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[00:00:00] We want to thank our partner, Avasure. Over 1, 100 hospitals are using Avasure's virtual care platform to engage with patients, optimize staffing, and seamlessly blend Remote and in person treatment at scale, drive measurable outcomes and augment clinicians with an AI powered solution that deeply integrates into your clinical workflows.

Aversure offers virtual care solutions supported by a secure, scalable infrastructure that helps you to lead your organization into a future where cutting edge technology is at your fingertips. and Compassionate Care Converge. For more information, check them out at thisweekhealth. com slash Avasure.

At first it was, how do we hire, enough people after the pandemic? How Now it's about retention.

How do we keep our people in roles? How do we develop them? How do we support the newer nurses that are inevitably coming into the field? And that's our wheelhouse.

Welcome to This Week Health. My name is Bill Russell. I'm a former CIO for a [00:01:00] 16 hospital system and creator of This Week Health, where we are dedicated to transforming healthcare, one connection at a time.

Now, onto our interview

(Interview 1) All right. We are doing an interview in action and today I'm joined by Adam McMullin with Avasure. And , we're going to talk cameras and virtual nursing and a bunch of other stuff. Adam, welcome to the show.

Thanks, Bill.

Always enjoy spending time together.

Yeah. And we've spent a bunch of time together with some CIOs in the room and whatnot. This is an interesting topic. I was talking to a CIO just the other day, and I said, what's your focus for 2025? And he said, efficiency, automation and efficiency.

Like we have to get more efficient in healthcare. And I found that to be very interesting and I'm not sure that's not going to be echoed by a lot of CIOs come January 1st. of, we're trying to find efficiencies across the board. Really want to go into your product set and what you guys are doing, because I think a lot of people are trying to [00:02:00] find efficiencies in those clinical workflows.

So what's currently going on? What are we seeing happening with regard to. the virtual space, the cameras in rooms, the ambient type stuff. What's the direction? What are we feeling? What are we seeing right now?

We're seeing a lot of continued focus on ROI, workforce productivity and safety.

So I think that trend, continues, there was the shortage of nurses that became extremely acute coming out of COVID and agency spend has been managed down. So that's abated a little bit. You still have the nursing retirement trend. You have margins that are lower that we're all familiar with.

And now that health systems have really spent the last two decades applying technology to get more things in a digital format so that they can make better decisions. There's the how do we optimize these systems and how do we bring technology in that allows us to operate more efficiently in a safer environment.

So that's where we're spending a lot [00:03:00] of time. I've been with Avasure now it will be three years in the spring. Thrilling to be part of this team in this market at this time, and one of the reasons I joined was just the clarity of value proposition in that Avasure pioneered this virtual safety observation space where you take 16 roles, turn them into one.

and get way better results. And that was the core value prop where, you take up to 20 percent of patients need safety observation. If you do that in person, depending on your geography, that's 20 to 35 an hour. You do that virtually and that's 3 an hour. And oftentimes when you're observing patients, you're actually taking away from that nursing care team.

And we think every day about how do you enable care teams to be more efficient, to bring the joy back to that job, and then enable better outcomes. And when you're doing these types of things, your falls rates are dropping by 50%, Trinity saved 23 million, UCSD 10 [00:04:00] million. So we're really seeing our customers leverage virtual safety technologies.

We can talk about virtual nursing if you want to go into there. and other virtual technologies and now computer vision and ambient to hardware the right things to happen at the point of care and to really drive that workforce productivity and those safety value

props. this like a re imagining the infrastructure in order to enable a more efficient set workflows around the point of care?

What's interesting is You know, you get into those patient care environments, that area has been traditionally dominated by a lot of different disconnected and point solutions. Most everyone is through their EMR adoption. And, I think you we have discussed this with other CIOs at the this week health meetings, the 229 meetings about the trends towards platform.

And now folks are saying, okay, I've got this. highly manual environment [00:05:00] where I've got the largest workforce, my clinical workforce engaging in, how do I make that more automated? How do I make that work better for us and more efficiently? And people are stepping back and saying, all right the technology is starting to hit this crossover point where it's providing meaningful automation, right?

We're seeing really, Interesting things happening in the large language models around documentation that's driving value. As you get into the clinical environment, you're seeing we're able to do things in virtual care centers that allow you to load balance your critical resources across your organization.

As an example, as you look at admissions and discharge workflows, oftentimes doing those in a virtual care center, you can spend more time, you can get better documentation. In certain cases, you might want to have a hospitalist involved. You can pull them in because they're in the virtual care center.

And when you're doing that, You're starting the discharge on admission. You're engaging the right resources. Your discharges are [00:06:00] happening before noon. That impacts flow. Once again, efficiency, if you have an ED backlog. And then when you overlay things like computer vision, you can start to either augment efficiency.

Detecting things in the environment you might want to know about. Hey, that patient's about to elope, or they're a falls risk, or they're not getting mobilized when they should get mobilized. Or automating things. Hey, that room is empty. We should get another patient in there. Or we've missed mealtime.

And, we've got a nutrition concern there. That's what we're really excited about and seeing more of that coming to bear. And then integrating with the other systems in that space. But also, broadening our portfolio do things that were previously disconnected

solutions. Avasure? Does it have the elements of a platform for a health system?

Avasure, if dialed it back, we've been around for 15 years. We're a very healthy company. We're fortunate to serve over 1, 100 [00:07:00] hospitals. But the solution started out as more of a point solution. And as we know, \ that is not what health systems need. It's not what the market's demanding, it's platform.

And, we've added capabilities around virtual nursing, physician rounding pharmacy, other use cases, and computer vision. We really are the most proven scaled platform in healthcare. If you look at Trinity in our virtual care center, we've got, over a hundred hospitals running out of two centers.

We're deploying all across CHS, all of Providence so we can really do this at scale, but the other element of being a platform is also being open. And in our market, we feel that it's very differentiating where there is so much innovation happening both in virtual care, computer vision, ambient, and we're, making a promise to our customers that whether you're using Avasure applications on the platform or third party applications, whether those are your [00:08:00] EMR or Epic or innovative ICU applications like Clue, that's fine.

And that we can arbitrate and handle all of that integrate with the rest of that environment.

Yeah, open and integrated. CIOs about this is one of the things. we're going into a new set of technologies, Open and integrated becomes key. When we went into the cloud, I remember people were saying what should we be looking for?

I'm like you should make sure you don't back yourself into a dark alley. Meaning like I just signed this 10 year cloud contract or even a five year cloud contract. I got in there, the costs were too high. Now I need to pull out. Oh my gosh, it costs a fortune to get out of this. And that's the cost of change when you're going into these new technologies.

There's emerging things. Open and integrated becomes real winning strategy so that you can make sure it does work with your EMR, make sure it does work with the things that you don't even know you need yet, because there's new camera technology emerging. [00:09:00] There's new AI technology emerging.

There's new computer vision. You have to have something that's going to be able to accept that and continue to build and grow on it.

Yeah, and we're putting devices, in every room. And when you're doing that, there's only one device in the room. So whether you're running Philips eCare Manager or Epic or any other technology or different computer vision models, our customers need to know we support that and that's done in a standardized way and that's efficient.

And not, creating some, very unstable web of customized integrations. Strategically, I think our customers really want to know that's part of our ethos and strategy, right? We've got a wonderful partnership leader that just makes sure that we're pre wiring these things for the benefit of our customers.

But then also making sure our IP around change management and implementation , considers how these things integrate. And we're able to bring these integrations to the point of care and do the change [00:10:00] management with the nursing team so the stuff actually gets used.

who's driving these conversations in the health system?

It's interesting because you said safety and I can think, all right I know what group did that in my health system. And then you talk about cameras in the room. I think of what group owns that. And man you're working across a broad, spectrum of the healthcare organization, aren't you?

Yeah, we really

specialize different health systems, have different roles. But there is a general trend, traditionally we've always had an extremely strong relationship with the chief nurse. We've got a wonderful chief nurse advisory board. We are deliberately, we are a technology platform, but we are also 15% nurses.

And we think that is incredibly important that you put all the technology into a health system unless your care teams adopt and use it. And if and embrace it and are excited about it, , the investment isn't realized. , the ROI isn't returned and we really want to, especially when we're talking to CIOs, which I'll get to in [00:11:00] just a moment.

We want to be the company that can work to make your clinical teams really excited about you, right? And say, Hey, not only we get the tech, we want to make sure your clinical teams are using it. And they look at this solution and say, Hey, from a CIO perspective, chief nurses are saying you did a great job.

You put in tech here, it's working, and this has been a great partnership. We see a lot from the chief nurse, where we're historically engaged, but because of the platform element, because of the integration element, because of computer vision, because of the AI and security concerns, the CIO has a tremendous, or their VP of clinical labs the CIO function has a tremendous role to play here.

And then certain health systems have, whether it's a chief digital officer or someone just specifically driving virtual care. So we find we have to really As we're engaging with customers, engage with all those constituents and have clinical people talking to clinical people and our, technology people talking to technology [00:12:00] people and hopefully bridge that gap.

Conversations we have been having, one of the things I will always throw out there is how many of you have a camera in every room and there's some that are still using the, on wheels, they will roll it in when they need it and that kind of stuff, but I'm hearing a lot of the larger health systems.

have initiatives around this. I definitely have pilots going, but they have initiatives around saying, you know what, we think the future is a camera in every single room and integrated workflows utilize that camera and integration into the EHR.

We just did some polling with the American Organization of Nurse Leaders and with QIIME and across the base, everyone believes in the end state of camera in every room.

The ROI to get there has been the thorny issue. And whereas when we started off at the beginning of this discussion, we talked about virtual safety observation. That has a massive ROI, and that ROI can actually fund camera in every room. However, as you extend beyond [00:13:00] the mobile devices, which can be used for safety, into camera in every room, and you introduce virtual nursing physician rounding, that's a much more nuanced and layered value proposition.

that's one where you really have to Look at it by what problem are you solving and have specific solutions, examples, right? If you have ED backlog and you need to get people admitted in your health system, you don't want to have a leakage. You can do admissions and discharges virtually.

It will work better. If you cover a lot of geography and you have specialized skills that are not available in your remote hospitals causing you to have to get people out of their community, bring them into, central then you can put those people in the virtual care center, things like wound care and respiratory therapy and hospitalists and allow people to remain in their community health setting.

So those value propositions become very layered. And then if you're using one technology in the ICU, maybe another [00:14:00] technology for telestroke, maybe another technology for virtual nursing or sitting, there's a consolidation value proposition that gets you to camera in every room where you just say, Hey, let's get the right platform.

And then we have one, and we'll integrate that to the different applications that make the most sense.

This is going to be a fun space to watch and pay attention to. And it's interesting. The ambient listening, I think has hit that tipping point that the ROI models are there, people see them and whatnot.

And then the cost of implementation has come way down. And so we're seeing this tipping point in almost every health system. I'm talking to ambient listening, we're doing the and they're rolling it out at scale. How far away do you feel like we are from the use cases starting to line up and almost everybody heading at this in to try to do this at scale?

We are at the tipping point right now. we are seeing A number of our customers go to a device in every room. And that device is, the high quality [00:15:00] night vision audio. It's additional and audio and sensors that allow you to better characterize what's happening in that room.

And we keep layering on new value propositions. I'll give you a couple of examples. We've talked a lot about physician documentation on the LLMs. Nursing documentation, obviously, is coming. Almost all of the sort of large LLM providers are working on that. We're working to facilitate that in the room.

But then there's all the non clinical stuff. And we just launched new module with NVIDIA and Oracle so that when you're in the room, all those things that you used to hit your nurse call button for to say, hey. When am I going down to radiology? Can I get my lunch? The room's too warm. Can I shut my shades?

Doing that through an LLM to once again minimize burden on care teams so that you have better workforce productivity. Those are really interesting things. We are adding a model to a model and a half a quarter right now on computer vision. To be able to look at [00:16:00] everything from patient flow, to safety conditions, to are people actually using PPE and for other conditions, is an IV bag empty?

And as you start adding those things in as that provides a data layer that allows better decision making, safer care environments, and greater efficiency. So it's all of a sudden Uber showed up. Why did Uber show up? Everyone had a smartphone. We all know the story.

And then you had GPS and you had to get all of those elements in place. Once you go to device in every room and you layer in LLMs and you layer in computer vision, It just, the flywheel really accelerates around very specific targeted ROIs that you can layer onto that platform and provide greater automation, efficiency, and safety in the care environments.

And then doing that in a way that ultimately, allows that to be a better environment to operate in. And when we talk to chief nurses, it's a lot of like, how do we bring the joy back to the job, right? At [00:17:00] first it was, how do we hire, get enough people after the pandemic? How Now it's about retention.

How do we keep our people in roles? How do we develop them? How do we support the newer nurses that are inevitably coming into the field? And that's our wheelhouse. And that's

exciting stuff, Adam. I'm looking forward to 2025. I think we're going to have a lot to talk about, especially if we have another one of these interviews at the end of next year we're going to wait

to do the retrospective.

I know it's,

Moving. I've never been in a faster part of healthcare technology since I've been in healthcare. This is changing very rapidly and our team's working really hard to make sure that we continue to offer the best things to our customers.

But it's been a lot of fun.

That's fantastic. Thanks. I really appreciate your time.

Thanks, Bill. Always

enjoy

it.

Thanks

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