26d82b3c-6769-49ed-94ea-40002ca91529/23-0 00:00:03.136 --> 00:00:07.145 <v Jordan Cooper>We're here today with Doctor Michael Kirchoff of Cooper</v>

26d82b3c-6769-49ed-94ea-40002ca91529/23-1 00:00:07.145 --> 00:00:07.646 <v Jordan Cooper>Health.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/34-0 00:00:08.016 --> 00:00:11.126 <v Jordan Cooper>He is the chief innovation and Patient safety officer.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/46-0 00:00:11.136 --> 00:00:12.266 <v Jordan Cooper>Michael, thank you for joining us today.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/52-0 00:00:12.726 --> 00:00:13.566 <v Kirchhoff, Michael>Thank you for having me.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/84-0 00:00:14.186 --> 00:00:18.176 <v Jordan Cooper>So for those who don't know, Cooper University Healthcare is</v>

26d82b3c-6769-49ed-94ea-40002ca91529/84-1 00:00:18.176 --> 00:00:21.707 <v Jordan Cooper>an academic health system, pacing Camden, NJ with 900</v>

26d82b3c-6769-49ed-94ea-40002ca91529/84-2 00:00:21.707 --> 00:00:23.276 <v Jordan Cooper>physicians and 663 beds.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/119-0 00:00:23.646 --> 00:00:28.259 <v Jordan Cooper>Today we have a dual topics that I think will be of interest to</v>

26d82b3c-6769-49ed-94ea-40002ca91529/119-1 00:00:28.259 --> 00:00:32.583 <v Jordan Cooper>many of your peers across the United States, and that those</v>

26d82b3c-6769-49ed-94ea-40002ca91529/119-2 00:00:32.583 --> 00:00:35.466 <v Jordan Cooper>topics are metadata and technical debt.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/147-0 00:00:36.246 --> 00:00:40.660 <v Jordan Cooper>Many organizations have a laundry list of things that they</v>

26d82b3c-6769-49ed-94ea-40002ca91529/147-1 00:00:40.660 --> 00:00:45.148 <v Jordan Cooper>like to accomplish, and Dr Kirchoff, you've been working to</v>

26d82b3c-6769-49ed-94ea-40002ca91529/147-2 00:00:45.148 --> 00:00:47.466 <v Jordan Cooper>ameliorate your technical debt.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/156-0 00:00:47.536 --> 00:00:50.166 <v Jordan Cooper>Tell our lesson ners kind of what?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/167-0 00:00:50.216 --> 00:00:53.166 <v Jordan Cooper>You know what is the breadth of your technical debt?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/172-0 00:00:53.176 --> 00:00:54.146 <v Jordan Cooper>How do you prioritize?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/189-0 00:00:54.156 --> 00:00:56.724 <v Jordan Cooper>How are you tackling this problem and innovative way over</v>

26d82b3c-6769-49ed-94ea-40002ca91529/189-1 00:00:56.724 --> 00:00:57.166 <v Jordan Cooper>at Cooper?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/190-0 00:00:58.016 --> 00:00:58.486 <v Kirchhoff, Michael>Sure.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/235-0 00:00:58.496 --> 00:01:02.501 <v Kirchhoff, Michael>So, you know, in general, I think a lot of organizations are</v>

26d82b3c-6769-49ed-94ea-40002ca91529/235-1 00:01:02.501 --> 00:01:06.375 <v Kirchhoff, Michael>grappling with technical debt and really the point of view</v>

26d82b3c-6769-49ed-94ea-40002ca91529/221-0 00:01:04.946 --> 00:01:04.986 <v Jordan Cooper>E.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/235-2 00:01:06.375 --> 00:01:10.446 <v Kirchhoff, Michael>that I bring from an innovation of patient safety side is the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/235-3 00:01:10.446 --> 00:01:13.006 <v Kirchhoff, Michael>safety implications of technical debt.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/237-0 00:01:10.586 --> 00:01:10.856 <v Jordan Cooper>That.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/282-0 00:01:13.016 --> 00:01:16.592 <v Kirchhoff, Michael>So we have a great team on the IT side and on the budgetary</v>

26d82b3c-6769-49ed-94ea-40002ca91529/282-1 00:01:16.592 --> 00:01:19.691 <v Kirchhoff, Michael>side of really addressing technical debt and really</v>

26d82b3c-6769-49ed-94ea-40002ca91529/282-2 00:01:19.691 --> 00:01:23.564 <v Kirchhoff, Michael>focusing on making sure that our life cycle plans make sense and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/282-3 00:01:23.564 --> 00:01:26.126 <v Kirchhoff, Michael>are keeping up with the latest technology.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/293-0 00:01:26.136 --> 00:01:28.516 <v Kirchhoff, Michael>I have no complaints about our team there.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/342-0 00:01:28.526 --> 00:01:32.144 <v Kirchhoff, Michael>They really do a fantastic job and our Co CEOs, especially</v>

26d82b3c-6769-49ed-94ea-40002ca91529/342-1 00:01:32.144 --> 00:01:35.945 <v Kirchhoff, Michael>Doctor Mazzarelli, is really focused on making sure that life</v>

26d82b3c-6769-49ed-94ea-40002ca91529/342-2 00:01:35.945 --> 00:01:39.134 <v Kirchhoff, Michael>cycling not only from our applications but also our</v>

26d82b3c-6769-49ed-94ea-40002ca91529/324-0 00:01:36.466 --> 00:01:36.746 <v Jordan Cooper>Yes.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/342-3 00:01:39.134 --> 00:01:42.199 <v Kirchhoff, Michael>hardware that we're really focusing on that as an</v>

26d82b3c-6769-49ed-94ea-40002ca91529/344-0 00:01:40.846 --> 00:01:40.986 <v Jordan Cooper>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/342-4 00:01:42.199 --> 00:01:42.996 <v Kirchhoff, Michael>organization.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/396-0 00:01:43.266 --> 00:01:47.685 <v Kirchhoff, Michael>But what we talked about earlier was there's this other side of</v>

26d82b3c-6769-49ed-94ea-40002ca91529/362-0 00:01:46.786 --> 00:01:47.016 <v Jordan Cooper>That's.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/396-1 00:01:47.685 --> 00:01:51.689 <v Kirchhoff, Michael>technical debt that I see looking at patient safety and I</v>

26d82b3c-6769-49ed-94ea-40002ca91529/373-0 00:01:50.346 --> 00:01:50.416 <v Jordan Cooper>E.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/396-2 00:01:51.689 --> 00:01:55.348 <v Kirchhoff, Michael>hear about from other organizations when we talk not</v>

26d82b3c-6769-49ed-94ea-40002ca91529/378-0 00:01:52.306 --> 00:01:52.536 <v Jordan Cooper>It.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/396-3 00:01:55.348 --> 00:01:59.076 <v Kirchhoff, Michael>only about technology, but also about patient safety.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/427-0 00:01:59.206 --> 00:02:02.415 <v Kirchhoff, Michael>And that's specifically there is another impact of technical</v>

26d82b3c-6769-49ed-94ea-40002ca91529/434-0 00:01:59.886 --> 00:02:00.476 <v Jordan Cooper>Yeah, E.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/427-1 00:02:02.415 --> 00:02:05.834 <v Kirchhoff, Michael>depth other than the fact that I just have an application that's</v>

26d82b3c-6769-49ed-94ea-40002ca91529/427-2 00:02:05.834 --> 00:02:08.096 <v Kirchhoff, Michael>that's not being supported anymore, right?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/464-0 00:02:08.106 --> 00:02:11.297 <v Kirchhoff, Michael>That's what everybody knows about, or I have a piece of</v>

26d82b3c-6769-49ed-94ea-40002ca91529/464-1 00:02:11.297 --> 00:02:14.488 <v Kirchhoff, Michael>hardware that is now out of warranty and I can't get it</v>

26d82b3c-6769-49ed-94ea-40002ca91529/452-0 00:02:12.186 --> 00:02:12.396 <v Jordan Cooper>And.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/464-2 00:02:14.488 --> 00:02:17.736 <v Kirchhoff, Michael>serviced and now I suddenly have a large capital outlay.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/503-0 00:02:17.746 --> 00:02:21.080 <v Kirchhoff, Michael>That's the technical debt most people are familiar with, and I</v>

26d82b3c-6769-49ed-94ea-40002ca91529/503-1 00:02:21.080 --> 00:02:23.778 <v Kirchhoff, Michael>think a lot of healthcare organizations are really</v>

26d82b3c-6769-49ed-94ea-40002ca91529/503-2 00:02:23.778 --> 00:02:27.006 <v Kirchhoff, Michael>understanding that they need to focus on that and understand</v>

26d82b3c-6769-49ed-94ea-40002ca91529/503-3 00:02:27.006 --> 00:02:28.646 <v Kirchhoff, Michael>that they need to address that.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/506-0 00:02:27.206 --> 00:02:27.396 <v Jordan Cooper>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/526-0 00:02:28.866 --> 00:02:32.328 <v Kirchhoff, Michael>But there's other implications, and that's really what I wanted</v>

26d82b3c-6769-49ed-94ea-40002ca91529/526-1 00:02:32.328 --> 00:02:35.086 <v Kirchhoff, Michael>to talk to your listeners and viewers today about.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/582-0 00:02:35.096 --> 00:02:39.376 <v Kirchhoff, Michael>But just you know, there are other impacts besides the bottom</v>

26d82b3c-6769-49ed-94ea-40002ca91529/582-1 00:02:39.376 --> 00:02:43.726 <v Kirchhoff, Michael>line besides the money we need to spend to keep our systems up</v>

26d82b3c-6769-49ed-94ea-40002ca91529/556-0 00:02:41.256 --> 00:02:41.476 <v Jordan Cooper>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/582-2 00:02:43.726 --> 00:02:47.453 <v Kirchhoff, Michael>to date and our applications running properly and our</v>

26d82b3c-6769-49ed-94ea-40002ca91529/582-3 00:02:47.453 --> 00:02:51.526 <v Kirchhoff, Michael>hardware safe from cyber attack and still within warranty.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/591-0 00:02:51.536 --> 00:02:55.946 <v Kirchhoff, Michael>And that's when I postpone doing some work.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/617-0 00:02:52.196 --> 00:02:53.746 <v Jordan Cooper>That's and.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/607-0 00:02:56.076 --> 00:03:00.205 <v Kirchhoff, Michael>What are the implications for workflows and patient flows and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/607-1 00:03:00.205 --> 00:03:01.536 <v Kirchhoff, Michael>patient information?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/624-0 00:03:01.866 --> 00:03:04.478 <v Kirchhoff, Michael>And I think that's the thing that a lot of people lose focus</v>

26d82b3c-6769-49ed-94ea-40002ca91529/624-1 00:03:04.478 --> 00:03:04.606 <v Kirchhoff, Michael>of.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/622-0 00:03:05.596 --> 00:03:06.026 <v Jordan Cooper>Right.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/648-0 00:03:06.036 --> 00:03:08.891 <v Jordan Cooper>So the main mission of a hospital or healthcare delivery</v>

26d82b3c-6769-49ed-94ea-40002ca91529/648-1 00:03:08.891 --> 00:03:11.845 <v Jordan Cooper>system is to provide care increasingly with the transition</v>

26d82b3c-6769-49ed-94ea-40002ca91529/648-2 00:03:11.845 --> 00:03:12.846 <v Jordan Cooper>to value based care.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/674-0 00:03:12.976 --> 00:03:16.158 <v Jordan Cooper>It's also to keep patient populations well and out of</v>

26d82b3c-6769-49ed-94ea-40002ca91529/674-1 00:03:16.158 --> 00:03:19.752 <v Jordan Cooper>receiving at least duplicative care or potentially avoidable</v>

26d82b3c-6769-49ed-94ea-40002ca91529/674-2 00:03:19.752 --> 00:03:20.046 <v Jordan Cooper>care.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/739-0 00:03:20.796 --> 00:03:25.230 <v Jordan Cooper>So could you walk our listeners through a concrete use case or</v>

26d82b3c-6769-49ed-94ea-40002ca91529/739-1 00:03:25.230 --> 00:03:29.663 <v Jordan Cooper>anecdote of the last year or two when you've had conversations</v>

26d82b3c-6769-49ed-94ea-40002ca91529/739-2 00:03:29.663 --> 00:03:33.534 <v Jordan Cooper>with leadership and with clinicians on your team about</v>

26d82b3c-6769-49ed-94ea-40002ca91529/739-3 00:03:33.534 --> 00:03:38.108 <v Jordan Cooper>the implications of the patient safety implications of technical</v>

26d82b3c-6769-49ed-94ea-40002ca91529/739-4 00:03:38.108 --> 00:03:41.979 <v Jordan Cooper>debt and how that actually played out and affected the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/739-5 00:03:41.979 --> 00:03:45.356 <v Jordan Cooper>prioritization of reducing that technical debt?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/737-0 00:03:45.896 --> 00:03:46.486 <v Kirchhoff, Michael>Sure.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/764-0 00:03:46.556 --> 00:03:49.703 <v Kirchhoff, Michael>So a lot of times what happens is if you're gonna incur</v>

26d82b3c-6769-49ed-94ea-40002ca91529/764-1 00:03:49.703 --> 00:03:53.356 <v Kirchhoff, Michael>technical debt, there's there's the things we just talked about.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/774-0 00:03:53.366 --> 00:03:55.446 <v Kirchhoff, Michael>But there's also a latent errors built into that.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/811-0 00:03:55.456 --> 00:03:59.226 <v Kirchhoff, Michael>So for example, you're expanding as an organization and you're</v>

26d82b3c-6769-49ed-94ea-40002ca91529/811-1 00:03:59.226 --> 00:04:02.757 <v Kirchhoff, Michael>electronic health record has a facility structure and that</v>

26d82b3c-6769-49ed-94ea-40002ca91529/811-2 00:04:02.757 --> 00:04:06.467 <v Kirchhoff, Michael>facility structure, there's a lot of overhead associated with</v>

26d82b3c-6769-49ed-94ea-40002ca91529/811-3 00:04:06.467 --> 00:04:06.766 <v Kirchhoff, Michael>that.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/839-0 00:04:06.776 --> 00:04:10.186 <v Kirchhoff, Michael>So for example, we need to build that out and test it, but then</v>

26d82b3c-6769-49ed-94ea-40002ca91529/839-1 00:04:10.186 --> 00:04:13.224 <v Kirchhoff, Michael>there's also all the other dependencies on that facility</v>

26d82b3c-6769-49ed-94ea-40002ca91529/839-2 00:04:13.224 --> 00:04:13.756 <v Kirchhoff, Michael>structure.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/856-0 00:04:13.766 --> 00:04:17.826 <v Kirchhoff, Michael>All the downstream systems, right, I don't think anybody has</v>

26d82b3c-6769-49ed-94ea-40002ca91529/856-1 00:04:17.826 --> 00:04:19.356 <v Kirchhoff, Michael>a single best of breed.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/893-0 00:04:19.366 --> 00:04:24.225 <v Kirchhoff, Michael>We all have legacy systems that are emirs are interfacing with</v>

26d82b3c-6769-49ed-94ea-40002ca91529/864-0 00:04:21.526 --> 00:04:21.676 <v Jordan Cooper>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/893-1 00:04:24.225 --> 00:04:28.235 <v Kirchhoff, Michael>any changes in facility structure and then metadata</v>

26d82b3c-6769-49ed-94ea-40002ca91529/893-2 00:04:28.235 --> 00:04:32.862 <v Kirchhoff, Michael>sociated with what's going on with patient flow or place of</v>

26d82b3c-6769-49ed-94ea-40002ca91529/893-3 00:04:32.862 --> 00:04:34.096 <v Kirchhoff, Michael>care, et cetera.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/935-0 00:04:34.326 --> 00:04:38.949 <v Kirchhoff, Michael>All those require quite a bit of overhead on as far as testing</v>

26d82b3c-6769-49ed-94ea-40002ca91529/935-1 00:04:38.949 --> 00:04:43.277 <v Kirchhoff, Michael>and validation, and sometimes when organizations grow they</v>

26d82b3c-6769-49ed-94ea-40002ca91529/935-2 00:04:43.277 --> 00:04:47.899 <v Kirchhoff, Michael>want to grow and get those new spaces up and running, and they</v>

26d82b3c-6769-49ed-94ea-40002ca91529/928-0 00:04:43.496 --> 00:04:43.746 <v Jordan Cooper>It.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/935-3 00:04:47.899 --> 00:04:48.486 <v Kirchhoff, Michael>may not.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/975-0 00:04:48.496 --> 00:04:51.786 <v Kirchhoff, Michael>They either may not do the testing, which is a big mistake,</v>

26d82b3c-6769-49ed-94ea-40002ca91529/975-1 00:04:51.786 --> 00:04:55.021 <v Kirchhoff, Michael>but more often than not they say, well, let's use existing</v>

26d82b3c-6769-49ed-94ea-40002ca91529/975-2 00:04:55.021 --> 00:04:57.926 <v Kirchhoff, Michael>structures because I can't afford to do the testing.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/973-0 00:04:56.286 --> 00:04:56.426 <v Jordan Cooper>That.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/982-0 00:04:57.936 --> 00:04:59.466 <v Kirchhoff, Michael>And I realized that testing is important.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/993-0 00:04:59.476 --> 00:05:02.826 <v Kirchhoff, Michael>So now you've introduced latent errors in the system.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1023-0 00:05:03.476 --> 00:05:07.355 <v Kirchhoff, Michael>I've the technical that I've taken on is not to building out</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1023-1 00:05:07.355 --> 00:05:10.980 <v Kirchhoff, Michael>the representation of my organization appropriately, and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1023-2 00:05:10.980 --> 00:05:14.286 <v Kirchhoff, Michael>then that may have potential implications later on.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1032-0 00:05:12.056 --> 00:05:12.086 <v Jordan Cooper>E.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1078-0 00:05:14.296 --> 00:05:17.605 <v Kirchhoff, Michael>So for example, if you're in an organization and for many</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1038-0 00:05:15.176 --> 00:05:15.346 <v Jordan Cooper>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1078-1 00:05:17.605 --> 00:05:20.857 <v Kirchhoff, Michael>organizations have disaster plans, and in those disaster</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1078-2 00:05:20.857 --> 00:05:24.394 <v Kirchhoff, Michael>plans they've built out in their facility structure, disaster</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1078-3 00:05:24.394 --> 00:05:27.246 <v Kirchhoff, Michael>beds and now we have a sudden need for new space.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1075-0 00:05:24.396 --> 00:05:24.626 <v Jordan Cooper>Yes.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1117-0 00:05:25.266 --> 00:05:28.816 <v Jordan Cooper>Now if E.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1107-0 00:05:27.376 --> 00:05:31.260 <v Kirchhoff, Michael>So an organization may consider using some of those best</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1107-1 00:05:31.260 --> 00:05:35.006 <v Kirchhoff, Michael>designated for these Serge plans as patient care area.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1134-0 00:05:35.296 --> 00:05:39.487 <v Kirchhoff, Michael>But the point is there are downstream dependencies related</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1134-1 00:05:39.487 --> 00:05:43.536 <v Kirchhoff, Michael>to that, so classic patient safety example would be I've</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1143-0 00:05:39.506 --> 00:05:40.896 <v Jordan Cooper>Well, uh. Uh.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1134-2 00:05:43.536 --> 00:05:44.246 <v Kirchhoff, Michael>built out.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1150-0 00:05:44.356 --> 00:05:48.696 <v Kirchhoff, Michael>I've used existing facility structure that caused the bed.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1149-0 00:05:47.706 --> 00:05:48.556 <v Jordan Cooper>At all.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1218-0 00:05:48.806 --> 00:05:52.840 <v Kirchhoff, Michael>You know, Serge, bed XYZ and now there's a code blue or medical</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1157-0 00:05:48.846 --> 00:05:49.116 <v Jordan Cooper>And.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1187-0 00:05:51.096 --> 00:05:51.166 <v Jordan Cooper>E.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1218-1 00:05:52.840 --> 00:05:56.937 <v Kirchhoff, Michael>emergency in that and that goes to our downstream legacy systems</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1218-2 00:05:56.937 --> 00:06:00.592 <v Kirchhoff, Michael>to our operators at call an overhead page and now they're</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1204-0 00:05:59.266 --> 00:06:01.666 <v Jordan Cooper>Yeah. Anything.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1218-3 00:06:00.592 --> 00:06:04.437 <v Kirchhoff, Michael>calling overhead page to search space XYZ as opposed to some</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1218-4 00:06:04.437 --> 00:06:07.336 <v Kirchhoff, Michael>physical location that clinicians know about.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1259-0 00:06:07.346 --> 00:06:10.920 <v Kirchhoff, Michael>So by kicking down the road, even building out facilities</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1259-1 00:06:10.920 --> 00:06:14.370 <v Kirchhoff, Michael>structures and doing this downstream testing, etcetera,</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1259-2 00:06:14.370 --> 00:06:17.821 <v Kirchhoff, Michael>you introduce latent errors in the system that may have</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1254-0 00:06:17.576 --> 00:06:17.856 <v Jordan Cooper>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1259-3 00:06:17.821 --> 00:06:19.176 <v Kirchhoff, Michael>implications later on.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1288-0 00:06:19.356 --> 00:06:22.817 <v Kirchhoff, Michael>And in our owner organization, as we identify those, you know</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1288-1 00:06:22.817 --> 00:06:26.500 <v Kirchhoff, Michael>we then go to leadership and go, hey guys, you missed this and we</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1288-2 00:06:26.500 --> 00:06:27.616 <v Kirchhoff, Michael>go back and do that.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1347-0 00:06:27.626 --> 00:06:30.694 <v Kirchhoff, Michael>But you know when you're initially thinking about the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1305-0 00:06:29.846 --> 00:06:31.506 <v Jordan Cooper>Uh, OK.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1347-1 00:06:30.694 --> 00:06:34.159 <v Kirchhoff, Michael>total cost of ownership around expanding an organization and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1312-0 00:06:33.596 --> 00:06:33.826 <v Jordan Cooper>And.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1347-2 00:06:34.159 --> 00:06:37.283 <v Kirchhoff, Michael>expanding the facility, you really need to think about</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1347-3 00:06:37.283 --> 00:06:40.861 <v Kirchhoff, Michael>there's other costs associated with that, not just the PCs I'm</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1347-4 00:06:40.861 --> 00:06:44.156 <v Kirchhoff, Michael>putting in that space or the monitors I'm putting in that</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1341-0 00:06:41.886 --> 00:06:42.206 <v Jordan Cooper>It's.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1347-5 00:06:44.156 --> 00:06:44.496 <v Kirchhoff, Michael>space.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1351-0 00:06:44.546 --> 00:06:44.806 <v Jordan Cooper>Yes.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1375-0 00:06:44.606 --> 00:06:48.401 <v Kirchhoff, Michael>But it's also that I really look at the facility structure and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1375-1 00:06:48.401 --> 00:06:51.955 <v Kirchhoff, Michael>how that, how that interface all our downstream systems et</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1375-2 00:06:51.955 --> 00:06:52.376 <v Kirchhoff, Michael>cetera.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1418-0 00:06:52.606 --> 00:06:56.011 <v Kirchhoff, Michael>And that's something that the safety side, we've been drawing</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1418-1 00:06:56.011 --> 00:06:59.470 <v Kirchhoff, Michael>a lot of attention to so that we don't fall into that risk and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1421-0 00:06:58.996 --> 00:06:59.216 <v Jordan Cooper>There's.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1418-2 00:06:59.470 --> 00:07:02.874 <v Kirchhoff, Michael>introduce those latent errors into our system and can protect</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1418-3 00:07:02.874 --> 00:07:04.356 <v Kirchhoff, Michael>our patients in the future.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1433-0 00:07:04.626 --> 00:07:07.586 <v Kirchhoff, Michael>When that information then flows, the other downstream</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1433-1 00:07:07.586 --> 00:07:08.016 <v Kirchhoff, Michael>systems.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1429-0 00:07:08.896 --> 00:07:09.326 <v Jordan Cooper>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1453-0 00:07:09.336 --> 00:07:12.817 <v Jordan Cooper>And you also mentioned not only physical the integration of</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1453-1 00:07:12.817 --> 00:07:16.066 <v Jordan Cooper>physical and digital, but also just within the digital.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1467-0 00:07:16.176 --> 00:07:19.244 <v Jordan Cooper>For example, when you're out of, organizations are going through</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1467-1 00:07:19.244 --> 00:07:20.706 <v Jordan Cooper>an application rationalization.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1485-0 00:07:20.816 --> 00:07:24.656 <v Jordan Cooper>If you're mapping old metadata to new metadata, then the lookup</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1485-1 00:07:24.656 --> 00:07:26.216 <v Jordan Cooper>tables don't work anymore.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1505-0 00:07:26.226 --> 00:07:28.476 <v Jordan Cooper>For example, in some cases, and.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1489-0 00:07:26.646 --> 00:07:26.846 <v Kirchhoff, Michael>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1494-0 00:07:28.116 --> 00:07:28.336 <v Kirchhoff, Michael>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1497-0 00:07:28.346 --> 00:07:29.146 <v Kirchhoff, Michael>And that's another.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1503-0 00:07:29.216 --> 00:07:30.136 <v Kirchhoff, Michael>That's a classic example.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1517-0 00:07:30.146 --> 00:07:32.300 <v Kirchhoff, Michael>I know we were gonna talk both about technical debt and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1517-1 00:07:32.300 --> 00:07:32.646 <v Kirchhoff, Michael>metadata.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1527-0 00:07:32.656 --> 00:07:34.496 <v Kirchhoff, Michael>This is where the two really meet, right?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1534-0 00:07:34.186 --> 00:07:34.446 <v Jordan Cooper>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1554-0 00:07:34.506 --> 00:07:39.052 <v Kirchhoff, Michael>Because with all these transactions is the metadata,</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1554-1 00:07:39.052 --> 00:07:44.455 <v Kirchhoff, Michael>the physical location and the virtual location, and those have</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1551-0 00:07:43.036 --> 00:07:43.256 <v Jordan Cooper>And.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1554-2 00:07:44.455 --> 00:07:45.226 <v Kirchhoff, Michael>to align.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1580-0 00:07:45.276 --> 00:07:48.434 <v Kirchhoff, Michael>And sometimes you know, for example, we build a new tower</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1580-1 00:07:48.434 --> 00:07:52.026 <v Kirchhoff, Michael>and now we have, we've built out all this new facility structure.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1606-0 00:07:52.036 --> 00:07:55.370 <v Kirchhoff, Michael>We have old facility structure and that metadata is someone has</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1606-1 00:07:55.370 --> 00:07:58.546 <v Kirchhoff, Michael>to go back and rationalize that and make sure it all aligns.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1639-0 00:07:58.896 --> 00:08:02.876 <v Kirchhoff, Michael>Because if you don't fix those, you potentially introduce latent</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1639-1 00:08:02.876 --> 00:08:06.794 <v Kirchhoff, Michael>errors and those latent errors might be as dangerous as sending</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1639-2 00:08:06.794 --> 00:08:09.426 <v Kirchhoff, Michael>somebody to the wrong location for a code.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1651-0 00:08:09.496 --> 00:08:11.116 <v Kirchhoff, Michael>But they might be inside it.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1654-0 00:08:09.556 --> 00:08:09.836 <v Jordan Cooper>But.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1656-0 00:08:11.126 --> 00:08:11.686 <v Kirchhoff, Michael>Insidious.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1688-0 00:08:11.696 --> 00:08:14.217 <v Kirchhoff, Michael>Like for example the accommodation code that's</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1688-1 00:08:14.217 --> 00:08:17.488 <v Kirchhoff, Michael>associated with that facility structure may come across as a</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1688-2 00:08:17.488 --> 00:08:20.545 <v Kirchhoff, Michael>Med surge when reality it's a step down or critical care</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1688-3 00:08:20.545 --> 00:08:20.866 <v Kirchhoff, Michael>space.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1720-0 00:08:20.996 --> 00:08:24.660 <v Kirchhoff, Michael>Now you're missing out on that facility that facility charge</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1702-0 00:08:23.736 --> 00:08:23.926 <v Jordan Cooper>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1720-1 00:08:24.660 --> 00:08:28.204 <v Kirchhoff, Michael>because the metadata on the, the the accommodation code is</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1715-0 00:08:26.196 --> 00:08:27.866 <v Jordan Cooper>Now that that.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1720-2 00:08:28.204 --> 00:08:30.726 <v Kirchhoff, Michael>different in somebody forgot to fix that.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1724-0 00:08:30.736 --> 00:08:31.936 <v Kirchhoff, Michael>So there's a lot.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1751-0 00:08:31.976 --> 00:08:35.423 <v Kirchhoff, Michael>There's a lot of cost to rationalization and growing and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1751-1 00:08:35.423 --> 00:08:38.688 <v Kirchhoff, Michael>part of that is the safety component and the metadata</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1744-0 00:08:36.646 --> 00:08:36.966 <v Jordan Cooper>And.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1751-2 00:08:38.688 --> 00:08:39.836 <v Kirchhoff, Michael>associated with it.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1818-0 00:08:39.846 --> 00:08:42.861 <v Kirchhoff, Michael>But it also has also understanding the total cost of</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1818-1 00:08:42.861 --> 00:08:46.047 <v Kirchhoff, Michael>ownership of these migration strategies and making sure</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1777-0 00:08:45.156 --> 00:08:45.396 <v Jordan Cooper>Uh-huh.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1818-2 00:08:46.047 --> 00:08:49.745 <v Kirchhoff, Michael>you're going back and having the time and resources allocated to</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1818-3 00:08:49.745 --> 00:08:53.386 <v Kirchhoff, Michael>make sure you're looking at all that legacy stuff and doing all</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1792-0 00:08:49.796 --> 00:08:50.066 <v Jordan Cooper>And then.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1818-4 00:08:53.386 --> 00:08:56.856 <v Kirchhoff, Michael>the appropriate stress testing to make sure that information</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1814-0 00:08:55.916 --> 00:08:56.376 <v Jordan Cooper>OK.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1818-5 00:08:56.856 --> 00:08:58.676 <v Kirchhoff, Michael>flows to where it needs to flow.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1843-0 00:08:59.166 --> 00:09:03.178 <v Kirchhoff, Michael>Billing is proper and that those physical locations match up with</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1843-1 00:09:03.178 --> 00:09:05.366 <v Kirchhoff, Michael>the virtual location in the system.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1907-0 00:09:03.236 --> 00:09:07.694 <v Jordan Cooper>Ah, so it sounds like if any of our listeners are persuaded and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1907-1 00:09:07.694 --> 00:09:12.082 <v Jordan Cooper>interested by this application rationalization, technical debt</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1907-2 00:09:12.082 --> 00:09:16.470 <v Jordan Cooper>awareness about the implications technical debt has on patient</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1907-3 00:09:16.470 --> 00:09:20.719 <v Jordan Cooper>safety, it sounds like a lot of governance and processes and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1907-4 00:09:20.719 --> 00:09:24.828 <v Jordan Cooper>testing or kind of what they need to begin implementing in</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1907-5 00:09:24.828 --> 00:09:27.196 <v Jordan Cooper>order to account for these risks.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1898-0 00:09:27.426 --> 00:09:27.616 <v Kirchhoff, Michael>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1913-0 00:09:27.626 --> 00:09:30.316 <v Kirchhoff, Michael>What it comes down to is just best industry practice, right?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1929-0 00:09:30.426 --> 00:09:33.316 <v Kirchhoff, Michael>Your your information technology department really needs to make</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1929-1 00:09:33.316 --> 00:09:34.916 <v Kirchhoff, Michael>you know good stakeholder analysis.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1937-0 00:09:34.926 --> 00:09:37.676 <v Kirchhoff, Michael>Good project management, good communication skills.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1941-0 00:09:37.686 --> 00:09:38.356 <v Kirchhoff, Michael>It's all stuff.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2018-0 00:09:38.366 --> 00:09:42.501 <v Kirchhoff, Michael>Everybody who's listening just knows about, but what a lot of</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2018-1 00:09:42.501 --> 00:09:46.169 <v Kirchhoff, Michael>teams fail to realize is the extent of it and how many</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2018-2 00:09:46.169 --> 00:09:50.303 <v Kirchhoff, Michael>resources you actually need to do a full stakeholder analysis</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2018-3 00:09:50.303 --> 00:09:53.771 <v Kirchhoff, Michael>and a full risk analysis of these minute mitigation</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2018-4 00:09:53.771 --> 00:09:57.505 <v Kirchhoff, Michael>migrations to make sure that you've looked at all those</v>

26d82b3c-6769-49ed-94ea-40002ca91529/1998-0 00:09:55.436 --> 00:09:55.676 <v Jordan Cooper>OK.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2018-5 00:09:57.505 --> 00:10:01.506 <v Kirchhoff, Michael>downstream systems and not just that the information flows.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2010-0 00:09:58.196 --> 00:09:58.426 <v Jordan Cooper>OK.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2034-0 00:10:01.696 --> 00:10:05.126 <v Kirchhoff, Michael>But then when it pops up at the other end, does that end user?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2046-0 00:10:05.176 --> 00:10:06.956 <v Kirchhoff, Michael>Is that does that data make sense to them?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2055-0 00:10:06.966 --> 00:10:08.056 <v Kirchhoff, Michael>Do they know where to go?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2101-0 00:10:08.146 --> 00:10:11.296 <v Kirchhoff, Michael>And if you forget to look at your operators and now you're</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2062-0 00:10:08.226 --> 00:10:08.416 <v Jordan Cooper>So.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2101-1 00:10:11.296 --> 00:10:14.552 <v Kirchhoff, Michael>pushing them physical locations that no longer make sense or</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2101-2 00:10:14.552 --> 00:10:17.968 <v Kirchhoff, Michael>you're pushing it to your coders and you're billing department,</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2088-0 00:10:14.866 --> 00:10:15.026 <v Jordan Cooper>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2101-3 00:10:17.968 --> 00:10:19.836 <v Kirchhoff, Michael>and then those accommodation code.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2110-0 00:10:19.846 --> 00:10:21.666 <v Kirchhoff, Michael>So it makes sense you're going to miss out.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2135-0 00:10:22.486 --> 00:10:26.227 <v Jordan Cooper>So I did mention just a moment ago about metadata, which is the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2135-1 00:10:26.227 --> 00:10:28.916 <v Jordan Cooper>second topic that we're going to cover today.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2224-0 00:10:29.066 --> 00:10:33.125 <v Jordan Cooper>And on the I mentioned kind of screwing up mapping between</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2224-1 00:10:33.125 --> 00:10:36.977 <v Jordan Cooper>lookup tables when you're mapping from old metadata new</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2224-2 00:10:36.977 --> 00:10:41.449 <v Jordan Cooper>metadata, the topic of metadata itself is becoming of increasing</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2224-3 00:10:41.449 --> 00:10:45.645 <v Jordan Cooper>interest to many healthcare delivery systems as Gen AI rises</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2224-4 00:10:45.645 --> 00:10:49.635 <v Jordan Cooper>in prominence as a topic that everyone is focusing on, in</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2224-5 00:10:49.635 --> 00:10:53.693 <v Jordan Cooper>particular when healthcare deliveries are sons are looking</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2224-6 00:10:53.693 --> 00:10:58.096 <v Jordan Cooper>to integrate Gen AI into their healthcare delivery system, they</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2224-7 00:10:58.096 --> 00:11:00.916 <v Jordan Cooper>often need to train models on their own.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2301-0 00:11:01.326 --> 00:11:05.359 <v Jordan Cooper>Uh data of different kinds, whether it be Phi or other sorts</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2301-1 00:11:05.359 --> 00:11:09.524 <v Jordan Cooper>of metadata, and I think we were today, we're going to discuss</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2301-2 00:11:09.524 --> 00:11:13.292 <v Jordan Cooper>kind of what, what data governance, what needs to happen</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2301-3 00:11:13.292 --> 00:11:17.325 <v Jordan Cooper>to ensure that you have the right metadata in order to train</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2301-4 00:11:17.325 --> 00:11:21.423 <v Jordan Cooper>your, your, your Gen AI models and kind of what is what we're</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2301-5 00:11:21.423 --> 00:11:25.522 <v Jordan Cooper>best practices in the past and how they how are they evolving</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2301-6 00:11:25.522 --> 00:11:25.786 <v Jordan Cooper>now.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2303-0 00:11:26.236 --> 00:11:26.666 <v Kirchhoff, Michael>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2339-0 00:11:26.676 --> 00:11:30.319 <v Kirchhoff, Michael>So this is a hard question to answer, and obviously there's</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2339-1 00:11:30.319 --> 00:11:34.023 <v Kirchhoff, Michael>the broader concepts of like bias in the data, et cetera and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2339-2 00:11:34.023 --> 00:11:37.726 <v Kirchhoff, Michael>healthcare or qualities when you're deploying these systems.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2345-0 00:11:37.736 --> 00:11:40.026 <v Kirchhoff, Michael>And that's where that data really shines.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2354-0 00:11:40.216 --> 00:11:43.526 <v Kirchhoff, Michael>But the other is the the tipple.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2358-0 00:11:43.536 --> 00:11:44.806 <v Kirchhoff, Michael>Set the simple lasers.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2414-0 00:11:45.016 --> 00:11:49.120 <v Kirchhoff, Michael>You don't know because when we look at these systems and we're</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2414-1 00:11:49.120 --> 00:11:53.158 <v Kirchhoff, Michael>looking at sort of the emergent characteristics of the hidden</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2414-2 00:11:53.158 --> 00:11:57.132 <v Kirchhoff, Michael>layers in these systems, we don't really understand a lot of</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2414-3 00:11:57.132 --> 00:12:01.235 <v Kirchhoff, Michael>times what those features are, that the system is keying on to</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2414-4 00:12:01.235 --> 00:12:04.166 <v Kirchhoff, Michael>understand to make that generative decision.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2424-0 00:12:04.356 --> 00:12:07.466 <v Kirchhoff, Michael>And for humans, a lot of times, how many people?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2431-0 00:12:07.476 --> 00:12:08.946 <v Kirchhoff, Michael>The diagnosis makes sense, right?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2449-0 00:12:08.956 --> 00:12:13.116 <v Kirchhoff, Michael>But it may turn out that location may play a role there.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2447-0 00:12:11.076 --> 00:12:11.376 <v Jordan Cooper>At.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2476-0 00:12:13.126 --> 00:12:16.613 <v Kirchhoff, Michael>So when we're thinking about the data and the metadata, you're</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2473-0 00:12:14.366 --> 00:12:14.386 <v Jordan Cooper>E.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2476-1 00:12:16.613 --> 00:12:19.491 <v Kirchhoff, Michael>going to use in training systems, the more data the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2480-0 00:12:18.846 --> 00:12:19.216 <v Jordan Cooper>Huh.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2476-2 00:12:19.491 --> 00:12:20.266 <v Kirchhoff, Michael>better, right?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2522-0 00:12:20.276 --> 00:12:23.844 <v Kirchhoff, Michael>We're seeing that across the industry, bigger generative</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2522-1 00:12:23.844 --> 00:12:27.600 <v Kirchhoff, Michael>systems, the bigger the data set, the better, the more rich</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2501-0 00:12:26.416 --> 00:12:26.586 <v Jordan Cooper>Yep.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2522-2 00:12:27.600 --> 00:12:31.481 <v Kirchhoff, Michael>the data system that we're rich the data the better and other</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2522-3 00:12:31.481 --> 00:12:34.611 <v Kirchhoff, Michael>contexts of that data, specifically the metadata,</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2518-0 00:12:31.766 --> 00:12:32.076 <v Jordan Cooper>And.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2522-4 00:12:34.611 --> 00:12:34.986 <v Kirchhoff, Michael>right.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2559-0 00:12:34.996 --> 00:12:39.423 <v Kirchhoff, Michael>So maybe not just patient demographics and diagnosis gets</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2559-1 00:12:39.423 --> 00:12:44.078 <v Kirchhoff, Michael>me to where I need to go, but maybe the system at the hidden</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2574-0 00:12:41.166 --> 00:12:41.316 <v Jordan Cooper>Well.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2559-2 00:12:44.078 --> 00:12:48.352 <v Kirchhoff, Michael>layer is keying on location data, time of day, data, et</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2559-3 00:12:48.352 --> 00:12:48.886 <v Kirchhoff, Michael>cetera.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2637-0 00:12:48.996 --> 00:12:52.841 <v Kirchhoff, Michael>So if you're not saving that data and then putting it into</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2637-1 00:12:52.841 --> 00:12:57.012 <v Kirchhoff, Michael>your datasets for your training, you may be missing out on that</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2589-0 00:12:53.896 --> 00:12:54.106 <v Jordan Cooper>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2637-2 00:12:57.012 --> 00:13:01.248 <v Kirchhoff, Michael>and what further confounds that is, you often don't know how the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2598-0 00:12:57.226 --> 00:12:57.466 <v Jordan Cooper>And.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2637-3 00:13:01.248 --> 00:13:05.485 <v Kirchhoff, Michael>original basis that was trained was the basis of trade with that</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2637-4 00:13:05.485 --> 00:13:08.613 <v Kirchhoff, Michael>metadata are not thus introducing that metadata</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2637-5 00:13:08.613 --> 00:13:11.936 <v Kirchhoff, Michael>aligned with the previous training regimen or not.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2633-0 00:13:09.236 --> 00:13:09.426 <v Jordan Cooper>That's.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2692-0 00:13:12.306 --> 00:13:16.500 <v Kirchhoff, Michael>And then when there's a mismatch between the data set of initial</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2650-0 00:13:13.106 --> 00:13:13.336 <v Jordan Cooper>And.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2692-1 00:13:16.500 --> 00:13:20.113 <v Kirchhoff, Michael>training and then fine tuning, how does that affect the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2692-2 00:13:20.113 --> 00:13:24.243 <v Kirchhoff, Michael>emergent features in the latent space, and how does that affect</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2692-3 00:13:24.243 --> 00:13:28.436 <v Kirchhoff, Michael>the decision making the weights of that and that's hard to know.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2748-0 00:13:28.526 --> 00:13:32.625 <v Kirchhoff, Michael>So it's not only important to have this data because it helps</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2748-1 00:13:32.625 --> 00:13:36.525 <v Kirchhoff, Michael>the AI key on items that the human observer may not key on</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2748-2 00:13:36.525 --> 00:13:40.888 <v Kirchhoff, Michael>and get you more robust answers, but it also has implications for</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2748-3 00:13:40.888 --> 00:13:44.722 <v Kirchhoff, Michael>off the shelf AI that now you're trading and what was the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2748-4 00:13:44.722 --> 00:13:46.506 <v Kirchhoff, Michael>training regimen initially?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2752-0 00:13:46.516 --> 00:13:47.186 <v Kirchhoff, Michael>What was that data?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2827-0 00:13:47.196 --> 00:13:50.916 <v Kirchhoff, Michael>What was the metadata and do those things align and then the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2765-0 00:13:48.376 --> 00:13:48.636 <v Jordan Cooper>That.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2827-1 00:13:50.916 --> 00:13:54.757 <v Kirchhoff, Michael>bigger 50,000 foot view in as much as that, what this has been</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2775-0 00:13:51.276 --> 00:13:51.586 <v Jordan Cooper>Great.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2788-0 00:13:54.706 --> 00:13:54.966 <v Jordan Cooper>That.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2827-2 00:13:54.757 --> 00:13:58.598 <v Kirchhoff, Michael>a day to do with respect to bias and all the other things that</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2827-3 00:13:58.598 --> 00:14:02.195 <v Kirchhoff, Michael>we're really focused on in healthcare and and so much show</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2827-4 00:14:02.195 --> 00:14:05.549 <v Kirchhoff, Michael>that Joint Commission is starting to focus on this and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2827-5 00:14:05.549 --> 00:14:06.646 <v Kirchhoff, Michael>the FDA et cetera.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2833-0 00:14:06.566 --> 00:14:06.716 <v Jordan Cooper>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2880-0 00:14:06.906 --> 00:14:10.896 <v Kirchhoff, Michael>You know this bias in these general systems is a hot button</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2880-1 00:14:10.896 --> 00:14:14.953 <v Kirchhoff, Michael>topic, and the metadata and understanding the context of the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2880-2 00:14:14.953 --> 00:14:19.342 <v Kirchhoff, Michael>data and the person that is part of that data in system is super,</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2880-3 00:14:19.342 --> 00:14:22.866 <v Kirchhoff, Michael>super important for understanding bias and outcomes.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2873-0 00:14:20.016 --> 00:14:20.306 <v Jordan Cooper>Yes.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2891-0 00:14:23.906 --> 00:14:28.157 <v Jordan Cooper>You know, some of the examples you provide remind me of classic</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2891-1 00:14:28.157 --> 00:14:29.086 <v Jordan Cooper>public health.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2900-0 00:14:29.656 --> 00:14:32.836 <v Jordan Cooper>Uh case studies, for example.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2904-0 00:14:32.916 --> 00:14:34.546 <v Jordan Cooper>I think in the 1970s.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2926-0 00:14:36.586 --> 00:14:41.038 <v Jordan Cooper>There was not clear evidence at the time that both systolic and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2926-1 00:14:41.038 --> 00:14:44.516 <v Jordan Cooper>diastolic blood pressure were worth measuring it.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2947-0 00:14:44.526 --> 00:14:47.712 <v Jordan Cooper>There was meaning to the lower number and so we didn't use to</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2947-1 00:14:47.712 --> 00:14:48.996 <v Jordan Cooper>collect that information.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2974-0 00:14:49.006 --> 00:14:52.227 <v Jordan Cooper>And it wasn't only until later that we incorporate that we</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2974-1 00:14:52.227 --> 00:14:55.556 <v Jordan Cooper>found, I think Professor Mike Clagg from Johns Hopkins found</v>

26d82b3c-6769-49ed-94ea-40002ca91529/2974-2 00:14:55.556 --> 00:14:56.866 <v Jordan Cooper>out, hey, you know what?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3032-0 00:14:56.876 --> 00:15:00.423 <v Jordan Cooper>Both numbers actually do have value and meaning, and gosh, I</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3032-1 00:15:00.423 --> 00:15:03.969 <v Jordan Cooper>wish we'd been collecting both numbers for a long time so it</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3032-2 00:15:03.969 --> 00:15:07.748 <v Jordan Cooper>could be for future discoveries where another one that's kind of</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3032-3 00:15:07.748 --> 00:15:11.353 <v Jordan Cooper>a fun one to to talk about is before the Queen Indoor Air Act</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3032-4 00:15:11.353 --> 00:15:12.806 <v Jordan Cooper>in the late 20th century.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3047-0 00:15:13.026 --> 00:15:16.126 <v Jordan Cooper>Coffee drinking was an indicator of lung cancer because it was</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3047-1 00:15:16.126 --> 00:15:17.306 <v Jordan Cooper>correlated with smoking.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3074-0 00:15:17.316 --> 00:15:20.971 <v Jordan Cooper>People used to have a cigarette with their coffee, and so it may</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3074-1 00:15:20.971 --> 00:15:24.063 <v Jordan Cooper>be helpful to predict lung cancer by capturing who's a</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3074-2 00:15:24.063 --> 00:15:24.906 <v Jordan Cooper>coffee drinker.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3091-0 00:15:24.976 --> 00:15:27.465 <v Jordan Cooper>But of course, those are the sorts of things that just seems</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3084-0 00:15:25.026 --> 00:15:25.206 <v Kirchhoff, Michael>Yep.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3091-1 00:15:27.465 --> 00:15:28.036 <v Jordan Cooper>so irrelevant.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3095-0 00:15:28.046 --> 00:15:29.656 <v Jordan Cooper>There's no causal relation.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3112-0 00:15:29.736 --> 00:15:32.726 <v Jordan Cooper>Why would I care about coffee if I want to study one cancer?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3172-0 00:15:32.856 --> 00:15:36.872 <v Jordan Cooper>So just take that as an analogy for, you know, 60 years later</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3172-1 00:15:36.872 --> 00:15:40.046 <v Jordan Cooper>with different kinds of contextual data and data</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3172-2 00:15:40.046 --> 00:15:43.738 <v Jordan Cooper>elements and data space about what might be relevant and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3172-3 00:15:43.738 --> 00:15:46.847 <v Jordan Cooper>predictive for either a patient's health or for</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3172-4 00:15:46.847 --> 00:15:49.956 <v Jordan Cooper>something that could help train a Gen AI model.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3168-0 00:15:50.586 --> 00:15:50.886 <v Kirchhoff, Michael>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3191-0 00:15:50.896 --> 00:15:56.486 <v Kirchhoff, Michael>And this is key in the emergence the emergent characteristics of</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3191-1 00:15:56.486 --> 00:15:57.346 <v Kirchhoff, Michael>the model.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3232-0 00:15:58.356 --> 00:16:02.506 <v Kirchhoff, Michael>The human again may think this data point is irrelevant to the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3199-0 00:15:59.996 --> 00:16:00.026 <v Jordan Cooper>E.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3232-1 00:16:02.506 --> 00:16:06.590 <v Kirchhoff, Michael>outcome from a face validity perspective, but it turns out it</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3232-2 00:16:06.590 --> 00:16:10.740 <v Kirchhoff, Michael>actually is important for the model, and that makes inter till</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3232-3 00:16:10.740 --> 00:16:13.506 <v Kirchhoff, Michael>interoperability research very difficult.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3249-0 00:16:13.516 --> 00:16:17.424 <v Kirchhoff, Michael>It makes explain ability very difficult, so it's a fine</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3249-1 00:16:17.424 --> 00:16:19.586 <v Kirchhoff, Michael>balance, so more interpretable.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3258-0 00:16:19.596 --> 00:16:21.196 <v Kirchhoff, Michael>I want something to be the more explainable.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3294-0 00:16:21.206 --> 00:16:24.815 <v Kirchhoff, Michael>I want to model to be the more I'm going to give data that has</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3282-0 00:16:24.306 --> 00:16:24.596 <v Jordan Cooper>That.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3294-1 00:16:24.815 --> 00:16:28.365 <v Kirchhoff, Michael>facility to a human observer that this makes sense that these</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3294-2 00:16:28.365 --> 00:16:30.026 <v Kirchhoff, Michael>are associated or correlated.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3304-0 00:16:30.956 --> 00:16:34.226 <v Kirchhoff, Michael>But it turns out more data density.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3314-0 00:16:35.136 --> 00:16:39.146 <v Kirchhoff, Michael>Other metadata may actually help the system become more accurate.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3321-0 00:16:39.376 --> 00:16:40.476 <v Kirchhoff, Michael>The converse is also true.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3345-0 00:16:40.776 --> 00:16:44.916 <v Kirchhoff, Michael>Sometimes it's Data Aronofsky trains the system for outcomes,</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3345-1 00:16:44.916 --> 00:16:49.056 <v Kirchhoff, Michael>so again on the interpretability side and face validity side.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3357-0 00:16:45.336 --> 00:16:45.766 <v Jordan Cooper>OK.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3376-0 00:16:49.506 --> 00:16:53.884 <v Kirchhoff, Michael>Umm it it's it can cut both ways and it just really speaks the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3368-0 00:16:53.216 --> 00:16:53.656 <v Jordan Cooper>Managed.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3376-1 00:16:53.884 --> 00:16:56.246 <v Kirchhoff, Michael>need to do this type of research.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3389-0 00:16:56.726 --> 00:17:00.336 <v Jordan Cooper>To metadata can provide a kind of audit if you're trying to.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3398-0 00:17:00.346 --> 00:17:02.936 <v Jordan Cooper>If they've been problem problems interpreting past data.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3399-0 00:17:03.246 --> 00:17:03.686 <v Kirchhoff, Michael>Yep.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3401-0 00:17:03.696 --> 00:17:04.386 <v Kirchhoff, Michael>Sometimes.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3446-0 00:17:04.396 --> 00:17:08.326 <v Kirchhoff, Michael>Uh, but it also may provide a more data rich environment from</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3446-1 00:17:08.326 --> 00:17:12.002 <v Kirchhoff, Michael>the model than to key on a characteristic of the data set</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3446-2 00:17:12.002 --> 00:17:15.108 <v Kirchhoff, Michael>that a human wouldn't necessarily pick up on and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3446-3 00:17:15.108 --> 00:17:17.326 <v Kirchhoff, Michael>potentially make it more accurate.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3443-0 00:17:15.756 --> 00:17:15.956 <v Jordan Cooper>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3459-0 00:17:17.596 --> 00:17:19.186 <v Kirchhoff, Michael>It's hard to say.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3476-0 00:17:18.006 --> 00:17:22.580 <v Jordan Cooper>I before we wrap up, I I'd love to hear about the contextualize</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3476-1 00:17:22.580 --> 00:17:26.796 <v Jordan Cooper>this conversation about metadata in your work with sepsis.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3502-0 00:17:26.886 --> 00:17:30.606 <v Jordan Cooper>I think that Cooper Healthcare is a national leader in sepsis</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3502-1 00:17:30.606 --> 00:17:34.326 <v Jordan Cooper>care and I think you have an interesting story about metadata</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3502-2 00:17:34.326 --> 00:17:34.926 <v Jordan Cooper>and stuff.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3515-0 00:17:35.106 --> 00:17:35.606 <v Jordan Cooper>Is that right?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3510-0 00:17:35.856 --> 00:17:36.326 <v Kirchhoff, Michael>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3531-0 00:17:36.336 --> 00:17:39.644 <v Kirchhoff, Michael>So early on we were doing a lot of the the this early work and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3531-1 00:17:39.644 --> 00:17:40.746 <v Kirchhoff, Michael>understanding sepsis.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3536-0 00:17:41.876 --> 00:17:45.646 <v Kirchhoff, Michael>We were collecting what had face validity.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3550-0 00:17:45.996 --> 00:17:47.346 <v Kirchhoff, Michael>What's your heart rate this hour?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3555-0 00:17:47.356 --> 00:17:48.036 <v Kirchhoff, Michael>What's your heart rate?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3564-0 00:17:48.046 --> 00:17:49.786 <v Kirchhoff, Michael>Next hour, what's your blood pressure this hour?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3572-0 00:17:49.936 --> 00:17:51.246 <v Kirchhoff, Michael>What your heart rate, your heart.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3589-0 00:17:51.256 --> 00:17:54.560 <v Kirchhoff, Michael>Blood pressure the next hour and it turns out that that overall</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3589-1 00:17:54.560 --> 00:17:56.366 <v Kirchhoff, Michael>trend is really, really important.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3648-0 00:17:56.436 --> 00:17:59.585 <v Kirchhoff, Michael>But when you want to start to create models that predict that</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3648-1 00:17:59.585 --> 00:18:02.836 <v Kirchhoff, Michael>earlier and earlier and earlier, the amount of variation minute</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3648-2 00:18:02.836 --> 00:18:05.782 <v Kirchhoff, Michael>to minute, 2nd to 2nd is actually a stronger predictor of</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3648-3 00:18:05.782 --> 00:18:08.981 <v Kirchhoff, Michael>patients that are going to then deteriorate before the obvious</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3648-4 00:18:08.981 --> 00:18:11.876 <v Kirchhoff, Michael>deterioration of high heart rate and low blood pressure.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3656-0 00:18:12.076 --> 00:18:12.406 <v Jordan Cooper>Uh-huh.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3679-0 00:18:12.146 --> 00:18:15.772 <v Kirchhoff, Michael>Once you have high heart rate and low blood pressure, you know</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3679-1 00:18:15.772 --> 00:18:18.994 <v Kirchhoff, Michael>you're really behind 8 ball picking up that decrease in</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3677-0 00:18:18.666 --> 00:18:18.886 <v Jordan Cooper>That.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3679-2 00:18:18.994 --> 00:18:21.296 <v Kirchhoff, Michael>variation earlier on is very important.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3714-0 00:18:21.306 --> 00:18:24.454 <v Kirchhoff, Michael>So when we did a lot of our initial early studies, we were</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3714-1 00:18:24.454 --> 00:18:27.549 <v Kirchhoff, Michael>capturing at the bedside heart rate and blood pressure is</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3714-2 00:18:27.549 --> 00:18:29.096 <v Kirchhoff, Michael>emitted to minute 2nd to 2nd.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3731-0 00:18:29.286 --> 00:18:32.816 <v Kirchhoff, Michael>But in the data sets that we exported, we did it every hour.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3798-0 00:18:32.966 --> 00:18:36.541 <v Kirchhoff, Michael>And then what happens is we did some great research on that</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3798-1 00:18:36.541 --> 00:18:40.055 <v Kirchhoff, Michael>space and then we started to learn that understanding this</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3798-2 00:18:40.055 --> 00:18:43.987 <v Kirchhoff, Michael>data at smaller and smaller time intervals and understanding that</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3764-0 00:18:40.596 --> 00:18:40.816 <v Jordan Cooper>And.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3798-3 00:18:43.987 --> 00:18:47.681 <v Kirchhoff, Michael>variability could be predictive, we couldn't go back and redo</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3798-4 00:18:47.681 --> 00:18:51.314 <v Kirchhoff, Michael>those studies because we just jettisoned all that other data</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3798-5 00:18:51.314 --> 00:18:53.816 <v Kirchhoff, Michael>that would have been potentially helpful.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3836-0 00:18:53.966 --> 00:18:58.269 <v Kirchhoff, Michael>Now the issue there is back in the day, is it very expensive to</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3836-1 00:18:58.269 --> 00:19:01.967 <v Kirchhoff, Michael>store all this data as that's getting cheaper and more</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3826-0 00:18:59.896 --> 00:19:00.206 <v Jordan Cooper>Happy.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3836-2 00:19:01.967 --> 00:19:03.916 <v Kirchhoff, Michael>inexpensive and easier to do?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3842-0 00:19:02.746 --> 00:19:02.896 <v Jordan Cooper>It.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3886-0 00:19:04.286 --> 00:19:07.672 <v Kirchhoff, Michael>I would always make the argument that just collect as much data</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3853-0 00:19:06.206 --> 00:19:06.416 <v Jordan Cooper>OK.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3886-1 00:19:07.672 --> 00:19:10.899 <v Kirchhoff, Michael>with as much density as you can, because you never know when</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3881-0 00:19:08.136 --> 00:19:08.466 <v Jordan Cooper>That.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3886-2 00:19:10.899 --> 00:19:14.338 <v Kirchhoff, Michael>that's going to be helpful when it's economically feasible to do</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3889-0 00:19:12.266 --> 00:19:12.456 <v Jordan Cooper>Well.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3886-3 00:19:14.338 --> 00:19:14.496 <v Kirchhoff, Michael>it.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3897-0 00:19:14.506 --> 00:19:16.676 <v Kirchhoff, Michael>I wish we had that second to second.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3910-0 00:19:16.966 --> 00:19:19.249 <v Kirchhoff, Michael>A heart rate data because we could have done a lot more</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3910-1 00:19:19.249 --> 00:19:19.616 <v Kirchhoff, Michael>research.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3957-0 00:19:19.886 --> 00:19:23.697 <v Kirchhoff, Michael>We ultimately went on to do some of that work, but the initial</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3957-1 00:19:23.697 --> 00:19:27.629 <v Kirchhoff, Michael>work really the data set didn't support some of the new findings</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3949-0 00:19:24.916 --> 00:19:24.976 <v Jordan Cooper>E.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3957-2 00:19:27.629 --> 00:19:31.500 <v Kirchhoff, Michael>people were getting out of that data, which was that second and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3957-3 00:19:31.500 --> 00:19:32.346 <v Kirchhoff, Michael>2nd variation.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3983-0 00:19:32.836 --> 00:19:36.331 <v Jordan Cooper>And when it comes to sepsis, just even having like 20 minutes</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3983-1 00:19:36.331 --> 00:19:39.883 <v Jordan Cooper>earlier notification or an hour or notification can make a lot</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3983-2 00:19:39.883 --> 00:19:41.066 <v Jordan Cooper>of difference, right?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3988-0 00:19:40.766 --> 00:19:41.646 <v Kirchhoff, Michael>Umm yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/3996-0 00:19:41.516 --> 00:19:44.726 <v Jordan Cooper>So how would you advise health systems listening to this?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4012-0 00:19:44.736 --> 00:19:48.846 <v Jordan Cooper>How to balance a cost of just collecting a bunch of data?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4039-0 00:19:48.856 --> 00:19:52.471 <v Jordan Cooper>And by the way, if it's a lot of information that's not</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4039-1 00:19:52.471 --> 00:19:56.408 <v Jordan Cooper>interpreted and it's not, and there's just garbage, you know</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4039-2 00:19:56.408 --> 00:19:57.376 <v Jordan Cooper>it needs to be.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4049-0 00:19:57.436 --> 00:19:59.966 <v Jordan Cooper>How do you advise an organization to not?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4067-0 00:20:00.006 --> 00:20:03.256 <v Jordan Cooper>You can lose the meaning of the data if you just have everything</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4067-1 00:20:03.256 --> 00:20:05.056 <v Jordan Cooper>collecting everything all the time.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4072-0 00:20:05.116 --> 00:20:06.036 <v Jordan Cooper>How do you advise them?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4084-0 00:20:06.046 --> 00:20:11.427 <v Jordan Cooper>How to the balance, cost and organization and future value</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4084-1 00:20:11.427 --> 00:20:12.886 <v Jordan Cooper>potential value?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4110-0 00:20:12.936 --> 00:20:15.056 <v Jordan Cooper>How you how would you do that?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4092-0 00:20:15.496 --> 00:20:15.866 <v Kirchhoff, Michael>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4166-0 00:20:15.876 --> 00:20:18.674 <v Kirchhoff, Michael>No, that's a really good point because you know the classic</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4166-1 00:20:18.674 --> 00:20:21.379 <v Kirchhoff, Michael>counterexample here is I OT right if I if I have my watch</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4166-2 00:20:21.379 --> 00:20:23.757 <v Kirchhoff, Michael>collecting a bunch of accelerometer data and heart</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4166-3 00:20:23.757 --> 00:20:26.695 <v Kirchhoff, Michael>rate data, but it doesn't know the difference between what I'm</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4166-4 00:20:26.695 --> 00:20:29.587 <v Kirchhoff, Michael>sleeping on, I'm awake or when it's off of when it's on, it's</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4166-5 00:20:29.587 --> 00:20:30.006 <v Kirchhoff, Michael>etcetera.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4181-0 00:20:30.126 --> 00:20:33.975 <v Kirchhoff, Michael>There's a lot of garbage in that data, and despite having great</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4173-0 00:20:30.166 --> 00:20:30.306 <v Jordan Cooper>Yeah.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4181-1 00:20:33.975 --> 00:20:34.756 <v Kirchhoff, Michael>data density.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4198-0 00:20:36.236 --> 00:20:40.424 <v Kirchhoff, Michael>Might not be helpful, so it's the same as the technical depth</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4198-1 00:20:40.424 --> 00:20:41.166 <v Kirchhoff, Michael>discussion.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4202-0 00:20:41.556 --> 00:20:43.056 <v Kirchhoff, Michael>Good stakeholder analysis.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4217-0 00:20:43.066 --> 00:20:45.562 <v Kirchhoff, Michael>Getting the right experts and subject matter experts in there</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4217-1 00:20:45.562 --> 00:20:46.246 <v Kirchhoff, Michael>to talk about it.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4241-0 00:20:46.656 --> 00:20:50.150 <v Kirchhoff, Michael>Know what the latest literature shows in terms of how these data</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4241-1 00:20:50.150 --> 00:20:53.106 <v Kirchhoff, Michael>points may relate to the outcome you're interested in?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4268-0 00:20:53.176 --> 00:20:57.070 <v Kirchhoff, Michael>And then balancing that with the total cost of either curating</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4252-0 00:20:53.266 --> 00:20:54.376 <v Jordan Cooper>And yes.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4268-1 00:20:57.070 --> 00:21:00.346 <v Kirchhoff, Michael>the data to your point is, does the data make sense?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4285-0 00:21:00.956 --> 00:21:04.283 <v Kirchhoff, Michael>Is the data clean or is there garbage right that there's a</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4285-1 00:21:04.283 --> 00:21:05.466 <v Kirchhoff, Michael>cost related to that?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4373-0 00:21:05.476 --> 00:21:09.299 <v Kirchhoff, Michael>Either technical or human to look and validate that data, and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4373-1 00:21:09.299 --> 00:21:13.123 <v Kirchhoff, Michael>then as the ultimate cost of that storage and manipulation of</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4373-2 00:21:13.123 --> 00:21:17.069 <v Kirchhoff, Michael>that data, so understanding the need and the potential benefits</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4373-3 00:21:17.069 --> 00:21:20.645 <v Kirchhoff, Michael>of more metadata and data density and match that with the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4331-0 00:21:20.186 --> 00:21:20.406 <v Jordan Cooper>The.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4373-4 00:21:20.645 --> 00:21:24.530 <v Kirchhoff, Michael>total cost of doing that work and then having just really good</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4373-5 00:21:24.530 --> 00:21:28.415 <v Kirchhoff, Michael>project management getting the right stakeholders at the table</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4359-0 00:21:27.706 --> 00:21:27.976 <v Jordan Cooper>It.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4373-6 00:21:28.415 --> 00:21:31.930 <v Kirchhoff, Michael>and having that conversation because in the past we just</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4373-7 00:21:31.930 --> 00:21:33.656 <v Kirchhoff, Michael>never had that conversation.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4399-0 00:21:33.866 --> 00:21:37.683 <v Kirchhoff, Michael>So my recommendation would be just have the conversation so at</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4380-0 00:21:34.146 --> 00:21:34.386 <v Jordan Cooper>So.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4399-1 00:21:37.683 --> 00:21:41.136 <v Kirchhoff, Michael>least you know what you risk by not saving all the data.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4408-0 00:21:42.186 --> 00:21:44.916 <v Jordan Cooper>I appreciate your time with us today, Michael.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4423-0 00:21:44.926 --> 00:21:48.987 <v Jordan Cooper>We covered a lot of information from meta technical debt to</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4423-1 00:21:48.987 --> 00:21:49.596 <v Jordan Cooper>metadata.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4452-0 00:21:50.026 --> 00:21:53.902 <v Jordan Cooper>You've kind of already addressed this, but if there was something</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4452-1 00:21:53.902 --> 00:21:57.659 <v Jordan Cooper>that you wish you knew, if you could speak to Michael Kirchhoff</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4452-2 00:21:57.659 --> 00:21:58.716 <v Jordan Cooper>of four years ago.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4454-0 00:21:58.906 --> 00:21:59.516 <v Jordan Cooper>What?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4485-0 00:21:59.526 --> 00:22:03.211 <v Jordan Cooper>What would you tell yourself and engaging in with kind of</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4485-1 00:22:03.211 --> 00:22:07.150 <v Jordan Cooper>considering patient safety with regards to technical debt and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4485-2 00:22:07.150 --> 00:22:10.326 <v Jordan Cooper>reviewing metadata, what would you tell yourself?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4527-0 00:22:11.796 --> 00:22:16.549 <v Kirchhoff, Michael>To really think about the implications of it, what I find</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4527-1 00:22:16.549 --> 00:22:20.728 <v Kirchhoff, Michael>myself doing a lot of now is really looking at the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4527-2 00:22:20.728 --> 00:22:25.808 <v Kirchhoff, Michael>implications of this data as it pertains to bias and equality</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4527-3 00:22:25.808 --> 00:22:27.856 <v Kirchhoff, Michael>and access in healthcare.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4583-0 00:22:28.036 --> 00:22:31.883 <v Kirchhoff, Michael>Because that's ultimately we're charged with the good keeping</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4583-1 00:22:31.883 --> 00:22:34.985 <v Kirchhoff, Michael>and the health of our communities and knowing how</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4583-2 00:22:34.985 --> 00:22:38.398 <v Kirchhoff, Michael>whatever tool we're applying applies to our particular</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4583-3 00:22:38.398 --> 00:22:41.686 <v Kirchhoff, Michael>communities and their demographics and their data is</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4583-4 00:22:41.686 --> 00:22:45.346 <v Kirchhoff, Michael>something that I think every health system struggles with.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4603-0 00:22:45.356 --> 00:22:49.442 <v Kirchhoff, Michael>And it's a big item for us to have an eye on because we're,</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4603-1 00:22:49.442 --> 00:22:51.076 <v Kirchhoff, Michael>it's our mandate, right?</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4717-0 00:22:51.136 --> 00:22:54.602 <v Kirchhoff, Michael>We need to care for those in our communities and those</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4717-1 00:22:54.602 --> 00:22:58.320 <v Kirchhoff, Michael>communities vary from place to place and time to time, and</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4717-2 00:22:58.320 --> 00:23:01.787 <v Kirchhoff, Michael>knowing how systems may or may not meet the needs if a</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4717-3 00:23:01.787 --> 00:23:05.379 <v Kirchhoff, Michael>particular community is something that we're focusing on</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4717-4 00:23:05.379 --> 00:23:09.160 <v Kirchhoff, Michael>a lot now because in the past many vendors did not focus on</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4663-0 00:23:07.396 --> 00:23:07.636 <v Jordan Cooper>That's.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4717-5 00:23:09.160 --> 00:23:13.130 <v Kirchhoff, Michael>that and we find we're playing a little catch up on that right</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4717-6 00:23:13.130 --> 00:23:16.974 <v Kirchhoff, Michael>now and knowing that back in the day and really asking those</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4693-0 00:23:15.006 --> 00:23:15.166 <v Jordan Cooper>And.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4717-7 00:23:16.974 --> 00:23:20.692 <v Kirchhoff, Michael>questions, especially of the vendors who were creating the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4717-8 00:23:20.692 --> 00:23:24.410 <v Kirchhoff, Michael>systems to make sure that they have inclusive data that is</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4722-0 00:23:23.916 --> 00:23:24.046 <v Jordan Cooper>The.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4717-9 00:23:24.410 --> 00:23:25.166 <v Kirchhoff, Michael>represented.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4751-0 00:23:25.446 --> 00:23:29.064 <v Kirchhoff, Michael>Of our patient population and that that data is free of biases</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4739-0 00:23:27.746 --> 00:23:27.966 <v Jordan Cooper>And.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4751-1 00:23:29.064 --> 00:23:32.279 <v Kirchhoff, Michael>is something those were those were not frequently asked</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4751-2 00:23:32.279 --> 00:23:34.116 <v Kirchhoff, Michael>questions three, five years ago.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4763-0 00:23:34.126 --> 00:23:35.976 <v Kirchhoff, Michael>Those are questions we asked every time now.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4782-0 00:23:37.236 --> 00:23:40.386 <v Jordan Cooper>For our listeners, this has been doctor Michael Kirchhoff, the</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4782-1 00:23:40.386 --> 00:23:43.486 <v Jordan Cooper>chief innovation and Patient Safety officer at Cooper Health.</v>

26d82b3c-6769-49ed-94ea-40002ca91529/4795-0 00:23:43.576 --> 00:23:45.106 <v Jordan Cooper>Michael, thank you so much for joining us today.</v>