00:14

Inga Bergen

Anjali Bhargava ist Internistin an der weltberühmten Mayo Clinic und leitet dort nicht nur die Automatisierungsstrategie, sondern auch das Office of Belonging. In dieser Folge sprechen wir über KI im Behandlungszimmer, Menschliche Nähe im digitalen Zeitalter und warum technologische Innovation nur funktioniert, wenn sich Menschen gesehen und wertgeschätzt fühlen. Ein Gespräch über Heilung, Wandel und die große Frage: Was darf KI und was darf niemals verloren gehen? Welcome to the Visionaries of Healthcare Podcast. I'm super excited about my guest today. It's Dr. Anjali Bhagra. She is physician lead and chair for enterprise automation at Mayo Clinic. So Anjali, welcome to the podcast. I'm super excited to talk to you because actually your role is very unique. I haven't come across with a person that has this very unique combination of the two, I would say, most important topics actually in healthcare. And the question I would love to discuss with you today is how large healthcare systems can lead in technological innovation and in human transformation. And you have a really rare dual lens as chair of both the Mayo Clinic's Enterprise Automation and its Office of Belonging. I actually had to look it up because I didn't know what it was. I think we don't have that in Germany. Yeah, this is really a unique role. I mean, how did you get to combine these two perspectives?

01:58

Anjali Bhagra

Yes, Inga, first of all, thank you for having me. It's an honor. And that's such a great question to kick off. So I'll say at first glance, AI-driven automation as well as institutional belonging seem like two distinct tracks. But for my professional journey, these are very deeply intertwined. And both stem from a core commitment to human-centered transformation. I think you said it just absolutely spot on in your introductory comments. I would say early on in my career as a radiologist in a very different part of the world where I was really integrating point-of-care imaging in relatively resource-poor setting to now working as an internal medicine physician, taking care of patients with complex and serious illness. And in my professional journey, working as an educator, working as a leader, you know, I really realized that achieving excellence in patient care and that true experience of healing requires not just cutting-edge science, not just cutting-edge technology, but also cultural intelligence with a real intentional focus on empathy and inclusion. So as a practicing physician at Mayo Clinic and overseas, I'd say I had clear firsthand view of the friction points that often burden the clinicians, but also as a patient, what are the friction points that burden our patients? And developing a deep understanding then through my different experiences of what really goes under the hood with AI and technology. That's where intelligent automation and my role and everything we do within our organization entered the picture. And it was not just a tech solution, but it was a way to truly lessen the friction and the burden, both on the provider side, but also on the experience side for our staff as well as our patients, so that we could really give time back to our care teams who are engaged in this experience and truly reduce things like burnout. A lot of my research during my professional career is focused on resilience, both individual as well as organizational. So I would say I was very fortunate to cultivate the skill set that's required, but really it was that commitment that really helped me sort of advance technological advancement in a sustainable way with a strong cultural foundation. And both of these roles within the organization Personally, for me, championing belonging, which is an individual value, but it's also a core value of Mayo Clinic, something that is a strategic imperative at Mayo Clinic. It's not just a checkbox. We know that for our patients to truly feel the healing and the care, both of these worlds need to come together. So I would say this is very, very strategically prioritized both innovation and belonging. I am fortunate to have a foot on both, you know, both the spaces. When people truly feel seen, valued, and supported, they are more innovative. And we see that within our staff. They are more collaborative. They are more resilient. And that's true for us here at Mayo, whether we are developing an AI algorithm, whether we are deploying new technology, whether we are converting a patient at the bedside, it's at the core of everything we do. So personally for me, these two tracks, automation, AI, and belonging, really converge around one goal, and that's empowering people.

05:40

Inga Bergen

You know what's interesting to me? You used the word healing, and I'm thinking, I think I recorded around 200 episodes of my podcast. I don't remember anybody using the word healing. And I also like that you frame it in a way that AI is kind of a cultural revolution that we face. I mean, at Mayo Clinic, I just briefly browsed through your history of automation. There's a lot there that the Mayo Clinic has done. But now this shift, I would say it's more profound and more radical in certain ways because AI also mimics or can mimic what humans are doing. And it's a big cultural change to adopt it on the one hand side, but then on the other hand side also to point out what is the human value in the process. And I would be super interested in your view on that.

06:40

Anjali Bhagra

Yeah, I think you raise a very important point. What is the right way? And I'm speaking specific to healthcare. For us to bring this to our toolkit. So as a physician, if we really think about, you know, what have physicians used, what's, what has been in our toolbox, in our toolkit to really help patients, that has continued to grow over the decades. I think right now we are at an inflection point because our capability with technology is rapidly growing exponentially by the week. Yes. But it really begs a very important question. You know, what is the right way to integrate it into the experience of healing? And I would say healthcare is not insulated. If we really look at the adoption curve of humans with these technologies, we can all agree that we lean towards these for comfort, for efficiency, for, entertainment for a variety of different reasons. I think what's unique in healthcare is, you know, we are talking about lives. We are talking about patients', people's privacy. We are talking about much higher stakes. We have much more to lose. And there is a distinct component of human touch in healing that contributes to recovery and healing, right? So what is the best ingredient and how do we bring it together What is that right size of human in the loop and tech integration? These are all excellent questions, and I would say our guiding vision at Mayo Clinic is needs of our patients come first. That is something you can ask any Mayo Clinic employee in our sleep at any time during the day, and you're gonna hear it come out from pretty much over 80,000 people at Mayo Clinic. And I think when you have a very strong foundation like that, that becomes a unifying vision for all of us who are working at these tools. So when I say all of us, I mean the clinician leaders, I mean the operational leaders at Mayo Clinic, I mean the technology leaders. And when we come together, that's where magic happens. And that's where we move this whole idea of how do we help the patient in front of us? You know, what are the key ingredients? Where do we need to retain the human touch? Where do we need to bring AI to build efficiency, productivity, that extra layer of safety, that extra layer of quality? And most importantly, I think in medicine, we are all eager to deliver the next-gen cures. We want the experience in healthcare to be preemptive, to be precision-oriented, to be individualized, to be preventive. So there's a lot we want to do. But we haven't had the kind of tools that we have today. It's up to us. I think it's a collective responsibility now across sectors, across industry, that we do it in a responsible way that's fair, that's accountable, that's effective, that's safe, that's valid.

09:53

Inga Bergen

And you mentioned that, I mean, the level of innovation, the speed of innovation, it's from how I observe it, it's getting faster and it will become faster and faster and faster and faster. And there will be cures for diseases that we don't have today. But they will of course not be available for everybody because the systems need to adapt and, and the innovative healing methods need to find their way to the patient. And this is super interesting, the speed of innovation at the one hand side and then the capacity of adopting innovation, on the other hand side, the right mindset you actually need. Let's get more concrete how you make sure that at Mayo Clinic, because of course you're one of the most prominent and most innovative healthcare providers or hospitals in the world, hospital chains in the world, how do you make sure you're on top of the game and you integrate all of that?

10:56

Anjali Bhagra

Yeah, Inga, thanks for that question again. I would say I shared our guiding vision a little bit ago. How we bring it to life today is very exciting, number one. I would say as an organization, we are committed to innovation. It's one of our core values at Mayo Clinic, and we have made deliberate investments for anything to come to life. There needs to be visioning, of course, you know, strategizing, but then also commitment of resources into that. One of the things that I feel very fortunate of that Mayo Clinic is spearheading is a platform model for medical care. And what this model really allows us to do is make care accessible across the globe, 'cause you mentioned it in your comment, We want to ensure that we move away from a very traditional pipeline model of care. A patient will come to my clinic and will go to 10 other places to get the kind of care they need. We want to really flip that to a true platform model where we can bring in different partners from technology, from biopharma, from biomed, all of that in a big platform model of care. So I think Foundationally, us spearheading that largest data sort of collection across the globe has been a very, very, very strong and robust foundational step. I would say internally how we make it happen is again through an ecosystem and orchestrating people, processes, and technology. So for example, to give you an example, our team works with multiple other teams including our IT team, including other groups engaged in building foundation models, GenAI capabilities, teams within our strategy to really come up with a roadmap, a well-strategized roadmap that defines what our short-term, near-term, and long-term goals would be. To give you an example of a tangible project of this is our current rollout of deploying technology in the exam room. We are using ambient AI tools that listen in the background and automatically draft clinical notes. Imagine being able to focus entirely on your patient, making eye contact, making that experience for the patient more human and more, and less distracted while the note practically writes itself. And we are also looking at going to the next step and automating the coding, billing, and other tasks that clinicians spend a significant time doing. That's the kind of transformation we are able to bring in the exam room with a collaborative team behind it, which includes our technology partners, which includes IT team at Mayo Clinic, which includes the strategy team at Mayo Clinic, which includes clinical leaders at Mayo Clinic, as well as our operational leaders. And I think we can see— I don't think, I know we can see direct benefit to our patients when their medical conditions are comprehensively and accurately documented and it's available to them, you know, for access. I would say another example on our business operations side would be deployment of bots and intelligent agents to streamline parts of our revenue cycle process and other business processes, including things like prior authorizations. These aren't the flashiest tasks, but in the background, this invisible work, when automated with an effective workflow, really provides smoother access to care, patient experience, and financial clarity.

14:47

Inga Bergen

And if you, if you talk about a platform model that allows Mayo Clinic to offer care to basically every person around the globe, or to offer care to every hospital, to every physician around the globe, to offer this access to, well, automized— well, I'm trying to find the right word for it, but it would be automated processes that deliver the best possible diagnosis, care, whatever it might be? Do you think of that when you talk of a platform, or can you describe what platform means to you in that sense?

15:34

Anjali Bhagra

Yes. So Inga, for any complex problem to be solved with technology, I think you need 3 components for there to be a solution. First is data. What are we going to use at its core to be able to understand the problem, to be able to have some very objective, tangible information to act on. So that's foundational. And that's exactly what Mayo Clinic platform provides. De-identified data from across the globe, which is diverse, which is not limited to only one kind of population, but really allows for the data pool for these tools to be born. The second thing that's needed is compute. We can have all the data, but if we don't have the means to orchestrate a solution that can be very robust with strong inference and, you know, the blueprint, then obviously, you know, we aren't going to be able to create the solutions. And the final thing that's needed is talent. We can have the data and the compute, but if we don't have the right talent at the right time for, for developing and for deploying these solutions, then I don't think we can reach the kind of impact that we are talking about at a global level. And essentially, the Mayo Clinic platform provides all of these, the data, the robust data, that's required, the kind of tools that go into creating these solutions, and also the talent for the development and deployment of these tools, not just within our organization, but all organizations that are participating in the Mayo Clinic Platform model. It's not just within United States, it's across the globe. So that's what I mean in simple ways by Mayo Clinic Platform.

17:32

Inga Bergen

Yeah, okay, super interesting. I refer to my conversation with John Halamka, who was at the time— Yeah. We had recorded the podcast. He was running the Mayo Clinic data platform. And yeah, it's really, yeah, it's mind-blowing what becomes possible if you have that structured data and that access. And if you actually, now that I speak to you, combine it with automation and with cultural change, well, it becomes really a force. And that's the second thing I want to talk about. That's your second role that you have, you're building a culture of belonging at Mayo Clinic. And I also had never, well, come across that vocabulary, I think, in all my conversations for my podcast. And I wanted to ask you at first, can you explain what is an Office of Belonging and what does that mean?

18:30

Anjali Bhagra

Yes, absolutely. So Mayo Clinic, we, as I shared earlier in my introductory comments, that belonging is a strategic imperative at Mayo Clinic. This is prioritized from top-down, bottoms-up, and all around at Mayo Clinic. With this, we know that within our organization, it's very important that every member at Mayo Clinic feels valued, feels seen, feels supported, and recognized for their efforts. We also want to ensure that our patients feel that same sense of belonging from across the globe when they seek care and healing at Mayo Clinic. So we at Mayo Clinic have measured belonging over the last 5 years. It's part of our staff surveys. This is something we pay deep attention to. We track, we try to understand through various sentiment analyses, at Mayo Clinic. So I would say belonging, psychological safety, the wellbeing of our staff, and our commitment to our values all go hand in hand. What we do really within the office is we work with teams across our sites and Shields. So sites including Arizona, Florida, as well as Minnesota and our health systems and international locations. As well as our colleagues working within clinical practice, our staff working within research, our staff working within education. So those are our three shields. We really intentionally architect our environment, our environment including our physical environment, our psychological environment, as well as our cultural environment, with a goal that every individual, regardless of background or identity, feels empowered to thrive. And we do this through several teams that are embedded. This is not a top-down thing. It's a very grassroots level, I would say, initiative. It's driven by our staff. It's driven by our colleagues. It's driven by leaders at all different levels within Mayo Clinic. Once again, with the single north star of making every person at Mayo Clinic feel valued, feel belonged, and ensuring that we cultivate that psychological safety.

20:57

Inga Bergen

And I mean, you also reflect a lot on leadership in the, I mean, in the era of AI and automation and all these new possibilities. And that's what I would like to deep dive into a little bit because I feel the role of medical personnel is changing. And it's not, well, it's not easy for everybody. And it's also something that we just started discussing. Actually, in my sphere, the narrative was AI won't replace humans for a very long time. And now we see, okay, this is basically not 100% true. It will replace some parts of human work. And then also roles will change and this requires a new leadership. How do you frame that?

21:54

Anjali Bhagra

Yeah, Inga, I think this is a collective responsibility. This is really where we— it's a societal responsibility for all of us because essentially what we are seeing is a shift in how we do our work. We also know based on birth rates across the globe and the projected shortages in pretty much every industry, but very, very stark deficits in available workforce in healthcare. We know that it's impossible to recruit from a deficit. So I do want to begin with that. And this is not as widely recognized because I think there is so much hype around AI and there is sometimes a more dystopic view on, you know, what AI will do to humans. And I also want to bring the other side, which is the more utopian view to this, and that is that realistically speaking, we have a shortage of physicians. We have a shortage of every kind of healthcare worker, including nurses, surgical techs, and you name it. We are really in a state where we've got to strike that balance when we bring these tools and technologies in and really frame and try to carve out how they— this tool will help us mitigate that shortage as well. And candidly, when we bring these tools in, the nature of work that humans do will shift. And that does mean that we will readjust in where we deploy humans in the loop and where we feel that the AI is going to deliver a safer, more efficient, more productive, with higher quality sort of benefit in that care journey for our patients. This will be a moving target. There will be results in shifts in the kind of work that humans are more suitable to doing. And I don't see this being any different than every revolution that we've faced, starting from the Industrial Revolution. If we really look at manufacturing plants, you know, 5 decades ago to today, they look very different. And can we argue on the quality and the safety that we have created. So I think it's necessarily the same shift happening with the exception that unlike some of the other revolutions, AI right now is in the hands of 8 billion people potentially on planet Earth. So I think what's unique now is scale. What's unique today is the democratization What's unique today is the massive access to everyone. So it's not just that the nature of work is changing, it's how we live is changing, how we consume anything is changing, how we consume information is changing, how we consume entertainment is changing. You can get access to YouTube on a Delta flight now in real time. So it's, it's an entire shift. In how we live. And I know we kind of get a little more dystopic when we talk about work and how AI is really going to replace humans. But I would, you know, really bring that challenge back. It's not just a pocket.

25:15

Inga Bergen

I don't think that it's necessarily a bad thing. Right. Because I mean, we could talk about so many more topics that you work on. For example, physician well-being and resilience, you know, and the workload on the workforce at the moment that is, yeah, that is really hard for many people working in healthcare. So there's a lot to do, but we don't have that much time, unfortunately, even though I would enjoy talking to you for hours more.

25:47

Anjali Bhagra

Inga, if I could make a quick comment on the workload and the burnout and the stress and the exhaustion for healthcare clinicians and providers. So since I've devoted a lot of time studying it, and we have a lot of teams at Mayo studying this, I would say in the last decade, a lot of our work was focused on admiring the problem. There was a lot of research around why we are so burnt out and why we are so stressed. What is the role of individual resilience versus organizational resilience. To me personally, what's most exciting right now is that with these tools, we are actually doing something about it at scale, which was very difficult to do without technology. I shared examples of documentation burden and the administrative burden with you earlier. It was nearly impossible to do something at scale within healthcare prior to this. So I really think we are at a very exciting time where we can actually address these problems of burnout, exhaustion, and significant amount of stress in the healthcare system.

26:57

Inga Bergen

Yeah, I totally agree. So we have the utopia in front of us. We can have the utopia in front of us. You said multiple times it's a, well, the society, it's a task for our whole society. It's something we face and we have to shape. What do you think? What is it that AI and automation cannot replace in healthcare?

27:22

Anjali Bhagra

AI and automation and technology will never replace the human touch in healthcare. They will never replace the human empathy in healthcare, and they will never replace that experience of healing that humans provide to humans.

27:40

Inga Bergen

Yeah, that's a great sentence. I think for every patient who has been in a difficult situation and had that, well, a human seeing him or her knows what you're talking about. And you have such an impressive career and you're so on the forefront of so many developments. I would just like to I would like to ask one more question. What kind of trends are you watching right now that you find really interesting and that our listeners should follow?

28:15

Anjali Bhagra

The first trend that I will highlight, which we talked about a little bit earlier, is democratization to access. I think this is powerful. This is something we need to keep in mind when we design tools. This is something we have not experienced in the past at this massive scale. So my colleagues and listeners, if you are engaged in this work, keep in mind the massive scale that can be driven because of the democratic access to this technology that actually is now available to our patients as well as providers within healthcare. I think it's a unique opportunity for us to empower our patients. The second thing that I want to really highlight is whatever we are building for today is obviously the worst possible technology 'cause it's getting better by the day, by the week. Keep that in mind. I don't think any one of us can be aspirational enough. And so that is a very important trend to all of us within the field to be mindful of. I would also bring forth this concept of hyperautomation and really augmenting, automating, and collaborating so that we aren't doing this in silos, but really looking at problems and the potential to solve them end-to-end versus siloed tasks. And finally, I would say and put another plug-in for human-in-the-loop automation. I think that is— there's a lot of focus on this. There's a lot of emphasis on this for all the right reasons. There are global organizations really spearheading of what this could and should look like. And I see this trend growing over the next months and years with really a focus on robust governance to make sure that whatever we build is for everyone. That focus can never be lost.

30:22

Inga Bergen

Yeah, I mean, that's really a great and such an important point. I'm really happy actually that I can listen to our conversation again because there's so much in it. And do you have one book or do you have a principle to share that shapes your leadership?

30:41

Anjali Bhagra

Inga, I would kick off with Don't wait to be ready. Transformation doesn't come from perfect plans. And this is something that I can vouch for. I've failed multiple times, got back right up with the help of our teams. It really comes from courageous steps. So be bold. Don't wait. Surround yourself with people who see the potential, who can co-create, co-develop, and reimagine the future. Don't try to fit in. Into the current state. One book that I would highly recommend is "The Age of AI" by Henry Kissinger, Eric Schmidt, and Daniel Huttenlocher. It really explores how AI is reshaping. It's reshaping knowledge, it's reshaping power, and it's reshaping our society. It, it calls out the challenges that we leaders face that we need to think about. And these are not just technical challenges, but these truly are philosophical and ethical challenges. And I know we are talking about technology and belonging together and how we cannot lose track of why technology is so important at this point. It's really shaped how I view AI in healthcare, which is not just a tool, but really a force that we have a responsibility to guide with intention and with human belonging at its core.

32:07

Inga Bergen

So thank you so much, Anjali, for this great conversation and for all your insights and also for your work. And I'm looking forward to meeting you at Health Europe in Amsterdam very soon. Thank you so much for your time.

32:22

Anjali Bhagra

Me too, Inga. It's been such a great time hanging out with you. You have a great one and see you soon.