Xi (Sisi) Hu, PhD & Heather Schmidt, DO • Live at the Summit

This episode was recorded live at the 2025 Joy & Wholeness Summit in Asheville, North Carolina.

Dr. Xi (Sisi) Hu is a Co-Founder and the Chief Wellbeing Economist of Atalan Tech, a mission-oriented startup focused on using machine learning to predict and prevent clinician burnout and turnover. She is also a Fellow of the Center for Labor and a Just Economy at Harvard Law School and Research Economist at the National Bureau of Economic Research, with a research focus on labor issues. She specializes in modeling disruption and risks in labor markets, and is passionate about protecting the wellbeing of workers in the healthcare industry. Dr. Hu received a National Science Foundation grant to study COVID’s impact on healthcare workers. Her expertise is in risk science where her work has received media attention from around the world including the World Economic Forum, Sky News, the UN, among others.

Dr. Heather Schmidt is a family medicine physician in Fond du Lac, WI, who trained at Midwestern University and completed her residency at Exempla/St.Joseph’s Hospital. She became the Medical Director of Health and Wellness at Agnesian HealthCare in 2013 and transitioned to the System Medical Director of Healthy Work and Well-being for SSM Health in 2020. Dr. Schmidt has collaborated with various partners to integrate well-being into initiatives such as leadership development and employee safety and has been instrumental in implementing the SSM Health Care for Caregivers peer support system and Schwartz Rounds. She continues her medical practice with a focus on weight management and mental health and enjoys spending time with her husband and daughters, skiing and boating in Wisconsin.

Thanks for tuning in! Check out more episodes of The Well-Being Connector at www.bethejoy.org/podcast.

Transcript

Introduction: 0:00

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Voiceover: 0:13

Welcome to another episode of The Well-Being Connector podcast hosted by Roy Reid and sponsored by the Coalition for Physician and APP Well-Being. This episode is one of a multi-part series recorded live at the 2025 Joy and Wholeness Summit. Thank you for listening.

Roy Reid: 0:31

Welcome to the Well-Being Connector podcast. We are recording live from the Joy and Wholeness Summit here in Asheville, North Carolina, sponsored by the Coalition for Physician and APP Wellbeing. I am joined now by Sisi Hu and Heather Schmidt. They're getting ready to do their presentation here tomorrow at the conference, and they're going to do a little bit of conversation with me today to outline the program they're working on, the results they're getting, and some of the things that they see in the future. So welcome.

Heather Schmidt: 1:04

Well, thank you for having us.

Roy Reid: 1:06

Absolutely. So we like to start with the journey that brought you to wellness and wholeness and what motivated and inspired you to do the work today. So Heather, why don't you start out?

Heather Schmidt: 1:17

Okay. Well, I'm a family medicine physician. And so I was actually trained as a DO and that was intentional. I really am just very focused on prevention and just that holistic healing, kind of really thinking about all of those things that are innately with in us that can help us be as healthy as we can be and thrive. And so many years ago, I actually was already starting to get kind of frustrated with medicine. I wouldn't say burnt out, but frustrated with how we did things, you know, just always taking care of the disease, but not really thinking about that whole person. And so shifted the way I did my medical practice. And that then grew into a role with my smaller healthcare system at the time that was focusing on wellness with other employer groups, our own employee and providers and then also patients and schools and kind of just doing some fun things in the community. And that really grew into really thinking about what does the work that we do look like and how do we actually change how we do our work to promote health versus just relying on those kind of things that we do as individuals to keep ourselves healthy, but recognizing that impact of the environment. And we joined as part of a bigger healthcare system. So SSM Health And just had really gotten to this idea of this changing people's mindset about wellness and opening people's minds that it's not an individual problem, that it's a system problem. This was 10, 12 years ago. So it was the common practice at that point was to rely on the individual. This was back in the day when it was yoga and meditation, right? You just take care of yourself and it's all up to you. But so I feel like it's been a long journey. It's, you know, I think I started this maybe in 2010 or so. But just this whole idea of how do we help people thrive and help people stay so close to their own meaning and purpose? Because that's how I've continued to do the work I'm doing. Well, how I stayed in medicine, really, right? And so wellness is just one of those things to me that I think is fundamental for our healthcare system. And if we don't help our own healers, how are we going to continue to take care of our patients and communities? Wow.

Roy Reid: 3:30

Sisi Hu.

Sisi Hu: 3:31

Yes. So I come from a slightly unconventional background. So I'm a trained economist. When we first started this work, I was working as a researcher at Harvard, looking at different types of disruptions. So I actually think of myself as a disruption scientist. So I was looking at climate change, how climate change affects the labor market, the economy, and then I moved into technological disruption, which is when I started looking into AI. But anyway after as a side project we put in a proposal for a National Science Foundation funded grant looking at COVID impact on healthcare workers that's when we actually started really getting into the burnout and thinking through it from a labour lens like what does that mean for the wellbeing of our clinicians and then we started interviewing health system leaders like Heather and Heather was one of our first respondents thank you very much so I called him out Heather and we started this work together and then I co-founded a company with my co-founder Tiffany at Lance. We developed a workforce intelligence platform. That's kind of how we got started into this and we used machine learning to predict the people who might be struggling on their own silently, thinking through how can we prove the ROI of investing in our clinicians' well-being. Awesome. Well, and the funny thing was that she says she emailed me. Somehow I caught the labor workforce department and thought, well, this is exactly what we need. We need to look at this economic impact. We've got to figure this out. And so we had this wonderful conversation that just opened this door for this partnership that really, I think, was divine intervention because it really came at the time where as a leader in a larger healthcare system across multiple states how do you know how people truly are doing and so this idea of this dashboard and really looking at kind of different types of data objective data in combination hopefully at some point with subjective data then we truly know how people are doing so we use data for everything else for population health so why are we not using it for our own clinicians?

Roy Reid: 5:45

Unpack the program that you brought to share with the group at the conference today. Tell me a little bit about what that looks like, how it's working and what you're striving to achieve with it.

Heather Schmidt: 5:57

Do you want me to take it? Okay. a little bit about, you know, well, what about interventions we've done? And how do we know that they're truly effective? And how do we invest in those ones that are actually working? And how do we scale them? Because there are best practices all around our system. So how do we identify those and be able to get our other regions being able to benefit from those same interventions? And so that's really what we're presenting tomorrow is one particular or two particular projects that came to us not actually through the projects themselves weren't to improve well-being. They were to improve patient care. But the people that were running the project were very interested in how did that impact well-being? How did that impact retention? And is it making a difference or not? Yeah, I think just kind of to add, I think what excites me the most is the potential of this methodology that we developed together to basically evaluate any intervention, any program that you have that looks at, you know, when it's a quality project, safety project, or it could be a well-being project. But I think part of the story that's missing right now is it's really hard to quantify what are the ROI, what is the return of investment in your programs? How do you actually prove that your program works? So this methodology is designed to be actually retrospectively create an RCP, like a randomized control trial through the data infrastructure we set up. So you can basically look at any program and then retrospectively and on a long-term basis say, hey, this program is working on this particular way. These are the metrics that we actually observe changes in and they're statistically significant and these are the things that don't work. We don't see any effects and these are some of the unintended consequences. So I was really shocked, not shocked, but surprised, very happy to see that the clinical pharmacist program that SSM Health had, had impact on not just the quality metrics but also the well-being. So we saw actually turnover risk for that group of people who received the intervention, we call it, reduced by substantially amount, and that equated to $1.6 million of cost savings that you never thought about quantifying before. So being able to visibly show some of this evidence and metric changes, I think it's what really excites me.

Roy Reid: 8:46

So unpack the details of that work that you did and describe for the audience the interventions and then what that did and then where it took them.

Heather Schmidt: 8:55

Sure, absolutely. So our One of our ambulatory pharmacy leaders, her name is Drea Meyer, we have a pharmacy residency project. And each resident has to do a project. A pharmacy residency, sorry. And each pharmacy resident has to do a project. And so this particular resident, Brooke Watson is her name, she came to me and just happened to say, hey, do you have any HR data on retention from providers? And I said, well, maybe we could take this one step further because she was looking at the economic impact of this particular intervention. And so we were able to, some of our clinics have an embedded clinical ambulatory pharmacist. Some don't. The project themselves actually started because we have very medically complicated patients. And we know that a lot of literature will show that pharmacists as part of the healthcare team can help offload some of that cognitive burden, can help manage those medical, the medicines that go along with these medical issues. And so, but we don't always have buy-in from some of the clinicians, but we also don't know that we have funding to make this possible across every single primary care site, right? This is one of these, is this going to make a difference? And so she actually had designed her intervention with subjective feedback, which I think is also very, very important. But we were trying to look at the objective data variables. So I took it to Cece and her team and they said, well, yeah, I think we can figure this out. And so that's where it came from. And so she could speak to the science behind the predictive analytics and machine learning piece much more effectively than I can. But yeah, no, I think it was really cool to be actually able to do that study because we got the data from Drian Burke and then really found another control group. Like, you know, how you would do a normal randomized control trial, you would find another group of people who are similar. So we developed an algorithm to basically match the treatment group, the people who had the clinical pharmacists with another control group. And then the match was really the score it was so high. I was like, oh, wow, you have so many similar providers. But anyway, and then we were able to test the differences of the people who actually got these help. And we saw a lot of improvements around documentation time, actually less pajama time as well, as well as per encounter, five minutes increase that they were able to spend more with their patients, which is what they're coming to medicine for. So being able to, I think I just, I was just so excited to see the numbers and then to see the graphs, which we'll present tomorrow. There are slightly confusing, but we'll make it work. I know we've presented this, we've got really good feedback, but I think we've got to a point where it's easily explainable. But super interesting results and hopefully we're also going to look at DAX as well. Yeah, so as you probably have heard, the ambient documentation is all rage, right? So it's helping to use the AI technology for good. And personally, I got my DAX just a couple weeks ago and And it's absolutely amazing. It's like a game changer. But we've been trying to really look at how do we implement this in the best way? Because it's very expensive and it's a huge investment. Everybody wants to do it, but it's, you know, we have to be smart and good stewards of financial resources as well. And if people aren't going to really use the tool, then why would we invest in it? And so we have been working with our IHT team and they have been kind of providing us the early adoption. Like a list of those early adopters and then kind of adding to that and then already seeing some benefits. And, you know, that it's hopefully going to help people understand that this can be very effective and this is worth a larger investment of both the provider's time to learn how to use the tool, but then also financially, of course.

Roy Reid: 12:51

And describe a little more detail of the intervention itself. What happens and what's Absolutely.

Heather Schmidt: 13:00

So DAX is actually a tool. And so people, if they get the license, so usually the way we've been trying to identify those are, we had our early adopters, but then also our leaders are recognizing who really could use some help. And then going to them, asking them if they're interested in using this tool, because some are not, you know, some are very hesitant to use the tool. And then being able to, once those licenses are secured, then we actually do that. a training and there's like a small group, like a cohort of people that are kind of meeting and learning from each other. And then they get some time to use the tool and then they can work with our IH team to do further training and kind of more customization of the tool. But I think what we've learned is that it's not plug and play. You know, it is going to be, you need to invest that time up front and you also need to make sure that you are engaging accepting of maybe your note looks a little different than what it would if you were to dictate it or type it yourself. So that's kind of the intervention in and of itself. We're just on the back end watching all of these kind of objective data variables that have been identified to be drivers of workplace well-being and burnout and turnover. And so some things we're seeing are maybe expected and other things we're like, oh, we didn't really expect to see that as an outcome, right? And so it's this idea of real-time And being able to course correct as needed is what my goal is, is to be able to say, okay, we're doing all these interventions. What's working, what's not? What's working if we tweaked it here, right? But it's almost this objective voice of those participants as we're also then trying to get that subjective feedback from them along the way.

Roy Reid: 14:43

And what are they doing now differently with the tool? What are the actions that are happening on the unit within the team that then creates the measurement? So

Heather Schmidt: 14:54

I'll speak to Dax mostly because, and I can only really speak to my own practice, but when I go in with a patient, I basically say, hey, I have this new documentation assistance. Are you okay with me using it? Of course, you always have to give verbal consent. They've all been very receptive. I hit the button and I sit and talk to the patient. And so I can be present and I can really truly hear, right? I can see that patient. I can like really make them feel valued and that their time matters as much as, you know, like then I'm spending that quality time with them. And then they, the documentation tool will tee up my note for me. And then I can correct it. Sometimes if I have a little extra time, I'll actually show it to the patient. We correct it together. And then we, they feel really comfortable with the plan. And then boom, I hit sign, note is done. No longer am I going back to my office and spending hours doing my notes or after work and closing my notes. And so that's ultimately the goal. And this ambient documentation has been kind of all the rage and well-being for a while. Yeah. It's people, we're not necessarily seeing like that change in some of the EHR metrics. So there's more to it than that, right? So it's really changing culture, I think, too. Some of us are used to going home and logging back in and we're used to doing our inbox after hours. And so we might have to change a little bit, you know, just coaching along the way.

Sisi Hu: 16:19

Yeah.

Roy Reid: 16:19

So layman's terms, you're giving people their life back. Absolutely. By automating the process and creating the discipline around that then gives that freedom to work on the other things that are important to them. Yes, absolutely. And so Cece, from a number standpoint, from an outcome standpoint, tell us about the results your team takes and then looks at for what the outcomes are going to be.

Sisi Hu: 16:45

For DAX or for the whole things that we've looked at,

Roy Reid: 16:50

Start with whatever you think is most important.

Sisi Hu: 16:53

Okay. So I think for just AI, like docs in general, I think what we found that was really interesting is that the effect really takes place for differently, for different specialties. And it depends on the demographic. So we saw younger docs are much more, actually. most of what I'm looking for, willing to adopt new technology. I think there is a piece around understanding, okay, out of like a population of 4,000 providers, who should you get the technology first? So there's a lot of work that Heather and I were sort of trying to figure out, well, should we be targeting maybe like providers of a specific group that are really struggling, for example, with that augmentation time? So going back to some of the data modeling work that we do, so we basically, for everybody, we make a prediction using machine learning, right? We take data that health systems already have, the electronic and health records and HR data, but essentially we're able to say, okay, all of these providers are struggling in this particular issue, and then they're really not doing very well. And those are the people, so we developed actually a prioritization card for rolling out some of these technological advances, or even I think for other interventions, it's really important to think about who would benefit the most from a particular intervention. But being able to say, okay, this is the, you know, out of 4,000, the top 10, 100 who are really struggling and they're struggling specifically for documentation. That's the subgroup of people you should, you know, roll out first and then help them, you know, and then sort of like do a hierarchical approach, right? And I think that what I'm really excited about with the work that I'm doing with Heather is we can sort of almost customize this approach to other types of interventions because we track 100 plus risk factors. So if you're developing an intervention that targets not necessarily documentation burden, but something else, we can have a measure that really sort of roll out that way. So you can help really to identify the people who will be struggling the most.

Roy Reid: 18:52

And from all of that, what are the downstream benefits that occur in their lives? What are the changes that you're seeing happen? And what's the transformation that occurs with that team?

Heather Schmidt: 19:04

Yeah, so what we're hearing back from subjective feedback from testimonials, right, people using this tool is this is actually going to prolong If I didn't have this, I might have retired, right? Things like this is a game changer. This is giving me time back at home. So we know that subjective feedback has been very positive. When we want to be data-driven and really understand, is this going to be a bigger system-wide change we should make, then let's actually continue to get the objective feedback too, right? So that's kind of our goal is to really have that comprehensive evaluation. Yeah. Okay. we do and so with that sole intention of giving time back to our clinicians and so our chief digital health officer Saad Chaudhry is his name this is his goal is to give time back and so we are working with that IHT strategy team to look at different interventions and what is the timeline of that implementation who would be that audience that will receive this intervention and how do we proactively track and so that's kind of next phase is where we're trying to go

Roy Reid: 21:11

Outstanding. So as we reach the end of our time together, what do you envision being some of the other outcomes that you're hoping for in terms of the overall impact on wellness, on wholeness with people?

Heather Schmidt: 21:27

Are we just talking about... You go first?

Heather Schmidt: 21:57

...believe nobody is trying to cause harm. But everybody has a job to do, right? So how do we actually know that sometimes there are happy accidents, but sometimes there are unintended consequences and these downstream effects of a decision that we make that we don't right now have a great way to measure that more proactively. And so in a perfect world, that's how I would see us using this. We're working with Adelante to develop a nursing dashboard as well. And in our process of doing this, we're working with our bedside nurses. We're working with our bedside nursing leaders to really design a tool. They have been incredibly amazing to work with, to design a tool that's going to be most meaningful for how they do their work. And so how do we continue to stay as kind of keeping the pulse on in a way that's going to be scalable across the whole system?

Roy Reid: 22:48

Sure. Sisi anything?

Sisi Hu: 22:50

Oh, I want to talk about what we talked about earlier, like that was your idea around connections, but being able to measure connections in a quantified way through data. We were thinking about coming up with some models to think about, okay, well, can we measure maybe the ways that our providers are connected with nurses, inbox messages, for example, but being able to say, hey, if you affect, you know, that contagion effect, but being able to actually quantify it and say, oh, well, if Dr. Heather Schmidt here is not doing well, who else in her arena is going to be affected? That would be so cool. I think it's doable. We have some literature that has network science and has done some work around that. That's probably one of our innovation projects for next year. Stay tuned. Other than that, I think quality and all the other stuff like nursing for other populations, residents, would be really cool to look into too.

Roy Reid: 23:46

I look forward to our next podcast where you talk about those things and how the impact is having. So thank you first for the work that you're doing. Thank you for sharing it with our audience today. I know they're going to benefit from everything it is and look forward to hearing how tomorrow goes with your presentation.

Heather Schmidt: 24:03

Thank you so much.

Roy Reid: 24:05

Absolutely.

Voiceover: 24:09

Thank you for tuning in to the Well-Being Connector podcast, brought to you by the Coalition for Physician and APP Well-Being. The Well-Being Connector offers insightful conversations with healthcare professionals devoted to fostering wholeness within their organizations. Each episode delves deep into the holistic approach to well-being, underscoring the importance of physical, mental, social, and spiritual health. For more episodes, visit our website at www.bethejoy.org /podcast.