Episode 14: Leading with Humanity: A CEO Conversation on the Future of Healthcare

Reliably Well brings you thoughtful conversations from those who are shaping the future of healthcare, focusing not just on the technical side of the industry, but on the human element, the stories, the struggles and triumphs of individuals who are driving change. Join us for candid discussions that highlight both the challenges and rewards of working in a field where humanity and healthcare intersect.

So we got representation all over the map here for folks that support your hospitals and are looking to get a fund. we’ve got some questions that Dr. Abraham and I are gonna walk through, but as you know, counts can go many different directions. So Dr. Abraham, can I get us started? Yeah, we promise to keep it tamed. I think first and foremost, thanks for the opportunity to partner with TLS hospitals. We don’t take it for granted.

We really do want to continue to be a good partner and not just a vendor. We’ll probably talk about that in little bit. But I’d like to hear from each of you. we’ll start with you and then kind of work stage left. But what ultimately led you to pursue a career as a hospital leader? And kind of talk a little bit about that journey. There’s probably a lot of twists and turns for all of y’all, but kind of from where you are today, how’d you get there?

It was really a leap of fate. I wish I had this grand plan that I thought of when I was a young kid and pursued it, literally was a leap of fate for me. When I say a leap of fate, I was a second year law student when I decided to make a career change. And for some reason, this thing called hospital administration. So again, this was over 30 years ago. This thing, hospital administration just popped in my head.

And I knew nothing about it. I’d been in a hospital once my entire life. That was to have my tolerances out. Yeah, we used to have to be admitted to get our tolerances out back in the day. and so I just started asking around and fortunately was put in contact with with a health system CEO in Houston, Texas at the time, who just so happened to be a former administrator in Tupelo back in the 70s. And so I placed a cold call.

to Dan Wilford is his name. And fortunately, Dan took my call. I said, Dan, this is, think I’m interested in hospital administration, but I know nothing about it. And he invited me out to Houston, Texas to meet a number of leaders in the business and serving as healthcare executives at the time and Memorial Thurman Healthcare System. Also had a chance to take a look at graduate programs as part of that process. And on my flight back from Houston,

on that trip, I said, that’s what I’m going to do. And, you know, I guess my exposure to the practice of law and during law school and clerking during the summers in between my law school years made me realize I didn’t want to be in the practice of law, but I wanted to be somewhere where I could work with people to accomplish things because I really enjoy teamwork. And it was a real good opportunity to

to do something that made a difference in people’s lives. Not just a personal career choice, but something where I could make a difference in the lives of others. So it literally was a leap of faith. So I went directly from law school into graduate school for healthcare administration, and then pursued that afterwards. it was a leap of faith, but looking back, I wouldn’t have done it differently. Kind of piggybacking on your law school comment.

When I was in high school, I actually wanted to be a lawyer, but my father had cancer and I didn’t want to go away to scold. So I decided to do a two year nursing program so that I could stay closer to home. I never really saw myself in the bedside nurse for my entire career, but I thought it could be a good starting point. And then I just gradually learned more about healthcare and continued my degrees ⁓ and operations kind of chose me.

saw the pathway that I thought I was going to be in. I really didn’t know where my career was going to go, but it’s just kind of where I ended up and I love it. So my path is a little bit different in that, like Shayna, I went to law school, but I would kind of thought I’d be in sports and maybe representing athletes and found that was not the easy path, especially right out of law school. And so I jumped into healthcare to get experience in contracts.

And where I found myself was in Nashville working for a not-for-profit Catholic, so it’s gonna be called St. Thomas Health. And what St. Thomas was doing at the time and being a kind of a young person that has never been exposed to healthcare, they were really trying to get ahead of the outpatient space. I think they formed a lot of inpatient market in Nashville outside of Vanderbilt.

And of course you have HCAs, but they’re kind of spread out and not necessarily centered in Nashville. so St. Thomas was buying up other hospitals in the middle Tennessee market, but trying to find their way into the outpatient space. And so what they put me on was trying to figure out how to go and join venture ⁓ imaging centers, surgery centers, and not only do it where they were kind of capitalizing it, but finding physician partners to do that with.

And so I cut my team doing that and found that I loved that it was a constant give and take either with physician groups or other health systems. And then also trying to figure out how to give access ⁓ in rural parts of Tennessee. And so I kind of doubled down in healthcare at that point and then moved in kind of internal behind the general counsel and started learning kind of the hospital game or the health system game. And so I…

My journey was kind of like unplanned, but once I found that I liked it, I found that the regulatory piece of it, the constant changes, the constant strategies, the curve balls that the government throws at you was fulfilling. I grew up in Hattiesburg, and so I moved my family back to Hattiesburg and took the general counsel job later and served there for 10 years until recently our CEO left.

and I was named interim CEO with really no intention of taking the permanent job. But over the course of ⁓ about nine months, there were some strategic initiatives that were going on in Havisburg that I got a chance, really was just, you know, grateful to have the chance to do that at that time and led several different initiatives that I think gave our board some confidence that ⁓ I could be the next CEO.

And so after a lot of prayer, after a lot of discussion with the board members and with my family, ⁓ I guess I need to say this upfront anyway, I’m four months in to the role at Forcell. We wanted to start with a personal question so you could get to know our leaders, ⁓ what brought them to this point. Now we’re gonna kind of bridge the gap into something as we were gonna talk,

four different categories of questions. The first set of categories of questions is we’re gonna talk about the relationship between clinician leaders and healthcare leaders. Then we’re gonna talk a little bit about how you view the future of healthcare and how our clinician teams and our alliance can support you on that journey. But one more question before we bridge to those categories is what’s one thing that… ⁓

might surprise that you could tell our clinical leaders that might surprise them about you as a leader. One thing that might surprise them about you. Let’s see, I guess two things come to mind. I played the trumpet in junior high and loved it, enjoyed it, but gave it up for sports. Regret giving that up. The second thing is I love music. Love all genres of music. But my favorite music is

the 90s grunge alternative. Who’s your favorite 90s grunge alternative? As far as I can’t pick a favorite. Dr. Crawford is that say this ⁓ when I was in my 20s I enjoyed jumping out of airplanes and skydiving ⁓ but kind of stopped that in my 30s tried to be a little bit more practical and then I would also add that I collect Megalodon teeth. ⁓

I’ve gone on a few excursions where we’ve dug for them and I have several very large shark tips.

How many air points have you jumped out of? Seven. Seven more than I had to look. Seven in the room? Yeah, would never do that. ⁓ Probably, it’s been a lifetime ago, but I was drafted by the Diamondbacks in 03 and played for about five years and traded to Pittsburgh, I think ⁓ in 06. And so it’s funny because

20 years ago, I think folks are at least around Hattiesburg. I’m gonna know that. It’s interesting, a lot of folks don’t know that now about me. The other is I have kids that are like 10 and eight, that twin 10-year-old girls and an eight-year-old boy, and they are super into sports. And so I try to coach as much as I can, but I am way more intense coaching my kids than I ever was.

And NIL wasn’t a thing as it is today back when you were playing. No, no, it was true amateur sports. Amateurism is dead. So one of the things that I think would be helpful is the healthcare environment, obviously post-COVID, is stressful for everybody. And it’s just fundamentally different in some ways. I do feel like it’d be helpful for our clinicians to understand

a challenge that you all face that might be different ⁓ to walk a mile on your shoes to where us working on Frontline, we don’t see what y’all do every day. Y’all have huge challenges, but what would be kind of a challenge that y’all as hospital leaders face today that could be surprising or give some insight to the Frontline clinician? Yeah, I can start.

What I have found surprising is that there are crazy efforts, and I don’t think this is unique to our health system, in trying to find pipelines of staff, and kind going back to kind of the COVID and post-COVID. We’ve seen locally that our nursing staff has kind of come back. In fact, had like about around 100 orientees this past apocalypse, which kind of gets us back to pre-COVID norms.

But we’re having a lot of trouble with other types of staff, mostly techs. And so we’ve developed programs with our junior colleges to kind of help supplement that staff. But it takes time to get those classes prepared or started, dividing faculty for those things. And so I didn’t realize how much time was spent, I guess, trying to figure all of that, pieces out to make sure that as a health system, you have

the team to deliver the patient care. I echo everything you’re saying. We have the same challenges and primarily the biggest challenges with entry level roles. As the market has changed, some team members go to work at Target for $17 or $18 an hour and it’s just very hard for those entry level roles. The thing that I think surprised me the most was how complicated payer contracting is.

specifically negotiating with some of the big insurance companies and trying to make sure we’re doing what’s in the best interest of our community and not backing down. And some of that requires you to get notice on contracts just so they’ll negotiate with you. And it’s almost like a game that it’s unfortunate that we have to play. So I mean, we all have very similar challenges. Jeff and I.

work with the Clavidop group. So we talk about these pretty often. But I think I understood the question is kind of thinking from our role as COO or CBO of the health system, kind of some of the greatest challenges. And for me, it’s not, I think the challenges of the role, whether you’re a CBO or COO in a health system is you have a lot of competing interests, right? lot of different constituents that

that you rely on, that you work with. ER and hospitalist group is one of many that we do. And so when we interact with a physician group like Relias, for example, we have to keep a big picture in mind. We can’t just focus on ER or hospitalist care or one single physician group. And so juggling those competing interests and priorities makes it a challenge because you all probably view that as, well,

Shane just doesn’t think we’re as important as some other group or some other department or service within the health system. It’s just that we have a lot of competing interests that we have to juggle constantly. And it’s not that one group is more important than the other or one service is more important than the other. It’s just we have to keep it in the context of our entire health care system. So I think that’s one thing that gets lost sometimes in the interaction relationships we have.

whether it’s a physician group, whether it’s a leadership group in the system or department or service. I think that that’s it. I think the other thing too is I think we don’t necessarily appreciate sometimes the magnitude of the decisions that we make. ⁓ And so if we don’t necessarily appreciate all of those all the time, you likely don’t appreciate those all the time. So it’s just the magnitude of decision making that we have every single day because

decisions you make in a system like ours, it could impact over 7,000 employees. Or it could impact an entire service that we offer. Or it could impact an entire community. If we make a change to a hospital, particularly in a smaller community, it has a ripple effect in that community. So I think the magnitude of decision making is another challenging area. With that in mind, one of the things we’re trying to fill here is common understanding between

What are the challenges you’re facing versus the challenges that they’re facing in it? ⁓ The follow up question here is, as clinical leaders in this room, you’ve got some of your lead APCs, social medical directors, directors of your different hospitals. What does an ideal physician leadership partnership with the hospital administration look like? When you take a step back and say, this is what I would like out of an ideal partnership with my condition leaders or other clinical leaders, what does that look like to you?

Yeah, I guess I’ll start and reserve and derive, maybe come back. I think being transparent and open ⁓ is a kind of foundational fundamental piece between a group and a health system. ⁓ And that seems like that’s kind of no-brainer, but I don’t know that it is and it doesn’t exist with all of our physician groups that we contract for services. ⁓ The next is accountability. And I think that ⁓

That’s a little bit tougher of challenge because ⁓ a lot of times those are hard conversations to navigate in healthcare world, whether that’s ⁓ something that the hospital system is trying to drive from a cost containment or a quality perspective that sometimes has, I guess, impact on how care is given, how medicines practice. ⁓

I just find that the foundational stuff where you can come to the table and talk has to exist. And then on top of that, you build trust and accountability. And if you can kind of later that in, and I think you can do that from day one, I’ll say. I think everybody wins. think the health system gets the services they need. think the providers get, you know,

So maybe some enjoyment in work. And then of course the patient is receiving the best care. Pretty much everything I was going to say. I think the collaboration is really important and the transparency in what whether it’s transparency about staffing issues or clinical outcomes. I think that just being able to have real conversations and not

not trying to hide things on both sides is really important. ⁓ And the trust, being able to trust that team is doing what they say they’re going to do on both sides is really important. ⁓ And then working with other ⁓ hospital-based services. ⁓ We have a great hospital-based teamwork meeting that relies on partners to participate in with our hospitalists and our critical care doctors. And it’s really helped.

create that collaboration. But just, I think just being there, providing advisement whenever we may not have all the information needed to make a decision. It’s just, but the foundation is that trust. I think trust is fundamental to that partnership and to that relationship. And it really is about a relationship. It’s not about a business objective. But I think it also starts with aligned long-term goals.

between the two partners. So, technical, lives and health system has to be aligned around long-term goals and not just what should happen next year with it and stay focused on those goals because we all have to deal with a lot of noise every single day, whether that’s noise in terms of activity, whether it’s those competing interests I mentioned earlier, but staying focused on those aligned goals and then communication. You can’t have trust without communication. ⁓

And so having that two-way communication, going back to transparency, as Jeff mentioned earlier, there shouldn’t be any secrets, right? And we all should just lay everything on the table and deal with it directly. And I think that does us to support that trusting relationship between the organizations there. And then I would also say that, you know, we talk, people throw out the concept of a win-win.

type in arrangements or transactions or contracts, that sort of thing. And I define a win-win as both parties come away feeling like, woo, that was tough. I can live with that, but I didn’t get everything I right? Because if it’s one-sided, it’s not gonna last very long. And you can’t have a relationship in a one-sided type of arrangement like that. So that’s how.

kind of my test of a win-win in a relationship. So to kind of build off of that, one of our desires is to not only develop that trust over time, but once that trust is built to capitalize on that and really collaborate to drive improvement. What is the best way for our clinical teams to communicate ideas or concerns or innovative solutions? Because we don’t need to be naive and think that we’re the first people to have thought out there, right?

And so there’s probably things that you all had been chewing on for a long time. We’re thinking about it from a different perspective, but what’s the best way to bring that to you all and your teams after that trust is built, but also to innovate, really try to drive change so that we’re not, it doesn’t fall flat. You’re like, great job guys. We talked about that six months ago, you know, but how can we, once that trust is built.

really trying to innovate in Columbia. You know, we acknowledge it takes us too long to get things done in healthcare. ⁓ And you have to deal with organizational structures and hierarchy, right? Well, what we’ve done as a system is try to get things accomplished more at or closer to the patient care level. And so several years ago, we created an initiative that we call SAS, which is an acronym for

⁓ simplify, automate, support, sustain. And so that’s was the intention around that was get at the grassroots level at the staff level, empower them to come up with ideas, solutions or opportunities that they see to address what we call hazard factors. ⁓ And so it sounds pretty basic, but if a ⁓ team member, say a nurse,

thinks about her workflows or his workflows every single day and what gets in the way of great patient care, what does not add value to their caring for a patient and give them, empower them with the opportunity to address it within their department or their area. So to get back to your question, I think

For us, the best thing is to handle it as close to the patient as possible. And so ideally with a relationship between providers and a health system, we ought to have the folks empowered at that level to work directly with the physician groups to make change happen or to get things accomplished. ⁓ I’m certainly have an open door and open to ideas and communication, but prefer that it happens as close to the patient as possible.

because that’s where the best knowledge and information and the best solutions come from. while I have an open door, I get texts in terms of ideas or thoughts and get emails. A lot of it just happens at a different place in the organization, much closer to the patient. I think a lot of things can happen closer to the patient, but sometimes there are bigger things. Or maybe there’s a topic that they’re not comfortable talking to their, their ⁓

operational partner about. And I think those situations are where ⁓ having relationships with the senior leadership team come in. And so if there’s something that is contentious between nursing and ⁓ the medical staff, that’s where I would come in to help defuse that situation. ⁓ We also have routine meetings with both groups together. And I think that is a place where some of that can happen. But sometimes it’s more on a one-on-one basis.

I can say experience ⁓ having those regular rhythms of particularly a lot of y’all’s teams. We have our monthly scorecard meetings and time for working through things together. And then I know particularly Mallory and I and others get together, various senior leadership perspective once a month just to talk about things that doesn’t necessarily be talked about among the whole team. And we’ve had very candid conversations in those rooms. That’s also an outlet where.

how do we find regular rhythms inside the work and inside and to be able to share those things. And I think if you do that over time.

I love the SAS model. That’s the first time I’ve heard that and I think it makes a lot of sense. I think trying to, we’ve had some recent successes at our hospital, our main hospital in Hattiesburg, but those successes have kind of come from clinicians, providers, and our nursing staff working together with the BLAS. One is,

Stroke calls earlier and other is length of stay discharges under a certain bitch water. But I say that I think it’s not that we’re doing anything newer in the last month or two. It’s just that some team, some freak got together and said, how can we do it better? And trying to free that space up maybe closer to patient care, I love that, is the way to do that. I think physicians and

and APCs are natural leaders in some of that thought change, that change, thought. And so I say, being able to facilitate some that or create the opportunity for that ⁓ and then give a outlet or ⁓ some mechanism to communicate that. We have great leaders in Hattiesburg and so I look at Dr. Jordan and some our other leaders that I do believe that that message can kind of get to me.

fairly easily uninhibited, but certainly like Shane, have been open to work for those types of discussions. But I’m not the clinical person, right? mean, I really want to remove barriers more than to make decisions on that. That helps us better understand the physician, ⁓ clinical leader and hospital leader type relationship. Now we get a little more specific and challenging related to where you see healthcare going.

how we can support it. I’ll be, I’ve got two questions. I’ll tell the first one, then Dr. Irwin will go, then I’ll go again. But we had the opportunity a few years ago for Shane to come visit with us. And Shane’s probably had a hundred panels since then, so you probably won’t remember this, but there was one thing you said a couple of years ago that had a big impact on us. And we were talking about the shift from inpatient services to outpatient services. And you were talking about

a percentage of your services that were delivered in the hospital or outside the hospital. And over time, how you expected even up to 70 % of your services could be delivered outside of the hospital in the future. And for a partner like us who ⁓ have 35 hospital-based physician practice partners, we’re like, okay, this is a, it’s a paradox, chef for us. So first question goes to Shane that I wanna hear everybody’s thought. Do you still believe that? And.

Where do y’all see inpatient versus outpatient migration in the teacher? I absolutely see it and the trend continues. mean, year after year after year, we continue to see the growth in the outpatient. We have growth in inpatient. The growth is certainly faster and things are shifting from inpatient to outpatient. ⁓ mean, CMS just announced a few weeks ago that

another several hundred procedures that will be removed from the inpatient only list so that they could now be done in ambulatory surgery centers. That’ll send a lot of volume outside the hospital. So I do believe that ⁓ with it. But as we look at the inpatient side of it, the volume is still there. I can’t explain why. ⁓ just sort of coming out of COVID and over the last two years, we’ve just seen

volume growth in the inpatient side as well as the outpatient, but in the inpatient side at 7 % per year, which, and we can’t explain it. So it’s continued, fortunately, but as the physicians and providers can relate, the patients are sicker than they used to be, which kind of has us, yeah, so it kind of has us thinking a little bit differently about,

services in the hospital and how we utilize our beds in the hospital. So we clearly need more critical care and step down capacity within our health care system, which of course changes the provider types you need in the hospital and that sort of thing. So that’s where we’re focused on the inpatient side is looking at how we can bring in more critical care and step down capacity into the inpatient setting, but also continuing to focus on the ambulatory or outpatient approach.

In Tuscaloosa, we’re a little behind with our primary care strategy. We are 76 primary care physicians short in our market. And so the last year I’ve been really focusing on trying to develop that. without private care doctors, the ER becomes the door for everything. But we do see higher acuity patients now than we have in the past. And we are also working on creating additional.

capacity for step down units, but I do hope that some of it slows down once we get some primary care and preventative services in place. Yeah, I’ll echo what they said, but I’ll add I think I think the way. Payers are working in let me say the way hospitals just a general or read a burst rural hospitals are going to have to figure out ways to survive and some of that may be big. Just become an emergency ring.

And some will just choose to close off. But I say that say I think our hospitals or at least our major hospitals, the catchment here is going to get bigger. And so where we may see a shift more locally to outpatient services, whether there’s access to them, I do think the bigger catch the area that is going to force more folks into ⁓ these larger hospital systems. And so we’ve seen that out of you guys have seen that but.

we’re noticing that patients are traveling further for our services. So kind of a long back line to leverage and to care for that catchment area, technology is gonna have to play some type of maybe not the primary role, what’s the thought, there’s all this artificial intelligence that feels like every week there’s a new app or a new way to do notes, there’s a new way to come through charts,

for your reimbursement or to take things to peer to peer at payer level. Where do y’all see kind of emerging technologies and how in the world do you sift through? I mean, it’s like, is this good? Is this bad? Is this reliable? Is it not? mean, it’s every week there’s a new type of AI powered technology and how do you, and that’s gonna play a role in some way, but how do you navigate that?

I’ll first start by saying that I’m not a believer that AI is going to replace a lot of individuals in healthcare, particularly providers. ⁓ so I think, but I think AI ⁓ is and can become and will become a greater supplement to what we do every single day in providing healthcare. We have a, we have a government structure to will group of folks that, some leaders and

and users have gotten together and we develop a framework for how we review and look at ⁓ AI capabilities before we bring something into the healthcare system and look at it from the empathy of supporting patient care. Is it worth the money? Can we really get the benefit out of what is advertised for using that technology?

But I’m a big believer in leveraging technology to help us gain efficiencies, productivity, to supplement in areas. I mentioned SAS earlier, that Simplify, Automate, Scale, Support, Sustain approach. So that automation was really around, we have thousands of opportunities throughout our healthcare system to convert manual processes by automating those processes, leveraging technology, which saves

a staff member time, a lot of heartache and doing things that they really don’t like to do or enjoy doing. And we could, we could get better value out of their work by repurposing them in some other areas. And so for us, a couple of examples, ⁓ we, we began virtual nursing in our Tupelo campus a couple of years ago. And so virtual nursing for the, us was intended to, to have nurses available.

remotely ⁓ and they manage the admissions and discharge process of a patient into the hospital. And so some of you may know that the admissions process takes about 30 to 40 minutes on average to complete by bedside nurse. The discharge process takes about 45 minutes on average to complete. And so we removed those processes from the bedside nurse to give back.

that time to the bedside nurse to take care of the patient. Not have to spend time tracking down items, trying to coordinate individuals, spending time going through the paperwork and the documentation on the admission and discharge process. So that’s ultimately helped us with productivity, it’s helped us on the length of stay management part of it.

is given better or it’s created greater satisfaction among the bedside nurse. Because when we started, I mean, piloted virtual nursing initially, there was a lot of thing, a little anxiety among nurses about what does this really mean? What is it going to do? And what is it going do to my job? after the pilot experience, we had every nursing unit asking us to bring virtual nursing capabilities to their unit.

The second technology that we’ve just begun to leverage, which is AI related, is ambient technology. So we piloted over the past year ambient technology in several of our clinics. So we had 38 providers in the primary care setting, as well as a few specialists who piloted the technology. So ambient technology allows for the provider during a visit with the patient.

and the provider and patient are communicating, ambient technology in the background is actually taking the clinical notes based on that conversation between the provider and the patient. So the provider has the opportunity to dedicate his time or her time to that patient, doesn’t have to go and spend time documenting into a computer. ⁓ And the product, the clinical notes as the product of that ambient technology has been great. ⁓ And so physicians, for example,

Based on a pilot, the physicians, 8 % of the notes are required as a manual editing by the physician after their review. So at 92 % of the time, effectively, they’ll capture the note and it save the physician from having to go document. We’ve had physicians tell us that it’s been life changing for them because many were having to spend actor hours.

documenting into the system based on those clinic visits after the fact. ⁓ And now those providers are saying, I no longer have to spend time after I was talking. So those are just a couple of use cases that we believe in. And you think about the applications outside of just that, where we’re using those technologies and using that service today, that’s just incredible. So we’ve taken that ambient technology from the pilot phase and now scaled it out to

200 providers across our system and we expect that to grow. We’re actually in the process of developing that governance structure that you already have specifically for AI and similar technologies. ⁓ We have a physician informatics committee that helps ⁓ spearhead ⁓ technologies, emerging technologies that really impact physician workflow. ⁓ And our goal is

within probably nine months to have something that integrates with our EMR. Our ER physicians are piloting some of this technology, but it is not directly integrated with the EMR currently. So we really want to get to something that is seamless for everybody. We have ⁓ started using, ⁓ I think it’s like a few clinics with bringing more primary care clinics on that, AMDN. I think we call it DAG, some other similar products.

It just, I think helps with one relationship with patient and being able to deal with patient. But one of the other ones that we’ve been talking about and we’re trying to trial, I’m not saying this, I’m not really sure we will get the trial, is a kind of a cop step monitor on the floors where the nurse doesn’t have to come wake you up to take vitals. And the fault behind that would be patients don’t have get woken up during the night and nurses have time to do other tasks.

So that would be one that I’m excited about. We don’t have a, well, we do have a process, we’re kind of like you. We’re still developing that. But my hope is that we see where AI kind of fills in gaps and shortages, particularly radiology right now is one specialty area that’s just hit hard. And I’d love to see, and I think we use some AI products, but I’d love to see, you know, enhancements there because of the shortage.

that really gets at the heart of patient care. Not only that, but where we’re finding that just we’re at the cost limit, there’s diagnosis that we’re looking at something and finding other things because AI’s able to spot it, it’s just in normal radioswitch. That’s kind of the whole path.

I think that will be music to a lot of our providers in the room to hear is on the radiology side for sure. But I think we appreciate the. Like can it be? We process our revenue cycle side of implementing a technology that will help with our denial appeals. It reads the record and actually formulates the appeal to the insurance company for us. And so that is an area that.

we’re hoping to see some improvement with as well. That’s great. I’ve got one more tactical question and then at some point here we may open up for, if you have questions out there in the of the audience. So looking through the future, we talked about inpatient, outpatient, talking about technology. I want to ask one question about capacity. I work with each one of your systems and one of the challenges is always, we thought

A lot of the stuff’s gonna migrate outside of hospital. Shane’s saying, 7 % year-over-year growth. I to pick on somebody, but this morning I got a message from our ER shift group. There’s 38 holds in the force general ER. Y’all deal with holds in your ERs and inpatient capacity issues. How are y’all thinking about the capacity challenges in your hospitals? You know, creative challenges, structural challenges, and what would you like our team to know about that?

I’ll start with this one. ⁓ It is something we talk about every day and we have been rounding constantly and knocking on doors trying to see who’s in different spaces. ⁓ They sometimes people just inhabit areas that were never really assigned to them and ⁓ we’ve we’re on a pathway I think for 16 additional beds that we recoup just by evaluating spaces and figuring out how to effectively use them.

Our P’s unit is also not, you know, doesn’t typically reach a high capacity. So we’re evaluating if we can take some of those beds for overflow. But our goal going into the busy season is to try to reduce as many holds as we can in the ER. Yeah, I would say our system, number one and number two priority is creating capacity in the hospital. And I think where we get back to up is we’re finding that we’re at 90, 95 percent.

of capacity on our floors. And so there’s just nowhere to put patients when they come in the ED and disposition. And so we’ve got to figure out how to do that. And we like, you’re kind of going around the building and finding where we have space and there’s not much there. And so what are our opportunities for us to do that? I say that to also go, I shared kind of a win from us, from our hospital where we saw, think 7,000 patients, which is a record for the monitor.

in August. ⁓ But we also had a very low ⁓ length of stay to discharge. And so our teams, your teams and our nursing staff are finding ways to like figure it out, be creative, but we’ve got to like release the valve at some point. So that’s probably for us. There are a lot of triggers or levers you have to pull to to improve capacity with it. But first of all,

I apologize for patients vetting in the ER. ⁓ Unfortunately, it’s ⁓ a fact of life that we’ve had to deal with for far too often. And, you know, we’re not short on physical space, facility space for it. We’re short on staffing. And that continues to be the rate-limiting step for us in terms of opening up more more capacity.

We’re relying, still relying on contract agency staff in a number of areas with it. And so ⁓ we continue to work on that pipeline of future staff, bringing more staff so that we can’t open up beds. In the meantime, we’re also looking at some ways that we could better utilize our space that would open up ⁓ more, give us an opportunity to open up more beds, assuming that we can staff those ⁓ in Tupelo.

specifically with it. But we’re doing everything from every day around capacity management that I’m sure Jeff and Mallory are dealing with at DCH and Forest General. ⁓ But that virtual nursing as an example is one of the tools that help us with managing that length of stay. And so the sooner we can get patients discharged ⁓ in terms of time of day as well as number of days they stay in the hospital.

That’s the best capacity generator that we have is managing on the stay and better using capacity that we already have today. And so for example, in Tupelo, we decreased average length of stay over the past year by ⁓ I think 2 tenths of a day. That may not sound like a lot, but you translate that over the volume of patients. And that’s thousands of days of available capacity that we have in our healthcare system.

So those increments of time, say per discharge, matters a lot in terms of generating capacity. There’s a lot more questions, but we don’t have time for all the questions that we could have. ⁓ The thing that we want y’all to know is one, we’re appreciative of partnership. I think everybody in here wants to be a partner with you all and not just a vendor. We certainly recognize that we want partner with the work that you’re doing.

And thank you for your vulnerability and learning that we have a professional baseball player, Scott Aber, and the music buff on our hands as well, because y’all are people as well as the roles that you have. So thanks for being with us. And if not, give me a round of applause.

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