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Becker’s Healthcare Podcast
Daniel Roth, M.D., EVP and Chief Clinical and Community Division Operations Officer at Trinity Health
00:11:42
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- [00:00]
A
Welcome to the Becker's Healthcare Podcast. I'm Chris Sosa, your host and I'm thrilled to be joined today by Dr. Dan Roth. He is the Chief Clinical and Community Division Operations Officer at Trinity Health. Dan, thank you for joining us today.
- [00:12]
B
Chris, it's fantastic to be with you. Thank you for having me.
- [00:15]
A
Wonderful. Dan, for those in our audience who may not be familiar with you and your work, could you please just introduce yourself and tell us a bit about your background?
- [00:22]
B
Yes, absolutely, I'm happy to. So by way ago background I was a primary care internist and in some ways I still think of myself as that. I've been out of full time clinical practice now for almost 18 years. So it's been a while. I spent eight years with a health system called Mercy Health at the time, today is Bon Secours Mercy Health in a variety of roles. I've been with Trinity health now for 10 years. So I've been in faith based Catholic healthcare proudly for 18 years and really focused on how do we make things easier for patients and how do we make things easier for clinicians and caregivers. It's hard to be a patient. I learned that in practice. It's really hard to be a patient. And one of the reasons it's hard to be a patient is because it's hard to be a doc, it's hard to be a nurse, it's hard to be a pharmacist. The system doesn't make it easy. I view my role and my commitment over those 18 years is try to find ways to make it easier in Trinity. My role as chief Clinical Officer, I support a lot of different activities from quality and patient safety, physician leadership, nursing leadership, but also the operations for our community division which includes like our medical groups, our population health endeavors, community health and wellbeing, but also get to support IT services and our EHR services here at Trinity. And all those were the guise of how do we in an increasingly complicated world make it easy?
- [01:39]
A
That's always a great goal, especially with an industry such as healthcare that as you said, is very complicated. Now, your title and all the things that you just mentioned briefly that are under your purview, there's a lot of ground to cover there. But I am simply curious, what are your top priorities today? And you can take that and whatever field you prefer.
- [02:00]
B
Yeah, there are a number. I think the, you know, one that I'm most excited about.
- [02:05]
C
Right.
- [02:05]
B
Is, is the advent and evolution of technology, specifically AI.
- [02:10]
C
Right.
- [02:11]
B
Is an area and there's, there's a few, you know, obviously we know this is going to transform how we provide care, right. To my way of thinking, it is the single biggest thing we've had in the last decade, or even maybe in my 18 years out of practice that we can actually use to make it easy. One of the reasons why I love it, right, having been in the technology and informatics space for a lot over the years, is the interplay between clinical and operational. So technology is always a means to an end, it's never an end to itself. And so as I think about the potential, we're going to have to be outstanding at leveraging these tools, particularly in the earliest stages, to drive our clinical and operational results on a negative side. Because we've never been in a time where we have to be more efficient, right. So over the years, the way the economics of our business work, we have to continue to get more efficient. Our revenue goes up less than our expenses year over year. With recent changes right from Washington and payment changes and coverage changes, that's going to get much harder. While a lot of my focus time in and out is how do we deal with those hard things? One of the things optimistically is technology over the course of the next few years is going to be a large part of solutions about how do we solve for some of those vexing problems. In addition to making it easier for.
- [03:34]
A
People, are there certain tools or operations or any sort of elements related to AI that you see are already making things easier, be it for patients or for clinicians?
- [03:50]
B
Oh, yes, most definitely. And there's a couple. As we think about AI at Trinity Health, and as I think about it, especially in the early days, we want to be in a position where we're looking to find things that aren't big gambles, but things that we know work because things are changing so quickly. I can remember just not even two years ago when generative AI ChatGPT came out, and now we're talking about a whole bunch of new things that two years from now we'll be talking about more things. So we're very focused on things that we know will have an impact and are in the intermediate term and near term future for us. So a couple of ones we've been focused on. So we're focused on how do we automate processes and make things easier and more efficient. So we're seeing a lot of success in our revenue cycle with our revenue cycle leadership and partnership and driving efficiency there. And then the other one which I'll highlight for us is ambient listening. So the second part is how do we make our clinicians, in this case, our provider is more efficient? And what we found now 18 months in is ambient listening is that thing for us.
- [04:57]
C
Right.
- [04:58]
B
And with that, we've learned a lot over the last 18 months that will help us in the next thing, whatever comes after ambient listening. And we've also made a significant improvement, right? An improvement for our providers, our physicians, but also improvements for our patients. And so, you know, ambient listening is that. And then I think the other great thing about ambient listening is its use cases are now multiplying, right. So we started off in practices, but now we're seeing use cases for it in the hospital and emergency departments and health systems across the country. And so it's also going to continue to apply and how we can use it will continue to grow. And so I think it's a great thing because it's going to snowball.
- [05:34]
C
Right.
- [05:35]
B
And you can feel that even today.
- [05:37]
A
Beyond the success, I should say, that you've seen at Trinity, Dan, have you seen successes in other health systems that you've been able to apply or you think might apply to your own health system?
- [05:50]
B
So I think, like I said, so our focus to date has been in our physician practices, right. Especially but not limited to primary care.
- [05:58]
C
Right.
- [05:58]
B
And even when we set out down this path with ambient listening and primary care, we wanted it to eventually have a positive impact on the patient. And so we said when we have a. We as a country, right. To your point, more than just Trinity, we have an access problem in primary care. And so we know that our providers who are using AMI listening in primary care today can see just about 2.1.9 patients more per day. So we're improving access for our patients. And we've seen our access measures continue to improve over the course of the last two years. And we think that's part of the reason.
- [06:34]
C
Right.
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B
Because access is a key part of our Trinity Health strategy. It does make it easier for patients, and that's enabling our providers. And so I think we have internally learned that.
- [06:44]
C
Right.
- [06:45]
B
But I think also what we're seeing others, because we're all going to learn from each other as these things evolve. So I've talked to peers and partners across the country who are using this in the emergency room. Then how do you figure out how to make ambient listening work in the emergency room? You're not necessarily seeing two patients more per day. It's not that you have a bottleneck there, but there are still efficiency opportunities. The same thing holds true in nursing. So I know a number of Colleagues across the country who are using ambient listening and nursing. And we're all going to learn from each other about mistakes that you might make. Because again, back to this interplay between clinical and operational, and how do we use technology as a means to an end? It's going to be super important for us all together as we sort of learn how this technology is going to work.
- [07:27]
A
Dan, thank you for laying out all these things that are looking ahead to several stages in the future. And that's a very good picture, I think, of what we're going to see here in the next few years. I'm also curious, though, you've had so many great details on how the technology is going to be helping not only clinicians, I should say, but patients. Is there anything else that's really exciting you right now? It can be AI. It could be anything, really.
- [07:54]
B
I think the other is, I think the move to outpatient care is exciting for me and I think exciting for us. I think it's another venue of making it easier for people, because I think we'll be able to. By having more sites of care closer to home, the ability for people to get care as an outpatient will improve both access. It'll be easier to navigate and make it more affordable, which is another key part of this. So I think that moved outpatient, which is complicated but really important, I think will be an important step for us. A few of us were talking, and then I was talking to family members over the weekend, how many surgeries used to be done in the hospital and now are all outpatient, and how much people prefer that. I'm excited for us as we grow our ambulatory surgery presence across the system and the ability to deliver care that way and be more efficient is another thing that I'm very excited about. There's a tremendous amount of opportunity there.
- [08:53]
A
Last thing I'll ask related to and really anything that you're excited about, what is key to getting staff and even patients on board with all these changes that are coming so quickly?
- [09:06]
B
I think it's always important with change. One of the things I like about technology, and especially today with AI, is, you know, it changes the way we do the work.
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C
Right?
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B
And I love change.
- [09:18]
C
Right?
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B
But not everybody loves change, right? So I think when I think about, you know, how do you lead through change? A couple of things. One of the things I would emphasize is always remember your why.
- [09:30]
C
Right?
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B
So we call our electronic health record at Trinity Together Care, and we start every Together Care meeting with our why. But everybody doesn't have the same why. I have my whys, but other colleagues and other caregivers have their whys. And so everybody has their why. So I think one of the things important for us is as we think about technology or any of these changes, let's not lose sight of our why. But our why always ends up with providing better care and helping people achieve their health goals. But never lose sight of your why. The second part of it is over. Communicate. So be a voracious listener and be a good communicator. Because it's hard to under communicate when things are changing. And you're always going to have to adapt and that bidirectional communication is really important so that you can pivot and evolve. And then the third is to develop the ability, and this is a challenge for all of us to fail fast, because not everything we're going to do is going to work. We have to develop the opportunity to fail fast. And the hard part about that is we're living in an economic environment which is not at all very forgiving.
- [10:37]
C
Right?
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B
And so on the one hand, it makes it all the more important to successfully fail fast and not let things linger that aren't being successful. But by the same token, and this is hard, we can't resist change because of the risk of failure. So it is, how do you mitigate risks and how do you have good indicators of what success looks like and make sure that you're on track because you don't want failure to be a resistance to future change, because change is the constant.
- [11:06]
A
Dan, thank you so much for laying out such a realistic and eventually meaningful process that change can be right. As you said, not everyone loves change, but it really is inevitable. So we appreciate you taking us through all the things that are going on at Trinity Health and how you intend to make things easier for clinicians and patients.
- [11:29]
B
The future is great. There's lots of opportunities for us and lots of tools coming our way that are going to help us be successful. And it's very exciting.
- [11:36]
A
Wonderful. Thank you, Dan. So, until next time, have a great one.