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Becker’s Healthcare Podcast
Using AI and Operational Strategy to Transform Care Delivery with Dr. Salim Hayek
00:21:03
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- [00:02]
A
The most important healthcare decisions don't happen in isolation. They happen when leaders come together. Becker's 16th annual meeting brings together more than 3,500 hospital and health system executives this April in Chicago. With 800 speakers from Ascension, Cleveland Clinic, Common Spirit and more, the conversations get real. Leaders will share how their scenario planning for policy shifts brief, breaking through value based care barriers and building clinical teams that translate new ideas into real world care. Join top decision makers in the room April 13th through the 16th. For the agenda and event details, visit BeckersHospitalReview.com and click on the Events tab in the upper right.
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B
This is Laura Deardo with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Dr. Saleem Hayek, Chair of the Department of Internal Medicine and Chief Transformation Officer at the University of Texas Medical Branch. Dr. Hayek, it's a pleasure to you on the podcast today.
- [01:00]
C
Thank you for having me, Laura.
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B
Now I'm excited for our conversation because I know there's so much happening in healthcare and it's truly a fantastic time to be in the space. So transformational in a lot of technology as well as new opportunities in care delivery models. But before we dive in, can you tell us just a little bit more about yourself and the organization?
- [01:20]
C
Thanks again Laura for this opportunity. So my name is again Salim Haik. I'm a cardiovascular specialist in Cardio Oncology, which means I take care of cancer patients. I'm also a physician scientist. I joined utmb. Now it's been a couple years from the University of Michigan where I was director for the Franco Cardiovascular center and I've joined UTMB as a Chief Transformation Officer and I'm now the Chair for the Department of Internal Medicine. UTMB is a truly special place. This is a institution with history. It is the first medical school west of the Mississippi. It has at its core truly a driven mission right care for the people of Texas and it's in its history taken care of underserved population, the indigent population, really a big focus on research. But in the past decade there has been a new focus for the University of Texas Medical Branch and its expansion and growth to be able to bring our services to the people in southeast of Texas. I was very excited to join UTMB as part of a new leadership team, new president, new dean, new Provost in this renewed mission to expand and grow the University of Texas Medical Branch and provide specialty services and primary care to the population here in Texas.
- [02:48]
B
That's fantastic to hear and you know, really cool that you have that opportunity to Care for such an important population and a variety of people within the community. So I'm excited to learn more about that. And you know, to that point, can you tell us about an important initiative that you led in the last year? What did you do and what were the results?
- [03:05]
C
One of the exciting parts here to be part of UTMB and this growth story is that it is a build project, right? We are not just, not just recreating, but even creating new processes, new approaches to enable intentional growth. And what we mean by intentional growth is not as much just capturing market share and deploying physicians, but really addressing a lot of the major challenges that healthcare faces right now and will continue to face or maybe face even more in the future, which is essentially the financial challenges, the unpredictability. And so a lot of what we are doing as we're growing is understanding how can we be more efficient but also provide the highest quality of care. How can we differentiate ourselves from our environment, from our competitors? And what is it that UTMB can provide that is unique? And so as part of my role as a Chief Transformation Officer, we were coming in at a time where AI is just launching. And when we think about AI, we think of a lot of those sexy, cool image producing, the whole large language model, providing chatbots, interaction with patients. Some people even think of AI from the perspective of, well, advancing diagnostics. These are the really big sexy things. But I'll tell you, the major value of AI is in to automate the less sexy processes, the backend process, how medicine works, how we enable our physicians, our staff, to provide the best clinical care. And the way we do that is leveraging AI to lift the administrative burden. So a lot of that work we're very proud to be doing and to enable a really much more nimble and efficient system to support our physicians. I'd say if I want to, amongst this big title, right? Lifting the burdens, making administration more efficient, ensuring the scope of our physician is at its max. One of the biggest initiatives is creating AI triage processes. And so in the current state of American healthcare, you know, it is estimated at about 40% of the care that we provide in the United States is low value care, in a sense. I'll give you an example. You know, a lot of people come back to their clinicians just to get refills of medications. I mean, you know, that's in a world in which you have people waiting weeks and months to see a specialist, yet you have scheduled patients coming in for a refill, or for example, a cardiologist might be seeing someone for hypertension, whereas hypertension could be easily addressed by a primary care physician. What we are doing now, what we've built, this is unique to utmb, is AI referral triage that is automated, that would help direct any referral, any patient coming into the system to the right provider based on their urgency, their complexity, the specific problem that needs to be addressed. And so suddenly we're prioritizing patient, that needs to be seen the most. And not only that, we're getting them to the right physician. So this is something that we've built over the past year. We've launched it, we've launched it in certain areas in early in January. And we are so excited to see some immediate impact in improvement of access and increase in complexity. And we are rolling it out gradually for the rest of the department of medicine and hopefully soon thereafter to the rest of the institution.
- [07:00]
B
I love that. I think it's so critical, as you mentioned, to have the AI and technology really working in spaces that can augment the human workforce and make things more efficient, effective, and truly provide a better experience across the board. And so that idea of the AI referral triage is really cool and seems like it's solving a good number of challenges at the same time. So when you're putting together something like that and really innovating and figuring out where you want to devote your resources, you know, how does that conversation start and what does it look like to build something internally like that?
- [07:35]
C
Good question, Laura. Here's. Here's the reality, right? And this is again, a reality that all of us are experiencing across the healthcare system. Margins are getting thinner. If any, if any, people are making significant margins. They're tremendous. Unpredictability in terms of the regulatory and reimbursement landscape coupled with that, there's an aging population, there's a huge need for medical care. And so how can we address this challenge? The answer cannot be, let's put more doctors, let's throw more, more people into the mix. Because the reality is we don't have enough doctors, we don't have enough apps, we don't have enough money to be paying these people the way they need to be reimbursed. And again, I'm not talking or referring to utmb. I'm talking about really American health care in general. And so when you think about what do we need to do that can be sustainable, is rethinking how we currently do things, taking our current workforce and making them more efficient. And this is where an efficient is not Just in the number of patients seen, but having them seen the right, having the right patient seen at the right time by the right provider. And so this is a lot of how our thinking has gone into this and how do we devise this. We looked at, okay, how do we transform our current workforce into being more effective? And I think that is the question that everybody should be asking because there is tremendous opportunities. But in that data that shows the significant amount of low value care that is being provided now, how do we, how do we go about doing this? The most important is the vision, right? I am someone who is technologically savvy, so I'm, you know, I've always been kind of the tech geek as a kid growing up and now you can imagine this world, this environment, how excited I am to be, to be living in this day and age and so with all the tools and all the toys that are available to us. So, you know, I know enough to be dangerous, let's say, when it comes to that field. But I'm not a computer scientist, I'm a physician. I do this to care for patients. But I've always wanted to leverage technology to help improve how I take care of patients. So with that vision comes first, second, you need again the technical support. And I'm very proud and excited to say that utmb, we have a great slew of engineers, of physician, you know, I would say physician technologists, right? We talk about physician scientists, but now I think we need to talk about physician technologists, right. Who have that interest and that we consolidate it together into what I call the AI center. So we now have a UTMB and AI center that comprises of these stakeholders. And what we do is that we build our own products. So that's a big part of that. But most importantly, we also partner with specific companies. So we have an evaluative process in which we have companies come and present to us their products and we gauge the potential for collaboration, the potential for building together. And it's done again in a very strategic way. Based on that initial vision that I set forward is that how do we again lift the burdens from our physicians, from our administrative, administrative staff, how to make our current workforce more effective and how do we generate more value for the patient and for the institution. And based on that vision, we've again focused our own engineers and our partnership with industry to create these products as that we're, that we're deploying here at utmb.
- [11:26]
B
I love it. That's amazing to hear and you know, really cool that you've got that type of innovation pipeline within the teams that you have, both on the clinical side as well as the technology side. And putting that together is so amazing. So I love the way you talked about problem solving too. I think there's so many challenges within the healthcare world today, but seeing where you can generate the most value makes a ton of sense. And, you know, to that point, in looking ahead for the next year or so, what are some of the big priorities and headwinds that you're focused on for 2026?
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C
So as we move forward to 2026, there's a lot of regulatory uncertainties, right? I think uncertainty is the major headline across across health system. I was just at the meeting of the association of Professors of Medicine in Scottsdale, and that was the biggest keyword, right? Uncertainty for the future. And I think the way we challenge that is again, going back to what I mentioned earlier, you know, making sure the foundation that we have is solid and robust. And so, again, while, you know, as builders, as leaders, we always want to, we're excited to have a new building, have a new fancy program with a new name. That is not what is what is going to help us sustain ourselves. That is actually added risk.
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B
It's.
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C
There's a lot of excitement and it's great. And I would love to have one day a fancy building with fancy tools. But as we as the in challenging uncertainty, we got to have a robust foundation to again, address these headwinds. Our major priorities is to make sure Texans get the best care and timely care. And so we have, as with everybody else, big access challenges. And a lot of our work in AI is directly addressing these access challenges through prioritizing those that need to be seen earlier and increasing the value of our care.
- [13:23]
B
That makes a ton of sense. And, you know, I think looking at that idea of uncertainty and especially the idea of risk in healthcare too, of course, you know, trying to figure out how to meet the challenges of the day are critical. But when you are also wanting to like, grow for the future in an uncertain time, how do you balance that and really just make sure everyone is focused on the right things at any given time?
- [13:49]
C
That's a great question, Laura. It's really distinguishing between de risking certain activities, right, Ensuring a foundation for growth and then actually investing in that growth. And so there's, you know, there's a mantra that, you know, you can grow yourself out of anything. I don't think that's true in healthcare. And the reason I don't think that's true is because the margins are so thin. Right. In a sense that, you know, and whenever you're reliant on an environment that is unstable and you're investing significant dollars in growth, and that growth really is highly dependent on the payer and reimbursement and perhaps, for example, let's talk about research. I'm a physician scientist. I want to grow academics, and that's been one of my greatest priorities. But how do I navigate the NIH situation? How do I navigate what funding looks in the future? So, point is, the first step is in establishing what is the risk of the different strategies or approaches that we want to do. The second step is before deciding to. To invest and grow, do we have a solid foundation? And again, when I say solid foundation is, are our services operating the way they should be? Are our physicians deployed the way they should be? Do we have a situation in which our physicians trust leadership? Right. Especially in times of change, that trust component in academic health systems is critical. Healthcare and academia is rife with distrust. And I have invested heavily in establishing a relationship of trust with our faculty so that they know that change is coming and that we are there not just to support them, but that they're part of that change. They're part of the planning, they're part of the vision building, and they're part of the execution. And so that foundation is critical. And although it's not always the sexiest thing, I think it is what is going to save us. And that was. That's kind of what. What is going to allow us to then do those exciting elements, which is building new programs, building new subspecialties, new tools, new gadgets. That's. That all comes after you've built a solid foundation. If the foundation falters, everything, everything falters. Right?
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B
Yeah. Yeah.
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C
In many programs, I mean, we've seen that across the nation, program programs that are just faltering because you have people leaving, you know, investment that just haven't yielded the return, the actual returns.
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B
That's such a great point. And, you know, always important to remember and keep in mind as you're looking at how you want to move forward into the future, you know, definitely don't want to be one of those programs that starts struggling after a few years, just, you know, when the momentum from the initial launch or whatnot wanes a bit. So I love that. What do you think the hardest thing you'll have to do in the coming year will be?
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C
You know, the honest answer is I don't know. Right. And the reason I don't Know it's because of the uncertainty that exists. What I'm hoping, well, what I anticipate the hardest thing will be is having to make decisions between, you know, where to invest, right, where to grow or where to cut. And so every idea is often in medicine, right? You get a lot of fantastic ideas and here's the reality, we can't execute them all. And that's my point. When we talk about de risking prioritization, foundation building. And so these are decisions that are not easy, right, because we don't work in isolation in academic healthcare there are multiple stakeholders, many leaders, many people with fantastic ideas and we need to decide on what is our next steps. And these are often difficult decisions, difficult decisions. But what makes it even more difficult is the uncertainty that lies ahead. And thus again my emphasis on foundation building and making sure that our foundation is strong enough to resist any of those challenges,
- [18:05]
B
I love that. I think that difficulty and the challenge in making those decisions and understanding or trying to figure out what's going to be the right thing today to build a stronger tomorrow is no easy task. I think having that foundation, as you mentioned, is critical and then continuing to build from there and staying nimble. Depending on what could happen, any kind of number of things could be on board for the rest of the year. But it's just fascinating to have that type of leadership and the structure within the organization to respond to it. And obviously we don't have a crystal ball, but as of now, I guess where are some of the areas that you are most strongly considering additional growth or how are you looking at success in the next year or so within the health system?
- [18:55]
C
Laura, just to add to your point, point, it is impossible to predict how things are going to look even within five years. I mean, anybody who is into the AI space realizes that the momentum and the rapid development of that technology is at a pace that just makes the subsequent impact or even the side effects of it completely unpredictable. And so that is both exciting but scary at the same time. So, so it's, it's extremely difficult to predict now in terms of our short term girls. So you're asking me what, what, what do I, what am I looking forward in a year? What I'm looking forward in a year is a significant return on investment on our development of the AI referral triage. And we want to see improvement in access. We want to see the sickest patients get seen first, first and get the care that we need. We want to see the right downstream utilization. We want to see surgeons busy doing what they do best and our specialists seeing the right patients while our primary care providers continuing holding the line in terms of the foundation of care for these folks. And so I'm very excited to I'm excited to see what kind of impact will that will these strategies deliver to us because this is not a long term impact tool. It will impact us on the short term as well as the long term, but it will have an immediate short term impact and I'm very excited to see what it's going to look like. I love that.
- [20:36]
B
Dr. Hayek, thank you so much for joining us on the podcast today. This has been such a fantastic conversation, truly valuable to understand your perspective and all the things that you're working on right now. And we'll be excited to continue this conversation as well the annual meeting. I know you'll be speaking there and so it'll be great to connect with you and see you at that point in a couple of weeks. So again, appreciate your time today and look forward to staying in touch.
- [20:58]
C
It was my pleasure. Laura, great to see you too.