well for the intended user. So

Erik Sunset: Sure, and I would, I would imagine a lot of that entails that, you know, whether it’s Epic [00:40:00] or Cerner or McKesson, whatever hospital system somebody’s using, it needs to work really well with that system of record, your core software,

Dr. Pete Stetson, MD: Yep. Both to have the right context for the decision-making point, uh, call– I call it the point of decision. You’re, you’re deciding you’re gonna do thing A or thing B. You gotta have the patient context from the system of record. And, uh, when you take the action, that action needs to be reflected back to the system of record one hundred percent.

Dr. Pete Stetson, MD: So integrating with our EHR, the EHRs across the spectrum, Epic, Cerner, all of the others, has been…

Erik Sunset: of them out

Dr. Pete Stetson, MD: There’s hundreds, yeah, and, uh, and both in the inpatient setting and on the outpatient setting, and there are different EHRs for nursing homes and freestanding dermatology customers, and oncology is different, um, have different EHRs.

Dr. Pete Stetson, MD: So, uh, we’ve learned a lot [00:41:00] about ensuring that we can, uh, listen to and write back to all of these different, uh, these different systems of record

Erik Sunset: Sure. I have anything else to add, Dr. Stetson? Did we cover all of our, our key points here as we wrap up?

Dr. Pete Stetson, MD: Yeah, I think so. I, um, I, I might just sort of say, you know, I’m very, very excited about the potential for, uh, the, the, the proof points that we’re starting to see now for the potential of AI

Dr. Pete Stetson, MD: to orchestrate and be behind the scenes so that, you know, the room is helping the doc. The, the technology is facilitating and empowering the nurse. The… We’re driving throughput. We’re getting patients where they need to be, getting the access to care that they need. This is one of the core still unsolved problems, orchestration.

Dr. Pete Stetson, MD: Uh, but we can be really smart [00:42:00] about it, and the technology exists to stitch all this together and have it kind of be sub rosa and let the care teams work with the patients and, and, uh, have a really good patient outcome and patient experience. So, uh, there’s never been a better time for orchestrated care than today, and AI is making a significant difference.

Dr. Pete Stetson, MD: It’s a very exciting time to be in this industry

Erik Sunset: Way to put your stamp on the conversation. And before, before you go, where can folks either connect with you online? Where would you point them to for a website? How can, how can folks get more from Dr. Stetson?

Dr. Pete Stetson, MD: Uh, yeah, probably the best place is, uh, uh, I’m on LinkedIn. Um, and, uh, folks can hit me there, and, uh, I’d love to have a conversation. We, we’ve been having some conversations across the industry around, uh, you know, what are the new frontiers for orchestration of healthcare with AI, um, [00:43:00] and, uh, how to think about it as a strategic asset, a strategic differentiator within your healthcare system.

Dr. Pete Stetson, MD: It’s, it’s how healthcare systems can win. You could have the best EHR. If you don’t orchestrate your work, it’s not gonna flow.

Erik Sunset: I won’t step all the way onto my soapbox. The very best EHR only gets you so far, and it always has. You, you need layers on top of it. They need to focus on the next round of government requirements, you, you know, whatever CMS wants. They’re not building things like what you’re building, Dr. Stetson So we’ll be sure to get those, uh, links into the show notes.

Erik Sunset: On behalf of the entire DocBuddy team, thank you for listening. Be sure you’re subscribed on Apple Pods, Spotify, and YouTube so you get the newest episodes of the show. Dr. Stetson, thank you again. This has been a pleasure

Dr. Pete Stetson, MD: Erik, thanks so much for the opportunity. It was really great speaking with you today

Erik Sunset: Feeling’s mutual. We’ll talk again soon, everybody. Take care