As part of the Transform Hospital Operations Summit at Becker’s 14th Annual Meeting in April 2024, LeanTaaS Founder and CEO Mohan Giridharadas sat down with Rob Allen, President and CEO of Intermountain Health to discuss his journey and how they’re investing in AI to reduce healthcare costs, improve staff and patient experience, and achieve excellence in their hospital operations.
Mohan Giridharadas: Can you tell us about Intermountain Health and your background?
Rob Allen: Intermountain Health was founded in 1975 and is based in Salt Lake City. We’re a not-for-profit health system, which merged with SCL Health two years ago. Intermountain stretches across 630,000 square miles of seven states in the interior west with 34 hospitals, a health plan that directly insures about 1.1 million lives, around 400 physician clinics, 5,000 employed physicians and APs, and along with a lot of affiliated providers, about 66,000 caregivers.
I was hired as the President and CEO of Intermountain in December of 2022, so I’ve been in the role for about 16 months. I have 28 years with Intermountain over two different stints, and I served as Chief Operating Officer for five years before being named President and CEO, so I know the system well.
MG: When you talk about transformation, you’ve talked about keeping the organization focused on a few core and consistent themes. How do you define those themes?
RA: In healthcare, I think we have to help our caregivers focus on the goal and see change as part of the journey. They have change fatigue, rightly so, both from the stress of the pandemic, but also the changing world around us. How do we keep up with transformation without people getting burned out? How do we find joy again in the work?
We took a step back and evaluated what we needed to focus on at Intermountain Health for success, and we identified two strategic initiatives as an organization. The first is expanding value-based care. Our mission is to help people live the healthiest lives possible – 50% of our revenue stream in Utah and 37% system wide is at-risk pay. Expanding that, reaching more lives with the value-based care model is something we’re committed to.
The other key strategy is simplification: how do we simplify life for our caregivers and our patients? There is too much waste in the process and accessing care is too complex. Simplification is not just a driver for the experience side. It solves our staffing shortage problems and can help solve financial problems as well.
MG: You’re one of the few executives I’ve heard say that you believe the opportunity for cost reduction in healthcare is north of 50%, meaning you can cut the costs by more than half. How?
RA: First off, think about how much we spend in healthcare: 28% of the federal budget, approaching 20% of GDP, which is $4.4 trillion dollars. We have to figure out how to change the economics of healthcare.
Value-based care studies in the last couple of years projected that 27% of that $4.4 trillion was spent caring for things that are preventable. It's the care people needed, but had we been upstream, we could have kept them healthy before they got into those moments of crisis. That’s $1.2 trillion in spend.
On the simplification side, spend on waste is projected to be around 25% of that $4.4 trillion, which is another $1.1 trillion. Plus, nurses spend 30% of their time at the bedside and 70% at other administrative functions, which has to change. We should be thinking of how we flip that to remove waste, gain efficiency, and bring caregivers’ joy back.
That is $2.3 trillion of the $4.4 trillion that's available for us. If we can redirect it and think differently about how we approach health and wellness, we can reduce the cost of care and slow the growth of cost of care. The resources are there, but we have to start thinking and acting differently.
MG: When talking about AI and its application in healthcare, what do you think about clinical AI vs operational AI?
RA: I think there's actually three buckets of AI. There's the back office, operational applications, which we should be embracing as fast as we can to start reducing waste and finding efficiencies. And then you move into the clinical side, which I would break into two categories: clinical operations support and the clinical decision and treatment processes.
As you move further down the clinical line, we need to be thoughtful about the guardrails we put in place. I believe we should be on the cutting edge of AI, but the reality is there are risks here and the stakes are high if we make mistakes. The core foundational point for me is that those tools should never replace the expertise of the clinician caring for the patient. They should support and help guide the clinician.
MG: How do partnerships fit into your innovation strategy and can you give some examples of success?
RA: I’m a firm believer in partnerships. At Intermountain, we've never seen a project we didn't like, and we've never seen one we didn't want to do ourselves. But in trying to do everything, we end up going all over the place, with people working like crazy and still unable to get it to the finish line because there's too many priorities fighting for the same resources. If we're going to be successful, we've got to lean on partnerships, the capability of new technologies, and the expertise our partners bring.
For example, we’ve had great success with LeanTaaS’ iQueue for Operating Rooms solution, which uses AI to help us predict and manage block times. Downtime is expensive in the OR and iQueue helps us understand how to be more efficient. It's totally transparent so physicians can know what's available and prompts them to release their block times. We’re releasing block time 20 to 30 days in advance, so they can be proactively filled. We've seen a lot of efficiency gains in this process, and because of that success we’ve started to deploy iQueue for Infusion Centers to find efficiencies in our infusion sites too.
Another big move we're making right now is that within the next 45 days, every physician in our system will have access to DAX Nuance. We trialed it last year and our doctors are reporting saving two hours a day of time on charting.
We’re hearing from our doctors that after the trial, they feel like they have a life again. Instead of getting their charting done just before they pass out to get a few hours of sleep, they have time to relax, spend time with their families, and just recharge to come back fresh the next day. It's life changing. I think it’s what we need to be doing more of in healthcare, so we're excited to launch it across the entire enterprise.
To hear more stories like this one, register for the upcoming Transform Hospital Operations Summit on June 4-5 here.