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OR Manager Webinar: Using Mobile Technology to Improve Community Engagement Webinar Transcript


ELLEN LORD: Good morning, good afternoon to our listening audience. My name is Ellen Lord. And I am the OR Manager webinar coordinator. Welcome to you all this morning. We are going to be having our presenters in a minute. Just a few things to get started while everybody signs on, in case there is any difficulty with slides advancing, there is sometimes a delay between slides advancing and our audio portion of our webinar. Please understand if you have any volume problems, please check the volume on your computer so that you can be able to hear the audio portion of our program. 


This morning we are pleased to present a presentation sponsored by LeanTaaS using mobile technology to improve community surgeon engagement. We have two very excellent speakers this morning that we’ll be presenting on this subject. Our first speaker is Ashley Walsh. Ashley is a Senior. Financial Analyst and former. Perioperative Business Manager at UCHealth. Metro Denver campus. She obtained her bachelor’s degree in health science from Truman State University in Kirksville, Missouri. And her master’s in health administration from Maryville State Univeristy St. Lewis. Ashley has been with UCHealth since February of 2009. 


Her responsibilities include capital and operational budget maintenance, patient billing, utilization reporting, expansion planning, and perioperative supply chain management. She is Lean trained and participates in regular process improvement initiatives across UCHealth. 


Our second speaker today is Ryan DeGraff. He is the current. Senior Director of Perioperative. Services at UCHealth in Fort Collins,. Colorado, and has spent the last 10 years driving operational performance and health care. He has been with. UCHealth since 2014 and has played a critical role in improving its perioperative department. 


Previous to UCHealth, he spent five years at intermountain health care. Ryan obtained his bachelor’s degree from Brigham Young. University, and then continued on to get his master’s in health administration from the University of Minnesota in 2013. At this time, I would like to turn the program over to Ashley. 


ASHLEY WALSH: Thank you so much. And thank you all of you on the phone and for joining us this morning. We’re really excited to get an opportunity to share some successes we have had at UCHealth with you in getting our physicians engaged. I hope that my colleague. Ryan was able to join. Ryan was having a little bit of trouble logging on. But, Ryan, are you on now? 


RYAN DEGRAFF: I am on, yeah. 


ASHLEY WALSH: Great. Thank you so much. Sorry, everyone. OK. So today, let’s just go through our agenda. So we really want to start off by sharing with you our experiences and what community physicians really care about, especially in our preoperative environments. The ways that we really worked on getting our physicians engaged and the elements of engagement with them. And then most exciting, we are looking forward to sharing with you how we were able to introduce mobile technology into our perioperative process to really engage our community physicians, especially those physicians that we don’t get the fortunate pleasure of seeing all the time and that split their time. 


And we know their time is precious, but how we were able to really engage with them more and get them more involved in the preoperative process and process improvement at our campuses. So just a little bit more about UCHealth. UCHealth is a large health system in Colorado. My background was the preoperative business manager at the Metro Denver Campus. So right there in the center of your screen, that’s where I started off with UCHealth. And at my campus, we had about 38 operating rooms, both inpatient outpatient. Have grown rapidly in the 8 and 1/2 years that I was there. About six to 12% year over year in perioperative performance specifically. And have grown in operating room sizes as well. So very busy up and growing academic community. 


In 2012, we joined with northern Colorado where my colleague. Ryan works and became a system of UCHealth. Shortly after in. October of 2012, we joined with southern. Colorado, the Memorial Health System. So in total UCHealth is currently five soon to be seven hospitals. All of which are community hospitals except one. So love it Ryan if you would share with us a little bit about northern Colorado and the size of your area. 


RYAN DEGRAFF: Absolutely. So I right now cover as Senior Director. I cover a perioperative services for the north region. Now, the northern and southern regions are made up of community-based, community-focused hospitals, still part of, as. Ashley mentioned, a larger academic system. In northern Colorado, we have. Medical Center of the Rockies. At Medical Center of the. Rockies, we have eight ORs. And we have a surgery center that has four ORs. And we are in the process of building two additional ORs with the capacity to expand into four additional ORs. Poudre Valley Hospital, again a community-based hospital, has 13 ORs. And we also have a surgery center in Greeley, about 50 miles east of us. And we have two. ORs there as well. 


So it’s a unique environment and that we are part of a larger academic system but we are, as Ashley said, very community-focused, community-based hospitals. In northern Colorado, what’s unique is we have a really healthy mix of independent and employed providers, where 50% are employed and 50% are independent. Up to this point in time, we have really– I would say, up to a year ago, a year or two ago– we’ve really had a monopoly on health care market in northern Colorado. 


And then you started to see competition trickle in, Banner partnering with Kaiser, and other organizations. So that’s a challenge that we have been working with, is trying to find ways to engage our physicians, and especially now that they do have options. So again, it’s a tricky thing to navigate but we are in the process of figuring that out. And I’m excited to be doing it. 


ASHLEY WALSH: Right. And you see on the screen, we get about 66,000 surgical procedures in calendar year 2016. Calendar year 2017, it’s pushing upwards of 80,000. About 45% of those are done at the medical campus, in the academic campus in Metro Denver. But, Ryan, about how many procedures are you on track to complete this year in northern Colorado? I believe upwards of 25 or 30 or 28? 


RYAN DEGRAFF: Yep, upwards of 29, around 29,000 in northern Colorado. 


ASHLEY WALSH: Excellent. Great. So one more thing to note before we move on. Our providers don’t float across our facilities within the system. So they’re very localized for each region. So the providers that. I work more closely with in Metro Denver they stay in the Metro Denver region. For Ryan’s area in northern Colorado, they do flow between. Medical Center of the Rockies, Poudre Valley, and his ambulatory surgery centers. But they don’t come down to Metro Denver. 


So while a system and while we collaborate together, our providers are quite independent. And so we really lean on each other for how to continue to keep them engaged,. What’s worked in the academic setting doesn’t always work in the community setting. So Ryan, share with us a little bit about what you’ve noticed your physicians really care about in the perioperative environment and that you feel helps to kind of bring them back in and stay bringing their patients and their procedures to your location. 


RYAN DEGRAFF: Sure. I think really what it’s coming– we’ve changed our approach over the past two years. And again, that gets back to the fact that we now do have local competition. So with a change in approach, we’ve done a few things. I think the first thing in terms of engagement, we have we’ve tried to get again back to that healthy mix of independent versus employed. We try to get a lot of these providers at the table to have conversations initially about what meant a lot to these guys, what was compelling to them. And it really came down to a few things. When you look at the providers that we have, it came down to data and when I say data, specifically block time. We had quite a few challenges in the way. And there was a lot of confusion in the way that we allocated block. And in the rules that were built around block allocation and taking block from people who weren’t meeting certain block thresholds that we had established. 


So to go with that, there was in an ease of use as well factor where we initially had somewhat of a homespun dashboard that we built in-house. And we tried to use this initially. And it was very confusing. And I think the challenge we had with that was we always got questions around the accuracy of the data that we were using. So what these providers were talking about was getting something that was built in a way that there was no questioning around the accuracy of the data and something that was easy to use. We had put so many man hours into building this. And it was being sent to them in various forms through regular mail, email. And they just weren’t checking– so something that was more user friendly, something they could use, ease of use. 


So again, it was block time but meant a lot to them, block allocation. And then, just something as simple honestly as volumes. We were basing a lot of the decisions that we were making around potentially building new ORs, and allocating time to different service lines on volumes, and historical volumes, and volumes down the road. And we just didn’t have the accurate data. So it really came down to data. They wanted to know where they stood in the line up in. And that was important. 


The other piece was they wanted to have a say in the decision making process. Every year we go through what we call a value stream analysis. And this is really a comprehensive review analysis, market analysis, of our primary service area. And historically, this was just a simple meeting with administrators, managers. And we essentially based off of the market analysis determine priorities for the coming year. 


The providers were never involved in that. And so you would always get to the next year trying to tackle these different priorities and initiatives. And you would get questions about why. And then you would get pushback when you try to engage key physician champions. It never worked. So that was the other thing, was wanting to be involved in the decision making process to identify priorities for the coming year. That’s something that we really involved them with now as a value stream analysis process. 


ASHLEY WALSH: Thanks, Ryan. That’s great. Yeah, just touching a little bit more on that. When I started working with Ryan, I think we’ve been collaborating together about late 2014, probably, after he joined UCHealth, it was really interesting to hear about his experiences in northern Colorado and in relating that to mine in Metro Denver, because they’re quite different. So we know what drives physicians in the community to want to come to a location. Is there a good patient care quality? Is a location convenient to my office? Do they offer all the services that I’m looking for? Is patient safety a priority? And how is that handled? And really touching more on what Ryan was saying, how do we get access to the OR? 


The OR we know is what helps physician keep their practices alive and going. And obviously, there’s a revenue component to that. So then, how do we engage them to continue bringing patients to us, and understanding their data, and being engaged in that process? And so when we know that they want to attend a facility and bring your patients to the facility, how do we keep them engaged? And that experience was quite different than mine in the academic setting. I mean, my physicians were there for a reason. We are connected to a medical school. And they were growing their practices through education, and fellowships, et cetera. 


So when I look at how. I was communicating with my physicians in the academic setting and how Ryan communicated with his position, that’s where we saw a lot of similarities and challenges. So we know that really to engage the physicians, we need to communicate with them. So we need to let them know, hey, here’s what we’re seeing, here’s what the data is telling us. There’s so many procedures you’re doing. Here’s how much time you’re spent in the OR. 


There’s all different ways to communicate that to physicians. It can be verbal. It can be through communication boards. It can be through email. There’s so many different areas to communicate in. And it’s hard to always know which one speaks to our providers the most. And there’s really that component of the transaction to keep them engaged. So how did we communicate information to them? And how were they able to transact that? Did that go smoothly? And then, what was the feedback? So I want to be able to continually give providers feedback so does Ryan, whether it’s community or academic. And we want our providers to give us feedback. 


This part of the process is where we find a lot of similarities and challenges in both of our practices, and realize that we really wanted to enhance this process, to engage our physicians better, to have them more involved and have things more transparent in our hospitals and our perioperative environment, and provide a continuous feedback loop. So that’s where we really started to investigate the use of mobile technology, because I was very well aware of the fact that I, no matter how many emails I would personally send out, no matter how many attachments. 


Ryan, did such a good job and still does in northern Colorado putting together great communication pieces, whether pamphlets, brochures, et cetera, on what’s happening, how’s their perioperative performance, et cetera. When all that said and done, unfortunately not everybody picks up the pamphlet and read it, or not everybody opens their attachment in their email. What we have found though is we decided to go down the avenue of investigating mobile communications. And it seems very simple. And it seems as though, well, that could potentially be just like email. 


However, we found it to be quite different. So we’d started in approximately June of 2016 communicating with our providers through email, or I’m sorry, through text message to let them know, hey, Dr. John, last week we saw that you did this many cases. You were in OR for this amount of time. It looks like some of your cases were delayed. It looks like your turnover was approximately this. The minute we started doing this through mobile, the amount of feedback we got back from our providers was tremendous. So you can see as. I talked about, there’s all these different opportunities, in our omni channel of communication. 


But when we started doing this through mobile, suddenly everything shifted I was having more providers stop me in the hallway to say, hey, I got this message. I don’t think it’s right. Can we talk about it? Sure, absolutely. Let’s talk about it. And what was great about that was the perception some providers had of their time spent in the OR was different from the reality. And you put it right there at their fingertips. It made it very personalized for them. The feedback was very relevant because it was current, it was last week’s information. They had the ability to go back and look at last month’s information right then and there. 


So it starts with a text message. And then they have the opportunity. You might be able to see it. I know it’s a little bit small on your screens, but over on the text message there’s actually a hyperlink. And the hyperlink launches a mobile browser that has all kinds of key performance indicator information for each provider. So it’s personalized information, it’s relevant, it’s current, and it’s basically all of their performance metrics in one location. So it does not require any app downloading for them. It does not require any log on variable to access the information when they want. So that was really exciting because we initially started this in the academic setting, and then we rolled it out to our community settings. And similar feedback from both. 


I actually spoke to one of Ryan’s colleagues who in the northern. Colorado region noticed position started having more conversations than pre-post and at various meetings. Oh, yeah. I got my message. It told us that we were actually up 15%. And we did this many cases last month. So that was great to see the practice growing. In addition, we know that it’s still important to summarize information and make it very comprehensive. So we still have the opportunity to send out physicians scorecards by service line, by provider, et cetera, directly to whomever needs to have it. So the mobile just was a great way for us to open up a communication channel we hadn’t tapped into yet with our providers in all areas of UCHealth. And then to still be able to use performance score cards at the administrative level or at the department level or at the provider level, if need be, to have more detailed conversations on tons of very in-depth detailed sophisticated math in the background analytics, but in a simple, easy to read format and export whenever we want to. 


Let’s talk a little bit more about the transaction. I think a huge aspect of engaging our physicians specifically in the community environment is to make the transaction easy. And when I’m talking transactions in the operating room, I’m talking access to the space. A lot of us, and I’m sure many of you on the phone can relate to using block time, and i think block time is great for a lot of different opportunities. However, it doesn’t solve everything and it doesn’t solve everyone’s problems. Sometimes people practices vary. Sometimes they don’t have as consistent of an elective practice. Or sometimes, specifically in our community environments, we notice we do have litters in the community. And there is competition. 


Therefore, there are providers that are sometimes looking for where’s the place that they can get the patient in the soonest, to bring a surgery over. So the other thing that we introduced through mobile was portal into the OR schedule to really look at available time in the OR. So What you’re seeing right now is an example of what it looks like on a provider’s phone to access the over schedule and see when there’s available block time or doesn’t have to be block time, it can be open time, for them to request to seek approval to then put cases on. The big advantage for our community providers in this was if our providers have limited block time because they are splitting their time and going to various other campuses in the community to do surgeries, if their volume increases with seasonalities or patient populations increase with these types, and suddenly, their surgical volume changes, this allows them to look right into the schedule indicated by green were available days that they could request. 


And if they couldn’t request, there is a function where they can actually set an alert for themselves to then pin them back if another opportunity comes up, or if another physician releases time, they’ll let them know. So they could get right on and get a single day of block time or open time that would be dedicated for them. They could do this week over week, month over month, and not have to wait for the what can be sometimes a lengthy process of a block approval process to get a new permanent block or additional block. So this allow them access right then right there in an easy to use application. 


On the other side, we know that physicians aren’t always the ones that are going to do this, sometimes their clinic staff. So when I’m not sharing with you today but something that we did work on creating was basically the exact same view on a web portal. So our physician offices, their staff can go into a web browser and see virtually the exact same view that you’re seeing there as the example on the mobile, to tap into when is their available time in the hour and when can I request time. So we’re making the transaction much more simple for our providers. Next, a little bit more on the feedback, and just being more proactive and prescriptive with our providers. 


The other way that we use the mobile technology and mobile application was to let our providers know, hey, we noticed that you have block time next week. And we notice you have no cases scheduled. Are you going to use your time or would you consider releasing it? This was huge for us, because getting physicians to release time is often challenging. Because I know that they often question whether or not the time would be permanently taken away or whether that would negatively impact them. And we wanted to assure them that, no, this is not going to negatively impact you if you have to release your time. It’s actually doing us a favor on the OR side and letting us know when we can either adjust our staffing or offer that time to other physicians. 


So I had a question come through about the automated release reminders and how this works. The way this works is we are pulling from our EHR. UCHealth is an Epic customer, but there are other customers doing similar things with other EHRs– Cerner, Meditech, et cetera– and really pulling an extract on scheduled cases, who the [INAUDIBLE] is, when the cases are scheduled. And we’re also getting more advanced mining the data to know Dr. John typically books cases five days in advance for his block. It’s six days in advance, so for days, and then, we see no cases. So we’re really tailoring those reminders to each physician based on their booking practice, or each surgical group, or service line, based on their booking practice. 


So if we see that they’re booking practice typically doesn’t book up to the last minute, they might not get a release reminder because we know to expect cases to come in last minute. But if they’re booking practice is such that cases are booked weeks and months in advance, and if weeks and months in advance, we see absolutely no cases for a particular date, it will automatically ping the provider, hey, we see no cases, would you consider releasing your time? Hopefully, that answered your question. But if you have more questions on that, feel free to reach out to me offline after the webinar. So, yeah. 


Again, you’re seeing a simple text message goes out. This is a release reminder. Would you like to consider releasing your block? If so, here’s a link. You can do so right away on your mobile phone. In addition, we also send this through email to a physician’s practice. So we send it to, in this example, Dr. Jones’ surgical scheduler through email to say Dr. Jones has no cases, would you like to release it? Because we do know that sometimes these things are often managed by the providers practice. So what was great about that is we, in northern Colorado, [INAUDIBLE] date for the entire system now. 


In northern Colorado, in southern Colorado, even Metro Denver, after these when release reminders are sent out, their release rates go up tremendously, which is such a good thing for our awards because it increases that communication to our preoperative staff. I talked a little bit about this before. But we do have the opportunity when there’s nothing available in green. There’s the opportunity for providers to put a request in it, think of it as like your Amazon wishlist. So if they really want to perform surgeries next Friday, they have a bunch of extra cases. They’re getting ready to go on vacation for a couple weeks. They can request that time and set an alert for themselves. So that way, if another provider then releases time, in the meantime, the provider that requested that time and set the alert will be notified right away when someone else releases that time. 


This is great because often, especially in the community environment, I see it more in northern and southern Colorado, providers have very specific days that they can operate on. And this month, they may just really need two extra days, however they’re only available on Mondays and Thursdays. And so they’re able to set these alerts and create a wish list, and then be notified right away when someone else releases that time. So that’s been a provider [INAUDIBLE] so far that we have heard back, especially in our community environment, so that way they know at UCHealth they have an opportunity to communicate with the hospital, let them know they’re interested in bringing more cases this month on this day. And then they get personalized automatic feedback to let them know if, when, and yes or no, that they can or cannot– we cannot accommodate that request. 


The cool thing that I’ve heard from some of our community physicians just by doing some one on one feedback sessions with them is they don’t have this opportunity at other hospitals yet. So they enjoy the opportunity to be able to when they’re meeting with a patient right then in their office, have their surgical scheduler go on and see if there is available block time, in addition to their already blocked days or available open time, if you will. And essentially build to schedule the case almost right then and there if they get the approval right there, done in there. Approval time is less than 24 hours for all of our locations. So in less than 24 hours, if there was an available open time, we will determine if we can accommodate that request. Send them that feedback, it goes electronically. And then they’re free to schedule cases. I’m just going to scroll down, I believe– oh, great. Thank you. 


A little bit more on the feedback. We know that in the transaction process and the communication process, easy quick relevant communication is important. Making transactions simple and easy for our providers is important. And giving feedback and receiving feedback is important. So one thing that we do and our providers are asking for extra open time or extra block time, we’re also sending them personalized feedback on how the performance worked. So they get this on text or email. They can opt out of either one. And we let them know, in this example, hey, Dr. Lee, for the time period of November to May, or it could be one month, or six months– whatever the hospital determines. 


Right now we’re typically looking at a quarter of time or six months. We let them know how many blocks they requested ad hoc. We let them know how the performance was in those blocks. We saw [INAUDIBLE] that went really great. We saw opportunities for better utilization and other ones. So let them know how that they’re using the tool, we thank them for using their tool, and how their performance looked in the tool. So that way, if we have to have a different conversation with a physician, such as maybe this provider, for example, was asking for more block time for many months, and if we have to have that conversation with them that, unfortunately at this time we can’t accommodate permanent block time but we can continue to allow you to use mobile blocking exchange. 


We want those communications or those conversations, if you will, to go smoother. And so in sending that feedback more consistently to our providers, those kinds of conversations don’t often then come in as a surprise because they’ve been getting information on what their performance looks like, how they were using their time very consistently. So then when we’re having, if you will, a negative conversation with them, it’s not as challenging to do so. Another thing about making the communication easy for feedback is it’s obvious how we’re spending providers their feedback. 


What’s not obvious is how they have an opportunity to send back to us. So this is actually two-way text channel. So physicians are able to send feedback directly through the text. And it goes to a centralized location, where we can then monitor it and respond to their feedback, whether it’s questions, whether they’re questioning the data, whether they want more information, whether they’re really happy and want to thank us for sending that, or please don’t send it anymore more. They’re able to respond right away on text message. So they don’t have to go knock on the manager’s door or try to get their service specialist or figure out who is sending the messages and how can I talk to them about the data. They can do it right then and there. 


Ryan talked a little bit about trusting data. I think that is a challenge in a lot of our hospitals with providers at times, is do they trust the data. So we’ve spent so much time investigating our data across the UCHealth and cleaning up our data as much as possible, working with an organization to identify opportunities for enhancements in our accurate data collecting and repository of information. And now, that we have done that and we’ve been sharing this information with our providers for quite some time, we know that they trust the data now. And if they don’t trust the data, we know that many of their peers do. And so there’s also the opportunity now that we’re fortunate to have peer to peer feedback with each other. 


So we can actually use examples with our providers to say we had a similar situation with this service line and maybe you would like to if you have an opportunity to reach out to this provider to hear more about why, and what kind of analysis was done to audit the data. I’m just checking now to see if there were any more questions. But in summary, really that is what we have done at UCHealth. We’re proud of the strides that we’ve made and the successes that we’ve had and really introducing mobile technology with our providers. It’s actually allowed for a whole lot of other things too. Really reorganizing our blocks, looking at forecasting time, looking at being more transparent and fluid in our block decision making process. 


But most importantly, for the purpose of this webinar, it allowed us to really increase our communication with our physicians, most specifically in the community areas where our providers sometimes are not hospital employees and sometimes are not bringing 100% of their surgical volume to us. So it was a really great opportunity for us to engage them, get them more involved in conversation, get them more interested in participating in process improvement events. And we were really excited to share that with you today. 


So I’d love to answer any additional questions if anyone has any. If you’d like to reach out to me personally, my email is on the screen,. If you’re interested in learning more about the tools that we use at UCHealth and that allowed us to really introduce mobile technology as well as more predictive and prescriptive analytics and communication with our providers and administration, feel free to email LeanTaaS is the company that UCHealth worked with and they have sponsored this webinar for today. So if you’d like more information on those tools, I know that they would love to hear from you and schedule some one on one time with you as well. 


ELLEN LORD: Ashley, we do have a question here about software compatibility. If you could take that question, we’d appreciate it. 


ASHLEY WALSH: Absolutely,. I see that right there. So is this software compatible with [? pisces? ?] I will tell you this, this is cloud-based software so there is no server you need to download, there’s no application you need to upload to your computer or your phone. So wherever data lives, it can be extracted. I know from personal experience, the company has worked with about five different EHRs, so I would say the very short answer is yes. It would be compatible with [? pisces. ?] If there is timestamp information or scheduling information or block information electronically, that can all be extracted and uploaded to their servers. And the data can be manipulated and mined. And the predictive analytics can be applied. And the unique algorithms so then export the information back via mobile or web. 


ELLEN LORD: OK. We have another question here Ashley. How expensive is getting a tool like this? ASHLEY WALSH: Yeah, absolutely. So I would say that you know it depends on the hospital size, the OR size, and what really parts of the tool you’re looking for. I know there are a lot of different analytics providers out there in the community, especially in the perioperative space. I personally have looked at quite a few. I will tell you that the solution that UCHealth decided to go with was competitively priced with its peers in the market. And so I know that it would be very easy to obtain a quote through But if you have met with any other analytical providers and have looked at that, I will tell you that the pricing is competitive with that. 


ELLEN LORD: Thank you, Ashley. I’m just wondering, in terms of the spectrum of different age groups that would interface with this system, especially from an OR management perspective, what have you experienced as far as pushback from actual clinical providers? 


ASHLEY WALSH: Oh, yeah. Thank you. That’s a great question. And I’ll be honest, that was something I was very curious about when we started. Just who would actually look at the information? Would I see a difference in more tenured senior positions versus our younger physicians that were maybe finishing up fellowships or residencies? I’ll tell you that. I have had really– no it’s a very little pushback from any of the providers. And in fact, it was my more senior tenured providers, if you will, that were most excited and paying attention to the information the sooner. So that was really impressive to me. In fact, I like to use the example of the chair of neurosurgery who– he’s aware and has approved me to say this– but he frequently has many unread text messages on his phone. Many. I won’t tell you beanbag exact number. But it was interesting to see those copy he sent in my office to comment on the information he received on his department. 


So he’s in a department of neurosurgery so he receives information for the whole department. He would come in and say, see, I told you these volumes are going up. Sure enough they were. I got my text message on Tuesday. And I was able to look at the information. So knowing that they’re getting this information that is really easy to look at, very easy to use, simple to read and understand, with great analytics in the background, it was exciting to see him get excited. I knew that our younger physicians were– text messaging is just second nature, especially for the millennial generation. And really all of our generations now because it’s been introduced for such a long time now. So they were getting it. They were accessing it. I was getting feedback from them right away. 


Sometimes we get gifts and emojis sent back on the two-way channel, especially when we sent out, hey, you’re at 100% blocking utilization last week. And we get banners of hurray sent back to us. So I would say that the pushback was little. I’d say more than anything, providers appreciate it from what we have heard from our providers getting very simple, easy to read, easy to understand information. Ryan, I don’t know if you’re going to want to share on that as well. Yeah, go ahead. 


RYAN DEGRAFF: This is Ryan. I would jump in on that as well and just add that, I think, another part of the providers using the application. And again the text messaging is it really comes down a lot of it on our end, at least to what administration is doing with the data. So part of part of what we do is we circle back with perioperative governance group and we make decisions around block time in that meeting. We typically take the top five providers who are not meeting the threshold and circle back and have conversations. So as soon as you start– as administrators, as soon as you start taking action with some of the data and utilizing it, putting it to use, and taking and granting block time, people immediately start paying attention. And so they want to receive the text messages. And the other piece of that is this should never be a surprise. 


So the providers who we are circling back with and having conversations about maybe not meeting their block time thresholds, that should never come as a surprise to them. They should always be in the loop and in the know. And that’s what they appreciate now is the transparency. They’re in the know. They want to text messages because they know that we’re acting on the data. 


ASHLEY WALSH: Right, exactly. And, yeah, I’d love to share with any of you that are interested how we have actually used this and what type of predictive analytics and how it’s predictive and prescriptive and really looking at forecasting our blocks, if you’re interested at a later time. So I just see another question, and thank you for asking that, Robert, about the return on investment. I think this is a very important question to ask, because when you are looking at an analytical provider and bringing in another service that does come with a price tag, of course, I feel very passionate about being transparent and utilizing data to the best of its ability. And now, many of us have been in EHRs for over a decade now, we have so much data. And I don’t think we’re doing enough with it. 


So I do feel strongly that it is critical to really invest and partner with someone that meets your needs as a health system. Specifically,. UCHealth is actually published two case studies around using this product. The most recent one that was published, I am I’m happy to share with you offline if you’re interested. But we saw a consistent increase in our block utilization, translating actually to our overall utilization, which for us was an increase of approximately 500,000 in revenue per OR per year. So it’s quite significant. 1% increase in utilization in the perioperative space translates to a tremendous amount of revenue. I mean, I think we’re all on this call and we’re working in a perioperative environment how important are Kerry operative areas are in respect to revenue cycle of our hospitals. I would say, on average, from data that I have read across the country, it attributes that roughly 60% of our hospital’s overall revenue, net revenue annually. 


So using this space to the best of its ability, I think, is critical. And we are going to continue to be pushed to do more with less. So there’s a lot of different ways to look out return on investment with analytics. If there is more volume in the community and if you’re able to bring more volume to your location, that’s a win-win for everyone. The other thing to look at though is, are we able to hold resources that we otherwise may have staffed or used? And then, is that actually helping us also as a savings? The data and analytics can be used so many different ways. In the UCHealth case study, though, they were actually able to accommodate more cases, more volume during business hours than they had previously, from the use of introducing new tools and specifically mobile technology. So thank you for that question. 


Another question I see is, is there any patient protected information issues? No, currently we are not capturing any PPI information or sharing PPI information in the application through mobile. So we are strictly looking at utilization of volume metrics. We have explored if we want to kind of increase, especially in the quality of the area of communication what that would look like. So we are in discovery over some other module possibilities. One is cost per case. Others are different aspects of the perioperative patient experience. and the continuum of care. So right now, the answer is no. We’re not taking any patients specific information. We’re strictly looking at utilization, patterns of utilization by providers, by service lines, by time of day. But that could be a possibility down the road, especially if you’re interested. I don’t know if I see any other questions. I did put a little bit of information up about the company that you. UCHealth is partnering with, that the company who sponsored the webinar today, LeanTaaS. 


So just quickly a little information on them, they are Silicon Valley based software company. They have been in business about eight years now. And really strive to introduce new methodologies and care out with very sophisticated math and predictive analytics. So there’s a lot of talk in the community about predictive analytics machine learning. And if you’re interested in learning more about it, typically the great strides that this company has made, feel free to reach out to them and/or look on their website. You can see on the right hand side, they have a large customer following. They have now crossed over 50% of the country’s leading cancer centers. So some of you may be on that call that are already partnering with this company in the infusion space. So the two products that they have brought to market are an infusion and operating room. So love to share more about that if you’re interested. 


ELLEN LORD: Ashley, I think that. I don’t see anymore submitted questions. But I certainly just wanted to ask you a little bit more about the excitement that you see in the field once your information has been presented to a facility. And how really long it takes them to embrace the technology and make it start working for them? 


ASHLEY WALSH: Oh, sure. Absolutely. So the turnaround time is quite quick, because we have now had experience with multiple EHRs. I mentioned three of the largest in the perioperative space, Meditech, Cerner and Epic. So as far as using the information in these tools and rolling them out to positions, that can happen quite quick. It can actually happen in eight weeks or less, from the initial data transfer. The most important thing is to really get the right data out and align that with the metrics that are currently reported at these facilities. So turnaround can be quite quick. Adoption phase is different for everyone. So when it comes to really mobile technology like we’re talking about today, I think, the adoption phase can be quite quick and we’ve seen it be quite quick. 


Starting out with sending to a core group of physicians, getting them involved in some peer to peer communication, and then continuing to roll out to others. For the physician offices, we have found that many physician offices are signing each other up and sharing the information with their peers on their own, because the ease of use is so simple. There’s really little to no education needed on how you get into the application. And if an administrator approves them access, then they can sign each other up and send that through the approval process that way. 


Now, there are some other tools that we’re using that have been introduced through LeanTaaS and that we’ve been able to adopt at UCHealth, specifically more related to blocks and block forecasting, and how we really forecast time for providers. I would do it a little bit different and a little bit longer of a cycle. That does involve some change management especially with leadership teams. It presents leadership teams a new opportunity, a new way to look at allocating time. And with any new process, sometimes there is that adoption phase, if you will, or adoption to creating new governing policies or standard operating procedures, et cetera. 


So that’s what really adds to the time. But specifically as far as using the tool, sending out mobile text messages, getting data out of your. EHRs, that can be very quick. Like I said, eight weeks or less really could be the turnaround. 


ELLEN LORD: Well, that’s pretty impressive when it comes to getting something implemented in an OR. What is your suggestion as far as moving the information say, from someone at the OR management level then, if you will, into the administrative suite to basically have them see the advantages of a system like this? 


ASHLEY WALSH: Yeah, so you can see from the customers on the right that we have worked with and that have been a part of adopting these tools and mobile technologies, it really happened successfully from really be– we like to refer to them as the knights of the round table, if you will. So getting your senior level leadership involved with your perioperative leadership, your physicians and IT all at once. Working in the perioperative space for almost a decade, I know how challenging that can be, sometimes initially. 


But what’s so exciting and what really made things change faster for us– because Ryan mentioned this we had built a dashboards internally for years at UCHealth and tried for years to really increase the communication, the transparency, but it’s still presented so many challenges. When we showed our senior level administration how we could share this information quickly– in fact, the CEO of the whole system gets a text message every week so that she is aware of the volume and utilization that every region– the feedback we got was tremendous from finance, from hospital billing, from administration to surgeons and perioperative steps. 


So knowing how easy the data transfer was, the increase in transparency, that’s really what drove our leadership to stand behind, embracing an analytics tool, specifically this one and rolling that out across the system. The CFO of UCHealth has been kind and quoted that he cares so much about the perioperative environment because just a 1% increase in utilization yields over 200,000 in net revenue per OR per year. So knowing that he sees that in the data and stands behind doing what he can to support increasing transparency and using data to increase our efficiencies in the OR has been has been great for us. 


RYAN DEGRAFF: And Ashley, can I add something to that? I think one of the important factors for our administrators appear in the north is obviously everything that Ashley said, but it’s being able to make better informed decisions having the accurate data and the real time data. I’m going to give you a specific example. We were making– we’re in the process now of building out two ORs. Well, initially based on historical data that we were using before this program, we had planned to build six ORs. So going from six to two because of the data and how reliable the data is now saved us millions. And that alone was a huge factor. I mean, the fact that we can now make these informed decisions is a very valuable thing for our administration. 


ASHLEY WALSH: Thanks, Ryan. Thanks for sharing that. I would love to chat more with you. I really appreciate all the great questions that we got today. And thank you for your time. We will be at OR. Manager next week. I don’t know if any of you will be there. But we love OR. Manager conference and we’d love to have more conversations with you about your organizations and your interests perhaps in introducing mobile technology. So please look for LeanTaaS. You can look for my colleague. Catherine Halverson Carpenter will be there. And we’d love to have some conversations with you live. 


ELLEN LORD: Thank you, Ashley and Ryan for your very informative and interesting webinar today. And on behalf of. OR Manager we would like to thank you for your time and interest in providing the information, and to LeanTaaS sponsoring this webinar and the information that we have shared with our audience. Just as a reminder to participants, if you would like to have the availability of this presentation, it will be available approximately 48 hours after the live webinar. 


And you can receive your contact hours by logging on to the attached email address. And at that time, you can receive your certificate of participation. Once again, we appreciate the participation of Ashley and Ryan and the sponsorship from LeanTaaS. We hope that this has been informative and you have encouraged your OR to look at the technology that’s available to us through mobile, portals, and ways. At this point, we would like to end our webinar for today. We, again, appreciate your participation. This will end our broadcast. Thank you, and have a good day. 


ASHLEY WALSH: Thank you.

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