When faced with a major crisis, leaders have two choices. The first is to concentrate all resources on survival, doing whatever it takes to stay afloat. The second is to focus on surviving, while simultaneously figuring how to apply lessons learned going forward.
Edmondo Robinson, MD, falls into the latter category. Thanks to the solid foundation that had been established at Moffitt Cancer Center, the Covid-19 pandemic served as “an impetus for change and innovation,” and led to reimagining of the strategy in many areas, including patient-centric care.
Recently, Dr. Robinson spoke with Kate Gamble, Managing Director at healthsystemCIO, about how they’re restructuring to bring three core components — IT, data, and innovation — under one umbrella to ensure digital enables, accelerates and drive the strategy forward. He also discussed the vision Moffitt has to bake AI into “everything we do in cancer care,” the mission that drew him to the organization two years ago, and why being a CDO can feel “daunting.”
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- Part of Moffitt’s vision for the (not-so-distant) future is for AI to be “baked into pretty much everything we do in cancer care,” from business operations to clinical decision support to optimizing research.
- Call it digital front door or consumer digital — the terminology doesn’t matter. What matters is enabling “convenience, access and transparency for those we serve.”
- As homecare emerges as a preferred model, “an entire ecosystem is being built out and operationalized around the consumer.”
- When patients are diagnosed with cancer, being able to quickly connect them to a provider — and plug them into the clinical operational system — is critical.
- With digital tools playing a larger role than ever in the care process, CDOs face a great deal of pressure. But for people like Robinson, “that’s where we want to be.”
Q&A with Edmondo Robinson, MD, Part 2 [Click here to view part 1]
Gamble: You mentioned AI, which is a critical part of the strategy in terms of leveraging the data to improve decision-making. Can you talk more about that?
Robinson: AI is going to be so big. It’s already getting there, but my vision of the future — and this future is not that far off — is that AI is going to be baked into pretty much everything we do in cancer care. And I’m talking everything from business operations to clinical decision support and direct care delivery, all the way through to optimizing research. Everything we do.
Given that vision, we’ve built out our AI operational component under our health data services, led by chief data officer, Dr. Dana Rollison. In addition to that, we also have our research component under our machine learning department, which is led by our founding chair, Dr. Issam El Naqa. We are, by the way, the first dedicated cancer center to have a machine learning department. And we have AI operationalizing these concepts; they’re working closely together as well.
Baking AI into predictive analytics
We’re really baking AI into predictive analytics around patient outcomes. We’re looking at natural language processing so we can, for one thing, improve reporting. But we’re also looking at AI for imaging because it does very well in predicting based on patterns — for example, in pathology. But we’re also using AI for business processing. In some of our automation, we’re actually working with a company that builds AI into our automation processes on the business side. It really will be pretty much ubiquitous.
“Bringing it all together”
Gamble: Really interesting. And part of that is making sure you have the right pieces in place to enable all of this.
Robinson: Yes. That’s what I’ve been working on for the past few years with the Center for Digital Health together. It’s still early days, but bringing it all together, and then really understanding how we operationalize the concept so that we are truly driving toward our mission — that’s really exciting work. We’re right on the cutting edge, and even the bleeding edge, with AI and machine learning. There isn’t necessary a path that’s been blazed for us. We have to create some of that ourselves and work with good, smart partners in the industry to figure some of this out. But I think that at the end of the day, our patients, our clinicians, and our researchers will benefit.
Patient experience – “It’s a heavy lift”
Gamble: You just mentioned patients. When it comes to providing a consumer-centric experience, how has your approach changed? What are you doing to make sure technologies do what consumers need them to do?
Robinson: That’s a big topic. It’s a heavy lift, but it’s really important. We talked about virtual health, which saw a huge increase. That volume has since come down, but it hasn’t gone back to the baseline of what it was before. And so, I think there’s going to be a new normal in terms of the virtual visit component. That’s one aspect of it; what you’re getting at is even bigger, and that’s the concept of the digital front door.
I think of it more as consumer digital, with the consumer defined as an acknowledgement that we really have to understand the importance of convenience, access, and transparency for those we serve; that’s how I think about consumer and consumerism.
What’s the role of digital in getting us there? The digital front door is a strategy to execute on this idea of consumer digital. That might mean, how do you optimize your patient intake into a clinic visit? How do you think about patient reported outcomes in filling out forms and things like that? How do you think about their access to their own data, and how do you make that easy for them? And what about transactional things like paying bills, scheduling appointments, and communicating directly with your doctor or clinical team?
It gets into what we call digital therapeutics. There are ways we can deliver care digitally that are approved and have been validated, like with anxiety, depression, diabetes management, and weight management. Companies like Livongo are doing great things in this space.
Home as the new care site
It’s everything from transactional interactions and engagement, all the way through the digital therapeutics — and I haven’t even mentioned remote patient monitoring. But it’s thinking about wearables; thinking about connected devices like scales and blood pressure cuffs. That entire ecosystem is being built out and operationalized all around the consumer, and all around their convenience. I spoke with our CEO recently about the new site of care is going to be home. That’s going to be the site of care, and so we have to build an entire ecosystem around what that means.
Connecting with new patients
Gamble: That’s a really good point. In doing research for this interview, I read that Moffitt was working on connecting patients with a member of the care team right after they scheduled their first appointment. It seems like that can make a huge difference when you’re talking about cancer care.
Robinson: Absolutely. And if for no other reason, because it’s cancer and people are scared. They’re nervous. They’re anxious. And so, with First Connect, we jump in to try to understand what they need, and get them tied into to where, within Moffitt, we can best support that need. There’s a people component to that and a digital component. There was a strategic push, especially through our GI oncology department, with great leadership both from IT and our department chairs. It’s been great in terms of addressing patients’ concerns, which are understandable. The question is how do we get them to where they need to be, and get them what they need as quickly and as conveniently as possible?
Gamble: Can you talk about what was required to enable that? I’m sure there were quite a few steps.
Robinson: It is a huge operational change to pull this off. Because it’s not just having someone talk to the patient; it’s plugging them into our entire clinical operational system. And that requires rethinking how we approach all of our workflows, all of our clinical operations. Our clinical operations teams did yeoman’s work in pulling this off, in addition to our faculty leadership. It’s not a simple change; it’s a huge change, but it’s one of those things that was spurred on by the pandemic where we said this is something that we’ve got to do.
Gamble: Right. Looking at your career path, prior to Moffitt you were with ChristianaCare. What appealed to you about this organization?
Robinson: There were so many different things. Again, the mission — I know I talked about that earlier and I keep going back to it, but when I visited Moffitt’s campus in Tampa, I noticed it right away. It’s literally on the wall of the parking garage; it’s palpable. I noticed it the moment I set foot on the campus. When you have that clarity of direction and strategy, it’s actually much easier to do the work that we do, because we know where we’re going. At the end of the day, it’s really about that mission. As a hospitalist, it’s something I really connected with.
There are two other components. The vision of the leadership team to create digital as a strategic entity was, to me, really forward thinking. Alongside that is the fact that they operationalized it by putting data and IT together as a collaborative function within digital (I later added the innovation function). The idea that IT, data and now innovation could come together in concert to drive our digital strategy forward by enabling and accelerating our overall enterprise strategy, was the icing on the cake. For me, the thinking was, ‘you have to go there. You have to make it happen.’
Gamble: Right. It was really important to you that digital wasn’t just one of many pillars of the organization, but a central part in how things are done.
Robinson: Yes. And it’s fun to be in that place. It’s daunting, because there are a lot of expectations. The CEO will pop into my office and say, ‘Hey, what are you going to do about this? You’re the digital team.’ So we have that, but that’s where we want to be. We want to be right there, where what we’re doing is leading directly to what’s most important for the organization.