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Becker’s Healthcare Podcast
Dr. Gregg Nicandri, Chief Medical Information Officer at University of Rochester Medical Center
00:12:52
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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 Dearda with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Dr. Greg Nicandre, Chief Medical Information Officer at the University of Rochester Medical Center. Dr. Nicandre, it's a pleasure to have you on the podcast today.
- [00:57]
C
Super excited to be here. Thank you for having me, Laura.
- [01:01]
B
Absolutely. Now I'm excited for our conversation because I know we're going to be digging into some of the cool things that you're doing at the University of Rochester Medical center and specifically around artificial intelligence and virtual care. But before we dive in, I'm wondering, can you share a little bit more about yourself and your work in healthcare?
- [01:18]
C
Sure. So I'm the Chief Medical Information Officer at the University of Rochester Medical center, which is in Upstate New York. We're a mid sized system basically covering the area between Syracuse and Buffalo down to the Pennsylvania border. I also am a practicing orthopedic surgeon and have been CMIO now for about six years.
- [01:47]
B
That's amazing to hear and what an incredible experience, especially leading into what is happening today in healthcare and the digital transformation. I know nearly half of medical pract reported using AI in some capacity over the last year and it remains a key topic for health IT leaders. From your perspective, what are some of the use cases that are making a difference right now and how are you leveraging them within the University of Rochester Medical Center?
- [02:15]
C
Yeah, so I think the biggest use case, at least in my wheelhouse, where as Chief Medical Information Officer, my main task is really to try to improve clinician experience through leveraging technology to optimize workflows and well being. And you know, ambient documentation has been revolutionary really for the group of providers, particularly on the ambulatory clinical side. You know, we've had a pretty big rollout with about 1,000 licenses now distributed to providers who are using our ambient documentation solution. We've got 75% of those are actually active users and We've had really good outcomes across the board from our well being measures, our work after work measures our chart, closure rates and even revenue improvement.
- [03:21]
B
That's amazing to hear and you know, certainly interesting to have that opportunity to use technology in a new way and see some pretty stark results. As virtual care expands from AI enabled tools and remote monitoring to broader digital health platforms, introducing new technology brings its own challenges. What advice do you have for leaders who are navigating everything from governance to patient engagement? And can you share example of how your organization is balancing innovation and operational constraints?
- [03:50]
C
I think our motto at URMC is Meliora, which means ever better. It's important as you're kind of a continuous quality improvement organization that is always seeking and striving to improve, to understand that the capacity for the organization to actually change and adapt is limited. And so you really have to understand who will be using the tools, how it will impact them. And ideally you're working very closely with the people who design the technology, either the vendors or our own IT group to ensure that it's usable and that it's solving a problem. People who are going to be using the technology actually see if it solves a problem for them. Obviously adoption is much higher and we learned that through the Ambient Documentation initiative. This was solving a huge problem. And so it was very easy to get adoption wide uptake and to very quickly see results, whereas other technologies, depending on the level of impact and the level of usability, sometimes we've fallen short of that. Got it.
- [05:12]
B
That makes a lot of sense, you know, is really great advice, especially thinking through all of the different changes and technologies that are coming down the pipe today. And to your point, when you look at the change management on the people side, what has worked well to really help them understand, you know, the technologies and increase the adoption as well as, you know, I guess willingness to try new things and jump in.
- [05:40]
C
I think really what works well is kind of having a strategy and a rationale and having the strategy actually come from the people who work in our organization, frontline clinicians and staff. So I think it's very easy to get stuck into the trap of talking to vendors who, you know, say, hey, I've got this really cool technology and I think you have this problem and you could use our technology to solve that problem. Or even with our, you know, our ehr saying, you know, we think that you should do this because we think it'll be great for your organization. Well, you know, nobody knows our organization better than the people who work in it. And so really being close to them, staying close to them, understanding their pain points in saying and writing down kind of, you know, these are the things that are challenging us. Let's try to find some solutions that address these challenges and then go out and partner with your EHR vendor or some of the major, you know, incumbent technology players like Microsoft or Doximity or others to try to see if you can solve those problems together. I think that's been way more effective than just saying everybody's got a chatbot, we should probably use a chatbot. What should we use that chatbot for? And then just trying a pilot and seeing how it goes. I think you need to start from the inside and move out to the vendors as opposed to the other way.
- [07:28]
B
Got it. That makes a lot of sense and is a really helpful way to look at things and make sure you've got yourself focused and the team focused as well. Now, I know there's been a lot of recent legislation coming down the pipe when it comes to technology as well as healthcare. So how are you seeing some of both the state and federal regulations affect healthcare organizations and it specifically, have you had to adjust any of your strategies in response?
- [07:54]
C
So it has been very challenging, especially with the recent government shutdown. Right. We had a pretty good telehealth operation going and we've had some providers because it's been in place for now four or five years, who have converted their entire practice to remote and you know, unfortunately if they see Medicare or Medicare Advantage patients were no longer being reimbursed for those visits because home for the patient is not any longer considered an appropriate site of service. We also stood up a hospital at home program that we actually launched and went live with in September. And we were getting some really good results to the point that when we had to shut the doors on October 1, our major insurance partner contacted us and said, hey, well, can, can you just kind of keep, keep that open for our patients at least? But it really wasn't viable, unfortunately, for, for us to do that. And so, you know, I think it's, it's caused us to have to do a lot of extra work coming up with contingency plans, not necessarily saying we're, we're going to completely change course or we're going right back to, you know, all brick and mortar in person visits, but really kind of trying to understand how we can be agile as an organization and pivot in kind of these uncertain times.
- [09:33]
B
That makes a lot of sense. You know, it is fascinating to see how quickly the policies can change and then the broader impact that it has upon programs like your telehealth, virtual visits, as well as hospital at home. I mean, I think it's a great point you made that it can be challenging to spend time, time and energy and resources on those contingency plans just because, you know, there are so many other things that you have to be focused on as well.
- [09:58]
C
Yep, absolutely. Yeah, it's. It's almost like you're doing, you know, probably a third extra work because now you're having to come up with the solution based on the rules of today. But you've also got to think about a lot of what ifs to make sure that the whole thing makes sense and you know, what's going to happen and if different rules and regulations change or come into play or come into effect.
- [10:25]
B
Absolutely. Well, I think as we wrap up our conversation here, I'm curious, what's your top piece of advice for healthcare leaders as they prepare for further advancements in technology as well as the increasing demands for care?
- [10:38]
C
So I think it's really just adhering to sound continuous improvement principles. Right. You want to set up a system that facilitates agility. You want to continue to focus on clinician well being, staff well being, because that keeps them kind of engaged and more willing to adapt to changes which, as we've seen, are constantly coming, whether that's regulatory or whether that's brought upon by technology. And just to remember that, you know, you're solving problems for patients and providers and keep it focused on them, not necessarily, you know, what's the easiest or what's the coolest new thing that you want to try. I think, you know, there's a lot of things out there that, you know, you can do. There's a lot of problems to solve, and sometimes it's hard to kind of not chase after the shiny object, but to really focus on those things that are important as opposed to always, you know, what seems like it's the urgent thing of the day.
- [11:54]
B
Absolutely. That's such an important reminder. Dr. Nakandre, thank you so much for joining us on the podcast today. This has been a really fun and fascinating conversation, and I look forward to connecting with you again soon.
- [12:06]
C
All right, thanks so much.
- [12:10]
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 burdens, streamline billing and payments, and deliver critical insights when clinicians need it most. That means fewer clicks, more 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.