HJNO May/Jun 2024

DIALOGUE 16 MAY / JUN 2024 I  HEALTHCARE JOURNAL OF NEW ORLEANS of a hospital and as president of our sys- tem. Our chief nursing officer also serves as vice president of nursing for the system. We probably have eight or nine people serving in dual roles. We're really challenging our- selves to look at the cost of healthcare in new and creative ways. When I was in Chicago presenting at the Becker’s annual conference, there was a lot of talk about AI and how that might be able to adjust some of the repetitious functions that we do so that maybe we don't need to have that cost structure anymore. I hear you on the challenge of how much it costs. It's concerning, but we have to work together to create solutions. Editor It's gone up so much even since we started this reporting; we've projected it. What did you learn about AI in your conference? Nickens Mainly, there is a very healthy skepticism and a very robust, almost anxiousness, but also a very positive anticipation. That's what it is: When you think about everything you do that is repetitious, like taking notes on this call, that can all be done by AI. You turn on Copilot that's a part of your Outlook, and it'll record this call and give you a summary within seconds or minutes. The balance to that is it's about 90% accurate because it's going to take some liberties since it's still in learning mode. I think one thing people are really eager to see is if you look at cancer therapies. A lot of that is going through repetitive fails to find the truth. Can AI do that exponen- tially faster than a basic scientist in a lab? There's a lot of enthusiasm about the speed at whichAI could speed up clinical trials and research. Editor UMC is a teaching hospital. Much has been said about the differences between Gen Z and the millennial generation and ours. Have teaching styles had to change to accommodate these differences? And what has your team requiring that. So, yeah, I think it takes a dif- ferent kind of teaching, but I'd venture to say it's for the better. Editor What is UMC's payer mix, and what are the benefits and challenges to that mix? Nickens We're over 80% government funded, whether it's Medicaid or Medicare. The challenge is that's a fixed number. I can't go out and renegotiate a deal with the federal government or the state government on how much I'm going to get paid in the same way I could with Blue Cross or Humana. What many other hospitals have is the ability to negotiate and create some sort of attractiveness to that payer, so that they could have programs where they get paid more. That's one piece that can be a challenge, but I'm not finding it to be. I think at UMC there are certainly finan- cial concerns that need to be addressed. For us, the state has been very responsive and listens. So does the federal government. They recognize UMC as one of a handful of hospitals across the country — I mentioned Ben Taub in Houston or Cook County in Chicago or Grady in Atlanta — every major city has a safety net hospital like this, and so we have to work together to figure out our cost structure. Flip side of that is that in general, the fed- eral government and the state government pay on a very methodical and consistent way, so I don't have a bunch of accounts receivable waiting for a commercial payer. There are less denials. The state recognizes the care is needed, so there is some admin- istrative burden that's reduced. But it is defi- nitely a payer mix that is driven by the vul- nerable and those who are in need in the city of New Orleans. I always get cautious about forcing it into a box of socioeconomics. When you say vulnerable, you think of the homeless guy under the bridge, or someone who's really struggling to make ends meet. But anyone can be vulnerable if we are in a car wreck. We're vulnerable if we have a burn. learned from this upcoming group being trained now? Nickens Yes, I think teaching styles have had to change; a lot of things have had to change. If you go back to our generation, a lot of times, we were just told, "Well, tough it out. Push through. Power through." In fact, in the teaching world, if you look back 20 years, residents had to come out with an 80-hour work week. Prior to that, some programs required residents to live in the hospital and work 24/7. I mean, that’s almost absurd. But this next generation, they're very much focused on the holistic nature. They want to understand. I think they lead with their hearts in many respects. They believe in wellness and their own personal men- tal health. We're learning a lot from them, from their perspective on that, and I think our teachers, professors have had to make some adjustments. The intellectual piece, the idea of how you go about learning, I don't think that has changed in dramatic fashion other than technology. This next generation is so comfortable with technology. It’s amazing. You are raising your kids, and they're always playing video games. Well, we have so many robots now in the OR, if you played video games, you're already prepared to run the robots. The technology piece, I think, is what's been most amazing. You take a UMC where we constantly, every year, have the latest and greatest innovation and newest think- ing because we have the next generation of residents coming in. We have the ability to double down on all of that technology and study it and run trials and test it out. That means a lot because the industry is eager to try out their robots at UMC, or to try out therapies where you might be able to get that sort of treatment anywhere else. This next generation also holds us accountable. It's not just what, it's how. And I like that. I think that you can be brilliant and nice. You don't have to be ornery and mean to get your point across, and they're