Digital Health Talks - Changemakers Focused on Fixing Healthcare

Architecting Healthcare's AI-Powered Future: Insights from HealthIMPACT's 2024 Changemaker of the Year

Episode Notes

Join Mike Mosquito, HealthIMPACT's 2024 Changemaker of the Year, as he shares his vision for an AI-driven healthcare landscape. Discover innovative strategies to leverage emerging technologies, foster cross-sector collaboration, and drive meaningful transformation in patient care, clinical decision-making, and healthcare accessibility.

 

Mike Mosquito, Emerging Technology & Innovation - Special Projects, Northeast Georgia Health System

Megan Antonelli, Chief Executive Officer, HealthIMPACT

Episode Transcription

[00:00:30] Megan Antonelli: Hi, welcome to Health Impact Live Digital Health Talks. Today we're joined by Mike Mosquito, a distinguished expert in healthcare innovation and emerging technologies. With over two decades of experience, Mike is currently spearheading AI projects and more at Northeast Georgia Health System.

His unique blend of engineering, business, and healthcare expertise makes him a true visionary in digital health transformation. Hi Mike, how are you?

[00:00:58] Mike Mosquito: Wonderful, Megan. So glad to be here with you today. Thank you for having me.

[00:01:01] Megan Antonelli: It's so good to see you. Um, it was so great to spend time with you in New York in June at Health Impact.

Um, you know, I remember it wasn't so long ago that our friend Rachel Weisberg introduced us at HIMSS and, uh, you know, I was super surprised that we hadn't crossed paths. And I know we talked about it a little bit, but Tell us our audience, even though they probably know you well about your background and how you've cultivated such an amazing network over the years.

[00:01:28] Mike Mosquito: Well, I've been very blessed to have friends like Rachel around me that introduced me to wonderful people like yourself. So it was wonderful to meet you a few years ago. But I've been in the industry for a couple of decades, over a couple of decades now. So I've been around for quite some time, doing work with large, integrators, large vendors, like McKesson, Eclipse is all scripts.

And working in the industry. I actually left the industry for a period of time to go and learn some new techniques. So I left, to become a consultant, for some mid market companies over my career. And it was really to go back and retool. I think that in this industry, Megan, you have to continuously retool.

Even though healthcare, Moves slower than other industries for integrating new innovation and emerging technologies. I think that's changing, especially with the introduction of a I and how it's going to change the landscape of how we work inside and outside of the four walls of the health system.

For me, that tenure of running emerging technologies at McKesson and creating centers of excellence and healthcare have really afforded me the ability to see in a lot of health systems, how they operate. good and bad and how there can be a change made even with the smallest amount of budget, you need that healthcare executive influence also and that initiative and drive and strategic planning that's going to bring it forth.

So I've been very fortunate to work with not only health systems and providers and payers, but also Those emerging companies and those established companies that are bringing technology, to health care and to its entire target continuum, including the patient themselves. How do we change that patient experience?

How do we look at social determinants of care and biases and educate developers of technology? So I've amassed that. long tenure by one being good to those around me and helping those around me to connect the dots or being able to find those dots that they need to connect to. And so I'm very blessed to be able to present and do interviews like yours today and continue to share this knowledge with the folks out there on a global scale now.

It's been very blessed to speak to some folks UK.

[00:03:35] Megan Antonelli: Yeah, it's amazing. I mean, I think you mentioned it, you know, in terms of change, there was a, there was certainly a period where it felt like change happened really slowly in health care. And I think while health care remains, wisely risk adverse and, cautious in terms of how we adopt and move quickly, change does seem to be, here and happening more quickly in the last, few years for sure.

And that, reminds me, not only did you speak a couple of times at health impact, but you won the change maker of the year award. We got so many nominations and so many votes for your. Over the years. And so I'd love to hear, you know, sometimes all that change can be exhausting.

That pursuit of change, it's evolved over the years. Tell us a little bit about how that has, evolved and, what you think is important now.

[00:04:21] Mike Mosquito: I will say that it started, Many years ago, I'm an engineer. So give you a little background about me. I'm a mechanical, degreed mechanical engineer.

And so I'm a builder. My brain works that way. A hammer, but also a builder. When it comes to the corporate and IT and technology side of business. My career started developing portal technology, which is how McKesson found me and brought me in to help with the physician portal and that team.

Then after several other jobs, I was also given the job for running emerging technologies for M M I S or M I T, technology, up in McKesson, up in Alpharetta, Georgia. And that job really opened the doors for me to be able to develop, create, innovate, and tie it to the healthcare landscape. And so the first tablet that had healthcare information on it.

Power about McKesson technology. The woodblock models behind my desk right here. It was developed with Intel. And so RFID Dragon's 1st edition of how it was going to integrate with clinical suite. I was in, I was actually on the foreground of working with them and other telecom vendors of how to get communications.

across the landscape of health care. And so that Changemaker Award is, thank you very much. I am very honored to have received that. And I think anyone else out there that's watching and looking at this, you should look at your own package of effort, what you've done in your career, Get your nomination in and be in New York next year because it's really an impact.

It was impactful for me to be at Impact Health Impact, to see the folks, the likes of folks that were around me in the room. But to receive that award means that body of work that I'm continuously working on and trying to do more work around is going to continue because that's what drives me and it drives a lot of my friends that are around me that are innovators, that are, bringing new technologies to market.

So I, I appreciate you for that recognition.

[00:06:12] Megan Antonelli: Oh, absolutely. Well, we're honored to give it. I think, you know, McKesson, when I think back to, we used to do a lot of events and work with payer side and McKesson was really one of the first big technology companies that really served both sides of the market.

Right? I mean, they had a large provider. Practice as well as on the pair side. And I think, when you think about the stakeholders and how those are merging and converging. I mean, we talk about pay riders and all of that a lot, and certainly with the shift to value based care.

But I think that having that unique perspective to have worked with multiple stakeholders is so important. Are you seeing that come, be of more value now, um, than it has, tell us a little bit about that value.

[00:06:54] Mike Mosquito: Yes, I do. I really believe that having that broader landscape of being able to look across, inside the four walls, working with partners, how do you collaborate and how do you create together?

Better together is what I call it. Is even more valuable now because you have to understand problems first. Where are these problems? Not that hey, I've got this idea Well, is it solving a problem or you just think something's neat and no one's gonna buy it. So understand there are lots of problems in health care still that haven't been solved that have been around for hundreds of years.

We still haven't solved some of these problems so with technology being advanced in today's current healthcare landscape, I think that being able to look inside and outside, whether it's in the clinical suite or in the patient experience, figure out where those problems are and work with the right innovators, the right companies that are trying to say, here's a problem, and we're going to apply knowledge, experience, effort, and our own intellect and budget to fix that problem.

And whether it's around data, Whether it's around integration of services, whether it's around interoperability of technologies and how they come together. But how do I pull that collective knowledge together to collaborate? And I said something at your event, I said, you know, the seatbelt is in every car, and the guy that invented the first seatbelt, and it was patented, didn't keep it in one car.

He shared that knowledge across. It's in every car. And I said, in health care, we don't share like that. We don't collaborate on a grand scale. Yes, there are some pockets of collaboration that occur, but we don't on a whole. That's not what we do in the industry. My ATM card works in every ATM, no matter whose name's on the top of it.

We don't share like that. And I said, I hope the reason isn't for profits, but we know that sick people make money. Let's call it what it is. And so we need to heal people. We need to have better care. We need to keep people out of hospitals. But again, we don't share because we still are driven by the one thing, which is a dollar.

And that dollar, being able to provide better care can also keep you in an isolated area of being able to engage your, your patients, your community, and the ability to drive better care and outcomes. This health system is, lights out ahead of other health systems.

And here's why. Here's how they're doing it. Here's what you should be taking advantage of. Here's their people, processes, and technology, and the strategy they're deploying. Because what I did say at your event was, are you waiting on somebody to die across the street so that your market share can grow because everybody's coming over to you now?

[00:09:38] Megan Antonelli: Right. I think it's that, you know, the stakeholders, whether it's payers, providers, and then obviously even just among the providers, the competition that's there, but the incentives. You know, aren't aligned. I think it was, Shahi also said, you know, healthcare isn't, it's not engineered for the right, you know, to save patients.

It's engineered to save money, you know, or something around that. , I think when it comes to change, we've all recognized that so much is that those incentives that aren't aligned are where we are trying to make the changes happen to align those incentives around patients.

And then get us to a place where we can have, meaningful improvements to patient care and the bottom line, because if the bottom lines of all of the organizations that are involved don't get, impacted, it's not sustainable and they won't continue to do it. Had a few conversations with folks, around AI and hospital at home.

And it's like, they need to see the value. Another thing we talked about at health impact and you were on the panel is around, governance. And I think that we do see, and look, Brian Anderson from CHI was there and certainly there's collaboration happening around that.

Right. I mean, I think everybody is aligned when it comes to governance and sort of establishing the parameters, maybe sometimes around regulations, we can come together, talk a little bit about what your takeaways on that are. And, in your experience, what are some of the key areas that people should be thinking about?

[00:11:03] Mike Mosquito: Even though I sit, at Northeast Georgia, I help other health systems around the country with these problems. They're dealing with these emerging technologies, innovation, and the guardrails and governance that they're having to put into place, to evaluate technology up front.

You know, should I bring this in? Do I have the infrastructure? Do I have the skill sets in house to be able to, manage and support these new technologies? And what does that look like for my clinicians, and my patients and the operational? An IT support that's required. And so governance is one of those, and it's required.

These guardrails are required when you're looking at these technologies that can still do harm. If you're taking them at face value with unchecked human intervention. While chat GPT can do for writing an email or replying to a request. In the patient setting, it can do a lot of harm unchecked.

And so while I have, I'm co founder of an AI company, I also have to believe in guardrails. And when we talk to clients up front, those guardrails are in HIPAA compliance and cybersecurity and protections first. Those are the first conversations we had. And so these organizations that are looking at adopting, new technology being on the bleeding edge, they have to understand the immediate and some of the long term impacts of putting these solutions inside their infrastructure and what it could mean for patient care.

And what it could mean for interactions, in that care once it's outside of the four walls and unseen by IT if they're in the home now and being managed by the actual patient themselves. So remote patient monitoring and all these other nice words and buzzwords that actually bring the patient closer to being in their own setting of care at home, being comfortable at home and still being managed.

You have to understand there's also some risk. So the risk register for governance around emerging technology and innovation is quite large and growing larger day by day. I had a panel, Megan, this past spring, and I had a hospital and a partner on stage, an AI partner, and the question came from one of our sitting CIOs.

He said, if something goes wrong with the infrastructure, the data used in your AI modeler, and something adverse happens to the patient, who's at fault? Now, this is a room, it's a sold out room, and I knew where he was going when he started the question, and so I said, well, let's start with our provider, and she piped up, she goes, well, I bought this partner solution, and we had our governance go through in Vetham, and so it's on the partner if something goes wrong.

The partner didn't let her finish the sentence before, but that's not my data. That's your data using my in my tool. And so quickly, the audience was able to realize This doesn't work in the patient setting. It's your fault. It's not going to fly because somebody bought a tool, implemented a tool, but you use that data, to provide the information to that tool and something bad happened to the patient, right?

And so guardrails and governance are very important, but the outcomes and expectations of use of these technologies also has to be understood. What does that risk look like? And then how do you mitigate that risk as close as you can to zero, when you're implementing these tools. And that's a hard questionnaire.

[00:14:25] Megan Antonelli: Yeah. So when does that need to happen?

[00:14:27] Mike Mosquito: Up front, you need to ask some of these questions up front when you're evaluating these technologies. When you're looking at these partners to bring in with these new technologies, what are the risks? What have your other Customers or P.

O. C. Identified risk that I need to know of and then work with that part to be very candid with them. This is on you to help us grow together on your platform. So tell us where potential risk and pitfalls could be in implementing emerging technologies and how does that look for the patient when something goes wrong?

Then how do we mitigate it? You gotta have those conversations up front.

[00:15:00] Megan Antonelli: Yeah, for sure. I mean, does it happen that, you know, you have those conversations and it must make the negotiation process the sort of, you know, people already complained about how slow the RFP process is the sales cycle in healthcare with that added element to it of, you know, this uncharted territory, I guess, in terms of, who's responsible, are you seeing people making mistakes, cutting corners?

What's the, what's the sort of reality on the ground for this type of, you know, what's the impact of it?

[00:15:32] Mike Mosquito: I will tell you, I see them being cautious. So what I see with the institutions that I'm working with, they're more cautious. I'm being called in to provide support for being cautious and they give guidance and direction and strategy, using that left side of the engineering brain of how do I, put the right risk registers in place, right governance structure in place, to evaluate, implement, and determine who are going to be the best partners for that organization.

Not all partners are created equal across the board for every organization, small, medium, and large. How do you evaluate that partner? And it is not a decision always made inside seven days, and we're going to get you to push you through procurement and through legal, and we're going to be up and running on our POC in three weeks.

They're a little more cautious than that, but there are those that are out there that are cautious, but aggressively moving forward. They've got the right operational infrastructure in place to, one, intake new technology, get it structured with compliance and legal, and then move it into their setting of care.

More fluidly, they've got the operational pieces and the governance structure already there to evaluate, implement, and then evaluate on the backside, the outcomes, and make sure there's an ROI that's attached, and that could be tangible ROI in dollars or tangible ROI in exposure in your community. As a provider because not everything's about money.

[00:16:57] Megan Antonelli: And then, you know, it sounds like managing the expectations, right? Is an important part of that and understanding that. So that's great. And I think a lot of what we're seeing with AI is that the implementations happening more at the, administrative revenue, financial sides of the house first, right?

To get to the place where we have, Not less risk, but less patient facing risk. Right. But in that, of course, there's a lot of discussion around the impact of AI with virtual clinical teams and remote monitoring and, reducing burnout. What are some of the things that you're seeing that are being tested that people are seeing work?

Across the health care systems,

[00:17:40] Mike Mosquito: virtual nursing is the newest of those buzz phrases. I sat in front of a group that deployed. I'll call their name Orlando health. She and her chief resource officer, Spoke at a conference with me back in June.

And that cover at that conference, they really laid out a comprehensive plan of how virtual nursing is working for them. Not saying it works for everyone, but I'm saying that for what they've laid out and how they're deploying virtual nursing, it is one of those areas that they found fruitful and the ROI behind it is immense for them.

And so, I asked her how big of a bang are they taking this? She said, they're developing a new, they're building a new tower and virtual nursing is going in day one. As far as we talk about burnout for physicians and nursing and everyone else across that spectrum. The creativity and the innovation around that.

It's coming to the forefront with virtual nursing, putting these tools in place and telehealth, burst onto the scene during covid and it's stuck around in some areas it didn't go back in the box. Like, many thought that it would at 100 percent and that hasn't proven to be the case in all institutions, but it's good to see that telehealth does remain in place. I think telehealth should be broad spectrum for a lot of rural areas that have the bandwidth to be able to take it on because while you can't have a doctor in that community, you could provide.

That remote doctor via telehealth into that community for those underserved areas. And that backs into another problem. Is there funding for infrastructure for you to be able to put that in the homes? Or is it only over the cell phone? Is there enough cell coverage in those areas? So there's infrastructure questions we have to ask.

And are you planning from beginning of infrastructure to end of cure delivery and back from the patient side into the hospital being able to give the telemetry of those devices back into the medical record so that you can accurately manage and monitor your patients.

[00:19:36] Megan Antonelli: Yeah, it's really amazing the potential of it all. So in terms of the training and sort of upskilling that's required, right? When we talk about the assistive AI and how that's going to help even, from the remote and virtual, it's a, it's a different skillset.

Are you seeing organizations implement those programs? What are they looking like and what kind of resources are they putting towards these programs?

[00:20:02] Mike Mosquito: When you say, are you talking about full programs across the enterprise or in their communities or

[00:20:08] Megan Antonelli: within their organizations, you know, we already have a nursing shortage.

How are we getting to the place where the nurses we have are now capable of using all of these new tools and innovative technologies and ensuring that they understand, you know, sort of the implications.

[00:20:24] Mike Mosquito: I think that's a longer road, Megan. I think that the nurses and doctors have a lot in front of them already.

We keep adding buttons to, you know, their systems that they have for clinical decisions to forward, and we keep adding other widgets and things inside the setting of cure today. And now we're getting ready to add, you know, more tools. Oh, AI is going to save you so much time and so much more effort. I think there is, a learning curve required for how to transform your care settings.

With these new tools, and you can't say, hey, it's so easy to look at this tutorial and go apply it into your setting of care at your facility. So I think the companies that are building these tools, they're thinking about it, but being able to ask the chief nursing officer, or the CNIO of a health system.

How do we plan to implement these tools so that the nurses take full advantage needs to be asked more often up front. Before you start looking at solutions, the CNIO and the CNO need to be brought on board. The CMIO needs to be in the room to talk about what does it look like for a workload setting of technology to technology today and then post this POC and full deployment.

How much will it change? And you're going to see a dip. So now the organization is like, I'm gonna see it. They're gonna see a dip in productivity. Are they upset about their productivity? It's gonna come back. We don't know when. Could be a month, could be two months. That productivity dips when you're bringing on new tools because the adoption curve has to catch up.

I think that timeline for bringing on new tools is a little bit longer, than they were of old because these new tools, while very intuitive, they still are changing the flow of care in that care setting. And you have to give these clinicians time to learn how to use them, adopt them, and be able to integrate inside their head this new workflow.

[00:22:20] Megan Antonelli: Well, I'm glad y mean, and I think that's You know, we've made the mistakes before, right? With the HR saying, Oh, it's going to solve all the problems. You implement the technology. And in fact, there's unintended consequences and more problems can arise, and you have to anticipate that.

So, and that's what, often makes the implementation cycle as challenging and, and the decision process is challenging because it takes a while for the value to come around. And I think that it also goes back to being aware of the multiple stakeholders that are involved, right?

Because you can fix 1 problem and create a problem someplace else. And the technology can be, you know, plug a hole here, but not not there. You talked a little bit about, the AI language model, and the the translation tool that you've been working on and that They've already implemented, around the country here.

Tell us a little bit about that, because I think, not only are you, helping health systems, but you're also helping, on an innovation side. I think that tool itself does speak to, some of the unique problems in healthcare and it addresses those.

[00:23:25] Mike Mosquito: Thank you very much for that. Yes, Bot on Health is a bot that is a multilingual translation tool. It was a company, co founder of it, but it was deployed outside the U. S. first, and then we brought it into the United States. With this translation tool, we're able to take up to 158 languages right now and translate them.

So when you. Or in your setting of care, and you don't speak English, but you've asked for your discharge summary and your paperwork and everything else to come to you in your preferred language, so you can understand it because you may not speak English, or may not speak English fluent enough to be able to understand your medical paperwork, our tool now translates that information, and we actually put this bot on the front end of your care setting, whether it's your digital front door, a specific website or specialty website, and we now can bidirectionally schedule, So Talk and integrate this into your setting of care to bring a patient into your care settings, in their language, in their comfortable language setting, to be able to communicate with you.

So, the premise here is be able to take this tool into disparate areas where, The underserved are not provided translation services that are adequate and be able to use this tool. And it can be used internal for your staff, for communication, or it can be used for your patient care and your patient experience.

So this is really, we're seeing it transform on the payer and provider side. It's transforming that patient engagement, that patient experience for how they collaborate with their patients now. Because right now, it is, if you go into. Name an EHR and you ask for it in another language. I can show you the evidence that it comes to you in English, or if you say Spanish, it is not Spanish.

That is spoken by anyone that I know it's broken, and it's not coherent. And so these tools, while we say that they have these capabilities, we haven't been able to see them perform at a level that our, algorithm and our black box has been able to put out into the industry. So we're very proud of this.

My CEO, Karen, she's been doing a great job of driving the company forward. And I think that this tool is going to be a leader for really looking at. Were we not serving our patients in the language that they want to speak to us for, for care? And when you have no shows, no, this is probably because they didn't understand they needed to come back for a visit.

[00:25:54] Megan Antonelli: Right. It is. It's amazing to me. I think we all talk about AI and how transformative it is. And there's still a lot of things we're not getting right. I mean, a lot of the ambient technologies don't understand, you know, languages, let alone accents, right? I mean, there's a lot of things that are still being worked on that without that, You're only fixing something or solving a problem for such a small population.

So this is such a, even though it might seem like a small piece of it, it's transformational in that without it, none of this really continues to work, even from a reimbursement standpoint, from note reading, from, the clinical provider, and patient communication.

So as we have a few minutes left, tell me a little bit about, you know, what you're telling hospital CIOs right now when they're evaluating and prioritizing AI solutions.

Like, what are the top two, even just one, or maybe it's 10 things that they should keep in mind, as they, you know, really prioritize and don't just, you know, not following that shiny, you know, object, but what do they need to really look at?

[00:27:00] Mike Mosquito: Understand that you need an emerging technology and an innovation strategy for your health system is one.

You need to know how to stay ahead and competitive. You need to understand what technology should look like in a setting of care. So it's not just Bob's workshop that put together a widget and you're going to implement it. Understand what an enterprise tool looks like and can it have governance at your standards?

Implemented around it. Those guardrails. Can they be put around that technology? And how do you evaluate that? Have that checklist in hand? Have a governance committee that evaluates it earnestly and candidly, to be able to not stifle innovation and the adoption of technology, but evaluated and understand how they should be implementing it.

Because there's two types of governance councils that are in play. Be a collaborator. With innovators in the industry, with emerging technologies, with these new thought leaders and bring those thought leaders around you, not for a sales cycle, but for education around what tools are in the industry and attend those industry conferences where you can become educated.

You need to understand for yourself and you need to understand what technology is around you. If you want to be a leader in your market, or you can wait for it to get to you at some point. I'll tell you, I love my hat, Megan, and I will tell you the biggest part, I have the hat that says change on it.

It's inevitable in health care. In every health system, change is inevitable, and if you're not ready for it, it's going to run you over. So our CXOs that are out there that are looking, hey, do we have AI? You've had AI for decades now in your health systems and clinical decision support.

You've had these types of tools that have been giving you guidance. outside of the physician's voice, but now they're moving faster. They're using larger data models and these models can hurt. So have these three, those are my top three that I say, put them in place, to give you that structure. To give you that guidance and be able to then bring the right people around you to give you that support for here's what our tool can do.

I'm not trying to sell you. I'm trying to show you how I solve a problem and then you move from there into what does it look like to implement your solution.

[00:29:12] Megan Antonelli: Well, that is, that is great. I mean, all such good advice. So tell us our audience what the best way to find you is in terms of, whether, are you on LinkedIn?

I'm on

[00:29:23] Mike Mosquito: LinkedIn. Most of you probably seen me on the recap. You'll see Megan's recap coming out real soon. Awesome. So it'll probably come out right at the time this airs, but then that week, I'm going to put her recap from her event out there. There's the award right there, Megan. But

[00:29:38] Megan Antonelli: you can

[00:29:39] Mike Mosquito: find me on LinkedIn.

You can find, look me up at Mike Mosquito at LinkedIn, or you can find me on Twitter, Instagram, or any of the other platforms, but mostly people find me on LinkedIn under Mike Mosquito.

[00:29:54] Megan Antonelli: Yes, the recap is awesome. And as you said, you do go to a lot of conferences, and it's an amazing thing to be able to see.

And, you really do a great recap of them to do those takeaways. And, you know, as someone who works in this area, we always try to make them as impactful as important and hope that we're driving the discussion further. And there's nothing like someone summarizing it to say, okay, this is what we talked about here.

Let's move the needle at the next one. So thanks for doing that. Mike, I appreciate it.

[00:30:22] Mike Mosquito: And thank you everyone. One more thing, Megan, just like you, I have my podcast dropping. Real soon, the buzz will be coming your way real soon. Just like you and you'll be being on your wonderful show.

I'd love to have you on the buzz with my cohost, Maureen Nyleen. I'm going to be watching that real soon.

[00:30:41] Megan Antonelli: Love Maureen. That would be awesome. Thank you, Mike. Thanks for being here. Can't wait to join you on the buzz and, everyone else. Thank you for tuning in to health impact live digital health talks.

We hope you enjoyed Mike's insights and, you know, he has inspired you today and no doubt will continue to inspire you join us next time as we continue exploring the cutting edge of healthcare innovation and digital transformation. Thanks.

[00:31:07] Mike Mosquito: Thank you.