Latest / Becker’s Healthcare - Clinical Leadership Podcast / Sowmya Viswanathan, Chief Physician Executive at BayCare Health System

Transcript

Sowmya Viswanathan, Chief Physician Executive at BayCare Health System · Becker’s Healthcare - Clinical Leadership Podcast

• 0:02
  The most important health care decisions don't happen
• 0:05
  in isolation.
• 0:06
  They happen when leaders come together.
• 0:08
  Becker's sixteenth annual meeting brings together more than
• 0:11
  3,500
• 0:12
  hospital and health system executives this April in
• 0:15
  Chicago.
• 0:16
  With 800 speakers from Ascension,
• 0:18
  Cleveland Clinic, CommonSpirit and more, the conversations get
• 0:22
  real. Leaders will share how their scenario planning
• 0:24
  for policy shifts, breaking through value based care
• 0:27
  barriers, and building clinical teams that translate
• 0:46
  This is Laura Dirda with the Becker's Healthcare
• 0:48
  podcast. I'm thrilled today to be joined by
• 0:50
  doctor Soumya Viswanathan,
• 0:52
  who's a chief physician executive at BayCare Health
• 0:54
  System. Doctor Viswanathan, it's a pleasure to have
• 0:56
  you on the podcast today.
• 0:59
  Thank you so much for the invitation. Looking
• 1:01
  forward to a great discussion.
• 1:03
  Absolutely. Now I'm excited for our conversation because
• 1:06
  I know there's so much happening right now
• 1:08
  in health care, particularly.
• 1:10
  I'm excited to learn more about what you're
• 1:11
  doing at BayCare. I I know there's just
• 1:13
  such a unique community that you serve down
• 1:15
  there and a lot of innovation. You're in
• 1:17
  growth mode. So I'm gonna be excited to
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  learn more about that. But before we dig
• 1:21
  in, can you tell us a little bit
• 1:22
  more about yourself and BayCare health system?
• 1:26
  Absolutely.
• 1:27
  I'm an internal medicine physician, and I spent,
• 1:31
  the bulk of my career in Northeast. I
• 1:33
  was in Massachusetts.
• 1:35
  I was clinical for the longest period of
• 1:37
  time, and then I did a whole bunch
• 1:39
  of leadership roles.
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  I was with various health systems, including UMass
• 1:44
  and
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  the Partners Healthcare System.
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  And then I was at Dartmouth Hitchcock, spent
• 1:50
  some time with the for profit world with
• 1:53
  Tenet Health
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  before I landed in BayCare health system, and
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  I've been here a little over three years.
• 1:59
  It's been a wonderful journey at BayCare.
• 2:02
  We are located
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  on the Gulf Coast and on the West
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  Coast Of Florida.
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  We are the largest health system in West
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  Central Florida with 16 hospitals.
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  We are building our seventeenth.
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  We have 34,000
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  employees
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  and more than 6,000
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  physicians
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  who are deeply engaged in some form of
• 2:23
  relationship with us or the other, including employment
• 2:25
  and clinically integrated network, ACO, etcetera.
• 2:29
  We provide
• 2:31
  all kinds of services
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  as an integrated health delivery model. So it's
• 2:35
  end to end services,
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  hospitals,
• 2:38
  ambulatory footprint, including ambulatory surgery center.
• 2:42
  We have urgent care clinics. We have multiple
• 2:44
  specialty clinics, including multi specialty and primary care
• 2:47
  clinics.
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  We have imaging centers. We also have virtual
• 2:51
  care.
• 2:53
  We provide telehealth services.
• 2:55
  We also have our own health plan. It's
• 2:57
  a small health plan, but
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  this is where, you know, this whole spectrum
• 3:02
  of value based care comes into play. We
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  kind of provide all kinds of services within
• 3:06
  our own system,
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  and
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  we are also an academic medical center.
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  Absolutely. Wow. That is an incredible amount of,
• 3:17
  services that you provide in ways that you
• 3:20
  are integrating within the community to continue to
• 3:23
  boost the health and access to care. Now
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  I'm curious. When you think back in the
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  last year or so, what was the most
• 3:29
  important initiative that you led? What did you
• 3:31
  do and what were the results?
• 3:33
  So academics, I would say in one word,
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  was the biggest initiative that I have led
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  since I've landed here. I'll share a little
• 3:40
  bit of the historical perspective.
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  BayCare as a health system came together as
• 3:45
  a group of community hospitals that decided they
• 3:48
  were going to become a health system
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  and an integrated health delivery model.
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  At that time, we were not heavy into
• 3:55
  academics. When I came here,
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  we did not have a robust GME program.
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  We had, two very small residency programs in
• 4:04
  pediatrics and psychiatry
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  with no plans whatsoever to enhance or expand
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  that. And we also had leadership change at
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  the same time where new leadership came on
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  board. Around the same time that I came
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  is when we had Stephanie Connors, who joined
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  us as CEO of BayCare.
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  So both of us coming from academic backgrounds
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  in our past,
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  we said, hey, you know what? For us
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  to really address the physician shortages
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  as we move forward into the next decade,
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  we have to look at why can't we
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  provide academia here. Because we have all of
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  the necessary
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  aspects of what goes into an academic medical
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  center in day care.
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  We have the infrastructure that's needed, so we
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  should become an AMC.
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  And so we went down the path of
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  starting up GME programs.
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  We have significant,
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  we have made significant headway in our GME
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  program. We went from the two small programs
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  of 20 resident, 29 residents total
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  to our plans now of having almost 650
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  residents graduating by 2029.
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  That's a robust and very aggressive goal, but
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  we are steadily moving forward. We have gone
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  from the two small programs, as I mentioned,
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  to establishing
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  16 programs currently.
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  We already have 300 residents who are with
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  us today.
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  In a span of two and a half
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  years, we have done we have made that
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  achieve achievement,
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  and we are not looking back. We are
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  gonna continue to enhance the GME program.
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  And in our attempt to really become an
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  AMC,
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  our biggest achievement was definitely
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  our collaboration with Northwestern,
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  up in Chicago.
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  So you must have read in all of
• 5:51
  the news articles and the press releases that
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  Northwestern collaboration with BayCare
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  has been a significant milestone for us.
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  Super excited about all of the work that
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  we'll be doing with Northwestern,
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  including research endeavors, including
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  faculty development programs, and really enhancing the academic
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  footprint in Florida.
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  That's amazing to hear. And, you know, what
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  a a great foresight in order to be
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  able to start an academic program and and
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  have those seeds planted and foundations built for
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  growth. I think, as you mentioned, it is
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  an aggressive goal going from the the two
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  initial programs and 29 residents to having 650
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  by 2029,
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  but I can imagine you've got a great
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  plan plan to get there. What types of
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  resources do you need and expertise is important
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  when you're setting up an academic program and
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  trying to transform a community system into an
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  academic system?
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  So the definitely, the two aspects are the
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  teaching or the educational
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  environment
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  as well as research facilities. So
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  we were doing some amount of research. I'll
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  start with research. We were doing some level
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  of research mostly by community grants, but we
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  were not like
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  the, you know, the big AMCs up north
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  where there's a lot of NIH funding, a
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  lot of NSF funding. It was a lot
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  of community focused grants and state grants.
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  So our goal was to really in enhance
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  the environment in which research is being done
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  so that we are fostering the different aspects
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  of research, including
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  we were doing sponsored research, for example.
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  We need to do something which is day
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  care original research,
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  And we hadn't been doing that. So we'll
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  be focusing heavily on how do we start
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  up clinical trials. And this Northwestern collaboration is
• 7:34
  gonna help us with that because it helps
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  us think differently in terms of, can we
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  have a multicenter trial if there is, like,
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  a cardiac
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  procedure that we are doing differently or a
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  new innovative
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  method of doing an electrophysiology
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  or EP study, etcetera.
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  So that is the aspect of research that
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  we are gonna enhance while we continue to
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  gain from the community grants.
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  The second piece is
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  teaching.
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  We had been dabbling a little bit in
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  teaching because we used to get
• 8:06
  APPs like the physician assistant and the RN
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  nursing students who used to come over from
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  the local universities.
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  We also had residents and students coming over
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  from our local partners here,
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  USF and Florida State University, University of Florida.
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  We have engaged deeply with USF and FSU.
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  And,
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  we just needed to increase the amount of
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  teaching that we are doing. And what was
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  beautiful to see is there was significant appetite
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  in the physicians to really go in that
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  direction.
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  Our physicians felt, well, we have so much
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  talent here.
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  We are
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  some of the best in class with high
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  quality care. We provide clinically excellent care.
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  How do we continue to nurture this environment
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  where we groom the next generation of residents
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  who will be taking care of us in
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  the future? Because
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  sixty eight percent of residents who graduate from
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  GME programs
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  stay in the area where they graduated from
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  for at least three years after.
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  If that's a statistic,
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  then I will gain significantly from at least
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  three quarters of the
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  650
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  residents graduating who will become physicians at BayCare.
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  They'll be taking care of all of us
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  as we get older. And that's what we
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  want, is high quality residents coming from our
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  own programs who our physicians have taught, and
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  they will service the community.
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  So we have pretty much the infrastructure.
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  The system is also something that's important because
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  the system was committed
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  to making that kind of investment.
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  That's great to hear. And and definitely it's
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  so important to have that leadership and and
• 9:42
  the executive team committed to those types of
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  transformations. I know Stephanie Connors is such a
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  dynamic leader and so inspiring and and gets
• 9:49
  things done too. So that's incredible to to
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  hear, and thank you for digging a little
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  bit deeper there. Now looking ahead for 2026,
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  what are some of your big priorities as
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  well as headwinds that you're facing?
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  Well, some of the priorities are definitely
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  not different than many other health systems. It's
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  basically moving care upstream.
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  And I can share with you with,
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  having
• 10:11
  looked at some of the other parts of
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  the country,
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  definitely
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  Florida, Southern states, I think, especially Florida, has
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  been a little bit late in moving forward
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  with value based care.
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  We have not had a lot of payment
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  model shifts until recently.
• 10:27
  The payment models have been a little late
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  other than the federal and the regulatory
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  volatility that's going on,
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  you know, which is also influencing some of
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  the decisions we are making.
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  But let's say the central, the CMS funded,
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  grants that are coming our way, those we
• 10:44
  have already started moving in similar to others.
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  But then it is a state payment model
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  shift. We haven't really moved very aggressively in
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  value based care. So my biggest priority will
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  be
• 10:56
  to start moving physicians in that direction
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  where we have traditionally done so much of
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  fee for service type of model of care
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  delivery.
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  We now to start training, and we have
• 11:07
  been training, but we have to start enhancing
• 11:09
  the training
• 11:10
  of the physicians and the whole care team
• 11:12
  model to really deliver on, look at the
• 11:15
  total cost of care of patients. How do
• 11:17
  you look at utilization metrics? How do you
• 11:20
  continue to enhance quality while you're controlling
• 11:23
  the utilization of services? So that will be
• 11:26
  a big focus, truly moving us in value
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  based care model.
• 11:29
  Now as we do this, I mentioned to
• 11:31
  you how BayCare is a 16 hospital system.
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  We have large facilities
• 11:37
  that cannot have empty beds. We need heads
• 11:40
  in beds because that's the way we sustain
• 11:42
  our whole integrated health system.
• 11:45
  So for that to happen, as we move
• 11:47
  care into ambulatory,
• 11:49
  we need to ramp up the types of
• 11:51
  services in the hospitals.
• 11:53
  Right now, we provide a lot of primary
• 11:55
  and secondary level of care. We provide some
• 11:57
  tertiary care.
• 11:59
  Our goal for 2026
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  is to move the entire health system forward
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  to provide high end tertiary care
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  as well as start working on quaternary care
• 12:08
  services, which is gonna be
• 12:10
  big amount, big ticket items,
• 12:12
  high acuity,
• 12:14
  severe cases,
• 12:15
  very complex cases, including looking at transplants.
• 12:19
  So that will be a big driver for
• 12:21
  us in 2026.
• 12:23
  The other big thing that we are working
• 12:25
  on
• 12:26
  is recruitment of specialties. As you know, private
• 12:29
  equity firms had
• 12:31
  nationally had looked at health care. They had
• 12:34
  invested in health
• 12:35
  care. But now as some of the PE
• 12:37
  firms are backing off from some of these
• 12:40
  specialties,
• 12:41
  we're struggling because these specialties are coming to
• 12:44
  us and saying, well, we're going under or
• 12:47
  we are going to be collapsing and
• 12:49
  we are no longer going to have a
• 12:51
  job. So we don't know whether we'll be
• 12:52
  in the area.
• 12:54
  It started last year with anesthesiology,
• 12:57
  where we had anesthesiologists
• 12:59
  in the market because we were contracted with
• 13:01
  them. They were not employed by us.
• 13:04
  They came to us and they said, well,
• 13:06
  we are not sure if they're going to
• 13:07
  stay in the state and we may have
• 13:08
  to move somewhere. We may have to go
• 13:10
  to an AMC.
• 13:11
  So we started looking at a nontraditional
• 13:14
  methodology
• 13:16
  of employing
• 13:17
  specialties,
• 13:18
  which usually are not employed unless you're an
• 13:21
  academic medical system.
• 13:23
  So anesthesia, for example,
• 13:25
  usually because they don't have their own panel
• 13:27
  of patients, many health systems don't employ them
• 13:30
  if they are not an AMC.
• 13:32
  So we have gone down the path since
• 13:33
  we're already becoming an AMC.
• 13:35
  We said, well, this is time for us
• 13:37
  to look at that specialty and say, we
• 13:39
  need to employ anesthesiologist. So that's a big
• 13:42
  headwind for us that we were able to
• 13:43
  walk into last year. We have done tremendous,
• 13:47
  had great progress in that and employing anesthesiology,
• 13:50
  and
• 13:51
  we're making a lot of headway there.
• 13:54
  The third aspect,
• 13:56
  is population.
• 13:58
  Population has grown tremendously in the Florida market.
• 14:02
  As you know, through COVID, many people who
• 14:05
  could work remotely,
• 14:06
  they migrated from
• 14:09
  the northern colder states and they came and
• 14:11
  settled down in the Southern states.
• 14:14
  So Tampa and Austin, Texas, I think, were
• 14:16
  the fastest growing cities in the country.
• 14:19
  That said, when the people moved down here,
• 14:22
  the types of generations,
• 14:24
  the types of people, the demographics of the
• 14:26
  people who came here were the younger generation.
• 14:30
  So what ended up happening is Florida being
• 14:32
  usually a state of, like, retirees, you know,
• 14:35
  it's a haven for retirees.
• 14:37
  Our health system was not prepared for the
• 14:40
  number of young people settling in Tampa market.
• 14:44
  So the whole this BayCare market is now
• 14:47
  having
• 14:49
  huge numbers of young population settling here.
• 14:52
  The need for those specialties has gone up,
• 14:55
  which is pediatrics
• 14:56
  for children
• 14:58
  and women's care, OB GYN,
• 15:00
  to take care of all the pregnancies and,
• 15:02
  you know, taking care of the women who
• 15:04
  are settling here.
• 15:05
  So these are some of the big priorities
• 15:07
  that we'll be working on from a population
• 15:10
  and specialty perspective, peds and women's care.
• 15:14
  Anesthesia is a specialty that we'll continue to
• 15:16
  work on.
• 15:18
  And just moving care upstream with payment models
• 15:21
  and
• 15:22
  enhancing tertiary care in the hospital while
• 15:24
  moving towards value based care aggressively in our
• 15:28
  outpatient centers.
• 15:33
  Okay. Wow. That's fascinating. That's a lot to
• 15:35
  to think about and a lot of transitions
• 15:37
  that are happening all at the same time,
• 15:39
  but also really, you know, fascinating to think
• 15:41
  about the the puzzle complexity of how you're
• 15:43
  running health care system, making these transformations into
• 15:46
  an academic center, and then really changing with
• 15:49
  how the market's changing, the economics, the demographics
• 15:52
  even of of what's coming into the Tampa
• 15:54
  market and and around in that region of
• 15:57
  Florida. So, that's fascinating.
• 15:59
  What do you think, out of all of
• 16:00
  these things, will be the hardest thing you
• 16:02
  have to do in the coming year?
• 16:05
  The hardest thing, probably the most work will
• 16:08
  be around the value based care movement,
• 16:12
  ramping up our
• 16:13
  physicians to understand total cost of care
• 16:17
  because we have to amplify what we are
• 16:19
  doing in the ambulatory setting.
• 16:21
  We need to enhance
• 16:23
  the work,
• 16:24
  not just the brick and mortar, but the
• 16:25
  availability of services in ambulatory care. So we
• 16:29
  need more virtual care. We need to be
• 16:31
  able to support more telehealth services, more technology
• 16:34
  and innovation
• 16:35
  so that the physicians feel they can offload
• 16:37
  to the ambulatory footprint for
• 16:40
  doing this value based care model. And, of
• 16:42
  course, enhancing
• 16:44
  the tertiary and quaternary care on the back
• 16:46
  end. Because if you don't do that, financially,
• 16:49
  the sustainability
• 16:49
  is not there.
• 16:51
  One of the
• 16:52
  aspects of this movement that we are doing
• 16:55
  to help physicians
• 16:56
  and
• 16:57
  prevent burnout of any cause is
• 16:59
  because physicians
• 17:01
  need to be available to provide that access.
• 17:04
  And,
• 17:06
  our health system has traditionally not
• 17:09
  done a lot of work with APP integration
• 17:11
  into practices.
• 17:13
  We are moving in that direction this year.
• 17:15
  There'll be heavy integration of allied health professionals
• 17:19
  and providers,
• 17:21
  who will be supporting both PAs and NPs,
• 17:24
  who will be supporting our physicians and practices,
• 17:26
  as well as in the hospitals.
• 17:28
  That is a big movement that I'm really
• 17:31
  looking forward to. It took a lot of
• 17:33
  education and continuous education of physicians to see
• 17:36
  how they can embrace APPs in the practices.
• 17:39
  So this is gonna be a beautiful journey
• 17:41
  as we build the teams to support that
• 17:43
  movement in value based care and improving access.
• 17:51
  That's helpful to understand. And I think, you
• 17:54
  know, it's so fascinating to see how you're
• 17:55
  looking at value based care and where some
• 17:57
  of the holes are. I think when you're
• 17:59
  looking at the clinical side as well as
• 18:01
  the financial side, I mean, there's a lot
• 18:02
  of big changes
• 18:03
  overall. But for the clinical team, for the
• 18:06
  physicians and nurses already on board, what types
• 18:08
  of things are are they having to adjust
• 18:10
  about the way they think about practices or
• 18:13
  their standards or protocols?
• 18:14
  How are they being affected by the transition
• 18:17
  of value based care, and what are you
• 18:19
  doing to make it as strict seamless as
• 18:21
  possible?
• 18:22
  Yeah. Absolutely. So we are,
• 18:26
  changing the model to support the value based
• 18:28
  care model. One is along team based care.
• 18:32
  So really looking at services, we have, for
• 18:35
  example, a value based care team that has
• 18:37
  a population health services division.
• 18:40
  The team of care coordinators, clinical pharmacists, quality
• 18:44
  folks, they all sit in one location.
• 18:47
  Now what we are looking at doing is
• 18:49
  enhancing and embedding them in the practices so
• 18:52
  they are there in real time for physicians
• 18:55
  so that they are part of the team
• 18:57
  that's providing that team based care. Because that's
• 18:59
  how you move towards value is when you're
• 19:02
  able to get the physician,
• 19:04
  get the patient, the physician, and their patients,
• 19:07
  caretakers all involved in the care of the
• 19:09
  patient,
• 19:09
  then you can reduce the readmission rate. You're
• 19:12
  able to better care for them in the
• 19:14
  home environment.
• 19:15
  We have also involved in hospital at home
• 19:18
  programs. So for all that to happen,
• 19:20
  we really need to enhance the services at
• 19:22
  the ground level, which is in the practices.
• 19:25
  The second thing that we are doing is
• 19:27
  a lot of work around AI innovation.
• 19:30
  I know AI and tech is like a
• 19:32
  big buzzword these days. We're actually looking at
• 19:35
  all of the practical
• 19:37
  implications
• 19:38
  of
• 19:39
  inputting these AI tools in our practices.
• 19:42
  If it's going to help the patient,
• 19:45
  if it's going to help with delivery models
• 19:47
  that's going to take care of the patient
• 19:48
  when they are at home,
• 19:50
  we are definitely evaluating all of those tools.
• 19:52
  And we have we have looked at multiple
• 19:55
  platforms that's going to help the patients
• 19:58
  with not just the patient navigation into practices,
• 20:01
  but taking care of them in their homes
• 20:03
  so that they are not heading back into
• 20:05
  the hospital and increasing the
• 20:07
  the
• 20:08
  the complexity
• 20:09
  of their problems by delaying care. So we
• 20:13
  really want them to have the best available
• 20:15
  services.
• 20:17
  Access is critical,
• 20:18
  whether in the form of physicians and APPs.
• 20:21
  Having access to the teams,
• 20:23
  so the value based care team will provide
• 20:25
  all of those support services.
• 20:27
  And with technology, we feel like we can
• 20:30
  improve the operational efficiency and effectiveness
• 20:32
  of the care that we are delivering.
• 20:35
  So a lot of great work that's going
• 20:37
  on in in this tremendous growth mode.
• 20:41
  Got it. That that's super helpful. Thank you
• 20:43
  so much for digging a bit deeper. Before
• 20:45
  we wrap up, I wanna talk about growth
• 20:46
  as well. Where do you see some of
• 20:48
  the best opportunities for organizational growth?
• 20:52
  For us, specifically, I had mentioned some of
• 20:55
  the services, which is growing much more rapidly
• 20:57
  than others, which is women's care services and
• 20:59
  pediatric growth. And to help with that, we
• 21:02
  are not only just looking at the ambulatory
• 21:04
  footprint.
• 21:05
  We're actually building our own freestanding children's hospital.
• 21:08
  We already have a children's hospital. We're building
• 21:11
  a freestanding children's hospital that's going to be,
• 21:14
  it's slated for in the next three years.
• 21:17
  So that is the timeline where we need
• 21:19
  to enhance the services we are providing. It'll
• 21:21
  provide every aspect of pediatric care that's possible
• 21:25
  from end to end,
• 21:26
  whether it's going to be early stages of
• 21:28
  primary pediatric services to end stages of
• 21:32
  transplants for pediatrics, BMT, CAR T and all
• 21:34
  of that.
• 21:35
  Then we are looking at
• 21:37
  the APP integration. As I said, that's where
• 21:40
  the organizational growth will occur because it's the
• 21:43
  types of people we have in our team.
• 21:45
  We need more, not just physicians who are
• 21:48
  providing the care. We need more nurses. We
• 21:50
  need more allied health professionals. We need more
• 21:52
  techs.
• 21:53
  And we need more PCLs who are on
• 21:55
  the ground level providing the care for these
• 21:58
  patients.
• 21:58
  So along with the growth of the population,
• 22:01
  we are matching the growth
• 22:02
  with the types of people who can provide
• 22:04
  that level of care. These are two big
• 22:06
  areas we are focusing on. But as every
• 22:09
  other health system is doing,
• 22:10
  we are not doing this without or ignoring
• 22:14
  the enhancements in technology and innovation we need
• 22:16
  to input. We are integrating that into the
• 22:19
  practices as well.
• 22:23
  Fascinating.
• 22:24
  Thank you so much for joining us on
• 22:26
  the podcast today. This has been such a
• 22:28
  fantastic conversation. I'm really excited to learn more
• 22:31
  about what you're doing at BayCare and,
• 22:33
  you know, continue to dig deeper at the
• 22:35
  annual meeting. I know you'll be speaking on
• 22:36
  a panel and really truly,
• 22:38
  you know, sharing some of these great insights
• 22:41
  and and learnings that you've had. So I'm
• 22:42
  looking forward to that, and, it'll be a
• 22:44
  great opportunity to grow and and, connect with
• 22:47
  others. So, thank you so much for your
• 22:48
  time today, and looking forward to April. Thank
• 22:50
  you. And when you come, thank you so
• 22:52
  much, Laura. Really looking forward to it.