Transcript:
Jordan Cooper 0:04
We’re here today with Julie Smith, the corporate IT director of clinical applications and support about this health care for those who don’t know about this.
Healthcare is headquartered in Pensacola, FL and comprises 3 hospitals, four medical parks, a complex network of primary care and specialty clinic practices, and an Institute for Orthopedics and Sports Medicine.
We have an interesting topic to discuss today.
We’re going to be discussing alleviating clinician burden with the creation of help desk desk tickets that leverages Gen AI technology.
So Julie, thanks for joining us.
And please, let’s dive right in.
Tell me a little bit about CASI.
Julie Smith 0:49
CASI.
CASI is our newest team member.
I always ask people if we can introduce them to CASI.
CASI stands for the clinical application support interactive bot, so she is she is called CASI by those of us who know her well.
Jordan Cooper 1:07
And tell me about the genesis of Cassidy.
What was going on about this health care prior to the introduction of this Gen AI tool?
And what were some of the problems that (Baptist healthcare was facing?
Julie Smith 1:23
So we had when we implemented our current EHR, we had contracted for a third party EHR support vendor for help desk specifically for their product.
Jordan Cooper 1:35
There’s.
Julie Smith 1:37
And as we were watching the Slas and getting the reports every month that comes in, what I noticed is that I was seeing whole times of two and three minutes and you know Max wait times and and then how long it was taking to get some of those tickets even opened, right.
And we all know that our clinicians, their focus is not on calling the help desk.
It’s not on trying to resolve a problem that they’re having, it’s all about the patient care and they have more work than they usually need.
Jordan Cooper 2:09
It.
Julie Smith 2:09
And so I started thinking about how can we take that off of their plate?
Jordan Cooper 2:12
E.
Julie Smith 2:15
I’ve been looking at reduction of burden.
Overall, I think most healthcare systems have, but that was one that I really wanted to tackle and take away.
So that was really where it all started.
Jordan Cooper 2:27
Got it.
And just so our listeners are clear, these help desk tickets are with clinicians requesting support within their electronic health record, which is epic.
So there’s some kind of issue that is either requiring immediate assistance for patient care or they can’t close out an issue and they’d be waiting on the phone with the patient in the room.
UM for sometimes you said 3 minutes or somebody to get on the phone and just listen to what the issue is and it would take even longer to resolve these issues, correct?
Julie Smith 3:00
Brought.
I’ll correct one thing.
We’re not on epic.
We are on Altera sunrise throughout our enterprise, but otherwise yes and and they may may or may not be with a patient when they’re making those calls.
Jordan Cooper 3:05
Terrorist.
Turner.
Julie Smith 3:12
Sometimes it’s an education question.
They just need to know how to get past a step that they’re working on, and sometimes they might get an error.
So it does kind of just stop their workflow and it’s tracks.
Jordan Cooper 3:22
Right.
OK, so you have an issue and then you know your team comes around and says, well, there’s there’s, uh, you, you partner with Microsoft 365 and you have you’ve learned about copied studio and you have some ideas about how Gen AI could augment the internal help desk and move away from a vendor help desk.
Can you talk about the workflow with the vendor help desk and how you propose to make this a budget neutral request to leadership so that you may might be amenable to this suggestion.
Julie Smith 3:54
Would be happy to also mention the fact that you at first our first thought wasn’t.
Ohh well we have Microsoft and we can use to copilot studio.
Jordan Cooper 4:04
Umm.
Julie Smith 4:04
That would have been so much faster and easier if we had gotten to the solution that quickly, but really it was trying to find out.
Asking ourselves, having conversations.
What is the fastest way and the fastest way?
Was they just need to give you a couple of pieces of information.
How can you get a hold of me and what the problem is?
And then just keep moving and that’s where the thought of the bot came on.
Jordan Cooper 4:25
Umm.
Julie Smith 4:28
As you mentioned, we wanted to do, we needed to do a been to a budget neutral approach.
I mean, we all see that in healthcare and and have for several years.
How critical it is to manage that budget?
So I wanted to start by looking at our current vendors and did they have something that they could help us with as you mentioned, of course we have Microsoft 365 and so we took a look at what they had to offer and then we also had to understand well if our our providers are still calling a third party service desk outside of our walls then is the chat bot going to do as much good as we’d hoped and we came to the solution that it’s not we wanna bring that clinical service desk actually back in house.
Jordan Cooper 5:05
Yeah.
Julie Smith 5:19
And we can talk a little bit about that as well.
That’s in the complement to CASI.
But then we took a look at how can we build this copilot studio bot?
And we went to the vendor vendors are supposed to be our partners.
How can we do what we need to do in the most efficient manner and we were looking for somebody who could partner with us and help build the bot because we wanted to roll this out and in full from the beginning, making sure that we skipped any hiccups when we rolled this out to our clinicians.
Jordan Cooper 5:42
Well.
Got it.
And so you were able to develop CASI, this clinical application support interactive bot.
Tell me right now, how is CASI interacting with your internal help desk right now from the perspective of a clinician.
So can you walk me through an actual storyline of I’m a clinician, I’m in the patient room.
There’s some kind of issue and my patient sitting right here.
What do I do?
Julie Smith 6:23
We we have within Citrix right now, but soon and I say soon then the next week we’ll actually have a launch point directly within their EHR.
So that it is within their workflow that they can select this to launch CASI.
It already knows who they are.
So because you know, we work with Microsoft already, it says, hey, we know that this is who you are.
Jordan Cooper 6:46
Perfect.
Julie Smith 6:50
This is how we can contact you.
This is your email address.
And then it just gives them simple options.
The options are do you want to open up a ticket?
We all know physicians are busy, so we’ve also offered do you wanna open up a ticket on someone else’s behalf?
Jordan Cooper 6:58
Umm.
Julie Smith 7:04
So that office managers charge nurses, anybody who might be working with them, maybe some of their support staff could go ahead and do that for them as well.
So they could open up a ticket or they could search for additional information.
Jordan Cooper 7:15
Take a look.
Julie Smith 7:17
All they do.
OK, so let’s say I have a problem.
I’m trying to prescribe a controlled substance.
We have to go through ECS for that.
Jordan Cooper 7:28
Uh-huh.
Julie Smith 7:29
I’m getting an error and so I need to open up a ticket.
The nice thing is that caffeine knows who you are, so she already knows that you’re a physician, and so it actually gives me an option.
Do you need to open up a ticket?
Yes.
Is this for general clinical information or is this for ECS?
It’s for ECS.
Give me your contact information.
At that point, they may actually put in their office manager’s name or number.
That’s fine.
We understand again, they don’t want to be on there long and then they just let us know in a sentence or two what the problem is.
So two clicks my contact information and a sentence, and within 2030 seconds they’re back in their regular patient flow.
Jordan Cooper 8:10
Got it.
Or they could even stick their head out of the the patient exam room and say, hey, you know, office manager, nurse, whoever happens to be around, would you mind going into CASI and opening a ticket for prescribing controlled substance and then they could do it on a clinician’s behalf?
Julie Smith 8:27
Absolutely.
Jordan Cooper 8:29
It’s just of 10 second request to a colleague and they can go ahead and do it even though they don’t have the prescription authority.
They can open the request on behalf of the requesting provider.
Julie Smith 8:41
That’s right.
Now, if it’s a general, how do I use the system?
Maybe they’re newer.
They haven’t used control substance prescribing very long.
Jordan Cooper 8:46
Perfect.
Umm.
Julie Smith 8:51
CASI does have the ability to search through all of our education documents.
We have hundreds of education documents, so if she says if the doctor says, oh, I just need a little bit more information, that’s great.
What do you need information about?
He or she types in ECS and it says here’s all the information we have on ECS.
What can I help you with?
So self serve I don’t have to call somebody and wait for a call back.
Jordan Cooper 9:13
So many of our listeners listening to this episode maybe wondering I love this new technological solution.
It seems to expedite things.
It seems to solve a real problem.
It’s budget neutral because it’s replacing an external vendor call center that you’ve now gotten rid of and scaled back, and you brought some more stuff in House leadership likes it.
They’ve approved it because it is budget neutral, but the next question that a listener may come up with is can we talk about change management and provider adoption?
What is provider responses bin like?
Anecdotally, what sort of feedback have you received?
I know you’ve done a soft roll out, but maybe promotion is still on the horizon.
How have you been managing kind of adoption of CASI and have there been any pushback at all saying, hey, we’re used this other workflow, how are you, you’re changing it on us?
Has there been any any difficulties or challenges with implementing CASI?
Julie Smith 10:11
That’s a great question.
We took the approach of of really a marketing approach.
Jordan Cooper 10:16
Umm.
Julie Smith 10:16
One of the reasons why we gave her the name CASI, we’ve also for adoption used in AI avatar vendor third party.
Jordan Cooper 10:22
Umm.
Julie Smith 10:27
We just subscribed to it.
We’re we’re able to put in some some scripts, so it’s engaging.
So when we have announcements over what’s coming out new in the EHR, if we do have maybe a scheduled downtime, any kind of plans we give that to them in an engaging way that has helped.
Again, they’re busy.
Sometimes they don’t want to listen to even a one or two minute video.
Overall, they’ve accepted it because it’s a if they love it, use it.
If you don’t go ahead and call the help desk, you still have that workflow option or turn to the next person beside you.
So from a physician standpoint, we haven’t seen it big uptick in adoption, but I’ll say our soft rollout was about a month ago.
So we’re very, very new into this where we have seen a great deal of adoption is in our physician clinics.
Jordan Cooper 11:09
Umm.
Julie Smith 11:17
So the support team that they work with, as you mentioned the doctor leaning out and saying, hey, I’m having a problem call the help desk.
Jordan Cooper 11:19
So.
OK.
Umm.
Julie Smith 11:25
Those are the team members that we’re seeing a lot of it.
And today, actually this week we are taking the time to round on our nursing units.
Our nurses are busy.
They don’t see emails, you know, they’re worried about their patients.
And so we’re going out to them and when we round, we also mention it too.
Jordan Cooper 11:40
Umm.
Julie Smith 11:43
My told my team, oftentimes we’ll get a phone call as a clinical application support and sometimes we say, well, have you opened a ticket yet?
Jordan Cooper 11:46
OK.
Julie Smith 11:54
I told him from now on what I wanna hear if they say ohh I don’t have a ticket.
Say, did you tell CASI cause CASI will open up the ticket for you?
Jordan Cooper 12:02
Right. So.
There’s two things I want to follow kind of tie up this case study here.
One is, I understand that there are some metrics for measuring CASIs effectiveness that may be presented at HIMSS in the future.
Do you?
Can you tell me something about what you’re thinking about and how you will evaluate the effectiveness of CASI and how your leadership will be evaluating certain KPI that you’re collecting pertaining to this, this intervention?
Julie Smith 12:35
Yeah.
Thanks for that, Jordan.
We did just submit a proposal for HIMS 25 and you know next year down in Las Vegas and what we’re hoping to be able to give is a very robust amount of KPIs around the use of it.
Jordan Cooper 12:40
Umm.
Julie Smith 12:49
We already know that it is saving minutes every time a physician needs to open up a ticket because we specifically tracked when we had one of our providers opening up tickets.
We wanted to know specifically what was their wait times.
Everybody’s wait time is important, but of course we focused on those.
We know that the wait time has significantly decreased.
We’re continuing to do studies on that.
Jordan Cooper 13:14
Uh-huh.
Julie Smith 13:15
Corrently, when they send in the information, they tell CASI what the problem is.
Jordan Cooper 13:17
It.
The.
Julie Smith 13:21
CASI opens up a ticket.
Initially it’s going into a queue to be reviewed, but very soon our plan is that will directly go to those teams, so it’s going to directly go to the clinical team.
Jordan Cooper 13:26
Umm.
Julie Smith 13:34
It’s not just clinicians using this, it might be anyone who’s in patient access registration or in other areas so they can pick where this ticket needs to go and it doesn’t have to stop and a queue it can actually get to the person and get assigned quicker.
So those are some of the things that we’re gonna be looking at is how we can expedite the help to everybody who’s using CASI.
Jordan Cooper 13:56
So in addition to measuring the effectiveness of CASI, as I mentioned earlier, you know with the, with the kind of change management efforts, I understand that you spearheaded efforts as a primary leader for a carousel of change for EHR optimization.
That has included collaboratively working with physicians specialties to customize the platform for their specific workflows.
Can you tell me about the origins of this carousel of change and how you’ve used it in other projects and then how you brought it to bear in the cache project?
Julie Smith 14:31
Yeah, the carousel of change has been around at Baptist for several years and it’s because there is such a clamor for optimization of the EHR.
Everybody wants what they’re using optimized and So what we wanted to be able to do is to be able to focus on specialties.
Umm, you know anyone who works in the EHR realm knows that you can’t customize every document for every provider or every order set.
So what we’ve done is we’ve taken that carousel, the specialty gets to come on board, talk to us about what are the pain points, maybe what’s been underutilized, what they’re spending the most time on and then we’re able to optimize those and sprints.
Jordan Cooper 15:10
Umm.
Julie Smith 15:14
And once we have that optimized, then they get off the carousel.
Jordan Cooper 15:14
Uh-huh.
Julie Smith 15:18
We let the next specialty on the carousel, it’s their turn to go around and get optimized and then we come back around.
Jordan Cooper 15:24
And were you able to leverage the carousel of change at all with CASI?
Or is CASI the product of the Carousel of change?
What was there any interplay between the two?
Julie Smith 15:33
CASI is really more cross the entire organization, but and so I wouldn’t say it’s necessarily connected to the carousel of change.
Jordan Cooper 15:36
Umm.
Julie Smith 15:41
It’s really connected to that decreasing clinician burden, but you mentioned change control.
Jordan Cooper 15:44
Umm.
Julie Smith 15:46
So I do wanna go back to something you mentioned earlier.
We haven’t touched on which is generative AI, and I think that when it comes to AI, you know, anybody in an IT in healthcare IT is talking about AI in some way.
Jordan Cooper 15:51
Umm.
Julie Smith 16:01
Of course you need to have governance.
We do have a a steering committee when it comes to AI with CASI, we were able to take the generative AI.
Of course, we spoke with compliance, we spoke with our security team.
We made sure that there wasn’t any concerns and what she was able to generate and what we’ve done is really given our organization that first step into generative AI, but with a very restricted amount.
So we provide her the documents that she can read and she can generate information for us.
She can’t go out and search the Internet and let you know what the weather is in Orlando right now, but she can, however, tell you what the directory is.
Do you need help for biomech support?
All you have to do is ask her what’s the number for BioMed?
She’ll let you know what that is.
Jordan Cooper 16:51
Got it.
So it’s she has a limited pool of data upon which the machine learning algorithms are trained that are defined particularly specifically by the governance, compliance and security teams.
Julie Smith 17:03
That’s right.
And that’s the first step.
That’s where we are right now.
You know, I think that just talking in general, not necessarily specific to CASI or our health system, you get to stair step that in based off of governance based off of how comfortable people are.
Jordan Cooper 17:19
Problem.
Julie Smith 17:23
So you might want to start with like.
We are very distinct library of information and what we do is we upload we have two or three documents.
Anytime we have new information that needs to go out through those documents, we take that through change control, just like we should.
And it’s great because the generative AI, we can upload information.
Jordan Cooper 17:42
That’s.
Julie Smith 17:45
When is our next upgrade?
What are we doing for hospital week this week?
Jordan Cooper 17:51
Umm.
Julie Smith 17:51
Even questions such as that general information can be uploaded to her, but I could see the next step being something that might be a resource for our clinicians that they already use and letting it look at that website and I I’m kind of hesitant to to go out on a limb and say any vendors cause stitely not why I’m here.
Jordan Cooper 18:13
But.
Julie Smith 18:15
But you know, we personally use umm, you know, a vendor for education and and clinical knowledge being able to maybe the next step.
Take a look at can we allow CASI to use that website with peer reviewed information on it?
Jordan Cooper 18:30
The.
Julie Smith 18:32
That might be the next step, but we’re not there yet.
Jordan Cooper 18:35
So if you were to just looked in the future towards what could be done with Gen AI app, this healthcare beyond help desk tickets, it sounds like you might be looking for educational purposes to pull in marketing information.
Look at peer reviewed academic medical journals.
I have this particular patient and this specialty practice and I heard that there may be a study here, but is there any other clinical trial that my patient may be eligible for?
Do you know?
Are there any kind of thoughts towards a road map of an interoperability road map to pull in different kinds of data sets and give that CASI access to different kinds of data that either that may not live within the EHR?
Julie Smith 19:20
Yeah, Jordan, I I hope you will come back and ask me that a year from now because we, you know, we really are so new to rolling CASI out.
I think she has been extremely successful and those that have started using her use her everyday.
Umm I I think where we can go is I don’t wanna say limitless, but possibly I think all of those examples you gave are perfect examples of where I would love to be able to get to umm and then you know on and and and this isn’t specific to (Baptist I I don’t want it to make make it sound like it is.
Jordan Cooper 19:44
Umm.
Julie Smith 19:51
But you know what I’ve heard?
And I love this as I’m rounding in the hospital.
I have people saying, oh, this is great.
Can we get a bot or can we just put our information in CASI?
Hey, can we get a bot that we can put out HR information and so people are asking me questions and I love that.
Jordan Cooper 20:06
Umm.
Julie Smith 20:10
It’s making them think about it in a way they never have before.
Jordan Cooper 20:14
So as we approach the end of this podcast episode and you’re talking about how other people are reacting to CASI, I’d like you to speak to our listeners for one minute and just what are some of the lessons learned or what do you think is one thing they should be aware of as they consider bringing Gen AI to their clinicians and their own organizations?
What advice do you have?
Julie Smith 20:35
Oh gosh, anybody who knows me knows I can never just have one point right? Umm.
I would say make sure that you are in contact with your security team.
Your IT compliance.
Make sure that there aren’t questions that are abounding that maybe get ahead of where you are and stay on top of that, but also in encourage those questions and so we are also partnered with a vendor and one of the things I looked for in that vendor is I wanted them to teach us.
Jordan Cooper 21:00
Yeah.
Julie Smith 21:08
I didn’t want to vendor that.
I needed to attached to within, uh gosh, they need to be here and they need to support us forever.
Jordan Cooper 21:15
1st.
Julie Smith 21:16
I wanted them to say, hey, let us teach you how to do this so that you can support yourself and you can build and you can expand on your copilots.
Jordan Cooper 21:19
The.
Julie Smith 21:25
And so that was something that I would encourage as well.
The more you know is, the more you know.
Jordan Cooper 21:30
Sounds like a pathway to independence vendor who teaches you how to fish instead of giving you a fish.
Julie Smith 21:36
Exactly right.
Jordan Cooper 21:37
Alright.
Well, thank you very much.
Uh, for a listeners, this has been Julie Smith, the corporate IT director of clinical applications and support at Baptist Health Care.
Julie, thank you so much for joining us today.
Julie Smith 21:48
Thanks Jordan.
