Loading summary
Transcript20 lines
- [00:00]
A
So this is Alan Condon, back with another episode of the Beckers Healthcare Podcast. And today I'm thrilled to be joined by Chris Carmody, Senior Vice President and Chief technology officer of UPMC, which is an integrated academic system with more than 40 hospitals across Pennsylvania, Maryland, and New York, as well as a substantial international footprint as well. Chris, delighted to have you back on the podcast with us today. For those of our listeners who might not be as familiar with yourself or the work that you do at UPMC today, you mind giving us a little bit more information about your experience and your background?
- [00:34]
B
Sure. And thanks for having me, Alan. It's always great to participate with Beckers in many different events, so I'm happy to be here today and share our journey. But, yes, I've been at UPMC just under three decades in many different IT roles. The last 12 were in the Senior Vice President and Chief Technology Officer role, which has really given me a lot of opportunity to work with great people across not just our IT division, but also from a clinical and operational perspective, to engage in leveraging technology and improve how we deliver patient care across all those different sites you just mentioned when you introduced me.
- [01:14]
A
Fantastic. So three decades at UPMC. What a tenure. And like you said, last 12 years in that SVP and Chief Technology Officer role, which, for today's conversation, I'm really excited to kind of dive right into a big project that UPMC recently got underway, namely going live with Wave one of the UPMC Bridges project. Can you start by telling me what were some of the biggest technological or operational hurdles in getting to that Go Live moment, and how did your team overcome them?
- [01:47]
B
Sure. I think I'll take a step back and kind of give you the context on how we arrived, where we're at today. And it really starts with how UPMC has always been advancing the use of technology, going back the almost three decades that I've been working here. Back in the late 1990s, we had a big effort to actually implement and digitize all the records across upmc, and at the time, selected Cerner, which was very inpatient focused. We also were running EPIC back then, at the time, from an ambulatory perspective. And basically we tied and stitched both together with another solution to share patient records semantically across the different systems, and we kind of grew from there. So as we are moving forward and implementing EPIC and having all these different ancillary systems, it was really challenging to keep them all secure and maintained across our institution. So that really brought to light the need to go to that single instance of epic. And we started with what we call Wave one of our UPMC Bridges project. We really didn't want to make it all about technology. Technology really just was the enabler. Implementing a single instance of EPIC enabled us to leverage that platform, leverage a lot of the functionality that EPIC delivers out of the box, and help transform how we deliver care efficiently, effectively and improve the outcomes. And that's really the goal of doing this project. So getting to that point, there's been a lot of different challenges that we planned for, that we were anticipating, but until you live through it and go through it, you don't realize the impact. And again, the obstacles that you have to overcome. On the technology side, of course, a lot of that has to deal with building new interfaces for the systems that we consolidated on to say, okay, we're going to use XYZ system to connect an EPIC to help support it, and again, as an ancillary system, or how we decided to configure the new version of EPIC that we're using versus what some of our users may have used for another legacy version of EPIC being deployed or a different EHR system that now they're being brought together on this one platform. So it took a lot from a technology perspective to make it happen. But I would say even more importantly, it took coming together as an organization, bringing together our clinical leadership, our operational leadership, revenue cycle, all these different areas to come together and make system wide decisions on. This is how we want to make the system operate and function so we can have more standardization. So when we have to pivot quickly down the road, or if we wanted to innovate and advance different and new technologies, we can do that at the broader scale and size that we operate as upmc.
- [04:54]
A
Yeah, I think to your point, a huge, huge, fantastic organization and system that has grown quite substantially over the last couple of years, not just domestically, but also abroad, but specifically domestically. I know UPMC has acquired a few hospitals and has plans to acquire a couple of hospitals in a completely new state in Ohio, I believe. Not over the line yet, but I know that's, that's a work in progress, I guess. As a Chief Technology Officer, what are the biggest challenges that you run up against when acquiring a hospital or multiple hospitals, then moving to integrate and consolidate to, to a single iteration or a universal iteration of the EPIC EHR platform?
- [05:38]
B
Yeah, we apply, I would say, somewhat of a cookie cutter approach that we have our own playbook. And it's not just hospitals, right. It's physician practices, It's Other parts of healthcare delivery that as they become part of upmc, we want to systematically and intelligently and safely move them over to our standard platforms and technology. So we, we typically start with the infrastructure which in some cases might be in good shape, might not be in good shape, but we like to establish that base foundation so we can ensure that we can deliver all the different technology and innovations effectively to that particular part of the institution. So that's probably number one and number two is, okay, how do we get them onto our HR systems and finance and supply chain systems as well as the EHR and other clinical systems that we use. So it's again, it's a step by step approach and playbook that we use that we've found to be successful over the years. The big change coming obviously is now we're introducing this new environment of our UPMC Bridges epic instance which now, as you know, different acquisitions acquire moving forward, they'll be brought on to that new EHR environment, become a part of the UPMC family. So I think we've gotten better and improved over, over the years and I think every situation is unique in and of itself because again, there's some things that are great, there's some things where we need to address that to make sure again that we're doing things from a patient safety perspective is number one not to not disrupt that. Number two is again to establish that core technical capability from an infrastructure perspective so we can actually deliver the best IT and technology that we can and connect those new sites into UPMC to leverage the great care providers that we have and support across our entire institution.
- [07:43]
A
Yeah, and we know loads of several major health systems across the country kind of undertaking a similar project to UPMC in terms of consolidating, working to consolidate to one single iteration of their ehr. No doubt a lot of operational clinical efficiencies that come with that. Can you walk us through maybe what's, what's particularly unique about UPMC single EHR vision? Maybe anything that sets it apart from other EHR consolidation efforts you see in other systems across the country?
- [08:14]
B
Yeah, I think we just, and nothing against the other institutions, I think we all have our own journey that we're on. As I mentioned before, coming from nine different EHRs and hundreds of ancillary systems to one platform with about 300 ancillary systems connecting into it is really what makes our situation unique from my perspective. But it's not that others aren't moving from multiple EHRs, it's just the number of different EHRs that we're dealing with seems to have us stand out a little bit more than others. And with that becomes the challenges with again the technology in terms of integrating the systems that do remain. It comes with training and educating, engaging our clinical users that have used those disparate systems throughout their career at UPMC and moving them onto the single platform. You know, our goal's always been to make sure that we can standardize wherever possible. And we're in that process of now stabilizing and optimizing our new Bridges environment with the partnership that we've established with our world class physicians and nursing and operations to improve our UPMC Bridges out of the gate. And again, that's just part of the process. And those are the kind of steps that are similar and expected when any institution goes through this huge transformation of, you know, switching from one hr to, to another or again like we're doing, consolidating down to one brand new ehr.
- [09:53]
A
And in terms of the UPC Bridges project now with, with Wave one success in the rear view mirror, I understand you're now training and working your way up to the Wave two of the rollout. Can you kind of share maybe what lessons you learned from the first wave, that Wave one and how that's shaping your approach for this next time around?
- [10:14]
B
Yeah, there's, there's definitely a lot of lessons learned. Again, going into it, we anticipated certain things happening and they did and it was really how we prepared and how we responded to it. And training is a great example. We found some discrepancies in some of our records that we had to clean up in order to ensure that everyone on Wave one got the appropriate training that they needed. Because again, you're using different terminology and different groupings and classifications for users on a new system than maybe that they used in their previous EHR environment. That was one of the things our training team has been tremendous and obviously to train over 40,000 users in wave one and close to 70,000 in our wave two, which starts early next week. The sign up, the registration for our staff to start planning out to get their training, but making those processes more seamless to make sure that when you go live, one of the first things EPIC tells you the first three or so days, a lot of it's around the security classifications, hey, this person was designated as this type of user, but they need this other piece of functionality to do their job. When you're dealing with that many thousands of users, you going to find those. And, and, and again EPIC coming to the board and Partnering with us. They were, they were, you know, putting out those things that, that's what we should expect and that's what we found out. And again, that's, that's what we take into Wave two, those learnings, so we can make it a better process, more efficient process during that transition. Because it's, you know, we, we don't lose sight of what, what's happening in our world. Right. We're, we're changing the comfort of the existing environment that people have been using and trained on, like I said, maybe their entire career at UPMC and giving them something new while they're still focused on delivering the world class patient care that happens across upmc. So our job is to make it less stressful, to make it a more seamless transition and be there to support them at the elbow virtually. We have command centers that are, we're up and running for weeks to make sure that we could address and remove any of those types of barriers as we've moved forward. So those are probably some of the examples of lessons learned. But it's been across the board again, going through something this big and this broad and impactful. This is a once in a lifetime career for many people to have. So it's a great learning experience and, and we wouldn't be doing our job as, you know, professional IT people if we didn't look for ways to improve how we could make the next wave even better than the first.
- [13:04]
A
Yeah. And I guess if you could share wave two, what is the projected date for that currently? Or is it still a moving target?
- [13:13]
B
No, it's planned out for early May of 2026. So we're about what, six months or so away. And I can tell you, you know, backing up before we went even live with Wave one, we were already working and planning on Wave two. So there was a lot of overlap in, in the process. It wasn't like some sequential, like we have to finish wave one before we move on to wave two. Now we've had teams and planning and, and a lot of meetings in preparation for wave two along this journey. So our, our biggest decision for the timing and for how we broke up UPMC into these two big chunks to implement, was really trying to minimize the impact on patient care and patient safety. That that was the number one driver for us planning and doing what we did. And you know, we made tweaks to the schedule before, but we ultimately arrived at this decision. This was the best approach to mitigate any of those types of risks.
- [14:21]
A
Yeah, I think it's such A significant massive undertaking. Like you said, once in a career for many kind of leaders. In this instance. Wave two coming in May 2026. I guess in terms of where you stand now in terms of this project, can you share maybe Chris, how this transformation is improving integration already? I know like you said, moving to that one each or three ancillaries over 40 hospitals, multiple physician practices. I know we're not at wave two yet, but is there an example where maybe system wide connectivity is already making a difference?
- [14:56]
B
Yeah, I think the biggest or at least out of the gate, obviously there's new functionality with the version of EPIC we went live with. There are 13 generative AI models that are integrated into workflows that we're seeing those efficiencies and usage with that's making a big difference in impact. Just some of the workflows in general where we are using EPIC Rover for nurse documentation. So we've given our nursing staff an iPhone to be more mobile and more engaging with their patients and capture some of the documentation and we're seeing that completion time shrink by 84 minutes. So again a lot of positive workflow changes that we've seen. And from my perspective, again being the IT person but what my operational clinical leadership and you know, the boots on the ground the users are telling us is it's, it is making a difference in how we're delivering patient care because it's making, it's making things a little bit more efficient and more effective in how we're doing it. We're able to close many more care gaps probably than ever before because again being on one system, one platform helps us identify and make sure we're following up and following through to do everything that we're supposed to be doing. So that's what I see now. Now when you we talk about connecting all the different environments, I think we'll see that a bigger impact across into wave two. We have a lot of, we have a significant amount of patients that do have care provided where they live, maybe like in the middle of Pennsylvania, but they have or are seen by doctors in Pittsburgh. So having that one record and be able to share and view, it's going to be a huge opportunity, at least from a technology perspective. Don't have to share that data across multiple systems. It's in there. They can see the notes immediately, they can see the test, the test results. I think that's where we'll see a bigger impact after all of UPMC is on our EPIC Bridges environment.
- [17:11]
A
Right. I guess jumping back to earlier in terms of those 13gen I models that you'd mentioned, are those EPIC add on tools and maybe is there one or two of those A models that you can maybe kind of highlight specifically in terms of how it's making a difference and what it's allowing your providers or your operators to do?
- [17:32]
B
Sure. A very popular EPIC GEN model is called art. So ART is a generative response technology that allows a physician or a care provider that gets a message from a patient. EPICS technology assesses and evaluates that and generates that response. That helps speed up the time it takes for a physician to get back to that patient who's inquiring about something through their MY Chart or in UPMC's case, we brand it myUPMC. So they're speeding up the process. In that case, it's taking a little bit of cognitive burnout away from that provider by drafting the response and allowing them to edit it before they send it back. So that's a pretty basic example, but it's those little tweaks that are removing time that is inefficient to a certain extent from the providers and caregivers across upmc. And that's what we've seen with the early adoption of those 13 models that are built into the workflows, which is pretty cool technologist perspective. We obviously have a long way to go with, you know, advancing more and more different types of AI. But another one that ties in close to EPIC in that same sort of space is we are a big user of ambient listening AI from a company called Abridge that was formed out of upmc. And what Abridge does is captures and documents that interaction between a doctor and a patient in real time and basically inserts a drafted note in for that physician, that doctor. So what we're seeing is over 1.5 million recorded minutes that translate into actual clinical notes for doctors that use that in their workflow. So it's saving them time on documentation. The accuracy level is extremely high in terms of that translation service that's happening with utilizing a bridge. And the feedback that we've gotten from both doctors and patients using it is again, it's another tool that helps them have that conversation that they're not turned over, typing into a computer. They're being able to listen and pay attention and allow the computer and in this case allow the generative AI to actually do what it's supposed to do so they can focus on delivering healthcare. So I think that's a pretty cool piece too that this journey that we're going to Continually see growth in and there's lots of different workflows and opportunities for using technologies like a bridge. As we move forward with our, our journey to a single platform of epic. And like I said before, going back to our decision, why we made it to go to a single platform is so when we want or we see a new technology that's gonna solve a problem for us and how we're delivering care, how we can make it more efficient, we can implement that at such a quicker and full scale approach across all of upmc. And I think there's a tremendous benefit to the patients that we serve to be able to do that.
- [20:54]
A
Yeah, no, I specifically, I think those, those couple of the ambient listening technology like you highlighted and those other IIM models I imagine just from a provider feedback, I imagine is amazing. Getting that FaceTime back with and on the other side of the hand, patient experience as well, no doubt is benefiting as well from more engagement with providers, physicians across the board. So fascinating to hear the early results there and then how that might grow and expand across the organization down the line. Chris, last question for you. I have no doubt. Wave one completed. Wave two coming May 2026. Hindsight is 20 20. Right. So for other CTOs or CEOs listening to this conversation who are about to embark on a similar EHR transformation, is there one lesson from, from the UPMC Bridges project that you wish someone had told you before you started?
- [21:48]
B
I think everyone, everything that everyone told me was pretty spot on. It was going to be challenging. It was going to take a tremendous teamwork and effort to get us to where we're at. So it was just, it became a reality. Right. We kind of knew it was this daunting task, but I would give a piece of positive messaging and advice to my colleagues out there that are thinking about or maybe a little bit earlier on the journey here. And I would just say it is so critical your project depends upon it to have the right engagement and relationships with your clinical leadership, with your operational leadership and just generally with all your user base to make sure that you're communicating, you're listening, you're working together to define where you want to go as an organization. And I think that speaks to, you know, our, our success to date has been that engagement. Our, our chief nursing executive has been nothing less than amazing. She's been a tremendous force in driving us forward and it's been a great experience for me working with her and partnering with her, our CMIO and my partner in this journey. From an executive perspective, Dr. Rob Bart has been, again, equally as amazing to help drive our organization forward and, and without those types of partnerships. And then there's many more. Every area of our organization is represented and again, engaged to make sure that we are moving forward effectively. But if you don't have that, that would raise significant flags from my perspective, that you need to get the right people involved, engaged and making sure they're carving out the right amount of time that they can meet, that they can process some pretty critical decisions for your organization in order to move things forward appropriately so the project becomes that success. And we were told that up front. And honestly, that's why our project is called UPMC Bridges. It's not called UPMC Epic because we saw this as a bridge to the future from where we are as an organization and where we want to be. And again, it's all focused. It all goes back to how we deliver our patient care and looking for those efficiencies and quality improvements and patient safety that will come along with having one system to manage and maintain as we move forward.
- [24:26]
A
Yeah, no, it's such a huge, huge undertaking. No doubt the benefits already there to see, but a lot more coming down the pipeline, I think. Hats off to you and your team, your leadership team and all the physicians you work with on this project. Certainly look forward to catching up again down the line. Maybe post May 2026 to kind of hear how it finishes up. Excuse me. Chris, an absolute pleasure having you on the podcast with us today. Thank you so much. Always a pleasure to connect with a fantastic leader from upmc. We really appreciate it.
- [24:54]
B
Likewise, Alan. I appreciate Becker's and everything you do for our healthcare industry and looking forward to come back after wave two.