← Becker’s Healthcare Podcast
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- [00:02]
A
@ 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]
B
This is Laura Deardo with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Bob Rebecco, Chief Information Officer at Mahaska Health. Bob, it's a pleasure to have you on the podcast today.
- [00:55]
C
Thank you. It's a pleasure to be here.
- [00:57]
B
Absolutely. Now I'm excited to have you on the line because I know technology is evolving so quickly and it's such a fascinating time in health it right now and so it'll be great to get your perspective on several things as we talk through the conversation. But before we dive in, can you tell us a little bit more about yourself and your work in healthcare?
- [01:16]
C
Yeah, absolutely. So currently I'm the Chief Information Officer at Mahaska Health and I lead all the organizational information technology initiatives. So data science, artificial intelligence, cybersecurity, informatics and what my goal is is as I do that we want to ensure that there's seamless integration of those technologies to enhance patient care and operational efficiency. I was drawn to Mahaska Health by its meaningful mission and its empowering culture. Passionate personally about fostering collaboration. Collaboration relationships are very important to me. I love mentoring emerging talent and I look to make a daily positive impact in healthcare and beyond. Prior to that, I've been a senior leader now in healthcare technology for about 27 years. I've done predictive analytics, process optimization, change management. I also was an operational director as a service line administrator, data governance, experience, design, a lot of things. I also have a six Sigma Black belt, so I'm very passionate about optimization, continual optimization, process improvement, and then beyond that. Personally, I love to contribute within the arts and academic communities. I serve on the Board of Directors for the Indianapolis Ballet and the IU School of Science and I was very humbled. I received a Distinguished Alumni Award from the Science Alumni association based upon the contributions I've made over the years. And then in a nutshell, I am very committed and really enjoy fostering collaboration I love mentoring emerging talent and just every day I look to make a positive impact within healthcare and beyond.
- [03:32]
B
That's amazing to hear and, you know, certainly a really fascinating journey you've had in healthcare and now taking you to Mahaska, where I can imagine, you know, there's a really big need for your skills in technology. Before we, you know, dive deeper, can you tell us just a little bit more about Mahaska Health and some of the things that you're doing there?
- [03:54]
C
Yeah, absolutely. So Mahaska Health, we are a critical access hospital in rural Iowa. We're very focused on meeting the needs of our community, the healthcare needs, and doing beneficial things within the community. We have been in Iowa now, I think since 1910, 1912. And every day we are growing, we're growing our outpatient service lines. We are doing services within inpatient and internally there are some things that we're working on too with artificial intelligence and EMR optimization, workflow optimization, a number of things that we're just looking to provide benefits both to our providers and to our the patients that come to see us.
- [04:54]
B
That's amazing to hear and what an important mission and service that is to the community. Now I know nearly half of medical practices report using AI in some capacity over the last year and remains a key topic for health IT leaders as well. Can you tell me a little bit more about that and you know, what you're seeing in AI today?
- [05:13]
C
Yeah, absolutely. So from what I've seen, the real impact today shows up in three focus areas. So first you have ambient clinical documentation, also known as the AI scribe or artificial intelligence scribe. So within our hospital we do use a scribe today. It's called MD Hub and it's been well received by our providers and it's reduced burnout and after hours starting. Second, there's the operational focus and revenue cycle copilots. So what can we do that enables our revenue cycle to have better processes around denial, prediction and appeal, drafting, coding assistance and then inbox triage. So we look at those and we run those like process improvements and it's incremental improvement that we focus on. Third, there's care access and patient experience. So we use dashboard within our organization to maintain line of sight and we look to reduce no shows, personalize. The outreach that we do through we're on Epic, so personalized outreach we do through MyChart and other mechanisms and then we look to route patients so that wayfinding, routing patients to the right side of care. The second and the third items that I mentioned in relation to what we do. At our organization we've been reliant on, so we are a community connect and we have a partner and we're on epic. So we've been reliant on our community Connect partner and epic's timeline for those. Our focus has been on the AI functionality that is embedded within our emr. We aren't resistant to adding third party bolt ons. We do look at those as well. When we look at bolt ons to our emr, we're looking for specific value that is shown by those AI products that would not be something that would be available within epic. Epic. Many folks who are listening to this podcast probably have seen some of the roadmap items that's been mentioned. As far as what EPIC is looking to do for AI as they continue to release these, we plan to adopt as soon as they become available to us and our strategic roadmap, they're on it. We follow our Community Connect host partner. So UnityPoint Health is our host partner for our EPIC solution. So long story short, and in a NutShell, we're prioritizing AI to remove administrative friction, to protect clinical time, the clinician's time, and look to improve safety and experience. So and we also, as we do that, we're mindful about measurement, thoughtful about our change management approach and adaptable and pragmatic about tech. We're preparing ourselves to roll in EPIC as they come and we also are looking at those third party tools where they show value for our providers and organization.
- [08:34]
B
Absolutely, that makes a lot of sense. You know, it's great to hear that you're using it in the clinical as well as the operational setting to really maximize the care you're able to give. Now, I think especially zeroing in on virtual care as that expands from AI enabled tools and remote monitoring to broader digital health platforms. Introducing new technology brings its own set of challenges. So what advice do you have for leaders who are navigating everything from the governance to patient engagement? And can you share some of the examples about how you've been able to balance that innovation with operational constraints?
- [09:11]
C
Absolutely, absolutely. It's the fun of being in the technical world. There's unlimited demand. So the biggest challenge that I see and face today is managing that large amount of demand for the innovations that are out there within the constraints of finance resources. So we have limited people, we have limited money, and every organization, including Mahasca, we're all looking to stay ahead of that technology trend curve and adopt those new tools as they come in. So the downside, you know, the Limitations I mentioned is that can restrict our ability to build, maintain, optimize our solutions. So the approach that I have is mentioned. Three before, there's three now. Three important threads that I look to model at our organization is number one, provider engagement by default. So we look to at Mahasca, our clinicians voices our providers. Voices are a priority. We want to hear what they need, we want to hear what they're looking for. The goal is to essentially make their lives easier so that they could focus on patient. So we gather their thoughts, we go in with a beginner's mind. So no assumptions. We may have things that we've learned over the past, we can apply those, but we want to learn from them. No assumptions. We identify champions, we validate workflows, and we do usability, functionality, validation. So the issues as we're going down this path are minimized and adoption isn't something that's like an afterthought. Number two, you want governance. So we promote clear governance. We determine the accountabilities, communication pathways, expected outcomes, and essentially we have a playbook. So have a playbook drafted, have it in place before you go down the path of the work. Last is a tiered demand process. So as these things are coming in, they're coming into a big funnel, technology funnel. And how do you prioritize those things? How do you structure it so that those are things that can be done within the limitations we have? So we have two pathways. One is a formal one, not highly bureaucratic, not a lot of red tape, but there are steps and it's for those items that are high, lift, risk, cost. So there's a little bit more involvement as far as how you structure those as they go into where you, you pass them for deployment. The second is you have like a demand management light. So smaller lower risk requests, initiatives, things that maybe you want to throw against the wall, just see if they stick those go through DM light very quick. You can be very agile about you look at it, hey, low risk, low resource need. Let's go ahead and just try it out. So the overall goal of that process is you'll find that business value as quickly as possible. You want to do it with minimum waste, don't want to have a lot of resources, costs associated with it and then find out where it's a failure. So, you know, get to the business value and then that light path you have will empower you to get as quickly as possible to a quick win or a fail fast.
- [12:50]
B
Absolutely, that makes a lot of sense. You know, really Embracing that mentality of trying new things and being quick to make a change as needed, you know, seems to be really important in the nimbleness of today. And I wanted to ask you as well, what are you seeing in some of the recent legislation both on the federal and state level that affect healthcare organizations and health it specifically, have you had to make any adjustments to your strategy in response?
- [13:16]
C
Yeah, absolutely. Great question. You know, legislation environment is continually changing. Like sometimes it almost feels hard to keep up. And so really our strategy I mentioned earlier, we are community connect partners. So our strategy to meet as much as we can of those legislative needs is by putting EPIC at the center of our strategy. So as a critical access hospital, you serving a rural region, we are resources. The benefit of having EPIC is, EPIC is, is actually doing a lot of these things for us. So we have that relationship with UnityPoint and we can focus on our having a patient experience and focus on that side of it. Whereas the regulatory compliance ends up being embedded into many of the things that epic's doing already. So a couple of examples that I have with that is you have the interoperability and pricing transparency rules. So TEFCA or it's the Trusted Exchange Framework and common Agreement rule, those were adopted. Those are things that are out there. Thankfully EPIC has adopted it within their EMR and they have brought it into something called EPIC Nexus. We have already signed into that. So we are now meeting the TEFCA rules. And through that the big benefit is our clinicians now can access and send records nationwide under a single technical umbrella of all the different sites that have EPIC throughout the United States and actually beyond the United States. It reduces this need. You have a bunch of interfaces that can exist out there, there's faxing. The benefit is, is that you don't need those. It enables us to actually be able to see these records very easily, quickly reduce that clinical burden. On the pricing transparency side, we are continually, we do have that out there on our website. We continually validate that machine readable data and make sure the estimator is available publicly. Now the big one. So I mentioned a couple of ones. You know, the cybersecurity goes amongst the crowd. The cyber security is something that is a huge focus and it's something that the government and regulations and all of those is something that you know is very serious and there's big repercussions for things if you're not doing what you should be doing. On the cybersecurity front, it is continuous for us. So we treat it as continually Adapting, continually optimizing, we never stop. So as the best practice, we've mapped our controls to the health and human or health and Human services healthcare performance goals for cybersecurity. So hhs, we've mapped to those. So that's our best practice. And we are continually reviewing and looking at our cybersecurity program to make sure that we're meeting all additional best practices that are for health care. So as example, we do education, continual education with our team members, our clinicians, our providers, we do pen tests that kind of test our seals and for weeks we do risk assessments, we do external monitoring and then we actually do dry runs. So we do incident response rehearsals with the team members, providers, leadership, all involved. We treat it as a true incident and all of these things, those rehearsals especially, we test our processes, we find lessons that are learned, we bring them forward, we bake them into the program so that we optimize that program even further. And then the last thing just to mention about cybersecurity is the education, it's actually been really good, is we've involved our team members, our providers, our clinicians, and we're truly looking out for them too because these things happen on the personal side. So we do fish testing, we educate them, we make ourselves available if they have any questions or they receive something that might seem a little fishy. And the whole goal really is not punitive. It's just really to grow their awareness and resistance to the socially engineered attempts that, you know, they're getting every day to gain access to our systems.
- [18:13]
B
It's really helpful to know and understand the plan there because as you mentioned, cybersecurity is so critical alongside these other trends in looking at technology, interconnectivity and, you know, how you can really make the best experience for patients possible. Now, with our last minute here, I wanted to ask what's your top piece of advice for healthcare leaders as they prepare to for the further advancement of technology and rising demands for care?
- [18:38]
C
Absolutely. So I would say two things. Be disciplined about the architectural, plumbing and the foundations and be bold about the outcomes. So be disciplined about your architecture, your data foundations. Invest in real business needs analysis. Make sure you look to measure value before you start projects and stand up coes around the different focus areas you you are looking to do. As an example, we're doing a data science and AI center of excellence. And the job of these things is to make the business needs driven, repeatable, ethical expeditions. Second, run a structured, always improving playbook. So have a playbook determine what your current state is establish some KPIs so that you have points of measurement and use that as like your scorecard. Something that I like to do just because of my six sigma background is I have an A3. That's something used within six sigma and it basically becomes your report card. You map out the problem, root causes, the target future state have it all on there and you can, you can adapt as as you're learning what you're learning and then you'll have some quick wins test solutions do it lightweight. Track those results closely.
- [20:07]
B
Absolutely. I love that. Bob, thank you so much for joining us on the podcast today. This has been such a fun conversation, expiring to learn everything that you're thinking about and working on and planning for the future. And I look forward to catching with you again soon.
- [20:21]
C
Excellent. Thank you so much.
- [20:25]
A
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 teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions reduce administrative burden, 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 at athenahealth. Do.
- [21:10]
B
You.