Connecting the New Care Ecosystem. Part 1 of 2.

Better, smarter, faster. The neural network needed to power the digital ecosystem of health care is poised to transform care both inside and outside of hospital walls in traditional care settings. Meaningful data analytics positioned in real time to drive better diagnostics, intelligent operations, seamless care coordination, and integrated telehealth. This is the future of connected health care. We talk to the experts about transformational roadmaps for this evolving landscape, what's working, what's needed, and how we get there together. Welcome to health care on air presented by Verizon. Hi, everyone, and welcome back to health care on air by Verizon. I'm your host, Robin Goldsmith, health innovation principle, and a member of our health care insurance and life science team here at Verizon. Today, we're gonna be talking about connecting the new care ecosystem. And I'm joined by an amazing panel here My colleague Neshini and Doctor. Kazuki Nakagawa, Director of Innovation at UC Davis Health, CoLab, Digital Colab, Gentlemen, thank you, first of all, for being here. I'm excited for the conversation. Thanks for having us, Robin. Yeah. Thank you, Robin. So before we dive in, which into what I know will be an amazing conversation. Let's just do some brief introductions starting with UK. Sure. So Kayne Akayama, I'm a physician executive. At UCS Health. And like you mentioned, I wear, two hats here. So one is being the director of innovation for the Digital Health Innovation Hub Digital Colab. At UCavis Health. And I also serve as the executive director of a, an industry partnership with Amazon Web Services called the cloud innovation center and So we're actually in a pretty exciting and unique position at UCa's help because we have this in you getting yang model of innovation where the digital colab serves as more of the, the traditional model of innovation. And then we're also doubling down on this concept of open innovation which I think is really hard to find in health care, but when you're thinking about digital, it's so much about speed and experience more so than IP. Right? And so we really want to be that nexus of collaboration, and really creating the ecosystem around UC Davis Health, UC and and really around the the country and around the world. So it's very cool to have kind of the both the, both models of of innovation playing together. Really interesting. Go ahead, Ned. Yes, man. Thanks, Robin. I'm Ned Jeanie. I'm a health care technologist and Senior principal of Jijo Health and Health Equity business strategy at Verizon. And, my passion is leveraging technology to improve health outcomes and positively impacting underserved communities and narrow the digital health equity gap. At Ryson, I'm fortunate to work with the doctor Nakagawa at UC Davis Health to develop innovative strategies promoting connected health and digital health equity I'm proud to be at the forefront of the fight for digital health equity and committed to making tangible difference in lives of those who most need it. With Verizon's healthcare and life science team, with the Robin, we are striving to create a future where everyone can access the benefits of digital health innovation. So thank you, Robin. And Doctor. Nakagao for being here, and I'm excited to have this talk with you. You know, before we dive in, Kaye, I saw you at speak at hymns, and I've I think I've quoted you more than once, my friend. And I think you were speaking with Ned, and the concept of looking at technology and healthcare, and this idea of technology should be ambient and to use your words invisible. So it should, it should be running in the background enabling, you know, an incredible amount of things and just be invisible if you will. If you could start with kind of just talking about that notion because that just stuck with me. Sure. No. I I think we're really getting close to that state where technology is all in the walls. And we really bring back that human touch. Right? It's almost like how do we use technology to enhance the human touch in medicine. And I think in the in the v one of technology getting infused into health care, naturally we were putting a lot of the the computer screens and the mod, you know, the monitors, the keyboard, you know, a lot of the the the wires, all of that stuff was getting, jammed into the room, right, whether it's the appointment room or the ICU bed. And I think that's always part of the journey. Right, is that you're you you have to kind of see what the experience is like and realize where the experience needs to improve I think with a lot of the the new kind of AI, advancements that we've seen with large language models and even with a lot of the, opportunity to connect devices without having wires. Right? I think there's a very much a future where, we can really center the whole experience around people instead of the technology. Absolutely. Ned, any thoughts on that? Because I know you co presented in that, amazing, presentation. Yeah. Absolutely. I mean, it's, to, data points that came Doctor. Nakaal made, we need to create an, omnichannel experience and make the technology invisible to those who can access the system, easily and be able to connect with the clinicians and physicians to get the health care that they need. So technologies and enabler, and we want to make it simple for everyone who is using it. So I kind of jumped the gun, but I wanted to definitely reference that to kind of set the tone. But if we think about this connected care ecosystem. You know, what is that difference from a traditional healthcare system? And, you know, how is technology really enabling this expansion of care beyond the hospital, the traditional, you know, brick and mortar hospital now into the home. I know, let's with you, Ned, I know you're doing some incredible work across the country. If you could speak to that first. A connected care system, also, known as, smart connected health environment, is a integrated and coordinated approach to healthcare that, utilizes technology to connect patients, providers, and caregivers across various settings such as hospitals, clinics, and, in cases that are myself, the cases that I'm involved in, tribal communities and, in the native population. And it goes beyond the traditional, delivery model that primarily focuses on care delivered within the four walls of, hospital or clinic, connected care system, leverage digital health technologies such as telemedicine and remote monitoring, some of the work that we are embarking on with UC Davis Health and electronic health records to enable seamless communication, collaboration and data exchange. And data is a key element of how we can make the information that is getting collected actionable and exchanging the data amongst the stakeholders leading to more efficient patient center, care, and patients journey throughout that healthcare system. So it's a continuity of, care that is provided, to those patients as they travel through the healthcare system. Yep. No, it's great explanation. And Kaye, before you answer that, I want to see from your perspective, and I hear differing differing answers from depending on who I speak to, but how much of this innovation and shift in how we're delivering healthcare now was driven by the pandemic? You know, it seems to me that, you know, I hear different, different kind of time frames, ten years of innovation was accelerated, you know, eighteen years of innovation. The door to innovation was you know, blown right open. I'd love to hear from you kind of how much of a catalyst it was for the work you do at at UC Davis. Yeah. Well, I think it it was definitely a catalyst just because you can't embark on digital transformation without the patient really recognizing that modality of care being a viable way of accessing and and receiving the care. Right? So I do think it it definitely sped that up. But kind of going back a little bit to the history of UC Davis, right? You know, we, in the early nineties, we were one of the world leaders around telemedicine. And a lot of that history just comes from a almost form following function when you think about the innovation. Right? It it wasn't because we thought telemedicine was just, you know, exciting new technology to play with. Like, we actually cover about sixty percent of California geographically as the exclusive level one trauma center. So it's about thirty three, the fifty eight counties in California. So from from that need, you know, it was necessary for us, right, to connect the care and actually initially to telemedicine was between physicians. So it was like having our academic kind of tertiary as a tertiary medical center, like having our, faculty, provide the mentorship at the bedside to physicians in more rural community hospitals, right, and other community settings, That was the the the genesis of, I think, telemedicine for us. And and again, that was, you know, almost twenty years ago. Or more. So, so there's a whole history behind connecting care as a concept. And I wanna double down on what Ned was saying, right, that you use the word approach. And I think that's so important that we think of connected care as more of a strategy than a thing or Right? Like, I mean, help systems have always been connected to some level. Right? It's, you know, we have physician, we have people processes, technology, and data. And in the confines of a clinic or a hospital, that connection, it has always been there to some level. But I think what what when we really think about talking about connected care system, You know, one is it's a continuum. Right? And the pandemic has shifted that where we are on that continuum much more aggressively. Than we were, you know, five years ago. And on top of that, you know, how we look at what that strat what the core components of that strategy it's, geography, its data, its services, you know, so now rather than being in a highly regulated confines of a hospital or a clinic. We need to think about what the connected care strategy is in a much, much wider geographic area, right? We have to think about it across many more data sources. The data is now not just coming from a physician charting on paper or charting in the EMR, you know, it's coming from the Apple Watch. It's coming from a smart scale in the bathroom, you know, that might be sending data to a five g hub in the living room that then sends data into a vendor's cloud that then sends it to electronic medical record or flow sheets. Right? So I think the the the challenge and the opportunity is so different now. And it's partly thanks to the pandemic accelerating, but it's also just the the journey that that health care has been on, for for over two decades around that digital transformation step by step. There's so much more that we need to think about because the diversity of the ecosystem we have to operate in and connect is way more complex and way more expansive than than we've had to deal with before. Yeah. I love what you said about some kind of necessity breeds innovation. Right? And we saw even, you know, an older generation had to adopt doing this to engage in telemedicine during the pandemic, right? They had to. They got their son or daughter to set it up for them. So I love how you said that. Let's talk about, some of the challenges now of, of making that shift as you described, Kaye, you know, it is, it's a process as we all know, and it's not happening overnight. But you know, what are some of the challenges you see? And from your learnings, I mean, you, you, like you said, you've, you've been doing this for a while. You cover six million lives over a very diverse geography in California. If you could speak some of the challenges, you know, give some advice on what you've seen, which I think would be really helpful. Sure. You know, I mean, leading the digital health innovation hub here, we get to work with a lot of the the thought leaders across our health system that are really setting that clear vision and strategy for how we need to be thinking about what a connected care system looks like. And I I would say that technology is actually the easiest part to change. You know, the the challenge is actually the people in the process. Change management. Yeah. Right. You know, culture, the strategy, the workflows, you know, we know that a lot of our clinicians are completely tapped out, you know, and, they're relying on their muscle memory every day to get the work done. Right? And now we might have patients sending data from a two story three bed two bath house it may be a trailer home. You know, it may be from an on house patient. And that completely changes the the the workflows and the processes. Right? And and that has to be addressed from a very human centered design perspective. I think that's the biggest challenge. You know, one of the things that I'm seeing with, some of our leaders really, pushing that forefront is also thinking about what are the new roles that we need? And one of them is having digital help navigators. So as more and more data comes in, you know, in digital, the patient experience and the clinician experience is two sides of the same coin. So prior, I think a lot of the software, you can index the experience toward you know, the clinician, if it's electronic medical record or PAC systems, the patients didn't really interface with that, right? And then you have patient portals that were exclusive to the patient. So you a lot of the the experience was actually, running in parallel tracks. And, obviously, we index a lot toward improving the patient experience and, didn't have much of opportunity to improve on the the provider side. Now it's all connected. Right? If you're getting ten x hundred x more data coming from the home, the wearable from the patient, then somebody's gotta read and be responsible for that data. Yep. Right. And and and the physician and the clinicians are already maxed out. And so again, we need to really rethink the process and the people involved to make that a more high value, ecosystem. And so digital help navigators, I think, is a really interesting space. To help navigators and and the system also being like digital command centers. Where a lot of this data is flowing into a centralized, you know, place virtual space where there's actual new roles of people who are monitoring that information, right? And then whether it's AI or human, being able to flag based on, clinical, digital clinical guidelines that are set, right, to be able to escalate, to be able to address automatically or, you know, through kind of different referrals, the the right care in in in much more real time. So I think there's a lot of, interesting challenges that need to be really started out by solving the the people in the process side of of that that equation. There's a lot to unpack. There are some some amazing points. I mean, you brought up a great point with your clinicians are burned out. Right? We all know that. We all know where we're facing or they're they're maxed out, right, at max capacity. We're facing staff shortages in every health system, whether it's nurses, doctors across the country. You know, I think technology has to be adopted to fill that gap. I'd love to hear kind of your thoughts on that and and how much of that can can fill that gap. And then we'll touch on the data after that. Yeah. It's, it's it's a tough question in terms of figuring out exactly how technology plays a role. I I think that the the The North Star always has to be the experience. Yep. You know, as as a physician, I know that A lot of the clinicians, the work ethic is there. Right? And I think where there's more room for growth is in bringing that human touch back. Into the experience. Right? You hear a lot of clinicians, and I I actually worked with the chief wellness officer, for two years prior to launching the Digital Health Innovation hub with, you know, Doctor. Trisha and others. So I got to see firsthand where the problems are. And even go deep into EMR log data to see, you know, how many hours, our patients or our physicians charting in with pajama time and and all of this. And at the end of the day, you know, some problems are really hard to fix in terms of the number of hours that we that clinicians need to work to serve the demand of patients, but I I do think that some of the variables that we can really optimize around is reducing the clerical burden, right, reducing the administrative. And even, you know, in the in the moment of seeing the patient, how do we, again, remove the monitors, remove the wires, remove the alerts, and really allow most of the day of that clinician's, you know, time and experience to be connecting with the patient. Right? Yeah. I think if we can do that, then a lot of the burnout can be, reduced. Right? Making every interaction, every minute more meaningful. I think is, a more feasible approach to burnout as the kind of next wave of approaches than trying to reduce the number of hours they're working. You know, ultimately we may need to address all of them, but I do think that's really where some of the new technologies can help address that, that, that more, human centered experience of, of, of clinical care. Med, anything to add? No. I mean, in addition to the human side of it, certainly on the technology side as a technologist with, Verizon on the healthcare side, how we can, improve that side of it to make it more easier. To address all these, process and improvements that we want to bring to the healthcare system, to make it more interoperable, ability to for healthcare systems and devices to exchange data seamlessly to be able to, create that ecosystem of systems that are talking, in a truly connected and coordinated care approach to help the patients. So, I mean, one of the other areas that we are looking at is data privacy and security. And how healthcare organizations need to ensure that patient data is protected, and compliant. So while we are looking at the humans centric part of it in the back end, some of the technology aspects of it that, as a company like Verizon is looking at how we can address those challenges as well. Alright, folks. I'm gonna hit the pause button, and we're gonna continue this conversation on part two. Again, please subscribe to our channel. You can check us out on Google Podcast, Apple Podcast, and Spotify. We'll see you next time for part two.