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Becker’s Healthcare Podcast
Advancing Structural Heart Care and Embracing AI with Dr. Mario Göessl of Allina Health
00:17:29
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- [00:02]
Athenahealth Representative
@ Athenahealth, we know your ambulatory practice wants healthier a healthier business, healthier care teams, and healthier patients. But the complexities of modern healthcare tech make it hard for you and your care teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions reduce administrative burdens, streamline billing and payments, and deliver critical insights when clinicians need it most. That means fewer clicks, more time for patients, and stronger bottom Practicing medicine is complex, but running a practice can be that much simpler. With Athenahealth, see how simpler is healthier at athenahealth.com.
- [00:44]
Laura Dearda
This is Laura Dearda with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Dr. Mario Gusel, Director of Interventional Cardiology Fellowships, Director of transcatheter Valve Therapies and Interventional Cardiologist at Allina Health Minneapolis Heart Institute. Dr. Gussel, it's a pleasure to have you on the podcast today.
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Dr. Mario Gusel
Thank you for having us, Laura.
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Laura Dearda
My pleasure, absolutely. Now I'm excited to have you on because it'll be fun to hear just some of the great things you're doing at Allina and really how you're thinking about the future. But before we dive in, can you introduce yourself and tell us just a little bit about your background?
- [01:19]
Dr. Mario Gusel
Yeah, I'm happy to. I'm an interventional cardiologist here at the Minneapolis Heart Institute Alina Health, and as you probably know, some of us specialize a little bit in structural heart disease. So most of my practice, I would say it's 60, 70%, is probably structural heart disease, which includes the valve interventions like, say, Mitraclip Pascal, TAVR devices, tricuspid replacement devices, pulmonary replacement devices, Watchmen, these kind of interventions. I'm also a director of the fellowship program, so I'm always at the pulse of what the younger folks are feeling right now and in which direction they want to go when they apply to our fellowships, interventional and structural. And yeah, have some administrative roles here in our practice too. My my history is that I actually trained in Germany first and then I did some training here in the United States at Mayo Clinic. And this is my second private practice or academically oriented private practice for.
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Laura Dearda
That's fantastic to hear, you know, and interesting to understand that dynamic with leading the fellowship and having your finger on the pulse of what some of the upand cominging generation in newer training physicians are thinking about. What have you noticed over the last couple years? Is there any trends or things that have come up that are different than they were in the past.
- [02:51]
Dr. Mario Gusel
Yeah, I, I think that in our training programs, we certainly have seen an impact of, for example, the COVID pandemic, and there was some impact on training. I would say we have observed a little bit less independence of trainees coming out of that, you know, two, three, four years that than we saw before. There is. I think the current trainees often try to cover multiple subspecialties during their fellowships and may be a little bit of undecided or unfocused on their training trajectory. Where years ago we have seen folks clearly voicing the interest in structural heart disease, we can sometimes now see folks saying like, oh, I'm also interested in advanced heart failure or interested in advanced coronary procedures. And I always find that very difficult to accomplish. And I think due to the job market being a little bit more uncertain than it was years ago, my feeling is that some fellows or trainees are trying to cover as many subspecialties as possible to actually, you know, have a maybe competitive advantage over other applicants. Where I think most of us still feel like if you focus and follow one passion, you probably have a better success.
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Laura Dearda
That makes a lot of sense. You know, it's just fascinating to hear about those trends. And speaking of trends, what are some of the top three or so that you're following in healthcare right now? What's top of mind for you and some of the big priorities you're thinking about heading into the next year?
- [04:37]
Dr. Mario Gusel
Yeah, I think one of the exciting things or trends for me is certainly for many people, artificial intelligence and how that is integrated in our daily practice. I mean, there's so many exciting studies or exciting projects out there in our field. For example, how much information can you get from an EKG alone in order to make even therapeutic decisions on patients or finding undiscovered disease processes? But I also find artificial intelligence simply in our, you know, daily operational efficiency is very interesting. And that's. I think I'm even more interested in that. What I mean by that is, for example, we integrated about a year ago ambient AI into our clinic visits. And I have to say that that, for me was a game changer. Obviously, the notes are not maybe as personal as they are when I dictate them personally, but I find the value that I give to the patient by simply extending my visit time by sometimes 5, 10, maybe even 15 minutes is definitely compensating for maybe a note that is not as nicely written than a personal dictation. The summaries are excellent. I can literally leave my patient room and Within a minute, my note is written. It is such an effective, efficient tool that I now have at my hands at my iPhone, basically. Yeah. In addition to the ambient artificial intelligence, I hope that further tools that are similar to that could help us in our daily practice as well to make patient visits and all the work that comes with it after. Much more efficient. So I'm really excited to see more integration of artificial intelligence in our operational efficiencies. I'm excited about that, I think very much.
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Laura Dearda
Absolutely. And you know, AI is so interesting, especially thinking about technology and what it could potentially do for you as a physician. What are some of the considerations that you have to think about both on the opportunity side as well as the risk side when you're bringing more AI into the clinical practice?
- [07:10]
Dr. Mario Gusel
Yeah, I think we, you know, I think that we struggle with efficiencies. Right. I mean, on a daily basis. For example, in our healthcare system we still do a lot of manual processes when we try to do schedule optimization, for example, cath lab or the operating rooms. And I think that with the limitations in staffing, for example, and the increase in volumes of certain procedures, that those kind of operational efficiencies, especially scheduling, are immense opportunities where I think artificial intentions or at least processes like this can help us where manual processes are probably not effective enough. The danger of course, is if you integrate artificial intelligence gets it closer to patient care. Obviously the concern is always the control of the artificial intelligence outcome or the analysis. And I understand that patients have concerns there. And I think that every healthcare system has to obviously provide safety security there. If AI bots are inside the electronic medical records, helping with such efficiency that we don't lose any patient safety or data safety. And I think that's certainly a concern. But I think the opportunities are immense because overall I think healthcare systems need help in order to create the most efficient system and more most effective systems. Otherwise we will not be able to cope with the patient volumes appropriately.
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Laura Dearda
That makes a lot of sense. Fantastic. To kind of think through all of those things. And I know there'll be a lot of work around that heading into the next couple of years or so. Are there any other trends that you're thinking about and following right now or anything that you're really excited about?
- [09:16]
Dr. Mario Gusel
Yeah, I mean, I think maybe last year we talked about that already. I'm still very much excited about the trend towards the value based care. And maybe some people say patient first care, I think those are other words being used also. We know that there's obviously a big payer shift towards value based care, maybe even towards capitation. I think that in that shift there are great opportunities, also great risks for healthcare systems because they may not have the data integrity or data granularity to compete on that level yet. And I think we approached that last year as well. But I still think that in that process of really being patient focused and value focused, that there are great opportunities for us to select the appropriate interventions and treatments for patients that create the greatest value for the patient. And hopefully both on the payer side and the healthcare system side, we see a win win situation. I'm still excited about that and working on those value based care systems and contracts. I think for me personally is, is an exciting trend still.
- [10:43]
Laura Dearda
Absolutely. That's amazing to hear and you know, I, I love that kind of analysis of how we're thinking about value and what it really means for the patients and bringing the patient front and center into everything that you're doing. I think, you know, as we look at this evolution, how do you see things playing out over the next couple of years or so, especially given some of the exciting things that are happening, being able to collect more data and have more information on patients as well as, you know, the real drive in health care across the board to have better quality as well as figure out how to lower costs in a smart and meaningful way. Do you see this effort accelerating or where do you see things headed?
- [11:24]
Dr. Mario Gusel
Yeah, I think, you know, when I, for example, started my master's of healthcare administration training about, you know, two and a half years ago, when I had my first kind of interviews with folks who are in the midst of administration, I always sensed a great fear of this, you know, word value based care. Because people feared that healthcare systems did not have enough data to actually compete on that level. Right? They did. They just didn't know what the outcomes of patients, what the cost that they incur actually are because sometimes that granularity is not there. And over the last two and a half years or so I, I sense that there's more excitement, maybe also of course a forced excitement, but there's more excitement of having that granularity and getting closer to the goal of actually providing enough data to compete on for these value based care contracts, but also maybe even advancing it further where you say, well, are we getting two contracts that are more even on a capitation level? So I think that the sense I have, and I'm obviously not in the midst of administration because I'm very clinically focused right now still, but I think that I can sense within the physician groups, but also in the administrative group that there's this a more say, excitement versus adaptation of that process. And I hope it will continue. And I hope and that because like you just pointed out, the most important thing here is, yes, we need to have healthy healthcare systems that survive. That's a very important aspect of it. But I think with that trend to value based care, patients will have a better experience because it's not the focus on fee for service. The focus should and will be their outcomes, their experience and the selection of therapies that lead to that goal. And I think it will take a long time. It has been already a long time. But I can sense at least that more and more physicians and patients follow that trend.
- [13:33]
Laura Dearda
That's fascinating to hear. Thank you for digging a little bit deeper there. Now, before we wrap up our conversation, how are you thinking about growth over the next 12 months or so?
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Dr. Mario Gusel
Yeah, I think that's a very good question. Right. And maybe I focus a little bit more here on my subspecialty and structural heart disease, because structural heart disease, with the interventions that we mentioned in the beginning, is projected to see a lot of growth in the next two, three, four years. Many of the procedures that were initially in trials and studies are now commercializing. We can talk about tricuspid valve interventions like the evoke valve, we can talk about many TAVR devices and we can talk about devices that lead to therapies on the mitral valve. We have many commercial products on a congenital side of things. All of this has now developed or has surfaced in the commercial side of things is out of trials. And I think we expect, of course, that many, and we see that, that many referrals are now going to come in to treat patients with these major valve diseases. And most recent studies with us here, but also the most recent study shown at tcd shows that valvular heart disease is a growing problem and it's probably underestimated and not treated early enough. So overall, I think the projections are pretty clear. Structural heart disease, valvular heart disease will see growth in that, though we also have to make room, right? We have staffing issues. We have only so many slots to see patients in our clinics. We have only so many slots to treat patients in our cath labs. And for that, I think the trend of what we, for example, do here at the Minneapolis Heart Institute is to create space and volume shifts into our asc. We have an asc. We were one of the first ones who adopted it. And I think that trend is another maybe trend that I'm excited about, but also to see a shift from, you know, lower acuity interventions from the hospital setting into the ASC and then providing more space and slots for the higher acuity interventions and more, you know, time consuming interventions that are usually structured interventions. I think creating that, I want to say operational efficiency, using the ASC efficiently to shift and focus on higher intense interventions here in our hospital, I think is also very exciting trend.
- [16:24]
Laura Dearda
That absolutely is fascinating to hear and especially looking at how more things can go into the outpatient and the asc. And it's just been really cool to see more cardiology in that space. Dr. Gossel, thank you so much for joining us on the podcast today. This has been a really fantastic conversation and I look forward to connecting with you again soon.
- [16:43]
Dr. Mario Gusel
Thank you so much, Laura.
- [16:47]
Athenahealth Representative
At athenahealth, we know your ambulatory practice wants healthier a healthier business, healthier care teams and healthier patients. But the complexities of modern healthcare tech make it hard for you and your care team teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions reduce administrative burdens, streamline billing and payments, and deliver critical insights when clinicians need it most. That means fewer clicks, more time for patients, and stronger bottom lines. Practicing medicine is complex, but running a practice can be that much simpler with Athenahealth. See how simpler is healthier@athenahealth.com.