Building a Culture of Innovation at Tampa General Hospital

Scott Arnold [00:00:00]:
As far as I’m concerned, it’s not always just about technology, but creating the culture of having people think that way, that have the safety of failing on some things, trying some new things, and if it doesn’t work out, that’s okay. That psychological safety is really important to developing a culture of innovation. We’ve worked very hard on that over the last few years. We still have some work to do, but it’s a very exciting time in Tampa and I’m just happy to be a part of it.

Mike Robin [00:00:31]:
From Healthcare IT Leaders, you’re listening to Leader to Leader with Mike Robin sitting in for Ben Hilmes. Our guest today is Scott Arnold, CIO of Tampa General. In our conversation, Scott shares how Tampa General is creating a culture of innovation focused on improving patient experience through initiatives including Tampa General’s Experience center and an experimental drone program.

Mike Robin [00:00:55]:
Well, hey, Scott, good afternoon and thanks for joining me in a conversation today on Leader to Leader. And I have known in Tampa General for several years, worked and lived in the Tampa area, and I know how much of an innovation leader Tampa General is and how important that is. And I really do think that it’s a culture that you’ve created there over the years. So really excited to talk to you today and learn more about you and Tampa General. Scott, we know that you just came back from the UGM epic conference. Big event. Any insights that you can share with our listeners about the UGM conference and your attendance there?

Scott Arnold [00:01:33]:
Yeah, sure. To be real honest, there’s always something. I’ve been going for about 16 years now, and I think Epic always does a great job with programming UGM. I know my entire team, you know, they come back pretty charged up about some things that they’d like to see improve on our end or take advantage of new features or widgets at UGM. It’s just a matter of, like, what’s the firing order of things that we do and how quickly can we do it. I think that they do a really nice job of tempering, hey, these are the things that we’re working on. These are the things out in the future a little bit further. So over the years, they’ve gotten really good at setting our expectations on when to expect some of these things.

Scott Arnold [00:02:17]:
So we don’t get too excited about the things that may be way out there. But, you know, look, I get a lot out of the people around me that my colleagues on the ground. We, we share a lot of information. We have lunch together, we share what’s worked for us. And it’s not always about epic. It could be any common problem that we’re having with each other, but I thought this year was perhaps one of the 16 years, one of the better years. They’re never bad years, but this was really thoughtful, well done. And I like the velocity that epic is going with artificial intelligence, specifically generative AI.

Scott Arnold [00:02:53]:
That was one they jumped on very quickly with Microsoft and OpenAI, and I’m very excited about their progress there.

Mike Robin [00:03:02]:
So you’re the CIO and responsible for digital and innovation. So let’s talk about that evolution of how you’ve changed that and how you think the scope of your responsibilities today have changed compared to a decade ago. So talk a little bit about that digital role and that transition from CIO.

Scott Arnold [00:03:18]:
Yeah, no, absolutely. First, thanks for having me. I appreciate being able to talk to you about this and have this conversation. I’ve been with this health system, Tampa General, for 14 years, which in this particular role is probably extraordinary because our lifespans as CIO’s are that compared to a dragonfly, we’re usually swatted down and then on to the next thing. But I absolutely love this community. I’ve had the privilege to work with some great leaders. Our current CEO is phenomenal. We get along great, and we think a lot alike in terms of what digital and innovation means to our team members, to our patients, to our community.

Scott Arnold [00:04:03]:
And we’re both very invested in that. And you’re absolutely right. Innovation, I mean, we have 14,000 innovators. As far as I’m concerned, it’s not always just about technology, but creating the culture of having people think that way, that have the safety of failing on some things, trying some new things. And if it doesn’t work out, that’s okay. You know, we’ll generally. Somebody’s getting fired over a failed experiment to create a better environment. So that psychological safety is really important to developing culture of innovation.

Scott Arnold [00:04:38]:
We’ve worked very hard on that over the last few years. We still have some work to do, but it’s a very exciting time in Tampa, and I’m just happy to be a part of it.

Mike Robin [00:04:48]:
From my reading, I know that patient experience is something that you guys are spending a lot of time focusing on, and a great example of that is something you call the experience center. Tell our listeners about what you’re doing to improve scheduling, access to patient. How do you make that seamless process for your patients, which are so important to your success?

Scott Arnold [00:05:08]:
Yeah, I think probably a lot of my colleagues are working on this. As an industry, we don’t do a great job. And when I say we, I mean the big we as an industry, we, we don’t do a great job like other verticals, retail, finance, you name it. We haven’t made modern conveniences simple and that really comes down to access and scheduling and doing things that we’re used to doing in other parts of our lives. But having that available in healthcare as well, the experience center, is something that’s broader than just access and scheduling for us. I think that’s table stakes to having something called an experience center. But we’re really focused on care coordination and care navigation and leading our patients through medical journeys that, you know, that may be difficult. And whether that’s physically answering the phone in a call center or the digital nudges they may get through a navigation process, we’re fully committed to that.

Scott Arnold [00:06:10]:
So less friction and access and scheduling, making as much available online as possible. And that’s more than just primary care. That might be some specialties that frankly, there’s no reason why they shouldn’t be available for people to schedule like they do online today for primary care. But more than that, there’s the scheduling aspect, but there’s the financial navigation of what does my insurance cover, what does it not cover? And providing, you know, providing that navigation, having omni channel communication. So if I’m more comfortable chatting with somebody through text or phone or digital communication, it’s all secure. Those are pathways we’re creating and then tying that together with care navigation. So both physical and digital. So we actually have physical care navigators that are starting to support some of our communities and some of those medical journeys that people are on and getting diagnostics when they need them, helping with them, with the referral process so that people aren’t left to go figure it out on their own.

Scott Arnold [00:07:20]:
And I think that’s been historical in our industry and it’s something that not just us, I think a lot of my colleagues are working on as well.

Mike Robin [00:07:29]:
I agree. It sounds like you’ve created a win win for both the patient and for the health system. And if you’re reducing cancellations or providing better relationships, that’s a win for the patient. That’s a win for the clinicians as well. Tell us about some of the results. That’s got to have a positive impact on revenue. Can you share some of the results or outcomes you’re seeing? And how long has this program been going on and what kind of results have you seen?

Scott Arnold [00:07:53]:
Yeah, well, like anything, it’s, it’s ongoing, like it’s probably a multi year thing I’d say probably a little too early to tell. We have, we have noticed right away we’ve reduced a lot of friction in getting access in, but what we’ve also seen is the access that we’ve created has filled up pretty quickly. And so we still have a problem. And the problem is, why do I need to wait so long to get in to be seen? So we still have some work to do there, I think from, it’s really too early to tell right now. From a revenue perspective, you know, what’s been the impact, but the anecdotal feedback that we get from our patient family advisors is that gets remarkably improved, but with a caveat. We still have work to do.

Mike Robin [00:08:37]:
So let’s transition a little bit, kind of move the conversation to artificial intelligence and work that you’re doing there. I want to dive into some of your specific AI initiatives. But before we do that, let’s talk about how your organization handles this AI approach. Some fear that, some embrace that. So talk a little bit about governance. Guardrails take us behind the scenes. Your discussions that you and your leaders are having around the future of AI, how do you embrace that technology, but how do you create governance for it as well?

Scott Arnold [00:09:06]:
Yeah, it’s going to sound like we’re a little conflicted on it, but I think the net of it is that we embrace anything that will take a workload off of our team members, and that’s kind of where we focus our work with artificial intelligence and just kind of supporting our own team members and providers resiliency. With that said, we started over a year ago, maybe just a little more than a year ago, on some pretty hardcore governance around. And those bits of governance include all kinds of different stakeholders that may have a lens or an opinion that they can offer some things that if we’re just a freestyling AI into our environment, because that sounds like something we would do, we’re an innovative culture. We invite those sorts of things in. But with artificial intelligence, there are some guardrails and some concerns to make sure that what we’re using is safe and effective and doesn’t do harm. And so we have a pretty beefy governance that include physicians, nurses, informaticists, ethicists, people from compliance engineers, technical team members. Just really the full gamut of anybody that might see AI through a different lens. And we have spirited debate about different sorts of technology.

Scott Arnold [00:10:30]:
So there is a control valve, and the control valve usually starts with security. Nothing accidentally makes its way onto our network by default. We’ll catch it in the security and say, what is this? And if it’s artificial intelligence, we’ll say, not until it’s gone through the process of governance. And what that does is it creates an inventory of what assets are using artificial intelligence in our environment. And I, for the most part, we catch most of, I’m sure, in any environment, there are some things slipping through the net, but we like to think that we’ve got most of it understood and under control and we understand where and if we’re taking any risk and just, we’re thoughtful about it that way. So a great governance, it’s led by our chief medical informatics officer, Doctor Nish Patel, and he does a great job with it.

Mike Robin [00:11:20]:
Oh, fantastic. Yeah. There is this push and pull. What’s safe and what’s ready to go. Let’s go into some of the announcements. We’ve seen out there around that, the special relationships and projects, the pilot programs you’ve created. Let’s start with nuance, the nuance project, and tell us what you’re doing with ambient listen. Technology and how that could be a game changer for Tampa General.

Scott Arnold [00:11:40]:
Yeah, I like that one. I’ve been actually talking to a lot of colleagues about that. Our early results with our physicians have been very, very positive. In fact, I had a urologist walk up to me after a board meeting and said, I did 70 visits today, and I’m sure they were surgical follow up, something short to do that kind of all. He’s like, I did 70 visits today and I was home in time for dinner with my family, and I didn’t have any pajama time. He’s like, it’s been absolute a game changer for me, you know, and that was his perspective. Our CMIO is a practicing dermatologist, and he has me in quite often. He schedules my appointments for me so that I’m not terribly compliant with doing these things on my own.

Scott Arnold [00:12:28]:
So he does, and he’s like, hey, how about we do the visit with nuanced Dax? And I said, sure, let’s see how this works. You know, he did his exam. We talked about a lot of things. We talked about some things at work. We talked about upcoming vacations that each of us would have. And then after the visit, he stopped the recording and he showed me the note that it created. And it was amazing how it had kind of the intelligence to move the superfluous information out, not put it in the note, and then really just profile the visit itself and any medications that were involved and made a nice, tidy note from our visit. I was stunned how accurate it was.

Scott Arnold [00:13:09]:
Now he still has to review those things to make sure that the AI does its work, you know, appropriately. But so far so good. Ask me again in about six months with some other providers on it and.

Mike Robin [00:13:21]:
Seamless integration with your EHR and just able to go back and forth and.

Scott Arnold [00:13:25]:
Yep, it filed the note. And we’re very bullish on doing something similar for nurses to just getting an understanding of that workflow and a lot of the heavy work that they do in the inpatient setting with patients. Boy, would that be nice if we could get a workload off of them, too. But it goes along with the theme of really focusing our AI investments on things that are accretive to our team members, accretive in the way of kicking some load off of them. Administrative, just things that AI can do to support us, just get the best out of ourselves.

Mike Robin [00:14:00]:
Well, it takes that burnout that is so high from being in the HR so much. So switching gears a little bit. So you’ve announced a partnership with, is it Palantir? Did I say the name right to using Ed for in care coordination? So tell us a little bit about what your goals are in that space.

Scott Arnold [00:14:16]:
Yeah, absolutely. We’re very excited about. We have a lot of partnerships, but we have a few that are very large partnerships and very deep. Palantir is one of them, and we have a few others that I could mention as well. But Palantir is for us. It’s our analytics platform, and so we have a world class platform for the EHR. A lot of people have it epic on the analytics side of things, for research, for bioinformatics, for really, it just kind of treating patients running our business more efficiently. Palantir has been a phenomenal partner, and they move with such speed and velocity like we have never seen in healthcare, that we decided very quickly that to establish a deeper relationship.

Scott Arnold [00:15:05]:
So we recently engaged in a seven year commitment with Palantir. The focus with Palantir will be on things that our other partners may not do or do as well. We like to make all of our assets sweat where we can. So we’re not looking to necessarily replace anything that’s doing a good job, what it’s doing, but to fill some gaps where we want to move faster, where we don’t have insights, like we’re very data rich but insight poor. And that’s where Palantir comes in, along with the AIP, which is our artificial intelligence arm of the platform, can read and understand through generative AI. Some of our data that’s unstructured and make insights out of it we’ve never had before. And so if you consider most of our data is unstructured, you know, 70% of it in our electronic health record, unstructured by getting some insights out of that data now. Phenomenal.

Scott Arnold [00:16:05]:
So we are very bullish on it. In fact, we’re rewiring our entire care, navigation and care continuum with Palantir to get better outcomes, to manage ourselves more efficiently, and just offer the best tools to our team members.

Mike Robin [00:16:21]:
Thats super exciting. Love to hear how that matures for you as well. One of the other pilots that caught my eye was what you guys are doing with drones to assist with kind of life saving emergencies. Wow. Tell us a little bit about that.

Scott Arnold [00:16:33]:
Yeah, weve been working on that one for a lot of years, and that one is tricky. So its a partnership with a company called Archer First Response Systems, and we’ve been engaged with the founder for probably five or six years now. I’m thinking, and it’s really emergency delivery of, for example, an AED to somebody that might be feeling like they’re in cardiac arrest and getting it there faster than an ambulance can get it there. And the same with perhaps narcan delivery. Just when you think of a drone, it can get up in the air and go point to point a lot faster than EMS or a standard EMS or an ambulance in some areas. The tricky part about that, the reason why we’ve been admiring this problem for so many years, is that the airspace in Tampa is one of the most restrictive airspaces in the country. And in terms of the FAA, it’s called a class Bravo airspace. It’s very restrictive.

Scott Arnold [00:17:32]:
So we had to work through municipality, through the FAA to get a partnership. And so we ended up partnering with the county of Manatee, which is adjacent to the county that Tampa General is in, Hillsborough county. It provided a little more headroom, if you will, to fly the drone safely. And it’s all about safety. The FAA is doing a great job, the municipalities do a great job, but these things take time. And so we’re hoping that we see some great results from Manatee county here, Florida, and hopefully we can create a little space in the surrounding counties to do this. So, again, that’s kind of early in the process, but really, really some neat and innovative things going on with drones.

Mike Robin [00:18:19]:
That’s wonderful. I’m looking forward to watching that one and seeing, especially because I live in this area, so looking forward to seeing what happens there. Another pivot, cybersecurity, is on the minds of a lot of CIO’s these days. And I’ve certainly seen the impact of cyber attacks. Ransomware. Talk a little bit about your role in that area and how Tampa General’s handling that unique set approach, these attacks that have happened.

Scott Arnold [00:18:44]:
Well, we’re not a stranger to it. We’ve had our own issue here. It wasn’t as unfortunate as some of my colleagues where they’ve had full blown exploitations of their systems and complete lockdowns. We haven’t had anything like that. But we’ve had our share of fighting off the bad guys, and we handle cybersecurity as a strategy, not just as a tactic. And so to that end, we’ve pivoted from a pure defensive posture around cybersecurity to something that’s a little more proactive. And we’ve put together a team of threat hunters that’s more active and looking for those threats that occur every day. And frankly, we’re very picky about the partners that we keep now.

Scott Arnold [00:19:29]:
And so that’s kind of a newer thing where we’ve always been concerned about the cyber hygiene of our partners that touch into our network. Now we’re, you know, we’re on heightened alert on that. And frankly, the issue that we had was through the side door with a partner. Unfortunately, you know, for that partner, they’re, you know, they’re not a partner anymore, because for, frankly, they did not remediate. And as such, we’ve become very picky about our partners. And just like other health systems, we run drills frequently, we do red team exercises with the CEO and myself, and we run ourselves through nightmare scenarios to give ourselves a little muscle memory on how we would handle something that’s catastrophic. And it’s sad that we have to do that, but we have to, you know, it’s the world we live in now. But that’s our approach.

Scott Arnold [00:20:20]:
Probably not terribly different than a lot of other places.

Mike Robin [00:20:24]:
Go on the offensive, create governance and structure around it, have the right partners. That makes a lot of sense, and then practice it. Cause those things are gonna happen even though we don’t want them. So what’s next for Tampa Journal? What’s the next three to five years look like? And where are you guys heading? What’s on your big board that you’re looking out towards?

Scott Arnold [00:20:39]:
Right. We bought three hospitals recently, so we’re integrating those three hospitals that are just north of us. We’ve had really, over the last five years, we’ve had more than 300% growth. So I think that the steep growth for our health system. I expect that will continue, but also kind of tuning some of the assets we’ve amassed along the way, too. We do have to spend a little time doing that so that we get the best out of those assets and serve the community the best that we can. It’s hard when you’re growing at this rate to try to keep up with everything and do the best you can, but we’re creating a little time to do that. But we’re not slowing down either.

Scott Arnold [00:21:16]:
We’re gonna continue this deep growth. And when you look at service lines like oncology, it’s one of the fastest growing service lines we have. You know, we may pursue something like NCI designation, so the National Cancer Institute designation, which is pretty rare error for oncology. But I think things like that are in our future, and I wouldn’t have it any other way.

Mike Robin [00:21:38]:
Yeah, it sounds like you’re gonna be very busy for the next few years as well. Leadership, governance are all important parts of this, and that’s the reason for the success that you guys have. I know our listeners are going to really appreciate hearing what she had to say today, as I have. Thank you for being our guest today. We really appreciate your time.

Scott Arnold [00:21:55]:
Yeah, thanks, Mike. Appreciate it.

Mike Robin [00:21:59]:
I had a great time speaking with Scott about all the innovative work happening at Tampa General. Here are my key takeaways from our conversation. One, innovation requires an environment where employees feel safe to experiment, learn, and sometimes fail without fear. This approach has transformed Tampa General into an innovation hub. Two, Scott and his team take a balanced approach towards AI, combining robust governance with targeted practical applications, including ambient listening technology, to improve note taking and relieve provider administrative burdensh. Three, Tampa General’s experience center is improving the patient experience by employing digital nudges and omni channel communication. Tampa General is making healthcare more intuitive and less stressful for patients. So what did you think? What were your big takeaways from this episode? I’d love to hear from you on our social media channels, or drop me an email from our website on healthcare it.

Mike Robin [00:23:04]:
Thanks for joining us. For Leader to Leader to learn more about how to fuel your own personal leadership journey through the healthcare industry, visit Healthcare IT Leaders.com. don’t forget to subscribe so you don’t miss any insights, and we’ll see you on the next episode.