Join us as Dr. Andrew M. Davis and Amy Wainwright from University of Chicago Medicine reveals how AI-powered analysis of 37,000+ patients exposed a crisis hiding in plain sight: nearly 30% of hypertensive patients have dangerously uncontrolled blood pressure despite regular primary care visits.
Using cloud-based machine learning across 112 providers, Dr. Davis's team identified critical gaps traditional metrics miss—underutilized medications, missed referrals, and troubling disparities in care. More importantly, they developed interventions that work.
Discover how to leverage advanced analytics for measurable ROI, implement real-time clinical intelligence at scale, and empower providers with data-driven feedback that reduces cardiovascular risk at the point of care.
Andrew M. Davis, MD, MPH, Professor and Associate Vice-Chair for Quality, University of Chicago
Amy Wainwright, PharmD, Clinical Pharmacist, UChicago Medicine
Megan Antonelli, Chief Executive Officer, HealthIMPACT Live
00:00:00 Intro: Welcome to digital health talks. Each week we meet with healthcare leaders making an immeasurable difference in equity, access and quality. Hear about what tech is worth investing in and what isn't as we focus on the innovations that deliver. Join Megan Antonelli, Jenny Sharp and Shahid Shah for a weekly no BS deep dive on what's really making an impact in healthcare.
00:00:29 Megan Antonelli: Hi everyone, this is Megan Antonelli. Today we're tackling one of healthcare's most persistent challenges. Nearly half of American adults have hypertension, yet control rates remain stubbornly low. My guest, Doctor Andrew Davis, professor and clinical quality expert of University of Chicago medicine and clinical pharmacist Doctor Amy Wainwright, analyzed over thirty seven thousand patients across one hundred and twelve providers using a machine learning platform to uncover critical gaps in medication utilization and care coordination. Then they develop targeted interventions to address them. Today we're going to hear about that study and the interventions that they used. Hi Andy. How are you? Hi, Amy. Welcome.
00:01:13 Andy M. Davis, MD, MPH: Great to join you.
00:01:15 Amy Wainwright, PharmD: Great to be here.
00:01:16 Megan Antonelli: So glad you could join us. And really excited about this. You know, we work with the American Heart Association. We were there at Scientific Sessions. And congratulations on having the poster there, I'm sure. Um, such a great event. Every year, my favorite thing about it is seeing all of the physicians so excited about the technology and innovations that are happening. I often I'm often on the other side at the technology conferences where we talk about how technology is is a burden and it's difficult, but when I go to that one, I always feel like they're very excited to learn about the technology. So I'd love to hear about, um, Andy, let's start with you. Kind of your background and how you got, you know, sort of started with this, with this study.
00:01:59 Andy M. Davis, MD, MPH: Well, I'm a long time primary care physician. I'm a general internal medicine physician and also boarded in preventive medicine and blood pressure, uh, is a standard and, um, challenging issue as long as we've been working on it. Uh, and the the new American Heart Association hypertension guidelines, uh, gave us an opportunity to say, can we do a better job understanding who are, uh, poorly controlled blood pressure patients are, um, what are their comorbidities? Who has diabetes, who has renal insufficiency, who has heart failure? Uh, and can we feed back actionable information to the physicians who are seeing these patients, um, with precision on their medication, prescribing, their dosing, the number of classes they're prescribing. Um, and then finally, can we link it to some of the newer Bluetooth enabled blood pressure cuff measuring techniques that will allow us to bring in, um, population health, uh, clinical pharmacists to bear on the issue and really show that we're making a difference in their blood pressure control.
00:03:07 Megan Antonelli: Yeah. That's great. Amy, how about you?
00:03:10 Amy Wainwright, PharmD: Sure. Um, I've been a pharmacist for twenty one years. I've been here at the University of Chicago for about three and a half years. Um, working primarily working with the primary care group, um, primarily with hypertension and diabetes, um, most specifically in our remote patient monitoring program, um, where we, um, uh, give patients Bluetooth enabled blood pressure cuffs so that they can check their blood pressures at home. Um, and it's tied to a protocol where nurses and pharmacists weekly outreach to the patient and can, um, adjust medication and provide additional lifestyle education.
00:03:51 Andy M. Davis, MD, MPH: And, Amy, can you talk a little bit about the, uh, digital navigators, as most of our patients in this day and age now have smartphones. Where do the digital navigators fit in?
00:04:01 Amy Wainwright, PharmD: Sure. So we have a group of of medical assistants act as digital navigators who, um, who help the patients. Um, they link the help link the cuff to, um, epic, which is the EMR that we use into their mychart, um, as well as, um, help patients troubleshoot if they are having issues. Um, they do, um, also show the patient how to use the blood pressure cuff while they're in the office so that they can have the best, um, blood pressure accuracy, um, at the, at the home. Um, and then, um, they're also available for, uh, for troubleshooting moving forward so the patients can, um, can visit with the Digital Navigator, um, anytime and get more information and some help if needed.
00:04:54 Megan Antonelli: That's amazing. It's such an important piece of this. I mean, as we introduce new technologies and obviously how you use them, when you use them, you know, it becomes it's critically important, you know, especially in a in a research study like this. So were those already in place, um, or have they been something that you have to sort of bring in to, to kind of do studies like this?
00:05:17 Amy Wainwright, PharmD: So the Digital Navigators is something that when we started, um, the remote patient monitoring program for hypertension was something that, um, Doctor Shaw and Shaw, who is our, um, is kind of over this program. Um, he saw that that was a need, really, for patients to be able to, um, have that additional coordination for, for this. So it's, it's just part of the program as a whole, regardless if we're if they're part of a study or if they're just part of our general population.
00:05:50 Megan Antonelli: Got it. Now, in terms of that study, I mean, you know, I think hypertension is such a you know, it's almost it's one of those invisible ailments, right, that, you know, people, you know, don't know until they until they're diagnosed. And then keeping that compliance is often hard. So Andy, tell me a little bit about, you know, kind of what surprised you about the baseline data as you guys were doing this research in terms of, you know, what it reflected in terms of like the practice and chronic disease management and how how we're managing those populations.
00:06:23 Andy M. Davis, MD, MPH: Yeah, we're we're on the south side of Chicago. Um, probably fifty or sixty percent of our patients with hypertension are black ancestry. Um, so that was not a surprise. Our board came to us and showed our we had a persistent nine and ten percent gap in blood pressure control, using even a loose definition of less than one forty over ninety, with about sixty seven percent control in our black patients and seventy seven percent control in our white patients. And we actually made that a priority metric that we've been tracking. So we look at, you know, simple things. Saying, do you repeat a blood pressure in five minutes in case the traffic was terrible coming into the office? Um, but what MD clone has allowed us to do, and that's linked up through Julie Johnson and Tom Spiegel, and it's a cloud based kiosk platform that allows us to look at big data and pull in lots of things at the same time in a way that would just take lots of analysts time, particularly when you explore things. Each time you get a report, you have three or four more questions, and I can do those using the kiosk system in a matter of hours, as opposed to, um, getting back in the queue for for that. Um, I think the, the emphasis increasingly in healthcare is looking at overall cardiovascular risk, cardio metabolic, renal health. And what's been surprising to me is, um, or useful to me is understanding the context of, um, how many classes of, of hypertension medicines are being prescribed? Are they being prescribed an adequate dose? Are there contraindications such as kidney failure or weak kidneys in which that would affect the prescriber. And we also are bringing in adherence data. So if we if we see someone that perhaps is not taking their medicines using, uh, sort of all scripts, uh, feeds for refills, uh, we have the potential then to, to say maybe that medicine is too expensive, or maybe there's a side effect that you haven't discussed with your primary care physician. Uh, we can look at who prescribed all the medications, and we can go back to the twenty three primary care offices and the leaders in those offices and say, in these offices, um, you're not using enough combination medications. You're not using medicines like spironolactone, which can help in resistant hypertension. Um, we noticed that the median blood pressure and the last blood pressure have been consistently high. Would you consider a referral to the kidney doctors or to to our cardiologist? So it gives us a very rapid turnaround. You know, I get data within a few days of of it posting an epic, but then I can manipulate it with queries that are focused on a particular office, on a particular provider. Bring in comorbidities, lab data, uh, and also see if they've been referred to remote patient monitoring where our terrific population health nurses and clinical pharmacists can also be enlisted in getting these folks under better blood pressure control.
00:09:22 Megan Antonelli: And you mentioned the machine learning platform. Tell me a little bit about what that is and how it has, you know, what what data is going into that. How does that interface with the systems that you currently have?
00:09:34 Andy M. Davis, MD, MPH: Um, our relationship with them, I think they're based in Sheba Hospital, which is a big research center in Israel. Um, but they've been increasingly working in the United States with institutions like Intermountain Healthcare, Washington University, uh, and, um, the, the agility and the real time nature has been terrific. Uh, and we can ask a question and then think of three more things as we get the results back, and then just slightly tweak the, the query and, and look at the answers to that. So, um, I think it's me as a frontline physician with some health services research, but I'm not, you know, a full time health services researcher. Um, I can say, gee, who who has a heart failure? Um, how would that affect are they getting goal directed medical therapy that would keep them out of the hospital? Because we all know heart failure is a common reason for particularly Medicare population people to be admitted. So I think it's the timeliness the the big the big, uh, epic, um, tableau type of approaches are useful for getting out paper performance reports and CMS and, you know, um, um, adherence. But then to say, you know, what is it about the in a given office, These three doctors are getting great control and these folks are not getting great control. I can look at the demographics of the patients and say, huh, this person is not prescribing as aggressively or titrating upward as rapidly. Those are the kind of questions I can find very quickly that are hard to see in the big platform kind of quality reports that we're used to.
00:11:13 Megan Antonelli: Right. And how did the clinicians, when you give them that feedback, is it is it how is it? Um, you know, sort of how do they respond? Are they happy or are they like, how do you know that?
00:11:24 Andy M. Davis, MD, MPH: Um, if you make it easy to do the right thing. Uh, and, um, there's a phrase in quality improvement which says, you know who's doing a terrific job? Um, in the office. And, boy, we knew she was great already. Um, what does she do differently? Oh, combination pills. But aren't they all expensive? No. This combination pill is not quite so expensive. And, uh, patients have really liked taking fewer pills, and their blood pressure control is better. So. So I think, um, part of the, the challenge in large systems are, uh, in Mdck clone, I can say, has this patient actually been seen by a primary care doctor? And have they written a note on this patient in the last year? And so when we focus our reports on patients that the doc knows they've seen, as opposed to you get a report with, you know, fifty names and they say, well, I haven't seen these thirteen. This this data is rubbish. Uh, and so I think the ability to say, um, uh, yes. You've seen them. Uh, yes. You've coded for hypertension and you're not getting quite as good control as the, as the, uh, someone you also respect in your office. And here's some of the things they're doing a little more intensively that's looked at as helpful. So if we can make things easier to do the right thing, um, if we can bring on the population, health nurses and the clinical pharmacists to find affordable medications and better regimens, the patients are the physicians are happy because then their report cards for blood pressure control look better, and they haven't had to do too much thinking about it. So I think in general, people are happy if we can get accurate, timely data, if you give them a report from six months ago or a full year and twenty percent of the patients they had, they don't even think there belong to them, you're going to get pushback. And oh, it's another thing to ignore in my inbox.
00:13:15 Megan Antonelli: Right? Yeah. No, I think that's I mean, when I think about when we first started talking about social determinants of health and kind of all these increasing data points that we wanted to look at that would impact, you know, better patient care and how we could improve interventions. I just remember the first obstacle was sort of who's going to look at this data? How are we going to look at this data? How how is a physician possibly going to have the time to do more, you know, to look at more? And it just seems like with what you're talking about, not only are you Allowing them, you know, you're sort of pointing them in the right direction, but you're also then giving them that tool to, you know, make those improvements and provide better care, which of course, is why they're why they're in this to begin with.
00:14:00 Andy M. Davis, MD, MPH: And Amy can Amy is, you know, one of the most popular people. All our physicians know Amy in the medical, in our medical group. Uh, she's a wizard, not only in hypertension, but also glp1 and fighting with insurance companies about GLP ones. Amy, can you talk about, you know.
00:14:17 Megan Antonelli: How it sounds like you'll be popular with both my friends, too.
00:14:23 Amy Wainwright, PharmD: Uh, there I have no shortage of of of in-basket requests. Um, no, I so there's a lot there's a lot of things that I think, um, are really important, um, that that the MD clone as, as Andy was really talking about it. So, um, kind of, uh, one of the things that we have is monthly we, you know, because hypertension is such a big deal for our system once a month we have a hypertension management group that we kind of discuss, you know, at different interventions that were that we're working on, whether it's RPM, whether it's engaging our community health workers to help patients address, um, you know, some of those social determinants of health, being able to connect to, um, Meals on Wheels or, um, being able to even do a home medication, reconciliation with the pharmacist and the community health worker, or even if it's just reshowing them how to use the blood pressure cuff. Um, it's been nice with the MD clone kind of to go back to some of the points that Andy's made. Is that usually what we would do is we'd have the meeting, then the next month we would see if anything had changed. Um, but with MD clone, we were able to, uh, Doctor Davis was looking at that information. That evening, we would get an email out with the results of, you know, looking at it from a different, maybe a different angle or a different qualification. You know how many patients are on Ace-is and ARBs and we would get that list. And then, um, you know, if our team had another thing to, uh, to query, he could then, you know, modify that that day or the next day. And, you know, within a week we would have, you know, multiple, um, iterations of that, of that information so we could better focus, um, and we use it as negative or positive. So, you know, if one of our teams is having, you know, we have an off site clinic that has excellent blood pressure readings. And so, um, their, their blood pressure control rate is very good. So that made us want to go there and see what's different, you know, what are they doing. Right. That we're not you know, that that we're not doing is it. You know, the physical, you know, space that's nicer, better, you know, the free parking, those kinds of things or, you know, is it, um, is it the prescribing? So we're able to kind of filter down into that information? Um, now, as a, as a pharmacist, um, you know, one of the things that's been great is being able to, um, work with patients on making sure that they're taking their medications, um, understanding why they're on different medications. I also work with our population health nurses so that when they have patients that are more challenging, um, you know, have a more complex regimen, um, helping them, uh, know, kind of the next step to go to, um, that is, you know, it's very protocolized. But I think sometimes it's nice to have that, um, that additional person to feed back with, um, and to like, consult with. And so, um, our pharmacy, our pharmacist team also works, um, with the nurses in that capacity. We also do educations with them, um, to keep them up to date. So like when the guidelines changed, we went back through that with the with the nursing team as well. Um, so that we could provide that, um, that education kind of for our staff as well as um, be able to share that education to our, um, to our patients, um, so that they also understand why, um, why things are changing and why, um, the, you know, these changes, uh, to lower blood pressures are important, um, and that it's, you know, lowers the stress on their heart and their kidneys. So they're less likely, um, to have that heart attack or end up on dialysis.
00:18:24 Andy M. Davis, MD, MPH: And I want to pick up, uh, Amy's point about our hypertension task force. Rapid, timely, accurate data that you can quickly tweak and do another round is catnip for, uh, for physicians, uh, and particularly research interested physicians. So the lead author on this was Amber Johnson, who's an Nhlbi funded, um, researcher. We've worked with Tammy Polonsky and preventive medicine. We've worked with Celeste Thomas, who's an endocrinology. Uh, and, um, we're working with Nilda Saunders, looking at the deterioration of renal function and our people having, uh, spillage of albumin into their, their kidneys, uh, checked on a rapid basis. Um, when you get when you can get data and then modify it to the interests of your collaborators, perhaps in different departments. Uh, that's a very exciting thing. And I think adds to our momentum and sort of a sense that it's not just a silo of, well, I'll just talk about the blood pressure and never mind the diabetes or never mind the heart failure, you can pull in collaborators, you can pull in junior faculty fellows who have research interests. And as a team, you just get further, um, and you maintain the excitement and the momentum of your, your quality improvement.
00:19:40 Megan Antonelli: Yeah. I mean, it just it reminds me of that, you know, the days where we would talk about kind of the, you know, the report cards and the static sort of things. And this is much more of this, like interactive, real time. And also, I think that your point about, um, you know, even when it's like, well, I didn't see that patient or, you know, they can't argue with it because it's also accurate. Right? So it's real time accurate data that they're, that they relate to and they can then respond to. So you're just giving them those tools, um, you know, to practice medicine better.
00:20:11 Andy M. Davis, MD, MPH: And some solutions to you're saying we've got, you know, terrific folks who can help you get there. You know, um, they've missed three appointments. Well, we can look at no show rates and we can figure out if there's a community health worker that we might want to put on this case. Um, are there transportation issues? Are there literacy issues? Are there language barriers? And so there are lots of um, we can begin to, to really dig down on the people that are poorly controlled and are going to be future. They're going to, you know, not only ding us on our quality measure, but they're going to be future emergency room visits. They're going to be future hospitalizations. Uh, and that's that's what gets our chief financial officer interested. Uh, if we can, um, improve care and reduce dialysis and, uh, reduce length of stay in the hospital for heart failure, um, then suddenly it's not. Oh, you're doing a nice science project, but it actually may have importance for the budget of the of the medical center.
00:21:07 Megan Antonelli: Right. And, well, you know, maybe with the winds, Amy, like you mentioned, the you know, when you identify the pockets of where it's where everything is going, right? The clinicians want to take the credit for it that often. All you know, it has more to do with the environment or the situational, you know, or the demographics of, of of the space. Are there any, um, you know, were there surprises in terms of some of those factors that led to either, um, outstanding positive results or on the other side, on the negative side.
00:21:39 Andy M. Davis, MD, MPH: I think I was surprised, um, you know, I can tell you the, um, uh, about four thousand five hundred people with kidneys that are starting to get towards dialysis range. I can tell you, the ten thousand people with heart failure, uh, and I can also see how rarely they've been referred or at least completed a referral to specialists. So. So I think, you know, those are the people that are hovering to come into your hospital to, you know, um, uh, be expensive to the health care system. Uh, and they're, they're out there. And, um, often there are many other priorities and their lives other than taking medications. And if you say, uh, you're on three medications now, they're expensive. I can give you a combination pill that will make it easier and it's affordable and will help you on that. Or I can give you a a little video to watch that talks about a proper, proper dietary approaches. And that's going to help you feel better and do more of the things that are important, more important to you than coming to a doctor. Um, we may get more, more traction. So, um, I think the, um, in some ways it was not a surprise, but we knew we weren't doing a good job. Um, for all of our patients. And that's, um, um, been an important lesson, a little bit a bit sobering, uh, to to to see that. Um, but overall, I'm pretty optimistic that, um, you know, docs are innately a little bit competitive. They want to do well by their patients, and if we can set up systems to help them. So it's not all on them in a very crowded fifteen or twenty minute visit. Um, and the patient comes back to them three months later or six months later and their blood pressure is under better control. The docs begin to trust the information, and they begin to trust the process and are somewhat grateful for that team approach, and not all on them. With everything else they're having to deal with during their clinic visits
00:23:36 Megan Antonelli: Amy, did you have something to add to that?
00:23:38 Amy Wainwright, PharmD: Yeah, one of the things that we, um, created as part of the RPM program was a smart set. Um, so that, um, even if they weren't using the RPM program that the physicians could add in a mychart flow sheet so patients could upload blood pressures from home if they already have a blood pressure cuff. But it also listed some of the single pill combination, um, medications. I felt like a lot of our a lot of our team, especially because a good portion of our team are medical residents in training, and so they're not as familiar with those and what's available. And so making just some of those little changes, um, just across the system just helps bring it a little bit more to the, you know, to the front of mind, uh, front of eyes and front of mind so that they're more likely to prescribe a combination because they see it. They're not thinking, oh, I want to do I'm going to do a thiazide. I'm going to do an arb. Oh, I need to do a calcium channel blocker. Oh well there's actually now you can see. Oh well, there's actually a triple combination that we could put the patient on one pill. They're on three medications to lower their blood pressure. And we can get them under control a little bit faster. Um, so doing some of those things is really, uh, been super helpful. Um, we actually also did a focus group amongst our patients as to, uh, one of the reasons why, you know, why they might feel that, that they weren't taking their blood pressure as seriously. Um, as we thought, you know, often your physicians, um, area of focus and you, as a patient's area of focus that does not always match. Um, and so for our female patients, a lot of them, they were caregivers. And so they were more concerned about other people's, um, health and not their own. Um, so we've kind of reframed some of our discussions about, you know, using the old the saying about, you know, putting your mask on first before you can help somebody else. So making sure you're helping yourself and taking good care of yourself so that you can care for your grandchildren and great grandchildren, your, you know, your siblings, whoever you're helping your neighbors. Um, you can still go to church. Um, and then for, um, for some of our men, it was, um, we weren't as direct about how severe having high blood pressure is. Um, no one told me it would kill me. It would cause such, you know, it would cause me to go on dialysis. We kind of, you know, talk about how important it is. But I think, you know, sometimes you have to put it into, um, their situation. Like what? What why is it that we're, um, we're after it. You know, a lot of our male patients aren't as good, you know, using that, um, mask, same mask, um, scenario isn't necessarily going to work for them. But, you know, do you want to be around to, you know, help out your family? You know, you want to keep working all of those kinds of things because this could really land you in the hospital and not necessarily death, but disability could be a, you know, an issue. And, you know, being able to kind of refocus that. I thought that was very interesting when we when we had that fascinating.
00:27:03 Megan Antonelli: I mean, I think and when you think about, um, you know, when we talk about kind of digital transformation and how this technology can help, and here you're talking about, you know, much more simple solutions, right? Just we're changing how we're communicating with, with literally the sexes male versus female, you know, just simple things that, you know, we don't we just, you know, we make it all generic because that's easier. But those being able to speak to what matters to them, whether it's, you know, also the physician for changing their prescribing behavior or their treatment behavior, but also the patients, um, and just understanding those nuances. I mean, when you think, you know, it's like common sense. Um, you know, I was just reading, you know, I think it was, uh, Jane's article on common sense, you know, just practice medicine better, but we need the data to do it, right.
00:27:54 Andy M. Davis, MD, MPH: And one other thing I'll throw out, um, the the the chief of our general internal medicine is a health services research researcher named Nita. And she's done a lot of work in younger patients that are developing diabetes, even type two diabetes, in their in their late twenties. 30s. And we're seeing an awful lot of people, uh, you know, twenty five thirty five forty five who, um, are, you know, feeling pretty good because they're relatively young, but their risk factors are off the, off the chart. Uh, and, doctor, the research has said if you can get to people, um, in the first year or two of their diabetes and control them, well, they don't tend to get the long term complications that we're so used to. And so a lot of the pay for performance things are look at your fifties and sixty and seventy year olds. The horse is out of the barn. A lot of times, the damage to the vascular system and the kidneys have already been done. And so, um, Doctor and Doctor Celeste Thomas are also focusing on these, these younger age ranges. They're, you know, late twenties, thirties who are going to be your admissions are going to be your complications. Um, but we're getting to them hopefully ten or fifteen years before they, they, um, you know, have terribly swollen legs and can't breathe and have lungs full of fluid. Um, so I think that's another exciting area that we're looking we can identify these subsets. Uh, and that's we were talking about men and women. But I think younger folks also, there may be different communication styles, uh, different, uh, you know, certainly more digitally savvy. Uh, and so we open the opportunity to, to do tailoring, uh, um, not only by age, gender, race, socioeconomic literacy, language, but also just, uh, age. Uh, and that's been a bit of a surprise for me, and I think has really opened up the opportunity because that holds the promise of, you know, keeping the, um, uh, keeping people from ever getting into trouble at all rather than fixing them after they already have multiple complications.
00:29:55 Megan Antonelli: Right? Which is, you know, I mean, that's what it's all about, right? I mean, I think every conference, every, you know, sort of thing that you read about healthcare, it's all about how are we going to change from the sick care to a true health care system where we're actually managing people's health, extending their, you know, well span and all of that? And I think, um, this seems like a solution moving in that direction, which is which is exciting when it comes to you mentioned the CFO and what the CFO wants to see. Um, a little bit around, you know, I've been hearing as we've kind of gotten into maybe year two or three of some of the implementation of these AI and machine learning solutions, where you see the value, where you see the ROI. What are some of the key metrics that, you know, sort of the organization, the administration side on the hospital is looking at with these tools, and where are they seeing the value?
00:30:49 Andy M. Davis, MD, MPH: I think, um, initially we've sort of gotten our arms around the technology and seeing, uh, see what it can do on audit and feedback type of things. Uh, in the near term stuff, though, um, University of Chicago is a is a leading transplant center. Uh, and part of the reimbursement for transplants is if you have a, a robust waiting list for people who have been thoroughly vetted. And hopefully we're going to keep people from getting to the point of needing transplant. But, um, we've found a lot of people who are, um, the kidneys are quite weak, but they haven't had appropriate dietary counseling. They're not on the proper medicines. Uh, they're not watching, uh, their potassium, uh, in their foods, for instance. Uh, and if we can build that and connect to, Um, uh, the, you know, the proactive rental management. Uh, that's one thing. Uh, another thing we're also finding is, um, patients with heart failure who are not taking the four classes of medications that are useful and in some cases are appropriate for, um, cardiac procedures, uh, that are well reimbursed. Like, say, someone with atrial fibrillation, irregular heart rate, uh, and they have a poor ejection fraction. Their quality of life and their mortality is better if we identify them. And then we put them in the hands of the right interventional cardiologists, which, again, tends to be a more remunerative thing for the health system. So those are some of the, you know, the and then, of course, the big things of length of stay readmissions. Uh, um, there's also reputational, um, reputational thing if we can show that we're doing an excellent job, um, relative to other academic medical centers, uh, that builds referrals, that builds trust, and that's something that institutions care about right now. So I think that there is a MD increasingly is building out ROI tools and dashboards to help the managers kind of see what projects are under underway. Which of them can we connect to and, you know, clear needs that also have financial implications. And so the MD clone has been pretty smart about sort of building that in. But we're in that rollout period right now where we're beginning to to link to financial outcomes. Um, you know, docs want to do the right thing. You have to have a margin if you're you're a medical center. And I think increasingly, doctors are seeing, uh, administrators are seeing that they can work together, um, and have a mutual benefit.
00:33:21 Megan Antonelli: Yeah. No, that's that's amazing. And, you know, I think the value, um, just in being able to kind of, you know, that real time clinical analytics to get to get that to the physicians. I mean, um, is so important to the patients because they can act on it. And, you know, in in our last few minutes, we always like to close on the, you know, what are you most excited about in healthcare? And and kind of I mean, all of this is so exciting. So, um, Amy, maybe we'll hear from you on, on what you're excited about, and then we can close with you. Andy.
00:33:51 Amy Wainwright, PharmD: Well, since I was outed as the GLP one, um. Uh. Uh, coordinator, I, um, I am very excited that I believe that twenty twenty six will show us some, uh, additional GLP one agents, um, availability, as well as, uh, potential expansion into Medicare and Medicaid coverage. Um, which would be huge for our patients, um, uh, especially on the Medicaid side for some of that prevention, if we're we our program. Um, uh, as a side, we do, um, we also work with children, um, with, um, and their metabolic weight loss. And so being able to get somebody maybe as a as a young adult not to have not to, um, you know, reverse their hypertension, um, reverse some of obesity that that would be amazing. So, um, you know, we're we do have some patients that cross over between our weight loss and our blood pressure. And we're seeing some of those patients come off of their blood pressure medicines, which has also been exciting.
00:34:59 Megan Antonelli: Yeah, we're hearing that more and more for sure.
00:35:02 Andy M. Davis, MD, MPH: And yeah, I think, um, to me, having the, um, if you will, the content experts, in other words, the clinicians that are cared passionately about blood pressure or diabetes or kidney disease, be able to look at large databases, uh, you know, if you're if you're a person managing your, your IT department and your, the physicians say we want these sixteen things. Um, with MD, I can actually say probably only five of those things really count. And those are the things that that our analysts might then do a platform, put onto a platform and monitor more on a system level. But you you get the agility of the content experts, the physicians, without having tons of it, training themselves to be able to ask the questions and say, okay, we actually we don't need sixteen. We're not going to drive your analysts nuts with, can you get us this and can you get us this and can use that? And, you know, we can do the preliminary work and then come to the IT department and say, this is strong enough that we actually want to build in the standard reports around it, because we've shown that it has leverage in our patient population. So I think that marriage of content experts, um, with the more analytic ability and then that works hand in hand, the jury analysts in your IT department, um, aren't, uh, chasing will o the wisp things, which we didn't really need. Those sixteen. Sorry about all those other things we asked you to get. Um, I can do some of that preparatory work and get us, hopefully more in line with, you know, certifications from the American Heart Association or, um, building, uh, practices that, uh, um, are going to have financial implications for the institution. Um, without driving your analyst nuts with, you know, week after week. And we've got to get to another project. Uh, but I've got three more questions. Uh, and so that's where the kiosk based platform, I think has been a revelation to me. And I think, uh, we're going to see more and more value as we get more experience with it.
00:37:00 Megan Antonelli: Yeah. No, that's super exciting. I think that that promise of being able to really kind of translate the data into provider level action and prioritize, right? I mean, we're always sort of suffering from this shiny object syndrome in healthcare, where we're going after the next best thing. And to be able to, you know, one, know in advance that it's going to have impact, but to identify it and then to see the impact happen is is so amazing. So well, thank you both for for joining us today. I could learn about this and hear about it all, you know, all day. It's just exciting to see, you know, these programs and platforms in action and how they start from where they are all the way to, you know, really touching the patient and changing how the clinicians and the community are working together to take care of these patients. So thanks, everybody. Thank you, Doctor Andrew Davis and Amy Wainwright for joining us and for sharing the University of Chicago Medicine's experience for healthcare technology leaders working on population health analytics, quality improvement initiatives or care coordination challenges. This conversation offers practical insights on turning EHR data into clinical impact. I'm Megan Antonelli with Digital Health Talks. And until next time, we'll see you then. Bye.
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