S2E5: Innovation in Decentralized Health Systems (ft. Keith Halman, Texas Tech University System)

Keith Halman, Associate Vice Chancellor and Chief Information Officer at Texas Tech University System, discusses innovation and growth in a decentralized health system.

Transcript:

0:0:0.0 –> 0:0:7.90
Jordan Cooper
We are here today with Keith Holman, the associate Vice Chancellor and Chief Information Officer of Texas Tech University system.

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Jordan Cooper
Now, for those who don’t know, the TU system consists of five component institutions, 3 universities and Texas Tech University, Angelo State University and Midwestern State University, and two Health Sciences centers located in Lubbock and El Paso, TX, respectively.

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Jordan Cooper
Keith, thanks for joining us today.

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Halman, Keith
Glad to be here.

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Jordan Cooper
So we have three primary topics that we’re looking to cover today.

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Jordan Cooper
Like everybody else, we’d like to discuss Jen AI and what’s going on at TTU with that.

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Jordan Cooper
So it governance and investment portfolios and I’ll be talking about organizational realignment and IT service delivery models.

0:0:49.540 –> 0:0:53.130
Jordan Cooper
So with that, I’d like to open it up to you, Keith.

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Jordan Cooper
What sort of current use cases and scenarios have prompted you to develop your own Gen AI solutions and what are you looking to do with those solutions?

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Halman, Keith
So we’re really kind of at the very beginning of it.

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Jordan Cooper
But.

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Halman, Keith
Umm, we are located in the vast plains of West TX UM and so one of the initial triggers, at least from the Health Sciences side of things, was this initiative around one health that was a a big program for us for getting additional state funding and let itself do a lot of choices around where we put our our energy and developing our university system within West TX.

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Jordan Cooper
Good.

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Halman, Keith
Texas and one of the biggest drivers for that has been the fact that, you know, no secret rural communities or having a hard time getting access to healthcare.

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Halman, Keith
They go have to travel a long, long distances to do that, and we’re trying to figure out ways to better service those communities and give them access to a lot of the technology that is available to the medical industry.

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Halman, Keith
UM, you know, while you know, trying to have that balance between uh, doctor, patient interaction, uh, and the burden that it that is placed on the patients you know you have somebody who’s really sick and they have to drive in, you know an hour and a half, two hours to go see a doctor for you know or 1050 minute checkup but it can be really, really hard and expensive and burdensome to the family.

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Halman, Keith
So so we’re working on some issues around there.

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Halman, Keith
The other, the other thing is is that we have several programs under the One Health banner where we’re having this.

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Halman, Keith
Relationship between different areas of research.

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Jordan Cooper
Yeah.

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Jordan Cooper
This.

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Jordan Cooper
Yeah.

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Halman, Keith
So if you look at like our facilities up in Amarillo, TX, AH, we have, uh, a pharmacy school, a nursing school and a veterinary school all located up there on the same set of real estate with the idea behind that being that we get cross collaboration on research vectors for disease transmission.

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Halman, Keith
You can study what our transfer calls the.

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Halman, Keith
Food. Fiber.

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Halman, Keith
Health.

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Halman, Keith
Uh, link there where you know, you can kind of go all the way through a lot of aspects of our supply chain and see where possible infection infectious disease vectors are going, you know, and looking at research that can impact all aspects of that.

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Jordan Cooper
It’s.

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Halman, Keith
So uh, turning that towards an AI model, we have an initiative over in the Health Sciences center Lubbock where they are looking at employing AI models to look at standards of care and help with patient engagement, you know, so so you know, how do we get to the digital front door to get people there to talk to their clinicians?

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Jordan Cooper
I.

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Halman, Keith
And then how do we make use of that information so that we can then turn around and build better engagement models, but also get our research as to what the major healthcare concerns are within the region to build that back into where do we need to focus our energy in terms of providing services?

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Jordan Cooper
So it sounds like there are three main verticals, Keith for Gen AI at TTU.

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Jordan Cooper
One is going to be expanding the virtual care program to improve rural community access to care to would be collaboration and different healthcare disciplines on your healthcare campus up in Amarillo, and then facilitating a digital front door and improving patient engagement.

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Jordan Cooper
Would you say that’s correct and if so, would you mind delving into the into the technicalities of how this is happening?

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Jordan Cooper
You know what sort of data are they pulling in?

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Jordan Cooper
From what sort of sources?

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Jordan Cooper
How is it facilitating interoperability or building upon it?

0:5:9.370 –> 0:5:11.980
Jordan Cooper
Obviously you must have already had a virtual care program.

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Jordan Cooper
You already have research you already digital front door.

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Jordan Cooper
What in particular is AI Gen AI doing to augment your stack and your previous service lines?

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Halman, Keith
So that’s a great question and and and we’re honestly really at the very, very beginning of the generative generative AI discussion.

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Halman, Keith
UM, the, you know, people had a lot of high expectations about how easy it is to to bring this stuff to bear.

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Jordan Cooper
Umm.

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Halman, Keith
And the reality of it is, is that and we used a lot of tools to get through COVID, for example.

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Halman, Keith
And those set we kind of have our you know, we kind of had our Apollo moment and it with COVID and that we proved that hey, you can do a lot with automation and then the generative AI model started coming into the public conscious you know.

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Halman, Keith
Not long after that, right.

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Jordan Cooper
Umm.

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Halman, Keith
And so we’re we’re at really is is kind of at the very beginning because I think when you start talking bringing generative AI into the conversation, you have to realize what kind of investment you’re getting really ready to make, not only just to buy the tools, but what are you bringing to bear in terms of people, resources, your ability to train and develop these models.

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Halman, Keith
And also uh, you know, putting it putting into something, you know, that looks like a real practical investment because you can go down the rabbit hole.

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Halman, Keith
Really, really quickly.

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Halman, Keith
So.

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Halman, Keith
So for what we’re trying to do, we managed to get by with more of the traditional sources of artificial intelligence, right?

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Halman, Keith
Some of the the tools that are provided through, you know things like you know tools necessary to develop transcripts and put that into the patient record and that sort of thing.

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Halman, Keith
Uh, but really, we’re we’re we’re talking about.

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Halman, Keith
Generative AI is very, very nascent.

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Jordan Cooper
Just.

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Halman, Keith
Very, very early, the focus really is been to try to use something to uh, uh, build these datasets.

0:7:22.80 –> 0:7:35.820
Halman, Keith
But really, where the time and investment is right now is just the high level of planning that we’re having to go to to look into this because there’s not any kind of a canned solution out there that helps you get from point A to point B quickly.

0:7:35.970 –> 0:7:43.610
Jordan Cooper
So for example, if we were to make this very concrete, say you said, you know we we already have a digital front door, maybe it’s my chart.

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Jordan Cooper
Are you on epic?

0:7:50.720 –> 0:7:51.390
Jordan Cooper
OK, see you.

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Halman, Keith
Uh, we have multiple, actually multiple Mr Medical record systems that are out there, which is a little bit of a challenge for us, yeah.

0:7:53.510 –> 0:8:0.680
Jordan Cooper
So multiple EHR’s and you’re looking to improve the standard of care access and patient engagement.

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Jordan Cooper
You already have these programs.

0:8:2.690 –> 0:8:4.40
Jordan Cooper
You have some sort of idea.

0:8:4.50 –> 0:8:4.940
Jordan Cooper
Hey, Jenna.

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Jordan Cooper
Jenna I can improve access and allow us to, you know, whatever help with the virtual care, the research and the engagement.

0:8:14.100 –> 0:8:19.100
Jordan Cooper
How would you go about requesting that funding and getting approval?

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Jordan Cooper
Because like you said, it may be more expensive than what first looks appears to the eye.

0:8:25.170 –> 0:8:29.490
Jordan Cooper
You know you’re the vice Chancellor, associate vice chancellor of TTU.

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Jordan Cooper
Would you have to go to the legislature, to the governor for an appropriation to the, to the Chancellor?

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Jordan Cooper
You know you’re the CIO.

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Jordan Cooper
Do you have to?

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Jordan Cooper
Do you have a certain kind of budgetary process that you would need to go through in order to buy or build your solution?

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Jordan Cooper
How exactly?

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Jordan Cooper
What’s your kind of decision making process and and governance process for getting your institution to a place where you have a genius, an AI solution?

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Jordan Cooper
Is helping your researchers with OMOP.

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Jordan Cooper
That’s helping patients get the information they need when they need it and their caregivers as well.

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Jordan Cooper
And then helping people avoid having to make long journeys to to get care, by getting, delivering care virtually in their home.

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Halman, Keith
Uh, yeah, that’s a great question.

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Halman, Keith
So we are a university system, so each one of the agencies that we talked about, including the Health Sciences centers and El Paso and Lubbock, but all have their own chief information officers that I coordinate with.

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Jordan Cooper
Yeah.

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Halman, Keith
The initiative that I was referring to for the for the digital front door of the healthcare initiatives around that that was recently funded through some some state dollars that we got in the last Texas legislative session that just ended last year.

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Halman, Keith
And it’s a it’s a kind of a seed program.

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Halman, Keith
It’s a very, you know, everybody recognizes that this is kind of brand new.

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Halman, Keith
It’s very early on and and there’s going to be a lot of experimentation.

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Halman, Keith
That’s that’s happening there.

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Halman, Keith
So the main focus is to see if we can start with developing a standard of care there.

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Halman, Keith
And and then figure out you know what tools are gonna help facilitate that conversation, right?

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Halman, Keith
Because that part is pretty mechanical.

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Jordan Cooper
Right.

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Halman, Keith
Umm, you know a a generative AI solution may help you with chat bot or with that sort of thing, but a lot of those things are actually already kind of built into all of the tools that you can buy off the shelf.

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Halman, Keith
So really, from a strategy that’s probably the quickest way to get up and get it running.

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Jordan Cooper
It.

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Halman, Keith
And so we’re kind of looking at what it takes to get those up and solid and what that plan looks like when you have.

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Halman, Keith
Uh, a consortium of clinics out there working to to provide all these different services.

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Halman, Keith
And how do we collaborate across again all these different EMR and all different stuff?

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Halman, Keith
Umm.

0:10:59.570 –> 0:11:5.480
Jordan Cooper
So in in interest of time, I’d like to move on to the next topic that we were going to discuss today and that is it.

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Jordan Cooper
Government governments developing investment portfolios and project and portfolio management portfolios.

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Jordan Cooper
What sort of work is going on there?

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Halman, Keith
Yeah, sure.

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Halman, Keith
So this this is not the fun stuff.

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Halman, Keith
This is all the boring stuff, but unfortunately what you’ve got to do is you’ve got to get people who write the checks a good excuse to help you do some of these great things, right?

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Halman, Keith
So we’re we’re looking at a couple of different initiatives right now where we are refactoring our governance to look at changing the, the, the, the budget model that we’re working with at the system level.

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Halman, Keith
What we’ve done there is we have defined our budget based off the service portfolio that we provide and less about individual organizations that compose that right lots of times in a traditional IT budget, you say here’s the IT here’s the IT department.

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Halman, Keith
And here’s the nickels and Dimes that we’re going to give them to fund that right.

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Jordan Cooper
Umm.

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Halman, Keith
And what we decided to do is is to try to develop a conversation around what is the value of it and what are we really investing in.

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Jordan Cooper
It.

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Jordan Cooper
There’s.

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Halman, Keith
So I’ve had conversations with vendors that play in a lot of service areas that we and you know, provide IT services on and what we’re trying to do is develop our budget that kind of mimics what a lot of those vendors are doing to solve their products, right.

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Halman, Keith
So for example, if you’re using cloud ERP, they’re going to charge you by FTE.

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Halman, Keith
And since we provide services to universities and Health Sciences centers across the system, we’re changing our budget to kind of reflect something like that so that we can get kind of comparative numbers, if that makes sense.

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Halman, Keith
So people can kind of understand and plan for something that looks a lot like if they were to go out onto the market.

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Jordan Cooper
OK.

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Halman, Keith
This is what they would be having the conversation like. You know?

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Halman, Keith
So.

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Halman, Keith
So that’s a kind of a way of saying that the subscription models that a lot of our vendors are putting out there were turning around and trying to emulate that from a budgetary modeling standpoint.

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Halman, Keith
So that that a those conversations are very similar and we can create some transparency into to what it actually costs to really deliver those those services internally.

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Jordan Cooper
On the topic of IT, governance and transparency and and how you’re aligning the way you’re doing budgeting with the way that the market charges for services, I’m interested in hearing given that you have multiple Ehrs, how structurally you’re able to integrate that different data and promote interoperability?

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Jordan Cooper
Do you have a general unified data strategy that is supported by your governance structure?

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Halman, Keith
So each one of the institutions right now is making a large investment in trying to get data governance going.

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Halman, Keith
It is a real challenge, just simply because there’s a lot to do, way more than you know.

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Halman, Keith
People can really conceptualize in a given day.

0:14:9.560 –> 0:14:10.250
Halman, Keith
UM.

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Halman, Keith
And so we, we were working at at 2 levels, one for the common data set for the data that we share from our major systems.

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Halman, Keith
And then at another level, locally internally to all the various things that each institution has, because again, the the mission for each institution is slightly different and they’re going to have a slightly different tool sets.

0:14:30.380 –> 0:14:30.570
Jordan Cooper
So.

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Halman, Keith
And we’ve had a lot of discussions around, you know what, what data governance looks like having reference models as long as has been a help of Texas.

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Halman, Keith
Dir has has put out some of their kind of common reference data models, which has been nice to go.

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Jordan Cooper
It is.

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Halman, Keith
Take a look at UM and again it it’s it’s been kind of a unique situation for for how the you know how our institutions have operated because we especially on the Health Sciences centers with all of the independent clinics, they’ve all tended to operate independently.

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Halman, Keith
And for the first time now, we’re really having to make that investment and kind of creating that common language.

0:15:9.550 –> 0:15:14.250
Halman, Keith
And so it’s it’s gonna be a heavy lift again.

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Halman, Keith
We’re it’s some very nascent kind of discussions and a lot of that’s being driven by the fact that you wanna take advantage that these new and fancy tools and you’ll realize that in order to get data into these things, you got you, you kind of have to have some idea of what the common language is.

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Halman, Keith
And so it’s kind of a chicken and egg discussion.

0:15:31.250 –> 0:15:35.520
Jordan Cooper
I’d like to respond to what you just said and also segue into our third topic.

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Jordan Cooper
So the third topic is organizational realignment and IT service delivery models to help provide insight into the value of IT services.

0:15:43.750 –> 0:15:46.720
Jordan Cooper
Basically, how do you demonstrate the value of it?

0:15:47.140 –> 0:16:6.890
Jordan Cooper
The two leadership, two year to the legislature, to your funding sources in order to get the appropriate appropriation and and and secondly on the previous topic of governance, you have all these different organizations that overweight and you’re the umbrella organization over these five different organizations.

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Jordan Cooper
Each one has their own governance structure, has their own mission as you said, but now you’re trying to consolidate them and kind of align them not only in mission and governance structure, but also in the way that they’re budgeted.

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Jordan Cooper
How do you a handle any sort of pushback from those organizations?

0:16:23.870 –> 0:16:36.30
Jordan Cooper
Because every large organization has some elements that are reluctant to change and to how do you calculate the ROI and make the case for the value proposition you’re bringing?

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Halman, Keith
Well, you know and and that’s a fun topic.

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Jordan Cooper
Yeah.

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Halman, Keith
Umm, the thing about it is, is that you have to appreciate the fact that each one of those organizations has their own president.

0:16:49.890 –> 0:16:58.140
Halman, Keith
They have their own business strategy and and we’re here to help facilitate whatever they consider those business strategies to be.

0:16:58.150 –> 0:17:1.90
Halman, Keith
So one of the things about higher Ed.

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Halman, Keith
Yeah, yeah.

0:17:7.650 –> 0:17:7.990
Jordan Cooper
Umm.

0:17:2.920 –> 0:17:12.530
Halman, Keith
In general, is, as we tend to have a lot of tendrils running a lot of different directions, and so so the strategy that we have is what can we do to facilitate that?

0:17:12.540 –> 0:17:17.880
Halman, Keith
So I’m not setting the standard direction for all of them.

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Halman, Keith
What I’m trying to do is help them get where they wanna be and and so I’m trying to create that culture that way of engagement that says, hey, I’m here to help you.

0:17:32.500 –> 0:17:32.650
Jordan Cooper
Yeah.

0:17:28.380 –> 0:17:35.300
Halman, Keith
Here’s some things that we’re doing from a standard level standards level, but how does that help you get from where you need to be?

0:17:36.160 –> 0:17:36.890
Jordan Cooper
I like that.

0:17:40.120 –> 0:17:40.320
Halman, Keith
Sure.

0:17:36.900 –> 0:17:44.430
Jordan Cooper
Before we go on to the second part, I like the reflect on that for a minute and make an analogy because I feel like I see a lot of just text and culture and what you just said.

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Halman, Keith
Umm.

0:17:44.680 –> 0:17:58.500
Jordan Cooper
If we could create an analogy with the US federal government, it sounds like instead of having a strong centralized government in Washington, where Congress is running everything in the state legislatures are kind of subordinate to that.

0:17:59.200 –> 0:18:19.160
Jordan Cooper
It sounds like instead you there’s there’s the text in model of a more Federated system where each of the states or in this case each of the five entities are operating more independently in their own direction, and then the the umbrella organization isn’t so much top down as just trying to support the independent directions of each state.

0:18:19.170 –> 0:18:20.930
Jordan Cooper
Or in this case, each sub entity is.

0:18:20.940 –> 0:18:21.890
Jordan Cooper
That is that.

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Halman, Keith
That.

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Halman, Keith
Yeah, that’s that’s correct in this case.

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Halman, Keith
Uh, you know there the fun part about higher Ed is that we do a lot of things.

0:18:30.310 –> 0:18:46.830
Halman, Keith
The the crazy part when it comes to administering that is that every university system has an identity and within the state of Texas, we tend to let the let the agencies run more independently of the system office.

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Halman, Keith
Whereas if you go to other system university systems, they tend to to focus on trying to centralize more and more.

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Halman, Keith
So like if I go look at our colleagues up and say the University of Wisconsin, you see a larger service offering coming from their system office, UM, and you know, you see the one that the big, uh, Wisconsin logo. Right.

0:19:14.370 –> 0:19:20.30
Halman, Keith
Uh, that they’re they’re kind of all, all the all the institutions up there kind of tied to.

0:19:20.40 –> 0:19:30.30
Halman, Keith
Whereas is you come to Texas Tech University system and our component institutions all have a very strong identity on their own right.

0:19:30.40 –> 0:19:30.670
Halman, Keith
And so.

0:19:30.680 –> 0:19:34.330
Halman, Keith
So I tend to see us operating more on a facilitation standpoint.

0:19:35.0 –> 0:19:35.250
Jordan Cooper
Umm.

0:19:34.960 –> 0:19:35.510
Halman, Keith
Umm.

0:19:35.570 –> 0:19:37.510
Halman, Keith
In trying to help people get where they need to go.

0:19:42.360 –> 0:19:42.600
Jordan Cooper
OK.

0:19:38.240 –> 0:19:48.430
Halman, Keith
Umm, obviously standardization is something that helps everybody out, but at the same time you don’t want to compromise the mission because they’re they’re serving, you know, different areas of interest.

0:19:49.230 –> 0:20:6.700
Halman, Keith
Umm, so it’s kind of like having going back to the old 80s days where you had to kind of these conglomerates, these corporate conglomerates that we’re all doing different things, you know and and we’re we’re we have kind of the same same model of operation as those things did you know within there.

0:20:6.760 –> 0:20:15.0
Jordan Cooper
You if you wanted more collaboration between the medical school and the nursing school and the student identities in the other.

0:20:17.200 –> 0:20:27.880
Jordan Cooper
Subcomponents of TTU would would each organization be responsible for supporting their own interoperability, or is that something that would kind of come from TTU?

0:20:27.890 –> 0:20:40.440
Jordan Cooper
Would you organize taking the federal analogy again Interstate commerce, or would they take it upon themselves to exchange data between this medical school and that medical school school, this County Hospital and that County Hospital?

0:20:41.980 –> 0:20:42.470
Halman, Keith
Right.

0:20:43.340 –> 0:20:50.70
Halman, Keith
So that is is something that we are working on developing right now it’s it’s a combination of both.

0:20:50.80 –> 0:20:54.130
Halman, Keith
It’s it’s, it’s not pretty, it’s not streamlined by any stretch of the imagination.

0:20:54.720 –> 0:20:57.870
Halman, Keith
And it’s something that that we’re working on.

0:20:57.880 –> 0:20:59.800
Halman, Keith
Uh, you know, really.

0:21:0.450 –> 0:21:4.940
Halman, Keith
We we are working to raise the research profile of Texas Tech University.

0:21:8.390 –> 0:21:8.680
Jordan Cooper
Right.

0:21:4.950 –> 0:21:10.820
Halman, Keith
We got funding from the state and the terms of of tough funds.

0:21:10.830 –> 0:21:13.300
Halman, Keith
Everybody’s always heard about the permanent university fund.

0:21:13.310 –> 0:21:19.380
Halman, Keith
That’s that’s available to the University of Texas system and the Texas A&M University system.

0:21:20.110 –> 0:21:30.690
Halman, Keith
But we actually have six other universities or 6 total university systems in the state of Texas and the other university systems weren’t able to take advantage of that.

0:21:30.700 –> 0:21:34.510
Halman, Keith
So for the first time through the last legislative session, funds were set aside.

0:21:35.220 –> 0:21:38.980
Halman, Keith
Umm and Texas Tech was the the big beneficiary of that?

0:21:39.750 –> 0:21:51.290
Halman, Keith
Umm, with that, you know, being able to leverage those funds in the right locations, that has really driven a conversation about how do we do this interoperability when it comes to research.

0:21:51.760 –> 0:21:56.500
Halman, Keith
And so that’s a conversation that that I’m working on right now.

0:21:59.400 –> 0:21:59.520
Jordan Cooper
Yeah.

0:21:56.730 –> 0:22:3.140
Halman, Keith
I don’t have a good answer yet to that, but but it is something that we are working on.

0:22:3.150 –> 0:22:14.460
Halman, Keith
I think uh, you know, really, I think the trick is going to be, UM, again, going back to the value of what we’re doing, right.

0:22:14.600 –> 0:22:21.430
Halman, Keith
And the last thing a researcher wants to be told is you have to do something this way because they feel that it impinges on their creativity.

0:22:21.660 –> 0:22:21.870
Jordan Cooper
It.

0:22:26.630 –> 0:22:26.830
Jordan Cooper
But.

0:22:21.950 –> 0:22:36.210
Halman, Keith
And so one of the things that we’ve got to do is is sell the idea of there’s things that you really want to spend your time on and there’s things that you don’t want to spend your time on that are just stuff that we have to do and really make that conversation.

0:22:36.680 –> 0:22:37.250
Halman, Keith
No.

0:22:37.580 –> 0:22:38.850
Halman, Keith
Be oriented towards.

0:22:38.860 –> 0:22:45.210
Halman, Keith
Here’s how I’m enabling you to do research and A and a inexpensive as possible practical manner.

0:22:45.380 –> 0:22:53.470
Halman, Keith
So you can go focus on the important things and let us focus on some of those things that are important, but not necessarily important to the outcome that you’re looking for.

0:22:54.290 –> 0:22:54.960
Jordan Cooper
Thank you.

0:22:54.970 –> 0:23:4.460
Jordan Cooper
So for a listeners to remind you, this has been Keith Halman, Associate Vice Chancellor and Chief Information Officer of the Texas Tech University system.

0:23:4.630 –> 0:23:33.830
Jordan Cooper
Today we’ve discussed Jen AI and how it’s being used to drive expansion of virtual care to improve virtual community access, collaboration on research and improvements in patient engagement by facilitating and then enhancing their digital front door for patient care and how he’s been restructuring his IT governance in order to align with budgetary and consumption based models of payment in the commercial sector for SaaS and cloud based solutions.

0:23:33.920 –> 0:23:39.40
Jordan Cooper
And then how he’s been making the case for the value of it and approaching different governance challenges.

0:23:39.730 –> 0:23:40.630
Jordan Cooper
Uh.

0:23:40.670 –> 0:23:46.130
Jordan Cooper
Uh, that are presented in running a Federated large university system.

0:23:46.760 –> 0:23:48.940
Jordan Cooper
So Keith, I’d like to thank you very much for joining us today.

0:23:49.720 –> 0:23:50.720
Halman, Keith
Thanks for having me on.

0:23:50.730 –> 0:23:51.520
Halman, Keith
It’s great talking to you.