Episode Overview
Together, they explore how artificial intelligence (AI) is advancing into real clinical use, the persistent challenges of interoperability and data fragmentation, and the growing role of patient empowerment through wearables and remote monitoring. From AI-driven care delivery to the realities of data quality and integration, the discussion highlights both opportunities and gaps healthcare organizations must navigate.
Whether you're evaluating AI, strengthening your data strategy, or rethinking care beyond the hospital, this episode offers practical insight into moving from innovation to real impact.
LISTEN TO THE EPISODE:
Host:
Daniel J. Marino
Principal, ECG Management Consultants
Guest:
Tom Foley
Host of The AI Shift
Daniel Marino:
Welcome to Value-Based Care Insights. I am your host, Daniel Marino. Well, a couple weeks back, actually in early March, was the HIMSS meeting. I believe it was March 9th through the 12th. And although I didn't go this year, last year I went, and I thought it was fascinating. You know, AI was really starting to take off, and I think every vendor that was at HIMSS had AI in either their name, or somewhere within their booth, and so forth. And last year, if any of our listeners remember. We did a pretty nice overview on sort of the key takeaways of HIMSS, and the trends that were coming out of HIMSS that maybe providers needed to focus on. And then based on some of the requests that we had this year, we thought we would do it again. And although I wasn't there this year, one of my colleagues, actually one of the radio hosts that is on Healthcare Now Radio, was in attendance. So I'd like to introduce Tom Foley. Tom is, the host of the AI Shift, he is on Healthcare Now Radio, as well as have on-demand podcast, and was at HIMSS, and looking forward to kind of having, hearing your thoughts. Tom, welcome to the program.
Tom Foley:
Dan, thank you very much. Glad to be here.
Daniel Marino:
So, Tom, give me your thoughts. You know, last year, you know, as usual, HIMSS had a lot of vendors, there were some great conversations going on. What was your impression of the overall theme of HIMSS? What were some of your big takeaways?
Tom Foley:
Yeah, first off, I have to say, HIMSS was, was great. It is always great. It's great to have that annual, sometimes there's people you only see at HIMSS. In that context, from a networking perspective, and it was reinvigorating to catch up and chat and, and really get the, the lay of the land from other people's perspectives, so… But, you know, HIMSS itself, I think, to your earlier point, AI was actually, you know, naturally, a hot topic. If you didn't have AI someplace in your booth, you probably didn't get a lot of attention. But patient empowerment and mobility also, I think, rang through a lot of the messaging, and that's where I focused a lot of my time on the booths that I did go and visit.
Daniel Marino:
Yeah, when… last year, I had a lot of conversation, interviewed a few people, you know, around AI, and it was just… you know, I kind of see it as its infancy stage, you know, last year, and obviously, AI and the whole development of it, use of AI, I mean, is just, you know… just has come so far just in the last year. So when you think about it. Where there are a couple of really key AI elements that you saw in some of the technologies? For instance, AI related to maybe clinical pathways, or last year there was a lot of AI capabilities that were starting to evolve around some of the business processes. Was there a particular area there that really caught your attention?
Tom Foley:
Yeah, I think AI is definitely coming into the forefront. You know, so when you ask yourself AI, it's a broad… it's a broad.
Daniel Marino:
Sure.
Tom Foley:
Right? And healthcare is huge, right? So, to your point, you know, ambient listening might have been the theme of AI last year, right? Or, you know, how do I use AI in claims management, or X, Y, and Z element of the business? Where I think now AI is now front and center in the context of how do we enhance the delivery of care? And that was… that was exciting, because that is… that's really where… you know, the greatest challenges in the context of, I have, you know, we have… the market challenge is I can't hire physicians fast enough, there's not enough of them, can't hire nurses fast enough, there's not enough of them. But I got more… I have more sicker patients today than I did yesterday, so AI is a natural, platform to bring to the forefront and help solve that problem.
Daniel Marino:
One of the questions I asked a few of the vendors last year was, as we start to look at data, how are we going to process data faster to really begin to make sense of it? And to your point, when we start to think about patient risk, when we start to think about how we can aggregate the care maybe more efficiently, you know, that… I think everybody agrees that's going to be a huge benefit of artificial intelligence. Did you… did you have a chance to look at the differences between, say, the EHRs, Epic, Cerner, and so forth, that are processing all of this data related to clinical workflows? Or was it more that maybe the other third-party solution vendors, were they more advanced on being able to aggregate some of that data and maybe push it forward in terms of maybe, I don't know, innovative clinical workflows or something in that regard?
Tom Foley:
It's a great question, and when you talk about AI in and of itself…you have to ask, specifically when you talk about being in the clinical forefront, How does AI work in context of understanding that patient. If I was in an EHR, the context would be… what's in the EHR, when we all know that no EHR, stores 100% of the patient's record. Because I have 9… I'm a… I have 5 chronic conditions, and I see 9 different doctors, so they're not all in the same health system, and they're not all in the same EHR. What I felt was most interesting was the interoperability lab. Now, some folks might say, hey, the Interoperability lab has been at HIMSS for years, right? So, but now is the time, if you're gonna talk about AI, you gotta talk about interoperability.
Daniel Marino:
Sure, right.
Tom Foley:
And that was really the most interesting part, because, you know, I don't… I don't take this the wrong way, and I have several friends that work at EHR vendor… with the EHR vendors, but I'm not relying on an EHR vendor to solve this problem. And so…But, you know, if I'm gonna… but now is the time to look at, strategically, how am I bringing in data? From trusted third-party sources. And as we all know, the federal government has this QHIN TEFCA effort, which is good, but we also have Care Quality out there, we also have Commonwealth out there, and we also have other credible data sources, right? So QHIN hasn't picked up fast enough. F or me, in the context of how do I… how do I leverage that in order to… strategically, in order to affect, contextualization and personalization of the medical record in… in the EHR.
Daniel Marino:
That's what a lot of organizations are struggling with, because there is data all over the place. I think AI is allowing for us to more quickly normalize the data that is coming in. But obviously the data governance around AI, or AI governance, you know, is absolutely critical in that. But when you think about how you're going to aggregate that data and incorporate it into the care plan, the care models, you know, what to do with those level of insights. I think organizations are still struggling with that. Providers are still struggling with that. And I think some of it is managing, maybe, the bias that comes out of it. I think some of it is making sure that we have all of the information that's going to drive the results. Were any of those topics addressed at all? You know, that's a concern by a lot of folks.
Tom Foley:
Yeah, it is definitely a concern, and I… and you're right, there's not one, there's not a silver, lining here, right? You have to…there are some good vendors out there that will help aggregate the data, but they still, in and of themselves, don't get it all, right? And we still have some rules around what AIS is versus treatment, and there are still, I hate to say it because there's legal connotations here, but there are still some blockers in the neighborhood. And, so… we… we aren't… we aren't just there yet. And we have to do a better job even of, record matching, And things of that nature. Yeah, the data… the data's still dirty. And, but, and the, and the, and the data's… Proliferated, in too many locations to really get… to think that you're gonna get 100%… 100% of the data.
Daniel Marino:
Yeah. So did… did you see any, as you were walking around and talking to some of the, the AI vendors. Did you see anything, any solutions that really caught your eye, that were maybe really innovative, or something that, whether it would be in, you know, managing patients around risk, or maybe, I don't know, interoperability, related to data, or even how to manage, some of the, I don't know, surgical processing that occurs, you know, of patients in the ORs.
Tom Foley:
Yeah...innovative, that's a… that's a tough word, and… No, because.
Daniel Marino:
Because if I ask any of the vendors, they're gonna say they're all innovative.
Tom Foley:
Yeah, exactly, exactly. So, listen, when… listen, there are some very good vendors out there that are… that are working hard on the toughest challenge, in the… in the market, and that is interoperability. Having been very involved with HIEs and even direct messaging during the, the MU2, days and beyond, it is the… it is the hardest, part of the equation. So, but… but, so, we still lack, we still lack very significantly record matching, and we still lack, total access to data, because I still have to go to the repositories, the common repositories, right? The Commonwealths do a good job. Care Quality does a good job. The QHens do a good job. SureScripts does a good job, but I need… I need them all, and more,if I was really to affect the effort that I was trying to trying to, achieve here. So, I, I still say that the market still has a long way to go on the interoperability front, but I… listen, I was around, pre-High Tech Act. And if there was ever a… and I don't… I am not… I am not a government mandate guy, but…I will say, if there was ever a mandate. You got… everybody's gotta… everybody's gotta join QHIN
Daniel Marino:
Yeah, everybody's got to align.
Tom Foley:
They gotta align… no alignment, no strategy, no ex… and then, therefore, no execution, and that ultimately hurts patient care.
Daniel Marino:
If you're just tuning in, I am Daniel Marino, you're listening to Value-Based Care Insights. I am here reflecting on the HIMSS meeting that occurred, beginning of March, here talking with Tom Foley, host of The AI Shift. Tom, you had brought up one area, and I'd love to dive a little in, because this is, this is a focus that many physicians, many providers are really, are really looking at in terms of augmenting their care model, and that is around patient engagement, patient empowerment, really the whole mobility aspect there. And there's been so much focus on the use of wearables, on being able to incorporate that into a lot of the care models that providers are looking at, certainly as you think about recovery and just getting more information there to the providers so they can kind of help the patients, you know, through any type of condition that they have. I think some of that is also integrated with AI, but some of it is just standalone, right? It's just new technology. Were there some key areas there that you saw were kind of exciting around mobility, wearables, patient empowerment, any of that?
Tom Foley:
Yeah, I think, I think we're getting smarter in this space, and, you know, because at the end of the day, we talk about outcomes. And in order to affect outcomes, so that's another buzzword, outcomes, but the pathway to outcomes…is… is challenging, because you can't get the outcomes unless you get the behavioral change first.And then behavioral change comes on recognizing that there's a compliance issue here, and change doesn't come without change. But at the end of the day, change occurs when people start to be educated. So, the idea… so, a wearable, a lightweight wearable, if you will. Maybe it's a ring, maybe it's a CGM device, maybe it's a… A watch. A watch that, that is, you know, FDA cleared, if you will. There's a lot of watches out there that do a lot… that measure a lot of different things, but, you know. if you were in a doctor's office, you'd use an FDA-cleared device, not anything else. So, but the point is, is that those are… those data points now… become, it's like a lab result, I look at it. You know, when a blood pressure comes in, that's a result. It might not mean anything… it actually might mean something in and of itself, but put it in context of trends, right? It might be within range, but if I did that over a course of time, I might see, actually, a curve going up, right? Everything's in a good range, but anticipating that there's an event going to occur is very… is very powerful. So I think the whole remote monitoring model is becoming more mature in what type of devices that I use that are lightweight. I don't need a backpack to carry around a scale, a blood pressure cuff, a glucose monitor, a pulse ox, right? There are things that are lightweight and ride your skin, if you will. And through the, through the use of, like, a ring, or a CGM device, or a watch, things you use.
Daniel Marino:
And that's such a… that's a good point you bring up, because, you know, the wearables, if done correctly, will provide good data, right? And it'll support the trend. But where I see the intersection of data coming out of the wearables and artificial intelligence is the ability of AI to take that data To aggregate it with other data to allow some type of…modeling, profiling, some type of, proactive you know, output or information that would allow us to become more prospective on that patient's condition, right? Because the data from the wearable is important, to your point, but it's trend data, right? And it helps you kind of understand where you're at within, you know, different thresholds. But boy, if you can aggregate that with other conditional data. Well, then you're at the point where you can actually become more prospective in the care that you're delivering.
Tom Foley:
Exactly, so as… as data drives, intelligence, drives awareness, so, and even drives behavioral change. If I was a patient and I started to receive these, these data points myself, I could… I could… I'd be more educated and be more, and start to see a correlation between what… what I'm taking in and what… and what my vitals are, if you will, right? But at the same time AI is more like a health assistant. Remember, we can't hire… we can hire skilled folks in this industry, whether it be a doctor, a nurse, or any other certified resource. We can't hire enough, and we can't hire them faster, because one, they're not there, but two, so how do we… how do we, how do we provide resources that reach out to the patient and say, hey, I got your blood pressure today. And, and it's a little high, you know, hypothetically, and it reminds them maybe, hey, you know, about smoking, about, salt intake, about, you know, X, Y, and Z. You know, again, someone, a very low-cost modality.
Daniel Marino:
Yeah. Integration steps right there with some chronic diseases that provides even additional information or insights coming out of it.
Tom Foley:
Yeah, exactly. So, and it might be, hey, did you take your medicine?
Daniel Marino:
Right. Well, I think this is the AI bots are going to come into play, you know, because they're going to be out there, you know, almost reminding patients or providing additional information, you know, as an output of that. And I'm sure, you know, there was probably a lot of AI bot technology that was roaming all around, pardon my pun around HIMSS.
Tom Foley:
Yeah, so, I mean, you know, looking at even AI and medication adherence, as an example, and remote monitoring. Remote therapeutic monitoring, you can measure medication adherence. So, this is where I think we just need to get smarter about how we're doing things. In the context of remote therapeutic monitoring, you're required to get 16 measures in a 30-day period, right?
Daniel Marino:
Sure.
Tom Foley:
But studies show that you need to be 80% compliant on a medication for the medication to be effective. So, if I'm only measuring 16 days. We can applaud and say, yeah, I was able to create a reimbursement, but the real question is, did the patient get healthier?
Daniel Marino:
Right, where the outcomes are, absolutely.
Tom Foley:
What were the outcomes there? So, and the behavioral change is to take it, you know, your medications 80% of the time, because medication… lack of compliance leads to 10-30% of hospitalization. That alone is a huge cost saver to the market, just taking your medications as prescribed, and we all know 30 per… what is it, 30%, of scripts are never filled. Right. 50% aren't, compliance is… falls off after the first 6 months. It just goes downhill from there.
Daniel Marino:
I'll tell you, that's… so I do a lot of work, obviously, in value-based care and helping organizations with care management and all of those elements. That's a part I'm really looking forward to. I'm starting to see some real traction there, where you can look at some of the data coming out of these wearables, integrating it in with AI, and then creating it as, you know, real actionable, if you will. I think that's…That's where you're really gonna start to see, quite a bit of traction coming out of this, and folks will really take care of that. You know, they're gonna see the benefits of the technology changes.
Tom Foley:
Oh, absolutely. I think that AI is the, and I might have some bias here, but I do think AI is the… is the transformational platform that will drive… that will ultimately transform all of how care is delivered. It's not so much about the home anymore. I'm sorry, it's not so much about what happens in the brick and mortar, it’s what's happening in the home. It's how do I extend my brick and mortar into the home? And that is really where an AI agent that acts on patient engagement. And, it's more like, it's more like, instead of looking at it as urgent care and primary care, we need to look at the market as continuous care.
Daniel Marino:
Continuous care, right, and that has a big place to play, no doubt about it.
Tom Foley:
Yeah, so if we… if we can leverage AI to fill the gaps. AI is not about, taking away jobs. I've seen it far too much. It doesn't take… I've never seen a healthcare job taken away because of AI, but the point is, is that if we can use AI to fill the gaps where the human resources aren't available, we can do… we can really transform, truly transform the way in which, care is delivered.
Daniel Marino:
Yeah, I absolutely agree. So when you think about HIMSS this year compared to last year, what do you think has changed? Was there any, you know, was there any different themes? Was there any different… you know, I know even last year there was a big focus on…maybe wellness? Yeah. I remember going to a few of the presentations there. Was that… was that a theme this year, or did you see that the HIMSS leadership kind of reinvented themselves and, you know, every year they kind of have a different theme based on where… where the trends are of the market? Any… anything come to mind?
Tom Foley:
Last year was themed on, wellness, and certainly this year's theme was, AI, and I… and if I were, advising HIMSS, I might talk about… ask them to… next year, if they could talk about the continuation of, of care. It's, it's about the, the, the overall care pathway, as opposed to just wellness, as opposed to just AI.
Daniel Marino:
Maybe they should bring up AI wellness, right? Because we all may need some wellness around our…
Tom Foley:
Exactly. Well, so instead of… instead of criticis… you know, there are those out in the market that are always criticizing the new thing. It might be more so because it is new, and there are risks, but I, in my experience. There's a lot more people approaching the use of AI in a most credible way. And yeah, there's always distractors in the, in the market, but let's leverage it in a most credible manner, and use it wherever it needs to be used, frankly. Whether it be in…
Daniel Marino:
I think the theme in this next year, you know, and if I was to give any advice to him, I would definitely focus attention around AI governance, the use of, you know, the appropriateness of the use of AI, and where it could be integrated, because I think, you know, in conversations that I've had with providers, they're struggling with that, right? It's like, how far do you take it? So that would definitely be a strong area of focus, and I know the government's looking at that, you know, they're putting all sorts of new regulations in place.
Tom Foley:
Yeah, and sometimes, you know, Sometimes you got to let the market go. And to figure it out, as opposed to rushing to put some guardrails around it. Now, there are… if you're… if you're implementing AI, you're already thinking about safety, I would say. In my experience, they are… and doing it much more rigorously. You know, in my experience using AI, we have… I have doctors, that I was like, geez, I don't know if I would have asked that question, but AI seemed to have asked a very good question here, right?
Daniel Marino:
And they compliment you on asking.
Tom Foley:
Yeah, exactly, so it's, you know, don't underestimate the power of AI, in the context of things that we're doing, and ask a doctor, ask a doctor who has worked with AI in the delivery of care, what they think, because I… I do think that there are some leaderships in whether it be payers or, you know, there are some progressive payers out there, which is a good thing. You know, you always have this bell curve, right? You had the bleeders out there, right? And I think that we're kind of moving away from the bleeders to the early… more of the early adopters, and I think we're going to start to see the tipping point, where, you know. One, it's safe, you can use AI in delivery of care, and you can use it in an appropriate way.
Daniel Marino:
Where it kind of, where it kind of fits in. As we wrap up here, you know, obviously host of the AI Shift, why don't you talk a little bit about, just real quick, your program, and maybe how folks, you know, might want to get ahold of you, or kind of, link up with you if they have any other further questions. You're clearly an AI expert.
Tom Foley:
Thank you, I appreciate that, Dan. But, yes, Tom Foley, The AI Shift, it runs on Healthcare Now Radio at, 11 a.m. and 7 p.m. each day, and, and if you're up at 3 o'clock in the morning, certainly take a look, listen then. You can reach me, my LinkedIn profile is, TFoley, and, and it does have the, the program listed in the banner, so you'll know it's the right T. Foley. And yeah, so reach out. I'd love to, I always like to, talk to folks that have, questions or points of interest or perspectives that are different than mine. I, you know, to me.
Daniel Marino:
Well, I've listened to your program a couple of times, and a number of times, matter of fact, and you do a nice job. You always have.
Tom Foley:
I appreciate that.
Daniel Marino:
Well, Tom, we're… we're out of time, but I want to thank you for coming on and sharing your insights, related to HIMS and AI, and, you know, love to have a further conversation about that, maybe sometime, you know, next couple months or down the road. To all of our audience and listeners for tuning in, I want to give a special shout-out and thank you for continuing to listen to Value-Based Care Insights, and until our next insight, I am Daniel Marino, bringing you 30 minutes of value to your day. Take care.
About Value-Based Care Insights Podcast
Value-Based Care Insights is a podcast that explores how to optimize the performance of programs to meet the demands of an increasingly value-based care payment environment. Hosted by Daniel J. Marino, the VBCI podcast highlights recognized experts in the field and within Lumina Health Partners
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