Episode 2 : AI in Healthcare:

A Cure for Clinician Burnout

Tom Lawry

Managing Director at Second Century Tech

SCT_Spotlight_Tom Lawry: Audio automatically transcribed by Sonix

SCT_Spotlight_Tom Lawry: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Intro/Outro:
Welcome to the Smart Care Team Spotlight, presented by Care.ai, the Smart Care Facility platform company and leader in AI and ambient intelligence for healthcare. Join Molly McCarthy, former CMO of Microsoft, as she interviews the brightest minds in healthcare about the transformational promise of AI and ambient intelligence for care teams.

Molly McCarthy:
So too often technology makes caregivers lives harder, not easier. It's time for smart technology to empower care with a more human touch. Hi, I'm Molly McCarthy, and welcome to the Smart Care Team Spotlight. And I'm so excited for our guest today, Tom Lawry. Hey, Tom!

Tom Lawry:
Molly, how are you?

Molly McCarthy:
It's been a while. It's so great to see you. I do want to give our audience a little bit of background. They might not know you as we know each other from Microsoft, but Tom is a leading AI transformation advisor to health and medical leaders around the world, a top keynote speaker, and best-selling author of Hacking Healthcare: How AI and the Intelligent Health Revolution Will Reboot an Ailing System. He's the managing director of Second Century Tech and former Microsoft exec who served as the National Director for AI for Health and Life Sciences, as well as director of Worldwide Health and Director of organizational performance for the company's first health incubator together at Microsoft for quite some time. Prior to Microsoft, Tom was senior director at GE Healthcare, the founder of two venture-backed healthcare software companies, and a health system executive. And your work, I know your work's been featured all across the globe in Forbes, CEO magazine, Harvard Business Review, Inside Precision Medicine, Podcasts, Webcasts. And you also wrote your first book, AI in Health. And congratulations, I know that you were just named one of the top 20 AI voices to watch. It's so great, and we're honored to have you here today, Tom.

Tom Lawry:
Molly, It's great to be with you. You left out my paper out when I was 14, but yeah, anyway, great to be with you.

Molly McCarthy:
Just to get started, I wanted to read you something, and I actually have to put my glasses on for this because it's quite small, but I just wanted to read you a little paragraph here. It says, AI holds the promise of freeing health practitioners from many of the repetitive administrative tasks that soak up their time and make them less effective as caregivers. A time is coming where AI-assisted analytics, simulation, and hypothesis testing can help humans drive decision-making, strategy, and innovation across all care settings. Beyond empowering and extending the skills of clinicians, the ultimate goal of applying the intelligence revolution to health is to provide a more efficient and personalized experience for patients and consumers. Quick question. Who said that?

Tom Lawry:
I don't know. Is that one of my books or ...?

Molly McCarthy:
One of your books.

Tom Lawry:
I'm in a violent agreement.

Molly McCarthy:
So I just, I went back. I obviously have both your books. I highlighted that section, but I don't want to go through all the statistics that I see virtually every day around burnout shortage of healthcare professionals. It's thinking about working to top of license, these are all really challenges that health systems face today and have for quite some time. And I just would love to hear your thoughts where we are today on, you know, why AI and ambient intelligence can be applied to healthcare effectively to create what really, I consider a smart care team. So, for example, as a nurse, I'd be working at the top of my license, like you said in your book, no more repetitive administrative tasks, etc. And really thinking about that quintuple aim of not only better patient outcomes and patient experience, but also a better clinician experience. So I'd love to hear from you, your top-of-mind thoughts.

Tom Lawry:
There are so many things that I could say, and I'm trying to figure out how to parse it to be succinct. So what, I'd start by saying is, in many ways, I think AI has a PR problem right now at many levels, but the first one is everyone is talking about AI as a technology. To me, AI is not about technology. Done right, AI is about empowerment. It's about restoring the power to doctors and nurses. For all those things that were the reasons, the intrinsic value by which someone decides to be a clinician. So you look at, for anyone listening, what was the intrinsic reason you decided to become something in healthcare? And then you ask the question, if you're on the front lines practicing today, how much of that intrinsic thing are you doing today? So the data shows, a study from Stanford says physicians spend more time doing administrivia than they do seeing patients. There's another study by McKinsey and Company that essentially says doctors and nurses, up to a third of what they do could be automated with AI. And the key here is it's not the intrinsic things that you really want to do that people talk about playing at the highest level of your license. I'd like to talk about what is it when you're driving home, you think, God, I'm really glad I do what I do versus grinding your teeth for all of the things you're forced to do. Eric Topol, who wrote the foreword to my last book, I love this; he was the first to coin the phrase keyboard liberation. Think about the amount of time as a clinician, or even as any knowledge worker in healthcare, you spend doing these low-level, highly repetitive things that are not a good use of your time. So the promise is imagine, according to these studies, if a third of what you do could be automated. And I turn to you to say I'm eliminating a lot of those low-value activities, I'm giving you a third of your time back. What would you do with it? And to me, that's the premise for where we should be starting rather than the talk about the technology, rather than the talk about the existential threat of AI. I want to turn that around and say, what's the existential opportunity for everyone in health and medicine?

Molly McCarthy:
Yeah, no, I love that. I think back to, over the past year and just time at Microsoft over ten years and just the concept of how can we, in a clinical way, utilize AI. I know a lot of the solutions and partners that we worked with really worked maybe more at the operational and financial level, but thinking about clinically, how can we infuse AI, for example, into the hospital room through ambient intelligence, for example, with documentation, or even one of the areas that we worked on too was the concept of virtual nursing. And when I say virtual nursing, I really mean having a resource who's not necessarily in the room, but a remote resource to assist with a unit. It's really specific to what the patient needs are so that it's really a care team approach. You have that nurse in the room, you might have the registered nurse remotely, you could have a nursing assistant, you have the physicians, the OTPT dietitians, nurse practitioners. And so thinking about the concept of virtual nursing per se really has been around for quite some time with even back in the day where we would have, I think they called it at one hospital, a bunker nurse. So sitting remotely, and they would Skype in or link for business, we can go way back on the names, and act as a resource, whether it's double-checking medications, etc. So that concept has been around for a while, and I think I'd love your thoughts on how with regards to technology and changing practice and behavior, and you were a health system executive, but how do health systems not just pilot, but really develop solutions at scale so that they're achieving that ROI on the technology, but also really improving the overall experience of both the caregiver and the patient. And I guess scale is something we talk a lot about, and I just want your insights on how that can happen.

Tom Lawry:
Well, Molly, there were at least ten questions, what you just said, but I'll try and parse those. So starting with where you just left off, as you know, between Microsoft, where I was both national director of AI for Health and Life Sciences for the Americas, I spent six years doing data and analytic projects on the worldwide team, which meant 80% of my work was with health providers and systems outside the United States. And over a decade of doing this, the real challenge that you've raised is always, today, everyone's using AI, very few are getting value at scale across their organizations, and the question is why? And at least in my experience when I've gone in and worked with these organizations, and they've got leadership committed, and they've got adequate budget, and they're hiring the right teams, the single best predictor of whether if I come back in two years, they're going to be doing that value at scale is really not the technology, not even the strength of the data science team, it's whether the leadership teams get their roles in driving change. And I've had these conversations with CEOs before when I asked them, What's your role? And their answer is, Well, I've hired the best CTO. I'm making sure the Budget Committee knows this is a priority. It's like, no, no, no. I ask you the question, what your role is as CEO, because as leaders, driving value with scale is all about creating priorities, shifting the culture, having a digital uplift when it comes to training people, the greatest impediment to success at scale is that leadership imperative. When that's not happening, the next thing I see is the resistance of the entire workforce. And I always am quick to point out it's not their fault. Our ability to bring the doctors and nurses along, to not only bring them along, but have them feeling like they've got their hands on the steering wheel. Because driving change through AI and value is all about changing those clinical and operational workflow processes. Who are the smartest people that know how to do that? The nurses, the doctors, the ones on the front lines every day. Those are the people I want to have driving process change. When that happens, I'll come back two years later, great things are happening. If that's not happening, I'll come back two years from the time I was there, and they're going to be telling you about, frankly, the same use cases they were telling me about two years prior.

Molly McCarthy:
Right. Now, I would 110% agree with that. I think people process tech, that people piece in change management is so important. One thing you said in terms of bringing the doctors and nurses along, and if I can just beat my soapbox here for a second, I'm a firm believer in, always really have been throughout my career, is that you really want to include clinicians, nurses, doctors, whatever their professional license is, not only in the deployment, but in that design and development within your hospital so that you have a champion in those end users. And really, I actually spoke with a hospital the other day, and she happens to be the director of innovation and strategy at a children's hospital. And she said even though we know, like, for example, workforce and documentation, we know these are well-curated problems that exist every day. Even if they have money, there are still barriers to success in terms of deployment and scale, including, she mentioned, security legal and really, that continue to follow that program and to really examine that ROI.

Tom Lawry:
That's interesting. There was another part of your question at the beginning that I didn't address where you were touching on the whole concept of model of virtual nurses. And I guess my quick reaction to that is, let's go back just a few years and think about this. Telemedicine has been around for at least three decades. All the clinical literature going back 30 years prove it's clinically efficacious. Why did it take a global pandemic for us to pull it forward? And this gets back to your question about virtual nursing of, what are all the things that we could be, should be doing that are tech-enabled that for some reason we're not? And I'll just leave it there for you and anyone listening to contemplate, but we have so many things that we can be doing, and it's the premise of my last book, Hacking Healthcare. Let's take what we learned from fighting a global pandemic and apply that to how we solve the problems we have on chronic disease, on the opioid crisis. But we're not going to do that by using the same old ways of thinking and working.

Molly McCarthy:
No, I agree. And it's not just about videoing in an extra set of eyes or human into that room, but really still deciphering what's going on in that environment and ensuring that information that we're presenting to that clinician, whether they're in the room or remote, is pertinent information that's been sifted through where they don't have to go digging for data or looking for data, but it's presented in a way that they can make that decision in a timely manner. And to that end, one of the areas we've talked a little bit about virtual nursing and really what it is and where it can save time, one of the areas that was a surprise, I think, for a couple of different pilots that I worked with over the past year was, in one pilot, they had two spots for virtual nurses, and they actually had 200 applicants for that. And they really wanted to utilize their seasoned nurses for those positions, so that was as much as we like to think, well, maybe they're not ready for it, etc. And that told me that, yes, they're looking for new solutions to really change the model of care. And the other piece really was around the enhanced patient safety that it provides, especially when you might have a nurse who's been licensed for 6 to 12 months, they're thrown into a situation like we know they were in the pandemic. I have a friend who said their niece was a charge nurse after six months during the pandemic. But any thoughts to like, in terms of the models of care and how AI will continue or just technology will continue to be infused?

Tom Lawry:
Well, again, the bottom line question is how do we liberate these valuable, precious clinicians from all these things that are wasting their time, that are factors in contributing to the burnout and leaving the profession? And I firmly believe that properly done, artificial intelligence drives value. And the real issue is how does AI drive value? It drives value by coming in behind those skilled clinicians, those humans, to do something better than they can do, but it's always coming in behind to support the unique qualities of those caregivers to make them better at something they care about, not what I care about, what they care about because they're on the front lines every day doing work. And already, and I just want to pause because I think there's some rule on podcasts and webcasts where you can't finish one without at least talking about generative AI, so let me throw that out. So to your question, there's a whole lot swirling around on that. There's a lot we don't know. We're all early in the journey. I want to point that out, but having said that, there's a lot of really great hard evidence that already, it can do things like automate things like clinical notes and standard clinical formats, like so. So how do we take all of those things? It's still human clinicians in the loop. How do we start doing that to free them up, to be spending more time doing patient care, doing research, or even something as radical as getting home more often in time for dinner with their families? So that's the promise. I could spend several episodes of your podcast and webcast talking about real examples today. And the question is back to the virtual nursing or why did it take a pandemic for us to pull telemedicine forward? Everyone talks about innovation in healthcare, and my challenge to everyone is, well, let's talk about what that means, and let's really put that into practice in measurable ways that materially support the people on the front lines delivering care.

Molly McCarthy:
Yeah, no, I think to that end, my next question would be, as a CFO or someone looking at the ... the cost justification of such investments and change management, but it's almost like asking what's the cost of not doing this, of not investing in this tech?

Tom Lawry:
Yeah, absolutely. And we're talking about clinical, but I'll just step out for a minute. Clinical is probably more complex than other things, but I had a really great call today with a company out of Israel called Hairo doing using conversational AI to automate so many of those touch points as far as contacts with consumers and patients, both administratively and clinically. So look at the work they're doing, very safe, to basically automate the work of so many humans to actually improve that experience that a consumer patient is having and make those people in the contact center and other places more efficient, again, playing them to the highest value, safe, easy. They've got some ROI numbers that are pretty impressive. So even starting in places like that drives measurable value. And then we go beyond that to say, when it comes to defining the best starting points for the use of AI, I always like to, I always get initially shuffled to certain technology, people who are important and they're great. But when it comes to deciding where to start in the use of AI, it's like, I want to get to those people on the front lines, the physicians with the highest volume for their specialty, the nurses on the floors that are going home at night doing that. If only we could do this better. Those are the ones I want to talk to. Those are the ones that typically have the best ideas to start down this process of driving value in things you care about.

Molly McCarthy:
Now, I'm obviously, as a clinician, I agree, and that's probably how I even got into tech many, many years ago. I do want to just start to close. I wish we had more time and could go down the, a few different rabbit holes, but if you think about where we are today and where our health systems are, and most of our listeners are going to be CNOs, CNIOs, nurses, physicians, healthcare executives, this kind of lightning round, what comes to your mind when you had to go in today into a facility, and you're going to probably kick this back to me, but what is your single most important practical piece of advice I would say for them with regards to tech? And I know you just talked about like, listen to what your physicians and nurses are up against, but just wondering, besides reading your book, what's some advice that you've given lately?

Tom Lawry:
Well, again, leadership imperative, whether you're a CEO, you're in the C-suite, or you're a medical leader, it is all about bringing every knowledge worker along. The big thing I'm pushing on now is we have one of the biggest upskilling initiatives that we have to undertake that healthcare's ever seen. That has to happen, it has to start now. It's not to say that clinicians need to learn how to code or even be able to explain a neural network. They have to understand what's there, what it's capable of, and then how they're going to use that to, again, be better at something they care about. And maybe I'll close with a quick story. So I was in Dublin giving a talk two weeks ago. At the end of my talk, it was actually a lot of fun, the people that rushed up to the front of the stage that wanted to talk, there were about a half dozen medical students that were in the audience, and they started talking very effusively about AI and everything, and then they finally pivoted. I said, How's that going? They were everywhere from first-year medical students to residents. And they basically said, our curriculum that we're that were being taught from is at least 4 or 5 years old. None of what you said is being taught as medical school students. So I look at everything from the upscaling we need to do for everyone working today, and then the challenge is what's happening with the nursing school, the medical school curriculums, because we should be baking this in now because we're turning out students like that, that we're excited and also very frustrated to say we're not learning this as we go through medical school. So upskilling, and then saying to any clinician, look, this is not that hard. It's all about how we bring it in behind you to make you better. Back to it's not about technology, it's about empowerment.

Molly McCarthy:
Right. So leadership upskilling, really, behind the scenes. That's how I felt with tech. It should not be something that they see or play with, should be happening behind them. Well, Tom, thank you so much for joining the Smart Care TeamS Spotlight today. I hope that we can chat again in the future because I really look forward to seeing where you go and where health goes in the next 6 to 12 months. So thank you so much.

Tom Lawry:
Well, thanks for having me on.

Intro/Outro:
Thanks for listening to the Smart Care Teams Spotlight. For best practices in AI, in ambient intelligence, and ways your organization can help lead the era of smart care teams, visit us at VirtualNursing.com, and for information on the leading Smart Care Facility Platform, visit Care.ai.

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"I would say, we've come to a moment in history where our profession is at the greatest risk that I believe we've ever seen it before. That nursing is at a moment in time where there might not be enough nurses to keep healthcare operating in the future if we don't start really redesigning our environments to place them at the forefront of what needs to happen." - Tom Lawry

Presented by care.ai

care.ai is the artificial intelligence company redefining how care is delivered with its Smart Care Facility Platform and Always-aware Ambient Intelligent Sensors. care.ai’s solutions transform physical spaces into self-aware smart care environments to autonomously enhance and optimize clinical and operational workflows, delivering a transformative approach to virtual care models, including Virtual Nursing.