Unveiling the Future of Healthcare Delivery with Dr. Scott Schell, Chief Medical Officer at Cognizant

[00:00:08] [SPEAKER_00]: Hey everybody, welcome back to the BEAT podcast here at Vive in Los Angeles.

[00:00:14] [SPEAKER_00]: Today I have the privilege of hosting Dr. Scott Schell on the podcast.

[00:00:19] [SPEAKER_00]: Dr. Schell is an accomplished senior executive, surgeon, and healthcare futurist with over

[00:00:25] [SPEAKER_00]: 30 years of experience spanning the healthcare, biotech, and technology sectors both in the

[00:00:30] [SPEAKER_00]: US and globally.

[00:00:32] [SPEAKER_00]: His leadership roles have included CEO, CMO, Chair, Director, and Executive Consultant

[00:00:38] [SPEAKER_00]: and he brings an extensive background that includes healthcare delivery and operations,

[00:00:43] [SPEAKER_00]: pharma, med devices, clinical trials, and data science.

[00:00:47] [SPEAKER_00]: Such a pleasure to have you here on the podcast Scott.

[00:00:50] [SPEAKER_01]: Dr. Scott Schell Hey Saul, it's just such a pleasure to

[00:00:51] [SPEAKER_01]: be here with you today and I really look forward to our conversation.

[00:00:54] [SPEAKER_00]: Dr. Scott Schell Definitely look forward to it as well.

[00:00:56] [SPEAKER_00]: First of all, I just want to say I'm impressed with your background, the different

[00:00:59] [SPEAKER_00]: things that you've done.

[00:01:00] [SPEAKER_00]: Even coming into the podcast room today, you noticed some of the audio.

[00:01:03] [SPEAKER_00]: I mean, you're kind of a jack-of-all-trades guy.

[00:01:07] [SPEAKER_01]: Dr. Scott Schell Well it's very kind.

[00:01:08] [SPEAKER_01]: It's interesting because the pandemic has really taught us about paying better attention

[00:01:11] [SPEAKER_01]: to presence both digitally and physically and so background noise can be really,

[00:01:15] [SPEAKER_01]: really super annoying when you're trying to get a point across or learn something

[00:01:19] [SPEAKER_01]: new doesn't it?

[00:01:20] [SPEAKER_00]: Dr. Scott Schell Yeah, big time, big time.

[00:01:22] [SPEAKER_00]: So Renaissance Man you are.

[00:01:23] [SPEAKER_00]: Want to jump into some of these questions.

[00:01:26] [SPEAKER_00]: How do you see digital transformation reshaping healthcare delivery in 2024?

[00:01:31] [SPEAKER_00]: And what are the main challenges and opportunities this presents?

[00:01:35] [SPEAKER_01]: Dr. Scott Schell It's a great question.

[00:01:36] [SPEAKER_01]: I have the privilege of being able to speak to healthcare, C-suite,

[00:01:40] [SPEAKER_01]: IT leaders and business line owners in organizations ranging in size and

[00:01:44] [SPEAKER_01]: complexity from single hospitals and regions to IDFS systems.

[00:01:49] [SPEAKER_01]: And every single one of those individuals is really very highly focused on the

[00:01:53] [SPEAKER_01]: concept of digital transformation and most of them are really well underway.

[00:01:57] [SPEAKER_01]: Last year we did a provider automation survey where we engaged 300 of exactly

[00:02:02] [SPEAKER_01]: these kinds of individuals and looked at outcomes as related to workforce

[00:02:06] [SPEAKER_01]: effectiveness and financial success.

[00:02:08] [SPEAKER_01]: And it's interesting because fully a third identified call center operations,

[00:02:12] [SPEAKER_01]: care management, patient access and patient financial services as their

[00:02:16] [SPEAKER_01]: greatest automation opportunities.

[00:02:17] [SPEAKER_01]: And as I look at that, that really is about digital experience for the

[00:02:21] [SPEAKER_01]: patient, which is I think the moment that we're facing.

[00:02:24] [SPEAKER_01]: And really the objectives around the patient experience then devolve down to

[00:02:28] [SPEAKER_01]: things that center on satisfaction, health outcomes, productivity of the care

[00:02:33] [SPEAKER_01]: providers.

[00:02:34] [SPEAKER_01]: And particularly I think solutions that optimize call center operations,

[00:02:38] [SPEAKER_01]: clarify and streamline the patient's interaction with their financial

[00:02:43] [SPEAKER_01]: experiences and really overall improve their ability to access schedule and

[00:02:47] [SPEAKER_01]: obtain healthcare services.

[00:02:49] [SPEAKER_01]: I think are really spot on and important for every health system.

[00:02:53] [SPEAKER_01]: There's no question that patients are confused and increasingly angry about

[00:02:57] [SPEAKER_01]: healthcare cost billing, transparency and payment systems.

[00:03:01] [SPEAKER_01]: And all of those were clearly reflected in the survey data by leaders in

[00:03:05] [SPEAKER_01]: each of the three tiers that I talked about.

[00:03:08] [SPEAKER_01]: And so therefore I think call center automation and patient financial

[00:03:12] [SPEAKER_01]: services tools become increasingly important.

[00:03:15] [SPEAKER_01]: So the question is from my perspective, is this an area where health

[00:03:19] [SPEAKER_01]: systems should be focusing?

[00:03:20] [SPEAKER_01]: And I think emphatically, yes.

[00:03:22] [SPEAKER_01]: And I think the healthcare organizations agree with at least half of those

[00:03:25] [SPEAKER_01]: that we surveyed and are currently engaged with really actively moving

[00:03:30] [SPEAKER_01]: down the line in these areas.

[00:03:32] [SPEAKER_00]: Yeah, thank you for that.

[00:03:33] [SPEAKER_00]: And I think it's really great, Dr.

[00:03:35] [SPEAKER_00]: Schell, that you honed in on the patient and really in a day where

[00:03:40] [SPEAKER_00]: consumerism is so important in healthcare more than ever.

[00:03:44] [SPEAKER_00]: So we know digital transformation projects don't always go smoothly.

[00:03:49] [SPEAKER_00]: What specific complaints and struggles do you hear about how patient

[00:03:53] [SPEAKER_00]: experience projects can go wrong?

[00:03:55] [SPEAKER_01]: I think it's a really important question, Saul.

[00:03:57] [SPEAKER_01]: And I think it's important also at the beginning to drill down to make

[00:04:01] [SPEAKER_01]: sure that we're talking about it from the perspective of the systems

[00:04:03] [SPEAKER_01]: that are deploying these projects versus the patients perspectives of

[00:04:07] [SPEAKER_01]: their impact on their experience.

[00:04:09] [SPEAKER_01]: So we at Cognizant live in the area of the systems and the

[00:04:13] [SPEAKER_01]: technology, so let's spend some time hovering on that.

[00:04:16] [SPEAKER_01]: Again, the survey that we did provided some very interesting insights

[00:04:19] [SPEAKER_01]: and cost overruns were the number one complaint.

[00:04:23] [SPEAKER_01]: Although I suspect that this is primarily an issue during

[00:04:26] [SPEAKER_01]: first implementations.

[00:04:27] [SPEAKER_01]: And here's why.

[00:04:29] [SPEAKER_01]: Projects change scope, organizations gain practical insights about

[00:04:32] [SPEAKER_01]: what IT and myNpower assets are actually required for deployment.

[00:04:37] [SPEAKER_01]: Next, health system leaders really, really want to have useful analytics

[00:04:41] [SPEAKER_01]: to inform them about strategic and operational pivots.

[00:04:44] [SPEAKER_01]: And digital transformation and automation systems can provide massive

[00:04:48] [SPEAKER_01]: amounts of data.

[00:04:49] [SPEAKER_01]: And so that means that automated integrated analytics are just

[00:04:54] [SPEAKER_01]: completely essential for success.

[00:04:56] [SPEAKER_01]: And adding these analytics and actually being certain what they

[00:04:59] [SPEAKER_01]: are is typically a process and evolution.

[00:05:02] [SPEAKER_01]: So adding additional analytics and reporting capabilities drives costs

[00:05:05] [SPEAKER_01]: as well.

[00:05:06] [SPEAKER_01]: The third complaint really, I think, focuses upon return on

[00:05:09] [SPEAKER_01]: investments, because all of these projects are undertaken with the goal of

[00:05:12] [SPEAKER_01]: if we do this, then our efficiencies or revenues, et cetera, will improve.

[00:05:17] [SPEAKER_01]: And people need to think and be mindful that there's a lag between

[00:05:21] [SPEAKER_01]: deployment and actually realizing these returns.

[00:05:25] [SPEAKER_01]: And so calculating that expected lag into ROI makes people feel more at

[00:05:29] [SPEAKER_01]: ease about early returns and feedback.

[00:05:32] [SPEAKER_01]: And then after cost and implementation and analytics, we talk

[00:05:36] [SPEAKER_01]: about barriers to implementation.

[00:05:38] [SPEAKER_01]: Staff training, change management, complexities related to

[00:05:42] [SPEAKER_01]: implementation that limits the system capabilities really round out

[00:05:46] [SPEAKER_01]: the rest of the most frequent concerns.

[00:05:48] [SPEAKER_00]: Some really good ones that you point out there, Dr.

[00:05:50] [SPEAKER_00]: Schell.

[00:05:51] [SPEAKER_00]: And with AI and machine learning, big buzzwords in health care, what

[00:05:55] [SPEAKER_00]: ways do you see these technologies having a tangible effect on both

[00:06:00] [SPEAKER_00]: providers and patients?

[00:06:01] [SPEAKER_01]: Right.

[00:06:02] [SPEAKER_01]: Well, we all have been completely inundated with chat GPT and AI.

[00:06:08] [SPEAKER_01]: And transformational change, opportunities and threats to our

[00:06:12] [SPEAKER_01]: existential reality.

[00:06:14] [SPEAKER_01]: And I've had hundreds of conversations over the past two years

[00:06:18] [SPEAKER_01]: specifically about these topics.

[00:06:20] [SPEAKER_01]: There's no question that it's taken society, health care, technology,

[00:06:24] [SPEAKER_01]: daily life completely by storm.

[00:06:26] [SPEAKER_01]: Until a few weeks ago, I used to joke that there's going to be AI

[00:06:29] [SPEAKER_01]: in my laundry detergent.

[00:06:30] [SPEAKER_01]: Then I went to a big box store and saw that the electric toothbrush

[00:06:33] [SPEAKER_01]: and the vacuum cleaner were now AI powered.

[00:06:36] [SPEAKER_01]: I'm not exactly sure what that means, but somehow I have in my mind

[00:06:39] [SPEAKER_01]: that there's some nagging critic similar to my mother who is going

[00:06:43] [SPEAKER_01]: to say you're not doing it right.

[00:06:44] [SPEAKER_01]: That is too funny.

[00:06:46] [SPEAKER_01]: Every single health care executive I know is focused on AI and every

[00:06:50] [SPEAKER_01]: health system that we interact with has a plan and a budget

[00:06:54] [SPEAKER_01]: specifically for AI investment.

[00:06:56] [SPEAKER_01]: And while their specifics aren't fully formed, the killer app is

[00:07:01] [SPEAKER_01]: perceived as one that dramatically improves operations and outcomes.

[00:07:05] [SPEAKER_01]: In whatever context they're currently struggling.

[00:07:09] [SPEAKER_01]: I think health systems have some real significant opportunities to use AI

[00:07:12] [SPEAKER_01]: in its various forms to augment the patient experience.

[00:07:16] [SPEAKER_01]: We and other in the marketplace are deploying AI tools to help

[00:07:19] [SPEAKER_01]: patients access benefits, payments, and cost information.

[00:07:23] [SPEAKER_01]: That harkens back to the first question.

[00:07:25] [SPEAKER_01]: GenAI, I think, is particularly helpful in augmenting call center

[00:07:29] [SPEAKER_01]: interactions because it provides real-time insightful summaries

[00:07:33] [SPEAKER_01]: and answers related to the patient's history, their journey through

[00:07:36] [SPEAKER_01]: the system, and suggestion for improving their outcomes and providing

[00:07:40] [SPEAKER_01]: them a solution to the problem that they present with.

[00:07:42] [SPEAKER_01]: And then I think another significant area is AI enhancing the prior

[00:07:47] [SPEAKER_01]: authorization process, which you know involves specific patient

[00:07:51] [SPEAKER_01]: information, plan and regulatory data, and sometimes local regional

[00:07:54] [SPEAKER_01]: requirements as well.

[00:07:56] [SPEAKER_01]: And so we see tools now that really optimize this and decrease

[00:08:00] [SPEAKER_01]: the inborn errors that happen when human processing happens.

[00:08:04] [SPEAKER_01]: I think AI has an important role in digital transformation and

[00:08:07] [SPEAKER_01]: healthcare.

[00:08:08] [SPEAKER_01]: We're all, I think, focused on and worried about having solutions

[00:08:12] [SPEAKER_01]: that don't make decisions that can hurt patient care.

[00:08:15] [SPEAKER_01]: But along the continuum of AI, which includes machine learning

[00:08:19] [SPEAKER_01]: and robotic process automation, all the way up to the generative

[00:08:22] [SPEAKER_01]: solutions and large language models, I think there are solutions

[00:08:27] [SPEAKER_01]: that can meet many of the needs that are confounding health systems

[00:08:30] [SPEAKER_01]: in their journey today.

[00:08:31] [SPEAKER_00]: RICK That's a really thorough summary and certainly great,

[00:08:36] [SPEAKER_00]: tangible impacts that these technologies could bring healthcare

[00:08:39] [SPEAKER_00]: both providers and patients.

[00:08:41] [SPEAKER_00]: Are there any pitfalls in regards to Gen AI?

[00:08:44] [SPEAKER_00]: You did mention Gen AI in your response that patient experience

[00:08:47] [SPEAKER_00]: leaders should watch out for.

[00:08:49] [SPEAKER_01]: TOM So the concept of AI hallucination where the Gen AI model

[00:08:53] [SPEAKER_01]: gets it wrong is appropriately terrifying for caregivers.

[00:08:58] [SPEAKER_01]: No one wants to have an input or a decision-making aid or tool that

[00:09:03] [SPEAKER_01]: acts autonomously that results in the injury of a patient.

[00:09:07] [SPEAKER_01]: And so all of those types of models now are in pilot or proof

[00:09:11] [SPEAKER_01]: of concept roles or are finally adjudicated by a live human

[00:09:16] [SPEAKER_01]: clinician before being implemented or released.

[00:09:19] [SPEAKER_01]: However, if you look at it, these concerns really aren't as

[00:09:22] [SPEAKER_01]: relevant if you look at AI related to digital transformation that

[00:09:26] [SPEAKER_01]: focuses on the patient experience because you're not talking about

[00:09:28] [SPEAKER_01]: just-in-time clinical decision making.

[00:09:31] [SPEAKER_01]: Demographic, utilization, financially, scheduling data, these are

[00:09:35] [SPEAKER_01]: generally accurate and contemporaneous.

[00:09:39] [SPEAKER_01]: And so once an AI system has been properly trained on that system,

[00:09:43] [SPEAKER_01]: the risks for errors or AI hallucinations are actually quite low.

[00:09:47] [SPEAKER_01]: The key really is getting the essential robust training pool of data.

[00:09:51] [SPEAKER_01]: And without that, you'll introduce bias.

[00:09:53] [SPEAKER_01]: And we've seen that in some of the public facing systems where AI

[00:09:56] [SPEAKER_01]: systems are listening to themselves and then repeating stuff which is

[00:10:00] [SPEAKER_01]: compounded in their errors.

[00:10:02] [SPEAKER_01]: And this is going to be another area where health systems and

[00:10:05] [SPEAKER_01]: providers have to focus because their data pools are traditionally

[00:10:09] [SPEAKER_01]: fragmented and poorly organized.

[00:10:10] [SPEAKER_01]: And if we look at some of our largest system providers, they're

[00:10:14] [SPEAKER_01]: very, very heavily focused on data harmonization and quality

[00:10:17] [SPEAKER_01]: improvement, which is going to be a years long process.

[00:10:22] [SPEAKER_00]: Yeah.

[00:10:22] [SPEAKER_00]: Well, thank you for that.

[00:10:23] [SPEAKER_00]: There's certainly, like you said, real time clinical decision support

[00:10:27] [SPEAKER_00]: where some of the concern is, but then the day-to-day things where

[00:10:31] [SPEAKER_00]: big value could be added.

[00:10:33] [SPEAKER_00]: For those organizations that haven't started with their digital

[00:10:35] [SPEAKER_00]: transformation projects yet either with or without AI, do you have

[00:10:39] [SPEAKER_00]: any tips to help them make a strong start?

[00:10:43] [SPEAKER_01]: Sure.

[00:10:43] [SPEAKER_01]: The first is a recognition that automation initiatives can cover

[00:10:47] [SPEAKER_01]: massive portions of operational and strategic landscapes.

[00:10:51] [SPEAKER_01]: Some deployments can be entirely standalone and others require

[00:10:54] [SPEAKER_01]: technology change and integration to infrastructures, APIs, and

[00:10:58] [SPEAKER_01]: the AI tools that you're using.

[00:11:01] [SPEAKER_01]: So my key comment there is focus first on identifying the most

[00:11:06] [SPEAKER_01]: important functional solution that your system needs.

[00:11:09] [SPEAKER_01]: Second, find the technology solutions to those specific

[00:11:13] [SPEAKER_01]: problems and the business partners with whom you can work to

[00:11:17] [SPEAKER_01]: deployment.

[00:11:18] [SPEAKER_01]: Third, focus on the change management.

[00:11:21] [SPEAKER_01]: Everybody talks about change management but people are averse

[00:11:25] [SPEAKER_01]: to the concept of a change in their day-to-day and I think

[00:11:28] [SPEAKER_01]: they're fearful in some cases about the automation technologies

[00:11:32] [SPEAKER_01]: replacing their roles.

[00:11:34] [SPEAKER_01]: In fact, what you're doing is you're freeing them from

[00:11:37] [SPEAKER_01]: repetitive work to bring them to the top of their training

[00:11:40] [SPEAKER_01]: and their capabilities.

[00:11:41] [SPEAKER_01]: The organizations that I've worked with that have seemed to have

[00:11:44] [SPEAKER_01]: gotten it right the first time institutionalize this by

[00:11:48] [SPEAKER_01]: establishing an internal center of excellence or a leadership team

[00:11:52] [SPEAKER_01]: that's accountable to supervise the automation process.

[00:11:56] [SPEAKER_01]: It's really important to clearly define your goals and objectives

[00:11:59] [SPEAKER_01]: with KPIs that this leadership team can own and then send

[00:12:04] [SPEAKER_01]: forward into the organization for their leaders to adopt and

[00:12:07] [SPEAKER_01]: champion.

[00:12:08] [SPEAKER_01]: Again, work with partners who can maximize the benefit of the

[00:12:12] [SPEAKER_01]: technology both from an integration and deployment

[00:12:15] [SPEAKER_01]: standpoint and also importantly I think manage the often transient

[00:12:19] [SPEAKER_01]: staffing requirements and the costs that are associated.

[00:12:22] [SPEAKER_01]: If you're a hospital system it makes no sense to hire 500 IT

[00:12:26] [SPEAKER_01]: specialists who you know are only going to be there for 9 to 12

[00:12:28] [SPEAKER_01]: months.

[00:12:29] [SPEAKER_01]: And then measure the project, the timeline, the goals and the

[00:12:34] [SPEAKER_01]: costs and their KPIs all the way to their conclusion because by

[00:12:38] [SPEAKER_01]: doing that you can avoid cost overruns, you can take care of

[00:12:42] [SPEAKER_01]: the inevitable changes and enhancements that you now

[00:12:45] [SPEAKER_01]: recognize because you're in flight with the efficiency that

[00:12:48] [SPEAKER_01]: goes along of having all those teams and assets in place and

[00:12:51] [SPEAKER_01]: don't have to come back and rework it later.

[00:12:53] [SPEAKER_00]: Some really great points there and folks hit rewind on this

[00:12:56] [SPEAKER_00]: one because Dr. Schell really offered some big value

[00:13:00] [SPEAKER_00]: points on that response.

[00:13:01] [SPEAKER_00]: That's the beauty of podcasts.

[00:13:03] [SPEAKER_00]: You could listen on demand so hit rewind if you need to

[00:13:06] [SPEAKER_00]: some notes on that one.

[00:13:07] [SPEAKER_00]: But also in the show notes we'll leave a summary of the

[00:13:10] [SPEAKER_00]: discussion that we had here today with Dr. Schell.

[00:13:12] [SPEAKER_00]: Dr. Schell, what closing thought would you leave people

[00:13:15] [SPEAKER_00]: with and what's the best place they could reach out and

[00:13:17] [SPEAKER_00]: learn more about you and Cognizant?

[00:13:19] [SPEAKER_00]: Fantastic.

[00:13:20] [SPEAKER_01]: Well Saul let me say again how much fun it's been here to

[00:13:22] [SPEAKER_01]: spend time with you and talk about this today.

[00:13:25] [SPEAKER_01]: I think the one takeaway message that I'd like to leave

[00:13:27] [SPEAKER_01]: your listeners with is that I think automation tools ranging

[00:13:30] [SPEAKER_01]: across the spectrum of what's available now up to and

[00:13:34] [SPEAKER_01]: including GEN-A are perfect tools to consider in doing

[00:13:38] [SPEAKER_01]: what we talked about in the last question.

[00:13:40] [SPEAKER_01]: That is unloading a lot of repetitive manual work and

[00:13:43] [SPEAKER_01]: raising staff's time and input to the last mile.

[00:13:49] [SPEAKER_01]: I think that's important because staff are overworked

[00:13:51] [SPEAKER_01]: and feeling burned out and I think we all recognize that

[00:13:54] [SPEAKER_01]: the economy and staff pressures are troubling every

[00:13:57] [SPEAKER_01]: healthcare institution.

[00:13:59] [SPEAKER_01]: So I think these tools really can drive change there

[00:14:01] [SPEAKER_01]: and avoid a lot of the pitfalls that we've talked

[00:14:03] [SPEAKER_01]: about.

[00:14:04] [SPEAKER_01]: Cognizant is always available for you to reach out and

[00:14:07] [SPEAKER_01]: you can reach out to me directly and I'll be happy to

[00:14:09] [SPEAKER_01]: chat with you or connect you with some of my

[00:14:11] [SPEAKER_01]: associates who can find the right pathway for your

[00:14:13] [SPEAKER_01]: particular needs and solution.

[00:14:15] [SPEAKER_01]: And thanks again so much for making the time for us

[00:14:16] [SPEAKER_01]: to talk.

[00:14:17] [SPEAKER_00]: It's our pleasure Scott.

[00:14:18] [SPEAKER_00]: Really appreciate you and looking forward to our

[00:14:20] [SPEAKER_00]: next chat.