Stemming the Loss of Clinical Expertise
This week I am talking to Hass Saad MD, Founder & CEO of Detroit Medical Informatics (DMI) a unique organization offering a highly successful elbow side clinician support, training and technology implementation in hospitals and healthcare settings.
Hass grew up as a digital native and was entirely comfortable using the technology when he started training as a doctor. He started work as a doctor in a site that was implementing Cerner’s systems and with technology experience, he became the go-to expert for all things related to the EHR and he became one of the busiest people in the hospital doing technology support with his clinical colleagues. As he describes it he did not necessarily know the EHR technology better than the vendor staff but spoke in terms his colleagues understood and could learn from
I don’t speak technology, I speak medicine
What struck him was the disconnect between the implementation of this technology and the challenge physicians had with using these systems. This was especially acute with more senior clinicians
On his way to founding DMI, he worked for a renowned cardiologist, one of the many mentors and pioneers you find in medicine but he was struggling with the new technology and like many senior clinicians was considering exiting the profession early because of these struggles. Hass set out to change this and help keep these innovators and pioneers in the profession to stem the loss of clinical knowledge and experience from our health system.
Clinician Elbow Side Technology Support
They have attracted a wide range of clinical talent that has enabled many physicians and care providers to explore additional career opportunities with technology innovation. He has enabled physicians to provide better ideas and promote clinician engagement and innovation coming from newly minted physician entrepreneurs.
Listen in to hear Hass talk about the lonely transitioning to a physician entrepreneur and the early days of setting up a business that now employs over 300 doctors who are creating solutions to some of the wicked problems they see in healthcare. He has created a vibrant company filled with the people experienced in delivering care to create a better healthcare environment for patients, physicians, and care providers and improve the way we deliver healthcare medicine and preserve the art of medicine and how they adapted to the new virtual world of elbow side support in the era of COVID19 pandemic. As one client physician put it:
I was going to retire and quit if it were not for the services provided by the DMI team
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next week at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
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Raw Transcript
Nick van Terheyden
And today I’m delighted to be joined by Dr. Hass sad. He is the founder and CEO of Detroit medical informatics or DNI has thanks for joining me today.
Hass Saad
Nick, thank you so much for having me. It’s an absolute pleasure. So as I do always, I think it’s important to get a little bit of your background and how you arrived at this point. You’re a physician, you’ve delved into technology. Tell us a little bit about how you arrived here, with all of the skills and indeed the focus around this technology and supporting clinicians with technology.
Yes, so, you know, to, to kind of kick it off, I sort of, you know, I was sort of raised in the digital era, you know, technology and I grew up in that generation. So sort of growing up in, you know, the digital era, I was able to really understand how to use technology, how to, you know, that would benefit me whether it’s personally or professionally. And so during, you know, my internships actually, when I was in medical school, I had an opportunity to do some internships at Detroit Medical Center, which at the time was a Cerner flagship hospital. They were using Cerner extensively the education that was provided to us as interns and for the physicians and everybody was, you know, really well beyond what normally would be provided. So I had sort of this opportunity to really learn how to use an EHR extremely well, Wiles, and, you know, my internships, medical school, and going through that journey. And, you know, essentially, when I was in med school, I learned that there were healthcare systems adopting new technologies, specifically EHR, and they were reaching out to people to fly out and help out, doctors really understand, you know, how to use this EA hrs and what to do with it. So, you know, at, you know, as any med student, and as any resident would do your you look for these sort of moonlighting opportunities, just a way to sort of supplement your income as a broke student. So I sort of jumped into that, because I knew how to use an EHR very well. And I also, to some degree, I saw some sort of despair at the time, with, you know, physicians really not understanding how to use it. And what I quickly realized is, you know, after I went to the first hospital, a second hospital, you know, I looked around and at the time, and really till this day, the industry really only offered one solution to help healthcare systems, and physicians really understand how to adopt and implement a new technology. And that was really, you know, folks that came from a technology background that walked into a healthcare system or walked into an O r, and spoke technology to a surgeon that spoke medicine. And it’s clearly you know, healthcare and technology are two different worlds and the language of technology and the language of medicine is also, you know, completely different ends of the spectrum as well. And, you know, doing the work that I did, I realized that I was all of a sudden, the busiest guy in the hospital, every doctor, every clinician, everybody wanted to work with me. My phone was blowing up all day, everybody had my cell phone number, I was working 16 hours a day. And to my surprise, you know, I thought to myself, I don’t necessarily know the technology better than the folks sitting next to me do they’re actually here from Epic. They’re here from Cerner. They’re the ones that built this stuff. But, you know, why am I the busy one? Why is everybody want to work with me? And I sort of realized, you know, it’s because I walk into a situation and I don’t speak technology, I speak medicine. And it’s a language that physicians want to understand. And it really having a medical background, you also know that physicians really care about the why, right? Why am I doing this? Why is this here? Why do I have to do this? And that’s really what I was able to translate for that. But to kind of sum up the journey, you know, I sort of continued doing these sort of side gigs, if you will, and I was going through residency and applying to residency and all that, and I ended up landing up a cardiovascular research fellowship in northern Michigan, where I worked for one of the most renowned cardiovascular surgeons in the world. And while I was working for him, I, I looked to him and I thought to myself, you know, he’s making such a tremendous impact in the field of cardiology, and, and I really aspire to be this way to where I can make an impact, you know, a broad impact on the field of medicine. And I started to really have those sort of feelings and thoughts that you know, me becoming a, you know, traditional physician may not necessarily be the path for me And so I kind of started to feel this way and go back and forth in my head and everything. And then I realized, you know, this is a lunch that I’m going to have to take and if Timing is everything for it, so, you know, I actually quit residency after my first year of that research fellowship. And I launched EMI and the the intention to do my was essentially to provide physicians, actual physicians that practice here in the states that use these EHR platforms here in the States, to fly them out across the country, and to support our colleagues and practice that are trying to adopt new technologies, and really provide a you know, firsthand, you know, peer to peer approach in that education and training. So that’s pretty much you know, the the backstory of it, and what led to creating DNI. And, in really, you know, the one thing I didn’t mention, and all of that is, while I was doing this work, the one thing that really drove me to leave clinical practice and to do, what I was doing is, is while I was training, I walked into any healthcare system or any office that I had opportunity to train at night, like many medical students, many physicians, many residents, you know, you look at the physicians as mentors, and as, you know, sort of the gods of medicine that sort of created the path that we, you know, walk on today. And I noticed that especially the senior physicians that that we were supporting, they were struggling the most, and most of the people that were supporting, didn’t necessarily care to take too much time with the senior physicians, and they were working with the younger tech savvy ones. And the whole notion is, although they’ll phase out, but in my mind, you know, when I looked at the senior physicians, I thought to myself, well, those are the innovators, those are the pioneers of healthcare, those are the ones that teach us, you know, how to practice medicine, how to do what we do, and if we don’t focus on them, if we don’t preserve their legacy in their practice of care, you know, healthcare itself is going to change. In You know, that’s really a lot of what drove the passion to really create something that wasn’t necessarily offered in the industry, and a solution that could potentially be better than, you know, anything else that that the industry, you know, was taking advantage of, at the time.
Nick van Terheyden
So extraordinary journey, you’re what I would call a digital native, so you grew up with that it was sort of, you know, almost a natural speak. It’s fascinating to me that you were one of the busiest people in the hospital, but not through medical things. I mean, it was, you know, the technology support, because you were providing that sort of direct interaction that people understood comprehended reminds me a lot of some of the experiences I had, although, you know, at the time that I was doing some of this, there was more resistance to it, quite frankly, people looked at me as a little bit of a, an oddity, because I was absorbed with this technology could see the value. As you you know, stepped out that must have been a difficult thing to stop practicing and, you know, move to a different focus, but you clearly saw the value, and what you could bring, because I can’t believe that you’re not driven by the same thing that every other clinician is, which is, you know, how do I bring value to the patient? Tell us a little bit about those, you know, experiences in the early days of this?
Hass Saad
Yeah, so So, you know, transitioning from, you know, physician to entrepreneur is probably one of the hardest things that I’ve done yet in my life. And, you know, to kind of, to go back a little bit I do come from a traditional background, you know, I’m a son of son of immigrants that, you know, are the Americans success story that pretty much came here homeless and, and raised five kids and three of them are doctors and, you know, so in my family, you know, if you’re a doctor, you’re wearing a white coat, and you have a stethoscope around your neck. So transitioning from that was obviously a huge psychological burden and barrier overcome, but, you know, eventually you start to realize, okay, well, this is the right decision, hopefully. So, in Yeah, I always like to say when I was in medical school, when I was in residency, if I wanted to become a cardiologist, I could have threw a rock and hit 50 cardiologists that would have been my mentor. When I went from physician to entrepreneur, I was a lone wolf, there was nobody out there to help me. You know, I you know, just to clear it up. I went to University of Michigan undergrad, I got a science degree I did minor in business management, but I’m not a business major. I don’t have an MBA or anything like that. And, and transitioning from physician to entrepreneur, you have to learn so much and you have to really start to get into things that you were never trained for, whether it was an undergrad, medical school, residency, or any of that. So, you know, so that sort of was really the big barrier and the big hurdle, what really drove me was, I recognize that, you know, in with all due respect, physicians are very infamous for complaining about certain things that happen in their day to day. And they don’t always do something about it, whether it’s, you know, hospitals merging and acquiring, or it’s insurance companies changing rates, or it’s the EHR, they complain a lot about this sort of stuff, and, you know, credit to them, they don’t necessarily have the time to step away from the bedside and go up to the executive offices and contribute and do what they have to do. But, you know, I knew I didn’t want to become that I knew I wanted to do something where I could create a solution where I could have input, and where I can inspire other physicians to take a part of this right to kind of transition from the bedside to, you know, sort of the boardrooms and to provide more white coats in these decision making meetings than there are suits in these decision making meetings. Because truly, at the end of the day, what I wanted to do was I wanted to create a better, you know, healthcare environment, you know, not only for the patient, and obviously, the patient’s always a center of focus, but I wanted to make, you know, the lives of my colleagues of my physician, colleagues of the nurses of the care providers, I wanted to somehow improve the way that they practice medicine, and to preserve, you know, really to preserve the art of medicine, which is what, you know, make someone like me grow up from five years old, wanting to become a physician, right? And that’s sort of it’s one, it’s one of those unique industries that’s truly run by culture. And in, you know, there’s a lot of things you could change in the healthcare setting, and a lot of things you could do, but the culture of medicine is really what is the driving force. And that’s really what I wanted to preserve and what I wanted to make better.
Nick van Terheyden
So for those of you just joining, I’m Dr. Nick the incrementalist and today I’m delighted to be joined by Dr. Hass sad. He’s the founder and CEO of Detroit medical informatics or DNI, we were just talking about the initial journey and how lonely it was for you to sort of step out the fact that there were limited resources to sort of guide through that different process, but the opportunity of really bringing more clinicians to the table, the decision making tables, and it would seem you’ve been pretty successful at creating a tribe, because you’ve attracted a lot of talent that’s now working with you supporting you doing some of these things. Tell us a little bit about how you did that? Did, did people just suddenly come stop knocking on your door? What was going on there?
Hass Saad
Yeah, that’s a great question. So, you know, in the last five years, DMV has hired roughly 300 physicians from across the country have multiple, you know, specialties, clinical specialties, to support, you know, the health, the healthcare systems that we have gone into support? And, you know, it’s, it’s kind of two things. One is yes, we do go out of our way to attract people to get people to sort of look at the side of healthcare. But the other sort of thing is, it’s also a very unique time in health care, there’s a lot of physicians and care providers that are looking to, you know, maybe step away from the bedside step away from clinical medicine, and they have what, you know, the industry considers the golden handcuffs where, you know, I, I do very well here, I can’t really do something else, or, you know, even if I do something else in healthcare, I’m kind of losing the doctor in me and losing sort of that feeling, that feeling of satisfaction that I get, you know, providing care. And so, you know, having an industry where you have individuals like that, that are already sort of maybe one foot in one foot out, and then creating the sort of opportunity to where, hey, you know, you could come out and support us for a couple of weeks, you would come out support us for a few months or a few years. It’s completely up to you, we’ll work around your schedule, what we want, ultimately is for you to go out and to help our colleagues that are are doing what they’re doing. So the the most interesting part of, you know, what we’ve learned and what we’ve seen in the last five years with the 300 physicians, aside from the actual work they do when they’re with the EMI is how we have, you know, introduced physicians and clinicians to this sort of side of healthcare, this sort of, you know, the business side of healthcare, the technology side of healthcare, you know, something again, we never learned about it in med school, we never learned about it in residency, and it sort of opens their eyes to see you know, what happens when $3 billion organization, you know, changes this entire infrastructure and how many moving parts are involved. And more importantly, it provides them an opportunity to see how valuable they are not just with treating patients, right, my belief, you know, the physician and the clinician are the keys to any healthcare systems, doors, right, you can operate, you could, you know, you can see patients, you could treat patients without the CFO, without the CEO, you could treat patients without any of those people there. But you cannot treat a patient without the physician and clinician. And this opportunity that we have provided has allowed these physicians to see that it’s not just, you know, my value isn’t just in providing patient care, my value is, you know, providing, you know, health care with better input and better ideas and real life experiences. So, you having this sort of opportunity to provide them has really, you know, we want to do is, if you can, if you continue to stay with us, that’s great. But if you want to go out and do something on your own, or while you’re with us, you know, we we encourage you to really think of different ideas, think of, you know, what your colleagues are struggling with? And how can we fix that for our colleagues or for the health system or for the patients one day, right. And so many of those 300 physicians have gone on to, you know, completely leave traditional medicine go into, you know, more executive leadership roles at health care systems. Some of them have, you know, worked with healthcare startups, some have even created their own healthcare startup after this sort of opportunity. And, and really, that’s the whole idea behind DMA, right? It’s, it’s really to ignite the physicians in the clinicians to really be a part of change versus become a result of the change. And, and, you know, that’s one of the most satisfying parts of what I’ve been able to accomplish in the last five years and continue to, you know, attempt that.
Nick van Terheyden
So I, you know, impressive track record of really sort of engaging physicians, getting them back at the table, I think, you know, providing a career pathway or a supplemental career, or honors the side hustle initially, for many of these folks, to sort of allow them to test the waters even and then, you know, spread their wings almost is how it feels like, as you think about, you know, the success. So you you’ve got tremendous success, in fact, you know, I know, you’ve got a fantastic list of clients who talk very highly, you know, the experience that they have so much so that they couldn’t imagine doing the work that they do and implementing technology without the support of DNI. Tell us a little bit about that. And, and what happened when COVID-19 hit because that must have been something of a challenge.
Hass Saad
Yeah, absolutely. So you know, as far as the support, you know, the one principle that we’re driven by is to be committed to quality, right? It’s not, it’s not a game of quantity, it’s more about the quality of the support that we bring in, obviously, bringing in very educated physicians and things is, is why we’re doing all of that. And, you know, as far as us assisting healthcare systems, I think that sort of ties back into the physicians that we bring in, and why they love doing what they do, because what we’re able to see is, in a way, we’re improving patient care, maybe not necessarily directly by touching the patient, but indirectly by improving the way our colleague practices medicine, with the use of technology that improves patient care. And that’s really what drives us to continue to serve these clients and make sure that that they’re going to be okay. So we’ve had people think, say things to us, like, you know, our patients would have died if it wasn’t for you, or I was gonna retire and quit if it wasn’t for you guys coming in to support us and to teach us how to how to continue practicing and doing what we do. So that’s always been, you know, really phenomenal asset to have is, you know, and having a physician there, you have to sort of set of eyes, this clinical set of eyes to where, you know, if you’re making a mistake as a new end user, having an actual physician that can tell you, hey, that’s a lethal dose of medication that you’re about to apply to this patient, that’s really critical. But then COVID came along and you know, all along, we were in person and we were flying out to health care systems, and we had a surgeon to sit next to your health care system surgeons and internist, internist, etc. and COVID came along and, and, you know, obviously, there’s a lot of limitations to traveling and you don’t want to introduce, you know, hundreds of people or dozens of people even into a healthcare system, during a pandemic. And so we actually were engaged recently in the fall by a client that said, you know, Why don’t you guys come in give us a hand, we are very, you know, we have a very small footprint, no matter where we go, we don’t necessarily believe in bringing in hundreds or 1000s of people, we keep it, you know, minimal at best. And so we were actually going to head out there fly our doctors out there to support them in two weeks before we were heading out there. They gave us a call. And they said, you know, they were in upstate New York, and they said, you know, the numbers are getting out of hand over here. And we’re really worried about everything. You know, have you guys ever gone virtual? And can you guys go virtual? Well, no, we hadn’t gone virtual. And the reason is, because we never had to go virtual in the past. But can we go virtual? You know, we immediately said, Yes, we’ll do it. Because there’s to us, there’s no question, we want to be there to support our colleagues. And if we’re not going to be the ones there supporting these physicians, and these clinicians in a language that they understand, then somebody else is going to do it. And it’s not going to be what they understand. And they’re going to be a mess. So, you know, we work hand in hand with our vendor partner with the with the healthcare system. And, you know, rather than introduce brand new technology, and set up some infrastructure on our own, and force the healthcare system to use it, you know, we looked at it like, hey, they’re getting epic. Right now, there are a trans transitioning to a brand new EHR, we can’t ask them to learn a new form of technology. So we worked with what they had, we adopted all the infrastructure that they had our doctors, you know, took all the time to learn how to use it to do whatever needed. And essentially, we provide a full implementation support for, you know, 100 plus million dollar epic implementation, fully virtual, we had roughly 14 physicians across 11 states in the country, supporting this healthcare system, 24 hours a day, seven days a week through a call center, we also had a virtual screenshare, to where our doctors were able to log in and take a look at what’s going on, we even had functionality to be able to do what you know, healthcare systems called personalization labs, where you sort of customize and curate the EHR to fit you versus, you know, molding the physician that fit the EHR. So we, you know, we we continued to do what we always do, but it was virtual, obviously, we learned a lot through that, you know, one of the biggest disadvantages of going virtual is you are no longer that extra set of eyes on the floor, you have to really wait until somebody recognizes that they have a problem they call in and say that they have a problem. But, you know, I think the when when you provide a quality sort of service to you know, any customer, and you really know what you’re doing and know what you’re talking about, it’s very, you know, quickly recognized. And by quickly recognize what I mean is, after the first week, there wasn’t a person in the health care system that didn’t have the phone numbers to our doctors, and we were, you know, really there and brought in to help other physicians and mid level providers, because that’s the workflow that we know. But we had nurses and caretakers, and, you know, registration, folks giving us a call asking us for help, because they knew that, you know, we knew exactly what we were doing with this, because not only do we understand the EHR, but we also really understood, you know, how to, you know, use it as end users ourselves.
Nick van Terheyden
Okay, so, um, you know, in, in the balance of the time left, you’ve clearly provided this extraordinarily valuable service. physicians, clinicians are loving it, I think it’s this sort of elbow side support with people that speak as you described medicine. We, we’ve got a minute left, where do you see this going? Do you think you’re going to be out of a job? Are you going to it’s, it’s, it’s all of this rolling out? And we’re just going to be fantastic. We’ve done it, you know, moving on now?
Hass Saad
No, yeah, that’s a that’s a very good question that’s asked often so yes, our you know, a lot of our focus is on, you know, implementing new EHR or transitioning from one to another. But in the last few years, DMA has really strengthened its optimization services to where we go to health care systems that currently have an EHR that want to improve it. However, you know, it’s not just EHR s and I, when I look at BMI, and what I think of BMI is it’s a group of individuals that understand the the psychology and the behavior of physicians and clinicians better than anybody else can in the industry, not only because they are a physician or clinician, but because they’ve supported 10s of 1000s across the country. And, you know, our perspective on workflow, our perspective and how people interact with technology in the healthcare setting. That is where I see the future of DMA. Because, you know, right now, we’re sort of introducing individuals to a computer, you know, we’re transitioning people from an archaic EHR to a new EHR, and a few years ago was from paper to EHR. And it’s sort of like, you know, Apple in the 80s, right? It’s, you know, Apple in the 80s, initially just introduced the computer, they wired everybody up. And then after the 80s, came the nineties.com, boom. And it sort of is reminiscent to that. And healthcare where we have a lot of innovation happening right now, we have a lot of products and services being innovated around technology. And after that phase, we sort of got into the 2000s, with social media, and that’s where consumers started to really dive in. So I think that, you know, the industry is just starting to wake up, I think the industry of healthcare, it is really, it hasn’t even scratched the surface yet with with just EHR is I think, you know, our experience and our understanding of what healthcare providers really want, what really works for them, that can really be applied towards any product or any service that’s going to be introduced into the healthcare setting. And, and, you know, that’s why I feel that DMI can continue to sort of be that bridge between, you know, medicine and the technology that’s being introduced.
Nick van Terheyden
Exciting times. Unfortunately, as usual, we’ve run out of time. It just remains for me to thank you for joining me
Hass Saad
and in your neck, thank you so much. And I i’ve always listened to these shows and you know, it’s always been a way I start my day and I’m very excited to have been here and would always love to catch up here soon.
