Healthcare expert Lorren Pettit shares insights on how hospitals are transforming from basic digital systems to AI-powered smart healthcare environments, covering real-world applications and implementation challenges.
Key Takeaways:
Lorren Pettit, Alliance for Smart Healthcare Excellence
Megan Antonelli, Founder & CEO, HealthIMPACT Live
0:01: 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, Janae Sharp, and Shahid Shaw for a weekly no BS deep dive on what's really making an impact in healthcare.
0:29: Hi everyone. Welcome to Health Impact Live.This is Megan Antonelli, and I am excited to be with my guest here today, Lauren Pettit. Lauren is a digital health product management executive whose fingertips are on some of the most significant assessment frameworks shaping American healthcare. From the HIM's EMR adoption model to Chime's digital Health Most wired program, has been instrumental in creating the roadmaps that health systems use to measure and advance their technology maturity.Now, as head of the Smart Community Builder Initiative, he's tackling perhaps the most complex challenge yet, helping organizations navigate their journey from human directed care to supervised autonomous environments.
1:11: Lauren, welcome to the show.
1:13: Thank you, Megan, glad to be here.
1:15: And so, you know, I'm so excited to have you. Tell us a little bit about the Smart Health Care Alliance. Is it the Smart Hospital Alliance? I just realized I don't have it in my notes.
1:25: It's the Smart Healthcare Alliance.
1:28: I had it first.
1:29: Smart Healthcare Alliance.
1:31: The Smart Health Care Alliance is actually a new not for profit alliance that was formed at the end of last year, beginning of this year, under the direction of CEO Steve Liber, formerly of, of him.
1:46: So we have a really good track record of somebody who's been there and done that.
1:51: , the Smart Hospital, or the Smart Health Alliance, is actually home to the Smart Hospital maturation model.
2:01: And again, if you're familiar with the hymns and the EMR adoption model, we have actually replicated in many ways some of those learnings that both Steve and I had hymns and chime of now applying that type of mindset and those type of tools for the smart hospital environment.
2:22: Yeah, I mean, that's amazing.
2:23: Steve is such a great guy and he's been really at the forefront of this.
2:27: And I think it's so important, you know, even as we think about just the role hymns has played in this evolution, and of course, chime in helping hospitals, you know, really adopt and, you know, embrace the technology and then of course, get recognized and and and kind of create that.
2:44: , element where they, you know, not only obviously want to do this from a, you know, patient and improvement standpoint, but where we can recognize and look to them.
2:53: So, kudos to, to you and to him for doing that.
2:57: And I think as we look at this development of smart hospitals, which tell me a little bit because I, you know, smart hospitals and those that word has been around for a while.
3:08: When you are using it, what does that look like?
3:11: What are, what are we talking about?
3:12: Yeah, yeah, it's it's one of those things in healthcare, we use a lot of buzzwords and so we have to be very careful that we are purposeful and intentional what we mean.
3:24: So, I would sort of differentiate between a smart hospital and let's say a digitally advanced hospital, or digitally advanced hospital is actually using technology in the, the, the care of, of patients and it could be the CPOE.
3:40: , this clinical, practitioner order entry, different technologies.
3:47: With the smart hospital, we're actually leveraging the technology to be more from a predictive standpoint.
3:54: So for example, when we have a patient, that has propensity to fall, you know, we have those different technologies in place, the ambient technologies.
4:05: , that are monitoring and being able to predict, let's say the patient's gait, the propensity for, bed sores, etc.
4:14: you know, those types of things that can actually sort of be predictive and get ahead of the curve so that we are actually preventing these type of negative outcomes.
4:26: That would be just an example.
4:29: Yeah, I know, and I think it's an important distinction, you know, and as we've watched the hospital, you know, sort of digital transformation of healthcare in general, you know, that sort of hospital unbound to, you know, virtual health and hospital at home, as well as, you know, what is going in the hospital.
4:50: And I think you've mentioned this a little bit in terms of that.
4:55: A lot of other outside of the United States where hospitals are sort of being newly built, they tend to be a little bit more, you know, ahead of the curve, whereas we're still, you know, dealing with some legacy buildings that, you know, maybe aren't ready for this yet.
5:11: Absolutely, yeah, and I can say sort of like the Indonesia and Malaysia, you know, we we're, we're, they sort of they've been laying down the runway for smart hospitals and so we certainly have an eye towards what's going on over there.
5:28: I will just sort of say, you know, we talked about the EMR adoption model and, and, you know, the, the smart hospital.
5:35: One of the things that was really propelled.
5:40: The EMR adoption model was meaningful use, and we had a lot of money that was being thrown towards the hospitals in terms of their adoption and use.
5:50: And so EMR, the MRAM as we call it, Brazil was at the right moment for it to take off because it became this roadmap for organizations and the hospital CIOs, like, you know, they can have all this money, you know, what could they do, and they needed to have a pathway.
6:09: I it's really sort of hard to think that we will ever be able to replicate that type of experience.
6:18: That said though, you know, is that what we did with the MRAM, has been be able to provide that sort of roadmap, and guide.
6:28: And as well as benchmarking, so you can sort of see and so that's what we've been doing with the smart hospital and with maturation model.
6:36: And again, keeping an eye towards what was has been going over in Malaysia and Indonesia and and you know, that's been really instructive, but we also have our own stamp here in the United States and in Western society and, and so to be able to really sort of see how culture, how people, the domain, for example, part of the smart.
6:58: hospital, plays really significantly and really sort of the adoption and and really sort of direction of how hospitals really will be adopting the smart hospital.
7:10: Right.
7:11: Well, and, and to sort of dig a little bit deeper into to that, tell me a little bit about, you know, when you look at what a stage one hospital looks like right now in that maturity model versus the stage 5.
7:23: You know, where are we now or where is that stage one hospital and where are they going?
7:27: Yes, so just in terms of the nomenclature, we're, having been, you know, hymns, chime, you know, we call them stages and hymns and levels at at chime.
7:38: we're very purposeful to be really to have our own stamp and so we actually, call them leaps.
7:44: we're moving from leap 1, leap 2, leap 3 up through through 5.
7:49: I'll just sort of give you a little bit of background to, having been instrumental in developing a number of these models.
7:55: , 7th stage at hymns, 10 levels at chime.
8:03: We really were very purposeful of of trying to go with a 5 model, stages or levels if you will, right, or leaps, and part of that was just to keep it simple, and again, not to get too wonky, but we do know in a lot of the maturation model world, you can go, you know, a little, so many different partitions.
8:34: A lot of them go with 5 stages because there's an element of trying to keep it simple.
8:38: And so we've, you know, that was part of a driver for us.
8:42: to your point though in terms of where organization, what is a leap one organization looks like, where we are in terms of just the evolution of digital health in the United States, we're already starting off with sort of a base understanding that, you know, organizations are digitally capable in terms of like, you know, they have the EHR that's that that that's sort of Almost the entry level, and, and so it organize, and we don't see really organizations nowadays that don't have an EHR.
9:18: So that's, you know, one of the factors.
9:21: As we move up, you know, we're looking in terms of being able to integrate, you know, the technology, CPOE with digital imaging, so those type of things are, are understood as like a level 2, like a leap 3 is really around that context.
9:40: , awareness, automation so that we're coordinating work flows, and again becoming a little bit more smarter with the efficiencies in the organization.
9:51: A lot of times, it's more operational.
9:54: And then a leap for would be leading towards that sort of the cognitive support, so it really more in terms of AI guided decisions that would be, helping the, the clinicians as they work along and then really the leap 5 is what we call that sort of supervised, autonomy.
10:14: You know, here we have AI which becomes really sort of initiates some of the care, you know, with you know within guidelines and guidance as well as human oversight, but it, you know, it becomes the technology is, is being much more involved in the process.
10:37: That I think I actually in the conversations that we've been having to kind of prep for for our conference next week around, you know, when EHRs were implemented and, you know, they were system-wide and not highly specialized, a lot of the AI tools and a lot of the pilots that are being done are being done sort of departmentally, right?
10:59: In a specialty area.
11:01: So when you look at across an organization and when you're making those evaluations, are Are you looking for pockets of, of excellence in a certain department or cross and work?
11:13: Yeah, that's a great question.
11:14: So, let me sort of give you a little bit of a context too of just a historical, having been involved in like the MRAM with hymns.
11:23: One of the learnings that we had was that we imputed a capability in one unit to the rest of the organization.
11:33: And we've certainly found some, you know, pushback against that appropriately so.
11:39: So, That makes sort of sense as the evolution of and the adoption of technology came along, you know, we would pilot it in one area and get the kinks out and then to be able to extend it to the enterprise wide.
11:55: That's the same sort of learning that we've had now and applying it here with the Smart Hospital.
12:01: we are interested in, in the capability.
12:03: Do you have that capability in the organization, to do, you know, AI, you know, with the translation services, for example.
12:13: , but also we, we, we look at it sort of twofold.
12:18: How extensive is it being used?
12:22: Is it, you know, just in the ED or is it being, you know, put on the floor too with those capabilities?
12:29: The other part is use, and this may sort of sound funny, but you know, you can have technology, but are you using it?
12:40: And again, you know, having been, you know, this is not my first rodeo, I certainly learned that we really have to take into account The usability factor.
12:52: And so, capability, you know, we can score you and give you points if you're thinking about the the the model itself, give you points for that you have a capability, but it's those additional points of, you know, how widespread is it?
13:05: Is it being used in a piloted or is it enterprise-wide?
13:09: And ultimately, the idea is that it would be enterprise wide for most technologies.
13:16: There are some that are going to be, you know, localized and we recognize that too.
13:22: Yeah, and I think that's, I mean, it goes back to the sort of conversation that we have often around people process technology and you can have the technology, but until you get to the culture and the, the processes, you get from the implementation to actual adoption to transformation, right?
13:39: And of course, you're an author, right?
13:40: You have, I think you have a book, around cultivating digital culture, right?
13:46: so from that, I mean, tell us.
13:48: A little bit about what you think, you know, culturally it's gonna take to get these get hospitals to kind of move to this smarter, smarter space.
13:58: Yes, again, just from a personal standpoint has been a real big interest of mine.
14:04: And so one of the things, as relates to the smart hospital and with AI I would say that there's a lot of fear.
14:12: There's a potential fear, let me put it that way, potential fear.
14:15: Of the use of AI.
14:17: Now, we are been like culturally have been, our society has been like a bullet going, you know, it's, we are adopting it, we're using it and But there are those concerns around Well, so many concerns, but you know, one of the things I like to hone in on is from a clinicians standpoint, their fear of being replaced.
14:40: Is this going, the adoption of this technology going to put me on the unemployment line?
14:47: Those are very legitimate fears.
14:50: And so, as an organization, you know, starts to adopt and say that we're gonna head intoward being a smart hospital.
14:59: You know, it is really make, you know, important that we bring the clinicians and staff along.
15:05: You know, in many ways, again, what we want to be able to do, and this is just not selling it, but it's, it's really true, is that technology, this AI can actually help clinicians work at the top of their license.
15:18: Again, we, you know, that's a, a term that we're buzzing around, but it truly is, is to be able to allow a lot of clinic clinicians, clinicians actually go into, remember, you know, for altruistic reasons, that's a lot of real driver where people, you know, really want to get into being a nurse or a doctor, you know, it is for altruistic purposes.
15:40: As organizations have moved towards being high tech.
15:46: We're still like the high touch, and I really believe that what the smart hospital is going to allow us to actually really balance high tech and high touch together, but it's to be able to bring people along with that.
16:00: Yeah.
16:01: Yeah, and I think that's so important and I mean, again, you know, and I don't need to keep that, but it's learning the lessons that we, the mistakes that were made kind of in EHR adoption as we look at this next transformation that's gonna happen across the organization and, you know, I think we didn't predict the challenges that The, the friction between physicians and nurses and the EHR well enough and, and this with, with the adoption of AI and kind of that discussion of an autonomous, you know, system, the, the fear is there, right?
16:35: Culturally, and so everybody's been addressing it.
16:38: For a long time.
16:40: And at the same time, only recently, do I think we're actually seeing technologies that the clinicians feel are truly helping them.
16:49: Correct.
16:50: And if I may just sort of add on to that too, you know, one of the main learnings too from, you know, the adoption of the EMR was that a lot of organizations, CIOs went ahead without really bringing in like the clinicians, getting their feedback, their input.
17:07: , you know, and again, I sort of get it.
17:10: It's like, hey, we've got these great tools to support you.
17:14: Look what we've done for you.
17:16: But, you know, as a clinician, it's like, this is my practice, this is my license on the line.
17:23: You know, you need to bring me along.
17:25: And, and so I think we're seeing organizations that are moving down that smart hospital pathway.
17:33: They've been burned by the EHR experience and so they're being actually smarter, you know, as they're moving forward with the smart hospital approach.
17:44: Sure.
17:45: And so with, with the Smart Health Alliance and, and the health systems that you're working with and, and sort of seeing these ambient, you know, intelligence implementations and, and what is, what's working, what's not, you know, tell us a little bit about where you see, you know, the best progress.
18:02: Where are some bright spots in that, you know, in, in that, where, you know, you would say to A health system CEO who's looking to make these moves, like, this is a good first move, you know, this is, these are the, you know, you don't have to mention actual companies, but like the the technologies that are most promising that are, you know, being adopted and making people happy in the organization.
18:22: Yeah, yeah.
18:23: So more globally, you know, the AI has really been in healthcare has really been used.
18:29: , in the safe areas, not, you know, quote unquote safe areas, right?
18:33: But your revenue cycle management, being able for data exchange and, and doing the pre pre-authorizations, things that are, are really sort of have been safe and, and, and again, it makes sort of sense is that you want to be able to test the water, see how it works, get those bugs out so that you're not putting patient lives directly at risk.
18:56: , so we've seen some great, you know, success in there, but clinically we are starting to see areas too, right?
19:03: You know, so with radiology and imaging, being able to sort of call through, all these, you know, myriad of images to be able to sort of percolate to the top, those that are suspect, those ones that really, you know, prioritize for human attention intervention right away.
19:25: So those are sort of successes.
19:26: I would also sort of point to the like in terms of the ICU where we're seeing, you know, sort of like the alarms and the, you know, there's been like that alarm fatigue.
19:37: So some of the technologies in that area to be able to really reduce that alarm fatigue.
19:44: I married a nurse, you know, very, very thankful for these, you know, types of interventions.
19:52: Ares that were, you know, Still sort of under progress would be, you know, things such like the ambient, you know, sort of the voice areas, you know, being able to block out some of the other noise that that gets into the way.
20:10: And so, you know, that's one of the areas I find that work is still yet to be done.
20:16: And then one of the areas that's also really surprising.
20:20: I, I would sort of put it around how, hospitals are actually using the AI to be able to redirect the cleaning staff, you know, to be able to look at efficiencies and, and, you know, really cue them up in the appropriate areas, a non-clinical area, but we know how clinical, how significant having the room ready is for, you know, getting people out of the ED out of, you know, the hallway medicine that Has been so rampant in in certain quarters.
20:49: Yeah, we were just having, you know, I mean, it's this conversation around kind of, you know, you want to take the most innovative technology and apply it to the most innovative area and, you know, but the reality is that there's a lot of broken things and a lot of gaps and a lot of things to fix that if fixed would then allow for better care.
21:11: Streamlining patient care, you know, and so this, this push and pull between kind of, you know, fixing small, less exciting things that, you know, are broken to, you know, real, well, you know, you might term as as kind of innovation and, and kind of finding that place.
21:28: I mean, I have it in, in that like curating a, you know, the conference, you know, the program, and you're thinking, oh, you know, you want to have it, you know, you want to cure, we want to cure cancer.
21:37: I want to improve the patient experience we want to do this, but, you know, getting them their food on time in a cheap and efficient manner could also be, you know, a great thing, right?
21:46: At least towards, you know, patient compliance, right, that you know you got them on you're on their side and that compliance works towards ultimately patient outcomes and the like, so it's really just it builds off of one another, absolutely.
22:03: When looking, you know, in our last kind of few minutes, you know, I had a funny experience recently.
22:08: I was, I actually got to I got to tour the Chargers practice facility here in Los Angeles.
22:17: And as I'm touring it and sort of, you know, going, Oh, football, and this is fun.
22:21: What I realized as I walked through it was in fact that it was a $500 million building.
22:27: Designed to keep these people healthy.
22:30: Right?
22:31: The gym is the biggest, the field is, well, the field is the biggest, but the gym is this unbelievable set up where their, their workouts are tracked, their, you know, things are tracked, their, their cafeteria, their foods are tracked.
22:44: They put the foods in, the macros go to their app.
22:46: I mean, it was, it's literally a healthcare facility, whether they, you know, want to phrase it that way.
22:52: They certainly don't want to call it that.
22:54: But, that to me, walking through is what I saw.
22:58: So when we think about.
23:00: What that smart hospital looks like and what the future looks like, where we wanna both fix the healthcare system that is, you know, we say all the time is a sick care system.
23:12: And then we have, you know, what does the hospital.
23:16: Of the future look like, or, you know, to make it not impossible to answer the question.
23:22: Just the healthcare facility that makes sense to people, you know, that that does that, both from a prevention standpoint, but also, of course, from a caring for sick people.
23:32: How does that all kind of come together?
23:34: What, you know, when you think about that vision?
23:38: I'm gonna ask it in two ways.
23:39: One, I think from the hospital, standpoint, the smart hospital is still sort of will be a central hub.
23:46: Where, you know, we will still have acute episodes and, and we will, it will be the place that organize people and society looks towards, for, interventions and like.
23:59: I do believe though that we'll start to see areas of Coordination, more of a hub, if you will.
24:08: So the the hospital at home, we've talked about that's a growing area, right?
24:13: being able to remote care is going to be a real significant part all tied back to where the, the acute component is and where, to be perfectly honest, right, that's where the greatest dollar spend investment is gonna occur.
24:29: you know, if you do it there and then it's gonna trickle out because we know.
24:34: I'll answer is also in another way, and this is a game from a personal standpoint interest.
24:40: so, my first master's is in gerontology, study of old age.
24:45: I have had a long standing interest in the senior population and senior care.
24:52: I do believe, and again, I'm I'm very intimately aware of CMS's their five-star program for the nursing home, and how they calculated the measures and all that.
25:03: I'm going somewhere with this is that.
25:08: The nursing home is probably one of the areas where we have the best data.
25:15: Truly publicly available data on the relationship between staffing, staffing levels, the input.
25:23: And quality measures.
25:25: Now, you think of it from a factory standpoint, you know, labor input creates output, you know, widgets.
25:32: It's the same type of thing that we think about in in healthcare.
25:35: We have labor input.
25:37: Creating quality output.
25:40: As we bring in AI.
25:43: Into this nursing home.
25:47: That environment better than any other else that we have out there.
25:51: We'll be able to really uncover the true efficiencies that AI in a smart hospital, smart technology can bring in, because right now, we're dealing in, in a world where there's a lot of promise of technology that with AI agenic, you know, it, it will produce this.
26:14: Theoretically, it makes sense.
26:17: We saw the same thing with the EMR adoption model, right?
26:19: It was that you get to a late stage 7 and you get, you know, all these outcomes.
26:27: But we didn't really have the the data for that.
26:29: Now, with, with the nursing home again, I'm I'm most intimate with this versus any other place, we have the data that looks at the hours per resident day for nurses, LPN CNA's to be able to then look at that as an impact and output on quality.
26:49: Being able to see the introduction of what Ambient technologies will bring.
26:54: I think that is the future of to be able to really sell with hard data that we can create true efficiencies of what that looks like.
27:06: Right.
27:06: I know that's pretty wonky, but I, I love it and I, and I do think that that, you know, I mean, it's also that.
27:14: That intersection or that, you know, where healthcare is siloed where we could, we need to work on that, right?
27:21: I mean, that, that interplay between nursing homes and whatever the healthcare facility of the future for You know, elderly, you know, whether that is a nursing home or becomes more assisted living and all of those things, how they interact with the hospital and improving that space is probably one of the most important things that we can do in improving chronic, you know, chronic disease management as as people age, right?
27:49: Yeah.
27:49: And, and I'll just sort of say to again, it's a valuable story for the health IT vendor community.
27:57: Again, you know, our sales folks, the marketing are, are talking about the efficiencies that AI will deliver, and we get it.
28:07: But we have to prove it ultimately, and that was one of the the lessons that came out of the EMR adoption was we're getting, we're investing in all this stuff, what are we getting for it?
28:19: And so that's why I, I'm, I'm most helpful or, or, or hopeful that we will actually be able to demonstrate clearly.
28:29: , from a scientific standpoint, that AI is actually creating efficiencies, in, in the delivery of care.
28:38: 100%, absolutely.
28:40: tell our audience how to get involved in Smart Healthcare Alliance and, you know, what they, what they can do, what, you know, what, what's the next steps there.
28:48: Right, yeah, I got to.
28:50: So, the smart Hospital.AI is our website and in there we have information on the smart.
28:59: Hospital maturation model, that's free to organizations, healthcare organizations to complete, and, and so again, we will score organizations and help them guide guide them along in terms of giving a roadmap of what it looks like to be able to move towards a smart hospital.
29:17: We also have the smart healthcare.
29:20: tech.com site.
29:22: And again, that's sort of our, our channel because we are focused on the excellence of healthcare, that is sort of the channel that we're trying to then promote, you know, what other organizations are doing, sort of the learning's best practices.
29:37: So those are the two sites I would direct folks to.
29:41: Awesome.
29:42: Well, thanks so much for joining us, Lauren.
29:44: It's been great to get to know you and hear about about the organization and and kind of the thought process that's gone into it as we, you know, really just enter this new, you know, transformational period within within healthcare.
29:56: So it's exciting times and I'm excited to, you know, have you.
30:01: You know, sort of leading that journey and in the assessment.
30:05: It's great.
30:06: Thank you for having me.
30:06: It's been my pleasure.
30:08: Absolutely.
30:09: And for our listeners, thank you for joining us at Digital Health Talks and Health Impact Live.
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