NewYork-Presbyterian CTO Leo Bodden: Responsible automation and why it's important to retire legacy tech in healthcare

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Leo Bodden is the vice president and chief technology officer at NewYork-Presbyterian, a role he ascended to after spending more than two decades with the health system.

Mr. Bodden has experience with EHR technology implementation, technology partnerships and strategic oversight of IT functions within the health system. Heading into the next three to five years, he sees big changes in robotic process automation, EHR integration and moving information and services into the cloud. Here, he outlines the ongoing projects and strategic growth opportunities in these areas.

Question: If 2020 is a successful year for you, what will it look like?

Leo Bodden: There are a few things we are doing strategically and tactically that will fill 2020. We are in the process of transitioning from nine EMRs to one within our system; as we’ve integrated other hospitals with our health system, we have inherited some of their platforms, primarily EMRs. Over the next 24 months, we are in the process of retiring eight of those systems and keeping one. That will help us align the strategic plan for the system.

Another initiative we are focused on is setting a good foundation for automation. We are looking at what processes and services can be automated and which technologies can be leveraged for automation. Over the next few years, I anticipate we will spend a lot of time primarily building the foundation and in parallel we’re executing on immediate-term opportunities. We are actively monitoring what is happening in the industry to ensure we find ourselves in a really good place within five years, as any longer means we will have fallen behind. We should have the foundation in place in two years but it will likely take about five years to execute.

Q: What tasks and processes are most ripe for automation?

LB: We have already automated a number of processes as we develop and optimize the foundation. For example: we had a very manual timekeeping process for missed punches - staff starting their shift are required to punch in as part of our timekeeping process. If someone missed a punch there was a manual process for confirming whether individuals were at work or not. Now we use robotic process automation to activate a machine that manages this timekeeping process for us.

Length of Stay (LOS) is another area where we recognized process optimization opportunities exist. To help streamline this process, we activated an artificial intelligence (AI) system that helps care teams prevent delays and maximize patient flow. The AI actively monitors events, predicts delays and informs care givers when actions need be taken in order to support and process patients throughout their stay, and ultimately discharge them at the expected time.

NewYork-Presbyterian tested the waters with these programs, and they have been very successful in the areas where we tested them. We actively track the effectiveness of robotics process automation for missed punches as well as the AI platform for LOS and confirmed it’s made us considerably more efficient.

These were examples of some of our initial programs as we focus on opportunities where we can more effectively optimize our staff. It’s important to understand that we expect AI to support and augment the individuals doing work, not eliminate people’s jobs.

Q: How will you make decisions on large technology investments in the next year?

LB: Healthcare technology in general has lagged behind in comparison to other industries, making the adoption of some next generation technologies including the transition of services to the cloud difficult. We are developing the structure for how we expand investments to effectively leverage the cloud to quickly meet the ever-changing needs of the business. We need to figure out what should and shouldn’t go in the cloud and how to simplify the decision-making process for the appropriate applications.

We have been doing application rationalization where we identify which applications should be kept, replaced, retired or consolidated. Next year we will primarily focus on retiring legacy technologies, and coming up with the right algorithm to quickly decide whether new applications belong in the cloud or in our data centers as they come in. We are being very thoughtful since some organizations unexpectedly increased their costs after inappropriately sending services to the cloud.

Q: Where will you focus most of your time and energy next year?

LB: I can't ignore the amount of effort that it will take to transition from nine EMRs to one. If we were to expand on the things I mentioned already, we are also kicking off a major transformation initiative as an organization. We are working with Accenture to formulate a plan for transform care end-to-end. We dubbed the initiative "Imagine" because we want our people to think about healthcare, were it structured in the right way, what would they “Imagine” it would be?

When I think about what “Imagine”, technology is front and center, then alignment. We need to align the people, processes and technology to ensure a consistent patient experience, whether we are providing that experience in telemedicine, services at one of our hospitals or clinic visits.

Q: What do you consider the biggest potential threat to your organization?

LB: Disruption, for me, is a major concern. Healthcare has not been disrupted, unlike every other industry on the planet. After every disruptive event, the organizations in the industries disrupted cease to exist as they were. I see that as a major concern. As an industry, we've been protected and insulated from competition and from new entrants into the market due to regulation; that same regulation kept the industry from evolving and moving as fast as tech moves.

As technology evolves, it is becoming easier for new groups to enter the healthcare market. On one side, we see competition from hospitals that are providing services across state lines as tech makes it possible to get close to patients without being physically adjacent. You have urgent care centers popping up everywhere. We also have a political landscape that makes it easy for everyone to go after healthcare.

Technology companies, whether you are talking about Apple, Google, Amazon or startups – they are also getting into the healthcare space. We have to pay attention to what these potential disruptors are doing and respond appropriately if we are to remain relevant in years to come.

Q: What is the most interesting initiative you have planned for 2020 that will affect the patient experience?

LB: As part of the Imagine initiative, Access is key. We want to make sure patients have access to our services 24/7, 365 days a year without any disruption or limitations. If you think about the way services are provided in other industries, they make it easy for you to access them online any time. You can purchase something from Amazon without even setting up a password account. If you want to schedule a flight, you log into the app and you can set up your itinerary without any problems. For healthcare, if you want to schedule an appointment, you have to call the office between 9 a.m. and 5 p.m. on a weekday to schedule the appointment. This isn't convenient for patients, and an issue we will solve with Imagine.

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