Transcription Media File Name: Radio-RasuShreatha.mp4 Media File ID: Media Duration: 11:42 Order Number: Date Ordered:

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1 Transcription Media File Name: Radio-RasuShreatha.mp4 Media File ID: Media Duration: 11:42 Order Number: Date Ordered: Transcription by Speechpad Support questions: Sales questions:

2 Justin: Well, thank you very much for tuning in, and welcome back to This Just In on HiMSS radio. We're broadcasting live from the HiMSS '16 annual conference in Las Vegas. Very excited about my next guest, Rasu Shrestha, CIO or chief innovation officer for UPMC. Welcome to the show. Rasu: Thanks very much, thanks for having me here. Justin: And you actually have a fan base, just so you know. When I got here to the show to begin setting up, people were asking, "When's Rasu coming on air?" So it was kind of funny. Not many people have a fan base that actually show up way in advance, but you did. Terrific. Where do you live per se? Rasu: Pittsburgh. Justin: You do? I thought so, but I have a strong affinity for Pittsburgh. My very first career outside of college, I was with HBO and Company, which now is McKesson, we worked out of a 1 Penn Center West office, right there outside of Pittsburgh. Rasu: Yes, absolutely. Justin: I lived in Moon Township at the Polo Club, in Moon Township. Where do you live in Pittsburgh? Rasu: So, up north in Pittsburgh Hampton Township. Justin: Sure. Excellent. I love being and am very proud to be from Boston originally, but I had never met people so nice is Pittsburgh, and I actually remember calling back to my family going, "These people are really, really nice." I didn't realize how hard we were back...when you grow up in Boston and New York you're just a little bit more of an edge, but when I got out to Pittsburgh, I was just kind of shocked at how nice people were and welcoming, and I couldn't think of a better city to kick off my career in. Rasu: Well, thank you. You should come back because Pittsburgh, the city, has really transformed itself in the last many years. Justin: Well, yeah, and it even did when I was there. I was in, not to give my age, because I'm only 28 years old, but I was there in 1996, And I couldn't believe, it had transitioned a lot since then. It was no longer a steel city. It was cleaned up and it was beautiful, so now I'm sure it's even ten times better.

3 Rasu: Absolutely. The new export commodity for Pittsburgh is not steel or coal; it's eds, meds, and technology. That's what we're focused on. Justin: So from your perspective, and I'm always excited to have a provider on the air and join us, because hearing your perspective specifically of what you're tackling, the goal over the two days of this radio show is to get actionable intelligence and best practices on how to navigate the future of healthcare. And we do it industry-wide a lot, with a lot of guests, but with providers we talk about specifically from their organization; so in your community, what are the top trends that you're seeing in the Pittsburgh community and for UPMC in general? Rasu: So it's really interesting, right. When you look at all of the things that have been happening in the Pittsburgh area, it's really ground zero for accountable care. Justin: That's great. Rasu: We talk a lot in the industry right now of moving from volume to value. Well, guess what? There at UPMC, we're living and breathing it on a day-today basis. We're not just a provider organization with over 20 hospitals, 3,800 physicians; we're also a large peer organization with 2.9 million covered lives, right, so this integrated delivery financial system that we are, the peer provider - yin and yang - that we are, we're pushing the boundaries of value-based care forward, and that's really interesting because I think that's where healthcare is going. Justin: So how many patients do you guys cover? How many covered lives do you guys have? Rasu: So on the health plan side it's about 2.9 million members. Justin: Wow, that's fantastic. Rasu: It is. Justin: So the accountable care; diving in, what are some of the, we'll talk about best practice and all that and how you address it, but what are some of the others? So accountable care on the front lines of, obviously, some of those peer interactions, but what else do you see for trends? Anything from the technology side maybe?

4 Rasu: So, yeah. So on the technology side, what's really interesting is, you know, I've been fortunate to be part of a team at UPMC where over the last several years we've really been pushing the boundaries of interoperability, really for the last decade, okay. So before interoperability became the buzzword that it is today we've been pushing that boundary, really looking at how do we make sure that we connect the dots across these disparate silos of information systems? The end goal is not a successful goal line. The end goal is connect the dots across the silos of information systems and really get to meaningful insights at the point of care. Justin: So you're talking about population health, analytic, data visualization, and so forth? Rasu: All of the above, right. Because at the end of the day, if you boil it down from those buzzwords to what's real, as a clinician I can tell you, today we're more detectives than we are clinicians, right. So how do we make sure that we leverage the power of analytics and machine learning and deep learning and pattern recognition, and connect the dots across all of these disparate silos that we've never imagined before to be possible. Clinical, claims data, financial data, performance data, and really get insights that result in behavior change for clinicians, potentially for our patients and our health plan members, and consumers at large. So that's what we're really pushing for. Justin: So what are some of the ways that you guys have addressed that? Because that's certainly advanced care and advanced medicine. So what are the ways that you've addressed it over the last, say, five years, or two to five years or so? Rasu: At UPMC our tag line is "life-changing medicine", right, and it's lifechanging medicine, not life changing medicine. So the idea there is, how do we leverage the power of the data to get to intelligent healthcare? The strategy that we have at UPMC is really condensed into this organization that I'm part of - I'm fortunately part of - which really is sort of the tip of the spear for the rest of UPMC in our approach to innovation and commercialization of what we know to be the right solutions for the pinpoints that we're living and breathing on a daily basis. So UPMC Enterprises is this organization at UPMC that really puts its money where its mouth is. We like to co-invest and co-create. We like to partner with the right strategic organizations - partners, big, small - across the board to really push the needle in the way that we're delivering care and transforming the face of healthcare. Justin: Do you do that through a venture fund then, in a way? Or how do you do that?

5 Rasu: Enterprises, right now, is really an organization that is funded internally at UPMC. This is our strategy, to really push the needle forward in innovation. We're making investments in startup companies. We're making investments and co-creating solutions with organizations where we're aligned in the pinpoints that we're trying to address and move the needle forward. And what we're doing is we're not just making these investments, like a venture fund would do, but we're opening up the living lab that is UPMC. We're putting in our data and our insights, bringing in our clinicians. And this is a very collaborative, cohesive process across the peer provider organization that is UPMC. I think that, at the end of the day, provides the most amount of value back to these specific initiatives. Justin: So all three, a little bit of a curveball, just from a question standpoint of technology. Do you guys use virtual care in tele-health strategies yet in your...? Rasu: Absolutely, absolutely. Virtual care is really important. In fact, one of the more recent investments that we made, just a couple of days ago, absolutely, was with a company called Vivify. We actually were part of funding the company and we're big believers in the area of adding intelligence to remote care, and this notion of mobile population health management, where we're stratifying the risk population across the board. We're saying, "All right, let's make technology easily accessible to these patients who are going through CHF or chronic illnesses, whether it's through an app or a set of devices that we give to the patient, at no cost to the patient." Leveraging that data to get at meaningful insights that would change behavior before that patient comes in to any of our emergency departments or any of our hospitals. Justin: Yeah, that's fantastic. So I guess, kind of a two-part question, but I'll start off with, what other health systems around the country might you say, "They're similar," because this is very unique. So is there anybody else doing this from a health plan standpoint? Kaiser's a different beast all in itself, but I mean is there...? Rasu: We're fairly unique in all of the different things that I said. I think there are many healthcare organizations that are trying to do specific facets of what we've been doing. What we're doing right now, what I described in our strategy with UPMC enterprises, is actually not new. This is really a culmination of all of the lessons learned, of the things that we've been doing in the last decade, decade and a half. So we've been doing this for awhile. In addition to the appetite to put our money where our mouth is, we open up the living lab, as I described earlier, put in our data with 8.9 petabytes worth of data at UPMC that continues to double every 18 months.

6 The insights, all of the different facets of the peer provider organization, and also at the same time, the tremendous amount of research that's going on at the University of Pittsburgh, the nature of how we're working with organizations like CMU, Carnegie Mellon University; also happens to be in Pittsburgh. And we're doing a lot of things around big data and machine learning, so I think if you look at all of those different facets, we're very unique. It's a different organization than, I think, anything else that exists out there. Justin: I would completely agree. So if there's an organization out there that is moving down this path, even at an incremental level, what are some of the best practices that you would share? Because what you've bitten off is a lot for someone to chew on, and I had not realized the breadth and depth of it, but I'm very impressed by it. What would you say would be, "Hey, as you're taking on more risk and maybe move into the payers' space a little bit," as you've done some partnering there and they do some partnering there, what best practices would you offer? Rasu: I'd say three things. First and foremost, I think it's important to innovate, and innovation means many things to many different people, but innovation essentially means thinking outside the box and really trying new things, right? Which brings me to point number two, which is simplify. I think we are so caught up in complexity in healthcare today, and we embrace complexity like this warm blanket that we're so afraid to let loose of. I think it's really important for us to simplify things in healthcare. Innovation isn't about adding more things, it's about taking things away. And then last but not least, focus. I think it's really critical for organizations like us, and in healthcare in general, to just focus, right? Focus on your core strengths and the attributes that you bring to the table. Don't get blinded by buzzwords. Really focus on doing the right things, because at the end of the day, that's what brings the successes forward. Justin: Well, I think that's almost like a business class all in itself, what you just went through. I mean you're talking about innovation, simplification, and focus. That's the art of success usually in general, but that's fantastic. I did have a nurse, head of informatics for New York Presbyterian on about an hour ago, and she gave the best practice that I had not heard before, but a little bit to what you had brought up; it was really around, they take a step back every year and look at all their changes and how can they simplify, because sometimes you complicate things, because you're also fixing on the fly. When I heard that, that made my bells go off in my head going, "That's a great best practice. Take a step back, look at everything holistically, and what can you simplify?" Rasu: Take things away, don't just keep on adding.

7 Justin: That's right, because a lot of people just do is add, add, add, and you realize how complex. Then you get all the other issues with the care providers and usability and all that kind of stuff. Rasu, thank you very much for joining me on the air. You are a true pleasure, great guest, and hope to have you back at some point. Rasu: Thank you, Justin. Justin: Thank you, take care.