UiPath Forward 2024 | Anjali Bhagra & Biju Samkutty, Mayo Clinic

Clips
News
More from UiPath Forward 2024

Anjali Bhagra, MD

Physican Chair Lead, Automation Core

Mayo Clinic

Biju Samkutty

Chief Operating Officer

Mayo Clinic

Mayo Clinic pursues healthcare automation while maintaining the human touch

The Mayo Clinic is highly ranked in a long list of medical specialties, and it has embarked on a journey to use healthcare automation as a key resource in maintaining its world-renowned reputation for patient treatment and care.Through technologies that encompass artificial intelligence and 3D printing, the clinic has embraced tech tools not merely for reading CAT scans, but also to improve the important relationship between physician and patient.The Mayo Clinic’s Biju Samkutty and Anjali Bhagra talk with theCUBE about healthcare automation at UiPath Forward 2024

play_circle_outline Integration of automation in healthcare, from diagnostics to administrative tasks

play_circle_outline Striking the Balance: Technology Adoption, Clinician Skills, Patient Trust, and Transparency in Healthcare

play_circle_outline Transformation of healthcare experiences towards personalized, intimate care

play_circle_outline Role of automation in healthcare discovery

play_circle_outline Democratizing access to data for discovery

Info
Transcript

Anjali Bhagra & Biju Samkutty, Mayo Clinic

Anjali Bhagra, MD

Physican Chair Lead, Automation Core Mayo Clinic

Biju Samkutty

Chief Operating Officer Mayo Clinic

TheCube's live coverage of UiPath Forward 2024 in Las Vegas, Nevada. Anjali Bhagra, the physician chair lead automation core at Mayo Clinic, and Biju Samkutty, the COO of Mayo Clinic, discuss the role of automation in healthcare. Anjali shares her background at Mayo Clinic and how automation has improved patient care by streamlining processes and allowing more time for patient interaction. Biju explains how automation is transforming healthcare delivery by reducing administrative burdens and enabling more personalized care for patients. They also discuss the ... Read more

explore Keep Exploring

What are the challenges in implementing technology for diagnosis in healthcare and how can stakeholders align to create value and scalability in the process? add

What is the fundamental basis of the relationship between a provider and their patient in healthcare? add

What is the importance of trust in healthcare transformation and the deployment of technologies in patient care? add

What role will automation play in discovering new healthcare approaches and new science? add

What are the benefits of automation in reaching remote patients for cancer trials and democratizing access to discovery tools? add

bolt Powered by CUBE AI

Anjali Bhagra & Biju Samkutty, Mayo Clinic

search

Rebecca Knight

>> Good morning everyone, and welcome back to theCUBE's live, two days of coverage from UiPath Forward 2024 here in Las Vegas, Nevada. I'm your host, Rebecca Knight, sitting alongside my co-host and analyst, Dave Vellante. I'd like to welcome two guests to the show. We have Anjali Bhagra. She is the physician chair lead automation core at Mayo Clinic. Welcome, Anjali.

Anjali Bhagra, MD

>> Thank you.

Rebecca Knight

>> And Biju Samkutty, the COO of the Mayo Clinic. Thank you both so much for coming on theCUBE.

Biju Samkutty

>> We're excited to be here.

Rebecca Knight

>> So Anjali, I'm going to start with you.

Biju Samkutty

>> Sure.

Rebecca Knight

>> Pretty much everyone's heard of the Mayo Clinic, a world-renowned hospital consistently ranked as one of the best in Rochester Minnesota, specialties in cancer, in cardiology, heart surgery. But maybe our viewers don't know about you, so tell us a little bit about your work history and how you got to be where you are.

Anjali Bhagra, MD

>> Sure. I never miss a chance to tell this story. So very proud, very honored to be at Mayo Clinic. I've been at Mayo a little over 20 years now. I started my career at Mayo as a trainee, so trained at Mayo Clinic, and there was no looking back, and stayed there as a physician. My current practice is within internal medicine, so I see patients with complex and serious illness from across the country and the globe. Very, very satisfying place to be because this is really where we do a lot of medical detective work, which I obviously don't do alone. And I have the honor of teaming with specialists across Mayo clinic. I wear a few other hats at Mayo. Along with Biju, I co-lead intelligent automation, something I find very, very exciting, and I'm so glad we are having this conversation with you today. Very timely. I also lead DEI at Mayo Clinic and work directly with leaders from across the enterprise. So I feel very fortunate. I think Mayo is known for a lot of different things. And I think what's really special to me, and I've heard it from all my patients that I've seen over the past 20 decades, is how Mayo Clinic takes care of people, whether it's patients or staff. I think it's our people-centered approach and how we operate really guided by our value. So our guiding value is the needs of the patients come first, and that is our eternal truth. That's our North Star. I think it's very powerful, and we'd love to have you at Mayo clinic someday so you can experience it firsthand.

Dave Vellante

>> It's interesting that you are, as a clinician, leading a co-leading intelligent automation. How did that come about, that decision?

Anjali Bhagra, MD

>> Yeah, I've reflected on that. So I've had the fortune of serving as a physician in different specialties. I my medical career as a radiologist, and I think automation really happened in places that I wasn't actively seeking, but it was part of what I was doing. We just didn't have the term automation. So as a practicing radiologist, reading hundreds of X-rays, CAT scans, and literally playing a game of finding Waldo in an attempt to diagnose the disease was a pretty daunting task. And imagine now all the state-of-the-art automations that we can utilize and deploy. So I would say fast forward from reading X-rays and imaging tests to providing care at the bedside as an internist, utilizing something called point-of-care ultrasound, which is at the bedside, you use a handheld machine to examine your patients. But you're not only looking at the diagnostic side of it. You are obligated to act on it. What's the best thing to do? And I think at those times, I was really seeking some state-of-the-art automation so that I can be, first of all, sure of what I'm diagnosing my patients with, and then really providing care that's in time, the best quality care. I would say though, in my role as in leading DEI at Mayo Clinic, that's where inclusion, equity, and diversity really hit home. And I feel like at the core, when we deploy these technologies or develop them, it's these guiding principles that build longevity, that really build that human-centered approach that we want. So that automation is indeed then a paradox. If you think about it really allows humans to be humans. I know there is a lot of skepticism around, will the robots or automations replace humans? I didn't go into healthcare for the love of paperwork. And trust me, this is... For the first time, I actually see that I can give that human touch to my patients because of these technologies that enable my diagnostic capability. They cut down my administrative time on tasks that actually pull me away from my patients. And then finally, I would say business school kind of cemented it all in, how do you make it happen? Where the rubber meets the road, what are the models that need to be in place for scaling and solving for a stakeholder input?

Dave Vellante

>> Interesting multi-dimensional background. You don't run the football pool

Anjali Bhagra, MD

>> I am a tennis mom, but not the football pool.

Dave Vellante

>> Now, of course as a COO, naturally, you'd want automation drive productivity. But how did you come into this? And where are you in that journey so far?

Biju Samkutty

>> Yeah, I think we are early in our journey, but quickly maturing. We started our automation journey really in some of the safe areas, in finance, in some of our back office functions. But what we've been slowly evolving to, and Anjali called it out, is impacting the people that we fundamentally serve in a different way and driving that productivity. Adding to my comment really quick, Anjali's comment earlier, it might sound weird that a physician's helping to lead automation, right? But what's really cool is at the core of healthcare, we're really a people-centered organization. We're caught up on the patient, centered around the patient. We really can't effectively drive change without thinking through the business discipline of it, the technical discipline, but really make sure that's focused in a way that we're driving our clinical capabilities in a different evolution, in a different approach. That doesn't really happen without us really tag-teaming together to fundamentally make sure we go from back office now to evolving the way we're thinking about healthcare and transforming it through what we would say intelligent automation, agentic automation that's being called out today. That's really not going to happen without balancing, how do we think about processes and evolve them, but how we do it in a way that our patients are more feeling the benefits of those, feeling a more seamless engagement with us from a organization, allowing us to take resources that we've effectively spent managing backend activities, and double down on her efforts effectively to serve the patient delivery and deliver better outcomes ultimately?

Dave Vellante

>> The patients want the doctor's attention. The doctor's super busy, they're drowning in paperwork sometimes, so she or he can't spend enough time. You're addressing that problem. Rebecca and I were talking about, well, sometimes you just want to get an answer. So as a radiologist, you probably knew the answer, but you couldn't tell the patient. The patient's like, "How's it look doc?" But the time to diagnosis has been compressed.

Anjali Bhagra, MD

>> Correct.

Dave Vellante

>> I presume automation is a big part of that.

Anjali Bhagra, MD

>> Yes.

Dave Vellante

>> Are we going to get to a point where it is real time, where the machines are actually assisting and can actually give a diagnosis, or is that quite a ways off?

Anjali Bhagra, MD

>> Oh, I don't think it's quite a ways off at all. I think the technology is ready. It's right. It's here. But what's happening right now, which I think is a classic thing to happen in that cycle of innovation, is there are many, what I would say like silos of excellence. The technology can solve for step eight through 10, but we need to find an end-to-end sort of process that can come together so we really are creating value versus solving for pain points haphazardly. Technology's all there. We need to thread the needle, and we need to have a clear view of how we are going to build value for our patients on the consumer side, and then for people practicing in healthcare, which is provider, clinicians, the frontline staff, and also the payers. It's a pretty interesting ecosystem altogether. So I think it's aligning the stakeholders and agreeing to which processes will lend the most gains. Because there are a hundred different ways of doing things right now for one task. Even though technology is ready, I think we need to do a little bit of discovery work on what's the best way to do it, so it's lean, it's sustainable, and most importantly scalable. So we do have to solve for the scale problem, but also the integration problem.

Rebecca Knight

>> How does this change the kinds of skills that are needed for practitioners today? Of course, bedside manner, empathy, compassion, those were always really important things that you'd want in a doctor, a nurse, a clinician. But how does... If AI and automation are taking over more of the repetitive tasks, and also including the really important ones like diagnosis, how do you see the future of work at Mayo Clinic? And what are we looking for now? Biju?

Biju Samkutty

>> One of the things I would say is we're hoping that our physicians and our care teams actually get back to the core of what they do, which is delivering empathy and delivering outcomes. To your point, you called out administrative burden. They're consumed and tasked. They're sucking through tons of information. At Mayo clinic, we're a tertiary quaternary center. So what that means is patients have gone to two, three other locations a lot of times before they've come to us, which means now we have that much more medical records, that much more in documents that need to be knit and pieced together to figure out if there's a right solution or the right opportunity, or right way to approach it. And what we've unduly done to do the right thing for our patients is we ended up asking our physicians to take on that burden and figure out, comb through hundreds of pages of medical records, hundreds of pages of information to figure out what the right approach to a patient is. We're hoping through our ability to start applying these different technologies, we can take a lot of those administrative pains away, take 70% of the record and consolidate in a way that delivers a more thoughtful document or a thoughtful view of the patient. So the pieces that the physician actually needs to think about and articulate and that can't really pre-predict technology, that's what they're focused on, and less on the things that we can really comb out of the information. So we're presenting the holistic picture of the patient so that our physicians, like Bhagra and others, can effectively deliver the best outcomes and deliver the best care humanly possible.

Dave Vellante

>> So I'm curious as to how you think about the self-serve for the patient versus the clinician. Because I know when we use LLMs, tribal knowledge is still really important. You've got ChatGPT, you've got Perplexity, you got Llama, you might have Gemini, and you try them all, but you have intuition. And then you can even use Google searches, and you finally get to an answer much faster, so it compresses it. So I still feel like, at least in the near term, you need that knowledge, that domain expertise. Now as well, the patients are getting savvier.

Anjali Bhagra, MD

>> Yes.

Dave Vellante

>> Google search helped with that.

Anjali Bhagra, MD

>> Yeah, yeah, yeah. The doctor Google.

Dave Vellante

>> In some ways, it caused problems. We are all going to die every time you do a search. And so how do you think about... Two-part question. How do you think about the role that the doc plays? And does that continue? Obviously it does, but that intuition and the access that the patient has to his or her own healthcare.

Anjali Bhagra, MD

>> Yeah. Yeah. So a great question. And I would say as a provider, as a physician, I think the fundamental basis of a relationship with my patient is trust, right? So you ask a very important question, and that can only be built and sustained if we have clear understanding that I'm always acting in the best interest of my patient. Now, the kind of tools I may use to facilitate the care will evolve over time. Think about when CAT scan was discovered. Now, that's an added. That's a technology-enabled look inside our body. Now, we weren't as critical of a CAT scan as we are of some of these technologies, but to me, it is a tool that enables me to diagnose my patients faster. We use less than 10%, less than 10% of information that we gather in healthcare. If you've been to a healthcare provider, how many times you're asked questions, and then have you ever wondered, do they ever use all this information that I've provided to them? And I will tell you that we struggle. We do struggle with that.

Rebecca Knight

>> Data overload.

Anjali Bhagra, MD

>> Right? It's data overload, but sometimes it's a garbage-in, garbage-out model. So that's why when I said technology is out there, but we need to own it now. We have the responsibility, and I feel the same way towards my patients. I may use different tools at different times, but my North Star is I got to get to a diagnosis as soon as I can and give you the best possible level of care. So a fundamental approach I would say for physicians, frontline providers is to move together, be transparent of what we know, what the limitations are, have a frank discussion, and move them along in the upskilling curve. I know Rebecca, you asked earlier, what does it take to train physicians now, right? We used to teach bedside manners, and you can teach people to be empathetic. But I will tell you that 10 years from now, our med students who are going to be practicing, their work is going to look very different. They are way advanced. They are not going to work the way I did. They are adopters of technology. They create their own personalized ways of utilizing technology. So I think that upskilling really involves, how does this come together with the kind of work we do in healthcare, which is take care of humans? And there are lots of initiatives that are in flight. We start within our med schools just kind of understanding the role of technology. But the good news here is that our patients are as much adopters of technology as our providers. A four-year-old can use a device without reading an instruction manual. Before they even get to know the alphabet, they know how to put their devices on. If you think about, it's not like humans need a whole lot of training. And I would say there are two areas where technology really enhanced what we do. One is ubiquitous integration. My patient doesn't need to know what kind of LLM was used, or natural language processing was used for me to be able to diagnose the microcalcification cluster in the breast to diagnose breast cancer early, right? That's happening in the background. But we pay attention to it, but the patients don't. We do share with them that we use the latest technology, but it's not like we need to bog them down. But we do need to talk to them about how data is being used, what it means when they give us information, what are the different ways that data is being leveraged to come up with new cures to be able to transform healthcare delivery with things that Biju mentioned earlier. How are we going to build efficiencies? But then we need their advocacy. We need their voice as long as we stay fiercely committed to transparency and maintaining trust with our patients, and sharing with them, yes, right now, ChatGPT or any other LLM hallucinates, because it doesn't have context. It can tell you what the next best word is in that generation. It's very generative, but it's not context-driven. So for me as a physician, as I would use any tool, I need to contextualize and decide, does this help my patient in meaningful ways? Can I trust this information? What's the credibility? What's the source? It's like me using any other research evidence. Not every research evidence can be applied to all patients. It has to be individualized. And that's the fundamental approach we take.

Dave Vellante

>> And this is super exciting to me. And as your customer running operations... Do you remember the scene in Field of Dreams at the end when the older doctor comes out and he's got the doctor bag? I remember when Doc used to come to the house-

Rebecca Knight

>> With the bag....

Dave Vellante

>> with his black bag. I was just a tiny little boy, but-

Rebecca Knight

>> You're not that old.

Dave Vellante

>> Yeah, no, I remember it. The experience was completely different. And then the healthcare system got overwhelmed with, whether it was regulation, but administrative and paperwork. And you go into a doctor's office, they're so stressed out, and you can just feel the tension. You're putting forth a vision that you're creating an experience that maybe it's not like Doc , but it's a much more intimate and personalized experience that you're creating, isn't it?

Biju Samkutty

>> Yeah, that's right. I think a lot of what we're spending time on is not getting lost in the shiny new tool, but starting to lay out what healthcare transformation fundamentally looks like, because we got to get back to the point that our patients feel like their personalized experiences. They're not just another number in the line of care to a point that they can trust the data that's being put in and the outcomes that are really coming out, as well as our own, our clinicians and our teams, right? So Anjali I actually brought up trust. I think trust is going to be really important as these tools continue to push forward, as we think about transformation as well. If you take ChatGPT, Llama, give them the same question, you're going to get three fundamental differently responses, which creates a trust issue, creates a challenge for what's real and what's not. Now, put it in the patient's hand. I'm a patient with a stage four pancreatic cancer. I sit and say, "Hey, what's my path to recovery?" I just did this yesterday just to see how a patient will respond. The emotional turmoil that might come from each of the responses. These tools are going to overwhelm our patients. And then is it up to our staff to help guide them through the fundamental journey? And so part of what we are starting to do from a healthcare transformation standpoint is really get caught up on how do we deploy technologies in a way that we can prove out and trust the value of the data, put intuition and the experience of our great physicians back where they should be at solving the final problem, making sure they're the right decision, and then giving and bringing clarity to the information. Because one of the things we pride ourselves on Mayo Clinic is bringing transparency to the patient. That comes two-fold in a good way. In a sense, you get everything that we do, our notes, our medical records, all in your palm. The bad thing is you see all of it. So how do you then translate it and make it in simple ways so that I, as a patient, can then fundamentally take this and say, this is how I need to manage my world going forward. I have a daughter who has neurological conditions. And so sometimes when we spend time going through the medical notes, it can be overwhelming. But spending time, and then trying to figure out, what does that simply mean to me, all this data, and being able to encapsulate it in a way that's then meaningful back to the patient saves a terrible lot on a parent like us, helps us to more effectively deliver care for our four-year-old, and allows us to better engage between our clinical teams and ourselves so we can move healthcare forward together in a thoughtful way. So that's what we got to get to.

Rebecca Knight

>> Wow.

Dave Vellante

>> What role will automation play in discovering new... Will it play a role? Yes, it'll take away some of the paperwork, it'll create a better experience, but what about new discoveries and new healthcare approaches, new science? Is there a play for automation there?

Anjali Bhagra, MD

>> Yeah. We need an entire episode because this is so exciting, and it's a really good and a very important question. So if you look at discovery cycles in medicine, they tend to be very long, and they tend to be very tedious. And it involves processing of vast amounts of data and very complex processes, exactly the kind of things that automation solves for, agentic automation and... So I think it plays a pivotal role for analyzing data, collecting data, but also helping us deploy the data in different scenarios that that will be used to create new discoveries. And it's being used in every aspect of genomic research, or any kind of research, cancer research. So there's large number of registries, for example, when we are doing cancer trials, and we need to reach patients that are remotely located across the country, across the globe. So I think automation really allows for democratizing access for discovery tools to a large number of patients so that we move everybody along. And it's not just if you have zip code is a certain thing and you live right next to us, then you can come and participate in trials because that is a huge barrier for discovery because you do need to have a wide open pool. So I'm combining a few themes here, but I would say fundamentally, democratizing access to the kind of data that's needed to drive discovery, but then also collecting large amounts of data, analyzing large amounts of data more expeditedly, but then combining data from a lot of different sources. So at Mayo Clinic, fundamentally we are transforming by completely revolutionizing the healthcare model from being a pipeline model to a platform model. So what we want to do is we want to work with the partners that are needed for accelerating discovery, or discovering at all. We need to be able to work across pharma. We need to be able to work with tech. We need to be able to work with other organizations within healthcare. So I think with automation as a tool, we are able to break that mindset of competitors, but we all become collaborators and really help galvanize and accelerate discovery by bringing stakeholders in. It really is a binder, if you will, in that batter. So that's needed for discovery.

Rebecca Knight

>> Yes.

Biju Samkutty

>> It also helps us fundamentally see what we haven't seen, right? Here's automation and AI in real life at Mayo Clinic, right? So we took the last five years of patients that actually had real strokes, but we knew they had a stroke after they had it. We took that data. We took automation to pull that information in, and AI to basically look for patterns that the human eye could not see. And what our cardiology team was able to take is EEG data and other information, ECG data and others to fundamentally look at those same patients. And what the AI was able to help us predict was 90% of the cases and predict to the month where the stroke would've occurred, where as a clinical team, we wouldn't have been able to see that because it was seeing patterns in the information in the data that wouldn't be normally seen, or in reality, we wouldn't have the time to review in the depth and the patterns of what was going on month to month, year to year with these patients. Now applying that, think about the fact that a clinician can get, in their hand, hey, your patient is more likely to have a stroke because of these indications, now because of these new patterns we're identifying. That's an incredibly valuable tool that's helping our physicians then now apply their intuition and deliver fundamentally better care to the people.

Rebecca Knight

>> Well, Biju and Anjali, thank you both so much. A really fascinating and inspiring conversation. Thank you.

Anjali Bhagra, MD

>> Well, we are so glad.

Biju Samkutty

>> It was great.

Anjali Bhagra, MD

>> Thank you.

Dave Vellante

>> Very exciting. Thank you.

Rebecca Knight

>> Yes. Yes. Likewise. Thank you. I'm Rebecca Knight for Dave Vellante. Stay tuned for more of theCube's live coverage of UiPath Forward 2024. You're watching theCUBE, the leader in enterprise tech news and analysis.