Reimagining Healthcare: Antoinette Thomas' Journey in AI and Augmented Reality, Microsoft’s Innovations, and CVS Health Collaboration

Can you imagine reshaping the future of healthcare with the power of AI and augmented reality? That’s exactly what Antoinette, a nurse innovator and healthcare experience futurist at Microsoft, is working towards. Join us as she recounts her incredible career journey from studying textile science to becoming a pioneer in nursing technology. From her hands-on experience in pediatric critical care to leading cutting-edge projects in healthcare IT startups, Antoinette provides a heartfelt and insightful perspective on how technology has transformed patient care and nursing workflows over the past three decades.

In this episode, we also tackle the pressing issues facing healthcare today, including the anticipated 2030 healthcare crisis. Learn about the critical role of AI in revolutionizing healthcare delivery and the urgent need to harness real-time insights from healthcare data. Antoinette shares her thoughts on educating nurses about AI to alleviate fears and boost efficiency, highlighting the significant partnership between Microsoft and CVS Health. We also discuss the burgeoning field of retail health, with CVS Health setting the pace for accessible and transparent healthcare services. Plus, hear Antoinette’s reflections on visionary leaders like Satya Nadella and Karen Lynch, and get a glimpse into her upcoming talks on healthcare experience and workforce transformation. Don’t miss this enlightening and forward-thinking conversation!

More at https://linktr.ee/EvanKirstel

Transcript

Speaker 1: 0:02

Hey everyone. It's Evan and Irma here with Avera Health and today we have such an intriguing and important guest today with us from Microsoft, a nurse innovator and healthcare experience futurist, Antoinette, how are you?

Speaker 2: 0:19

I'm wonderful. How are you guys today? Thanks for having me.

Speaker 1: 0:22

We're so excited to chat. Thanks for being here, and you know we're so intrigued by your personal and professional background and bio. Of course, everyone knows Microsoft, but let's start with a little bit about your personal journey and background. How would you describe that journey today? And you know how do you today. And you know how do you describe your current role.

Speaker 2: 0:53

Sure. So I always I was always interested in sciences actually went off to university to study textile science and quickly realized that that was not the path for me, so took a quarter or two and got myself into nursing school and it was all up from there, so graduated in 1991. I've been around a while and started in the pediatric critical care unit and I can remember that very vividly. I loved it. But I do remember walking in there that day and being like extremely overwhelmed by at that time what was all the technology? Which is very simple and basic technology.

Speaker 2: 1:32

But I spent about 17 years in that area of nursing practice. About midway through there got a master's and became a nurse practitioner and just kind of went up to the next level of practice in Pete's Critical Care. But about 16 years ago I decided I needed a change and that change for me was to really try to make the move from clinical practice out into the healthcare technology industry, and so at that time there weren't many clinicians moving out into the industry. I was able to find myself a role in a company that many nurses, if you're listening, will know, and that's Alaris Medical Systems, which was the first smart IV pump.

Speaker 2: 2:26

I believe they're now owned by BD, but that's where I kind of made the leap and then just kind of, you know, I worked there for a few years, learned so much, went to work for some health care IT startups where I was just telling someone the other day, working for a startup is like getting your MBA. You've learned so much. Landed at a small emerging company that was headquartered in Dublin, ireland, that was a Microsoft partner, so as you know we have thousands of partners, so companies that build their technology on our stack.

Speaker 2: 3:09

It was a inpatient bedside experience solution and I'd always been you know I've been. When I practiced clinically I was very interested in patient experience side of things but worked there for about six years and then in the middle of the pandemic Microsoft, the team that I'm on the woman leading it at the time said hey, we have an open role and I think you should come and talk to us. So it was kind of one of those things. I wasn't looking for it and it happened. And I have been here I'll be going into my fourth year, so that's a little bit about my journey. People ask me all the time do you miss clinical practice? And sometimes I miss that hands-on touch of the patient inside the hospital. But I've never looked back and I think I still practice nursing every day, just with a different tool set, and I get to help thousands of people at a time. It's it's a good, it's a good life, yep.

Speaker 3: 4:20

Well, fantastic career trajectory, very interesting. So let's talk about evolution of technology in nursing. So you've been a nurse for more than 30 years and, by the way, huge thank you to you for your nurse nursing work and to all the nurses out there. We have huge respect for nursing as a profession and for all the role, the role, the huge role that nurses play in our patient journeys, in our experience, in our healthcare. So now I want to quote you. So you said that you were in the first generation of nurses to work with the introduction and subsequent wave of technology into our practice, altering our workflows and how we perform patient care. Please talk more about evolution of technology through the decades, how you've seen it through the lens of nursing and this is prior to COVID, because I want to ask a different question specifically about COVID a bit later. So talk about that evolution that you've seen.

Speaker 2: 5:21

Yeah. So I mean, as I mentioned 1991, stepping into that ICU, we had electric IV pumps, we had ventilators, we had what I thought was a lot of technology, and it was for 1991. But when I think about that, compared to what the technology is today, it just really it's like flipping a light switch. But I remember I recall my first year on that job and my new job. We were still mixing medications at a common IV cart and I mean everything from drips to we had scheduled narcotics that we could pull a drawer. And I remember the PIXA station coming along and if you're familiar with the PIXA station, that is a machine where they hold the medications there and you have to enter data in. The door will open after you enter the correct patient data in. You take your single dose and you do what you need to do with that. And I thought at the time I was like, oh my gosh, this is so cool, it's going to be better for the, it's safer, it's more cost-effective. But at that time I kept thinking we're entering information on a keyboard, where is that going and is anybody doing anything with that information? And then you know, we were on flow sheets, paper flow sheets at that time. Then we had like order systems that came about. There were electronic medical records. At the time my organization was not using them, but I mean we know the history then of electronic documentation, of patient medical record. Smart IV augmented reality in one city communicating with another city across the world. We can train people with that, we can educate patients with that.

Speaker 2: 7:34

And then most certainly, artificial intelligence, which AI has been around a while in health care and it's kind of like our daily lives where we pick this up and there's AI things happening.

Speaker 2: 7:48

It's just in our life flow and AI has been in workflow. It's just now AI is being introduced in a much different way where we have to make very conscious decisions about applying this so we can optimize the business of healthcare but most certainly alleviate human suffering, address the nursing workforce crisis, which I'm sure we're going to talk about in our time together. So you know, that's the evolution that I have seen and it's certainly different from being someone who's providing care to now someone who works for a company who is leading the world in artificial intelligence and understanding and knowing, like what we talk about on a daily basis. And I like to say I'll go to bed tonight having known something about artificial intelligence and what we're doing today and how we did things, and I'll wake up tomorrow and it's different and something new has happened, and that's true. So really exciting and it is uncertain, but it's exciting.

Speaker 3: 9:01

Well speaking of uncertainty, excitement and leaps and bounds in technology, when it just makes huge leaps forward. Let's talk about impact of COVID, in particular on nursing and technology. So obviously we all lived through the COVID pandemic, which accelerated wider adoption of technology, trying to address the unprecedented problems that COVID had brought upon our healthcare system. So nurses are innate problem solvers and there was a huge need for that kind of skill specifically during the pandemic. What new ideas and creative problem solving did you observe or were part of during those four plus years of the pandemic?

Speaker 2: 9:46

Yeah, I think the biggest one was, well, number one. You're so right, nurses will figure out a way to solve the problem and they will do it on demand on the fly. And we saw that and I had one chief nursing officer actually say to me that she witnessed in a year's time like from 20, the beginning of 2020 or March there when the pandemic started, through the next year. She said it was like 20 years of transformation happened in one year. Because you're you're forced into doing it. So you, you know, nurses were like we can't do things that way anymore, we don't have the time for it, it's not safe for us, it's not safe for the patient.

Speaker 2: 10:29

So perhaps workflows or things that they were doing that really were not meaningful to the IQ work that they were doing and saving lives at that time, they dropped that Communication. How they were able to figure out how to communicate with each other when they were in isolation rooms using things like Teams or other virtual methods, how to be able to facilitate communication between patients and family members on the outside Staffing ratios, family members on the outside staffing ratios I mean, I don't think we can begin to understand, unless we were there in that moment, what it was like working so hard, short staffed, while you know maybe your colleagues were getting sick, so they were figuring things out on the fly, and these are things that have now started to carry over into the nursing practice of today. I think there's nursing practice pre-pandemic and nursing practice post-pandemic, and we're still continuing to see that evolve.

Speaker 1: 11:39

Yeah, so much to take account of. And switching over to the technology side a bit, you know, of course, Microsoft helps drive and shape so many tech friends and there's so much happening in digital health within Microsoft as well. What are some of the innovations, contributions that you're making at Microsoft that are top of mind? Maybe some we're not even aware of. I'm sure there are many, many things happening at the moment.

Speaker 2: 12:09

Yeah, so this was before the pandemic. Satya Nadella, our CEO, put a stake in the ground. He's a very empathetic leader and so he looks at things very holistically. He looks at the world and how are we really going to help the world? Because we are the largest software company in the world, we're a great American company, but we have an obligation to end human suffering in multiple ways, and healthcare is one of those ways. He knew, as Azure was starting to evolve into something that was much bigger than we had imagined, that he was going to put a stake in the ground on healthcare. So we're really kind of leaning into four areas in healthcare.

Speaker 2: 12:54

One is and this is all you know really based on the foundation of being in the cloud, and that's where everyone's going to have to go, because to operate and function at scale, it's going to have to happen in the cloud, with all of the storage and the rapid computing that's required, and now certainly for AI, but innovating at scale. So Microsoft's a platform company. We have all of the machinery to help people build and innovate, take their new ideas, create something new, commercialize it. So how are we going to help people innovate and scale? How are we going to help them optimize and reinvent their business, and that certainly has something to do with the cloud, but also our other products. You know, like our business, that products, teams, you know, whatever that might be, anything that's in our cloud, our Azure, cloud services. So how are we going to help them optimize and reinvent their business? Elevate the consumer experience. I think one thing that is we've been trying to do for a long time we still haven't hit the nail on the head is create an end of one in the consumer or patient experience, and at Microsoft we choose to call it consumer experience and we've thought long and hard about this.

Speaker 2: 14:15

There are specific times in your healthcare journey where you are a patient. You are inside the four walls of a healthcare system or maybe at home receiving some sort of treatment. You have an illness, whatever that is. You're patient during those times, but in the other steps of your journey, you're a consumer, just like you consume any other type of service, whether it's retail, banking, entertainment, whatever, and so we have to look at things differently. We have to look through that lens.

Speaker 2: 14:43

And how do we create the end of one, a personalized, longitudinal experience, and that's really done through the connectivity in the cloud and the management in the cloud and then leading the future of healthcare. Certainly, you know our position right now in the world with AI and where we're going with. That is part of it, and just a little bit about that. So you know, ai is going to help decrease health care worker burnout and burden. It's going to improve the experience, but it's also going to do things like allow for speed to diagnosis, like allow for speed to diagnosis. It's going to allow for our pharmaceutical and medical device companies to develop treatments and cures more quickly and so we can alleviate and eliminate human suffering. So that's kind of where we're leaning in when we talk about what is, you know, microsoft's role in healthcare right now.

Speaker 1: 15:45

Wow, I had no idea that is amazing to hear laid out like that.

Speaker 3: 15:51

Yeah, Evan, I think you had a follow up.

Speaker 1: 15:54

Yeah, I do. You know. Just thinking about what you described, it sounds like the key to unlocking that opportunity for patients and providers is data, and so much data from the digital health side, the patient side, the provider side, the researcher side. How do you think about the challenges of big data, democratizing that data? For those healthcare consumers not customers those patients and the providers, it's a big challenge.

Speaker 2: 16:27

Yeah, and I'm going to circle back again to AI, because we talk and I know you guys do too talk about liberation and democratization of data for healthcare providers or clinicians and for consumers. So I think AI is the ultimate liberation and democratization of that data, and there's so much data. We don't use 95% of the healthcare data that we create and store. So, first of all, like what is valuable. So, first of all, like what is valuable and can we get to? Does it make sense? Can we get to it quickly? Can we connect it with other data sets to create meaningful insights? And we have to do that. It's like it's in real time and that's really how we think about it.

Speaker 2: 17:24

The other thing that we like to make provocative statements and get people thinking and the cloud itself is becoming AI. You know, right now we look at the cloud as a place where we can lift and shift, or whatever you want to call it, you know, migrate and modernize, move things to a cloud store data. It's not just about storing the data in containers anymore inside a cloud. It's about releasing it and it's about being able to connect those data sets, and so that cloud is now computing more and more and more and it is becoming AI and healthcare will become a platform. Healthcare is a platform like Tesla. You don't buy a Tesla for the car. The Tesla is the software.

Speaker 3: 18:21

So let's talk about AI as a platform and specifically AI in healthcare. So recently, the 2024 Annual Work Trend Index for Microsoft and LinkedIn came out. It's aptly titled AI at Work is here. Now Comes the Hard Part, so it provides a comprehensive view of how AI is reshaping work and labor market more broadly. So, in the context of workforce challenges and nursing retention issues and huge amounts of data, and how do we drive meaningful insights from it while empowering the workforce? Just tell us about your thoughts on AI in healthcare and its long-term effects on labor and patient outcomes.

Speaker 2: 19:15

Ultimately, yeah, I'd like to bring a name of my colleague on my team up here. Her name is Dr Kathleen McGraw and she's our chief nursing information officer and Kathleen, really, she owns our healthcare workforce crisis point of view. So how we look at that, how we're approaching it, but one of the things we talk about at Microsoft in the health and life sciences is this compelling event of the year 2030, and 2030 is the year where all of the baby boomers will finally age out. So we are going to have more older people, we're going to have more sick people and a higher demand for care and as it stands, stands today, in 2024, we don't have enough people to deliver the care that's already needed and we don't have. We don't have a good pipeline not just of healthcare providers but of people in general, because American women, the birth rate has fallen and it takes two children per female to repopulate the generation ahead of us and currently women are at about 1.8 children. So we those are hard facts, you know, and so we have to think about those hard facts and how we're going to address the demand for care with the lack of people. So we tend to think about that in multiple ways and if we're just talking about addressing, you know, how to provide care, we have to first look at how are we helping our healthcare customers mainly help traditional healthcare systems look at the sheer numbers and understand that this is coming and get them ahead of the curve like, just have that open, honest conversation and so that really aligns to helping them. Also think about new business models and new care delivery models before we even put technology on top of it. I always like to say we have to look at the underlying problem before we put a digital bandage on it, because otherwise it's just going to be a digital bandage. It's not going to help. So you know that that has. That conversation has to happen. And part of those business models are what type of relationships they have or will have with their payers, what type of relationships they might have in the retail health space, because there's going to be a lot of offset of primary care to retail type locations.

Speaker 2: 21:58

But there's still going to be a need for inpatient care, care in the home. It's a big one and that needs to be solved quickly because people need to get paid for care in the home. So that's a payer and a provider problem. And then you know care delivery models. We have a lot of conversations with healthcare systems about, you know, now, delivery models. We have a lot of conversations with health care systems about you know now, virtual nursing. So that's more inpatient, aligned, like how you could have a command center and someone's monitoring so many patients and speaking with the nurses on the floor, but that could extend out to the home as well.

Speaker 2: 22:39

So there's that, but that could extend out to the home as well. So there's that. And then there's definitely the use of AI, and this is a very sensitive subject right now, because nurses are wary of AI and I believe it. Just we need to educate them about what its true potential is and bring down the fear factor and help them understand that you know they're going to, they're going to need it, and it can start with things like understanding the demand. So, like what you know, are we going to have enough? We have all this many beds in our hospital. We know they're going to be filled.

Speaker 2: 23:24

We're going to look at these numbers in this area of central observability and make predictions about how we need to staff that. What's the acuity level? What's the pipeline of nurses coming in? Can we use virtual nursing? So start with things like that and then the that's like more of a back end approach to how to use AI back office. And then front end is how do we bring AI to the surface in their workflow to help them prioritize and focus, and so that's just kind of how we talk about it and how we look at it, and Kathleen's leading a lot of that work.

Speaker 1: 24:03

Incredible. I can't wait to catch up with her as well. And speaking of the commercial side of the equation, I'd love to hear more about the strategic partnership with CVS Health. I feel I'm at CVS Health at least twice a week, so it's an important topic to me personally. But describe that work at the partnership with Microsoft and how does that inform you as far as the future of retail health?

Speaker 2: 24:29

Yeah, so CVS is a passion project of mine. I've been working alongside our Microsoft account team with the CVS folks this will be going on my fourth year and I've seen a lot of evolution. We've definitely seen them make major moves with big time acquisitions like Oak Street Health and Signify. They have obviously their core business, which is their retail business inside their brick and mortars, and then their Aetna and Caremark business, so essentially they are in the throes of working on verticalizing healthcare, which other people have tried to do. They seem to have many of the core components of the success, or what would make you be successful at verticalization, and the way I look at that from my role is that's our job at Microsoft is to help them successfully verticalize in healthcare by really creating a connected system between all their lines of business. And I think another important thing to talk about, you know, in looking at how we work with CVS, is understanding that very, very large companies are. They have a multi-cloud strategy, so there's going to be, and there should be, more than one cloud. And at.

Speaker 2: 26:04

Microsoft, how do we with our technology not just our cloud, and they have our cloud but with our technology and the other things that we bring to the table, how can we show value in the multi-cloud environment? So that's like from a technology standpoint, that's really, you know, the crux of it and how to make them successful. From the side of the consumer experience, which is really my joy zone is I have been watching retail health for a very long time and I kind of predicted its rise, and maybe that's because I have my husband and I have a 38, a 30 and 28 year old daughter. So I've seen how they interact with the health care system and what is important to them. So retail health, cvs health in general, you know it's it offers the ability of choice. So choice and choice in where they're going to receive healthcare services, whatever that is, services, whatever that is. There's a convenience factor that retail health offers that traditional healthcare systems. Just they're not set up and designed to do that yet and I hope they do get their value.

Speaker 2: 27:34

And I always talk about value in terms not of value-based care in this situation, but financial value. So if you know that you're not feeling well and it's probably strep throat or whatever that is. You know that you can go to a retail health organization. It's either going to be billed to your insurer or you know how much you're going to pay. You know right up front this is how much this is going to cost me. You can go right. You know they can. Whether you're doing it virtually or in person at a minute clinic, they're going to. If they prescribe you something, you're going to take a few steps and you're going to be right there. You know picking up your prescription.

Speaker 2: 28:20

Value is a big thing and we need to be talking about that's a crucial conversation in healthcare right now. You know there's a lot of people struggling and medical debt is like the top. You know reason for bankruptcy in our country, and so we need to be more honest and transparent about the conversation around value. And then access. You know CVS are located in urban areas and I think that they're they're really trying very, very hard to solve the access problem and they are also very focused on health equity. So I could go on and on about what I value about retail health, but I get to see it firsthand.

Speaker 3: 29:05

Yeah, Shifting gears just a little bit. Of course, you give a shout out to Kathleen McGraw, who we know and we've actually interviewed her on this show. So obviously she's a transformational leader, as you are, and I know you draw inspiration from other leaders like Satya Nadella and then the CEO of CVS Health, Karen Lynch. So do you want to just maybe briefly tell us what inspires them as leaders and how that is important? Their leadership is important to actually achieving that healthcare transformation.

Speaker 2: 29:38

Yeah, I think Satya and Karen have similar philosophies and looking at things holistically and certainly healthcare delivery holistically in our country. And so you know Karen is very geared into on how to like address certain specific populations. I'll just use this for an example. So, like the Medicare Advantage population and with the acquisition of Oak Street Health and I was just sitting in a room with some of the Oak Street Health leaders a week ago and just so blown away so blown away I know about their model of care and how they're able to successfully like handle the highest risk Medicare Advantage patients but learning more about that model and their high touch care. So, like Karen's very focused on addressing the problems of scaling to healthcare in this country, but doing that in a very compassionate and meaningful way.

Speaker 2: 30:42

Satya is the same and Satya just builds the technology to be able. You know his company builds the technology to enable all of that, but Satya as a CEO you can ask anyone at Microsoft and you yes, we are in the church of Satya Like we just love him because he puts his money where his mouth is. He really he brought the growth mindset to our culture. He changed our culture and when we go in and we're talking with customers.

Speaker 2: 31:21

Sometimes those conversations go to a place where they're like we want to know more about your culture because we need to make cultural shifts here so tell us about that and we have deep conversations about that, and that's one of the things that Satya brought to the table and making sure that we're coming to every conversation with an open mind and every conversation where we are not the smartest people in the room or at the table, and it just changes the way you think and deal with your colleagues and do business. And I mean he also projected that Azure, that the cloud was going to be the place where businesses need to be, and he predicted AI. So you know he's doing good.

Speaker 3: 32:15

And we should all do well by using this, yeah it's so inspirational it was wonderful to see the journey over the you know 30-plus years I've been following Microsoft.

Speaker 1: 32:28

Well, unfortunately, we do have to let you go. We could probably go on another hour, but I see in the background there. Summer has arrived in Cleveland as it has here in Boston, so any chance to get out and have some R&R, enjoy the summer. What are your plans, personally, professionally, for the next couple of months? What's on your radar, kathleen? I'm sorry. Your radar, antoinette.

Speaker 3: 32:56

Oh, did we lose you.

Speaker 1: 32:57

And with that we lost you. Well, I think, I'm back, I'm back. Oh, here you are you. And with that we lost you. Well, I think.

Speaker 2: 33:02

I'm back, I'm back, oh, here you are.

Speaker 1: 33:03

You're back. I was just saying, Antoinette, what's on your radar the next couple of months? Besides checking your broadband provider? What are you looking forward to most for the summertime?

Speaker 2: 33:17

Yeah, we're getting ready to start our new fiscal year, so just kind of bring down on the first quarter of the year. I'll be out doing some talks on experience and workforce and, you know, just trying to brace myself for all these rapid changes that we're going through.

Speaker 1: 33:39

Well, we appreciate all your insights and the amazing work you do. Thank you for that again and thanks everyone for watching. Reach out to us, reach out to Antoinette and the Microsoft Healthcare Life Sciences team. They put out really great educational content, so we always like to keep on top of the latest and greatest. Thanks so much, guys. Thanks Irma.

Speaker 3: 34:03

Thank you, antoinette, thank you.

Speaker 1: 34:05

Have a good day. Thanks everyone, bye-bye, bye-bye.