Healthy Data Podcast_ Vicente Resto (UTMB) & Jordan Cooper (InterSystems)-20250527_163454-Meeting Recording
May 27, 2025, 8:34PM
21m 58s
Jordan Cooper started transcription
Jordan Cooper 0:03
Resto, the chief physician executive for the faculty group practice at UTMB, the University of Texas Medical Branch and the Senior vice President for Health System ambulatory operations and surgical services. Vicente, thank you so much for joining us today.
Resto, Vicente A. 0:19
Thank you for having me, Jordan.
Jordan Cooper 0:21
So for those who don’t know, UTMB health is headquartered in Galveston, TX, and has six hospitals with 1600 beds staffed by 1000 providers.
Today, we’re going to be discussing a whole data approach of proactive care, a homegrown model and interoperability at scale.
So I’d like to kick it off Vicente, by asking you to describe your whole data approach to proactive patient care management and preventive care.
Resto, Vicente A. 0:49
Well, thanks again, Jordan.
Happy to share some of our thoughts here.
Clearly, data is rapidly becoming, you know, a fundamental piece. You know of most, you know, economic activities, but also clinical care activities, you know, in academic medical centers like ours where we have tapped into data has been starting out with really epic implementation and all the layers and.
They continue to develop.
But alongside that, UTMB has been very involved.
Than de Novo development of uh data management. Uh tools.
Uh, that help you know, interface with epic and extract information from it, as well as other sources such as, you know, some of our revenue cycle related claims data.
Sources and the like to bring in together and try to develop, you know, models not only to understand where patients are and what they have been doing, but we’re done some work internally to develop, you know, predictive models.
To help us understand what they will be doing.
Now that’s come to the forefront, perhaps more globally, as AI has come up to the forefront, because that’s the fundamental piece there.
But we’ve been doing it for some time.
Jordan Cooper 2:07
I see.
And so you’ve been developing predictive models to determine what patients are going to be doing.
Can you speak to how you’re able to develop these models?
You said that there are different data sources.
Some are homegrown.
Some are claims data, some is revenue cycle.
Are you building on top of an open source platform?
Do you have a proprietary LLM?
What are you doing right now to develop your predictive models to?
Better manage those at risk.
Patients.
Resto, Vicente A. 2:39
So UTMB has been a strong collaborator with large entities like Microsoft for a number of years as well as others such as EPIC. And through that, you know set of interfaces. We have developed small and yet ever increasing projects.
The most recent of which was a formalization of a relationship with Microsoft, where we are wholeheartedly transitioning.
The majority of our data up to the cloud.
As a way to do several things for us, it’s now a place where it’s a multifaceted and how people can interface with it. But just as important, you know when you live in a Barry Island off the Gulf of.
Mexico, America, you know, we’re kind of working on that.
The you know risk the risk of damage. You know it’s real and we have been for many years managing ourselves, you know, through backup data centers. But you know moving to the cloud.
Cloud is just really the ultimate security from that physical brick and mortar damage potential.
You know, having it there.
And really managing it through, you know, a data lake, you know, kind of functionality we’re really trying to, you know, sort of clean up the data, you know, to the degree that all of our mission areas can tap into it. Research, you know, education. But I go back.
Jordan Cooper 4:02
Mm hmm.
Resto, Vicente A. 4:04
To the premise of our discussion. Clinical care.
So we use that information you know, with regression analysis, you know type technology to help us with some predictive models more recently. You know, as I touched on, we have had a significant investments in the organization in de Novo large language model development, you know and so on.
And so forth to help us, you know, dive into.
Clinical work as much as you know, more research related work.
Jordan Cooper 4:37
You’ve mentioned your work on de Novo applications a few times.
I believe one of them is referred to as power.
It’s a home grown provider management functionality used to manage contracts where providers can model their own activities and see how it impacts compensation.
You mentioned you’ve been working on Rev cycle management as well.
Would you tell us about what’s going on with power?
Its genesis and its impact.
Resto, Vicente A. 5:06
Yes, power is very much an example of a homegrown functionality that we’ve worked now for really about 10 years. You know, with ever increasing iterations and improvements, the most recent of which is really AI powered, my power.
It’s an iteration, but that’s a system that we use for mostly faculty management. And when I mean faculty management, we track.
Contracts, yearly contracts.
Memorandum of appointments.
We call them.
We track, you know, the faculty effort, you know, assignment that we give.
Remember, we’re an academic organization with multi mission, so any one person can have a multitude of different activities and different missions.
So we track, you know, the time allocation and effort allocation each that translates further into salaries. We tend to compensate with.
Variable at risk arms to help you know.
Align activities you know with the organization S needs and all of these. As you may imagine, you know they’re very fluid, you know.
So not only does.
Power system help us track, you know the logistics, but it helps us also understand what past performance is and help each faculty member tap into their own formula and help themselves.
You know, with understanding, OK, if I vary my activity in this way.
You know, how would it affect my predicted compensation and so on and so forth?
So it’s been well received, certainly by the administrative side because it helps us organize ourselves and helps us predict, you know, in ways that you know really are fundamental for budgeting and predicting performance. But each faculty member, you know, many of them has also have also enjoyed their.
Ability to personally.
Predict and understand.
You know what their performance will translate to.
Forms of compensation.
Jordan Cooper 7:05
So I see that you’re working.
You’re leveraging power to affect provider behavior in order to maximize their compensation plan from their perspective and from your perspective, to align their efforts with organizational goals, I’d like to ask if you use power or any other tools to influence provider behavior to manage value based care espe.
With chronic disease management in order.
To better handle population health at UTMB.
Resto, Vicente A. 7:33
Absolutely. Yes, we do.
And generally speaking for that, you know we have analytics groups within our population health areas that build de Novo apps within Power BI.
Power Bi is really the fundamental engine that they utilize to then tap into the number of different databases to help you know, bring in that information and bring it to life.
You know in the back end, they’re looking at things like claims databases. They’re looking at our own epic models.
You know, at times we are able to collaborate with some of our sister institutions and the larger University of Texas system, you know, all to bring together what is happening in the market. All of that, you know, helps us frame.
Really, scorecards that are now highly edited and integrative that we can share with our frontline, you know, physicians and providers at large.
And help them align with the activities that we need them to help us deliver, such as annual Wellness visits that are so critical to capturing complexity every given year. You know, sort of.
Hccs, or comorbidity in the in the season lists.
Once again, it’s about the risk assessment that is so critical to understanding your with a baseline, you’re going to work against in value based care, oftentimes with consequent results around potential compensation pools.
For the organization, you know at large.
So yeah, I would say that we’re certainly quite data-driven there.
Jordan Cooper 9:08
So you mentioned that you collaborate with the larger UT health system.
I spoke at the beginning of this podcast about how we’re going to be discussing interoperability at scale.
You have many different data sources.
You mentioned revenue cycle, data sources, analytics, power BI, Epic and and I’m sure they’re myriad more data sources.
How does UTMB work to maximize interoperability at scale and, for example, access?
And access records outside of UTMB.
With the larger UT health system and incorporate those into patient care.
Resto, Vicente A. 9:44
Well, to be candid, I’m going to say with great difficulty and effort just to be as an answer.
But yes, we do that part to be practical.
Jordan Cooper 10:03
OK.
Resto, Vicente A. 10:04
Has enabled allow us not only to share with our sister organizations, but just our our colleagues in our market.
You know where we have the Houston metropolitan market is is quite large and populated by quite a few players. Thankfully, many of them have epic as their fundamental platform which allows care everywhere to be functional.
Jordan Cooper 10:10
Mm hmm.
Mm hmm.
Resto, Vicente A. 10:24
And and all of us understanding what a patient’s journey has been in a way that helps us, you know, promote best care around what we deliver.
But there’s certainly.
Other you know activities that we have engaged that are much more in the initial phases of of development.
And this goes back just to the fundamental philosophy that we are a very large system. When you assess all of our health related institutions, which traditionally have functioned quite independently, you know it’s most folks would define us as a loosely associated federation of independence.
But the power you know of integration is clear.
Some others in the market are clearly showing us, you know, in real life.
You know what that kind of scale can sort of help bring forth, not only in terms of power, of understanding, but importantly in ways of promoting health, you know, by unified, you know, processes and protocols of care, but also importantly to lower.
Jordan Cooper 11:30
Mm hmm.
Resto, Vicente A. 11:32
The cost of care care delivery.
So what does it take to do this?
Well, again, you have to work through politics, you know, and you have to come to alignment, but ultimately you end up in the technical piece. And I’ll give you an example.
One other things that we have been trying to promote is really a way to come together as a fluid, you know, sort of group of Confederates around, say, radiology reads.
You know, and where we can flex, you know, where we may have you know.
Short staff, or perhaps you know a long queue you know of reads waiting to be finalized that we could potentially in theory as a as a collective, we could tap into some of our colleagues.
You know, many of whom you know are also academic function and a similar set of, you know, quality sort of benchmarks and expectations. And we can sort of be more fluid there.
Why has it not happened to date?
Technology.
I mean, that’s when you have fundamental discussions about connectivity. You have foment fundamental discussions about what systems, you know, do you use to archive your images or to read?
Have your reads.
How does that, you know, particular software or platform interface where the revenue cycle piece that’s so critical to generate, you know the the payment associated with those activities. So as it turns out, you know most of us use different.
Systems and even when we don’t use different systems.
I’ll go back to Epic as a point here.
I mean, there’s no two epic deployments that oftentimes are the same.
They’re really customizations.
So we’re kind of at that stage where we’re getting over the inertia, you know, to understand what the value proposition could look like.
Jordan Cooper 13:17
Mm hmm.
Resto, Vicente A. 13:22
And some there’s some difficulty, you know, but important discussions around, OK.
How are we going to approach you know, this bringing together our technical part, our capabilities and platforms so that we kind of unify.
There and does promote then the the soft activities such as reading and the like.
And that’s that’s active, you know work going on right now.
Jordan Cooper 13:44
I like to delve deeper into that.
So you did talk about interoperability externally to U PM, UTMB?
You spoke about leveraging epic and care.
Every epics care everywhere in order to bring in Ccd’s from other institutions, particularly in the Houston area, but internally within UTMB, you also spoke about how in radiology, there’s a lot of challenges with.
Reconcile different data sources.
And clinical data archives and different reads and revenue cycle management.
So I think our listeners would love to hear more about cuz they’re facing similar challenges.
So how do you approach a strategy to unify many different data source platforms internally at UTMB?
Resto, Vicente A. 14:31
Well, just to be clear, what I was touching on prior to as you described, it’s really not an issue within utmbi.
Think we’ve done quite a good job within our our own organization and I’ll touch on you know, if that’s what you’re getting at those challenges about bringing those platforms together.
Jordan Cooper 14:38
Everything.
Thank you.
Mm hmm.
Resto, Vicente A. 14:49
I was really referring to the capabilities of really coming together and gelling as a larger University of Texas system.
You know, that’s when you essentially talk about UTMB, but you’re also talk about University of Texas Health Science Center.
Antonio University of Texas Health Science Center in Houston.
You know Andy Anderson, the University of Texas Southwestern, I mean, you’re now in each of those situations talking about very large organizations, some of them such as ours, a system with a system.
Jordan Cooper 15:08
Got it.
Mm hmm.
Resto, Vicente A. 15:17
And how is it that you bring that scale together?
That’s the part that takes an enormity of intention, you know. But you know, that has to be fueled by just some commonality of of thought.
And commonality of purpose which I think you know we’re we’re getting to much more work to be done.
Jordan Cooper 15:38
So yeah.
Resto, Vicente A. 15:39
To I’m sorry, go ahead.
Jordan Cooper 15:41
So you’re the senior vice president for health system ambulatory operations and surgical services at UTMB Health.
Obviously you have counterparts at all the other Ut’s that you mentioned across the state of Texas.
How is it that you’re able to meet the needs of your many different service lines of your ambulatory operations when you have patient cycling between those different UT sites?
Is that the challenge or what is the biggest challenge?
What is the best path towards collaboration with your peers in order to better serve patients in Texas?
Resto, Vicente A. 16:17
Well, I would say quickly. Again, the path is not always clear for sure. So I don’t know about clarity.
I go back to you know it.
It all starts with an idea.
It all starts with painting a vision of what it could look like, you know, and that’s where the problem starts, so to speak.
Jordan Cooper 16:35
Mm hmm.
Resto, Vicente A. 16:36
I think like minded individuals who bring in collaborative frameworks, you know, such as the system itself, works hard to develop amongst all of us is really the the starting point.
But in the end, you know, it’s all you know, going to come down to how is it that we can iron out, you know, some differences and importantly, understand how a collective actually will bring value not only to the collective but to each individual, you know, and that.
That’s maybe the hardest part of of how to think through some of these problems.
Jordan Cooper 17:11
That is a challenge of a Federated system.
Why should all 13 colonies join together into one United States?
We are approaching the end of this podcast episode, so I’d like to pose a final question to you.
I’d like you to speak directly to our listeners.
About one kind of if you had a magic lamp, as it were, and you could make a wish about one data challenge that you wish could just be resolved.
What would you?
What would you like to see?
What kind of biggest challenge are you facing that you’re going to try to resolve?
And and maybe additionally, if you like, what piece of advice would you give yourself a year or two ago in facing the data challenges that you that you faced back in 2023?
Resto, Vicente A. 18:06
I think you know the thing that comes to the forefront to me is security.
Cyber security is is such a real thing.
Everybody you know increasingly lives in an environment where you know a significant amount of RIT investment has to be, you know, applied in that space because.
Failing to do so and having to deal with a A a true, you know, ransomware type intervention event is is.
It’s a real problem and we’ve seen it, you know, most recently not so much in a given health system, although there’s plenty of examples of this, but really more fundamental to our system in in one of our exchanges, you know, change healthcare where it manages hours and so.
Many other claims.
I mean, they were the target of such an attack and it was crippling not only to them as a singular organization, but it had ripple effects that certainly were felt here.
In not just, you know.
Bad actors evolved their capabilities almost as fast as everybody else does.
So that that certainly, you know, keeps me up at night.
The yeah, that has to be tops for sure. What I would do today that’s different.
From, say, two years ago.
I would have to go further back.
You know, I because I’ve always been very data oriented.
Jordan Cooper 19:37
Mm hmm.
Resto, Vicente A. 19:37
I mean the other part we’re not discussing about here is I’m a surgeon, scientist by training and certainly by much of my first part of my career.
So in a way, I have learned to manage, you know, fundamentally as I do science, you know and that’s you know, with experiments, with hypotheses, with data collection with.
Data review and conclusion drawing.
Jordan Cooper 20:01
Mm hmm.
Resto, Vicente A. 20:01
And that in the business world, you know is you have a problem and then you fart, you know, an idea that you transition into a pilot and then you develop KP is, which you collect and then you analyze, and then you hardwire something network and something that didn’t.
That’s just a parallel process to research.
Jordan Cooper 20:21
Mm hmm.
Resto, Vicente A. 20:21
And so the idea that data is gonna have value and provide insight, it’s always been a part of my approach to work. And I think just the environment in our industry and and you know just really it as a whole. You know we’ve seen it just flourish in.
In such obvious ways across our lives. And then you bring it into our industry. It’s just validated in so many ways.
Maybe I would have thought, you know, move faster, you know.
Jordan Cooper 20:50
Huh.
Resto, Vicente A. 20:52
So, but there’s always layers to that.
Jordan Cooper 20:55
All right, Vicente.
Well, we’ve covered a lot of ground today. We spoke about a whole data approach, a proactive patient care management, some homegrown models of provider data management that you developed with Rev cycle management, working with interoperability at scale external to the organization. We spoke about drilling into Radiologies as.
A specific service line where there’s value in providing interoperability of data.
And then we’ve emphasized cybersecurity and made a parallel between research.
And data management and making data-driven decisions.
So I think that will resonate well with our listeners.
So, Vasant, I’d like to thank you for joining us today.
Resto, Vicente A. 21:37
Thank you, Jordan. It’s been a pleasure.
Jordan Cooper 21:39
For our listeners, this has been Vicente Resto, the SVP for health system, ambulatory operations and surgical services and the Chief physician executive for the faculty group practice at the University of Texas Medical Branch Health in Galveston, TX. Take care, Vicente.
Jordan Cooper stopped transcription
