Tressa Springmann CIO LifeBridge on Building a Virtual Hospital

This Week in Health IT Tressa Springmann
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Continuing our series of discussion from CHIME/HIMSS 2019 we hear from Tressa Springmann where we discuss the opportunity to transform the call center into a virtual hospital.

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Bill Russell:                   00:11                Welcome to this week in health it where we discuss the news information and emerging thought with leaders from across the healthcare industry. This is Bill Russell, recovering healthcare CIO and creator of this week in health it a set of podcasts and videos dedicated to training the next generation of health it leaders. This podcast is brought to you by health lyrics, helping you build agile, efficient and effective health it. Let’s talk visit Health to schedule your free consultation. We were recording a series of discussions with industry influencers at the Chime Himss 2019 conference. Here’s another of these great conversations. Hope you enjoy.

Bill Russell:                   00:47                All right. I’m going to have you introduce yourself because you know we talked about this on the last podcast is people spell your name wrong and say your name wrong, so I want to make sure I don’t do it wrong. So if you could introduce yourself.

Tressa Springma:           00:58                Great. Hi everybody. I’m Tressa Springman. I’m the senior vice president and CIO at lifebridge health in Maryland,

Bill Russell:                   01:07                so it is Tressa.

Tressa Springma:           01:11                Got It. It’s the word assert backwards. Oh really? Although I don’t think that was intentional. It was also my great grandmother’s name.

Bill Russell:                   01:18                Oh, there you go. My, uh, my son is dating a girl named tess and she makes it clear it’s not Tessa. Is that,, what is it short for contes? No it’s Tess I’m like, I don’t know. I mean, when you name a kid, you got to really think through what’s, what’s the ramifications or the emails going to be misspelled for the rest of their life.

Tressa Springma:           01:39                Oh, I went by a nickname teddy for 18 years because I didn’t want to deal with trasha Teresa Teresa. So yeah.

Bill Russell:                   01:46                And now you figure as a CIO, they should at least figure out and learned her name

Tressa Springma:           01:50                for sure. Although you’ll see my last name spelled wrong all the time. It’s two x two ends. Got It. Yup.

Bill Russell:                   01:57                All right, so enough about your name. Uh, we’re here at the, uh, chime conference. I, uh, you know where I want to start. I want to start at the last chime conference where you presented on your digital hospital. Great. Um, give us, actually just give us the like two minutes of what you guys are doing around the digital hospital.

Tressa Springma:           02:15                Great. Well, I’m sure you’re hurting quite a bit about virtual care. Right. And in Maryland under a global budget, we’re really being encouraged to make sure that, um, our sites of care or the most clinically effective at the lowest cost point. So that’s really created a huge catalyst for telehealth.

Bill Russell:                   02:35                Yeah. Because there’s a different, uh, mechanism done by the state of Maryland in terms of your reimbursement.

Tressa Springma:           02:41                That’s correct. We have a waiver for Medicare and are under this global budget, which really encourages us to make sure that we’re keeping the growth in the total cost of care beneath the rest of the nation.

Bill Russell:                   02:52                So it caused you to step back and say, we need to be innovative here. And so what’d you guys end up doing?

Tressa Springma:           02:57                That’s right. Well, aside from making in a lot of non hospital components of the healthcare delivery system, um, we now are putting technology in place in the form of this virtual hospital to help us really facilitate those transitions of care that in other care settings where it’s still reimbursed through volume, um, you see those silos in the episodes. You know, you, you come into a doctor’s office or you leave the hospital and that’s the end of your interaction at lifebridge with the virtual hospital, um, driven by telehealth and then a digital platform and technology as well as CRM. Um, we are creating digital touch points when our patients, before our patients come after they leave and are really using it to encourage in referral activity.

Bill Russell:                   03:48                So texts emails, those kinds of video chat. Okay. Yep. And is this initiated by, so your, your virtual, uh, I keep calling it different things.

Tressa Springma:           03:59                That’s ok virtual hospital, That’s what we call it.

Bill Russell:                   04:01                virtual hospital. Um, is that primarily staffed by uh, non-clinicians? It’s more a care navigator.

Tressa Springma:           04:11                So when we started out, we had a traditional contact center that did appointment scheduling and we started bringing on board clinicians, um, largely mid level, um, or emts actually. And you know, lifebridge one of our core facilities, Sinai hospital is of Jewish tradition. So our virtual hospital has, um, US privileged mid levels and nurses that went home to Israel. And so now for a much more cost competitive footprint, we have American clinicians, um, fulfilling this role in our virtual hospital. So it combined at one point so that it was not just the administrative getting that appointment scheduled, but if while Scheduling that appointment, it’s clear you have a patient in crisis, the turfs right on over to the clinical agents, who then attend to the patient in that way.

Bill Russell:                   05:06                This is interesting. I mean the reason this is interesting to me is because I ended up talking to a lot of clients who have five, six call centers. And so if you have that kind of, first of all, if you have that kind of footprint of five six call center, you probably has some dysfunction and whatever, just lines of communication. But this could be a path where they go, hey, we have these five or six call centers and we bring it in. But there’s an awful lot. I would imagine there’s a lot of workflow work. There’s a lot of

Tressa Springma:           05:32                tremendous process was, and that’s where it starts moving traditional healthcare it into other industries. That’s where, um, contact center software. So that these agents, we have agents in the Philippines as well, so that they have a very, uh, just like an agent at Amazon. They have a very prescribed approach to how they are to handle a patient, or a consumer who’s inquiring. And those are just scripts that are built in the contact center software. And then CRM. We have, um, Evariant which is a form of salesforce.

Bill Russell:                   06:09                Sits on top of Salesforce. Right.

Tressa Springma:           06:10                Yeah. And, and that helps us make sure that if we’ve already had a touch with you, either a physical touch or a digital touch that we know about it and we can use that to continue that relationship we have with you. Um, and then it’s all wrapped around, uh, you know, telehealth and then just traditional workflows. And of course we’re integrating these different tools with our EMR because obviously that’s essential to the provision of care. Right.

Bill Russell:                   06:35                So your um, your, your virtual hospital, how many screens do they have? That’s one of the things we see in these call centers. Sure. Know. 10 15 screens.

Tressa Springma:           06:45                Well, so my CMIO is also the medical director of our virtual hospital. And when he joined me, his passion was telehealth and virtual care. So we brought his interest and his talent together and use that as a launch point for our clinical and administrative contact center to move into this idea of a virtual hospital. Um, you know, we do hundreds a week now, a virtual ed teller triage. So you walk into one of our ers and within five minutes you’re getting a video visit by an er, mid level. So you’ve seen a clinician and the orders are entered. Um, the meds might be prescribed before you even actually physically see the care provider. So it’s, it’s really helped, um, create not only better care, but also, um, it’s, it’s, it’s really helped us to start leverage technology like other industries have.

Bill Russell:                   07:44                So you just listen to this session on machine learning and AI and it was out there. I mean, it’s, it’s big. Yeah. Um, and I think people assume that, I mean, I’ve talked to some people who were saying, hey, you know what, uh, what are health systems doing with machine learning and AI, the, the real answer to that is it’s been implemented in a lot of different areas, but it’s still kind of daunting. I mean, how do you, when you walk out of a session like that, um, I’m, I’m curious how other CIOs feel when they walk out. Like, oh gosh, this is too big to even start, or is, it’s like, okay, I’m going to break this down for my team. How do you, what do you walk out?

Tressa Springma:           08:23                It’s funny because at the end of that session, I, I turned to doug who’s an old friend of mine, Doug Abel. And I said, wow, it was, if we all have enough going on, I better get up to speed. But, you know, um, and I’m, I’m a junkie when it comes to reading things and Harvard Business Review, I think it was in January of this year, they did a fantastic summary piece dissecting the basics of AI and the different levels of maturity. And, um, it really helped give me confidence that yes, it’s a tremendous opportunity, but we need to go crazy just yet. You know, we’re used to business process automation and that’s the first level of Ai, like Scripts keyboard emulation, that’s first level Ai. Yep. So that’s the things that we’re doing very well. Um, the next layer, we at lifebridge have a tool that sits on top of our EMR called the Rothman index and it gathers all these tidbits from the Emr and it alerts our physicians when there’s a patient who’s decompensating that maybe doesn’t physically look like they’re going south, but their EMR and lab values, et Cetera, are suggesting that they’re going south.

Tressa Springma:           09:35                Um, again, these are predictive, you know, I think that, um, if we step away from just the practical yeah. Reality, that there’s so much information out there and that our ability to really have the right information at the right time, so the right decision, um, it’s just overwhelming. Think of the burden that is, that brings to our care providers. And then start thinking about how to use the ability for AI and machine learning to have access to all of that very quickly, merely to offer up to your care providers. What’s the right decision to make and allow them to still make that decision but have it be a fully informed decision where they don’t have the burden of having to read 90 hours a weekend just to keep up with it. So look, I think there are vast opportunities. We’ve all seen it though with even the self driving car. It’s been talked about for a long time.

Bill Russell:                   10:29                It hit that peak now it’s coming down a little bit.

Tressa Springma:           10:31                That’s right. It’s coming down. It’ll get there. I think it will gap there. Um, it would be great. It’s the majority of the time in our life we’re all about things with intention and choice. Um, I don’t know if it’s going to be in our near future, but it’s exciting.

Bill Russell:                   10:46                Yeah, it is exciting. So this conference, this conference is huge. 45,000 people, a million vendors and whatnot, education sessions. Um, I assume you come with a plan,

Tressa Springma:           10:58                I have a plan,

Bill Russell:                   11:00                is the plan around making sure you look at certain technologies, certain, I mean, what kind of plane do you have?

Tressa Springma:           11:06                Sure. Um, well first of all, the CIO forum is huge, right? Really being able to touch base and see if, um, my peers are feeling what I’m feeling, seeing what I’m seeing, reacting in the same way, have a tip or two with something I’m struggling with. Then I absolutely spend the majority of the next day. Tomorrow I’ll be walking the floor. I walked from zero to 9,000. Sometimes. Sometimes I put on a pair of tennis shoes and uh, you know, usually people are pretty kind to me, but you know, I’m really looking for a couple of things. I’m looking for new entrance, I’m looking for trends because you see them on the floor. And then I’m looking to hunt down specific vendors that I have a conversation in need of. And then of course the, the rest of the time is, is really, um, connecting with peers that I haven’t seen.

Tressa Springma:           11:59                Um, I have a couple of contracts I need to close. Um, and a few different. Um, I would say one fantastic thing about himss is that as a CIO, usually there are about five to 10 vendors that you’ve been curious about, but your schedule just can’t accommodate it. And you know, when you commit your time and you’re bringing them to your organization with all their resources, excuse me. Um, at least I can feel better about coming here and learning a little bit more than asking them to commit all those resources when in fact we might not have anything that’s even close fit. So I usually take some opportunity to do that. So I have about six or seven very specific vendors where, um, I need to become a little bit better educated.

Bill Russell:                   12:48                And so do you bring team members to sorta get them, bring them along?

Tressa Springma:           12:51                I try to, I have a couple folks here this year. I, um, we, we had a big go live last week and we’re in the middle of a big due diligence. Um,

Bill Russell:                   13:00                there’s always something, there’s always something,

Tressa Springma:           13:03                right? I, uh, I’m most excited, or am I a, I’m responsible for him as well. And we have an him analyst and she’s fantastic, but she’s young and bright eyed and bushy tailed and has never been to himss. And I’m, I’m trying to make sure I can hunt her down so that like by the end of day one, her head isn’t just spinning.

Bill Russell:                   13:24                It’s like, Hey, this is a lot bigger than we think. Uh, the, uh, I had two very young, they don’t like to be called this, but millennials who came to himss one year and I said to him like, look, when you come back, you have to do a presentation. They’re right. And they did videos just like this and came back and they’re like, hey, we talked to this vendor, this vendor, this vendor. And then they just such a great job actually some of that sort of inspiration for these conversations. So, um, yeah. The, so are you hearing anything from your peers that has sort of surprise you or interesting in terms of trends or are things that people are saying?

Tressa Springma:           14:05                No, not really. I mean I’m, I have my ear to the ground on the announcements by CMS and onc. I think they will obviously be very informing as, you know, when budgets are tight, you always start with, all right, what’s on the list of it’s regulatory in nature. So that’ll definitely have some info.

Bill Russell:                   14:23                The two things I’m hearing so far and I’m purposefully getting in front of people and having these conversations, uh, one is around social determinants. It’s like, Yup. Um, okay, it’s getting to a point now where we have to figure out something. We don’t know what we’re gonna do yet. Yeah. I mean, some are further along than others, but they’re like, all right, we gotta got to figure out how we’re gonna get this data together. And then the other is around the consumer digital experience. Although your virtual, there’s somewhat that, but um, people are saying, yeah, it’s more than a phone. It’s more than, you know, it’s, uh, you know, how are we going to interact with these people? How are we going to break that? Like this morning stock, how are we going to break down those silos of loneliness? And isolation and whatnot. So those have been two of the things that are, I think are interesting. People are looking at technologies to say, how do we move care out of our facilities, which will be an interesting financial challenge.

Tressa Springma:           15:16                Well, so we’re definitely doing that because we’re incented to do that. Right? Yeah. So I dunno, it’ll be interesting to see. But you’re right. I mean I think we’re really on point for digital and consumerism, I’m feeling very comfortable about that. We have a long way to go. Um, but I think we’re

Bill Russell:                   15:32                you don’t want your team to feel too confident at this point. That’s right. They’ve got a lot of work to do, right? That’s right. Well, the good news is there’s a lot of neat work being done down here. I mean, with epic breaking apart their Api Apis and an APP, orchard, whatnot, you’re seeing some creative solutions and that’s where I think you guys collaborating and talking about what you can bring to market is

Tressa Springma:           15:50                I say, you know, there’s a whole generation that grew up without watches because apple invented the smart phone. And wouldn’t it just be up to apple to reintroduce a watch and now you know all all these folks want watches. Again, it’s the same when we started in the industry, we were doing native development. I worked for eds, I was a systems engineer, right, and now we went to vendor off the shelf and amrs largely are becoming a utility play and we’re going to innovate around. The edge is doing development. Again, it comes back together.

Bill Russell:                   16:21                Tricia, thank you. Always appreciate the time. Thank you. Appreciate it.

Bill Russell:                   16:25                I hope you enjoyed this conversation. The shows a production of this week in health it for more great content. You can check out our website at or the youtube channel thanks for listening. That’s all for now.


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