Roundtable sessions at this week's CMO Exchange include discussions on use of artificial intelligence tools, integrating advanced practice providers into clinical care teams, medical director accountability, and addressing workplace violence.
More than two dozen CMOs and chief clinical officers are attending this week’s HealthLeaders CMO Exchange in Utah.
The CMO Exchange features a series of roundtable discussions on issues that are top of mind for clinical leaders. Roundtable topics at this week's CMO Exchange include use of artificial intelligence tools, integrating advanced practice providers (APPs) into clinical care teams, medical director accountability, and addressing workplace violence.
CMO Exchange participant Thomas Balcezak, MD, MPH, executive vice president and chief clinical officer at Yale New Haven Health, provided a preview of these topics in a recent interview with HealthLeaders.
Thomas Balcezak, MD, MPH, is executive vice president and chief clinical officer at Yale New Haven Health. Photo courtesy of Yale New Haven Health.
Use of AI tools
In healthcare, it is important to view AI tools broadly, according to Balcezak.
"As a physician administrator, I like to look holistically at how the organization operates," Balcezak says. "I don't make a distinction between the sharp end of clinical care with the physicians, nurses, and pharmacists, and the support end of clinical care with the back-office work such as preauthorization. I think broadly about AI applications in terms of how to make the whole care experience better."
Yale New Haven Health has deployed several AI tools that have a direct impact on clinical care. For example, one of those tools conducts ambient listening and transcription for patient encounters with clinicians.
"We have an AI tool to assess deterioration of patients in the inpatient setting, which lets clinicians know patients may be deteriorating before they are in crisis." Balcezak says. "We have an AI tool that performs pre-evaluation of radiologic exams to help radiologists to quickly and completely evaluate radiograms."
An example where Yale New Haven Health uses AI tools to improve back-office work that impacts the care experience is specialty pharmacy prescription preauthorization.
"We use an AI tool to summarize the patient's clinical information in order to provide that information to the payer," Balcezak says.
There is not widespread concern among clinicians and other clinical care team members that AI will replace clinical staff, according to Balcezak. Instead, the technology will be assistive.
"It's similar to automotive technology such as power steering and lane change warnings," Balcezak says. "People have not thought that these technologies would eliminate the need to drive. It helps people drive more safely and helps people drive with a better degree of precision. In the world of clinical care, this is what AI is helping us do as well."
For example, AI tools can help clinicians manage the barrage of data that is being generated in healthcare such as data points that need to be evaluated and new clinical knowledge that needs to be integrated into patient care processes, Balcezak explains.
"AI is going to make clinicians more effective and hopefully reduce some of our burdens," Balcezak says.
Deploying APPs
APPs have become essential members of care teams at health systems, hospitals, and medical groups, according to Balcezak.
"Almost every day, we are adding more and different kinds of advanced practice providers to our care teams," Balcezak says. "As care becomes more complicated and as the physician shortage continues to grow, we are increasingly looking to advanced practice providers to help extend physicians and help physicians to take care of patients better and more efficiently."
At Yale New Haven Health, APPs have been deployed in every care setting.
"APPs help in the operating rooms. They help on the inpatient floors. They help in our outpatient clinics," Balcezak says. "I can't think of any clinical care space where we haven't seen APPs make inroads in helping physicians take better care of patients."
Specific examples of APPs working in care settings at the health system include advanced practice registered nurses and physician assistants in ICUs helping critical care physicians take care of patients and APPs helping cardiothoracic surgeons to do procedures such as vein harvesting and closing the chest after surgery.
"APPs are playing critical roles in helping physicians," Balcezak says.
Medical director accountability
Medical director accountability is a top priority at Yale New Haven Health, according to Balcezak.
"We are conducting a large review of all our medical directors at health system sites to ensure that their jobs are appropriately structured," Balcezak says. "We are making sure that medical director job descriptions are appropriately scoped so that the lines of accountability are made clear."
Ensuring medical director accountability mirrors efforts to promote quality care, Balcezak explains.
"You need to ensure that the right structures are in place," Balcezak says. "You need to make sure that the right processes are in place to drive the outcomes that you want to achieve."
Depending on what medical director you are talking about, desirable outcomes can be more efficient flow of patients at an inpatient or ambulatory location, better quality outcomes, or better patient experience, according to Balcezak.
"It comes down to structures and processes to drive the outcomes you are seeking," Balcezak says. "If you can't define what outcomes you are looking for, then it can be hard to determine what structures and processes to put in place."
Addressing workplace violence
Limiting workplace violence is a focal point at Yale New Haven Health, with Bridgeport Hospital President Anne Diamond, JD, leading the effort across the health system, according to Balcezak.
Efforts to address workplace violence at Yale New Haven Health include installing weapons detection technology at the health system's facilities and crafting patient codes of conduct, Balcezak explains.
When patients commit acts of workplace violence, healthcare facility leaders must act immediately, according to Balcezak.
"You need to address an episode of workplace violence in the moment," Balcezak says. "You need to make sure that the patient and the staff are made safe."
Steps also must be taken to address the aftermath of a workplace violence incident, Balcezak explains.
"You need to support all of the staff members who were involved in an event," Balcezak says. "You need to support staff physically and emotionally."
The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.
To find out more about the HealthLeaders Exchange program, visit the program’s webpage or the program’s LinkedIn page. To inquire about attending a HealthLeaders Exchange event and becoming a member, email us at exchange@healthleadersmedia.com.
Christopher Cheney is the CMO editor at HealthLeaders.
KEY TAKEAWAYS
CMOs and other clinical leaders should view the impact of AI tools holistically, with an emphasis on both direct effects on clinical care and effects on back-office applications that influence the care experience.
With clinical care becoming increasingly complex and the growing physician shortage, advanced practice providers have become essential members of care teams.
Addressing workplace violence should be a focal point at health systems and hospitals.