Latest / Becker’s Healthcare Podcast / Lisa Borbon, MSN, RN, BC-NE, Administrator for the West Florida Division of Advent Health Home Care

Transcript

Lisa Borbon, MSN, RN, BC-NE, Administrator for the West Florida Division of Advent Health Home Care · Becker’s Healthcare Podcast

• 0:00
  Hello. This is Francesca Matthews with the Becker's
• 0:02
  ASC review podcast.
• 0:04
  I'm thrilled to be joined today by Lisa
• 0:06
  Bourbon,
• 0:07
  MSNRN,
• 0:08
  administrator of West Florida Florida division of AdventHealth
• 0:11
  Home Care. Lisa, thank you so much for
• 0:14
  being here today. Thank you for having me.
• 0:16
  Yeah. To start us off, could you please
• 0:18
  introduce yourself and tell us a little bit
• 0:20
  about your background?
• 0:22
  So, yes. My name is Lisa Bourbon. I
• 0:24
  have been a nurse for twenty six years.
• 0:26
  I have been in leadership probably about twenty
• 0:29
  of those twenty six years in executive leadership
• 0:32
  probably for the past ten years.
• 0:35
  My experience,
• 0:36
  extends from the front door of an ER
• 0:39
  working as an ER nurse,
• 0:41
  to the backdoor of hospice. I've worked in
• 0:43
  hospice, and I've I've also done different, leadership
• 0:46
  roles and executive leadership roles all through the
• 0:49
  all through my career.
• 0:51
  And I designed my career that way because
• 0:53
  I really wanted to understand what the patient
• 0:55
  goes through when they are coming into the
• 0:58
  to the world of medicine
• 1:00
  as a sick person.
• 1:01
  Mhmm.
• 1:02
  Absolutely. And what are the top three trends
• 1:05
  that you're following in health care today?
• 1:08
  I'm most interested in, the telehealth,
• 1:11
  the wearable medical devices that are moving way
• 1:14
  beyond anything like fitness watches. I mean, there's
• 1:16
  so many new things that are coming,
• 1:19
  that really gives more control
• 1:21
  of our patients,
• 1:22
  and their
• 1:23
  their decision making process for their diseases and
• 1:27
  and to be healthy. And all the AI
• 1:29
  driven
• 1:30
  products that are coming out that would really
• 1:32
  help with these predictive algorithms
• 1:34
  and provide more, how do you say, precise
• 1:37
  patient insights,
• 1:39
  making sure we really understand their diagnosis, making
• 1:41
  sure we've got the right diagnosis. So all
• 1:43
  of those things have really been on the
• 1:45
  top of my mind for the for the
• 1:46
  top three trends in health care.
• 1:48
  Mhmm. I've definitely heard a lot in that
• 1:50
  kind of that last component of what you
• 1:52
  mentioned there. Just make we're using AI to,
• 1:54
  yeah, kind of cut out any,
• 1:57
  you know, inefficiencies
• 1:58
  or also just, like you said, make everything
• 2:00
  more precise and,
• 2:02
  that kind of overall just, like, streamline the
• 2:04
  diagnosis and treatment process. There's so many advancements
• 2:07
  happening there.
• 2:08
  So many. What are you most excited about
• 2:11
  right now? We just mentioned a few things,
• 2:12
  but what else are you excited about in
• 2:13
  health care?
• 2:15
  I think that, you know, really, those are
• 2:17
  the three things that are exciting me as
• 2:19
  well because this puts a lot of the
• 2:20
  information into the patient's hands. If they become
• 2:23
  a partner in their own medical journey,
• 2:26
  they're not just,
• 2:27
  passive
• 2:29
  recipients.
• 2:30
  They can give us information
• 2:32
  that we may not see because we're not
• 2:34
  with them twenty four hours a day, seven
• 2:35
  days a week.
• 2:37
  So it really is
• 2:39
  a challenge.
• 2:40
  It's a challenge and a gift, I think,
• 2:42
  in both is that they understand what was
• 2:45
  happening to them in their body and and
• 2:47
  what they can do to prevent it, but,
• 2:48
  also,
• 2:49
  we don't want them to have too much
• 2:51
  information that gets them to the point where
• 2:53
  they're very nervous,
• 2:55
  and are thinking about things that plausibly are
• 2:57
  not happening. So I think
• 2:59
  the wearable devices, the telehealth,
• 3:02
  the AI driven
• 3:03
  personalization
• 3:05
  really helps them get the right information in
• 3:07
  their hands so that we can have
• 3:09
  a really great conversation on what they're gonna
• 3:12
  do and what they're not gonna do to
• 3:14
  improve their health.
• 3:16
  Absolutely. And, it's really interesting the point you
• 3:18
  just brought up. It's kind of double edged
• 3:20
  sword of,
• 3:21
  you know, the democratization
• 3:23
  of medical information. It's
• 3:25
  you know, as both a writer and then
• 3:27
  also as someone who experiences health care, it's
• 3:29
  it's it's really interesting to kind of
• 3:32
  have all, like you said, all the information
• 3:34
  that can sometimes be overwhelming. I'm just curious
• 3:37
  as a follow-up, if you have any experiences
• 3:40
  or
• 3:41
  if you can speak to the process of
• 3:43
  finding that middle ground with patients
• 3:45
  where, you know, they can be empowered with
• 3:48
  information and have more access to education about,
• 3:51
  you know, medicine and whatever their health concerns
• 3:53
  may be, but
• 3:54
  I know it can also
• 3:56
  kind of verge into the concerning where people
• 3:57
  maybe are coming in with inaccurate information or
• 4:01
  overly concerned about something that's not the key
• 4:03
  not their diagnosis. Just can you speak to
• 4:05
  finding that balance a little bit? Yeah. I
• 4:08
  think the key in finding that balance is
• 4:10
  truly understand where their mental health is as
• 4:12
  well. I mean so just a little
• 4:14
  background. You know, my mom in the past
• 4:17
  two years has had, unfortunately,
• 4:19
  three falls
• 4:21
  and three breaks, and, you know, she
• 4:23
  she thinks that
• 4:25
  the more she falls and the more she
• 4:27
  breaks a bone, the less time she has
• 4:29
  on this earth. And I I think she
• 4:31
  read that somewhere in a Google search,
• 4:34
  and we had to sit her down and
• 4:35
  just really start to explain to her that
• 4:38
  those are things
• 4:40
  those are pieces of a small pieces of
• 4:42
  information that the medical
• 4:44
  field understands
• 4:45
  when diagnosing and caring for those patients. But
• 4:48
  it is not written in stone that every
• 4:50
  single person is gonna live this way even
• 4:52
  though they have,
• 4:54
  these things that have happened to them. So
• 4:56
  she started going down a a track of
• 4:58
  some depression, you know, and and she's a
• 5:00
  very, very active lady.
• 5:02
  Art a lot of she does a lot
• 5:04
  of things. She's active with her great grandchild.
• 5:06
  She's active with her grandchildren. She's active in
• 5:08
  the church. And and reading something like that
• 5:10
  and taking that in just put her in
• 5:12
  a in a place of, you know, concern
• 5:14
  for her own life. So mental health, I
• 5:16
  think
• 5:17
  we are starting to step more and more
• 5:20
  into that arena and really understand where the
• 5:22
  person's at before we start focusing and giving
• 5:24
  them all this information and then turning around
• 5:27
  and correcting that information as well.
• 5:30
  So that's one of the biggest pieces that
• 5:32
  I think we are getting into more and
• 5:35
  more about self care. And,
• 5:37
  it helps a lot when you understand where
• 5:40
  they're coming from and how or why they're
• 5:42
  googling the certain things that they're googling.
• 5:45
  But using devices such as,
• 5:48
  you know, blood pressure cups, it's gonna give
• 5:50
  you an accurate piece of information.
• 5:52
  Talking about your concerns with your medical provider
• 5:55
  and bringing to them
• 5:57
  what you found, where you found it, and
• 5:58
  letting in the medical provider sitting there explaining,
• 6:01
  look, this is a combination of a bunch
• 6:03
  of information.
• 6:05
  It doesn't always mean that all of this
• 6:07
  information is true. You gotta see where the
• 6:08
  source is coming from.
• 6:10
  And then, you know, again,
• 6:12
  using what they have
• 6:14
  and really understanding how they apply, whether it's
• 6:18
  a wearable medical device or they're on some
• 6:20
  sort of telehealth. How do they apply that
• 6:22
  to their everyday so they can get the
• 6:23
  right information?
• 6:25
  So those are that's that's how it's affected
• 6:27
  me personally
• 6:29
  in my own life. And then the patients
• 6:31
  that we care for, through our home health
• 6:33
  agency, you know, they always have a lot
• 6:35
  of questions, and then they have family members
• 6:37
  that are always involved in their care as
• 6:39
  well. So it is really it's really important
• 6:42
  that we spend time with our patients. We
• 6:45
  listen
• 6:46
  and listen to understand,
• 6:48
  not just listen to respond, and give them
• 6:49
  a moment. Let them let them get their
• 6:51
  whole story out before you start asking questions
• 6:54
  that take them down a whole different
• 6:56
  pathway that they didn't even intend on going
• 6:58
  to, and now they really were not heard.
• 7:00
  Their their question wasn't asked. They couldn't get
• 7:03
  there. So most,
• 7:05
  statistically out there, they say that most health
• 7:07
  care providers interrupt their
• 7:09
  patient within the first three minutes of them
• 7:11
  talking.
• 7:12
  So give give just sit stay quiet for
• 7:15
  a minute. Let them get all the way
• 7:16
  through it and then see what their question
• 7:18
  is so you could possibly
• 7:20
  give them a better answer and make them
• 7:22
  feel better as they leave from you and
• 7:24
  wherever else they're gonna go to.
• 7:26
  Yeah. Absolutely. Thank you so much for just
• 7:27
  kind of that personal
• 7:29
  personal touch there. And it also just seems
• 7:31
  like with so many advancements, including Ambient AI
• 7:34
  and these
• 7:35
  AI powered scribes that that,
• 7:37
  you know, while there is so much more
• 7:39
  information that can be confusing for people, physicians
• 7:41
  and other clinicians have more of an opportunity
• 7:44
  than ever before to be present with the
• 7:46
  patients. So that's also something interesting.
• 7:48
  Yeah. Very much so.
• 7:50
  How are you thinking about growth over the
• 7:53
  next twelve months?
• 7:54
  You know, from from where I'm at for
• 7:57
  home care, we want to reach the patient
• 7:59
  where they're at. And in one particular piece
• 8:02
  for us is keeping them out of the
• 8:04
  hospital.
• 8:05
  I don't think that we always have the
• 8:07
  right people at the table
• 8:09
  that discuss
• 8:10
  what a patient's discharge
• 8:12
  plan should be. There's just a report that
• 8:15
  was written
• 8:16
  not too long ago about sending patients to
• 8:19
  skilled facilities versus home health, and will we
• 8:21
  keep them out of the hospital even more
• 8:23
  if we send them to a skilled facility?
• 8:25
  Well, there was no evidence that that was
• 8:28
  the truth. So what does the patient want?
• 8:31
  So for growth for us, it's really about
• 8:34
  number one, meeting the patients where they're at,
• 8:36
  what are their needs. There's been such a
• 8:38
  change and a shift in the hospital system
• 8:41
  of what's truly sitting in ICU, what's truly
• 8:43
  sitting in the PCU world, what's truly sitting
• 8:45
  in med surge. What's sitting in that med
• 8:48
  surge world is, in my opinion, the PCU
• 8:51
  patient. So home care has really become your
• 8:53
  makeshift med surge.
• 8:55
  So we're really looking at different ways to
• 8:57
  meet those patients and meet the needs of
• 8:59
  those hospitals to get those patients discharged. They
• 9:01
  do not return back to their to their
• 9:03
  to their hospitals. So,
• 9:05
  you know, utilizing
• 9:07
  AI for scheduling purposes, do we have the
• 9:09
  right person to see that patient from a
• 9:12
  clinician standpoint? And when can they see that
• 9:14
  patient? And how do we make that drive
• 9:16
  easier for that clinician? So you you using
• 9:19
  AI in our scheduling world is great.
• 9:22
  Using AI
• 9:23
  even in the referral,
• 9:24
  reviewing that referral, picking out the most important
• 9:27
  pieces of information. Sometimes our referrals can have
• 9:30
  well over 50 pages. Our clinicians are not
• 9:32
  gonna read all those 50 paces. So how
• 9:34
  do we summarize that and get that the
• 9:36
  basic most important information to the clinician so
• 9:39
  that we can make them the most sufficient?
• 9:41
  So those are some of the pieces that
• 9:44
  we're looking at for growth. There are always
• 9:46
  those programs out there to prevent CHF, to
• 9:48
  present COPD readmissions,
• 9:51
  But that in that that is that is
• 9:54
  information that we've known for a while. Now
• 9:56
  how do we take the pieces that are
• 9:58
  out there such as the wearable,
• 10:00
  whether it's a watch or whether it's some
• 10:03
  sort of,
• 10:04
  medical device? How do we utilize that,
• 10:07
  in the everyday lives of this patient so
• 10:09
  they don't go back to the hospital?
• 10:11
  Mhmm. Absolutely.
• 10:13
  Is there anything else that's important to this
• 10:16
  conversation that I haven't touched on so far?
• 10:19
  I'm not sure.
• 10:20
  I think one of the big thing is
• 10:22
  also to understand that our patients are moving
• 10:26
  more and more
• 10:27
  away from the traditional Medicare insurance.
• 10:30
  And so we need to understand
• 10:32
  what types of insurance they have. They need
• 10:34
  to understand that too. And I get so
• 10:37
  often that our patients are not reading the
• 10:40
  fine print. They don't understand, and then they
• 10:42
  get into this place where,
• 10:44
  you know, they're unable to use their insurance
• 10:46
  the way they thought they were able to
• 10:48
  do that. So I would really encourage if
• 10:50
  you're changing your policy, whatever that is, please
• 10:53
  make sure you ask really great questions. Read
• 10:56
  the read the policy. Read the fine print.
• 10:58
  Talk to talk to that agent for quite
• 11:00
  a bit of time before you just sign
• 11:01
  on the dotted line,
• 11:03
  because we're gonna be utilizing more and more
• 11:05
  outpatient care services.
• 11:08
  The workforce challenges are gonna continue when it
• 11:11
  comes to retention of our staff in the
• 11:14
  hospitals, retention of our staff in outpatient clinics,
• 11:17
  and then integrating all that artificial intelligence in
• 11:21
  there. It's all gonna drive the growth. But
• 11:23
  if we don't understand the insurance piece of
• 11:26
  it, our patients are not still gonna be
• 11:28
  able are gonna be stuck
• 11:30
  in getting what they need, whether it's an
• 11:31
  MRI, whether it's an X-ray, or even going
• 11:34
  to an outpatient facility as an ASC.
• 11:36
  You know, where does this insurance take you?
• 11:38
  And I I think that's a big part
• 11:39
  of the conversation that we don't we don't
• 11:41
  have a lot of questions or we don't
• 11:43
  speak about enough, and our patients are confused.
• 11:46
  They don't understand what that means. I can't
• 11:47
  tell you how many times I've spoken to
• 11:49
  a patient. They're like, no. I have Medicare.
• 11:51
  I'm like, you don't. You have a replacement
• 11:52
  policy, and we have to go through that
• 11:54
  with them. So that piece is a big
• 11:56
  chunk, and it's missing a lot of the
• 11:59
  education components for our patients to understand what
• 12:01
  they're choosing.
• 12:02
  Mhmm. Absolutely. Yeah. Excellent point there.
• 12:06
  Well, that is actually all I have for
• 12:08
  you today, Lisa. Thank you so much for
• 12:09
  joining us. Thank you so much for having
• 12:11
  me today, and, I wish you the best
• 12:14
  day ever on a Monday. Have a great
• 12:15
  day. Mhmm. Absolutely. It's been a pleasure speaking
• 12:18
  with you, and I look forward to connecting
• 12:19
  with you again in the future. Thank you.