Empowering Healthcare Transformation Through AI Insights with Joe Moscola, Executive Vice President of Enterprise System Operations at Northwell Health

[00:00:02] Hey everybody, welcome back to the Outcomes Rocket recording live here at the Vive event in Los Angeles, California

[00:00:09] Today I have the privilege of hosting the amazing Joe Moscola

[00:00:14] Executive vice president of enterprise system operations at Northwell Health such a pleasure to have you here Joe. Thanks so much

[00:00:21] So I'll appreciate the opportunity absolutely a lot of great things happening here at the event and

[00:00:26] Really just to kick things off would love to to understand

[00:00:29] What's happening at Northwell the transformation the digitization all the efforts that you guys are up to?

[00:00:35] Thanks so much and really a pleasure to be with you Joe just a little bit context

[00:00:39] Northwell Health we're based in the northeast in New York metro area where an 18 billion dollar organization

[00:00:45] We see just about three million patient encounters a year and we've got about 21 hospitals and 900

[00:00:52] Physician locations what that means is we're pretty big

[00:00:55] But we're working really hard to not only make ourselves feel small but most importantly make ourselves feel personalized

[00:01:01] And I think that's where we really get into a lot of what we're seeing at Vive is that

[00:01:06] ability to leverage technology and ultimately

[00:01:08] Artificial intelligence as well in a really special unique way that connects us with our customers in a way

[00:01:13] We don't even understand today. We're on a digital transformation journey. Okay, great

[00:01:18] You've heard one organization say that you've heard 100. What does it mean for Northwell? A few things one

[00:01:24] We took a look at who's at the center of our circle just to sort of re-forecast the strategy just about two years ago

[00:01:29] And for us it's of course. Yes patient and consumer

[00:01:33] It's the clinician because a lot of tools and technologies have not enabled that individual

[00:01:38] They've added to that individuals workload without removing and so you get to these concepts of burnout and frustration

[00:01:45] Where's the joy in medicine?

[00:01:47] And then the third and arguably as important as the other two is

[00:01:51] Discovery like I said three million encounters. We certainly saw during COVID

[00:01:55] How much we could learn and grasp from all of those encounters and arguably the most important thing that we

[00:02:04] Really enjoying the marketplace that we are in is the incredible diversity

[00:02:08] You look at a county like Queens County

[00:02:11] Hundreds of different dialects that are spoken and so this notion of equitable care and how we handle that and how

[00:02:17] We learn from that is a big part of our journey. How does that translate?

[00:02:20] We are working really hard to modernize our solutions. We're converting to a completely new electronic record across all parts of organization

[00:02:27] Yes, epic second we are working to move as fast as we can to the cloud

[00:02:33] Obviously, that's a precursor to a lot of things

[00:02:35] We're going to talk about today and then lastly really getting focused in on that consumer relationship

[00:02:40] We've signed a deal with sales force just about a year and a half ago that we're really excited about and

[00:02:45] Going to be leveraging a lot of that information for what I'm sure we're going to talk about today as well

[00:02:50] That's fantastic Joe. Well, definitely a lot brewing over there at Northwell and all centered on patients care

[00:02:57] providers and

[00:02:59] Love that you mentioned just hey get small and get humble because at the end of the day

[00:03:03] It's a beast that that you really have to tame right exactly right exactly right love that alright cool

[00:03:08] Let's dig in our questions today are mainly going to be around AI

[00:03:11] How is AI currently used in your hospital and can you highlight some AI driven?

[00:03:16] Innovations that have benefited care and operations. Yeah, sure AI has been around for a while

[00:03:21] There's numerous examples throughout our organization

[00:03:24] What we are actively trying to do especially with the growth and success of large language modeling and

[00:03:31] Some of the sort of computing capabilities. We're really trying to put our arms around it a little bit more

[00:03:37] We've got instances within

[00:03:39] Imaging where we're leveraging it to evaluate for secondary findings. We've been partnering with AI doc for a number of years on that

[00:03:47] We have homegrown initiative where we've done one of our pediatric cardiac surgeons at our children's hospital

[00:03:54] Is using that same kind of technology and AI to identify

[00:04:00] congenital anomalies that haven't necessarily been followed

[00:04:03] From other studies, etc. And then making sure that we do get them within our care

[00:04:08] There's other examples within staffing and efficiency that we've leveraged for some time just in terms of ease of

[00:04:15] scheduling and nurse preference all that said we have recently

[00:04:21] Created a Center for artificial intelligence which we are calling an AI catalyzer and in many ways

[00:04:27] We're working to put our arms around it and really hug it and bring it in close

[00:04:32] Why what we certainly found is with the growing

[00:04:37] Availability of an interest in open AI

[00:04:40] We had a lot of individuals

[00:04:42] Physicians who sometimes were leveraging it in ways that we might not feel comfortable yet

[00:04:46] And we're gonna bring it in as close as we can

[00:04:49] Create some guidelines and then we're gonna in that same sort of speed look to push it back out

[00:04:55] I think one of the things that AI offers that makes so many people excited is the way that it can

[00:05:02] democratize data and democratize the insights that can be gained from it and

[00:05:08] Obviously our physician and clinical community that makes them really excited and anxious to get that power in their hands

[00:05:14] But we want to make sure that as we say do no harm first and

[00:05:18] That we're putting tools that deliver the highest level quality that that we know we can't deliver

[00:05:22] Yeah, you're approaching it very intentionally and with the end in mind

[00:05:26] So I think that's phenomenal what measures does your hospital take to ensure?

[00:05:31] Patient data security when implementing AI tech. Yeah, sure first off

[00:05:35] We want to make sure that we're seeing things

[00:05:38] Longitudinally across an individual and across our organization and first and foremost making sure that we're leveraging information

[00:05:45] That's in the cloud just gives us that level of security over

[00:05:49] Far superior from what we experience on an on-prem solution or something like that in addition

[00:05:55] What we are working hard to do is to put policies in place

[00:05:59] Where we only make certain forms of information and data available as we feel it's ready to be used in a way

[00:06:07] That's productive that maintains hip but then also is additive to the individuals journey

[00:06:13] We're leaving more of that patient insights and data from AI to the next phase of our journey

[00:06:20] Today we think about it in a somewhat I guess arbitrary way where 70% of where we're gonna leverage AI is gonna be focused on administrative and efficiency

[00:06:29] Yes, additive to ultimately to the patient journey, but not necessarily knee-deep in their health information

[00:06:36] That other 30% is where we're moving

[00:06:40] cautiously

[00:06:41] But with speed and I think that's the main

[00:06:44] Word that I continue to use as we think about this AI journey everybody's gonna have it

[00:06:50] We've got all these vendors coming to us with it

[00:06:52] And even if they say they have it they may not have what we're really referring to

[00:06:56] So there's a little bit of scrutiny as these things come in as well as and that scrutiny is gonna happen quickly

[00:07:01] With regards to the question in terms of security and how these this information is being leveraged and then what is it actually deliver upon?

[00:07:09] I think what we've seen is that many AI companies are saying okay, we're gonna deliver on this very specific

[00:07:16] use case

[00:07:17] But their business case is actually the the proliferation into other

[00:07:23] Workstreams that may not be aligned with our vision

[00:07:25] And so we're trying to understand that vision that journey and really look for

[00:07:30] Solutions that are enterprise grade that can grow with us said differently a platform that can grow with us and allow us to

[00:07:37] Buy but then in some cases build off of it in a way that we feel is safe for our patients and our system

[00:07:43] Thank you for that. Yeah, and I really appreciate the the thoughts around the approach

[00:07:47] Can you share any examples around best practices with leveraging data for outcomes from data cleanup usability?

[00:07:55] Yeah, sure

[00:07:55] We have enjoyed a joint venture partnership with an organization called ages ages and Northwell invested in a company called

[00:08:03] ascertain and ascertain makes investments into AI startups and things of this sort one of those examples

[00:08:10] That we've been very focused in on is this major health discrepancy that we see occurring in maternal mortality

[00:08:17] largely between black females and all others the

[00:08:22] increase in mortality within black females versus all other is quite staggering and one that we have taken on in a very

[00:08:29] aggressive way to better understand and leverage these AI insights to help make sure that we are taking into account in individuals

[00:08:38] complete being from their socioeconomic situation to their health situation and

[00:08:44] Food and nutrition and in making sure that we put in the appropriate

[00:08:49] prophylactic care to give them the best chance of a high at the best outcome

[00:08:56] Sometimes that is as simple as a baby aspirin and you look at the situation and because of either

[00:09:03] unconscious bias or

[00:09:05] We're not asking the right questions as clinicians or perhaps

[00:09:08] we're not following through to make sure that there is an ability to have that individual stay

[00:09:16] Compliant with that that protocol those are the types of places where AI can really come into play and

[00:09:23] Ultimately change behavior at the same time too because obviously this is a multifaceted problem. Otherwise, we would have fixed it already

[00:09:30] It's going to give us and it's giving us those insights where we can see some of those results real-time

[00:09:35] I think it's awesome that you guys are focused on that key problem to be solved with huge benefits to the community

[00:09:41] When solve so I love that without that without that

[00:09:45] And how does your hospital address interoperability challenges when integrating AI solutions across different?

[00:09:52] departments and systems yeah and look this is not only an AI problem

[00:09:56] But it goes even broader and it will be

[00:09:59] Accentuated from AI again because of the enthusiasm we spend upwards of 400 million dollars a year in capital in just IT

[00:10:08] And so there are many solutions that come our way

[00:10:13] That yes, we have full line of sight into and that we're aware of but there's probably about

[00:10:20] 25 to 30% of these solutions that come our way that I call below the surface of the water

[00:10:25] meaning we don't know about it until it's far in the process and

[00:10:31] Of course, we've got to plug it in somewhere

[00:10:33] And we've got to ensure disaster recovery and we've got to ensure cyber security

[00:10:37] And so we tend to get involved very late in the process

[00:10:41] And so what we are working to do right now is really overhaul our entire intake process as a large healthcare

[00:10:48] Organization one of the things I can say with absolute certainty is that we're struggling to prioritize investments just the same as every healthcare

[00:10:56] Organization is everyone's had a bit of a hard time over the last couple years

[00:11:00] I don't care what market you're in and having to reprioritize and prioritize what those initiatives are

[00:11:06] What we're looking for our solutions that not only as I was describing before solved not only the key use case

[00:11:13] But then can also be we can grow upon them and so we're looking for

[00:11:19] Yes, we're interested in those new and exciting ideas

[00:11:23] But we also want a partner with someone who has the capability to grow things enterprise-wide

[00:11:27] Yes, there's going to be some solutions that are just pure point solutions

[00:11:32] Especially as we get to some of the subspecialty areas and or certain components of revenue cycle

[00:11:37] But this is where I think we look at the the sort of digital playing field and

[00:11:44] With the right people in the room we can begin to understand what are we solving for today?

[00:11:49] Tomorrow and how do we get rid of the stuff quite frankly that's not solving for those problems as we've gone through

[00:11:55] proud migration epic integration

[00:11:57] We've gotten rid of literally hundreds of apps because we have maybe a couple people in the organization that are using them

[00:12:03] Literally a couple of people and so those are the ones where I would say yeah

[00:12:08] Sometimes we're gonna say no, but what I like to tell her team is offer an alternative

[00:12:12] instead of just saying no and show what we have in our inventory and what can answer those questions that they're trying to have

[00:12:20] Answer yeah, it's a great way to prioritize sometimes

[00:12:22] It's painful to make those moves and to take some of those toys away quote-unquote

[00:12:28] But when you're dealing with an enterprise and wanting to do what's best for everyone you got to make them

[00:12:33] Governance is often a bad word

[00:12:35] But it doesn't have to be it's one of those situations where I would say we as a function

[00:12:40] And I say that from the vantage point of IT and diddo who was our customer

[00:12:44] How do we align that to the mission and vision and objectives and goals of the organization?

[00:12:49] And if you can check all those boxes, alright

[00:12:52] Now we then come down to financial and return and this is where again

[00:12:56] We as a function if the organization is continuing to make investments as they have and they will and they need to

[00:13:02] Then it's incumbent upon us to show that return on investment

[00:13:06] And I say return on investment in its broadest sense that can of course be

[00:13:10] experiential it could be quality it can be

[00:13:13] Outcomes in the instance of quality it can be things that we've never done before

[00:13:17] Which AI is going to open up to us an incredible aperture of just because often times today

[00:13:23] It's a heavy people cost and AI is going to remove that and put it at a fraction of set cost

[00:13:28] And imagine what that can do to health outcomes imagine what that can do to mortality

[00:13:33] Imagine what that can do to trust between

[00:13:37] Consumer and provider, you know and on that note Joe. What do you believe is the biggest promise for AI and care delivery in?

[00:13:45] 2024 yeah, I think I think

[00:13:48] speed I

[00:13:50] Think understanding behavior

[00:13:53] Are two of the greatest things and speed could as much be where do I find and how quickly can I find the right doctor at the

[00:14:00] Right place in the right amount of time

[00:14:02] So that something isn't missed so that we get past this notion of difficult access

[00:14:07] And I think behavior one of the things that we struggle with the most is how do I get Joe

[00:14:13] To do what I'm prescribing to him even though I know Joe has

[00:14:19] Or I think Joe has because I see it in his chart. He's got two kids

[00:14:22] I'm not exactly sure how old they are, but I do and I think Joe last time he was here

[00:14:27] He said something's going on with his dad and some something with his mom

[00:14:31] So the reality is an a not gonna forget those things. Yes, Joe's got a daughter 17

[00:14:37] He's going to college got another 15 year old who's trying to worry about that and then at the same time

[00:14:42] Yeah, his father's got Alzheimer's his mother's got other ailments

[00:14:45] And he's more worried about that than taking his own medication or his blood pressure

[00:14:49] How do we make it so that?

[00:14:52] Joe is at his best health because we understand all the components and then how to

[00:14:57] Have him take those those clinical treatments or maybe those healthy habits that Joe's not so focused on right now

[00:15:04] And now at that point that's personalized medicine

[00:15:07] That's health outcome and that's changing someone's life love that yeah, hugely impactful for this year

[00:15:13] And it's possible with the work that you guys are doing with the technology that's coming around the corner and available already

[00:15:19] So Joe, I really appreciate you being on the podcast today. This has been a really great opportunity to chat with you

[00:15:26] What closing thought would you leave folks with and then what's the best place for them to get in touch with you

[00:15:30] And learn more about the work you guys are up to yeah sure. I think the thought I would leave everyone with is

[00:15:37] Be very

[00:15:39] Particular about what you want to put in your catalyzer to speed up or slow down

[00:15:45] There's going to be so much coming at us at once and every

[00:15:49] Organization vendor etc partner is going to be telling you they've got something so brand new and unique

[00:15:54] But you've got to stay focused on your organization's mission objectives

[00:15:58] You've got to control the spigot while not shutting the water off completely

[00:16:04] Because the reality is this is moving too fast for any one

[00:16:08] Department or anything to control and so the more that we can embrace it

[00:16:13] But then act as a way to speed it up and democratize it

[00:16:17] What in other words putting a freedom in a framework so that it's available?

[00:16:22] It's connected and we are learning from it and leveraging new use cases

[00:16:26] I think those are the those are that's when we're our organizations will be the most successful

[00:16:31] We'd love to have some folks reach out and share a little bit more of the north wall story

[00:16:35] And what we're trying to do to really disrupt this space amazing Joe. Thank you so much for being with us folks

[00:16:41] Thanks for tuning in look forward to our next discussion Joe