Roberta Schwartz and her peers across the Houston Methodist system would often exchange emails wondering when healthcare was going to deploy the latest-and-greatest technology solutions. Eventually they got tired of waiting and began piloting projects. The initiative was formalized in the spring of 2018 as the Houston Methodist Center for Innovation, with Schwartz, who is also CEO of the flagship hospital, at the helm. Plans include an innovation hub, where such vendors as Epic Systems Corp. and Apple can open pop-up stations and let clinicians play with new technologies and provide feedback. Schwartz talked with Modern Healthcare Managing Editor Matthew Weinstock about the innovation center’s goals. The following is an edited transcript.
MH: You’ve been with the system for a while, but recently moved over to the innovation center, right?
Schwartz: Toward the end of 2017, I’d been watching, along with a group of colleagues, the industry start to really talk and look more seriously about transforming itself by employing technologies that are now fully available in other industries. What we found was that we were all emailing each other on various topics related to technology in healthcare and what was available to us and what we were or weren’t taking advantage of.
Around March 2018, I said, “Let’s form a group that starts to talk about these things.” And that group was kindly nicknamed the DIOP group—digital innovation obsessed people.
I was the informal leader of our gang because I brought us together and started to force agendas. I run our largest flagship campus. I was slightly ahead of budget, so I said to my boss, “Just FYI, we’re going to just start some pilot projects out of this group, and I’m not asking for anything. I’ll just use my budget. Just want to let you know.” He gave his heartfelt endorsement. This group began doing a series of pilot projects and really speaking on a more formalized level about how we needed to transform ourselves, or someone was going to do it for us.
My boss, Dr. Marc Boom, who’s head of the system, said, “This is a direction that I think we should head.” That went through the summer, and it was formalized in the fall of 2018 as the Center for Innovation.
MH: As you think about those first emails you were having with your colleagues, what were you talking about that made you say, “Wow, we really need to look at X?”
Schwartz: Some of the ones that really sparked our interest in a big way were around telemedicine. Also digital access and appointment scheduling, ease of access for the patients, echeck-ins. Looking at things in the hotel industry that have become routine—you just check in ahead of time, pick up your key. Those kind of things weren’t really possible at the hospital.
MH: What were your first couple of pilots and what did you learn?
Schwartz: Expanding telemedicine at first to urgent care, but now we’re in behavioral health and other areas. Making online appointments and scheduling available for our patients.
We were working with a company around artificial intelligence in the emergency room, but we decided not to move forward. One of the things that was really important in these pilots and with the pilot group is we were OK with failing. “Succeed fast and fail fast” became a little bit of a motto because healthcare institutions, and hospitals in particular, are really afraid to fail. God forbid you say something doesn’t work.
MH: What about that AI model in the ED led you to think that we’ve got to put the brakes on that pilot?
Schwartz: For lack of a better word, it wasn’t working. (The vendor) sold a holistic package and they had put in piece A at some very reputable organizations. We already had piece A and what we were looking for were pieces B and C. When they tried to put in pieces B and C, it was literally blowing up, texting wrong people, not providing all the information.
One of the things we recognized out of that work is that these companies that are in a startup phase underestimate how large and complicated we are.
MH: Do you have other plans to explore AI innovations?
Schwartz: We have a chatbot named Mia. If you apply for a Houston Methodist nursing job, Mia will begin to chat with you. Mia has this series of questions and databases she can bump up against, and she can get you all the way through the application process from “I’m interested in hearing more,” to … scheduling your interview with a recruiter.
We did a pilot in mid-December with a few job classifications and opened it up to all of nursing this year. I think she’s been directly or indirectly responsible for hiring 27 people so far.
MH: Tell me a little bit more about the process automation that you launched. It seems to be more back end, but has a lot of benefit for you organizationally and in terms of efficiencies, right?
Schwartz: We’ve only begun to scratch the surface on how robotic process automation can help our administrative areas, and in three, four years, we’ll be also looking at how robotic process automation can help in our clinical areas. At one point someone was telling me they were talking to a hospital system and said, “How many people do you have in accounting?” The person said, “175.” The hospital person turned to someone from Microsoft who was there and said, “How many do you have?” They said, “31.”
We have an excessive amount of administrative burdens in billing, finance, in all other areas. If robotic process automation can help us reduce those costs, then as an industry we need to focus on it. Our goal is not to eliminate people; it’s to make our workforce more effective and put more people directly in the clinical business.
MH: What happens to those administrative people as you get better at the automation?
Schwartz: Two things. One is, we as a system continue to grow, so this will allow us to grow without necessarily adding people. The second thing is in every industry there’s always, over time, a change in the type of people you have in any organization and you can slowly have attrition in certain areas and grow in other areas. I think that we can slowly make those changes where we don’t have heavy impacts like layoffs. We want to manage this carefully and retrain our folks in areas where we need them.