Ep. 7: The Future is Now - How Technology Improves Patient Care

Brian: Host (00:08):

Welcome to the Living the Healthy Life podcast, where we bring you the latest on health and wellness from the experts here at Lee Health. Discover what's happening at Lee Health and take away tips and inspiration to reach your ideal state of health. Hello and welcome. My name is Brian Hubbard. I am the manager for marketing and brand management at Lee Health. With me as always is Carrie Bloemers, registered dietician and the director of education and navigation at the Healthy Life Center at Lee Health Coconut Point. Good morning, Carrie.

Carrie: Co-Host (00:37):

Hello Brian. And hello everybody.

Brian: Host (00:40):

Hello again. Thanks everyone for listening. Today we are going to delve into a fascinating topic, something that's great for the future of healthcare. Technology and how it helps improve patient care now and into the future. Joining us to discuss this topic are John Witenko and Dr. William Carracino. Gentleman, Welcome.

Jon Witenko: Guest (00:58):

Morning.

Brian: Host (01:00):

So let's just jump right in. This is a huge topic and whoever wants to field this first, we'll kind of just go back and forth. It seems like technology is changing every day. We have websites, we have apps, virtual visits, telehealth, new things from every direction we think aimed at making things more convenient for patients. That's basically the goal I think. Can you give us a little bit of background on where Lee Health is right now when it comes to technology and sort of a brief vision for where we might be going? John, I'll throw it to you first or maybe I'll throw it to you first, whoever wants to go.

Jon Witenko: Guest (01:31):

Sure. So I can start. So Jonathan Witenko, system director of Virtual Health and Telemedicine. So, I've been in my role here for the last couple of years. Specifically Dr. Carracino and I have been working together since 2014, probably, working on telehealth and what does it mean for the health system. And so in our kind of new capacity and Dr. Carracino can kind of introduce your new role, but we're making a kind of strategic change for the organization and how do we approach health in the new age as patients are becoming more technologically savvy, more adept, and really interested in pursuing their health and not just in a reactionary fashion.

Brian: Host (02:09):

That sounds good.

William Carracino (02:11):

Well said. I'm Bill Carracino, a neurologist, and I'm the chief digital health executive and CMIO here at Lee Health. And I agree with John, it is an exciting time. Technology is advancing very quickly and for multiple reasons. Patients are more engaged and interested in being engaged in technology. And this is probably a byproduct of the pandemic. Everybody talks about how the COVID pandemic pushed people very quickly and in large numbers from in person visits to telemedicine visits. And that's true. We're seeing a little bit of stabilization between where we were and where we were previously, historically within person visits. And that's still settling, but the pandemic has changed acceptance of technology, I believe in many ways as well. Everything from automated and contactless payments to toll booths. And you think about the amount of technology that has jumped into our lives in an almost required or compulsory fashion.

Brian: Host (03:23):

So we're thinking that basically people in general are more comfortable with technology these days because everyone's doing everything through their phones or whatever it may be. So if it's just kind of a natural progression, people want that convenience. Is that sort of close?

William Carracino (03:35):

That's what we say and it's interesting that we have initially looked at a generational gap in acceptance of technology. And depending on which study you look at, that gap is not as large as we had suspected it to be. Everybody had thought the millennials and Gen Zs would require technology and access on their devices and that's probably true. And then they thought that the more mature baby boomers plus were less likely to embrace the technology. We're not seeing that. There are pockets of both who prefer in person, but it seems as though it's not as stratified and hard bucketed as we thought it could be.

Brian: Host (04:14):

Interesting.

Carrie: Co-Host (04:15):

And we really saw that with our classes during the pandemic, we converted our programs, all digital Webex streaming live. And even though we're in person now, it hasn't gone away and it's an older generation taking those programs online too. So while we didn't think we'd need it forever, we'll continue those programs because they are participating and they like the convenience and that almost still social connection they get from it.

Brian: Host (04:42):

Carrie, we've talked about that before with your classes. More people can get involved.

Carrie: Co-Host (04:46):

Right.

Brian: Host (04:46):

And so from anywhere. Yes. If they're doing something.

Carrie: Co-Host (04:48):

Yep. There's snowbirds and they're up north and they're still coming to classes.

William Carracino (04:51):

We saw that with physician education. As my role as CMIO, we look to push education regarding the electronic health record to our providers. And previously we would do in person classes and it's just difficult to get there. People have a full day of patients, they have family commitments, everything from soccer to family dinners and we had good attendance. But now that we've transitioned to virtual, the attendance has quadrupled.

Brian: Host (05:20):

Oh wow.

William Carracino (05:20):

Yeah, we are seeing seminars that we put on that have 70, 80 people.

Brian: Host (05:26):

Wow.

William Carracino (05:27):

And this is fabulous.

Carrie: Co-Host (05:28):

Yeah. So you mentioned a little of that digital transformation in where we're kind of headed, but what is that vision that you both hold for where we're going?

William Carracino (05:37):

So digital transformation is a bit of a buzzword, but indeed it has meaning behind it in that it is the approach to a more virtual or technological solution on processes that were previously under technologically enabled. And it's going to be significant. And we're looking at many different areas and John can talk about some of those areas. But the idea is we're looking to, from patient care, meet the patient where they wish to engage. So that's the overall idea. Now, is that telehealth? Yes. Is it remote patient monitoring? Yes. Is it education? Yes. It's all the above plus more.

Jon Witenko: Guest (06:29):

I think the industry jargon is now that digital first, so we're going to push this as the new course. And we were talking the other day, our CIO, Rick Schooler, said, "Okay, digital first," with a question mark. Because for some patients, the millennials, the Gen Zs that come to the health system infrequently, yes, that's their preferred method. But then you've got other folks that want that human interaction, want that connection. But sometimes it's inconvenient. So rather than sitting in a waiting room, non-value added time, you have that potential of, hey, this is a low-acuity visit, this is perfect for telehealth. Or I'm doing my frequent follow ups, chronic care management, great instances. But other times where you want, again, that full connection, you want that provider to really see you and interact and form that rapport. In person is a preferred method.

Brian: Host (07:23):

And like we were saying, a little earlier, just when we were talking before the show, it's tough to say. We always say what's the future going to hold in five years? There's no telling. It's changing like you said, Doctor. It's changing every what? Every day basically. So we don't really know where we're going to be, we just know that we're going to be developing these things slowly but surely, I'm guessing throughout the years. So then that leads to the next question. How is all this technology actually improving patient outcomes? How does it help patients stay healthy? And what is a patient outcome, I guess, would be another good question in there?

William Carracino (07:59):

Great question. And the answer is I don't know yet.

Brian: Host (08:03):

Very good.

William Carracino (08:05):

If you look at medical outcome studies, they take years to validate, verify, and digest the data. I don't think this is going to take decades, but it's certainly going to take a little while for us to really see the difference between inpatient and televisits because a couple reasons. Number one, it's not 100% accepted across ethnic or age or sex lines right now. So it's hard to compare apples to oranges. I think it's going to be augmented by some AI or artificial intelligence data analyzing solutions. But it's still not where we see universal patient outcome improvements.

William Carracino (08:50):

That doesn't mean we're not seeing patient care improvements. So locally we have some struggles with times of access. We have lots of people, lots of providers, and then for half the year we have an influx of many more people from the north. So in terms of getting access, because it's just easier and less time dependent to get a televisit than it is to travel, park, check in, wait, et cetera.

Brian: Host (09:18):

Right.

William Carracino (09:19):

So there's no question we're seeing better and more open access and that leads to patient satisfaction. So if you get things easier, you get what you want easier, it's smooth, it's choreographed and successful, that leads to satisfaction across our lives.

Jon Witenko: Guest (09:37):

So I'll push back on you a little bit. So I think we do have some outcomes. I mean, your case in point from a stroke perspective. So here we were, door-to-needle is kind of the magic nomenclature and timing of how quick can we get the specific medicine and the consult in front of a patient. So you've got a provider who's got a drive from hospital to hospital or from home to hospital or wherever. That time again, it's 45 minutes. I think you coined it, kind of windshield time, of I'm not interacting with the patient, the patient is waiting, sitting idle.

Jon Witenko: Guest (10:10):

Now you insert technology and you can do that consult in three minutes. So as long as we're stabilizing the care, it's consistent care, now you go back to your access point, access is much quicker. So we've seen this in mental health, behavioral health and pediatrics where I don't have to take my kids out of class, I don't have to take off of work. And so you can get those visits sooner. So from an access perspective, I think the outcomes are better. Now from a care perspective, is the patient receiving the same care, is the provider spending as much time? Again, I think that's the verdict's still out. And as we're seeing it and depending upon the service lines, depending on the patient, their receptivity as well.

Brian: Host (10:55):

So that brings up a question, all these advances, these things that are coming around and changing and morphing and all that, how do you think, how are patients learning about these things? I guess is a good question. How are we getting the word out? Are we getting the word out? What should patients, I guess, look for? Is there something that they can do or their resources, things like that? Just to keep appraised of as these developments come, we know internally that there's all these wonderful things and I know when you're talking to patients at clinics or whatever, those things are likely communicated, but from your perspective, what's the best way to go about that?

Jon Witenko: Guest (11:34):

So I think that's been the most exciting and eye opening through this whole process. So since the pandemic, it's been really a gauging the pulse of our patients and the community. So we stood up a support center day one, recognizing some of these patients have never seen telehealth, have no idea how to use their smartphone. And so we went from, it was ringing through my cell phone to we put 25 people in a room to answer the phone because it was ringing nonstop of, "How do I connect to my doctor?" I know how to drive to college point, but I have no idea how to go to the app store and download an app or to connect and see FaceTime again still learning these pieces. And so how do you do it safely, securely, and as efficiently as doing it in the office? So, that's been amazing.

Jon Witenko: Guest (12:26):

Working with Carrie to interact. And how does your staff, again, outside education. And then you have, I know Stephanie Wardein talked on one of your other podcasts about the digital health equity.

Brian: Host (12:39):

Yeah.

Jon Witenko: Guest (12:39):

And so patients that don't have access, and I don't want to kind of belabor that point, but that's something we're really cognizant of. So it's a combination of marketing outreach to here's the easy steps to connect. And then we've got a hotline 24/7 for patients to call up. If you're having a visit, you're struggling with a visit, they can call at any time to connect to a live person saying, "Hey, help me, make sure I'm connected. And I'm confident that I'm going to see the doctor and not have to cancel."

William Carracino (13:09):

So I would look in the mirror doing a podcast.

Carrie: Co-Host (13:14):

Yes.

William Carracino (13:14):

There are podcasts out there, there are email campaigns. And I do believe that we are probably leveraging almost every media outlet that we can. And John and I have both done interviews like this, both for media, television, radio.

Brian: Host (13:30):

Excellent.

William Carracino (13:30):

But we also have billboards. But the real source is lee health.org. Everything should be on there.

Brian: Host (13:36):

Thank you for that. Applaud. Perfect.

Carrie: Co-Host (13:37):

I'd also share a little story. As you know, the patients are community members, you also have the ability to ask. I know a coworker of mine was looking to get an appointment, was pretty sick and didn't want to drive an hour down to the office near her work. So she got a hold of the office and they converted it to telehealth for her. So there's also that part of being a patient and advocate for what you need. So being aware that these options are out there and we have the infrastructure to do telehealth and sometimes you just have to ask. It's the easy-

Brian: Host (14:11):

That's a great point.

Carrie: Co-Host (14:14):

...Swap of the appointment.

Brian: Host (14:15):

Doctors and their staff are always willing to help when patients call. Because we always say on this podcast, primary care doctors are like your point of contact. So if they call the office, they can get that kind of info. My other question was what do you think is the biggest change now that technology is going to bring to the healthcare industry? We've already kind of discussed a little bit, but what do you see the industry as a whole changing as technology changes with it?

William Carracino (14:42):

So we spoke about the core already, right? So the example that Carrie just gave was providing care where the patient wanted to have the care. So if you look at the things that John and I are working on, we're starting to work on, many of them follow that theme.

Jon Witenko: Guest (15:00):

Yeah. I mean, you referenced prior artificial intelligence and chat bots and texting and kind of dynamic interaction. So you look at the challenges facing not just our industry, but across the country right now is staffing shortages. And so how do we really augment the staff to deliver the same great care that we were providing prior but more efficiently? So some of those are converting manual processes to digital to really augment just archaic workflows and legacy systems. Others is, hey, how can I do more effectively? So can I leverage computer machine learning and computing power to really process and understand where the patient is, who's the appropriate patient to interact with on a daily basis on a hourly basis from a sepsis, we've got deterioration indexes. So we've got a lot of algorithms in line that are helping us to determine who's the right patient to care for right now.

Brian: Host (16:07):

There's a lot of data. So it's basically some of the technology's helping to crystallize that data and figure out what you are supposed to do with it. Right?

Carrie: Co-Host (16:15):

Yeah. Oh, well before this, you kind of mentioned the idea of that leads to precision medicine. And can you give our listeners just a sneak of what that actually means?

Jon Witenko: Guest (16:24):

Sure. So essentially the pharmacy industry has been doing this for a while to say, okay, we're not going to give everybody one blanket drug. There's specific drugs that affect people differently. And so oncology, I think is probably, not the clinician in the room, but oncology is probably the leading source of this, of saying, okay, the old methodology of standardized drugs doesn't work. So we need individualized care and treatment based on your genotype, based on DNA and lifestyles and all those pieces. So how do you progress that even further to say, from a lifestyle, from a living perspective, from a nutritional basis, from my daily activities and daily life, what does care, what does health look like for me? So we know my metabolism is different than Carrie, so should I be eating differently? How does the food affect me? And what does it really mean at an individual level rather than treating me as kind of the blanket, hey here, you're a 40 year old male and this is what health should look like.

Brian: Host (17:28):

Rather than technology dehumanizing. It sounds like it's doing the exact opposite.

William Carracino (17:33):

It's very exciting. It's very exciting. John gave a great example. Unfortunately we've probably all known someone with breast cancer and oncology has been a leader. Where you see a breast cancer patient, they have their tumor markers, we probably all heard this, right? There's a plethora of tumor markers and based on the pattern they're pushed or set into a particular drug protocol that has been shown to be most effective. Now we've been looking around this for years in medicine, but now it's really exploding. And we even have a precision medicine department that's at Lee Health that's just starting to [inaudible 00:18:05]. One of my concerns about that is we're adding, there's just so much information for patients and providers, even with the EMR, there's so much information in the electronic health record that it's difficult to seal without some sort of a digestion aid. So when we add precision medicine and then we add genomic medicine, we talked about Carrie beforehand, and then dietary information, it's going to be very tricky to find out the best pathway on a personalized precision medicine philosophy.

Brian: Host (18:38):

I was going to ask, what does AI mean in this context? You're talking about artificial intelligence, people might have a... I'm just speaking myself.

William Carracino (18:45):

You're thinking of a robot.

Brian: Host (18:46):

Right. You might have a weird impression of what AI is. So what does it kind of mean in this way?

Jon Witenko: Guest (18:51):

So artificial intelligence is essentially leveraging the power of computers to compute quicker than we can and our brain can, or that there's so many different data points, go back to your sepsis all the time. So recognizing that I think there's 100 and what 62 different measures in our sepsis calculation to figure out the white blood cell count, the time, the temperature, all these factors. And so if you look at, it's kind of like, all right, I have a gut that this is going wrong, but if I can look at all this data to say, "Hey, we should start intervening and providing these medicines sooner," then suddenly you're able to compute at such a higher level and allow the machines to do the processing power and then bring back to the physician or the provider, whomever to say, "Here, I'm going to provide you all the level of data you need and help you make that analysis much sooner and quicker and targeted toward that patient."

Brian: Host (19:52):

That sounds excellent. So that's like the technology to compute quick and then the human touch comes with the physician or provider at that point.

William Carracino (20:00):

Correct. And the word AI is a bit overused, artificial intelligence. Because it really should include some sort of a learning, right?

Brian: Host (20:08):

Yeah.

William Carracino (20:08):

That the machine should learn from its mistakes or outcomes. So you have to have a feedback loop and you could argue whether that's exciting or concerning. But regardless, in terms of digesting the information, as John pointed out and pointing you in the direction using all the information that's available, which may include, throw a number, 300 data points that a human brain just can't historically manage is where we're going to go.

Brian: Host (20:32):

Excellent.

Carrie: Co-Host (20:34):

That's fabulous. And one more big question we definitely want to hit on today is how this technology is going to help us stay healthy, prevent some of the major sick care. How can this help us?

William Carracino (20:45):

So we've talked about how you ask for or request care where you want it, and there are a number of technologies that we are working on right now in terms of, we may have heard of hospital at home. So that's an extension or a logical evolution of things such as remote patient monitoring, which John and his team recently stood up at Lee Health, I'll let you take that, but is aging in place. If you had precision medicine in food, right Carrie? So if you had the ability to say, this patient needs to monitor their blank, insert, vital sign and based on the particular parameters or modifications of those vital signs or biometrics, needs to modify their exercise or diet in their medication profile in this fashion. So it's again, real time, updated, potentially AI augmented modifications where you live rather than going to the physician every six months or every year.

Carrie: Co-Host (21:47):

So many of us might be wearing those wearable monitoring devices already.

Jon Witenko: Guest (21:53):

Yes.

William Carracino (21:53):

Oh, I see.

Jon Witenko: Guest (21:54):

So I think that's where the change goes from the reactive, waiting till I show up at my provider and say, "All right, something is wrong," to changes the narrative to say, I'm starting to see this trend, or I'm starting to see precursors and triggers that something is happening and this is where I'm concerned. So rather than doing a dramatic 180 degree about face change or something transformational, it becomes just course corrections over time. And so you don't wait until the problem becomes extremely exacerbated, but you can again make those little gentle nudges to redirect patterns, behavior, lifestyle management to appropriate levels.

Brian: Host (22:43):

We talk about that all the time about the time, about Lee Health is, I mean healthcare as a whole, but since we're talking specifically about Lee Health in this case, prevention. Lee Health is not just going to the hospital when you're sick. It's actually a whole lifestyle. It's actually a whole prevention and care. I know this is huge for what you do. Preventing problems before they start, education, making sure that people are where they need to be, like you said John, before it's too late, honestly. So that's good to know that that technology is going to help us monitor that and get there.

Carrie: Co-Host (23:15):

And as consumers, we have a lot of tools on the market to monitor things lifestyle related, from sleep to heart rate to food intake to other behaviors like exercise, meditation, whatever it is you do.

Brian: Host (23:30):

You're wearing your watch, right?

Carrie: Co-Host (23:31):

Apple Watch, I am. I am. I'm actually a new watch wearer, so.

Brian: Host (23:34):

It helps.

Jon Witenko: Guest (23:36):

And all those factors come in. I mean, we've looked at some amazing ones. IOT or Internet of Things is basically connected technology. And it's all those different wearable devices that are coming on the market, out on the market or an FDA approval. From right now, we're doing remote monitoring where it's, okay, here's a blood pressure cuff, a pulse ox, and a scale, do it once a day. So the next iteration becomes continuous. So looking at a patient's respiration rate or a cough sensor, this was big during COVID of, okay, a little dry cough and lower respiration starts to be a trigger of, hey, is this patient desaturating? Do they need to come back to the hospital before it becomes too late? And so really having those precursors, kind of the warning and the signals to really interact sooner.

Brian: Host (24:31):

And we've started that virtual health program where we have certain patients will get absolutely items delivered to their home where they have... And I don't know specifically the...

Jon Witenko: Guest (24:40):

No, that's exactly it.

Carrie: Co-Host (24:40):

He's the guy, right? He's the guy.

Brian: Host (24:42):

Basically that was it. And you can talk, you have a setup, you have an iPad or whatever may be, and you talk directly to the office at that point.

William Carracino (24:49):

Now just taking what John has said though [inaudible 00:24:51] back to outcomes. Could we? Yes. Should we? Right. So is that really going to change outcomes? Are we going to be able to take that data and show that in whatever patient population, based on precision medicine, but identified patient population, who do we really change the care of? So John and I, mostly John, probably evaluate upwards of 50 vendors a month.

Brian: Host (25:18):

Wow.

William Carracino (25:19):

There's that many vendors. And we recently went to a technology convention in Orlando where there were, and no exaggeration, 75 acres. Acres.

Carrie: Co-Host (25:30):

Wow.

Brian: Host (25:30):

Wow.

William Carracino (25:31):

Of technology vendors.

Brian: Host (25:32):

Oh goodness.

William Carracino (25:33):

From the Orlando Convention Center. So there's lots of folks showing that we can, the question is, our job is, should we? And it seems to be yes, but...

Brian: Host (25:45):

Who do you choose to work with?

Brian: Host (25:49):

[inaudible 00:25:49]

Jon Witenko: Guest (25:49):

And it's great. I mean, each one of my kids have a Fitbit or a knockoff one that tracks their steps and they're excited, "I hit my 10,000." Is it changing their pattern or is it just fun? So then it becomes...

Brian: Host (25:59):

All that data.

Carrie: Co-Host (26:00):

Well this can be fun, Jon.

Brian: Host (26:04):

[inaudible 00:26:04] from a gamification.

Jon Witenko: Guest (26:05):

It's not fun, but is it changing their behavior? Is it changing their health or is it just noise? So that's where again, you go back to the AI conversation where the computing of, you've got this massive amount of data. And I don't want to look and say, "Okay, is 9,000 steps worse than... Is there a pattern there?" Or am I looking over time and starting to analyze and say, all right, this might be a precursor that gestational diabetes or childhood diabetes or a stroke or something deeper that needs to be thoroughly evaluated.

Carrie: Co-Host (26:40):

Yeah. Those are great questions, but I think you're right, it's going to be that data over time, right? But it starts with awareness. I've met with patients before as a dietician who never ever really even considered what they're putting in their mouth and suddenly they have these new diagnosis and need to change. They don't know anything about the back of the food label. Same thing. So it's like that monitoring, that knowing, that awareness and they know as kids now, but see how that'll impact them and their teens, early adulthood and beyond.

William Carracino (27:09):

So you're absolutely right. And then wouldn't it be fun if we were able to get to those people before they got the diagnosis?

Carrie: Co-Host (27:09):

Yes. Absolutely.

William Carracino (27:15):

So every smoker, most every smoker quits when they get a bad diagnosis.

Brian: Host (27:19):

Yeah.

William Carracino (27:19):

So that's good, they have to do that. But wouldn't it be better had we shown them something earlier? And we're going to have to ask for Carrie to submit her watch in a couple weeks to see if it's not [inaudible 00:27:31]

Brian: Host (27:29):

Might not be right.

Carrie: Co-Host (27:32):

The one that actually has changed me is the sleep tracker and keeping track of that hours in bed and it will check in with you at midday to see how well rested you feel and actually gave me a target amount of sleep. If I sleep eight hours and 30 minutes, I feel very rested. Usually any way. Otherwise I'm just okay.

Brian: Host (27:59):

Does it tell you, not to go off point here, but when you do the sleep trackers, does it tell you that hey, you snored for one hour, you got up or you moved? Or does it kind of tell you when...

Carrie: Co-Host (28:08):

Well, [inaudible 00:28:08] that restful period, light and then disrupted. You can mark when you've had to get up for children or whatnot and there'll be sleep interruptions. It matches your heart rate so you can see how low your heart rate drops and your average heart rate every night. But I will say that's one where it's like even me where I know how important sleep is that it's like, okay, get to bed. Your bedtime's important cause it's going to matter how you feel the next day.

Brian: Host (28:34):

That's very true. Right now, for instance. So to wind up here, we could talk about this all day. This is pretty fascinating stuff and it's obviously current and it's not just current, it's what's coming. Jon, can you tell us a little bit about Lee TeleHealth? Because we know that that's one of our initiatives and we talked about the pandemic and how that sort of came about and became more important during COVID. Can you tell us where we are with TeleHealth and what might be new with it?

Jon Witenko: Guest (29:03):

Absolutely. So we've got a couple different iterations. One for patients for urgent care. So I've used it unfortunately many times with five children. And so wherever you are, doesn't matter whether you're in Fort Myers or somewhere else in the country on vacation or snowbird, you're able to pick up your phone, go to a website and connect to leetelehealth.org or on through the app and see a provider 24/7. So pretty quick, I think it's about a seven minute wait time to see a provider. The visit's about seven minutes and it's great for low acuity symptoms, pink eye, UTI, rash, those kind of things.

Brian: Host (29:43):

Cold and flu too, correct?

Jon Witenko: Guest (29:45):

Yeah. Cold and flu.

Brian: Host (29:45):

Yeah. That's always a big one that we talk about

Jon Witenko: Guest (29:47):

And so then we've got the more seasoned with your lead physician, group provider. So whether it's a primary care or a specialist, you're able to connect for a scheduled visit just as you were going into the office to see a provider. Again, appropriate times. When it's right, follow up, those kind of things, to see the provider. And then we've also got a whole cohort of physicians on the inpatient side. So we referenced stroke prior or psychiatric care, different specialties. So it's really about bringing the provider closer to the patient from an access perspective. How can we do that quicker? And that's in probably 25 different service lines. Anywhere from nutrition, lactation. Again, we built a lot of that around COVID with PPE, conservation and really trying to get the specialist and right to the patient in a quicker time.

Brian: Host (30:41):

And what you had talked about earlier, gentlemen, was about how it's easier... The age groups. It's not as maybe segmented as we thought. And telehealth is actually, and I've used it, it's actually very, very easy to use and it's intuitive. It shows you how you're supposed to do it. And if you have questions, there's a place to call. All those things. So it's just another example of once people see the technology, they're okay with it and they're not as intimidated by it as we might have thought.

William Carracino (31:11):

And it's a learning curve. It was fortuitous that Jon and I put together the stroke program at Lee County and I performed the first stroke tele stroke consult in Lee County and...

Jon Witenko: Guest (31:23):

You were reluctant to start. We built it, you were a champion. And then he is like, I'm just nervous. It's that apprehension in the room. You've got it, everything there ready to go. And then you did the first one, came to me the next day and you were just glowing.

William Carracino (31:44):

Yeah, it was fun. We had to tweak things a little bit, but I agree. It was really fun and it was really very valuable. I mean, I didn't think I lost really anything in doing that consult. You needed a good team, you needed a good nurse, you needed a family when good to be there. But I was able to control the camera and see people's expressions and get their nonverbal cues and I was able to help myself. I was able to pan to the monitors and see the heart rhythms and things.

Brian: Host (32:12):

Wow.

William Carracino (32:12):

So it was really quick and satisfying. I performed over 200 as I said, and I really enjoyed it.

Brian: Host (32:21):

Anything kind of on your mind as we sign off for the day?

Jon Witenko: Guest (32:25):

Sure. I think it's really resonant in our name Lee Health, that we've been doing this experiment that our former CEO, Jim Nathan set up with the Coconut Point experiment many, many years ago in the little strip mall and really setting it up to be a health system. As you said, health doesn't happen just when you come to the hospital, it happens every single day. So as we embark upon what does that mean from a digital perspective and really providing greater access to care, really transforming lives and from the staff perspective, from the provider perspective, the clinicians and our patients' lives, and how do we partner in their health too along that journey?

Brian: Host (33:09):

Very well said.

Jon Witenko: Guest (33:10):

And I'd like to commend our current administration, including Dr. Larry Antonucci, because we now have digital as part of our strategic plan.

Brian: Host (33:17):

Right.

Jon Witenko: Guest (33:17):

So we've attached, and those of you attended the report out yesterday, we saw that digital is now part of our strategy. So it means it's percolated up and that we're going to continue this journey.

Brian: Host (33:38):

Thank you guys much for being here. Again, some of the resources, leetelehealth.org. For telehealth, you can find a lot of the information on technology on our actual home website for the system, which is leehealth.org. We hope you'll tune back in for upcoming episodes. We'll be interviewing experts around Lee Health so you can learn more about what we do and how we strive every day to fulfill our mission to the community, to provide the best care close to home. Thanks for listening everyone. Have a great day.