Healthcare needs more automation, but not the kind that just robotically repeats a process over and over. That would just lead to factory medicine. Instead, what healthcare needs is deep automation that can adapt in real-time to changing circumstances and that helps to personalize the care for each individual patient. Deep automation reduces the burden on clinicians and improves the overall patient experience.
Automation in Healthcare
Healthcare IT Today had the chance to sit down with Robbie Hughes, Founder and CEO of Lumeon, makers of a care orchestration platform that transforms the patient experience and helps care teams work at top-of-license. We spoke to him about the need for automation in healthcare, especially now that we are dealing with staffing shortages.
“When I think about automation in healthcare, it’s not about the little bits that you can automate at the edges of healthcare,” said Hughes. “It’s how you think about the process of care and how do you use technology to amplify and standardize at a level of quality to address the individual needs of patients. That is the big opportunity – the choreography of care – how we make sure to deliver the right care that is specific to each patient.”
Surface vs Deep Automation
In order to deliver carefully choreographed care, Hughes firmly believes health systems need to implement deep automation rather than surface automation.
A surface automation platform would know that the procedure was scheduled for a particular date. Ten days before that date, it would send a message to the patient with instructions and next steps. Seven days before that date it would schedule that patient to come in for the necessary lab work…and so on and so on. Surface automation is a sequential set of pre-determined steps.
A deep automation platform, however, would look at the medical record and realize that the patient had already had the necessary lab work done, so it would skip that step in the process. It would then look at the patient’s information – their age, weight, other conditions, etc. and at the procedure – and based on that combination, it would know that the patient requires X or Y to be done ahead of time.
“That’s what I mean by the choreography of care,” explained Hughes. “It’s bringing all these things together and personalizing care for the patient without a person having to lift a finger. There is a significant productivity gain for staff and there is a reduction in costs because we are not ordering lab work that isn’t needed.”
Lumeon uses deep automation to streamline care.
Affect on Staff
In the past, automation was seen by many as a way to potentially reduce headcount. That is no longer the primary driver for adopting this technology. Today, every health system is feeling the strain of clinicians and staff who are overworked and questioning their future in healthcare. Automation is now a potential pressure-release valve – reducing the burden on clinicians and staff.
“If you only rely on if-this-then-that type of automation, it will be like using a map of only turn-by-turn instructions,” warned Hughes. “If you miss one of those turns you will be wildly off course. That’s the challenge with a lot of healthcare technologies. What we need is something more like Wayz or Google Maps that replans as we go. That’s the way we think about the problem.”
Watch the full interview with Hughes and learn:
- What 3 things Hughes believes have come together in a recipe for disaster
- How a healthcare organization realized an 80% productivity increase
- Why the misconception around automation is a barrier to the adoption of automation
- Why personalization is the key to better care
Lumeon Health is a supporter of Healthcare IT Today.
To learn more about Lumeon visit them at https://www.lumeon.com/
Lumeon will be at ViVE 2022, visit them at booth 422.
TRANSCRIPT
00:08 Colin Hung – Opening & Welcome
Today we’re going to discuss staffing issues in healthcare. Sitting down with me today is Robbie Hughes, Founder and CEO of Lumeon. Robbie, welcome to the program.
00:31 Robbie Hughes
Thank you Colin, it’s great to be here.
00:38 Colin Hung – What are you hearing regarding staffing challenges?
It’s the number one topic in the news and it’s certainly dominating the headlines from a healthcare perspective: staffing challenges – clinicians and support staff. As the CEO of Lumeon, what are you hearing around this issue from your clients?
00:54 Robbie Hughes
Colin, I’m lucky that I get to spend a lot of time in Europe and in the US as well. I have to say that this a universal issue. This isn’t localized to one system or one state. This is something that is affecting healthcare providers everywhere. It’s multidimensional.
On the one hand, we’ve have to be honest and acknowledge that we have been working our health teams incredibly hard over the last couple of years. They have been doing things in deeply unpleasant conditions and doing things that as a society we should be very, very grateful for. That’s one element.
The other element is that the job they are being asked to do is not just more, it’s different. It’s no longer just seeing a patient in front of them. It’s as much about trying to coordinate people who frankly don’t want to be coordinated, who don’t want to come in, who don’t want to come back in to have care delivered in the way that they are used to because they are worried or concerned.
The third part is that there is a backlog of ‘stuff’ that needs to get done that has been missed.
You put those three things together, to say nothing of the politicization of the vaccine and hesitancy, and you have a recipe for disaster that is really quite troubling for the healthcare environment.
2:15 Colin Hung – The Choreography of Care
Automation is something near and dear to your heart, given that it is something that Lumeon does. It has an impact on staffing doesn’t it Robbie?
2:25 Robbie Hughes
That’s right.
A client who has deployed Lumeon will see somewhere between a 30% to 80% reduction in costs in delivering care. That’s a massive change to what it takes to deliver what is frequently a higher standard of care because you are making sure the right things are happening, deliberately, and purposefully for every single patient.
When you look at automation more broadly, people think about it in terms of: ‘I have this thing that I want to happen 100% of the time’. There are areas in healthcare where that works very well. Revenue Cycle is a great spot where people have doubled down and focused on claims processing [with automation]. That’s a useful way of saving a lot of time and effort, but that’s not where the focus needs to be today.
The focus needs to be on making sure our staff are operating at top of license and in order to do that we need to be eliminating the burdensome, repetitive things that are getting in their way.
When you get into that problem, it gets very interesting. Yes, there are still the small repetitive bits that can be done, potentially on the documentation of follow-up side, but the biggest opportunity comes from how we think about the choreography of care.
How do we make sure that you are delivering exactly the right care for every patient and doing that on a patient specific basis. If you can do that, what you will find is that you were doing too much – delivering too much care.
So much of healthcare today is delivered remedially. In other words, we are catching up on stuff that we should have done proactively. When I think of automation in healthcare, it isn’t about those 1’s and 2’s, those small bits that you can automate at the edges, it’s how do you think of the process of care and how do you use technology to amplify that so that you are standardizing at a [higher] level of quality and personalization.
That is the real opportunity.
4:49 Colin Hung
I love how you put that – “the choreography of care”. When multiple parties are involved, you really have to get that coordination going. Is there a particular area within healthcare where automation can really make a big difference?
5:16 Robbie Hughes – Significant Productivity Gains
The 80% reduction we achieved was in ophthalmology. It was around screen for glaucoma. We’ve done primary care work. We’ve done acute work. The biggest area of focus and demand we are getting from our clients right now is elective surgeries and recovery.
There is a backlog of patients who need to come in for their operations. These operations would have been driving the revenue engine of the health system. So how do you triage that backlog? How do you prioritize? How do you make sure that your OR’s are working at full capacity?
We found that by using our orchestration platform to do this has been a hugely beneficial – particularly when you consider the utilization of the care team. When you think about the current process, it’s very repetitive. You come in , we screen them, we check for certain things, we do the H&P, we order tests, the results come back, and maybe we refer them (maybe we don’t). It’s all done serially and in a very repetitive way.
This is where there is a misconception of automation.
The job of automation here is not to make sure the same thing happens every time. We’re not talking about factory medicine here. What we are talking about is using this personalization, what we call orchestration, to say ‘hey this patient has come in before, we’ve got their labs on file’. In fact we know that the procedure they are coming in for, we’ve got enough of the labs to know that we don’t need to order more labs.
That’s great! That means we don’t have to schedule them in for a lab test. So what’s left? Now what’s left is that we need to screen out these risk factors. Here again we can look at their medical record and we can see that we’ve already got that information. So what’s left now? Well now we know for this procedure, a patient that looks like this, that has this lab data, THESE are the 3 or 4 things that we need to focus on. Two I can do digitally. One I can do with a phone call. And one I can wait until the day of the surgery which I can then do face to face.
That’s what I mean by the choreography of care. It’s bringing all these things together and personalizing it…doing all of that without a human having to lift a finger.
If you can do that, we have seen in our studies this year between a 60-80% productivity gain.
7:54 Colin Hung – Reducing Costs
That is a brilliant example. It captures what you were talking about before. You don’t have to order all those extra tests, which are burden on the providers of care, because you already have a history of those tests. You are reducing costs overall for the health system.
For the patients, if I don’t have to have that test, that’s one less thing I have to do before my surgery.
8:23 Robbie Hughes
This is where it gets really interesting.
We’ve talked about virtual care. We’ve talked about telemedicine. The challenge today isn’t switching on Zoom or Microsoft Teams and doing a consultation remotely. That’s not the interesting problem. The interesting problem is identifying whether a patient could or should be seen virtually and if in fact that’s the right thing to do.
You put all of this together and now what we are doing is weaving in virtual and physical care together seamlessly on a patient by patient basis. That’s the future of care.
It’s not just about the consultation. It’s about everything around it. We have to make sure it all happens. That’s my focus. That’s my passion. That’s what we do as a company.
9:14 Colin Hung – Deep Automation?
I read something on your blog that was saying there is a difference between something I’ll call ‘surface automation’ and something you refer to as ‘deep automation’. Can you clarify what this?
9:25 Robbie Hughes
I can’t claim credit for that term. It came from a client.
In the case of surface automation what we are talking about is something like a notification going out to a patient. We know that when a patient has a visit coming up, we are going to notify them to make sure they turn up. This thing happens and we send this specific message out. Easy-peasy. That’s what we call surface automation.
What I have described in my [earlier] story is how we are dynamically changing the process of care on a patient-by-patient basis. That’s deeply weaving in automation into the processes so that they are flexing and contracting in response to what’s actually happening in real life.
What we know about plans is that they rarely survive contact with reality. Care plans are the same. We can say to a patient, come in and do this, this, and this. And as much as we would love that to happen 100% of the time, it doesn’t.
I think part of the challenge with deploying automation in healthcare is if you rely on if-this-then-this construct it’ll be like reading a map of only turn-by-turn instructions. If you miss one of those turns you are wildly off course. That’s the challenge with a lot of healthcare technologies. We have systems that are very instructive but not dynamic.
What we need is something more like Wayz or Google Maps that replans as we go – like an air traffic control system. That’s the way we think about the problem.
11:20 Colin Hung
You are so right. A lot of surface automation says “on day 5, send this message” which is great. It’s better than having a nurse manually do that. But what if this particular patient needs to be followed up with in 2 days instead of 5 because of certain other conditions?
11:46 Robbie Hughes – Personalization is the key
First, how do we personalize this to the patient. Second, how do we personalize it to the circumstance such that when this other thing happens, whether that thing is good or bad, that we can account for that and dynamically replan.
If I describe what Lumeon is at it’s very core it’s a dynamic care planning engine. That’s what makes all of this possible. Whether it’s applied in surgery, patient rounding, discharge planning, care transitions or access – it doesn’t really matter to us these are all viable use cases. The reason why it works so well is because it can account for reality.
Unfortunately, in our industry, you can’t deploy automation if it is unable to do that because then you’ll end up with factory medicine.
We should not try to deploy technology in areas where the job of the healer is important. For us, that’s why we are focused on these executional problems. There is a lot of runway there and a lot of opportunity. I would be very nervous about going into areas where I think the bond between the provider of care and the patient is foundational.
I see my job as freeing up the care team – providers, nurses, clinicians of all types – to be able to do that. We want them to do that. That’s what they got into medicine for. Not the nonsense that distracts them.
13:20 Colin Hung – Message for healthcare CIOs
If I was a CIO sitting across from you, what you say to me or recommend that I do to start thinking about more automation in my organization?
13:32 Robbie Hughes
The first thing I would do is listen to my care team to find out where the pain is. The reality is that every health system is different. There is no such thing as a prototypical healthcare system. So the first thing to do is listen to staff. Listen to what’s happening on the ground.
One thing that we do see across the board is that there is a substantial difference between what happens on the ground and what is actually reported through the organization. When we work with our partners on the ground, a lot of what we will do is [establish] that baseline and work out what is going on.
The second step, is to be open to the idea that there is a different way of doing things. I appreciate the change is hard. I appreciate that culturally, organizations get into a rut of “this is how we do things”. I don’t think we are at a place in the evolution of this industry where we can say canonically, that this is the RIGHT WAY. I think there is a huge diversity in opinion and that creates opportunity for evolution and differentiation.
The final thing I would say is to look at data. Try to analyze what you are doing and do it from a perspective of real evidence rather than someone’s opinion. My opinion is no better than yours or anyone else’s. Everyone has a lens through which they look at problems. Just because I look at a problem and I see the solution is automation doesn’t mean I’m necessarily right.
Focus on the problem, understand what your staff are telling you, and being very clear about what you are trying to measure/improve. That will tell you the answer. If it’s anything to do with efficiency, productivity or variability…those are the key areas where we can deploy [Lumeon] effectively.
The benefits you’ll see from that are improved engagement, improved retention, and frankly joy at work from your staff.
So be robust in your analysis. Be robust in how you are thinking about automation.
15:55 Colin Hung – Exciting announcement from Lumeon?
We are heading into the conference season, are there any exciting announcements that you are planning to make?
16:12 Robbie Hughes
We’ve got some super cool stuff that is happening. We’ll be in Miami like everyone else in March. The timing of that is good. We’ve got some very interesting new capabilities coming to market that we have been working on for the past 18 months.
I think of interesting things about our business is because we are so laser focused on the problem of orchestration it exposes us to a problem set that most people don’t see. The things that we develop and the capabilities that we are investing in are not first generation optimizations. What we are investing in are industrial-strength, second and third order solutions to problems that others are going to start seeing in the market in 5-10 years time.
I’m super excited about it. These are going to be transformative for our customers and that’s what matters.
17:24 Colin – Where can people go to learn more about Lumeon?
Where can people go to find out more information about Lumeon?
17:27 Robbie Hughes
Our website is www.lumeon.com
This podcast is obviously a great source of information.
I also write things on my LinkedIn profile. I’ve got some interesting pieces we’ve put up there. We’ve got a fantastic team who are always create great content that you’ll see syndicated through our website.
17:58 Colin Hung
Robbie thank you so much for your time today. It’s been a fun conversation. Really enjoyed having you here.
18:02 Robbie Hughes
Thank you Colin. It’s been a privilege to be here. Be well.
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