Solving Healthcare Scale with Smarter Tech: Insights from Jason Weshler

<p>Technologies will never be free. There's always a cost to innovate and develop. But when you can drive value and tie that back to outcomes, there there's immense reasons to be [Music] optimistic. Hello everyone. This is Cole from the American Journal of Healthcare Strategy. Joined by a really special guest from one of my favorite organizations, just a tremendous amount of experience, over 20 years of experience working throughout different organizations in the healthcare industry, Jason Wesler.</p> <p>Jason, can you please introduce yourself and your current role? Thank you, Cole. Excited to be here today. Uh, my name is Jason Wesler. I'm the vice president for outpatient solutions with Seammen's Health and Ears. As Cole said, it's been about 20 plus years in industry working in biotech with Amgen. Spent some time with Johnson Johnson Medical Devices and I've been really fortunate to spend the last better part of 15 years with Seaman's Health and Ears. Five completely different careers.</p> <p>everything from imaging equipment to point of care lab diagnostics, COVID uh testing, working in operations, working in marketing, and most recently got to join a new team focused on really helping our health system partners and clinicians bring care out to the communities in this outpatient care role. And that is uh why we wanted to talk. I saw your resume, of course, the experience, but specifically, uh, everyone knows, you know, I'm a big fan of of outpatient.</p> <p>I worked in ambulatory care, and so that that's a big reason. But I have to ask, Jason, did you ever expect to find yourself where you are now? I I did not, Cole. Um, prior to starting in in the industry, I was in restaurants. Uh, so that paid for college doing research. Thought I had a long career in medicine and ended up realizing that that wasn't in the cards. So got my MBA, kept learning and growing and have to say I'm very lucky that it's been a great pathway.</p> <p>Still impacting patient care, still impacting patient outcomes, which is a passion for me. So glad I get to contribute in a very different way daily to um outcomes overall over your experience because you've been focused on patient outcomes because that was kind of your your mission from the beginning from when you started college. You've seen a lot of different changes. You've also seen it from a lot of different angles.</p> <p>When you when you think about where we are now, how would you describe the current delivery model and then what gaps are you seeing from your perspective in the US? So the care model is constantly changing. Uh I remember early on my career going out to a site that was doing their first PCIs with no surgery backup and today that's common place in an ASC. Yeah. So so having watched care overall care delivery is changing. I'd say today in the United States we're seeing two typical models.</p> <p>We're seeing those standalone sites really focused on acute care delivery and we're seeing integrated delivery networks. So the hub and spoke type approach bringing care more broadly but still coordinating. And I think this evolution still only partway into the process. We're going to continue to see an evolution at health and we say it's a smartly connected system of care.</p> <p>So it's being able to better engage patients, better reach people in the communities, bring the right care to the right place at the right time. And SG2 had a recent paper, they said it's the integrated health health approach. So looking at helping patients achieve their health care goals while they're being treated for disease. So the more you do that locally in the community, uh the better care and better outcomes you're going to be able to deliver.</p> <p>In 2010 when you first joined uh Seaman's Health and Ears and you I think you were working on uh point of care ultrasound. Um what what changes have you seen in terms of the shift from inpatient to outpatient? Have you have you seen a drastic shift? And I guess when do you think you really started to see things heading in that outpatient direction? I mean because as you were saying you know ASC's are really as equipped now as uh you know hospitals used to be back uh 15 20 years ago.</p> <p>When did you really see this change take place? Well I'd be hardressed to give you a date.</p> <p>I spent uh the first part of my time with healthers in Canada which is a different health care system different realities but I'd say even in 2010 you started seeing the shift with lab and how could lab testing uh be done patient side in the outpatient space and we've gone from a point of care test which was fairly limited to observed tests to handheld blood analysis which will do a full metabolic pan panel almost in under a minute.</p> <p>So that that evolution keeps happening from an imaging standpoint as well. Ultrasound was always in clinics in physician offices. So that well predates my time at health and errors a lot of practice. Yeah.</p> <p>What's really exciting today is we can roll an 18-wheeler up to a community in the Philadelphia area and do breast cancer screening for women who otherwise don't have access to care where we pull up a 40ft truck to a mining community and do lung cancer screenings treating and screening four patients an hour. So, so care is really becoming more ubiquitous in the community. What technology is being used to implement these changes, right? We know we talk a lot about AI.</p> <p>Uh, and we know a lot of these things have been kind of, you know, biologically feasible, right, to do a lot of this stuff, but economically and technologically it hasn't been until it seems like accelerating very recently. What is that? what are you seeing that's enabling this? So, so I think well it there's a couple things at play here. Um when you talk about technology as you mentioned technology is continuing to get smaller, more cost effective, faster and AI is playing a big part of that.</p> <p>When we look at MR scanning as an example, the technologies evolved so that we can be more sustainable. So instead of using uh lots of helium to fill fill a MR scanner and having to worry about helium release, we we've gone to self-contained MR scanners where the helium is contained in the system and you're using less than a liter. So that means you can construct faster. You need less requirements for a room and the AI technology within it is allowing you to do a faster scan.</p> <p>And as we continue to focus on sustainability overall, it's making parts recyclable, being able to really focus on that circular economy of systems so that we're wasting less, we're making it easier to be more envir environmentally responsible and also more cost effective. Seams is a global organization, right? So they have interests in what's going on all across the world. As you mentioned, you were in Canada at the beginning of your time.</p> <p>Do you think this global outlook that even you have personally has benefited you in terms of your understanding of the challenges and you think about things like sustainability as well? It's now it's not just regional or local sustainability. It's a global environmental but it's also economic sustainability. Do you think you learned a lot from that experience in Canada and has it helped you to work with organizations in the US in uh maybe a different way? Well, that that's a fun question.</p> <p>Um I I think there's a lot we can learn uh by sharing experiences and thinking globally. The challenges in healthcare are common. In fact, more common than we often realize. The nice thing about being part of this large global company, we've set a sustainability goal for ourselves of having 3.3 billion patient touch points worldwide by 2030. And taking that further, we're saying we want 1.25 billion. So about a third of those in low and middle inome countries. Wow.</p> <p>So so there are best practices we can learn. There are practices when you listen to clinicians across the country. So so annually we'll host customer forums both within the US within Canada and globally where we get other health systems to talk to each other. the ones I've been able to listen to, I'm learning as much as the other people in the room. Why should and this kind of goes back to the first or the earlier question as well, right?</p> <p>When we're talking about implementing sustainability that allows us to in a way serve patients better, right? Because it's it's cheaper, but it's also uh less complex. The technolog is less of a hassle. That helium example is perfect.</p> <p>So when we're talking about globally right these these global connections have really facilitated that technology and that success why should providers look to organizations like seammens to help them overcome these challenges instead of going it on their own right instead of you know relying on their own uh research and you know a lot of these institutions have very small teams so sometimes it's just relying on on one or two people so what are some of the advantages in working with an organization like yours?</p> <p>Well, I think Cole, you hit on one of the first ones, which is organizations, no matter how large their health system is, everyone is resource constrainted. So, so being able to partner with a medtech company brings that additional perspective. So, I can share a recent fun example. uh one of the spaces we were looking at is how do you further decentralize care and we started thinking about what the ecosystem of bringing care as far as the home or into the home can look like.</p> <p>So I was very fortunate I had a team of global colleagues who brought different expertise, different skill sets to these conversations and we came up with a framework that we thought was pretty interesting. then got to share it with a large health system that's going through their own iterations and ideations of what this ecosystem could look like and we pulled out our model up and it did two things. it resonated with the customer.</p> <p>So the health system saw that we understood their world by bringing in those international perspectives and then they borrowed it and in a subsequent meeting that same image was put up and to me that's the ultimate sign of good collaboration of good learning when we can share knowledge we can learn from each other. The other advantage as a met company is we're talking to health systems worldwide. We're sharing with colleagues internally.</p> <p>So an idea that work really well in um British Columbia is equally relevant today in West Carolina or South Carolina. So being able to bring those best practices really allows us to empower health systems to solve their problems. What do you think the future holds for these kind of gaps especially you know you talk about North Carolina I think of you know the rural health but North Carolina at the same time is kind of becoming more urbanized and more developed. So it's it's interesting, right?</p> <p>Do we have a changes going on? We have a lot of uh issues as well. People are concerned about global health. Uh you know, there's a lot of things going on in politics right now people are concerned about. So there's all of these concerns and and these headwinds and we discussed a few of them at the beginning. Uh and and your examples now are great and how bringing this international knowledge is really helping organizations to plan better. What trends do you see for the future though?</p> <p>Is there anything that's really alarming or that's especially promising for the future as well? Well, uh, I I think there's a lot of noise right now and every time period, every year has some of that noise, but some of the trends are ahead. We know we have an aging population. We know we have workforce shortages. We know there's limited resources. Depending on what reports you want to look at or what studies, we'll be out of hospital beds in 2032.</p> <p>Um, and with all that to say, I'm very hopeful and I'm very I'm reasonably optimistic. And the reason I say that is we are finding new ways to embrace the next generation workforce. We are finding tools and technologies that allow us to scan remotely and bring care from an urban center into a rural community. AI is a very powerful tool. It's a tool though. It's not going to solve all our problems overnight.</p> <p>But when when used well, it will allow us to image faster, which means increasing capacity. It will allow us to read results more consistently so that clinicians can focus on the 20% if you go by a standard paro rule of more advanced cases that need that attention as opposed to spending a lot of their time on the 80% that are normal healthy scans. So, so obviously cost will always be a challenge. Mhm. New technologies, as we talked about a few minutes ago, bring cost effectiveness.</p> <p>They're not always a cost to innovate and develop, that back to outcomes. There's immense reasons to be optimistic. So you believe that patients will be actually in the next 10 years, let's say we're we're in 2035, they're going to be seeing even more value out of their care. I I hope patients will be seeing better value out of their care.</p> <p>I would believe that with the innovations coming through healthcare, the ability to better understand your own health as an individual, the ability to act preemptively will emerge and the ability to access care at the right place at the right time. So not waiting until you're in a severe condition, but actually get proactive. It's certainly viable. Now, now do all the other social factors fall into place?</p> <p>I wish I had a crystal ball clear enough to I have a question about this though because you know, as a society, we're really trying to push towards better quality and and cheaper. And so that that's hard to do, right? It's hard to make something better and cheaper at the same time. I think the technology is helpful for that.</p> <p>But the other end of the coin is a lot of physicians or clinicians at large might be a little uneasy about that because they kind of were told the same thing with EHR and EMR, right? When EHR comes in, you're you know, it's going to be so much better of a job. Your patients are going to have better quality. As that's come and gone, it's introduced a new series of problems. How do you prevent that from happening? Is there any work that you're do? Do you do you have clinicians on your team?</p> <p>Do you work with clinicians? Is there any strategies you have when you're looking to the next 10 years to make sure that this technology doesn't just help patients, but it also helps our providers. So, so in my many roles, I've yet to be fully immersed in the product development standpoint. So I know that we do have multiple teams working with providers, working with patients, thinking about usability and workflow, standardizing interfaces to address many of these concerns.</p> <p>Uh but certainly not my core expertise. What what I will say is change management becomes paramount. M and an example probably about 12 13 years ago I was standing in a room of uh laboratorans and I was talking about the benefit of point of care testing. So so I had a lot of people very unhappy with me because this is removing the cheese changing the way care is delivered. So I had an opportunity to ask two questions. The first question was, how many people like doing your dipsticks?</p> <p>And by your laughter, you can tell that was not the popular test. No. So, my follow-up question was, how many people want to be working on molecular and genetic tests, which are the way of the future. Every hand in the room shot up. Mhm. And my my comment was this is the opportunity that point of care testing brings. It's to allow people to focus on the tests that are more exciting, more relevant. Yeah, there will be trade-offs with new technology.</p> <p>There will be um some disruptions and some things that make people uncomfortable. And when we look at the big picture, success has to be defined as moving the overall society forward. So when you say that, what you mean is we can't give our patients the number one top quality care at the cost of everyone else.</p> <p>It has to be a mix of getting our clinicians to not burn out because we need clinicians and then at the same time providing that good quality care by having our clinicians be happy at their jobs. That that's definitely a core part of it. I'm Canadian so I grew up in a socialized health care system. Um well you're in Boston now. I am in Boston now. Yeah.</p> <p>And what I got to see is we were bringing high quality care consistently to the po population and some people needed the latest and greatest technology. Some people just need to be seen and treated in a timely manner. Yeah. Well, I I think balancing care and empowering physicians to drive their core area, their core specialties, where their passions are, giving them the right technology and tools. Um, and yes, some new technologies come with incremental cost.</p> <p>We introduced a dual source cardiac scanner a couple years back that is designed for cardiac uh CTA. So you're able to look at the vessels in the heart. What's really unique about this technology is it was developed for rural and other spaces that don't have the funding to put in a high-end dual source system where we think of the multiple millions of dollars.</p> <p>It was designed to be able to give those quick, accurate results and maintain a workflow that was consistent with other CTS in the health portfolio. So, we were addressing a lot of the needs and gaps that you've mentioned. Um, and it's driving better patient care and it's cheaper. It is. Yes. It's more affordable for sure. Yeah. Well, not cheap, but cheaper, closer towards expect. So, that's interesting. I appreciate you sharing this.</p> <p>So, there there's you're optimistic, but you think that there'll there'll be challenges along the way, but overall with the technology, you're optimistic that hopefully we'll get at least better as time goes on. Absolutely. our our global CEO challenged us at one point um and made the observation healthcare is one industry where as systems get bigger they don't necessarily get better. Yes. And and with that mindset we've used that in our approach to outpatient care.</p> <p>We use that in our our conversations with health systems to think about how can AI, how can new technology, how can looking at care pathways, innovate to help health care systems keep getting bigger because that's the nature of where we're going while becoming better. Yeah. So you're addressing the challenges of scale a lot of times. Absolutely. Yeah. That's interesting.</p> <p>I did a research report uh we're working on it now on economies of scale in healthcare and how once you reach a certain point especially in terms of data management, employee management, we run into the barriers. So that's very interesting. Uh I appreciate you coming on Jason. I I'm very intrigued in where you go from here with the with your work and where the whole organization goes in the future. You guys are working on some really cutting edge stuff.</p> <p>So, I hope we can have you back on again in the future to discuss as more developments come out.</p>