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The 229 Podcast: Inside the 229 CMIO Summit and Patient Access Innovation with Jennifer Goldman

Bill Russell: [00:00:00] Today on the 2 29 podcast.

Jennifer Goldman: I think that where access innovation can fail is when operations teams are not engaged from the start and physician leaders are not engaged from the start

Bill Russell: My name is Bill Russell. I'm a former health system, CIO, and creator of this Week Health, where our mission is to transform healthcare one connection at a time. Welcome to the 2 29 Podcast where we continue the conversations happening at our events with the leaders who are shaping healthcare.

Let's jump into today's conversation.

Alright, it's 2 29 podcast, and today I am joined by Jennifer Goldman uh, CMIO, and Chief of Primary Care at Memorial Healthcare System. I, Jennifer great to see you again. We just we just left each other from the 2 29 CMIO round table and, it was a great discussion and you really you really let out on the whole [00:01:00] idea of access and that's what I wanted to talk about today, by the way.

Welcome.

Jennifer Goldman: Thanks, bill. Great to see you again as well.

Bill Russell: so patient access is a topic that every CMIO I talked to is wrestling with, and that was obvious in that room. What's the complexity that people outside your role might underestimate?

Jennifer Goldman: So access is complicated because. It's influenced by so many people across the organization, and I think as, CMIOs CIOs I think we get focused on how technology can enhance access, for example, by enhancing patient experience with calls or using AI agents to do outbound or inbound calls.

But I think that the complexity really arises from. Schedule management at the physician level. And I think that where access innovation can fail is when [00:02:00] operations teams are not engaged from the start and physician leaders are not engaged from the start to really take a look at templates and make those difficult decisions to open up templates.

To be visible for online access, as well as pair down decision trees to make it easier for patients to choose the right physician and make an appointment.

Bill Russell: there was a couple interesting things to me about the conversation. One is, invariably it goes to technology, but technology shouldn't be the leader. It should be. following in this case you mentioned template complexity, that, that came up a fair amount. It seems like there's a whole bunch of things like the many specialties, you know, require pre-visit work, prior authorizations, lab results, imaging questionnaire.

There's just a whole bunch of stuff that you have to work through and then some people have some practices have built their economics around. No shows and predictable no-show rates and that kind of stuff. You [00:03:00] really do have to lean into the operational challenges that the physicians face before you can even begin talking about the technology.

It would appear,

Jennifer Goldman: Absolutely, and I think one of the ways that. We tried to reconcile that was creating this bi-directional communication forum in a governance over access, which in includes it from a build perspective, but also the call center leadership, as well as the leadership over the physician group, and spoke about some of the challenges that currently exist.

Really got a sense of what it would take for operational leadership and physician leadership to have that trust in the call center and in the online scheduling platform to open up their schedules. A lot of what we heard was help us with clinical escalation. If there's a way that we can embed clinical escalation in the workflow centrally, and it [00:04:00] works across specialty.

And that's really the caveat. That would be a significant contributor to toward a world where specialty practices can open up access and trust that call centers are able to put the right patient in the right slot. Because call center staff are traditionally non-clinical, that can be a very difficult thing to do on the front end.

And decision trees don't take into account every clinical situation. And so trying to embed clinical escalation. Centrally with a combination of humans as well as AI tools, I think is is something for sure that we're leaning into. But again, it's all about that continuous governance and collaboration across the board.

Bill Russell: It's interesting, as we talked about AI this past weekend, one of the things that struck me was if we can't build the process today for humans to do it it's likely we can't. Build the rule sets and all those things that we need to do. AI is not magic. It's not [00:05:00] gonna be able to figure out something that we haven't figured out and can tell them.

And in some ways it's context too, right? How it works at Memorial Healthcare System as opposed to just generically. I mean, it has to be very specific to, to your practices.

Jennifer Goldman: Yeah, exactly. And that's why we're, you know, we're exploring it, but we're not hanging the hat on that as the strategy. We can't, not yet.

Bill Russell: So what are you learning as you work through this? What's shifted in how maybe how you think about the problem.

Jennifer Goldman: I think for me what I've learned is I think it really goes back to leadership and the role of the CMIO at an organization and how. You know, sitting at that intersection of technology and clinical workflow is great to say, but how does that manifest in practice? And so much of where I see it manifest is in problems like this large organizational problems that really require an understanding of clinical workflows because we do that.

And understand you know, the [00:06:00] true operations. And I'm the chief of primary care as well as the CMIO. And so I have deep experience in operations and I think that really helps to lend itself to this because it's complicated to manage schedules for hundreds of physicians. And and that task in and of itself needs a seat at the table.

That leader needs a seat at the table. And then really understanding the technology, understanding what's. Hype, what can, what's real and what can really lend itself to the challenges I think is important. And then ultimately the ownership being with operations. But with that leadership translator functionality, I think is truly what I've learned in this role and with this particular problem that I think I can leverage with other problems across the organization.

Bill Russell: where are we seeing. Real traction things that are actually changing potentially how? How patients experience the health system.

Jennifer Goldman: What we've seen for primary care, for [00:07:00] example, was a commitment to opening up templates, really standardizing templates to standard visit. Slot times and then gi handing over templates to the cadence team in it to to own those templates so that the control and individual, customization of templates was not left at the practice level, but rather at the primary care organizational level. And then in addition to that, adding same day access across the board, either virtual or in person, helped to add an additional 10,000 patients, accommodate an additional 10,000 patients last year alone for same day access.

I think that's a success story that can really. Be leveraged across the organization, but with a caveat that primary care is not specialty care. Specialty care works differently. Access works differently at specialty and [00:08:00] subspecialty levels. And I think that's where, again, that governance comes into play so that we can hear directly from.

Service line leadership and understand what, what drives access, what are we complicating more for them potentially in decision tree build versus how are we making it easier for them, either through the use of technology build or really discussions on process between online sch, scheduling, call center and operations.

So So a lot.

Bill Russell: you know, as I was thinking about this past week, there was a couple of really good conversations. Is there any other discussion that really jumped out at you or conversation, that we had?

Jennifer Goldman: I really love these. The small group conversations because it helps all of us to realize that the issues that we're dealing with are not unique. And in many ways everyone else is dealing with them as well. One of the other things that jumped out was something that Lacey Knight brought up, which was that diffusion of innovation across the healthcare system and how we can do [00:09:00] that collectively without putting the burden.

On it, but really helping everyone at the front line bring forward good ideas for workflow or innovation, and then having a way to bring that back to the operational leadership of those areas, whether it's on a unit in inpatient, whether it's an ambulatory, whether it's in the emergency department.

And again, really ensuring that there's that communication between operations and IT leadership and using some tools to facilitate that, that I think really jumped out as an opportunity that we all have across the board.

Bill Russell: This is the first CMIO meeting I've sat in a while. because the CMIOs are an interesting group in that they really moderate themselves and the discussion. So I didn't have to moderate the discussion. So, but it was interesting to listen to it. It [00:10:00] feels to me like the the CMIO really has evolved over even the last couple of years from EHR. builder EHR optimizer, to really a business leader that, I mean, you talked about convening groups, bringing the right people together facilitating the right conversations escalating things to operations. I mean, we had a conversation about incidental findings or actionable findings. And as I was listening to that conversation, it wasn't about.

Well, we've gotta build this different. I mean, that's part of the conversation, but it was really about, okay, how are we gonna operationalize this? How are we going to make these things happen? How are we going to go from 10,000 more visits last year to another 10,000 this year? I mean, these are really core strategic leadership kinds of questions for a health system.

And the role to me feels like it's significantly changed.

Jennifer Goldman: Yeah, I feel that way as well, and I think. For everything that we talked about whether incidental findings, the diffusion of innovation or access. And in [00:11:00] many cases, even length of stay, for example, which is again, traditionally seen in the quality realm. There's so much of that collaboration and conversation that the CMIO role really helps to align across the organization because of that knowledge of clinical work, technology, and operations, and.

In so many cases, trying to roll out technology without those conversations and without that role can be destined for failure because it's not. It's the people and process as we know, and I know it sounds cliche, but it's that people process that really dictates how successful it's going to be. But it needs a facilitator and I think that the CMIO role is well positioned to be that.

Bill Russell: was great. Uh, Great to see you there and to see you at the city tour dinner as well. That's a different meeting because it's, it was were you the only CMIO at the table for

Jennifer Goldman: was uh, no, there was another there's another physician [00:12:00] not in A-C-M-I-O role, but I think positioned to be in that role. So there were two of us there. Mm-hmm.

Bill Russell: it was interesting and there was four or five CIOs at the table. And it was interesting to see those conversations and where that goes. It was a little different different direction it goes. I mean, that was very technical. This that night.

Jennifer Goldman: Yeah.

Bill Russell: So very interesting.

Jennifer, thank you for uh, for extending the conversation and being a part of the show. I appreciate it. I.

Jennifer Goldman: Thanks so much, bill. I really enjoyed it.

Bill Russell: Thanks for listening to the 2 29 podcast. The best conversations don't end when the event does. They continue here with our community of healthcare leaders. Join us by subscribing at this week health.com/subscribe.

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