Exciting things are happening at Becker's Healthcare. Stay ahead of industry trends with the new Becker's CFO plus Revenue Cycle podcast, your go to source for insights from top healthcare finance leaders. Tune in wherever you get your podcasts. And don't miss the tenth annual health IT plus digital health plus RCM conference, happening September 30 to 10/03/2025 in Chicago. Join thousands of executives, engage with industry leaders, and explore the future of health care innovation. Learn more about our upcoming events at beckershospitalreview.com. See you there. This is Laura Dierdo with the Becker's Healthcare podcast. I'm thrilled today to be joined by doctor Chris DeFletch, vice president and chief medical information officer at Penn State Health as well as professor at Penn State College of Medicine and emergency medicine physician at Milton s. Hershey Medical Center. Doctor DeFletch, it's a pleasure to have you on the podcast today. Hey, Hey, Laura. Thanks for having me. Appreciate it. Absolutely. Well, I'm looking forward to our conversation. I know we have a lot to talk about, and, certainly, Penn State Health is going through a huge transformation with EHR as well as, bringing in new technologies and doing some really cool things. And so I'm excited to talk about that. But before we dive in, can you tell us a little bit more about Penn State Health and what makes it unique? Oh, yeah. Absolutely. You know, proud to say I've been at Penn State Health for, for more than more than two decades, practice in emergency medicine the whole time and, being able to to serve as the chief medical information officer. You know, we've really grown from a single hospital, Milton Hershey Medical Center, to now, depending on how you count it, seven hospital systems across all of, Central, Pennsylvania. We're we're lucky really enough to be able to to to be able to take care of all of our patients in the Penn State area and the Penn State region. We're talking, an area that that you can get any type of care that you want right here at home. You don't gotta travel to Pittsburgh. You don't gotta travel to Philadelphia. You know, it's it's all done here, whether you need it in the community in Berks County or, you know, further west or up north of the state college. And, you know, we're academic tertiary care into Penn State. So, you know, we're we're coming off one of our, really, flagship moments. Penn State THON was this past weekend. And for those of you who aren't familiar with THON, it's the largest run student run philanthropic events, in the nation. The university students raised over $17,000,000 for direct care for patients pediatric patients suffering from cancer in the four and so it's called the four diamonds fund. And so all of our, pediatric patients who are getting treated, for cancer get it get it taken care of by the four diamonds fund. You know, you hear things like, other companies who who do this and they don't have care, but it's only, you know, for people who aren't in clinical trials. For us, it's everybody. Anybody who comes to Penn State, who has a a child suffering from from cancer and gets treated at our children's hospital gets it done for free. And this is really on the backs of these students. It's it's an incredible event that's turned out to be an event for all the high schools in the area as well. So they have mini thons at all of our high schools, and they'll build, you know, 10,000, 20 thousand dollars in each one of these high schools, in addition to the 17,000,000 that, Penn State bond students do. It's it's it's, it's heartwarming. It's it's incredible that and it goes directly to care. There's no intermediary. There's no other people. It's really students collecting money for the care of these these these, these pediatric cancer patients. And, you know, that's one of many things that, that Penn State, makes Penn State special. That's amazing to hear. And what a unique situation you have. Great to hear that the students are so passionate about raising that money and providing care for pediatric patients in the community. I think it's truly impressive and, very indicative of the community you have there, at Penn State Health. It's the reason I've been here for so long is it's it's about people taking care of people, and that's all they care about. I mean, it's it's you know, there's lots of things in medicine, lots of technology, and we're gonna get into that. And there's lots of this sort of stuff. The other day, it's about people taking care of people, and and and and Penn State students see that. And and people who work at Penn State Health see that. And and it's, it's it's really it's it's really an honor, kind of incredible to be around. Well, absolutely. Yeah. And and I think, to your point, I mean, it's something that, you know, a lot of organizations aspire to but have not been able to achieve. So is there anything that you see that makes Penn State Health special in that way, the culture, the community? You know, what really has been grown and fostered there for years that, has created, you know, this ability to truly, truly, support the effort that you're doing and have that type of community feel. Yeah. It's it's, what's it's it's very interesting. We've gone through a lot of transition at at Penn State Health over the over the decades, you know, starting off with, you know, the philanthropic thought processes of, of the Hershey Company, starting off the Milton s Hershey Medical Center with a single phone call and $50,000,000, you know, back in the sixties to creating a, a medical center and a medical school that I went to, in the middle of a cornfield in Hershey, Pennsylvania, really growing the town, right, and growing the area about who we take care care of and why we take care of it and, and creating this academic medical center that has now expanded to a health academic health system, across the region. It's really been incredible to see. And at the core, it's about, you know, people taking care of people. It's about, us staying at home. It's about us taking care of people in our region. You know, we have to be able to make ends meet. We have to be able to ensure that, you know, we can do what we need to do to take care, take care of patients from a financial perspective. It's about the care. And one of the, the ways that, you know, one of the, one of the prouder things, I think. Over the last couple of years, for me is that ability to connect, that strategic vision from the board to the executive level, down to the practical. How do you go from, you know, theory to practicality in a way? And it's hard. I mean, it's really hard, but the connection of people who, you know, really, you know, grew up here, live here, work here, have family members cared for in our hospital is really what drives us. And how we go about doing that. That activity is such a, is, is such a big deal. So, so for me, it's, you know, setting that strategic vision, aligning to it. Don't be afraid to fail. I mean, if you, if you go after something and you don't do it well, that's okay. Let's go back after it again. Tying in the university and research and activities into it is such a big deal. You know, give an example where, you know, I've been lucky enough to serve on, a board at, at Penn State University in the, in the College of Engineering, really the Department of Industrial Engineering, Industrial Manufacturing Engineering. We actually were able to create, an undergrad and a graduate degree in service engineering. Now that sounds funny, but ultimately nowadays. The United States is a service industry. Healthcare is a service industry. And, you know, while we do have some manufacturing, continuing across here, it's really about service. So we've been actually, able to create. A degree at Penn state university, in service engineering. So how do you, you know, manage projects? How do you understand the use of input, throughput, output, and lean sig sig the symbols inside of, health care delivery processes and apply them in a real practical sense? And so it's that connection between the academics and the practicality, I think, that makes, is really a difference maker at Penn State. That's amazing to hear. Thank you so much for sharing that history with us and certainly how it's grown and developed into what it is today. And, I'm curious, you know, thinking through the last year or so, especially, could you tell us a little bit about the accomplishments you're most proud of? Well, I you know, I think there's nothing nothing bigger than the decision to to move from, Cerner slash Oracle Health to, to Epic, as our, health care delivery platform. We didn't take that lightly. You know, we're a long term, Cerner client, actually, over twenty, years actually, about thirty years, working with Cerner, and the decision to, to, to move, towards epic, was significant and, you know, not undertaken lightly. And really, I think shows the ability of our organization to say, you know, we've really had great partnerships with companies in the past, and maybe it's just time to, to, to move, into a different area. We've had great success with, Oracle health and, and Cerner over the years, and, you know, I'll continue to help, you know, different groups like the VA VA and DOD and others, to be successful, with that platform. For for Penn State, it made most sense. We've got a lot of surrounding community hospitals, who have EPIC, and exchange of information with those companies is really an important thing for the care of our patients. And so the real coordinated decision, to move in that direction, you know, driven by some of our our physicians and and clinical staff, heard by our executive group, really run through our, administrative, and and boards and the board, you know, making the decision to move in that direction. I think I'm really proud of that just because it was such an inclusive conversation, and it was done with the motivation of the patient in the center, which, again, it is our core. Again, people taking care of people and how can we do that most effectively and efficiently. And so, you know, we don't do that lightheartedly. We've got, you know, thirty years of data in a Cerner system. We've been taking care of patients, you know, on that platform for a period of time. So now we're on, we're on our epic transformation journey. And, and, and I'm really, and, and I'm really, really excited to, to to help lead that. Well, that's amazing to hear. And, certainly, you know, looking at a project like that takes a lot of, time, effort, and resources from the leadership team and and everyone on the front lines as well of planning, that and then and then making the transition. So I'm curious. You talked about the discussions being inclusive and, making the decision, to make the switch as being, you know, something that, you didn't take lightly or the team didn't take lightly. I think especially knowing, how much goes into a transition like this. I guess, how did you balance or how are you balancing, the input with the potential output and and sharing that, change management with the broader team? Sure. Sure. You know, again, patient's always in the center. No question. How do we get that patient the the the best information for code decision making, making, for be able to take care of them in a most effective and efficient way, to be able to engage them in their home, to be able to incorporate, the ongoing data for, management of populations over time. All these things come into play. And, you know, we've we've again, we've had some great success with with, Cerner and Oracle in the past. And, you know, there was just some areas that that we thought that that Epic had a little bit of an upper hand on. And, again, with the interoperability with other systems, the ability to incorporate into, you know, data that would be, able to be used across systems, to to be able to coordinate with other systems and research and development for education and and, and research activities. We just thought really it was the time. You know, and so, it made the most sense for us. I think individual hospitals and health systems have to make their own decisions independently of what the needs are at that time. But, you know, for us, you know, we went through a process of engaging our staff and demonstrations and know, opportunities. Some of them kinda had come from other Cerner sites. Some of them come from other EPIC sites. And, you know, we take their, input very, strongly, and that was really a driver for the whole thing. And then, well, if the if the, if the working community and and patients and things are sort of asking for that activity, it's our obligation to look into it in great detail, and that's what we did. And in a in a really comprehensive long term investigation and, you know, costing and transformation and and and all of the work that needs to be done, we decided that was absolutely the best thing for us. And, and we're, again, looking very much forward to this, this transformational activity. That's great to hear. Thank you for digging a bit deeper in there. Now I'm wondering, I can imagine some of the big growth opportunities for the next twelve months or so are also tied to the EHR transition. How are you thinking about growth and and development, especially during this time of a lot of change? Yeah. So, you know, I I think, I think, change is such a neutral word. Sometimes people think it negative, something is positive. I see advancements, rather than change. And so, you know, people that just move from one thing to a next just for the sake of change, it's not really worth doing. You have to take advantage of where the advancement is, whether it's a technology or the people on processes. More importantly for me, it's the people in the process. How can I simplify the experience of the patients? How can I simplify the experience of our physicians and nurses and APPs and and and registration staff, so that they can provide that better experience inside of here? So for for us, it's really about how do we advance our organization. And we think this this platform helps us, advance the organization. I think there are other, components of it that, you know, we rally around, again, patients being first, but it could also mean, you patients who are on clinical trials, patients who, maybe, need additional support at home in a unique way. So it's not only just the, the EPIC transformation and advancement that we have with that EMR platform. But it's also other technologies that that be able to do that. So, you know, advancing your telehealth or or, you know, hospital home programs, which has been been very well received in our our community and, you know, people able to, take care of each other at home with the support of Penn State's hospital at home program, I think, has has been a big difference. I think there's some advancing technology in, you know, quote, unquote AI. I'm sure we'll get into that a little bit because that's the, you know, that's the catchphrase related to it, but it's really about how can technology be leveraged to improve the care and outcomes of our patients. And and so for us, you know, change you know, changing our core platform is one of it, then being able to build upon that, taking advantage of our university, and how can we incorporate those thinkers and knowledge into, our health system in a way that we haven't before in this new platform to maybe develop some technologies that haven't been seen before. But more importantly, I think for us, it's it's partnering with good companies, who want to, you know, have the same, moral compass, that same sort of ethic, that it's about the patients and the patients first. And, you know, we've been lucky to find a number of those companies out there that have, associated AI or other machine learning technologies that we think, you know, may be a great partnership with us to to advance the needs of our patients in in our area. That's amazing to hear. And, you know, certainly, a lot, as you mentioned, happening to improve patient care, especially given technology, the data, telehealth, virtual hair care, hospital at home, really great advantages for health care providers to continue to expand what they're doing and provide a better experience for patients. And I know you mentioned AI is something that is top of mind. I know a lot of hospitals, health systems, and organizations are, you know, looking at the best use cases for AI ways that they can really provide value through it, but also understanding, you know, there are risks involved there. So what are those tech conversations like when you look at new a AI technologies and and governance and those kinds of things? Is that something that you've, broached in a meaningful way with the leadership team? Yeah. We have. You know? And and, again, we we do this together. I think there's sort of, you know, AI is kind of a catchphrase now. And and in my heart of hearts, I'm an engineer, and I'm an emergency physician. So I I I'm I'm very tied to the practical. What is it going to make a difference for me or my patients to do this? Not the I love talking theory, and I love in my research space to be able to I've got a center at Penn State called the Center for Healthcare Organization Transformation, which studies, you know, systems systemness and and health care delivery science and things like that. And I love being able to think about that. But but as a CMIO, an emergency physician, I I really wanna say there's lots of these people out here with the word AI. What do they really mean by it? Right? Digging into the technology, what does it make sense to do? And, you know, there are some that are just using the words and not really understanding what it is. There are some, you know, who will say, yeah. We're using the catch phrase to get in the door, but it's really, you know, basic clinical decision support or machine learning to a degree rather than truly creating new, new information. Right? So for for us, we try and categorize it into, you know, is it in the discovery space? Space? Where's the data sits? How does that data get incorporated into practicality? Who owns that data whenever it gets generated? And, ultimately, is this an advantage over, what we're doing today or what we could be doing today based upon other basic technologies? I think the AI is real. I think it has tons of opportunity. I think it's a little bit overblown right now, but we'll come back to some semblance of reality. We did lots of piling and piloting in the generative AI space a few years ago. Actually, about five years ago, we were trialing some stuff. And two years ago, we got deep into a trial. I think about now is the time that we're starting to see it really have enough, accuracy and, benefits that you're starting to see some efficiencies gained in the and we're really talking about the document generative AI, space. I think we're starting to see it too in some of the, imaging and pixelation activities in regards to diagnostics. I think there's a lot of opportunity in that space. I think there's a lot of opportunity in the, NLP, to AI activities in, nondiscrete data. I think we're probably gonna start seeing some discovery in that, over the next couple of years. And, you know, say it before, I'll say it again. Health care is about people taking care of people. And, like, working in this discovery space, the people who you work with is such a big deal. So I'm I'm you know, at Penn State, I've got a great informatics team, and I've I've got a great research, group and a great college of medicine set of leaders who are really, you know, advancing the thought process at the college of medicine. And same way within our our our health systems of innovative leaders who are saying, okay. Yep. We're We're gonna spend a lot of our focus on epic and the transformation activities. But, you know, we've got a couple of these other spaces that, that we're gonna take care of as well. It's a lot. But it's an exciting time, to be able to be in health care and to see all of this stuff start to come to fruition. I I I joke a little bit. I've been doing this such a long period of time. I remember when people used to say, oh, just going to electronic records is gonna make things so much better and more efficient and more effective. Ask your normal doc on a daily basis with, you know, who've written handwritten notes and, and handwritten orders compared to CPOE and and electronic notes today, and ask them, is there really a difference, or not? And I think they may tell you, they may have a little bit of a different experience. So with that knowledge and and having done it for for such a period of time, it is the adaptation of the technology and the adoption of it is such a big deal because at the end of the day, it's people first, it's process second, and it's technology third. And, if I think if most people keep that in mind, keep their moral compass on something that makes a difference for their patients, you'll see the benefit to not only the people that you influence on a daily basis, but your health system. I mean, that's really powerful stuff. And and, you know, such an important lesson to remember how, you know, the technology and health care space has evolved. I know a lot of opportunities ahead, but challenges as well. Could you, talk a little bit about some of the challenges, that you're seeing and planning for in the next couple years? Sure. Sure. I I think, you know, we we talk about, what some people like to call social determinants of health. I like to call them maybe social indicators of of health outcomes, really talking about the impact of the day to day, and how it then affects there. I think we've got a whole generation of folks who grew up in the pandemic and who are struggling, with, you know, day to day activities, whether it's, depression, anxiety. You know, we've got a whole generation that are dealing with with that coming out of the pandemic. We've got an economy that is challenging for these young folks who are coming out maybe with, you know, lots of lots of debt from school or, you know, can't afford to put a down payment on the house because, you know, eggs cost $8 a a a dozen. You know, they're worried about feeding themselves. To me, that's where they're, you know, them then now they're thinking about how do I even get health care, or is health care even on that list of things when I have all these other things that are that are there? Here's where I think, we can make a difference. Here's where I think technology can advance things. I think that, you know, like, the hospital home has started blurring that line between taking care of patients in just the four walls of a hospital to, you know, the same type of care but within their home. I think we've gotta, you know, really get back to the basics of that with, with that type of care for patients at home. You know, the reality is in healthcare, it's episodic. You know, you may have one hospitalization, two primary care visits, and an emergency department visit in a year. That's a lot. Most people don't have one of those things. But yet the habits that they have or the need for care or need for, behavioral health or social support exists. So I think that it's our obligation, as a healthcare industry, especially healthcare IT, to see how can we leverage this technology to support patients in a way that they haven't been supported in the past. And for me, behavioral health and, you know, underlying anxiety, depression, and how can we provide support services in that space as part of, a community service, not necessarily fee for service or event activity. I think, there's a lot in there. I think AI has a a lot to do in that space. I think you could do the same thing with some other chronic diseases. I think you could do the same thing with medication management. So I think there's gonna be a lot of this, incorporating, you know, the people into the patient population. So instead of having one or two or three episodes of care, you know, at Penn State health in a given year, you you are a partner in health with Penn State. And, we help you through you and your family's journey, whether it happened to be through, you know, pediatric cancer that's getting paid for by the four diamonds fund, or unfortunately, you break your leg and you come visit me in the emergency department or or some other treatment. And so I think it's that, that community that that we have at Penn State Health. I think it's that community that we grow that you're not taking people, you know, out of town or flying them great distances because that's the only place that has that specialty and really provide that care, not only at your home, but having, you know, home care done at the local facility. So I I think that's where, you know, we're getting back to basics again, and I I think that's where technology can get us. I love that. And and, you know, such a really amazing picture that you paint of health care as it's moving, in a direction, again, closer to patients, but supported by technology and all the different types of investments that health care organizations are able to make. I'm wondering before we wrap up here, with our last minute or two, what is the number one thing that you're doing right now to set Penn State Health up for long term success? Yeah. It's really the basics. And and and building that epic foundation, for Penn State Health over the next eighteen months is really our priority. You know, we'll build upon that platform. We'll gain upon that knowledge, and, you know, we'll be lucky enough to leapfrog a couple of different areas in regards to the deployment in and of itself. But then it's the add ons on top of there. It's the how do we leverage our students and and and, and college of medicine? How do we leverage our university? How do we leverage the amazing, you know, physicians who are innovated in in and of themselves and allow them to innovate and give them platforms to do so, whether it's generative AI or, you know, pixelization of of, pathology specimens or or what whatever it happens to be. You know, give them a platform to be able to build upon the our our new epic, transformative baseline, to be able to to engage, their patients in a way they haven't been able to engage them before. So I I, you know, it's it's really gonna be about rebuilding that foundation and then then leapfrogging on top of that new foundation. That's amazing to hear. Doctor Defletch, thank you so much for your time today. It's been a great conversation. I learned a lot, and I look forward to connecting with you again soon. Great. Thanks thanks for having me. And I I, you know, started off with this, and I just wanna thank everybody, you know, at Becker's, but but most of the people at Penn State who've, you know, allowed Penn State to be so successful over the years. And it's really, all the people that I work with and the the the patients that I get to take care of and that we get to take care of at Penn State that allows us to to be so successful. And, man, I look forward to, just doing some great things over the next couple of years.