Revenue Cycle Innovation & AI: Jonathan Davis, Yale New Haven

Transcript

SHAWN STACK

On today’s episode of “Achieving Health,” I’m joined by Jonathan Davis, Yale New Haven Health’s Executive Director of Patient Access. Jonathan and I will discuss innovative technologies, workflows, and initiatives that are shaping and supporting revenue cycle challenges today, so stay tuned.

ANNOUNCER

This is “Achieving Health,” a podcast from Forvis Mazars, where we delve into the topics that matter most to healthcare organizations across the continuum of care. Our goal is to help you navigate the dynamic healthcare landscape and achieve health at your organization.

SHAWN STACK

Welcome to “Achieving Health.” I’m Shawn Stack, director in the Healthcare Practice at Forvis Mazars. Thank you for joining me. If you’re expecting to hear from my colleague and co-host Chad Mulvany today, he’s taking an episode off, but he’ll be back next week for our regular “Washington Watch” updates.

Today, I’m pleased to be joined by Jonathan Davis from Yale New Haven Health. Together, we’ll explore the innovative technologies and initiatives shaping their revenue cycle today, along with what’s next on the horizon. First of all, Jonathan, welcome to the show.

JONATHAN DAVIS

Thank you, Shawn. Happy to be here today.

SHAWN STACK

Why don’t you start by telling our listeners a little bit about your background and how you came to healthcare and your role at Yale New Haven Health as Executive Director of Patient Access?

JONATHAN DAVIS

Yeah, my background was a little meandering through healthcare. I actually started, I’m originally from Buffalo, New York, though I live in Connecticut now, working for Yale New Haven Health. But previously, when I was living in Buffalo, I started with what was, at the time, an Ascension Health hospital in Lewiston, New York, right on the border of Niagara Falls. Very small community hospital, probably about less than 100 beds in total, where I was in finance, in charge of budget, AR reconciliation, cash management. And that was really my first foray into healthcare out of accounting—I have a CPA by background; I was a forensic accountant before that—and that’s really where I learned some of the things for the first time and truly got to understand what it meant to be a healthcare operation, what hospitals have to go through on a daily basis.

And I actually really appreciate having started with a small community hospital, because I really got to see so much of what happens all around, from the nursing floors to the physician side to the community engagement. It really gave me an appreciation for the breadth of scope that does go into a community-serving hospital that sometimes, through just the sheer scale, can be sometimes difficult to capture with a larger system.

So, I really do appreciate that as my start as I continued to go through different places throughout my journey in healthcare, which eventually did end up with Yale New Haven Health. Switching from a finance journey to a revenue cycle where I originally came in right at the beginning of COVID, overseeing analytics and strategy for their revenue cycle department, overseeing some of the reporting, going through the data, which is quite voluminous, as you can imagine, through the number of accounts for a system the size of Yale, roughly an $8 billion health system, net revenue.

And basically it gave me the opportunity to really get into, I would say, the weeds of what is happening on a daily basis for patient treatment, both outpatient as well as inpatient. And over a couple of years, as we evaluated what was going on coming out of COVID, some of the changes that happened for many healthcare organizations, which included timing with a lot of retirements, something that pretty much happened on a national scale.

We evaluated our opportunity to reorg, and at that time they gave me patient access, which was quite a bit of a jump for me, going from a staff of 15 people to nearly 800. But it’s a change that I truly appreciate and really helped me understand and be better acquainted with those frontline people who are really the front door to our patients and truly appreciate what they do for that patient.

It’s not just letting them know that you’re here. It’s actually being that comforting smile, that comforting presence when you come in on your healthcare journey, many times nervous about what’s happening. It’s just nice to know that you might be able to see a friendly face.

SHAWN STACK

Yeah, that’s very interesting, Jonathan, because I don’t know if you knew this about me, but that is the path my career took as well. I was in the business office over government reimbursement and billing as well as transplant billing, and I made the switch the last couple of years in my operations career to the front end. So, and I don’t know about you, but it kind of, I think it builds a stronger leader on the front end, knowing what happens on the back end as a result from the workflows on the front end and helps you support that front end better, don’t you think?

JONATHAN DAVIS

I absolutely do. I’ve said to others that revenue cycle and healthcare in general, you have to think about it like an entire body, that everyone doesn’t really operate on its own. You’re all connected in the journey, whether you call it maybe like a circulatory system or some other connected, what happens in the front passes on to the back.

And having awareness and connection and communication I think is critical because if you try to operate in isolation, you’re just going to miss so many things. So, I’ve appreciated where my role has allowed me to be, being over both the front end and the analytics when it comes to looking at the changes that are happening. And in that journey, sometimes it really just comes down to facilitating communication to help understand what somebody thought they were doing right ended up being not right for somebody else.

And maybe it came down to a misunderstanding a process, misunderstanding a policy, or honestly, sometimes, not a few times, it could just be a wrong setup in Epic or your EMR that caused everybody who was doing something right, just to work out differently than it should be. And having that oversight and knowledge of both ends really helps to bridge those gaps.

SHAWN STACK

I couldn’t agree more. Yeah. And this is going to tie into where we’re going to go with our talk today, Jonathan, is that workflow experience, right? Because when you’re introducing AI and automation and optimization of workflows sometimes, and I think we’re seeing this more and more now and I think you and I have actually talked about this a little bit in our personal conversations, some of those workflows are outdated now, and they have to be recalibrated for this new industry, don’t you think?

JONATHAN DAVIS

I couldn’t agree more. You can’t automate a process that was really designed for paper 20 years ago. And when you look back at many of the EMR setups originally around like 2010, 2011, and 2012, and everyone had those pushes to go on the electronic health records, it essentially gave money to organizations to add electronic health records. And there was a bit of a rush, and this kind of happened across the board.

I remember being in that small hospital back in 2012, and there really wasn’t evaluation to say, how do we change our process? It was, how do we get our process to fit in this electronic world? And at that time it was okay. I mean, the scale was still relatively manageable. But now as we move into greater advancements in this technology as entire scope of what has changed and opened up with AI and other resources out there, it really leads us to trying to take that time to say, well, is our process allowing us to be successful?

If we really look at it as what is the outcome we’re trying to achieve versus what is the process we feel we need to do to achieve that outcome leads to very different results and taking a step back and pretending you’re starting from scratch and really just saying, here’s the outcome, here’s the technology. I think there probably would be a lot of processes across the industry that would change pretty significantly in revenue cycle. That said, we’re all faced with limitations when it comes to both what the government requires us to send and what unfortunately, our many payor insurance policy partners have, with their own individual processes and policies that we’re all trying to accommodate, which makes it really difficult to develop a robust and efficient system.

SHAWN STACK

As you’ve alluded to—and you brought up the pandemic here—you know, healthcare has experienced significant workforce disruption over the past few years. And that’s accelerated by, you know, of course, the pandemic, as you spoke about earlier, as both clinical and administrative teams shift work models, and then often moving remote or leaning into technology-assisted workflows, that shift has reshaped priorities, staff training models, and drove material changes in labor costs.

From your perspective, have those pressures largely stabilized, or are health system leaders still grappling with workforce shortages, engagement challenges, and ongoing demand vitality?

JONATHAN DAVIS

It still exists in different formats. I wouldn’t say it’s stabilized. Maybe some of the external factors have stabilized, where during the pandemic, there was a sudden change of the nature of workforce that forced people to modify what they do. Here, we’re faced with a different level. You have a changing education environment where a lot of people are certainly looking for different roles.

You have many of them, maybe not necessarily considering what used to be an opportunity to stick with a system for 30 to 40 years. We’re not seeing that level of applicant come in anymore. You still, not to say we don’t get good candidates, we still do, but I would say pre-pandemic you used to have a surplus of applicants, many of them probably more educated than you would expect for some of these entry-level roles.

And now it’s become so much more competitive in many areas that even, you know, other areas are paying more than some of our entry-level positions. And that has put pressure on us to figure out how we can use technology to be more creative in leveraging that workforce. Certain areas went home, and I think many people were starting to do back-office work, your billing, your payor follow-up work, from home, but it was very small steps there. It was under controlled environment. That obviously changed almost overnight, where now 90% of those offices started working from home, into the point that many locations actually gave up their real estate space. Unfortunately, areas like the front desk or anybody patient facing, they’re still coming in.

And that has become even more critical. I would say the peers I talked to in different organizations that manage some form of front desk, they will typically refer to it as a staffing crisis. How do you find qualified people for those front desk positions, where many of them do not want to travel into the office, they do not want to necessarily come in anymore when they have options to work from home, or competitive options down the road that may pay a couple more dollars an hour.

Because I think, Shawn, one of the biggest challenges that has led to this crisis is not just a lack of availability of people, although that factors in, it’s also the economics, the labor inflation that has led to rising wages. When our revenue on healthcare, we don’t get to just say inflation is growing X amount so we have to charge more.

That money always comes from somebody else. It comes from taxpayers, it comes from employers, it comes from patient pockets. And there’s really a limit on how revenue can grow. And unfortunately, I think you read this across the country as inflationary expenses and wage demands continue to grow and sometimes exceed what we’re able to negotiate in our rate increases and certainly get from the government. It’s putting a lot of pressure on the systems to figure out ways to; how can we do more with less?

SHAWN STACK

Yeah. So, you hit on that there. So, to fill in those gaps and to accommodate for that need, Jonathan, in adopting automation and AI enabled workflows, that can be intimidating for those teams. How have you educated and brought your organization along in embracing those changes that you need to make? And what leadership strategies have been most effective in enabling your teams to operate at their highest and best use using that technology or those automated workflows?

JONATHAN DAVIS

We’ve had success, especially when it comes to some of the workflows in the patient access area where certain tools on the front end, and I could talk separately about the back end automation in prior auth, which is probably a little more AI friendly these days than it has been in the past. But really, when it comes down to some of the services we’ve done on the front end like that, so self-registration, video-based registration for staff, it really came down to letting the teams know, not just the leaders, although the leaders have to be bought in.

I really do not believe in a model where a leader just says something and expects everyone to buy in. You do really have to get your people who are on the front lines using it to understand why we’re doing this, and the need for it to really it to be successful. Because I’ve been a part of too many implementations over my career at many organizations that you’re just told what to do, came from somebody up top, and maybe the thought was well-intended, but nobody on the front lines really understood the why. And that really led to almost critical failure of new technology adoption. So, what I’ve made sure is to really say here’s why we’re doing this.

We’re not getting the applicants we used to. When managers are covering desks, when staff are working more overtime than they want, and they’re coming in on weekends when they want to be at their family, we’re at a crisis that we’re not just going to be able to get new applicants and pay more money. There are just too many environmental factors and those days are gone.

We need this technology for you guys to get your life back. And that has really been critical in that adoption to say what is in it for me as a healthcare employee, working with patients, but also trying to have a balance of my own life, the supervisors, those managers on the front end, those are the people that have some of the toughest jobs, I think, in the non-clinical side of our healthcare, because they’re managing so much.

They’re managing coverage, they’re managing provider relations. They’re on the phone at 5 a.m. trying to coordinate callouts, and it is just wearisome on them and it burns them out. So, for them, this technology is really about a life-saving event for them. It’s about how can I move forward and get a piece of my life back because they love their jobs.

Nobody can really be successful here if you’re not at a point, if you don’t love what you do. There are so many other ways to make money that if you really come into healthcare it’s because you know you’re helping people out at sometimes their toughest time. And that means something. That provides value that a lot of other jobs do not.

So, that has been, in my mind, successful. Now there’s always an element, having my finance background, I will say that has helped me in putting together the business case that then gets your IT and business leaders supportive too. Because like many organizations, you can’t operate in a bubble that, even having the staff, the revenue cycle, patient access teams on board, you still need IT resources, you still need business support, you still need leadership backing.

And that is really having an understanding of how the budgets work, business works, even if it’s not the primary motivator. The reality is, you know, there’s still business aspects. And if you’re asking IT to devote their resources, their time, their limited resources. So, I’ve been successful in, when we’re saying this is a relief for the staff, but it also comes with budget savings because we don’t need to fill those 50 vacancies we have now.

We’re able to utilize technology to reduce some of that vacancy fill that we’d be churning with either temps, or new hires that are inefficient for a while, and overtime.

SHAWN STACK

I agree with you. And I think the word I would use is champions. You need front line champions as well as executive leadership champions, right, to educate why this as needed and to educate that this is work-life changing, right? I mean, it truly is. And don’t you think, even in access, don’t you think that the automated workflows, the AI, the digital front doors, actually helps them a little bit work to their higher potential?

JONATHAN DAVIS

Oh, 100%. And I think once, as long as those things are working right and working as intended, and I think the key to success is any of them: are you bringing in the people who understand what needs to get done? You’re not just making a technology in a vacuum and dumping it on their laps. You really need that early input.

And it doesn’t just make them a champion. I mean, it really just helps make the whole process better because they’re part of that. And their knowledge is helping to shape what will eventually be a much more efficient and smoother process because we’re not sitting in the back. And if something goes wrong, you know, maybe a few people notice.

No, this is, you’re working with patients in many cases and you’re working with providers. A mistake gets noticed very quickly. So, having those champions really be a part of that process is going to help that launch. And here’s the other thing too, is a lot of people forget—or no, they don’t forget, they worry about it.

What if something goes wrong? Well, it’s technology. Something will go wrong. I mean, that’s a reality you can’t wait for perfect, because we’re at a state today where we’re struggling to keep up. And in my mind, the cost of doing nothing far exceeds the cost of mistakes. But making sure everybody is involved, everybody’s part of it, so many people have an understanding of what needs to get done.

Really helps when you know some of those technical mistakes do happen because you have so many eyes on there, ready to jump in and say, oh, let’s correct this. You know, there’s a tolerance when they can see that, you know, it wasn’t a mistake because somebody was being lazy. You can’t predict everything. But if they’re communicating then it gets fixed very quickly.

And people see that. People see that corrections happen. And as a leader, I need to make sure people know it’s okay. It’s okay that they may have a bump in the road that, you know, letting the physicians know that, hey, this may happen, but we’re going to make sure your patients are taken care of one way or another.

If some of those digital tools with scheduling don't work out right away, don’t work, we’re going to follow them up. We’re going to monitor them. We’re going to call them and get that back up. So, once it does get ready, you know once it does work out it’s going to work very well. But if we run into any bumps, we’re here and it’s passing along that that oversight I think, helps people feel a lot more comfortable when it comes to accepting this technology.

SHAWN STACK

Yeah, I think it’s a continuation of, you know, something that is approved today as an automation or AI isn’t approved forever necessarily. You continue to study that, you continue to study the outcome, and are the patients engaging and embracing the technology? And not all of them will, right? And that’s why you have that human element available to take and handhold those people, those patients, and those consumers that don’t want to use technology or digital front door, you have that option for them. But many do. Many want to use digital front door scheduling and automated workflow processes and not have that human contact as much. But yeah, I think that’s very important, Jonathan.

Now, I know you guys are doing other things. And we’ve discussed your team’s use of AI in prior authorization workflows. Can you share the impact you’ve seen, particularly across both clinical and pharmacy areas? It sounds like you’ve had notable success on the pharmacy side in particular. Can you expand on that with prior authorizations?

JONATHAN DAVIS

Yeah, I would say that we’re very fortunate to have a prior authorization financial clearance team that has really been on the forefront of embracing new technology. And once again, this is a group who really sees it as a requirement for the future. They’re not worried about their jobs being taken away from it. They’re really embracing it because I think everyone there understands there’s not a shortage of work coming through.

And it’s not will there be nothing for me? It’s about can I actually do my work and still take a breath once in a while versus being completely overwhelmed with the amount of demand, and changing demand too. I wish it was at a point we could just be stable and predictive of what needs authorization and what not, but these policies change all the time, sometimes overnight, without us knowing. And it’s just that ridiculous nature of the communication patterns that make this very difficult. So, the technology moving forward has been certainly a journey, I would say, across the industry.

The search for prior authorization automation has been like the dream. It’s what everybody has been pitching probably for six, seven years, before even COVID, is automating end-to-end. I’ll say in few cases have I truly seen an end-to-end automation, but where I have seen a really impactful area is when there’s things that are certainly complex, and if anyone in the audience is certainly familiar with what it takes to authorize a pharmaceutical or infusion service, knows that these orders, the documents that the staff have to fill out, are incredibly complex. There is a lot of data that needs to go on, a lot of opportunity for error, which takes a lot of training, a lot of development, a lot of time to make sure that people doing this are up to speed and really understand what’s critical to get approvals.

Where we have seen success, and I would say its success over the last year or year-and-a-half has been in automation, AI that will go through the medical records for that authorization and truly, with a very high degree of accuracy, pull out the information needed for that specific payor, that specific drug, that specific authorization, summarize it for our analysts that do the authorization so they’re able to really take it and put it in. And it has certainly taken what would be a half-hour authorization, 20 minutes to a half an hour, to 10 to 15 minutes.

So, almost a 50% decrease of time. And what that has allowed us to do is, volume has gone up. We’re in a system that continues to try to grow volume. I mean, that’s the goal is you want to make sure you’re taking care of your patients in the footprint of patients. So, our pharmacy has been a very active, growing area of our business. And that has put a lot of demand on authorization. And this technology has really allowed us to take that growth without having to add new people.

SHAWN STACK

So, yeah, and when I would be talking to, you know, in my job, legislators or community folks or folks in D.C., that growth is access, right? It’s access for that community to access those services where before you wouldn’t have been able to offer those services to that many people because you couldn’t get through the minutia of the prior authorization request. So, now you’re able to see more patients that need these services, correct?

JONATHAN DAVIS

Yeah. And I think that that’s such a great point, Shawn, so many people overlook is those complex requirements are what prevent people from getting necessary care. And it’s not just your insured or employers. A lot of times it’s your it’s your Medicare managed patients, your elderly population who are on these plans because they’ve been guided for the Advantage plans.

And there are certainly benefits to them, but they also come with with an additional rigor that’s not their traditional Medicare. Those places where we require additional level of authorization and additional complexity can certainly, and have, led to patients not receiving the care or deferring care while this process is worked out. So, your point about the legislation, I think, is critical. That the more complexity we have, the more variation we have in those processes is going to impact patient care, because we just cannot keep up with the amount of staff and support needed to do all that.

SHAWN STACK

And you talked about this a little bit earlier, but, you know, implementation is rarely seamless and especially in complex workflows like pharmacy and clinical prior authorization, there are always challenges and kind of setbacks. How did you navigate those moments of setbacks or frustrations, and what strategy did you use to kind of sustain team engagement and momentum to ultimately drive success? And I know that’s probably a continual challenge for you, right, as payors require different things?

JONATHAN DAVIS

Yeah, it doesn’t stop. And I think that’s the key is this is about steps. You’re not, there actually isn’t a finish line in this because it’s not going to end. It’s having that process and working together to be involved. And honestly, I think once the teams start really feeling like their voice is important on these projects, that they see their contribution, I don’t need to push them. I don’t need to inspire them. In fact, the best thing I could do is get out of their way most of the time, as they’re invested, once they’re motivated, let them go. Let them be the owners.

Because I think that’s one thing that I would say people need more of in their careers in healthcare is being able to feel like an owner, being able to have a level of professional autonomy that says, you know, we’re really driving this and it means a lot to us to do that.

In my role at that point it just becomes, if they run into any barriers and they’re giving me updates on what some of those barriers may be, is to remove those barriers and not let their own progress get in the way. I would say where it’s really getting that early buy-in is at the beginning, you know, when they’re really trying to get that connection together, you haven’t started anything yet. Nobody has something really in front of them to work off of, it’s all still theoretical. If you have a couple demo videos, but now you’re trying to figure out where it is, that’s where I feel like having a leader is most important to say, here’s our north star, this is what we’re doing. Every time we bring something up: how does it impact the north star and is it critical today, or is it something that we can wait on until a little bit later?

I think that’s where implementations get derailed is everybody’s kind of thinking about, all right how’s this work in my world? Well, I need this step because I get that situation and it’s healthy to say I’m hearing you, but that’s only going to impact 5%. We need to worry about the other 90% to 95% right now. So, let’s put that aside. Let’s figure out how to just move those instances out of this process, let’s get this going and let’s not lose momentum here. And once you get that momentum going, once they start seeing successes, that’s when I can kind of more step back. And now they can start getting into the nuances. If those nuances become an issue later on, sometimes they just end up falling off because they realized it wasn’t important to begin with.

But at that early stage, you don’t know. I mean, you’re just trying to figure out what this means. And it’s not to say it’s not valuable, it’s just you’re just trying to say where that value is. So, my goal is, yeah, keep it simple at the beginning. Get those early successes so people can actually have a tangible impact, something that they can see and know and then let them start figuring out from there what needs to happen.

SHAWN STACK

But let’s bounce back here for a second, because I know you’ve been advancing changes across front end revenue cycle as well, particularly in scheduling and registration, check-in, and financial counseling. Can you share with listeners how that journey is unfolding? Because I know it’s unfolding right now for you, and what early successes or lessons you’re learning along the way in that perspective?

JONATHAN DAVIS

Yeah, some of what we’re trying to do, we’ve done. Like many, we’ve already done a lot of the self-registration tools where people come in, they use their phone or they use a kiosk to type in. And I think you hit on, there’s a portion that likes that, there’s a portion doesn’t want to deal with people.

And our lesson there is just make that easy. Don’t have people write for a long time. Don’t have people with lots of questionnaires. How do we limit what we can? And I would say without intervention, without having to have an ambassador, which a lot of people have, like if we just let people naturally choose, I would say 30% to 40% are very comfortable right now just going to those self-registration devices.

But that still leaves us with, you know, 60% to 70% of the population that still wants to interact with a human. And going to the staffing crisis we talked about, that’s becoming difficult. When you have a person, with only one person in an office and they call in sick, now you’re either pulling from somebody else, so you’re shorting another office, you’re covering with an expensive resource, so maybe a contract labor, or what a lot of times happens is you’re stretching your management team and they’re trying to cover that, which means they’re not doing the management, they’re not doing the process improvement, they’re not doing the oversight they should be. And it leaves us in a crisis.

So, we started to experiment. For the past several years, we’ve been experimenting with video-based front desk registration in a couple areas in limited scope because we really wanted to understand, well, does this work first and foremost for the patients? Are they comfortable with it? And as long as you kept it easy, most of them were. They still talk to a human.

I think that’s the thing is they’re still talking to a person. They’re not talking to a machine. We talk AI, but at this point, I’m not at a point, I believe, a voice AI for the majority of patient interaction, especially something that can be at times complex, like registration, is ready for an AI. May be there next year,

I mean, these things advanced quickly. Right now, you still need that person. So, but what the video does, because we all got used to Zoom, we all got used to Teams, it just lets that person do that face-to-face interaction, just remote over a monitor. But the patient feedback has been very positive in our surveys. It has been on par with where we were in the past, as long as they made it simple to interact.

So now, recently, we’ve engaged in a journey to extend that virtual remote platform, strategically using it at places where we are challenged staffing-wise. And it’s adding as a supplemental force to our teams that may not have the resources on there and leveraging centralized resources to help cover and support more offices. So, we’re not getting rid of a person.

We still have people at, predominantly, our desk. As long as, you know, they’re able to show up they’re there. But having this extra resource too, for coverage, for support of those lunches, for callouts, or just surges in staff and patient volume. Because many times our patients surge at different times throughout the day, they don’t come in steady. You just need that extra resource. Otherwise, you’re creating a very frustrating experience for both the staff and the patients.

So, this has been, it’s early, we’re still in that journey for rollout. But so far, signs have been positive.

SHAWN STACK

So, let’s wrap up here with kind of an open-ended question here or an exploratory question here. Where do you see the greatest opportunity, maybe for behind-the-scenes analytics to streamline access workflows and support your teams? And as you dream ahead, what possibilities are you most excited about or still hoping to unlock that are on your wish list?

I know I have mine for sure, but what, like two or three years ago, were you hopeful for that has never come to fruition? And what has just blown your socks off as far as what this can do? Because there’s been a couple of those for me too.

JONATHAN DAVIS

I, well, listen, the door of analytics itself and the data, I mean it’s been like 15 years now I’ve been hearing about how much data healthcare has, we just don’t utilize it. I really do believe that AI, that’s where it’s going to shine, is really just helping us understand that data. Because when you have millions of accounts, it’s very easy to miss the $15 you’re getting, you’re not getting paid less than you should be. But that’s happening thousands of times because you just have so many volumes and so few eyes to keep up with it. So, I’m really, really hopeful of what AI can truly do on that, really being a force multiplier in that regard.

But when we really think about the journey, we often forget about the clinician side in this journey. We are almost expecting them to become experts of payor policy. They’re supposed to know, because they, you know, they don’t have enough to remember, that this Medicare Advantage plan does not take the premium drug, that they only take this generic, but not the other generic, only this one.

And they had to remember that when they do their order or it’s not going to get authorized and it’s going to get denied. And then that, to me, it’s really adding intelligence and AI to that journey from the beginning. So yeah, so much would go so much smoother if we just gave our upfront clinicians better tools, and not just a tool that they could click on, but better support that.

It just happens up front, that it helps guide them to the point that they don’t have to remember it. And then all that is done correctly from the beginning. And then we wouldn’t need so much follow up, so much rework, because, you know, it’s just too complex of an environment for anybody to remember. I want doctors to take care of patients. That’s what I want them to do.

SHAWN STACK

Yeah, exactly.

JONATHAN DAVIS

I want nurses to take care of patients. I want them to worry about the person they have in front of them, not, you know, what they need to click on a dashboard and what drugs are supported or, you know, what policies allow for this testing but need additional detail to allow for testing under different insurance. You know, that’s not what they’re there for.

SHAWN STACK

Agreed. I agree 100%. What do you feel we as consumers, meaning healthcare have misunderstood and now some of us are catching on? Is it the workflow issue in utilizing AI? So, what are some of our self-imposed failures in adopting these new automation processes and technology?

JONATHAN DAVIS

I think the promise of AI, without understanding how to fit it in, was probably the thing that caused delays and has set many of us a little more cautious about what it can do and, in the process became more educated. But five years ago, everybody was just so excited about AI, AI, AI, you didn’t even know what it really was doing. It was just there. Let’s buy it. Everybody got so excited for promises without actually validating delivery, and I think I still see it sometimes that we get a little excited over the concept, but not actually the how.

And I’m a little more cautious about people that make claims. And I would say I’ve definitely become a little better in asking the questions when it comes down to tell me about this situation, a little more situation, a little more specific, so I can start weeding out those who are actually, have actually built something for real and can deliver it, versus yeah, they may have built something in a test situation, but they haven’t tried to apply it in a real situation yet with the real complexity, some of that being our own system limitations.

And they haven’t worked through all of that to try to figure out what it means. And I think it’s that overpromising, without understanding what the delivery should be, has been, I would say, kind of a frustrating situation over the years that I think we did spend a lot of, as an industry,

I mean, we were all on those councils. Everybody was kind of doing the same thing, and none of them came to fruition. None of them delivered the results. And I think that set us back and that made people afraid to try and that’s a little concerning to me, is we’re always in an environment we need to constantly improve for ourselves, for our patients, for our health systems.

And it’s that kind of PTSD that came out of that environment that we need to overcome. We just need to be more educated. We need to be more careful about who we’re letting into our partnership here, because it is a partnership.

And that’s one thing I will say about vendor and healthcare relationships is it doesn’t work if they just say, here’s a tool and go on. Like, you have to be, I have to trust that you’re going to be side-by-side with me. You know, you may not live with me, but you know you need to be that neighbor. When I need to borrow a tool, you’re coming over and I can count on you.

SHAWN STACK

Yeah. And they understand you and they understand the nuances of your business, right?

JONATHAN DAVIS

Exactly.

SHAWN STACK

And I think that’s also something that we can tell our newcomers to this area. And there still are quite a few newcomers to this area of advanced analytics and AI and automation and new workflows. That human component and that historical knowledge and that strategy that the human brings to it, they have to be a key partner with whatever that AI platform is that you’re bringing in continually, right? Ongoing.

Well, Jonathan, thanks again for joining me today and sharing your thoughts with our listeners. I always appreciate your-data driven perspective and practical approach to leadership. And now in this area of AI, and advanced analytics and advanced workflows, I think you’re so solid in this area. And it’s going to be interesting to see where you take Yale New Haven Health in the future. I’m sure we’ll be talking more. But really seriously, thank you so much for joining today.

JONATHAN DAVIS

Oh, you’re welcome. I enjoyed it. I appreciate the time.

SHAWN STACK

I also want to thank our listeners for tuning in and following “Achieving Health” wherever you listen to podcasts. If you want to learn more about the topics we discussed here. Be sure to check out the show notes for related content and information about how to get in touch with me and the team here at Forvis Mazars.

I’ll be back with my co-host Chad Mulvany next Wednesday, June 24, for the next round of “Washington Watch” updates. Until then, here’s wishing good health for you and the communities you serve.

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