The Healthcare CEO Podcast With Special Guest Dr. Edmondo Robinson

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Welcome to the Healthcare CEO podcast. Join us as Daniel Fernandez, healthcare leader and patient experience advocate leads dynamic one-on-one discussions with healthcare executives, consultants, and other industry experts. Listen in as they share actionable insights and unique perspectives into the day in the life of a healthcare CEO.

*The following has been adapted from our full-length interview, which can be found here.

Meet Dr. Edmondo Robinson

Dr. Robinson is a senior vice president and Chief Innovation Officer at Moffitt Cancer Center. He is also an associate professor at the University of South Florida’s Morsani College of Medicine, and holds both a medical degree and MBA with an emphasis in health care management.

Adapting in an Unprecedented Time

Daniel Fernandez (DF): Now, one of the topics I’m going to cover today is obviously a hot topic. It’s the pandemic. It’s impacted every business, every industry. It’s impacted everything globally. What are some of the ways that Moffitt is leading some digital strategies to adapt to the changes because of this?

Edmondo Robinson (ER): Yeah, it’s obviously a common question because we’ve all had to adapt, adopt, adjust, you know — whatever it takes to get going and keep going.

There were a couple of things that we really needed to do, and we needed to do them  quickly: One, we had to get our workforce that didn’t need to be in the clinic or in the hospital working from home. There was a big push for that work from home effort, and secondly, we needed to keep our patients home if we didn’t need to bring them into the clinic. And so we did both those efforts.

Changes in Clinical Care

And we started to assess and evaluate what needed to be done physically, from a clinical perspective, and what didn’t. Literally within a couple of weeks, we increased our virtual visits by 5,000%. And a couple of weeks after that, we were at about a 7,500% increase. That was sometime in April-ish, maybe early May. We’ve come back from that a little bit.

But, quite frankly, it’s going to be steady in terms of percentage. It’s not going back to where it was before. There’s a new baseline, and that’s going to grow, depending on the clinical scenario. So with clinical care, that’s just how we’re going to be delivering care from now on. It’s just how it’s going to be.

Changes in the Physical Workplace

There was also working from home to consider, like many other institutions, health care or otherwise. Do you really need to be on campus? Do you really need to be in that office? And so did a pretty deep assessment on that. And we had to make that transition quickly. We’re not going to go back to where we were before. We actually had to reassess our releasing strategy for office space because, if we’re going to have this percentage of our overall employee base working for home, why do we need to lease much office space? I think a lot of organizations are having the same conversation. One one way I like to describe it is we essentially developed five years worth of innovation in virtual in about five months.

Curbside Clinics, Digital Ecosystems, and Artificial Intelligence

DF: Are there strategies that were rolled out besides your telehealth and remote services that you foresee remaining long after everybody’s been vaccinated?

ER: So the curbside clinic as a great example, where essentially you drive up and there’s a menu of services that we provide — that we have provided for many years as a cancer center — that we can provide while you’re in your car, and we literally roll out.

It reminds me of those old-school dinners. We basically have highly trained nurses and staff coming in and delivering those services and making sure that you’re able to be safe, but also still receive your service. Cancer is not going to wait because we’re in a pandemic. The curbside clinic has been such a hit that we’re not just going to continue it, we’re expanding it.

There are other strategies that we had to think about in terms of building a digital ecosystem around patients and their caregivers. In cancer care, you have to pay attention not just to the patient, but to their entire care team — their family, their loved ones, their friends, the folks who are really supporting them through the cancer journey. So I group them into this together.

It really is a digital ecosystem. So, yes, it’s mobile. Yes, it’s a patient portal, but it’s also do you have online scheduling, do you have online copay, do you have Alexa, do you have remote patient monitoring, do you have wearables? There’s an entire digital ecosystem that we want to build around our consumers, and that strategy has been accelerated. And I think that’s going to continue to be accelerated even as we come out of the pandemic.

DF: Let me tap into your strategic planning brain for a moment. There’s been a recent trend whereby leaders have felt the pressure and have had to roll out a lot of things very quickly. A lot of strategies have shifted towards short-term gains and a forty five to 60 day window. Do you sort of agree with this trend? Do you think that could be detrimental to the organization?

ER: Yeah. So people needed to respond to a world changing event. If you were going in one direction and that direction wasn’t going to keep you viable, then you had to pivot. That’s commendable for folks to make that shift. That being said, there are ways that you can do that that make you long-term viable as well. It’s not just about getting through the next 60 days. It’s also about long-term viability so that you can achieve your mission.

Weighing Short-Term vs. Long-Term Viability

That means that you should leverage what you learned in your pivots for that short term to be even better in the long term So you should be capturing that learning and really thinking about what  to keep and what was just for the short term. Again, curbside clinic — we would never have had a curbside clinic if there wasn’t a pandemic. Well, guess what? Everyone loves the curbside clinic, so we’re going to keep it.

And so part of it is making sure that you leverage that activity to go longer term. But I would be very cautious as a leader about focusing heavily on the short term — even though you needed to get through these challenging times — and not paying enough attention to the medium and long term, you still have to pay enough attention to the medium and long term, because what happens is you’re constantly building infrastructure and building blocks for the next step.

If you let that slide, it’s going to take you that much longer to get to where you want to go. So you still have to have that longer term. So what I like is actually a combination of the longer term vision, as well as that being able to move to immediately respond. Your long term vision should be flexible enough to allow you to pivot as market conditions or, I don’t know, a global pandemic, might need you to pivot. So you shouldn’t be so rigid in your longer term vision and strategy. But you should still have it.

So what we did, as an example, is have a 10 year plan that’s broad and flexible. But directionally, we know where we’re going. And inspired by the pandemic, we said, let’s have a strategy refresh. Let’s go through a process of refreshing our three pillars that we’re focused on in our strategy. And let’s assess if that’s still where we need to go. And we refreshed that and made some adjustments to our long term strategy based off of what we learned from our short short term pivot.

DF: And speaking of next, let’s talk a little bit about what’s next for health care. Our natural tendency during times of uncertainty is to pause and wait for the ground to settle. When it comes to digital tools and technology, Do you think it’s time to pause or you think it’s time to lean in or accelerate into that?

ER: You know, there’s going to be winners and losers from a digital health perspective. And those folks who are best able to add value by leveraging digital solutions during this time are the ones who will come out of this, not just intact, but actually with large growth. And as others who were not able to respond or not able to truly add value in this time that are going to struggle.

That may apply to early-stage companies. That may apply to larger established companies. That may be applied to providers as well as health care systems and cancer centers and things like that. But there could be winners and losers, depending on how you might leverage your digital tools. Everyone had to respond, everyone’s doing some work from home, everyone is virtual. If you are just trying to survive through this, you’re going to struggle when it’s done with, in my opinion. If you’ve taken this as an opportunity to accelerate where the world was going anyway, you’re going to come out even better than maybe you even went in.

Leveraging Tools and Technology

DF: I like that. I can see that there’s also a sort of consolidation of tools and technology as well. Are you starting to see some of that?

ER: That’s inevitable. Not just with tools and technology, but also in the health systems themselves. You know, in times like this, consolidation is going to be the lay of the land. And so, absolutely, you’re seeing some really interesting mergers. But at the end of the day, who’s adding value to what we’re trying to accomplish in terms of improving the health of Americans? And so that’s where the underlying goals around this consolidation should be. Some of it’s also going to be about market position. You know, who can leverage their size to drive the market in one way or the other. So that’s some of the consolidation will be around that as well. But times like this, that’s what’s going to happen.

DF: And I imagine an organization of this size will better be able to handle the adoption of A.I. technologies.

ER:  Yes, partly. This is where, in my opinion, size is really critical, but where it also can be a barrier. So let’s let’s talk about it from a provider perspective. So a health system, a cancer center, in that perspective, the larger you are, the bigger your resource base is. There’s a certain baseline amount of investment you’ve got to make. And it doesn’t matter how big you are, you’ve got to make that same baseline investment. So if you’re much bigger, it’s an easier decision to make; so size really matters there. But implementation is challenging, the bigger and more diverse institution is.

Because imagine you’ve got a rural hospital in the Midwest, you’ve got an urban hospital in a large city in the South, you’ve got primary care clinics all over the place. You’ve got home health, you’ve got urgent care, and they’re saying, hey, we have to implement this across the enterprise. That’s seven different implementations, so that’s hard. So the implementation of these tools can be challenging, you know, based on your size and the diversity of your overall enterprise.

The Role of AI in the Future of Healthcare

DF: Are you starting to see some departments benefit from it more than others, or is that something that’s inevitably going to be a part of how we do business?

ER: Artificial Intelligence (AI)I is going to be a part of how we do business, broadly speaking. At some point in the future, in my opinion, AI will be baked into everything we do in healthcare, period. Where I’m seeing it really take hold is actually in the back office, the business operations. I’m really seeing some automation really take hold there, and it’s slow yet because health care is, of course, always a little bit behind because we’ve been doing automation and tech stuff in other industries. You think about rev cycle. You think about the supply chain. You think about documentation of coding. Right? There’s a lot of pieces that can be automated there and think about HR onboarding those kinds of pieces. So that’s what’s happening. And I think that’s really catching on and there’s traction there.

AI is going to be layered into robotic process automation, so your bots are going to be AI driven, so that they’re going to go and find your automation opportunities and they’re going to go and automate them essentially on their own.

DF: My mind is blown right now. Is there something that every healthcare practice should look for ways to leverage today, or how would they go about getting started?

ER: It depends on who you are. We have a Department of Machine Learning and AI officer as well, so we have a research department. And then again, we have an operations department here. So we expect to generate new knowledge and experience and new algorithms around AI That’s one that’s one bucket. A different bucket is you’re going to be the consumer of those algorithms, in which case what you’re really looking for is who are the folks in the market? Who are those players? Who are those companies who can really help you accomplish the strategic aim or aims leveraging their tools? So it’s more about a market assessment than it is about deeply understanding AI in any one in any sense of the word.

DF: For smaller organizations that don’t have an in-house AI team member, what would they do to leverage some of those technologies?

ER: I always start with the problem. You have to start with your prioritized list of things you’re trying to accomplish that you think a digital solution may be the answer. And then you go and look for those partners or those off-the-shelf products that are out there that can actually help you achieve your aim. Yeah, and if it’s AI, great! It may not be so. Again, I think AI will be baked into everything, but if you’re smaller, I wouldn’t necessarily go out looking for it. You go out looking for solutions, and AI might get you there.

Using Artificial Intelligence for Better Patient Care

DF: I love it. Here’s a fun question. You and I today, we just jump in a DeLorean and we transport ourselves to 2030. What does healthcare look like in 2030?

ER: So human beings — and there’s actually research on this — are really bad at predicting the future. I’m really not good. I’m not good at prognosticating. All I will say, though, is that what we’re seeing as a consequence of the pandemic, we will see a lot more of it. So virtual care, digital ways to connect with your patients and caregivers, AI and so on.

When I said AI is going to be in everything, I meant  AI will be in everything. So I’m a doctor, I still see patients in the hospital. What does that mean for me? That means that, for example, in 2030, which is actually not that far away, I will be seeing the patient in a room and having a conversation, I’ll do an examination of them, I’ll talk about the plan and when I walk out of that room, I’ll look on my my phone, and the entire encounter will already have been captured and documented, and the orders that I wanted will already be sent off to the to the lab or to the pharmacy. That’s AI with natural language processing and a whole lot of other other components, right? So yeah, AI is going to be in everything.

Where else are we going to see it? I’m going to want to look at how well we take care of a certain diagnosis. How are we going to do that? Well, we’re going to leverage data so well, we’re going to be able to go back and search all patients who have ever had a diagnosis at Moffitt or anywhere else, depending on what our dataset is, and AI is going to be able to basically develop a similar cohort of patients to whom you’re taking care of, and they say, here’s what we recommend is the best next step with that patient. So really, truly helping you develop your treatment course.

Also, imaging and radiology is another place which is really gaining traction. AI is going to look at that image and it’s going to serve up to the radiologist, hey, here’s what we think is going on. We think that this is a one millimeter nodule in the right upper lobe. But we looked at the old examination at the exact same location, so we think there’s no change. The AI will tell you that. Then the radiologist confirms it.

DF: I love that. That’s great. A little known fact: I was a director of radiology at one point in time. I can appreciate that more than you can possibly understand.

ER: It’s really cool! Right now it’s really good at pattern recognition, these algorithms. And in some of the specialties, the pattern recognition is really important. Think about pathology, radiology. You know, those are some of those areas where you’ll see the traction first and you’ll start to see by 2030. You’ll get traction and true market solutions. But they’re not widely used or widely known currently.

Final Questions

DF: It is said that leaders are readers. Do you have a favorite book?

ER:  If I’m going to read, I typically do it for pleasure. And so I read science fiction, actually, and I read a very specific subgenre of science fiction called Space Opera. If I were to have a favorite book, it would be the first Dune book by Frank Herbert. It’s building these worlds and then building the technology and building the way that the cultures interact with each other and leverage technology and all of that. That, to me, is fascinating. And I don’t know if it helps in my job or not, but I just enjoy it either way.

DF:  Final closing thought for our listeners, so any information and advice you’d like to share with that, maybe healthcare executive is on the other end of this listening?

ER: So I would say, the one thought that I had along those lines is that strategy is really, really important. And so I would want to reemphasize just how critical it is — especially if you’re talking about the leadership level, because the leaders are really creating that vision, articulating that vision, executing on that vision.

Let’s not lose the forest for the trees. Even though it’s going to be painful, you may have hit some negative margin quarters, which I get. It hurts, but if you approach work strategically in a way where you think that you can leverage the learnings that you’re having to place yourself even better than you were before, build your strategy, and build your team, and build your execution around that premise — that you can be better coming out of this than you were going in.

Learn More about How Dr. Robinson and Other Healthcare Leaders Are Shaping the Future of Healthcare

Watch the full interview with Dr. Robinson, and be sure to subscribe so that you don’t miss future shows where we interview other industry-leading healthcare CEOs and executives as they look to shape the future of healthcare.

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