Latest / Becker’s Healthcare - Clinical Leadership Podcast / Pam Oliver, Chief Medical Officer of Novant Health

Transcript

Pam Oliver, Chief Medical Officer of Novant Health · Becker’s Healthcare - Clinical Leadership Podcast

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  - Prepare to dive into the forefront
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  of healthcare innovation at our 14th annual meeting coming
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  up on April 8th
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  through 11th at the Hyatt Regency in Chicago, with thousands
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  of industry leaders converging over four dynamic days
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  of discussions on crucial topics from health IT
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  to executive leadership.
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  It's where the future of healthcare takes shape.
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  We can't wait to connect with you in person
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  and engage in these important conversations.
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  - This is Laura Zido with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Dr.
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  Pam Oliver, chief Medical Officer at Novant Health.
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  Dr. Oliver, it's a pleasure
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  to have you on the podcast today.
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  - Well, thank you for having me, Laura.
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  - Now I know we have a lot to talk about,
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  and I'm excited to really discuss further Novans News Center
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  for Public Policy Solutions.
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  But before we dive into that discussion,
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  can you tell me a little bit more
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  about yourself and your background?
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  - Sure. Um, I am Pam Oliver.
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  I'm Executive Vice President
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  and Chief Medical Officer at Novant Health.
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  I'm an OB GYN physician, um, by training at heart.
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  I should probably leave with that.
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  Um, we are a not-for-profit integrated health system in
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  North Carolina and South Carolina with 19 medical centers,
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  um, more than 850 locations across our network.
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  Over 2000 physicians, um,
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  and about as many as match practice, um, providers
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  who are caring for our communities in the Southeast.
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  Um, as Chief Medical Officer, I now have the, uh,
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  responsibility and take great pride and our safety
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  and quality, um, health equity across our organization,
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  medical education, including our graduate medical, um,
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  education programs, clinical research, um,
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  and that drives me as a woman of color, a physician driving
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  outcomes for our communities, uh, in a holistic
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  and a comprehensive approach is, um, really what my team do.
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  Um, and so, you know, I have a platform that I don't take
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  for granted, you know, in my role.
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  Um, and try to make sure I think that, that I leverage that
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  for good, which is why I really appreciate you, um,
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  having me here today.
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  - Uh, the pleasure is all ours.
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  Now, uh, from your perspective,
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  could you tell us about novo's New Center
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  for Public Policy Solutions?
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  Why did you launch it and what are your you focused on?
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  - So, Novan Health has been on a journey for many years to,
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  um, address several things related
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  to the care our teams provide.
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  One of those was, um, addressing burnout,
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  and another was tackling, being real tactical in
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  how we think about what is getting in the way
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  of our teams doing the good care
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  that we already know that they do.
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  So we've been on a journey of listening
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  and engaging, um, our physicians, our nurses
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  and advanced practice providers, to really appreciate
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  what it is that gets in the way of us delivering,
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  of having the best impact we can have
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  for the great care we already know that we deliver.
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  So we put together the Navan Health Center
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  for Public Policy Solutions in 2023 as an extension
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  of some work that we had already undertaken, um,
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  and wanted this to really be about developing actionable
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  policy with patients and clinicians at the center.
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  So right now, across our organization
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  and almost every organization, we are facing burnout related
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  to just the load of what gets in the way of,
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  of physician being able to take care
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  of the patient in front of them.
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  And so our goal with this was we'd done a lot
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  of work already to remove barriers
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  and to do what we feel like we could do.
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  We saw a lot of work that was being done.
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  We were listening to our clinicians,
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  and this was our way to really think about how
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  to bring together those thought partners,
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  those really smart people who are experts and understand
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  and appreciate every aspect
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  of the challenges that they're facing.
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  Put those smart minds together, help us
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  to identify the highest priority areas
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  where we can have real impact.
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  And when we have impact, it will not just affect
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  and benefit Novan Health,
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  but it will benefit all those across the country.
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  And so pulling together the Center
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  for Public Policy Solutions was a way for us to get
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  beyond some of the macroeconomic challenges
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  and weeping reforms that get caught up
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  and have maybe less of a chance of, of success,
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  and to get into the weeds, identify very specific solutions,
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  drive real change,
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  and see an impact during the careers of the physicians
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  that are facing these challenges today.
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  - That's amazing to hear.
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  And you know, what a, a really cool philosophy
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  to have in terms of being able to affect real change, um,
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  in the moment in being able to tackle those things
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  that can be dealt with, um, over, as you mentioned,
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  that kind of timeframe, um, within a physician's career,
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  or the time that there was no one to be able to, um,
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  really see the results.
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  That's so cool. Um, what are some
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  of the big healthcare policy
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  challenges that you're seeing right now?
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  - Oh, the, the, the one that we're targeting right now,
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  and one that is core to the challenges that we have
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  as physicians is overregulation.
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  Um, we go to school, we learn all the best medicines.
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  We believe in best practices.
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  We see patients,
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  and there are so many things that get in the way
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  of us being able to just take care of that patient.
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  And when, when we look at the studies nationwide
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  and they say two and three scary, that two
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  and three physicians and one in two nurses
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  report experience and burnout.
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  And it's not because of the, the care we're delivering, the,
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  the actual practice of medicine, it is
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  because of all the other stuff that's getting in the way.
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  And a lot of that is driven by policies, regulations, rules
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  that physicians have to jump through hoops to be able to do
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  what we know our patients need
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  and what is best practice for our patients.
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  So when we started, we've been on a journey for many,
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  many years to, as we looked at burnout
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  and we put together programs to address burnout affecting,
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  like looking at the both internal, what can I do
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  as a physician myself being present, working on, you know,
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  my my own, what I can control.
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  And what we really started getting into these external
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  factors that affect burnout.
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  And this falls into that external, as an organization,
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  we identified, we had a project called Getting Rid
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  of Stupid Stuff that some
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  organizations have done across the country.
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  And we, we looked at, we asked our doctors,
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  what are the things that you feel are just stupid
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  that are getting in the way that, um,
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  that block bog you down in a day,
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  take you away from patient care?
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  And we addressed hundreds of those over the course
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  of the first year even.
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  And we continue it year over year, removing clicks,
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  removing popups that don't drive value, um,
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  simplifying, um, workflows and,
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  and optimizing our, um, electronic health record.
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  And we did that. And that was
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  to take our doctors from the norm of spending two hours
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  for every one hour, two hours, documenting
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  and charting for every one hour patient care,
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  which is insane that that's the balance now that nationally
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  to reducing that time.
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  So we drove as much as we could.
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  And what we realized is sometimes we would send out a,
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  you a, a notification that to our teams
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  that now this is a new requirement or you need to do X or Y
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  and we started putting a y behind it.
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  Why are you being asked to do this?
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  And we need, need it to be clear.
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  Is this something that we as a system have chosen to,
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  to ask you to do?
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  Or is it something that someone else, a payer,
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  the government, um, the state is saying
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  that we now have to do?
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  And it was eye-opening
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  because it really helped us to see the amount of
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  external influence on the workload of our clinicians.
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  And so we set up a clinician, um, uh,
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  clinical partner engagement team, educating our doctors on
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  what are the, what is happening in the policy world.
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  We started engaging them more writing letters
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  to get feedback to CMS to the state, inviting them
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  to be active advocates.
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  And so as we pull those poly solutions together,
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  and we started talking about the biggest cha one of the, one
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  of the biggest challenges right now,
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  what they see in taking care of patients in front of them,
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  the overregulation topic that rose to the top was the idea
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  that when we see patients for a specific type of visit,
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  specifically a preventative visit, that um,
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  we are limited in what we can provide to
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  that patient without that patient having, um, to pay more.
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  And it then becomes a,
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  almost like the physicians in the middle is a
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  confrontational, um, situation that develops.
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  So the Affordable Care Act requires that insurers
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  cover annual checkups, annual preventative exams,
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  that those are visits in our world that are in the, in the,
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  um, insurers world that are designed to be, um, coming in
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  to get checked out, um,
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  and just do the routine preventative things
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  that is different than a po a problem visit
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  when we see patients.
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  And a lot of patients don't speak that language.
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  They don't understand, and I don't think the payers do a
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  great job of informing them
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  of the nuances of their coverage.
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  They see this as a free visit regardless.
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  So when the physician and when they have problems
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  and our teams do the right thing
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  and we address those problems at the time,
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  the patient then incurs a separate bill
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  where they actually have to pay something
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  and it leads to lots of anger.
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  And, um, the patients are, are, are upset
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  with their physicians and,
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  and their, their anger is directed to the wrong people.
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  'cause this contract is with their payer
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  and this is driven by the payers
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  or the government in some ways.
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  And we just, we need that to change.
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  We need to be able to take care of our patients
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  and do what we need to do.
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  And we would do the same thing for them if they came back
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  for a problem visit, it would be the same.
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  It's just that the pa we are not,
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  we are either prohibited from doing it without
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  applying the charge or we're asked to do it
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  and not charge so that we don't upset the patient.
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  And that's not fair to our physicians either to not be that,
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  to not value the time, the energy they're doing it,
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  or to be put in a situation where we ignore something
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  for a patient or, or have to have them come back knowing
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  that that might impact the outcome.
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  So overregulation the multiple rules that vary
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  by insurer, but this specific topic of, for our, uh,
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  especially our primary care physicians rose to the top
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  as something that if we can move the needle on,
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  they really felt would benefit them from an, um,
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  from a career burnout perspective.
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  - Well, that's fascinating to hear
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  and certainly, you know,
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  as you were describing this whole situation, um, I,
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  I can imagine extremely frustrating for the physicians
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  as well as patients and trying to figure out how to manage,
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  um, all of the, the different rules
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  and regulations from different payers, I'm sure as well.
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  Um, obviously you outlined a few
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  of the steps you've been taking,
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  but, um, how have you seen any of the response
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  or have you been able to move the needle at all, um,
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  within some of your conversations
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  with payers in, in that regard?
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  Or, um, is it still a work in progress?
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  - It's definitely still a work in progress.
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  Uh, we expect that some of this will take, you know, time
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  because there are so many parties that are involved, right?
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  There's, there are levers that the government obviously can,
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  um, pull to influence payers in this space.
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  Uh, individual payers may be willing to partner, um, and,
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  and, and make these changes.
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  There's not a, there may not necessarily be a single
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  solution that, or, you know, swipe
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  of a pen solves it for us.
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  Day one. Um, we put together, we did a white paper, um,
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  on this subject and released that, um, in the fall
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  with the input of our physicians
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  and our, um, leadership teams.
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  Um, and so we still are very much early in this,
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  but continuing the advocacy for, um, pulling in those,
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  like continuing to engage our physicians
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  and more, I will tell you that has had an impact that, um,
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  I don't want to understate is physicians feeling seen
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  and heard and knowing
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  that we are advocating on their part is priceless.
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  - Absolutely. That makes a lot of sense.
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  You know, and it's great that you've been able to, uh, fill
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  that space and fill that voice
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  and give them a platform in order to really, um,
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  make a difference, um, within the patients
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  that they're working with as well
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  as just the healthcare system overall.
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  And I'm curious too, when you look at, you know,
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  what you've been able to do at Novant Health
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  and, um, how health systems across the board are,
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  are really dealing with many of the same challenges.
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  What opportunities are there for those health systems
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  to really influence legislation
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  and public policy in the future?
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  - I think we have, um, there's, there's,
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  there's huge potential there.
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  And, um, it's really about starting with just listening
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  to all of all health systems, while we have similar
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  overarching challenges, um, have a unique opportunity to
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  use those experts that we work with
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  and partner with every day to inform us on
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  what the challenges are and to truly listen.
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  We bandaid and we, we fix things
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  and try to make it work within this complex kind of,
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  you know, I don't wanna say it's broken,
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  but really challenging system that we all, um, work with
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  and listening and, and, and, right, um, raising those voices
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  and pushing that forward so
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  that it becomes not just Novant Health who is identifying
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  and challenging and seeking solutions,
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  but there is a sea of, there are c it's a sea of voices that
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  all can sing and inform about these challenges.
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  I think that that is, that could be incredibly powerful.
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  Um, I do think that the more like our, our,
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  the more our clinical teams have an opportunity to engage
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  with lawmakers, um,
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  and that's across any health system, the better.
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  Um, that I've often found myself when, when
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  advising or speaking with, um, members of Congress
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  or state legislators, um, they're open and willing to listen
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  and don't always appreciate
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  or know some of these nuances and challenges.
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  So as, as health systems, we have both the ability to
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  and the duty to pull in our teams to do the best we can
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  to inform those who are setting these policies, having an,
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  um, have an opportunity to change these policies over time.
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  And we truly believe that our organization
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  will be a great resource, um, as timely policy,
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  timely policy changes, um, are on the horizon
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  and other health systems will follow suit.
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  - Well, Dr. Oliver, thank you so much
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  for joining us on the podcast today.
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  This has been such a fun and informative conversation
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  and I look forward to connecting with you again soon.
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  - Well, I look forward to updating you
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  as we can see progress from the great work we're doing
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  and I appreciate you having me, Laura.