Designing for Health: Interview with Steve Peltzman and Tim Woodward [Podcast]

Show Notes:

[00:00] Intros

[01:08] The limitations of traditional surveys

[02:16] Real-time feedback

[03:56] From patient experience to operational strategy

[09:00] Simplifying tech

[15:20] Making feedback systems accessible

[21:05] Data, AI, and the future of patient experience

[27:13] Steve and Tim’s favorite well-designed things

[29:54] Outros

Transcript:

Dr. Craig Joseph: Steve and Tim, welcome to the podcast. Hey Tim, why don't we start with you? Why don't you give us a little bit of a background of where you are now and how you got to this place?

Tim Woodward: Sure. So, my name is Tim Woodward, the AVP for the EVS department at the Montefiore Health System in the Bronx. And I've been in health care for over 35 years, and I've been working in the tri-state area since. I love health care. I want to transform health care. And that's my goal right now.

Dr. Craig Joseph: Sounds like you're well on your way. And also, after talking to you for a little bit, I'm not questioning your New York background. It seems self-evident to me. I was thinking maybe South Florida, but no, definitely, definitely in New York. Steve, why don't you tell us a little bit about yourself?

Steve Petlzman: My name is Steve Peltzman, and I am the CEO of FeedbackNow. We're a company that started out as a startup, got acquired, and spun out. What we do is put sensors in physical places such as hospitals, gather data, and then figure out how to operationalize them in real time. And we're in hospitals, airports, convenience stores, things like that.

Dr. Craig Joseph: So traditionally, if we wanted to know how services were going, we would do a survey, right? And there are some limitations there. And so, you know, tell us a little bit more about; you know what some of those limitations are. And how you think that you're moving beyond those.

Steve Petlzman: Yeah, sure. So, surveys are like you said, they're everywhere. You can't escape them. They are great at figuring out context from somebody, you know, 35, between 30- and 40-year-old male who just took a flight on Delta and had this experience and check, tick, tick, tick. And they're how companies operate today. Most companies look at that, you know, they get together every month or whatever, weekday, knows what it is. Go, oh, wow. Examine this and we figure out that we're all good at that and that we need to improve. Nothing wrong with that approach in and of itself, but its big limitation is that a people are very tired of surveys. They don't want to take them. Maybe they take them out of rage or, you know, because they had a bad experience or whatever, or they're incentivized to take them, in which case maybe you're not getting their best answers. But they also happen way after the fact. So after I've taken the flight, after I've stayed at the hotel, after I've left the hospital, they don't help me,

you know, when I'm in the hospital, when I'm in the hotel, when I'm on the plane, they don't help me in the moment. The other issue is that it's a summation of your whole experience.

So, if you say I had a bad experience, we don't know if it was on this day, at this time, at this exact place. It's just a summation, and I could keep going. There're all sorts of other limitations, like memory. People forget that they know that they had a bad experience. But since it's bad, everything and everything about that experience seems bad. So, these their memories are selective. And they also just forget what their frustrations were. Exactly. So it's not super accurate in that sense, but I think the one that is most relevant, you know, certainly this conversation, but the one that's most helpful to me is that it doesn't help people in the moment when there's an opportunity to help people in the moment.

Dr. Craig Joseph: Those are all pretty good points. I know that I often fill out surveys when I had a particularly good or bad experience, if it's kind of just average and ho hum and wasn't really memorable, I generally don't fill out that survey just if I if I had a really great experience, which I think a lot of people don't even do that, they just do it for really bad or really bad experiences. So, you find out all the negatives, but you don't find out the positives. Well, Tim, you told us you're a health care guy. I was getting kind of feedback in the moment. Running a hospital. How does that work for you? How did you get involved in using these kinds of tools?

Tim Woodward: Well, sure. I mean, I was a hospital patient at one time, and being a hospital patient, I was undercurrent comparable. And I realized how lonely and there wasn't a lot of assistance when I was lying there in a hospital bed and that nurse was so busy giving out meds and everything else that she had to do that. I said, there's got to be a better way. And one day a manager came to me and said, hey boss, I found something at the airport and I saw this. And so, we said, wow, this is a great idea. Let's call them. And we actually did it. And next thing you know, we're putting this into a hospital setting. And we said, this is great because exactly what to echo what Steve just said about feedback. Now we need the good with the bad right now at this moment. And we need to know how we can make it better when we have thousands of people walking through our door on a daily basis.

So, we decided to call Steve and partners with FeedbackNow, and we have them throughout the hospital here at the mouth of your health care system, in restrooms. We have them in the patient rooms and also now the nursing stations because it works both ways. It works with patients, and it works with our staff. And so, we want to make sure that we take that, that some of that work away from a nurse or a doctor on a daily basis, which is about 35% of their work is non-medical work. And so, we want to make sure that we pull back and say, how can we help them? And the patients now hit the buttons all the time, and they love it. So, it's on demand. A lot of times when nursing is rounding, they make say nothing happened, no comment. But after that fact, a patient might have a thought and it's too late because the

nursing leaders are no longer there. So now this button is in the room. And anytime, 24 hours a day, seven days a week. We are here for that patient.

Dr. Craig Joseph: So, I'm a patient and one of the many, many, many Montefiore Hospital rooms. And there's a button for me to call the nurse, but there's also a button for me to give feedback about something. Is that how that works?

Tim Woodward: Yes. And there's three buttons, one for housekeeping, two for food, and three for the engineering department. But one person will respond. And so we have an idea of what we're coming for, whether it's cleaning, whether it's food, or whether it's a light that's out or a temperature problem, whatever that may actually be.

Dr. Craig Joseph: And so, this is how you're decreasing the stress and workload on the nurses, because in the past, for all of my needs, there was only one button. And it's generally called the nurse call button. They generally went to the nursing station. Maybe a nurse answered it, maybe a unit clerk answered it. Someone answered it, and they had to figure out, you know, if you're having a medical emergency or did you not get your tray, or somewhere in between. So, you're kind of taking out a big chunk of those calls. And so, someone from your team, a non-clinical person, is going to respond. How do you have the throughput to be able to respond in a timely fashion like that?

Tim Woodward: Sure. So once the patient hits the button, it goes to the phone into a text message and tells us the room number and where, and we respond within about 10 to 15 minutes tops. And we go up to that room, see what they actually need, and see if we can handle it. And most of the times we actually can. And it's simple. It's a restroom, clean food, a coffee, maybe they got tea and they wanted a coffee, or they need creamer, whatever that may be. And so now we are able to provide further assistance to the medical teams.

Dr. Craig Joseph: Okay. And I think you mentioned earlier, when we're preparing for this interview. You had mentioned that your folks were a little antsy at the beginning, and that they were going to be doing a lot more. You know, on what they maybe didn't have signed up for all of this kind of patient care or interactions. And they were a little concerned, but it turned out that they loved it.

Tim Woodward: Absolutely. And, you know, health care. So, for so many years teams have worked in silos. And we broke down the barriers. We are an organization. It's not support services versus the nursing staff. We're all one hospital. And that's what we had to engage our staff and let them know that we are here for the cause of the patient and the nurses and one another. You know.

Dr. Craig Joseph: This is a technology that needs to go into a hospital. And so, I presume that there's 8500 engineers that go in there. And tear walls apart. I'm setting you up because I think it's not that involved. So, explain to us how does this work? What kind of wire? I mean, anything that you do that's technology related to a health care environment, it's really complicated. And it sounds like you've simplified it to a big extent.

Steve Petlzman: You know, where we deploy are generally places where there's a lot of people and a lot of things going on. Maybe it's transactions, maybe it's presses of the button or whatever. And it's, and it's usually places where there's a lot of infrastructure already there and the cybersecurity and everything like that. You know, what gets in the way of what gets in the way of trying this or deploying it, or deploying it. It's oh, you want us to integrate with the network, and we have to worry about personally identifiable information. The nature of real time feedback versus surveys is we actually avoid all that we are we said, completely away from personally identifiable information. So the nature of, you know, the feedback is, you know, simple presses of a button, whether it's one, two, three or green, yellow, red.

So one part of the of this whole sort of clean deployment is we don't deal with all that personally identifiable information. The second part is whether it's a hospital, an airport or anybody, they don't want us on their network, and we don't want to be on their network. We don't want the Wi-Fi; we don't want to have to relay rely on any of that. So how the solution works are these devices are battery powered, and almost all our devices are battery powered. Because not being battery powered means cables means. And it's so, so battery powered through and through them. Like if we can't do it with batteries, you know, it's got to be something special or different. And it's really rare for us. So pretty much everything we have is battery powered and be from a network point of view, it's a very unique design. These are not Wi-Fi based. They're and again, not just buttons, but we have people counters, we have noise sensors, all sorts of things. All of them. How do you do it?

And they don't write on Wi-Fi networks. They go back, over a long, range RF system, which connects to a gateway that we supply that goes like in a supply closet or underneath a desk, and that has a SIM card that goes out to the cloud through normal, you know, cell phone networks. And we do that because, you know, we don't want to bother the people. We don't want to integrate with the I.T people. We don't want to rely on their networks. We don't want to worry about security issues of their network. So, it's all just designed where we can go and stick things on walls with stickers or screws, no cables, no nothing. And that and then it works very, very well. And basically, it's a private network. At the end of the day that can expand just as easily as buying more sensors and putting them in more places.

Dr. Craig Joseph: It's almost like I CIO's dream here.

Steve Petlzman: I was a CIO. I was a CTO for that was the bulk of my career. And while we acquired this company and designed it from the beginning, that was one of the things that appealed to me is like, if I was the CTO of this hospital, I'd be like, oh, great, these guys are perfect. I don't have to deal with this, and I don't have to worry about it. And that’s one of the great things that appealed to us when we acquired the company.

Dr. Craig Joseph: Other than just feedback. So, okay, I have a problem with one of these three categories or red, yellow, green. In terms of my experience, you've got, I think you said noise sensors and people counters. Tell us a little bit more about how those are. Those are used in health care.

Steve Petlzman: Originally, the company called feedback. Now because it was about feedback in the sense of sentiment. And we've evolved for now. It's like feedback around signals. You know, we didn't tell anybody this, but really, I remember one day we just said, you know, we'd need to change the name because we're pivoting away right away, but we're adding to sentiment, all these other signals. But I want to know, actually, feedback still works because it's a feedback loop in real time feedback loop where whether patients are pressing one, two and three to say I want something, or detecting noise or tracking, we're basically taking data and figuring out the correlations of what's going on, and then operationalizing it with a, text out to the to somebody on Tim's team or, you know, it could, it could be to anybody to close the loop.

So, we think of it as real time signals. And it's anything that could affect the experience, not just sensors that we can deploy but also data we can take in. So, a couple examples. One is thought of a restroom. Think of a hospital with hundreds of restrooms. Now I can deploy Tim can deploy his forces to say, I'm going to go out there and, you know, clean them on a schedule once every two hours for each one, whatever half I pick is a guess. It's a guess as to the actual pattern of usage that happened, and it's going to be a bad guess. It can never be spot on. It's never going to be perfect either. Going to be too early, meaning I wasted labor. I sent somebody to a restroom that didn't need to be cleaned. Therefore, I wasted labor or it was too late. I sent them too late, and I created a terrible patient or visitor experience. And what we do is we'll deploy a people counter, how many people are going in and out of this restroom, and then sentiment out was the cleanliness of our restroom. We quickly correlate that to say things go bad when hundreds of reds, when 80 people use it in 120 minutes or whatever, and all you have to do is use the people counters to get ahead of that curve.

And most efficiently tell staff to go to that restroom and clean it at exactly the right time. Not too soon, not too late. And that's just a restroom example. But the same thing can happen with noise levels. And you know how many people are lingering in an area. You know, all you have to do is deploy sensors or data. It could be any type of data or sensor data that can come into our brain and figure out the most efficient way to act right now.

Dr. Craig Joseph: Tim, how do you kind of explain this to patients? Because I think it's different. Like, I again, I think most people going in the hospital, you mentioned that you were so dedicated to, understanding the patient experience, you became a patient yourself. Or maybe that wasn't exactly how it went, but you turned into a patient, as we all do at some point in our lives. How do you how do you kind of go about explaining this to patients that, hey, there's multiple ways for you to tell us what's going on, and we want to make it as easy for you as possible because you have people with different languages and different backgrounds. And so, yeah. What's the secret or secrets?

Tim Woodward: English and Spanish are some of the languages that we use. But it's also self-explanatory because there's a picture of the housekeeper, there's a picture of the engineering person. So that helps with a language barrier. And I think it's so great because of the fact we do have a patient advocate that goes around saying, if you need anything 24 over seven, just hit the button. And New Yorkers are either coy or they're not. And, but most of them are not. And so we, we really get the buttons quite often here and, and they're really excited to see us again. Sometimes they just want to come back and say hello. And they're used to the button in the room now. And they just want to see, hey, I just want to make sure that this button still works, you know.

Dr. Craig Joseph: How have you found that this is a differentiator for you? Like I, I would imagine that there are more than you know, there's more than one hospital system in the in the New York area. If I had an opportunity to go to Montefiore or somewhere else, this might be it might be really helpful in terms of kind of making sure that, you know, if you're in the hospital, you're really sick under any circumstance. But to be able to kind of be able to be taken care of and to not worry about bothering the nurse for when you don't need to bother the nurse, that that might be a difference for me, in choosing which health care system I want to go to.

Tim Woodward: Absolutely. And we had a nursing administrator from a New York City hospital, another one within our area. And she said, this is one of the greatest innovations that she has seen. It's so simple because there's others out there. There's the TV ones where you can access, helped by the TV, but it's a little bit more complicated. And so this one is self-explanatory. And so she said, this is what every hospital needs across the New York City and across the country. Because when you want something, you want it. Now, when somebody asks you what you want, you can't think of it because you're not feeling well, but it comes to you later. And when you're feeling a little bit better, or when the pain medicine sets in, we are there around the clock to have a vision.

Steve Petlzman: I think that's unique, which is that, you know, it's almost like a luxury, you know, like when you think about somebody who presses the button just to see what happens

and someone comes up. This is, can I help you? And, sorry, I like that. That creates moments, you know, moments that they go home, and they tell their friends about. Like, I was in a hospital and they had something that a hotel didn't have. The hotel. I go pick up the phone, I got to talk to a person. But the vision here, combined with our tech, was like, to me, the purest form of luxury that I can think of in a hospital setting. Like I want something, I press, they come. I don't have to, like, pick up the phone and dial and talk and explain, you know, like to me, that was, it's the ultimate in simplicity, but it's also like a luxury aspect in a hospital setting, which you normally wouldn't think of when you think of luxury. And I just, I, it's why we love working with Tim. Because he's just got these visions of where healthcare can go push us as a company. So, I think that's great. You know.

Dr. Craig Joseph: You kind of bring up the word innovation. And normally when I think most of us think about innovation, we're adding complicated. You know, we're something that has to have AI or has to have a lot of bells and whistles. And this is a pretty straightforward idea. But I would argue it is innovative because you've removed barriers. You know, as you mentioned, with the TV systems, I can do many things. One of them is to get some help, but it's a little more complicated. And especially in the hospital, I'm not feeling well at all to be able to just press a button. And, and I really like, Tim, what you said about the fact that it's just kind of like a picture. And so you don't need you don't need a lot of words to kind of understand what the buttons do and who's going to come when you press them.

Tim Woodward: You want us to think we're providing warmth, right? We're responding to the patient. We're getting there. And the complex part is actually getting what they want, right. And that end result and really helping out the patient. Most of my staff didn't realize when they walk into a patient room what they get out of the Or from me and it has changed their mindset because they were always out there checking on their staff, but now they're checking on patients and it's a different story. And they kind of are saying to themselves, that patient's got a much worse life than I do. Let me try to help them, you know, and that's what we're here for, to engage with our patients and for a better outcome. And when a patient does not worry about something, it doesn't just come out throughout the entire day. And then they write something negative on a survey when they go home, like Steve mentioned.

Steve Petlzman: You know, there’s simplicity in the hardware and in the operation that Tim set up. You know, I press a button that’s kind of based on it. Someone comes. But the sophistication behind the scenes is also an opportunity that we’re taking advantage of. So what you've got here is tons of data, in the hospital. Who wants what, when what are their patterns of need? What are their patterns of usage? You can, you know, cross that with data infection rates, you know, labor, usage and all this other stuff. And then you do correlations and you figure out how to optimize. And that's the stuff that's where the AI does come in where we can

and we are putting AI over that data. And actually, you know, beyond sort of like, human set alerts. I want to go to the room when somebody presses the button or when 50 people use it in 80 minutes, there can be an AI that in real time looks over that pattern of data and says, I just found a correlation here.

That's interesting. And sends an alert. And that's the advantage of what we're doing. And what Tim is doing is basically introducing structured data and unstructured data into this hospital operation. And where we can go with it is amazing. And that's the AI part and the sophistication part, even if the front end is simplistic, perfect. You know, because there's a lot of solutions out there are using AI cameras to figure out what patients want and need and, you know, that's great and that's probably the future. But for now, this is like, you know, you get the simplistic and you get the AI and the and the and the data as well.

Dr. Craig Joseph: Are there any directions that you see the industry or your company kind of going in the future in terms of how to leverage that data or are there other things? Because you mentioned, you know, people counters and, and noise, detectors, other things that you think you can add in that are relatively, you know, kind of low tech, not an AI camera, in other words, that can point to things that we haven't even heard about yet.

Steve Petlzman: So, I was like, we're a hardware company. We're actually data company. And, you know, while we manufactured the smiley boxes that you see, really what we did was we built our platform to basically say, let's take anything off the shelf that measures and collects data in real time, and we can integrate that in minutes. And actually, the noise idea came from Tim. We were talking about all the stuff that we just deployed. And Tim said, you can't detect data, you can't detect noise, can you? And we went, no, but give us a couple weeks. And now we couldn't. We deployed all these battery-powered noise sensors. And now we're thinking about noise background levels. Noise burst levels. You know, where we're headed is more sensors, more data, more data feeds.

And then also bringing in results if you will. So results can be survey scores. They could be infection rates. They could be anything that you think about as something that you want to correlate back to these real time signals. And then what we can do is figure out, hey, if you do A, B and C, if you keep green levels and restrooms down, this might to, you know, green levels in restrooms up to this percentage, we think infection rates are going to drop by this. We can start to correlate results with actions with the results and then and figure out patterns that maybe don't even make sense. But in the end, they optimize the labor and the usage of hospitals resources and the patient's experience and their outcomes as well. That's what we think about as a company is bringing in results, laying out all the different sensors and collecting all the data we can, putting that at soup and then and then just producing great results in the end, whether it's through AI or simple operations or whatever.

Dr. Craig Joseph: Tim, are there other leaders at Montefiore that are jealous and you can tell us their names? We'll make sure they don't listen to the podcast.

Tim Woodward: Not at all. But they were excited. And what happened was when I put it into one building, others said, what about me? So I had to keep silent. Cool. Steve, I think we're on phase H2, you know? And so we kept growing and growing and expanding and we kept saying, this is a trial. It's no longer a trial, but noise like Steve mentioned. Why is that important? Because it's healing. It's all about the healing process. And we put them right by the bedside. And we know the decibel level at 2 a.m. or at 2 p.m., and we want to make sure that we understand the patient's needs. They need to rest. And if we see that spike, we study it with each group. We have monthly reports. We have a dashboard that we could look at in real time. And we say, how can we make this better? What's going on? One example, nurses were huddling next to the patient rooms by the nursing station, and those were the rooms with the highest noise levels. So we asked them to move into a conference room. And they did. Noise levels drop; patient satisfaction went up. And so that's what we want. That's the end result.

Dr. Craig Joseph: That's actually an amazing story that the nurses were meeting. And physicians are, I'm sure, more guilty than anyone, you know, not realizing that even if you're not speaking loudly, that that noise can be heard in the rooms and patients may not be going to complain because they don't want to get anyone in trouble. But, by having that passive audio or noise level, it's you're not listening to what people are saying. You're just figuring out what kind of noise, what kind of sound level there is. That's amazing.

Tim Woodward: And we report it out in our patient satisfaction meetings on a quarterly basis. And they love to see that reports, you know, the survey scores, you know, you could see are going up. It all comes together. And I think that's amazing to see those results. Absolutely. And it's change makers. Everybody's becoming the relationships are actually building. And the change makers are making a difference by going to the patient rooms. Even if the patient said I hate it by accident, it's a win-win because they know somebody will come, they feel secure.

They created a moment. You know, like I said before, it doesn't even happen in, you know, in high end hotels. So to me, that's, how many people come back from hospitals and talk about moments of, of luxury or amazing customer service.

Dr. Craig Joseph: As we wrap up, we always like to end with the same question, which is, is there something that's so well designed in your life that it brings you joy when you use it? Why don't we start with you, Ste

Steve Petlzman: I love the question. I'm a big fan of design, and I was trying to, like, think through all the different things, and I didn't want it to be too esoteric an answer. But on the side, I play with small airplanes and have been doing it for a long, long time. And the plane that I've been flying the last ten years or so is called, Cirrus SR 20 and 22, and it's like the best designed, airplane I've ever seen down from, like, you know, unlike other aviation, you even have a handle you can pull where a parachute comes out if you get in trouble and the whole airplane come down. But the cockpit itself laid out perfectly. You know, all the functions, you know, follow through, all the alerts, all the, you know, weather display information. Every time I fly that airplane, I'm just marvel at how beautiful and comfortable they made everything, how they thought through everything. And it's just, to me, an amazing design. Not just technology, but design.

Dr. Craig Joseph: Tim, anything in your life that's so well designed, you love it so much.

Tim Woodward: Working in healthcare for over 35 years, we've always stayed the same. We haven't changed. And we need now to make the biggest transformation ever. Because times are changing and the expectations of our patients are. We want service now. And this was a dream for me because of the fact that we now can make a bigger difference with our patient population. And I always say, if we could do it here in the past, you could do it anywhere, you know? So why not? Why not say that the design that we're doing now is going to change healthcare forever, and patients now have the greatest opportunity of recovering at a faster rate, because when you have that urge or that need for something, we will be there and our response will be exactly what the organizations are asking me and everybody else wants respond now, get their response of this of hospital staff.

And that's what we look for. So, designing hospitals with noise, with feedback, now with restrooms, it enhances the overall experience. I don't fly planes like Steve. I don't jump out of planes. But I do love making a difference in the lives of others because I have two special need boys. And with that, I want their lives to be more simple. If they ever had to come to a hospital. And at least I can respond to that patient care room in a timely manner.

Dr. Craig Joseph: I love it. One of the best answers I got, and Steve is going to cost, is you're going to have to pay for that. Well, thank you Tim. Thank you, Steve. Really appreciate it and look forward to seeing what you two do together in partnership to improve the patient experience. I think it'll be a fun journey. And I look forward to watching it.

Tim Woodward: Thank you, Craig.

Steve Petlzman: Thank you.