Dr. Arturo Loaiza-Bonilla on Breaking Barriers, Innovation, and the Future of Medicine

<p>what is this other health system doing that maybe you know I can be you know learning from you know to me one of the things I always learn is learn from good things and also learn from errors so if I don't know what's out I cannot learn from anyone's mistakes I don't want to repeat them uh so that's also part of the of the conversation [Music] hello this is Zach with the American Journal of healthcare strategy welcome to the clinicians and Leadership podcast Series where we focus on empowering clinicians from bedside to boardroom I'm joined today by Dr Arturo loisa Bonia Dr Bonia do want don't you just take a second to uh introduce yourself tell us a little bit about you and your experience sure uh thank you sack for having me here it's always a pleasure uh talk to you so uh yes I'm Ur lonia I'm a practic medical oncologist uh I'm the assistant white chief of Hematology Oncology at s luk University Health Network um also associate professor at Temple University and the co-founder chief medical officer of mass bio which is a technology company focusing on AI um you know very happy to share my experiences here and you know take your questions and see how we can uh you know collaborate further and bring more you know leaders to the full hopefully with you know the work that you're doing yes yes well I'm I'm thrilled to have you on today and and I think you you have a unique combination of experience um in in in in clinical in administrative research technological there's you you you offer a unique combination of perspectives that that not a lot of other individuals and have and so I'm I'm thrilled to have the chance to to get to interact with you a little bit today and and pick your brain on some things and so um one one of one of the first questions I I want to I want to hear your perspective on is is the role that clinicians play or should play in in innovation in in shaping the future of healthcare and and in implementing changes what what role should clinicians and Physicians play in in shaping the future of healthcare yes uh the very important question um particularly at this time um what I always said and other folks have said if you're not on the table you're in the menu right you need to be part of the conversation uh because we've seen a lot of things happening in medicine uh you know the number of administrative tasks has exploded and there's Technologies coming up that are helping us to be more efficient and focus on what we always were inspired to become which was you know taking care of patients but um we as Physicians were very risk averse we're always in our you know little bubble of you know patient care and we you know get Satisfaction by taking care of those uh you know patients coming for for help that that we provided but um very seldomly we had the chance to get out of that box and make the decisions ourselves um and and I always thought about it in a in an interesting way so you know outside of our Lives as Physicians uh you know we are parents we are taking care of houses we are you know building our future together saving money doing being administrators of the lives of of many other folks I helped you know from from Colombia where I originally came from and but we get into work and it's like okay no I only do this tiny thing and everyone else makes decisions for me when I'm the one making a lot of decisions outside of my realm so kind of like removing that you know you know paternalistic approach to work and us being part of the equation and really having an impact uh where we're the end users right so we're the ones driving the a lot of the things that happening in the healthcare space so we should definitely be part of it uh and As Leaders as uh Enthusiast as collaborators and you know information Seekers um uh is important for all of us to be yeah well and in a in an industry like the health care field that that is exists for the patient and for the good of the patient you you want your your individuals like your Physicians and your other clinicians who who have that patient centered perspective to be the ones that are implementing those changes and Innovations because because they are they are actively seeing those changes and and understanding how those will impact the patient in in a unique way and so um you've you've touched on this this next question a little bit already um but but I'm I want to hit on it just a little bit more about the the barriers that prevent clinicians and Physicians from being at the the Forefront of innovation what what are some of those barriers uh yes of course uh everyone has different personalities and and and but um I did a masters in medical education precisely because I felt that no one really thought us as Physicians to uh you know Drive our interests in the best way possible so in adult learning there there's different ways for us to express you know our abilities to the best uh possible way and um one of the the things I've noticed uh and I had that myself but I had to overcome it was that the fact that we are because we're very risk averse right when we're decisions we want to or or nurses or you know everyone in the healthcare field we're always playing on the safe side we want to be playing for the safety of the patient the safety of the health system we are you know kind of like in defensive mode always trying to protect all the potential Futures that may be averse and that makes us to also feel more comfortable in the confines of a tiny role right like kind of like the you know doing what we do because that's what drives us single day but the the the I mean that's a nice approach and I appreciate it but it also makes us blindfold to all the other things happening around us so if I don't understand what's happening at the global level if I cannot Know What new technologies are coming or how this you know change is going to impact not only me but my patients and the health system in the future we won't be able to exert change and then I will not be able to even to deliver the care that I'm intended to give in a comfort zone so the the key thing is we need to uh kind of remove that barrier from our eyes and and go and see okay what is this other health system doing that maybe you know I can be you know learning from you know to me one of the things I always learn is learn from good things and also learn from errors so if I don't know what's out I cannot learn from anyone's mistakes I don't want to repeat them uh so that's also part of the of of the conversation well I think you you highlighted the balance that that needs to take place of of uh of of being safe and and prioritizing safety while also being encouraged to to to innovate and and and make changes and and and uh Ed increase our own education on on how those changes can be made that that ultimately better encourages safety for for those patients and and increases and and uh encourages better patient outcomes and so I'm I'm curious to hear your perspective on what what leaders can do what within the Health Care system to to kind of help break down those barriers and and encourage clinicians to be at the Forefront of innovation what what are some some some things that you that come to mind when you think of what what someone in a leadership position can do to to break down those barriers yeah so I I think there's always this best practices approach where we think that we have already you know done the right thing and we have it all well controlled uh and that's like you know I I been in different places I've been in Academia right like a full-blown academic you know IV League uh approach and I've been on the other side of the Spectrum in terms of you know private Equity 100% uh return investment but also quality purposes all patient center with unlimited resources and uh and then Community Based uh you know uh approaches where we are having you know restrain uh volumes and things that we need to focus on and I'm also at the for front of you know being an entrepreneur as well so what I I can do whatever I feel is is is possible so um I think what we need to learn here is getting uh outside of that box as I mentioned and and realize that uh yes we do things right but there is an opportunity to maybe do things better always uh not just having one person making the decisions uh I mean of course I don't want things to be a complete crazy consensus I want the Amazon approach you know uh you know you have a pizza the amount of people who can be there is what the most decision makers and decision have to be made them quickly and deliver it but also you know without hesitation as long as they have a purpose or a problem we're trying to solve so focus on the problems or the bottlenecks that are driving things to a direction that you don't want it to be or you want to accelerate it further and then uh you know do all your efforts into optimizing those workflows first and then you can do the much better as you release those knots that are the biggest ones that are holding things uh from really unleashing uh that's that's kind of like how I see things just so learn cross pinate and and learn from private uh Industries like you know they invested millions of dollars and doing the that innovation side and you know apply to what is happening in your local environment well and you just you you mentioned something that's fascinating and I love the analogy of of of uh untying the knots that you can tie untie first and and fixing the problems that that you can within your own role and and position first and then moving on to some bigger problems there and not only in that are you are you fixing problems and improving workflow but you're also increasing uh belief and respect within the team that that you are going to get that you're working with that you're getting things done and that you are you are moving the needle and you're making decisions that are going to better them and and ultimately better the patient and I imagine that goes a long way for for anyone that that is working with you as well um pivoting a little bit I I want to talk about your your experience um with uh you know being the co-founder and and medical director of of massive bio and the uh the the experience that that has brought you and I'm I'm interested because you you started that back in in 2015 a number of years before AI in in its you know last couple years has kind of taken the World by storm and is is widely more becoming more and more used in more and more common practice I'm I'm interested giving giving your expertise in in Ai and in digital health and and the the implementing new technology how do you approach the challenge of of build building trust among patients clinicians researchers other administrators in in the right reliability of of artificial intelligence and and the tools that that it offers yeah so um and I appreciate that question so uh so massive bio and it has an interesting name is you know come from massive parallel sequencing which was Next Generation sequencing we're doing genomic testing for all patients at time I mean it wasn't even done ously was done for certain number of patients but no one understood the results um then uh you know massive parall Computing which is basically AI in the past was Brute Force which was like just doing iterative process and and and we're still kind of like recovering from the AI winter now coming into the really Cambrian explosion of AI and synthetic biology which is like exerted change in the biology of the cancer and hopefully become like a drug Discovery and and and Beyond so I always try to see ahead of the game but also focus on the problem hand kind of like P backing on what we just talked earlier um and is um you create trust and you create adoption by solving a problem that people actually have many technological solutions that we have seen in the space and also have been like interesting blunders there are things that no people don't really need or use or there would not be a use case right now maybe in the future or maybe never um but you know we can do now something for example for clinical trial matching it's a fully automatable process we have the data we have the we have the mobile phones we have internet in many places and we have models that allows us to you know optimize the data extract information and do matching as long as we feed it with the expertise that we all have so that was a way for us to overcome that major roadblock uh in Cancer Care and Leon and show people in real time that this is something feasible doable and is scalable uh other solutions that are more complex like you know using you know Predictive Analytics by looking at X-rays and and kind of replacing you know complete workflows for radiology is they're not ready for prime time I think we need to focus on the augmented oncology or augmented medicine where those tools are helping us to be better and more efficient uh but also to increase adoption and I think uh we we had some prior conversations about it uh is the fact that it were SA time effort uh from you know doing these technology adoptions then we reinvest that that time which is you know invaluable into the patient experience into decreasing physician burnout so just because you're saving time doesn't mean you have to see more patients or do more things or or you nurse do more infusions because now you have more time because of this process let's focus on being humans because the AI is helping us to become more efficient uh on that aspect and and be part of the equation without the human in the loop without the end user being part of the whole discussion that solution will never be adopted widely it maybe have a eache somewhere but it will not have the adoption that is going to change the the future for the better for delivery of healthcare I'm I'm I'm curious to to hear your perspective on on something else uh that given the Innovation can can occur rapidly you know people are constantly coming up with with the Next Big Thing the next the next thing that's going to fix fix an issue fix a problem um so that process that brainstorming that that Innovation process Can Can Happen kind of quick the the regulatory reimbursement and and adoption and and you mentioned best practices it it can it can take a bit for something that is starts off as Innovation to become a best practice how do how do you and in your experience address the disparity between the rapid pace of innovation that Innovation can have and then the the slower methodical Pace that regulatory reimbursement and and healthc Care System adoption and can have how do you how do you address that disparity yeah and that's a that's a really hard problem to crack depending on the use case that we're talking about here uh so um the the first thing is to show success stories that are focused on the market you are you know talking to right so for you know Physicians and Regulatory is mostly about you know uh torch regulation is this going to increase my liability or not that's like an easy one to take uh make sure that you're safe that there's no bias that the the the solution is really focused on that for the patient it's about safety and accuracy and make sure that you're not widening disparities because of the algorithms or the solutions that you're you're putting together and uh also there something called the digital divide where people you know certain populations don't have you know the technology that you need to implement that solution so it could be the best solution in the world but if you don't have internet or a cell phone or you have don't have the literacy to access the the phone or because you know my grandmother she's Plus 90 plus years old you know she may not be willing to use the latest model of Technology right so uh that's that's part of that and for the regulatory aspect and Institution wise and particularly for payers uh you just need to start the conversation very early and make sure that um the solution you're bringing that it has a return investment right because for an institution it it's a lot of implementation so the people are are done with you know implementing things that are never going to be interoperable they cannot work with the EMR that they don't work with their workflow so it has to be almost like a premium approach that you just test it and try it and then you can expand um doing in a partnership with collaboration so always coming when you say oh Google is doing it with Donna Farber or MD Anderson or or s luks in the community then things actually start to move uh in uh the other thing is work with government from the beginning so right now there's a lot of opportunity now uh with you know initiatives like arpa H where they're bringing funds for really changing the future and making it more you know decentralized technology could driven so I love that approach I think we can Infuse that RH approach across all the technology Innovations we're doing where we're hearing first what are the problems how to solve them in a what call you know Hub spoke approach and then those spokes are actually bidding for that solution that they propos to be the issue then we're going to have much better support with a you know with you know government and and other public partner Partnerships that are working around uh Dr loisa Bonia you you you touched on another topic that I I want to cover um in this this interview is is the uh Health disparities and and um as as uh Innovation and and new treatments and and new processes come into place and become more adopted I'm I'm interested to hear how how we can prevent Innovation from from furthering those health disparities you mentioned you know the digital divide and and um there's there's other health disparities that that are uh that are just com common throughout the medical system and so how how can we ensure that there's equity in in Innovation and and prevent Innovation from from increasing and furthering Health disparities yeah and that's a major topic because we need technologies that are helping the whole humankind right so and no matter where they implemented they can be widely used uh uh in as we're talking the US uh the digital devide is a major thing but also what we call the Social determinants of Health uh so those are basically you know we as we don't have a uh you know a centralized uh you know health insurance system which is okay that's the your synchr of the United States I'm all for it I'm okay with that as long as people feel comfortable with that um we need to adapt so having the opportunity for um you know understand from those Technology Solutions or algorithms who are the ones at at higher risk for being left out right we we don't want necessarily that everyone needs to have the solution implemented because it may not work for everyone but at least for the ones that had the most impact we don't want them out of the discussion so um one of the things I always look into is like okay how are we assessing for you know rural communities like because people could be in the middle of nowhere they they still may have insurance they don't have access to the care that they need so how do we get those decentralization processes so they can be delivered closer to them either a clinical trial or a nurse for hospice or someone who needs help for support for medications or for treatments uh During certain period of time um so uh the same way we're doing it for like you know there's Uber there's instacart there is Amazon tells you things metric wise we can do the same and that's all AI so and they're already incorporating that we have the we need to have the same approach in healthcare uh because we can really do it as long as we uh optimize for the things that we want these patients to be you know getting the better experience from so um at M would do all the time for clinical trials and young where trying to De centralize everything get patients what we call justing time activation facilitating testing and all that stuff with uh you know at St Luke's uh we we have 15 hospitals across a very vast region in the Lehigh Valley and also all going to Jersey so we are aligning all those efforts to make you know Hub unpoke approaches as well and any technology solution that we're bringing we are having that conversation ahead of the game so it's just deliberate approach to it understanding those things so you are aware and try to find Solutions of course nothing is going to be perfect but at least you're getting closer to that you know better approach than before right well and I think that that you you I think that was a great answer and I think that you also just highlighted the importance of having someone with the clinical experience that's that's part of that's at the table not on the menu to use the the phrase that you used earlier um and and as a result they're they're able to keep the the patient uh centered as as they're seeking to find these Solutions and also better understand what their fellow clinicians and other clinical staff members are are going through and and can can help lead the Innovation um efforts in in in a lot of unique ways uh with their perspectives that they bring and so um uh Dr Loa Bonia I just as we get ready to conclude the interview I'm I'm interested you you've mentioned you know looking ahead and and and and staying on top of the field and and and learning and recognizing opportunities how what are some ways that that Healthcare leaders can can stay on top of an Ever Changing and ever evolving in an in an innovating field um because you've you've done that and you've done that quite well and so do you have any insights for for others who how how they can kind of do what you have done in that in that regard yeah so first uh understand your learning mode like some people are better you know listening so listening to podcast some folks are better visually so they you know watch you know YouTube or or something uh that is specific to that or going to conferences some others just like to read and stuff um and and just get impact from you know journals uh and and blogs and substack and all those different approaches um so I learn my Approach I I'm a great you know audiobook listener and podcast listener so I I you know whenever I had the time when I'm driving I optimize my time by doing so um I take also some time of my day to you know read news that are focused on me so I do specific you know Google alert searches for certain topics uh I understand that the the places I want to hear from so I go like you know open AI uh you know Google Google Gemini models what's happening with anthropic what's happening with perplexity and just get myself kind of acquainted to all those things and of course go to my professional societies uh and listen to what people in the industry where they have unlimited resources what they do so you can adapt it to your own things understanding the constraints that you have so you can be much more worthly uh and I get involved with organizations like anasco I mean the government Relations Committee so understand what's happening at the you know Nationwide level you have a lot of exposure like the FDA and CMS and also work with my state Society locally so I work with piso with the state Society I was on past president so I talk to my colleagues across the state and understand what they're going for and also Foster collaboration because at the end of the day we're all humans um there may be health systems that are competing against each other but we as humans don't we're are in the same mission to you know make it better for ourselves and our in our families and our nation so uh that's what I wanted to you know focus on uh looking at the future ahead of us yeah well and I I just loved I loved how you finished with the we we are all humans and we must collaborate there's there's no one individual that can can make a change that's going to extend beyond Sub make a substantial change that's going to truly impact the Health Care system that a group of individuals can't make a bigger change and so I uh I thought I think that was that it's a beautiful thing that we must work together it it can be hard but I'm glad that there's individuals like you that that are encouraging and promoting collaboration and and innovation in in the ways that you are so um Dr loisa Bonia I I appreciate your time today um thank you for for coming on and uh we we hope you uh have a great rest of your day thank you sir thank you nice to see you</p>