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Becker’s Healthcare Podcast
Making Digital Health Work for Rural Communities with Christian Milaster
00:13:30
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- [00:02]
A
Every year, Becker's annual meeting brings healthcare leaders together to unpack the most pressing issues facing the industry. And every year those conversations shift in profound and unexpected ways. This April, more than 3,500 healthcare executives will return to Chicago for Becker's 16th annual meeting. 795 elite speakers will offer new lessons, new case studies and predictions about what comes next. Join us April 13th through the 16th. For the agenda and event details, visit Beckershospitalview.com and click on the Events tab in the upper right.
- [00:38]
B
This is Scott Becker with the Becker's Healthcare Podcast. I am thrilled today to be joined by Christian Molastor and Kristen's going to talk to us about what he does, how he's grown, his business, the world of digital health, and a lot more. Kristen, so pleased to be with you. Can you take a moment to introduce your introduce yourself and tell us about both yourself, your career and your firm?
- [01:03]
C
Very good, yes. Thanks for having me on here. Glad to be talking with you. My name is Christopher Laster. I'm a German engineer by background, came to the US in 1998 and stumbled into healthcare at the Mayo Clinic in Rochester, Minnesota in the year 2000 and fell in love with healthcare and then had an opportunity to actually jump ship and focus on sharing my expertise and my passion for improving healthcare delivery with a larger audience. I shall say and I'm now leading Ingenium Digital Health Advisors and we are a vendor agnostic boutique consulting firm and we're specializing since 2012 on rural health transformation through what I call digitally enabled care. So digital health telehealth, RPM and in our role we provide design and implementation guidance to rural health systems, critical access hospitals, rural health clinics, community health centers and behavioral health agencies.
- [02:04]
B
Take a moment and tell us about it. Seems like there's a tremendous amount of funding that's going to move towards rural health. There's a tremendous shortage of physicians and caregivers in rural health and often aging populations. In your view, how could some of this money that's going to flow towards rural health be used well to actually make an impact on rural communities and people's lives?
- [02:30]
C
Well, as you can imagine, for someone who's been in this digital health care delivery spectrum and have worked almost 90% of our work in rural health, I'm very excited about this and I think I'm also very excited about how CMS is taking this on very differently than any grant funding in the past by really communicating very clearly that they want to see really clear outcomes and clear results and not just the spending of the money. So I'm very excited about the opportunity ahead of us here to really use everything that we've learned about how to not implement digital health in the last 20 years and to actually use this funding as an opportunity to do it right, to give rural patients more access to primary care and behavioral health to begin with, but also obviously to specialty care, which because of the geographic distances is always hard to come by. And so I think this is a great opportunity if and when it is deployed in the right way, and if and when the states are designing their RFPs in a way that demands what I call implementation science with regards to the deployment, not just the purchasing of digital health technologies.
- [03:42]
B
Fascinating. And talk about the trends that you're watching in two areas, digital health and rural health. What are a couple of the big trends that you're watching?
- [03:51]
C
Yeah, I mean, digital health has this plethora and it's now even fueled even more by AI. Again, the advancements that we have done in abilities that we can do that are also now powered by AI capabilities are virtually endless. I mean, there is no shortage of innovation and hasn't been a shortage of innovation for many decades now, but there's a shortage of implementation. And so what I have seen repeatedly, especially in the last weeks, come across my kind of inbox or my LinkedIn feed, is that realization that technology alone is not sufficient to really move outcomes and to achieve outcomes while it's theoretically possible. It always fails because not enough thought is being given to how to mindfully integrate these digital health solutions into the workflows and into the processes and actually give clinicians a chance to be involved in the design integration process. And so that's the one trend I'm seeing, is that there's growing realization and growing talk about that some companies have discovered, just like what we're doing, that there's a right way to implement digital health. And I think that knowledge is now making its way to the digital health vendors as well as into the committees that are making decisions about buying technology. With regards to the trends in rural health, I think it's not much has changed other than the growing need exacerbated by the anticipated cuts in Medicaid insurance eligibility. And I think the population increasingly, why they have more access to technology, maybe more technical affinity than 10, 20 years ago. The needs are still out there. And the, the chronic disease burden. We work with a couple organizations right now in West Virginia is just very high. And I think it's over the time, it's been a disproportional increase in chronic disease morbidity and also maternal health deserts are really, really very disheartening to learn about in many rural areas. So I think we've just seen an exacerbation of needs that despite all these, the progress with telehealth and other things still really haven't moved the needle. And so this rural health transformation funding is hopefully an opportunity to do right by the people who live in rural area.
- [06:27]
B
Thank you. You've got more and more rural health systems closing down labor and delivery and other services not because they want to, because they can't staff them. Are there answers to some of these questions? Are there long term answers to some of these questions or are we going to see more and more of the population just move to more metro areas in rural communities aid. Any quick thoughts there, Chris? I know that's a deep question, Christian.
- [06:53]
C
So I apologize, but yes, and it requires, it's a systems that requires a system solution. Yes. I mean the reality is that we cannot manufacture more labor and delivery staffing. It is very hard and obviously the actual intervention where we need to see the patient in person can only be done at a unit and it's not feasible if you only have five, six deliveries a month. So financially that doesn't make sense. I think it's an ounce of prevention. It's worth a pound of cure, I think is where we need to go with. And so I think we need to identify these high risk pregnancies early. Actually they are identified but we need to manage them well, we need to manage them with some digitally enabled hand holding, whether that's video visits, whether that's remote physiological monitoring, whether that's secure messaging, whether that's an app, but really hold the hands of this expecting mom and this budding life and really help them to stay safe, to stay healthy so that their condition does not exacerbate. And then it is a high risk pregnancy, but it's then a coordinated and conscious transition from being pregnant at home to then going into a more distant unit. But it's not an emergency transport. And so I think I really want to see much more embracing of these technologies which again the governing association has also recognized that they need to really change the protocol which was developed in the 1930s and hasn't really changed.
- [08:33]
B
Thank you. And take a second. Aside from being founder and CEO, you are titled Chief Methodologist and talk about why that is and what drove you to that title because it must mean something in how you think about the world and what you do.
- [08:47]
C
Yes, I think again, I'm an engineer by training. I think that every problem can be solved through a systematic approach and through a methodology. I thrive on the ability to design approaches or systems that are highly efficient and highly effective in being efficient. And so those are really the two driving forces behind my motivation. And so with that, I have developed over the last 25 years, starting at the Mayo Clinic, really a lot of systematic approaches on how to do certain things, how to launch a telehealth service, how to implement an RPM program, how to prioritize digital health strategies. And so I'm constantly trying to document it. And it also stems from this understanding that if, if the process is not defined, then you cannot improve it. And so in order to improve it, to get better, you really need to take the time to identify what is your methodology, what is your approach, what are your systems, your processes, your tools, your templates that you're using to create the outcomes that you want to create. And that really, as a leader of a boutique consulting firm, I see as my, the big asset that I can produce and contribute to the success of the consulting teams that we have and ultimately to the success of the clients and the values that we create for them.
- [10:18]
B
Really remarkable. And Christian, tell us what you're most focused on and excited about this year. Where are you most focused and excited this year?
- [10:26]
C
4 letters. RHTP Rural Health Transformation Program. This is the golden moment, so to speak, in my career where everything is coming together. There's funding available, there's avail, there's awareness about the needs for our expertise. And so we're that that is the primary focus is to really demonstrate in this first year of how this can be done well so that in future years, because the funding is over five years, we will be able to call on and help other states and other regions to repeat the successes that hopefully we can demonstrate this year can be achieved with the RGP funding, building on our 120 or so projects in rural health implementations.
- [11:12]
B
Thank you. And you've had a great leader, a great career as a leader, an entrepreneur, an engineer. What advice would you give to emerging professionals, emerging leaders? What advice do you give people?
- [11:27]
C
The biggest change for me was really investing in growing my own emotional intelligence. I came across this concept 20 years ago and I dived really deep into it. And then so that's one of the aspects is really recognizing and managing your own emotions and really understanding the emotions of people to be a good leader, be a good team member, be a good colleague. And then the other tools that I'm using is practicing the four agreements and the seven habits of highly effective people, specifically from the four agreements to don't take anything personally, that everybody is running around with their own story in their mind and it's never about you, it's always about them. And then being proactive, I think that's as a leader is the biggest skill that you can bring is to take action, to show resilience, where emotional intelligence comes in. And then the last and probably most important part is surround yourself with people that are smarter or more emotionally intelligent than you. And that doesn't just mean the people in your life or that you interact with, but the people that you read, the people that you read on LinkedIn, for example, that post and great posts or the people that write great books or are on great podcasts. So really immersing yourself with other leaders and looking as to what you can take on to grow and constantly improve yourself.
- [12:51]
B
I love that concept of self improvement. Christian, I want to thank you so much for joining us today on the Beckers Healthcare podcast. It's just a great pleasure to visit with you. Can you take a moment again and tell everybody the name of your firm and your full name so people know where to reach you and they can find you on LinkedIn. But give us the full name of the firm and your full name again?
- [13:10]
C
Absolutely. Thank you very much. It's Christian Malaster. That's M I L A S T E R. And the firm is Ingenium Digital Health Advisors. Can be found@IngeniumAdvisors.net thank you so very much, Scott.
- [13:23]
B
Kristen, what a pleasure visiting with you. Thank you so much for joining us.
- [13:27]
C
Thank you.