Latest / Medsolve Dynamics / Inside Oncology Operations: What Programs Are Dealing With Right Now | Heather Turner
Transcript
- Yoel Bakas: I'm so glad that we finally got a chance to get together and record it. we've been talking about some of these questions for some time. So I'm excited that we finally get a chance to put them down and share them with ⁓ the rest of the world. thank you being here today. Heather Turner: Absolutely, thank you. Yoel Bakas: Yeah. maybe just tell me a bit about yourself. your background? Tell me a little bit about, your world. Heather Turner: Sure, so I have around 14 years of experience in oncology. Started off as a radiation therapist, working clinically with patients, which I love. That led me to a leadership role ⁓ as an operations manager running a new cancer center that was built. So I had the... unique opportunity to be a part of that design and build for that cancer center. Did that for three or four years and then I moved into a director role. So I have the unique kind of array of experience there where I know the clinical side and I know what it's like to work on the machine and be kind of boots on the ground, but also the kind of operational and business perspective of oncology. Yoel Bakas: of experience there where I know the clinical side, I know what it's like to work on the machine and keep kind of boots on the ground, but also the kind of operational and business process of our company. That's awesome. And I love that you said that you like the clinical side as well. think that's so often I hear that from administrators how passionate they are about the patient and clinical side. because I think at the end of the day, That's why a lot of us are still in the space and in this field. yeah. I know that this year has been ⁓ a change year for reimbursement and we're seeing hearing from a lot of people that there's a lot of changes to reimbursement. There's a lot of changes operationally. What are you seeing out in the field? Heather Turner: That's right. That's right. right now I'm seeing a lot of complexity. cancer care has incredibly advanced ⁓ ⁓ The operational side hasn't always been able to keep up, unfortunately. There's a lot of staffing constraints. are shortages of therapists, physicists, even ⁓ physicians. seeing clinics struggling to find radiation oncologists to staff. ⁓ And the right mix of experience that I think a lot of places are looking for. ⁓ I'm seeing a lot of workflow and efficiencies out there, especially between departments like medical oncology, radiation oncology, imaging, ⁓ difficulty communicating between all those different departments and, just also the administrative burden now of prior authorization, which is kind of the hot topic right now today and radiation oncology specifically, but. documentation, compliance, it's a lot. It's a lot to keep up with. And I think, all those complexities create a system where there's a lot of really talented people out there and they're spending a lot of time navigating all these difficult things. And it's a struggle to focus on patient care, ⁓ which like said, that's why we're here, right? That's what we're passionate about. Yoel Bakas: people out there and they're spending a lot of time navigating all these difficult things and it's a struggle to focus on patient care. Just like you said, that's why I'm here, right? That's what we're passionate about. ⁓ Do you ⁓ leaders of programs right struggling with anything in particular? it is it just so busy and so much change all at once that it's hard to hone in on one thing? Is it, the the complexity of having to deal with like the day-to-day operations of the center, plus the clinical side, plus buying equipment, plus dealing with service contracts, plus the vendors, plus the reimbursement changes. it just seems like there's a lot. So I'm just wondering, how ⁓ are you seeing program dealing with ⁓ that ball juggling at the moment? And maybe ⁓ as you think through that, makes the ones that seeing do it well? do it well versus the ones that maybe aren't doing so well. What do you think is differentiating them? Heather Turner: I think the main difference are the ones that have been proactive and not reactive, right? So we've known a lot of these changes have been coming for quite some time now. Maybe didn't know all the details, but we know it was coming. And there's lot of centers that waited, they waited until after the fact to try to figure out what to do. And at that point, you've created a lot of problems, right? So, there's a lot of centers I've seen that have used data to anticipate what was going to happen, how it was going to affect their clinic, instead of just, having a quick after the fact. And, ⁓ you know, trying to standardize processes workflows beforehand so that they can be ready instead of just reinventing the wheel. ⁓ after all these changes have taken place because it is a lot to juggle all of those things, like you said, especially as an administrator. But I mean, even as a the clinical staff, they're the ones on the ground. They're trying to drop all these codes and perform all these tasks. And ⁓ as things have gotten increasingly complicated, I think it's just. the places that have just been proactive and prepared are the ones that are really thriving right now. Yoel Bakas: I've 20 % cuts in reimbursement, which of course changes how people, buy equipment, even equipment they bought that now all of a sudden maybe doesn't make sense or the proformas that they calculated don't make sense. we've gotten questions, as you know, from people saying, Hey, can you evaluate this, JV, can you look at our contracts? ⁓ Can we look how we're looking to buy equipment? Because some of the calculations they made originally just aren't making sense anymore in the new environment. I feel for administrators, I'm empathetic to the amount of work that they're under. then the of the stress ⁓ of, a 20 percent reimbursement cut plus seems seems like a lot at the moment, for sure. Heather Turner: It is, yeah. Yoel Bakas: and you're trying to still, like you said, still treat patients at the end of the day, right? the complexity is not, ⁓ it's not lost on me. have you, have you seen, a lot of centers think about AI I know there's a lot of vendors out there that promise a lot of improvements with AI and what it's to do. And, have you, have you seen or heard, from. administrators and from centers, how they're trying to juggle that and trying to make sense of that. Heather Turner: Sure, think there's a lot of pressure as you said right now. And I think there's a lot of curiosity with administrators and AI. think there's ⁓ a of us want to understand what AI can do. We're hearing about it everywhere you ⁓ You can't on any kind of social media. mean, even on television, it's everywhere. And ⁓ specifically in And I think we want to understand what it can do for us, know, around scheduling workflow optimization. ⁓ But, how do we figure that out? How do we decide what's best for us? Because there's so many options out there and it's overwhelming. And there's products claiming that they can fix our problems, right? we all our day to be easier and smoother, right? But I mean, what does that mean and what does it cost? And is it even worth it? There's a lot of skepticism too, because in healthcare we need to be accurate and we need our staff and patients to have trust in our workers and what we're doing that's critical to good patient care. And as we talked about the financial constraints, even tougher right now with all of these billing changes and ⁓ the are making more money, which is wonderful. That's great. That's what we want. That's how we get staff, right? ⁓ But things are not getting cheaper either. ⁓ You mentioned the service contracts and all the things that we have to deal with ⁓ on of what it costs to even. ⁓ get this AI, how does that impact us? And that's definitely a struggle right now. Yoel Bakas: Yeah, for sure. I've seen I've seen people trying to sort out AI, I think, backwards a little bit, right? Because there's so much technology that's being thrust upon every administrator out there. And so it's like they're being reactive rather than proactive, right? So rather than thinking about what the workflow should be or trying to think about what the processes that you're trying to improve, it's like some vendor shows up with something that says, hey, this is going to save you time or clicks or money. ⁓ and I think it's so important to really take a step back and think through what should that workflow be? What is it that you're actually trying to solve for? what are, what are the measurements that you're going to have or that you're going to put in place to see what the tool is going to do to actually improve your, your department? Cause otherwise you're just buying a piece of software to try and make something better. And it may just cost you money, but it's not going to improve anything or worse yet. It may actually take you longer. Because you end up getting sucked into trying to build it into something without having the workflow behind it that's running and that's making it work. I think there's for sure an opportunity for folks to think through that, what you're trying to solve before you actually go and do it, Heather Turner: Yeah. Yeah, it's funny that you mentioned that because I actually had a conversation with a physicist the other day who was in that situation where she had sat down with a vendor, watched a presentation, was super excited, kind of got mentally sold on this tool that was cool and we talked about it and yes, it was awesome. ⁓ I'm sure it would be very helpful and it was a workflow tool and I asked her, I was like, do you have a problem with this right now? is this an issue that you're facing in your clinic? And she didn't really have an answer. She wasn't like, yes, this is bothering me every day. I can't get this done. It was more like this looked really cool and I want to use it, but she didn't really even know why. ⁓ And I think that's probably what a lot of people are facing right now. Yoel Bakas: Yeah, and if I think if you don't know that piece of it, then figuring out if something's worth the investment is even harder because if you can't justify the workflow that you're trying to improve or the solution you're trying to actually come up with, then justifying the financial, return on investment is really hard. And so I think, those go hand in hand. ⁓ it's just a matter of sequencing them correctly so that you can actually have a really good understanding of what you're trying to solve. then. ⁓ make sure that, it brings value to your clinic in a way that's meaningful. ⁓ I think mentioned, service contracts, just a minute ago and, and dealing with those and negotiating those. we've been obviously sharing some thoughts on the importance of measuring performance from on, service contracts and why that matters. And I think it's similar to the discussion we just had on the software, If you're not measuring how the vendor is doing against the service contract, it's hard to be able to have a really strong negotiating position with that vendor when it comes time for renewal. And so I think, again, thinking through the key metrics that you want to measure and whether they're actually delivering in those or not makes a huge difference in today's environment ⁓ as head into ⁓ negotiation with the vendors. Heather Turner: Yeah, I agree. I'm not seeing a lot of centers right now that are even tracking those metrics, to be honest. I think a service contract is something that you get and you get a five-year, nine-year, whatever contract and you don't ever look at it again, except once a year when, AP sends you an invoice to approve and you approve it and you don't think about it again. And I think that's a huge gap right now in clinics and they probably... They don't even realize it. Yoel Bakas: you don't ever look at it again except once a year you know, AP sends you an invoice to approve and you approve it and you don't think about it again. Yeah. mean, I think that's a huge gap right now in clinics and they probably don't even realize it. Yeah. Well, I mean, especially given the number of, balls that the clinics are juggling It goes to an autopilot, but autopilot ⁓ compounds as service contracts do over time can become really significant in terms of the revenue for a clinic. mean, you're talking about millions of dollars of savings by doing this correctly versus not. again, no ⁓ to the administrators that trying to treat patients and run the center and everything else. It's just one more ball that they have ⁓ keep, in the air. it's hard. It's hard. And, we haven't even touched, of course, on the buying or replacement of equipment, which is another one, right? You have all the vendors that come in and, again, every bell and whistle it's on the quote. seen them I've seen them quotes that have every single feature, regardless of whether the clinic actually needs or not, or an of what the clinic is trying to do. And it's hard, it's hard as an administrator to deal with that, right? To know, Hey, I'm getting a quote from a vendor, but the vendor doesn't really have, interest of the ⁓ in mind when they're preparing the quote, they have their quarter, their end of year. They're trying to put the quotes together. And I'm not digging on ⁓ vendors, I mean, was on the vendor side for 20 years. It's just how it's set up, right? You're trying to sell as much as you can of what you have in your bag, so. Heather Turner: Right. Yeah, that's your job. Yeah, I mean, I think I've sat there and listened to, I've been on the other side of that, obviously, and listened to the vendor presentations. And I think often we hear, like you said, there's line items in there and we're like, I'm not really sure what that does. I don't know what this is. And some of the things even just get lost. I mean, these are contracts, many pages of contracts and they give it to you to read and... A lot of times it doesn't make sense to you, right? And if you don't have someone in your clinic or have someone on your side, like Medsolve for example, that can go through this for you and tell you what's missing or what's there or help explain things, you could end up spending a significant amount of money that is worthless for something that's just not, you don't need it in your clinic. Yoel Bakas: you you could end up spending the estimated amount of money that is worthless, you know, for something that's just not real meaning. Yeah, it's funny thinking back to, when I was on the other side and customers hated me but I refused to give people quotes for the longest time, right? somebody would ask me for a quote and I was like, I'm not going to give you a quote. I'm going to give you a spreadsheet. And they were like, but I need a quote. I have to budget for it. I was like, I'll give you a number. and I'll give you a spreadsheet, but we have to understand what it is that we're trying to actually put together I can actually give you a quote. Giving you a quote just sets up a price and some product, But it doesn't actually talk through the ⁓ actual you're trying to solve. And it was so important for me then, and it's even more important for me now on the other side of the table, helping these clinics to really understand what they're trying to do and what clinically they're trying to solve for. Because if you don't understand that, and you can't come up with what they're trying to do in the next five years, putting together a quote is meaningless. The last thing I wanted when I on the vendor side was to sell a piece of equipment that wasn't gonna do what the client wanted, and even more so now, that's all I care about is the success of the program and making sure that at the end of the day, what we've helped either negotiate or package makes sense. And there's so much less leverage with the big purchases that vendors are driving that I think it makes all the sense in the world to have somebody else that has been on the other side helping with that, understanding how that's assembled and putting those deals together. Heather Turner: Yeah, absolutely. would like to hear you talk a bit about Medsolve and just what are some of the problems in contract negotiation and review and even the AI and all the automation that is there? What are some things that we do at Medsolve that can help solve some of those operational problems? Yoel Bakas: I always start what the practice or the clinic is trying to solve for, That's why Medsolve exists, is to try and help the clinics. And there's really four areas that we focus on, as you know. One is how to buy and package things better. We've seen what works with vendors. We know that ⁓ sometimes having the vocabulary of the side in how you a deal together. and understanding how to bundle things together or how to look at something more holistically can make a huge difference in terms of discounts and the long-term ⁓ value that contract. And it's not just about price. It's about understanding that sometimes training or uptime or service can be what you're thinking about as opposed to just price. We do quite a bit of in the... operational workflow side of things to look at why practices are working the way they're working and see if there's any areas that we can help improve drive operational efficiency in to help again drive those those revenues. So that's another big area that we look at. if you think about the cuts and reimbursement and the challenges and margin pressures that everybody's under, we take a slightly different lens, which is, okay, got it. So there's going to be less money to play with. How can we help mitigate that? And one is the cost of the equipment and the cost of the service contracts. The other one is efficiency and improvements in the department. And then can we look at expanding the program through either new service lines like Theranostics or benign disease that can help bring additional revenue into the department as opposed to what you're already, focused on. ⁓ And then on the AI side of things, there is so much being thrown people. I never thought that, I'd end up using my computer science degree for this because it didn't really exist in this way back then when I still had hair. But the reality it helps to have somebody that understands the technology that's playing with it. And then ⁓ also understands the clinical and operational needs of a department to at it and say, Yeah, I can help with this and here's how you should think about it. Here's how you can evaluate it for your particular department. And I think every department is going to be unique. I think each department is part of what we take great pride in having people like you that understand the operations of the department and the clinical needs ⁓ of, a department tied together with the business side of the world to improve the overall efficiency and revenue for And, the last bit of it, and I have to say this because I think it's part of why we wanted to do Medsolve the way we've done it, is we wanted to work with people we really liked. part of what we wanted to create with Medsolve was a group of folks that trusted and that people liked and that were good humans. And I think that's such a big ⁓ differentiator for us as we look out in the market. Heather Turner: Yeah, I like that. can't tell you how many times I have sat through these vendor presentations like you said, or even after the fact after a... piece of equipment or software or something was purchased and I'm sitting there with the staff and they still feel like they don't know what they're doing with it, right? Like we have this new thing, this new shiny thing or this new cool tool and it's like, we're kind of using it and but we're not really even sure if we're using it to its maximum capacity if we're using it the way it's supposed to be used. So I think it's really, ⁓ wish I had someone like or a ⁓ company Medsolve when I was on that side to come in and help us even understand some of those things even more and how could be more efficient. Yoel Bakas: someone like you were, know, a company like MedSolm, when I was on that side, to come in and help us even understand some of those things even more, know, how we could even want to think it makes all the difference in the world for sure. Heather Turner: Yeah. when is the time for a center to bring in someone like Medsolve to support their strategy or to support their initiatives? Because that's the other thing, right? We don't have time. We're busy. We're running around doing all the things that we've talked about here. ⁓ So how do we as an administrator that we need help, that we need somebody to in and look at our workflows and look at what we're ⁓ and making sure that we are being efficient. Yoel Bakas: I think the short answer is the earlier the better because you can have a much longer ⁓ runway to help and to strategically at things like you said, If you're looking at a three or five or 10 year plan, it makes all the sense in the world to have someone that can help. If you're looking to buy equipment or you're looking at a service renewal or you're looking to expand your service lines or you just got hit with the reimbursement and you're not exactly sure what to do now. those are all great opportunities. If somebody's pushing new software, new software tools or AI is a great time to have a second set of eyes, on it and just help out. If you're running around and you don't have time to look at these things, that's a great time to call someone for help. that's a good indication that you probably need a little bit of help. And I think everybody's in that position to some extent because of the amount of work that the practices and directors have at the moment. Heather Turner: Yeah, I agree. Yoel Bakas: I appreciate your so much. ⁓ I know how much you being out with customers and helping with programs. it means the world to me and to them to have you on team and being out there to help. So thank so much that. And again, thank you so much for the time today. Heather Turner: Absolutely. Thank you for the opportunity. Great chat.