00:10:11 - 05:10:11
Nestor Carrillo 00:03
All right. Welcome to episode two of the risk management and patient safety podcast. This podcast is presented by Medplace. And we're excited to bring you conversations with top risk and patient safety thought leaders from organizations across the country. Please subscribe to get the latest news and content from the podcast. And if you found value in any of the episodes, feel free to share it. Also, if you're interested in participating as a guest, please send us an email and marketing and Medplace.com. Today I'm joined by Jarrod, once again CEO of Medplace. Hey Jerrod! How are you? Good, good, excited to be here and excited to cover some different topics that are top of mind. But I'll kick off with something that we've talked about last time. And I think it's a way that as an organization, we've summarized it using an acronym. Can you tell us about that? A little bit?
Jerrod Bailey 01:00
Yeah. We're in the business of connecting medical specialists that are super busy, because they're practicing specialists with organizations that need them. Right? And they need that in within very specific time constraints, they need a certain level of quality, and they have to do a bunch of really hard things in the middle, like sending information in a HIPAA compliant way. And getting on calendars with people who have very busy calendars who may be doing this as a favor. So the place that that interaction has done really, really well is actually inside hospitals. There's something that every healthcare provider has heard, and that's a Curbside Consult. And at its very basic level, it's where a doctor pulls another doctor aside in the hallway and says, “Look, I need your help”. Maybe it's a neurologist, he says, I've got this case, I'm wondering if you look at it really quick. And it's a really quick, informal way of getting some advice, so that the doctor that's providing care for the patient can move that care forward. And so that's a Curbside Consult, and it's done every single day. But, it's always done the right way. It's not always done like the most
Nestor Carrillo 02:35
up to snuff type of way.
Jerrod Bailey 02:36
There's risk involved with that, right? There can be unless you're checking a few boxes. There's kind of that thing about it, but it's so dang convenient. That's why it's used. And I think if you really look at the culture of medicine, doctors really like helping each other. And I think, in general, we as a society, like that type of interaction, right? So here, you have this thing called the Curbside Consult, that happens within the hospital. But what if that interaction could happen somewhere as convenient as that? What if it could happen at a larger scale? What if you could scale the Curbside Consult digitally? And if you could do that, if you could have that kind of ease of interaction as easy as me saying, “Hey, Dr. Nestor, can you help me with this case I'm looking at?” What could that open up?
So you imagine you take all of this, take the most brilliant radiologists in the U.S. today? And what if you could create a connection with them that seamlessly for things like peer reviews? I need a peer review from my radiologist. What if I could find another radiologist that radiologists would respect that he or she would Curbside Consult in a in a hallway? What if I could find that digitally; create that connection and make something that easy? What if you could use it for reviewing claims? What if you have like a CRP program communication resolution program, early resolution program, and you are wanting to assess your events, your harm events closer when they happen? You need to do it faster, right? But you don't want to sacrifice quality. What if you had something as convenient as a Curbside Consult to be able to make that happen? So that is at the crux of what we are really trying to design around. If there's other software vendors and software creators in the healthcare space that get this, most of them don't. Most people building software for healthcare are designing things that are complicated, right? And they create overhead and overhead. 20 clicks are more overhead than two clicks. Absolutely. And people will say, “well, it's just a click” but still, it's more overhead. When you amplify an entire interaction like that, with all this overhead, you don't get by. All of a sudden, it's not as convenient as a Curbside Consult. It's as if it becomes the thing you want to do last right day. So that means that even though I want to execute a peer review much faster for my physician than I am, I can't, because they don't have the tool to do that. And even when I tried to do it, there's so much overhead that the physician maybe outside of my organization, I'm asking to do it. It doesn't work. So how do you how do you scale a Curbside Consult digitally?
Nestor Carrillo 05:45
You're already fighting the hill of “this isn't what I'm used to”. This is a lot different from what I'm used to. I'm used to just going down the hall and talking to Dr. Garcia, whoever it may be.
Jerrod Bailey 05:59
You're inventing new behavior. And that's always a hard thing to do. Right? Technology should be so good that it is invisible to the user. And in a behavior that we're used to like calling someone on my phone, right, should be more like the design patterns that were engineering for this industry. And when you think about how much physicians are doing and how busy they are, we should absolutely be designing around that. We'll talk about some of the stuff like human centered design. But you also talk about that nurse who's managing risk, the end quality, a lot of times at her clinic, and she's an army of one, and she's got to get the stuff done. And yet she's wrestling with technology and all these other things that make it hard to find, engage the right medical expertise in order to do the thing that you need to do in order to move on with your life. So with all that said, we came up with an acronym. And the acronym you mentioned earlier: the acronym is curbside. So curbside methodology, and we're going to walk through today, the elements of that. And we're still kind of setting it up. Because it's a pretty comprehensive methodology. It's something that we built for ourselves, what we follow, we look, when we're engineering product and workflows, we're looking at all these elements of curbside to really tune in, in hone in all of the little interactions, and automations, all the other stuff that technology does to get out of the way, in order to make an interaction really simple. That's what we're going to talk about today.
Nestor Carrillo 07:43
And I think it's important to note. You touched on it a little bit that this is a framework that pretty much anyone can replicate. This is just kind of a way that we've set it up. But this isn't just proprietary to us. It's more of a kind of a collection of best practices,
Jerrod Bailey 07:58
it's a way to think about how you're interacting with medical specialty, how you're getting insights from people when you need it, and how you're making that entire exchange could work for both sides. So we're going to unpack that. I'll do inch deep today. And then over the course of this podcast, we'll probably go into these different sections. My goal is to give people tools that they can go use tomorrow, like if you're running peer review, at your hospital, and you want to know how to do external peer reviews faster. I want to give you tools to be able to do that right now. Just a little bit better than you're probably doing it. And then, over the course of the show, learn how we think about these types of things too.
Nestor Carrillo 08:43
Yeah. Sounds good. Let's dive in. So tell us about the C.
Jerrod Bailey 08:48
All right. So curbside. We didn't spell it funny. There's no Y's in there. The C is curation, classification and reading. What this means is, knowing who you've got, who you've got access to, right? You may have like your employed physicians, and all of their specialties and what they are good at. Ideally, you got their Cs. If you have all this information, you can use natural language processing and machine learning and stuff to crawl through those and figure out what everybody's good at. When you have something happen at the hospital, operationally, something occurred with a procedure, for example, all the resources you can go to internally. And ideally, you've got some semblance of that also for external physicians. If you don't have that, that's a big part of how you can speed up your process of peer review and claims.
And another thing; you might be even be interested in having physicians help advise your physicians on coding. You may have a vendor that that does coding advisements for you. But you may find out that or you may realize today that your physicians really want to hear that from another doctor. So how do you have all of your external resources known, so that you can very quickly figure out who's the right person to engage? Classification, curation. Who's good at what, what does each individual do? What do they do well? Is this person good at peer review? Is this person good at coming alongside and providing mentorship for one of your doctors is going through a claim? That would be really difficult. So you might have some external people that you'd like to use for that not internal because of politics. You may have people that you want to use for claims. If you look at all of the sub-specialties that generate more claims you're going to have in orthopedics, and you're going to have OB and your general surgery. These popular ones, who are your external doctors that have those backgrounds that you can tap on and know that they're available, maybe you've already have a contract signed with them and things like that. But how you curate them and what they're good at is important. Having a rating system. We use somebody externally, and they gave us a review, and they got a bad rating? Well, you'd better know that going into the next time you try to engage them. Do you even have a rating system to know how you did? If you're not running risk tomorrow, and somebody else two years from now is running this, do they have enough information to know that of your database of people whose good at what, and who should we call again, you should never call again?
So, the last part is enrichment and analysis. This is where I think we have the most opportunity as an industry to significantly improve our patient safety or quality systems, everything else. Let's say your physician is engaged to give me an opinion on something; I’m optimizing you for that insight. In my telling you the way I'm really looking for, beyond the medical record on other things, are you giving all of the information that you can, as pertains to this case, so they can make better decisions? My enrichment of your analysis is how I enable you to do that. Also your inherent experience in your field. Those two things together can give me great insights can probably level me up beyond what I'm doing today.
But what if I'm dealing with a case that there's known data on. This particular case, in this particular procedure is known to cause these particular issues that lead to a higher average claim than something else? I might want to know that, right? And that data is out there. There's also research on these different procedures that you as a doctor may or may not find are discovered, but that data is out there. What if that data automatically came along with your analysis? What if Medplace or some other place automatically fed that data, along with your analysis into what I’ve got? What if I had an analysis on your bias now? That's interesting now. Let's say that you've done 50 of these reviews in the past year or two? Well, what if I could record how many times you were in favor of standard of care or not? That's an interesting stat that nobody ever sees? But if that came along with your opinion, all of a sudden, I've got the calibration point for opinion. Or, what if I did blind reviews, what if I had three of you or six of you looking at the same case? I could also account for different perspectives. Would you all agree? Would you all agree on the same things, would you disagree? We want to do you have found something that the other five didn't, right? So that's an enrichment opportunity around analysis that nobody's really doing today. There's some that are doing it right. But when you use technology opens up the door to do these kinds of things. If all of a sudden a review is the easiest thing I'll do all day, well, maybe I'll get to, right. Maybe they'll do three of those for certain types of cases in certain situations, right. So, you know, between data coming in and enriching in the analysis, you already getting me being able to expand, augment your analysis to include like a larger scope, but just as fast. Those are really, really interesting things to me, as far as creating better, better systems. That's just data coming in ultimately How you are using that data and implementing is the rest of the equation.
Nestor Carrillo 15:04
Like I can see that being used by taking the insights or finding by say, this particular position, and whether he agreed with standard of care or didn't, and comparing it to say, like an association that aggregates this data as well. And matching that up and compare again, seeing how it stacks up.
Jerrod Bailey 15:20
Exactly right. The more information I can get, tell me when I've got an outlier, it's telling me when I've got something to deal with, or maybe just injecting best practices into that. Okay, you've seen this, this procedure when it went wrong in this way, here's a bunch of mitigation steps, here's a bunch of things other hospitals have done in this situation to improve their system. You imagine that right? If I'm getting a peer review done, and it comes with all of these best practices that other hospitals have done, That's really, really powerful stuff. And there, again, there's vendors that are doing pieces of this, some of them are doing large pieces of this, but this is where I think the opportunity is for us and for risk managers.
Nestor Carrillo 16:01
It's really helping to make sense of data. That's something that's talked about more and more. I think there's bigger conversations on it collecting data and collecting data and what to use it for what, what do you actually enjoy?
Jerrod Bailey 16:13
I have to have a degree in data science in order to do anything with it. Or is a data scientist working with a human centered design designer and in creating the insights that they need, at my level, to be able to consume to do something? I think that's where a lot of this opportunity is. So you'll see us over the course of this podcast, invite people in these different lanes, to talk about how they're doing these things. You know, what, what insights are they showing, and then we'll talk about how to incorporate that back into like a practical risk manager or quality practice.
Nestor Carrillo 16:48
And we can always we could probably spend an episode per letter to be honest. But that's something that we'll unpack moving forward and obviously, with guests moving forward, but is there anything else that you wanted to touch on the summary of curbside?
Jerrod Bailey 17:07
I think that's it for now. Let us know, as you're watching this and comments, and otherwise, where you have questions, or where you feel like you've implemented some of these techniques in and let us kind of feed that back to the community so that we can all learn together.
Nestor Carrillo 17:26
Right, absolutely. Great. Well, thank you for listening and for watching if you're watching and this is episode two. We'll be back and subscribe and like the episode if you found that helpful. Otherwise, see you next time. Thanks.