Modern Practice Podcast

Machine learning and AI in medicine – Part 1

For years relegated to science fiction, as exemplified when the HAL 9000 had a speaking role in 2001: A Space Odyssey, artificial intelligence (AI) now has become practical reality and in medicine, a long-hoped-for remedy in areas from pathology to electronic medical records. Yet, artificial intelligence, which encompasses machine learning and other functions, has limitations. In this episode, learn about the current state of artificial intelligence and what it can realistically achieve for your practice.
 
Guest speaker:
Shannon Sims, MD, PhD
Vice President
Data Intelligence and Interoperability
Vizient
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Show Notes
[00:56] Understanding concepts around AI
[02:28] Two main functions of AI
[03:33] Importance of prescriptive analytics
[04:26] Enabling clinicians make better decisions
[05:13] Machine learning and EMRs
[06:10] AI and the coronavirus
[07:52] Structural challenges
[09:01] AI and quality
[10:09] Role of clinicians in developing solutions
[11:04] Successes and limitations
 
Links | Resources:
Machine Learning in Medicine (NEJM—April 4, 2019) Click here
HYPE Randomized Clinical Trial Click here
Potential Biases in Machine Learning Algorithms Using Electronic Health Record Data (JAMA Internal Medicine—Nov 2018) Click here
On Deep Learning for Medical Image Analysis (JAMA—Sept 18, 2018) Click here
Artificial Intelligence in Health Care: Will the Value Match the Hype? (JAMA—June 8, 2019) Click here
Artificial Intelligence in Health Care: A Report from the National Academy of Medicine (JAMA—Feb 11, 2020) Click here
Artificial Intelligence: Promise, Pitfalls and Perspective (JAMA—June 23/30, 2020) Click here
 
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How clinical leadership can access usable data to drive meaningful change – Part 2

For data to be effective, the information needs to be current. It needs to reflect what is truly significant in patient care. And it needs to encourage consistency in practice. On this episode, a leading analytics expert continues his discussion on how you and your organization can shape the wealth of data you collect to guide the care you deliver.
 
Guest speaker:
David Levine, MD, FACEP
Group Senior Vice President
Advanced Analytics and Project Management
Vizient
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Show Notes
[00:23] The issue of data validity
[02:09] The issue of timeliness
[02:55] Data from the Wild, Wild West (ambulatory arena)
[04:03] Getting to the data—clinical data more valid than claims data
[05:10] Encouraging consistency
[06:22] Steps we can take now to better data
[06:46] Understand the data before refuting it
[08:12] The meaningless quest for an overall clinical score
[09:08] The sea of data
 
Links | Resources:
Transparency: A Critical Component in Advancing Health Care Improvement Click here
Leveraging the Power of Data and Collaboration to Change Healthcare Click here
Electronic Health Records and Meaningful Use (AHRQ) Click here
Public Health and Promoting Interoperability Programs (CDC) Click here
How hospitals can use data to improve efficiency Click here
 
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How clinical leadership can access usable data to drive meaningful change – Part 1

Big data has the potential to provide clinicians with the information they need to improve the value of their care. Yet, the challenges are in how to find the right metrics, out of all the information available, and then putting the metrics to the best use. On this episode, a leading expert in clinical analytics will discuss using data that provides a true picture of care and serves to improve care outcomes. He will also discuss what recent analysis is showing about trends during the COVID-19 outbreak.
 
Guest speaker:
David Levine, MD, FACEP
Group Senior Vice President
Advanced Analytics and Project Management
Vizient
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Show Notes
[01:37] Elements of meaningful data
[03:06] The data will never be perfect
[03:34] Attribution challenge
[03:53] Hospitalist example
[04:53] Data from the pandemic
[07:28] Not a major investment but a major commitment
[08:52] Bringing clinicians to the table early
 
Links | Resources:
Transparency: A Critical Component in Advancing Health Care Improvement Click here
Leveraging the Power of Data and Collaboration to Change Healthcare Click here
Electronic Health Records and Meaningful Use (AHRQ) Click here
Public Health and Promoting Interoperability Programs (CDC) Click here
How hospitals can use data to improve efficiency Click here
 
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Leadership pitfalls during the pandemic – Part 2

Lack of communication and fear of telling the truth are common pitfalls for leaders, and these pitfalls lead to the staff losing trust. In this episode, we continue our discussion on how leaders can develop and hone skills to keep staff engaged. Effective leaders are coaches and foster team-based care. Their actions lead to trust and resilience, in this time of crisis and beyond.
 
Guest speaker:
David Munch, MD
Senior Principal
Vizient
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Show Notes
[00:37] Need for leadership visibility where the work is done
[01:01] Need for inclusive communication: top-to-bottom and bottom-to-top
[02:37] Executives and middle managers average 65% of their time in meetings
[03:27] Leadership visibility in the surgical suite
[04:42] Give everyone the benefit of the doubt
[06:40] Make their job easier!
[07:45] What leaders can do today: four stages
[10:37] Having the right metrics
 
Links | Resources:
How to Succeed or Fail in Your Lean Improvement Efforts Click here
How Process Improvement Teams Can Help During the COVID-19 Crisis Click here
Lean Thinking during the COVID-19 Pandemic Click here
Resources to Support the Health and Well-being of Clinicians during the COVID-19 Outbreak Click here
 
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Leadership pitfalls during the pandemic – Part 1

This time of ongoing crisis has severely tested the resilience of clinical staff, increasing the risk of burnout and emotional exhaustion. Health care leaders must address the issue of resilience right now or the problem will accelerate. Leaders that do not engage their staff, that do not have visibility or transparency and do not give and receive feedback are risking loss of trust and even staff turnover. On this episode, we’ll consider ways to foster resilience among staff and avoid pitfalls in leadership.
 
Guest speaker:
David Munch, MD
Senior Principal
Vizient
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Show Notes:
[01:30] Staff resilience during the pandemic
[02:23] Rounding as a leadership style
[04:25] Essential characteristics of leadership
[05:07] Dealing with staff emotions
[06:13] Addressing frustrations
[07:43] Accelerating trust
[08:59] Necessity of team-based care
 
Links | Resources:
How to Succeed or Fail in Your Lean Improvement Efforts Click here
How Process Improvement Teams Can Help During the COVID-19 Crisis Click here
Lean Thinking during the COVID-19 Pandemic Click here
Resources to Support the Health and Well-being of Clinicians during the COVID-19 Outbreak Click here
 
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COVID-19 impact on provider practices – Part 2

This episode continues our discussion on the impact of COVID-19 on clinical practices by examining a new framework for health care, with the idea that it must be more adaptable, flexible and reliable than in the past. Practice data should reflect what we need to know about access, quality and even productivity. Finally, we explore the best approach for creating and developing new ideas and practices, one that originates from those involved in the care every day and not imposed from the top down.
 
Guest speaker:
Lina Patel, MHA, FACHE
Associate Vice President
Product Strategy and Management
Vizient
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Show Notes
[00:37] Future of the health care framework
[02:10] Using a nimble virtual care platform
[02:30] Leveraging practice data to look at access, quality and productivity
[03:42] Providers need options for developing new approaches
[04:06] How health care organizations should use practice data
[05:01] The Clinical Practice Solutions Center (CPSC): sharing data with clinicians
[05:27] Access and improvement insights
[06:19] Lessons learned from COVID-19
 
Links | Resources:
Clinical Practice Solutions Center—The Clinical Practice Solutions Center is a performance improvement solution focused on medical practices and developed in partnership with the Association of American Medical Colleges (AAMC) and Vizient. Find more information Click here
Using COVID-19 Learnings from Clinical Practice Solutions Center (CPSC) to Reimagine the System of Care Click here
Understanding the impact of big data on nursing knowledge (Nursing2020 Critical Care) Click here
It’s All about the Data in 2020 and Beyond Click here
 
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COVID-19 impact on provider practices – Part 1

Leaders in health care often confront the simple truth, “You can’t fix what you can’t measure.” In this episode, we explore the crucial need for a comprehensive, data-driven practice model and how to provide that across departments and disciplines. A data-driven model enables complex analysis of clinical practices to drive policy, refine best practices and deliver better outcomes for patients.
 
Guest speaker:
Lina Patel, MHA, FACHE
Associate Vice President
Product Strategy and Management
Vizient
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Show Notes:
[01:28] Leveraging the data
[03:02] The Clinical Practice Solutions Center
[03:47] Effect of the decrease and disruption of clinical procedures
[07:16] Virtual care
[09:20] Getting on solid ground
 
Links | Resources:
Clinical Practice Solutions Center—The Clinical Practice Solutions Center is a performance improvement solution focused on medical practices and developed in partnership with the Association of American Medical Colleges (AAMC) and Vizient. Find more information Click here
Using COVID-19 Learnings from Clinical Practice Solutions Center (CPSC) to Reimagine the System of Care Click here
Understanding the impact of big data on nursing knowledge (Nursing2020 Critical Care) Click here
It’s All about the Data in 2020 and Beyond Click here
 
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Facing the physician shortage – Part 2

Due to a number of reasons—physician retirement, limited medical school and residency slots, fewer physicians in rural practices and a population that is aging and growing—the country is beginning to experience a shortage of physicians. This problem is only expected to balloon in the next decade. On this episode, we examine a number of potential remedies for the physician shortage, from greater efficiencies in practice to a reliance on the clinical team approach.
 
Guest speaker:
Michael Dill, MPA
Director, Workforce Studies
Association of American Medical Colleges
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Show Notes:
[00:33] Steps to address the shortage (cont.)
[01:18] Evaluating the promise of virtual health
[04:49] Evaluating the role of Advanced Practice Providers
[05:50] Evaluating the role of clinical pharmacists
[06:26] Evaluating the role of hospitalists
[07:09] Improving efficiencies to offset the shortage: can it work?
[09:30] Addressing gender issues
[11:38] Addressing generational issues
[13:08] True magnitude of the physician shortage
[13:53] Addressing burnout
 
Links | Resources:
AAMC Study (2020) – “The Complexities of Physician Supply and Demand: Projections from 2018 to 2033” Click here
New AAMC Report Confirms Growing Physician Shortage Click here
15 things to know about the physician shortage Click here
Physician workforce in the United States of America: forecasting nationwide shortages Click here
 
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Facing the physician shortage – Part 1

Currently, fewer and fewer physicians are available to handle a patient population that is surging, mostly due to aging and the conditions that accompany it. The COVID-19 crisis has only heightened the dilemma. A recent study from the Association of American Medical Colleges predicts a shortage of between 54,000 to 139,000 physicians by the year 2033. This episode examines the ramifications of the crisis and how we can address it going forward.
 
Guest speaker:
Michael Dill, MPA
Director, Workforce Studies
Association of American Medical Colleges
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Show Notes:
[01:25] Summary of the AAMC workforce study and projections
[03:25] An aging physician pool and the effect of COVID-19
[05:09] The crisis in primary care and in small, rural practices
[07:41] A shortage of specialists and the needs of an aging population
[09:27] Diversity in the physician pool and barriers to access
[11:43] Addressing the shortage – three steps
 
Links | Resources:
AAMC Study (2020) – “The Complexities of Physician Supply and Demand: Projections from 2018 to 2033” Click here
New AAMC Report Confirms Growing Physician Shortage Click here
15 things to know about the physician shortage Click here
Physician workforce in the United States of America: forecasting nationwide shortages Click here
 
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Optimizing your clinical workforce – Part 2

Before the COVID-19 pandemic, a number of states were already expanding the scope of practice for Advanced Practice Providers (APPs). The pandemic only accelerated this expansion. On this episode, we continue our examination of what has happened to the role of APPs, discuss the potential benefits this poses for the future and focus on how to realize these benefits in clinical practice.
 
Guest speaker:
Christen Hunt, DNP, NP-C, CPNP-AC
Director, Nursing programs
Vizient
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Show Notes:
[00:29] Need for setting up communication patterns and an inclusive governance structure
[02:49] How to continue and propel the benefits of APP inclusion
[03:24] Three pillars to optimize the clinical workforce
[04:05] Taking a stronger look at workflow and improving it
[05:58] Prior authorizations example: who could do this task?
[06:48] Telemedicine opportunities
[07:40] Remote monitoring opportunities
[08:24] Greater access to patients
[09:30] “We’ve gotta change”
[09:54] Facing the challenges of the future
 
Links | Resources:
Is It Fair? How To Approach Professional Scope-Of-Practice Policy After The COVID-19 Pandemic Click here
COVID-19 State Emergency Response: Temporarily Suspended and Waived Practice Agreement Requirements Click here
Flattening the Provider Curve: Temporary COVID-19 Measures Expanding Scopes of Practice and Lessons from the Past Click here
 
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