<v Jordan Cooper>We're here today with Max Mail, the senior vice president, the digital health at Parkview Health. Max, thank you so much for joining us today.</v>

<v Max Maile>Welcome. Get a chat. Thanks Jordan.</v>

<v Jordan Cooper>So today we'll be discussing digital health and devices and care models that are changing within healthcare.</v>

<v Jordan Cooper>There's a lot of talk about personalizing care for each patient, but there's also the idea that standardization must occur to deliver lower costs and better outcomes. Max, I'd love if you could speak to our audience about how Parkview has been personalizing equipment and tools for patients in the operating room.</v>

<v Max Maile>In the operating room. So we we wanna personalize care in every aspect of care delivery. So we've been doing that through a number of different devices. Whether that comes to cure in the home setting or the different types of equipment that we invested in, in our ORS and those settings as well. So we want to be able to adjust for size and health, accommodations and all of those different pieces. A lot of that personalization starts with maybe tracking some of your data.</v>

<v Jordan Cooper>Umm.</v>

<v Max Maile>Maybe being able to access primary care or get care exactly at the point where you need it. So I think it's so much more than just the operating room itself. I think it's a whole care spectrum. The Parkview really done a great job of focusing on when you need care is really when we want to optimize that.</v>

<v Max Maile>And sometimes that could be well in advance of your operation, and likewise that could be in the follow up. So for you to have success on your surgery that may be in collecting various data points and stuff after your visit as well.</v>

<v Jordan Cooper>So there's a concept of smart rooms that you've been implementing at Parkview, would you say more about that?</v>

<v Max Maile>Yeah. So I feel like that's kind of a buzz term and the industry smart rooms, I'm not exactly sure what that means, but what we are trying to do is enable a lot of our hospital and inpatient rooms with more technology and some of that is technology that you may be familiar with in home settings where it's the Alexa or the voice activated type devices. So we've certainly explored how can we better leverage voice activation to do things such as capture notes that are providers taking or.</v>

<v Jordan Cooper>Umm.</v>

<v Max Maile>Assist with the nurse who may have both hands occupied at the bedside, and they could do something via voice activation to call for help or things like that so that I think all entails part of the smart room and then.</v>

<v Max Maile>I there's lots of tools out there, whether that adjusts televisions or blinds and other things that you can control lighting that you can control with various tools as well. One of the things we just implemented, which is pretty exciting, we have cameras in all the rooms now and that has allowed us to expand our virtual care offerings with services like virtual sitting or virtual nursing where we've got people in a bunker located in a different spot, a different setting, but who are able to provide bedside support whether that's.</v>

<v Max Maile>The supervision of a patient to make sure they don't have a fall if they're on a certain medication or have a certain high risk, as well as potentially offering bedside nurse relief for various tasks in the hospital. So by having these cameras out there, we're able to connect into those patient rooms and have a number of different options now for delivering either bedside care or specialty care.</v>

<v Jordan Cooper>Thanks for elaborating on the cameras Max and the smart room question that I asked. I think what you've been speaking about is a larger initiative which Parkview is referred to as a new virtual care department that is designed to provide 24/7 access to clinical support throughout every Parkview hospital. As you alluded to on just for the benefit of elaborating on this concept for our listeners, virtual nurses can be increasingly involved in bedside care, interacting with patients through the TV in the room that you just mentioned, providing education and coordinating faster discharges.</v>

<v Jordan Cooper>That could prevent serious illness or even death and example that you've spoken of previously is reviewing patient data to detect early signs of sepsis and notify bedside nurses to initiate a care protocol if appropriate. The question like to ask you Max is what has been the experience of standing up this new virtual care department for patients and for providers?</v>

<v Max Maile>Yeah. So we've benefited in historically here from having some virtual nurses doing our sepsis oversight that really developed with our nursing teams and really provides.</v>

<v Max Maile>Second, by second, essentially overview of patients and how they're doing and allows us to interact very early on using some predictive models as well to understand if if a patient may be starting to head down that route towards sepsis. So they're the patients from their benefit, they're constantly monitored in a very passive way that we can apply various algorithms and AI technology to understand, OK, this is going well or not going well, right, and jump in on care.</v>

<v Max Maile>Earlier than to change those paths for our nursing providers, I think and our our teams, I think they're very appreciative of the protocols that have now come with that, that allow them to make decisions quicker as well. So a lot of those components of sepsis in particular are very protocol driven and by working with our physicians and our nurses, they were able to develop those and really get pathways for when they can intervene and not not just when they need to make a call but when they can actually do something.</v>

<v Max Maile>Based on those protocols, so huge help I think in outcomes for our patients, which everyone's happy about. And then elaborating further on the space that we have that we just announced, we've kind of created this bunker that's high technology.</v>

<v Max Maile>There a lot of resources and support around our virtual nurses and virtual technicians who do sitting for us that that we can have everyone in one spot and really leverage the scale and scope of our health system with that resource. So you could be connected from an hour to away at one of our rural hospitals and still connect to those team members who were all together in a bunker that brings a couple of benefits for us actually so.</v>

<v Max Maile>As we look at nursing and the turnover that we've seen from COVID pretty substantial. So there's a high burnout rate for those team members, whether that's the physicality of it, the risk involved, whatever it may be, some of it's just the aging nursing sector there. And what we found is by offering virtual solutions for them, it's a different role. It's a different nursing role, but they can apply their skills and in a new way. And it's been a great tool for.</v>

<v Max Maile>For us to recruit and retain nursing talent as well.</v>

<v Jordan Cooper>And you're saying, so you've actually seen reduced rates of turnover and burnout by converting 4 nurses into this virtual care program?</v>

<v Jordan Cooper>Right.</v>

<v Max Maile>Yes, Sir, I that may be a strong statement. I don't want to go out on record and say something that's erroneous, but I would say well, we've been able to do is make a new job profile for these nurses. And so those who may have considered leaving our health system or their profession altogether, they have transitioned into those roles. And our benefit then is we get these very experienced nurses who are now helping us in the virtual side.</v>

<v Jordan Cooper>Few questions coming up in my mind as we're discussing this virtual care department you mentioned protocols generally when someone's listening to this episode, they may think, well, that sounds good. That's data-driven medicine. However, many will also recognize specially any medical doctors who are listening to this episode, that there's a high amount of historical variability in providing care based on residency programs and even department by department across the nation's historically, there is sometimes been provider pushback.</v>

<v Jordan Cooper>Of course, moving towards best practice protocols because it differs from what they've always done and what they learned. How have you been handling that? If you've experienced it at all?</v>

<v Max Maile>Yeah, certainly that's a a big Gray area, right? So as you look at digital health in general, I think there's there's kind of two mindsets here. One is that it's, it's this new way of practicing and it's jeopardizing some of the hands on and kind of components that you referenced there that are necessary to care for the patient.</v>

<v Max Maile>I would take a different spin on that. I think there's a different camp that just says digital health is just simply part of your healthcare. And how do we incorporate that then as a way of treating you, no different than you and I are interacting over video here rather than over a coffee somewhere or a physical recording. We've taken a new medium that allows for us to exchange data and conversation and stuff in real time and interact that way. And that's what a lot of digital health is doing.</v>

<v Max Maile>And so not, it shouldn't actually produce worse outcomes. It should enable us to create better outcomes and have better data going along, because now you've got maybe more reference points, you've got ease of connectivity with patients. So the goal really is to just, I think have digital health not be a separate kind of care, but to be embedded in care. With that said, to your point, I don't think a lot of the old protocols necessarily incorporate digital health into that, right. So as an example.</v>

<v Max Maile>Maybe we're very customized to or very.</v>

<v Max Maile>I used to, I guess taking one blood pressure reading. Right. So we call the patient and they've got a drive there in our setting, perhaps in a metro setting, they drive to the office and they get their blood pressure reading after navigating our campus and maybe getting lost. And, you know, this could be a stressful environment for people. But because we had one very robust medical device reading, we count that as an accurate blood pressure reading. But in reality, it would it not be better to have maybe a lesser grade device? But the readings are taken more frequently.</v>

<v Max Maile>To get us a better profile of the patient. So those are things that we've developed protocols on in the past that I think we just have to change our way of thinking in the future to see how we can better mesh everything together.</v>

<v Jordan Cooper>It's an interesting point, Max to raise Umm about having more frequency because you're able to do it at home without the logistics of having to come in for an appointment and kind of integrating care into somebody's current workflow, their normal life. You did mention real time. I wanted to ask a question about that, how has Parkview Health and implementing clinical decision support and automation in real time and what's been the some of the challenges of doing so.</v>

<v Max Maile>Uh, yeah, I think, yeah. The I'll start with the challenge first. The challenges are really in workflow adoption. So any of this real time sort of stuff is all new and it generates a lot of information, potentially information that may not be useful at all to our providers. And so you know the word of caution, there is just be careful that you don't inundate providers with useless sort of data. So how do you take that and trend it and make it valuable for clinicians to make decisions on?</v>

<v Max Maile>As health systems are are trying to balance, what's the risk in that right. So if we have all this data now, are we at risk for not making a decision on something just because we had the data, but it maybe it didn't bubble up to a certain escalation path. So lots of things to figure out there.</v>

<v Max Maile>The.</v>

<v Max Maile>The challenge is, I think continue to be in changing our workflow from what we've always done to incorporating that new technology. So that could be as simple as you know, biomedical devices. We're not used to cleaning something that's coming from someone's home. We're not used to shipping devices to patients in the home. How do you set them up on a program? How do you even support if someone has a Bluetooth connectivity in their home? Now we're trying to troubleshoot a home environment that we've never done before. We don't know what they're connecting to on Wi-Fi, all these.</v>

<v Max Maile>Variables get thrown out there, so really important for us to health system to continue to support our patients even as they may take some of those wearables or different devices home and capture that data in a very meaningful way to make good decisions from what I would contest that. Sorry Jordan, you were going to say something, I would contest that if we can get a lot of data points on that, even if it's not perfectly measured, as long as it's a reliable source measured every time, we can certainly make something of the trends.</v>

<v Jordan Cooper>You mentioned troubleshooting Wi-Fi connectivity with the Bluetooth enabled device at home. I'd like to transition our conversation to the ecommerce website. In particular, your partnership with Best Buy Health to launch a website where patients can buy assorted medical devices and Wellness products for conditions including diabetes care, heart health, general Wellness, mother and child health. Some of these items include glucose monitors, digital thermometers, fitness trackers, and patients can use compatible devices to automatically share data with their my chart account.</v>

<v Jordan Cooper>You've said previously that this program provides more options for seamless connections and takes the guesswork out of finding the right products. Now question Max is what are the consequences of patients making the wrong purchasing decisions?</v>

<v Max Maile>So spending money that they that their device now can't connect in a way they want it to connect.</v>

<v Max Maile>And I the the whole partnership with Best Buy, I'll give some context to that because it it came about, I think it's really important to understand why we reached out to them and why I think we both thought this was a good idea.</v>

<v Max Maile>I went to a big box store and and in their pharmacy section I just looked at. I think it was thermometers and blood pressure cuffs and there is an assortment of like 30 blood pressure cuffs you can buy, you know, all the way ranging from the very cheapest option of a couple dollars up to several $150.00, let's say for a very nice Bluetooth connected one. And it was a I'm in the digital health world and I don't even know which ones the right one to buy you know, so.</v>

<v Max Maile>We looked at that and said can we work with a partner and our physicians and try to guide patients so that they're not wasting their money. So if you want or maybe you're trying to lose weight, for example, and you've got to connected scale, the easiest way for that to just go into your my chart account for us, our patient portal is my chart. You just want that data enter it automatically or as seamlessly as possible and.</v>

<v Max Maile>So we wanted to have our teams working together with Best Buy and choose those devices, or at least let patients know what options were available, investment for them and would connect to their my chart account. So they didn't spend $50.00 on a device and then have to go populate something or make it so cumbersome that they just they don't want to do it anymore, right. And I think that's probably answering your bigger question. The danger is that we disengage our patients because we don't make it easy for them to connect.</v>

<v Max Maile>And for my health system side.</v>

<v Max Maile>We make it too hard for them to navigate and then you see others like Amazon and those coming into the health system arena. If they make it easy and we've made it hard, that's gonna jeopardize a lot of our business as well.</v>

<v Jordan Cooper>So I'm interested in determining in in exploring what was driving this initiative, and there's a few topics within that. One is, again, we did, I started this little direction of the conversation by talking about the challenges of connecting Bluetooth device, Best Buy Health has a Geek Squad for implementation at home to what it's done is that driving in the initiative or is this a profitable new revenue stream for Parkview Health? Remember, our audience is CIOs at large healthcare delivery systems. Is this something they want to pursue? Is this improving patient satisfaction? I know Parkview health.</v>

<v Jordan Cooper>Actually, as a patient and family engagement committee had did they request this what some of the driving, the driving forces behind this initiative?</v>

<v Max Maile>Yeah, it really came down to how we wanted our patient experience, right. So we are really big on making sure that that this is frictionless and seamless for our patients. So that it came about, it did come about financially, but maybe to the disappointment of health system CIO, they're not going to make a bunch of money on this or at least we're not. So maybe they can call me and tell me how to do that, but.</v>

<v Max Maile>We it's saving money for us, so it came about as we said, hey, how do we provide this home support? And it did actually come about as the two big asks for Best Buy initially were we've got this issue, patients are confused about going to big box stores and having to buy stuff that we don't know if they're able to connect it. And we'd like to have a say in guiding them there, but we don't want to manage all these devices. So I didn't want to have a multi $1,000,000 inventory of devices, nor did our pharmacy team or anyone else.</v>

<v Max Maile>Of devices that, frankly, they obsolete themselves very quickly, right, they go from a 2.4 gig network to a 5 gig network or whatever it may be. And now you're stuck with all these devices. Why I we're not in that market. We you know Best Buy is. And frankly we're not in the home fulfillment market where it's connecting those devices in the home and.</v>

<v Max Maile>And supporting those and even identifying Bluetooth issues and stuff like that. So we reached out, we said we had a problem. Here's what it was. We said we would love it if Geek Squad could come help in the home and at the time we started talking to them, they couldn't release some of their information. But I think since then, they have announced that they are more in the home now than ever on these medical devices with their Geek Squad group. So they can provide support. And I thought that was really smart on their part.</v>

<v Max Maile>So for us, the financial savings was not carrying inventory and not having the fulfillment, but still giving that experience to the patients and.</v>

<v Max Maile>I think that's gonna be key in the marketplace as we develop these home offerings as supporting that for folks. So we make no money off this. What we do is we route patients to a Best Buy site. There's no financial revenue for us off of that. We just think it's a better experience for our patients and we just recognize that wasn't our core competency.</v>

<v Jordan Cooper>So Max, we are approaching the end of this podcast episode, and as we do so, I'd like to mention that you've previously described yourself as, quote, an entrepreneur at a big organization, UN quote. We've spoken about ecommerce websites, we've spoken about a new virtual care department. We've spoken about integrating a partnership with a big box retail store and personalizing care and equipment for patients. I'd like to ask you to speak to our audience.</v>

<v Jordan Cooper>About the experience of being an intrapreneur, as it were, to build new initiatives and gain traction, adoption, acceptance and overcome technical, logistical, and human challenges. When you're trying to initiate these new programs, what words of advice would you give the CIOs listening who are trying to implement their own programs and are trying to overcome their own challenges?</v>

<v Max Maile>Yeah, that's a great question. So I think it's, first of all, it's a lot of fun. I I have a passion for entrepreneurship. And so it's really neat on this side or this edge of the curve. We're digital health is growing. And so to get to navigate that with a health system, I think is it's really special for me. I think it's great to see the impact it has on our patients and our team members that are part of this. I think they all feel the same excitement that I do.</v>

<v Max Maile>Part of how we look at our role, I think in that entrepreneurship role is being a bridge between technology and all the cool devices that are out there but but also working with operations to make sure that it's that we're engaging with them and creating solutions that are helpful for our providers and our patients so.</v>

<v Max Maile>And it's really easy to go out and spend money. I say that, you know, cautiously, like, as long as you have the money, you can go buy products and you can, you know, buy vendors essentially that have products. But the key or the secret sauce is always working with your operational teams and your nursing teams and whoever that may be to really look at your workflow in integrate that technology into those processes. I think that's what our team has just done. So well with is trying to partner with those groups.</v>

<v Max Maile>And by no means are we perfect. They're, you know, not every provider or Parkview is excited for digital health and we understand that and and we don't wanna force that on providers or patients alike. We just at the end of the day I think we just want to create options for patients that if they want a virtual care option, we've made that seamless and easy for them to have access to. And if they want to see us in person, that's always an option at the end of the day, the day too. So wherever the care for you may be best, we want to provide that solution.</v>

<v Jordan Cooper>Thank you. And again, this is been for those of us trust joining this has been Max mail, the senior Vice president of digital health at Parkview Health Max. OK, thank you for joining us today.</v>

<v Max Maile>Thanks, Jordan. Pleasure connecting.</v>