Latest / Becker’s Payer Issues Podcast / Advancing Rural Health Access and Innovation with Brendan Harris & Patti Jackson-Gehris

Transcript

Advancing Rural Health Access and Innovation with Brendan Harris & Patti Jackson-Gehris · Becker’s Payer Issues Podcast

• 0:00
  Hello, everyone. This is Jacob Emerson with the
• 0:02
  Becker's Payer Issues podcast.
• 0:04
  Thrilled today to be joined by two senior
• 0:07
  leaders from UPMC.
• 0:09
  Brendan, Patty, thank you both very much for
• 0:11
  taking the time to be with me on
• 0:13
  the podcast today. Before we dive into everything
• 0:15
  we wanna talk with you about and some
• 0:17
  really impactful initiatives going on at UPMC,
• 0:20
  can you both first tell our audience a
• 0:22
  little bit more about yourselves, your background in
• 0:25
  health care, and what your roles entail at
• 0:27
  UPMC
• 0:28
  today? Patty, I'll come to you first.
• 0:31
  Yes. Thank you. I'm very happy to be
• 0:33
  joining with you today. My name's Patty Jackson.
• 0:36
  I'm the market president for what I refer
• 0:38
  to as UPMC in North Central PA.
• 0:41
  I'm, coming to you today from Williamsport, Pennsylvania
• 0:44
  in Lycoming County, and I oversee four hospitals
• 0:47
  in a very rural part of Pennsylvania.
• 0:50
  So my career started a very long time
• 0:53
  ago, in my twenties in the Philadelphia market.
• 0:56
  And I worked, primarily as a consultant in
• 0:58
  the health care industry and moved to a
• 1:01
  for profit health system and then joined eleven
• 1:03
  years ago UPMC here in in Williamsport, Pennsylvania.
• 1:08
  The thing that I love most about my
• 1:09
  job is is waking up every day in
• 1:12
  these communities and figuring out how we meet
• 1:14
  the needs of of every single member and
• 1:16
  how we, you know, continue
• 1:19
  to do things differently and better, to ensure
• 1:21
  access to great health care. So I work
• 1:23
  with a great team and a lot of
• 1:24
  people really dedicated and passionate about what they
• 1:27
  do here.
• 1:28
  Thank you, Patty. How about you, Brendan?
• 1:31
  Hello. It's it's great to be back, on
• 1:33
  the the the podcast, and,
• 1:35
  I'm Brendan Harris. So I'm responsible for all
• 1:38
  of our state programs,
• 1:39
  that work on Medicaid.
• 1:41
  And, you know, I'm glad to be part
• 1:43
  of this conversation because I'm originally from a
• 1:45
  small rural community,
• 1:47
  here in Southwestern Pennsylvania.
• 1:49
  And, you know, I've seen firsthand
• 1:51
  in my life,
• 1:52
  you know, growing up in that small community,
• 1:54
  but also,
• 1:55
  in my time in government,
• 1:57
  really working through
• 1:59
  a lot of the challenges that our communities
• 2:01
  face in making sure that they're able to
• 2:02
  maintain access to health care and and a
• 2:04
  lot of these essential services.
• 2:06
  Wonderful. Well, thank you both very much for
• 2:08
  taking the time out of busy schedules to
• 2:10
  chat with us about some really important issues
• 2:13
  going on across the country.
• 2:15
  So I know you both are very familiar
• 2:17
  about,
• 2:18
  the crisis that rural communities across the country
• 2:21
  are facing and certainly in Pennsylvania
• 2:24
  with growing challenges
• 2:26
  to accessing
• 2:27
  high quality health care.
• 2:29
  And that pressure, it's hitting
• 2:31
  hardest in places,
• 2:33
  you mentioned, Patty,
• 2:34
  places like Lycoming, Potter Counties in Pennsylvania.
• 2:38
  So can you detail for us, Patty, a
• 2:40
  little bit about how UPMC
• 2:42
  is approaching rural health right now,
• 2:45
  new strategies,
• 2:46
  new initiatives,
• 2:47
  to really boost high quality
• 2:50
  care access?
• 2:52
  Absolutely.
• 2:53
  So the the area even though I'm here
• 2:54
  in Williamsport,
• 2:55
  I have three critical access hospitals,
• 2:59
  that I oversee in our region. One is
• 3:00
  in Lycoming County, one is in Tioga Tioga
• 3:03
  County, and one is in Potter, which you
• 3:05
  mentioned. And I use a little fun fact
• 3:07
  about Potter County when I talk about it.
• 3:09
  You know, a lot of urban markets have
• 3:12
  1,700
• 3:13
  to 2,500
• 3:14
  people per square mile. In Potter County, there's
• 3:16
  15 people per square mile.
• 3:19
  So, beautiful, beautiful land, but but it is
• 3:22
  a low population.
• 3:23
  So, you know, for me, it is always
• 3:26
  rooted in the needs of the community first.
• 3:29
  And so we do a health needs assessment
• 3:31
  every three years, and that's really where we
• 3:33
  get a pulse on where are the gaps
• 3:35
  in care, where are people struggling most. And
• 3:37
  and it's always things like diabetes, heart disease,
• 3:41
  you know,
• 3:42
  growing, you know, disease states, but also it
• 3:44
  it's food insecurity, it's transportation
• 3:47
  issues. Those are some of the fundamental issues
• 3:49
  with access to care. So we start there,
• 3:52
  and and the challenges facing us now is
• 3:54
  is really looking at how we reinvent and
• 3:56
  do things differently.
• 3:57
  We're focusing on right care, right place. You
• 4:00
  know, we can't be redundant. We we can't
• 4:02
  have everything everywhere,
• 4:03
  but we can make sure there's access points
• 4:05
  for care and that we can get people
• 4:07
  to the next level of care if they
• 4:09
  need it.
• 4:10
  And really focusing on on people getting further
• 4:13
  upstream, prevention, education. How do we keep people
• 4:16
  healthier
• 4:17
  to avoid some of those those, disease states
• 4:19
  that that we address on a regular basis?
• 4:22
  I always say to people, you know, the
• 4:24
  last place we wanna see you is in
• 4:25
  the emergency department. Right? We wanna keep you
• 4:28
  in your primary care office, keep you well
• 4:30
  outside of the walls of the hospital.
• 4:32
  We'll have the services for you if you
• 4:34
  need it, but we need to figure out
• 4:36
  how to address it further upstream. So it's
• 4:39
  it's a lot of things that challenges that
• 4:41
  are facing health care, and,
• 4:43
  it's gonna take partnerships across
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  all areas for us to figure out what
• 4:48
  we're gonna look like three, five, ten years
• 4:50
  from now.
• 4:51
  And and, Brendon, bring the policy standpoint in
• 4:54
  here from from the strategy that Patty just
• 4:57
  laid out for us for UPMC
• 5:00
  and where federal,
• 5:01
  state, rural health transformation goals are heading and
• 5:04
  have been laid out over the last year
• 5:06
  or so?
• 5:08
  Well, I I mean, I think, you know,
• 5:09
  Patty hit the nail on the head really
• 5:11
  with talking about, you know, those other things
• 5:13
  that have an impact on someone's health and
• 5:16
  well-being.
• 5:17
  And and, really, I think at the heart
• 5:18
  of it is is meeting people where they
• 5:20
  are,
• 5:21
  and finding those different avenues to provide care
• 5:24
  in that sense. And and, you know, because
• 5:26
  really at a from a policy standpoint,
• 5:28
  rural access is at a critical inflection point.
• 5:30
  I mean, I think we're seeing
• 5:32
  growing care deserts at the same time
• 5:35
  that we're seeing that the traditional models are
• 5:38
  not necessarily working.
• 5:40
  And
• 5:41
  it's not just about financial pressure on hospitals,
• 5:43
  in rural areas, which is obviously a big
• 5:45
  piece of things.
• 5:47
  It's it's about really trying to look at
• 5:50
  the overall health care system
• 5:52
  and how you can access those different gaps
• 5:55
  and and or assess those different gaps and
• 5:58
  really look at
• 5:59
  how you can get care to people either
• 6:02
  through technology,
• 6:04
  and telehealth,
• 6:05
  or meeting people where they are because, really,
• 6:09
  the the the care shouldn't be in the
• 6:11
  emergency room. And that's what's happened in a
• 6:13
  lot of, a lot of areas. And, you
• 6:15
  know, really, we're we're seeing some some really
• 6:18
  truly key policy opportunities as we look forward
• 6:21
  here,
• 6:23
  by the federal and state government with the
• 6:25
  the rural health transformation plan and program that
• 6:28
  was, part of the the the the big,
• 6:31
  HR one legislation that passed last year.
• 6:34
  And a lot of that is really aligned
• 6:36
  around redesigning
• 6:37
  and not just short term relief,
• 6:39
  because, really, at the end of the day,
• 6:41
  short term relief is not gonna do that.
• 6:43
  And and and this is really where UPMC
• 6:45
  has,
• 6:46
  a unique position in this,
• 6:48
  really at the end of the day because,
• 6:50
  you know, we're really hitting all the different,
• 6:53
  parts of the full continuum with the health
• 6:55
  plan, obviously, where I work, but also working
• 6:57
  in conjunction with,
• 6:59
  our hospital partners,
• 7:01
  our physicians, our behavioral health network, and our
• 7:03
  home and community based providers
• 7:05
  to really
• 7:06
  invest in the workforce,
• 7:08
  the bringing technology enabled care to the table
• 7:11
  and and doing this with as a regional
• 7:14
  collaborate,
• 7:15
  collaborative approach. Because at the end of the
• 7:17
  day,
• 7:18
  we're all in this together,
• 7:20
  and it's not just an us versus them
• 7:22
  scenario. And I think that's really where we
• 7:24
  look at some of these broader policy opportunities,
• 7:27
  and that strategy
• 7:28
  is becoming more and more clear. We can't
• 7:31
  just preserve what's here today. We have to
• 7:33
  look at how we redesign how care is
• 7:36
  delivered in these communities.
• 7:38
  And I think that's really where this program
• 7:40
  gives us some unique opportunities
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  because,
• 7:43
  you know, the funding is focused on building
• 7:45
  infrastructure and then bringing insurers,
• 7:48
  and some of us to the table to
• 7:50
  really help with that sustainability,
• 7:52
  because that's really at the end of the
• 7:53
  day. You can put a pilot together. You
• 7:56
  can try something new, experiment.
• 7:58
  But if you can't sustain it, it's not
• 7:59
  gonna solve the long term problems. And I
• 8:01
  think that's really where you need that broad
• 8:04
  collaborative approach together from both the payers, the
• 8:06
  providers, the community based organizations, the local elected
• 8:10
  officials
• 8:11
  to really come to the date table to
• 8:13
  really understand what's happening there and really look
• 8:16
  at how we create sustainable programs,
• 8:20
  alternative payment models, and having benefit design that
• 8:23
  really encompasses
• 8:24
  how you can meet people where they are
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  and really continue to serve in these rural
• 8:28
  communities. And, you know, while with the program,
• 8:31
  there's only five years of funding, I think
• 8:33
  the way that we can approach it collectively,
• 8:35
  and this is how we've done it at
• 8:36
  UPMC, is having all sides at the table
• 8:39
  so that we can work together to really
• 8:41
  sustain this and make sure that we're able
• 8:43
  to to to really reinvigorate rural health care
• 8:46
  and continue to provide that access.
• 8:48
  Absolutely. And you touched on this, Brendon, but
• 8:50
  part of this $50,000,000,000
• 8:52
  federal initiative is is grants for workforce development
• 8:57
  in rural areas.
• 8:59
  So can you talk to the audience a
• 9:00
  little bit about why workforce development is a
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  central
• 9:04
  piece of solving rural health care access?
• 9:08
  I I think at the end of the
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  day, you can't really provide care unless there's
• 9:11
  people. This is the people business. And in
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  places where you have care deserts,
• 9:17
  you have a a a lot of services
• 9:19
  that are disappearing.
• 9:20
  And we need to make sure that the
• 9:21
  workforce
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  is is really there and that we can
• 9:25
  have infrastructure in place, technology,
• 9:29
  and all those different things and big buildings
• 9:31
  and everything. But if you don't have the
• 9:33
  people, you're not gonna be able to make
• 9:35
  it work. And that's really at the heart
• 9:37
  of it. And, you know, we see opportunities
• 9:40
  and we look at this in OB.
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  Obviously, that's a big challenge that we've got
• 9:43
  across the board, but also with substance abuse,
• 9:46
  behavioral health, all these things, even in urban
• 9:49
  areas.
• 9:50
  So we need to really kinda collectively come
• 9:52
  together to look at that, and and
• 9:55
  it's it's a safety issue at the end
• 9:57
  of the day for a lot of this.
• 9:58
  And if you don't have the infrastructure in
• 10:00
  place and the workforce that's able to provide
• 10:02
  that care, it really limits what you can
• 10:04
  or cannot do,
• 10:06
  with providing that care.
• 10:08
  And and, Brendon, I know that UPMC has
• 10:10
  been investing
• 10:11
  in surgical OB fellowships for family medicine physicians,
• 10:15
  rural OBGYN
• 10:17
  fellowships.
• 10:19
  Actually, Patty, you know, I know Brendon touched
• 10:21
  on this earlier in terms of the the
• 10:23
  care deserts that are emerging in in parts
• 10:25
  of the country.
• 10:26
  So from the clinical standpoint,
• 10:28
  if we're talking about maternity care deserts specifically,
• 10:32
  they're they're becoming more common across your region
• 10:35
  as well in the markets you serve. So
• 10:37
  what does that mean for pregnant women in
• 10:40
  an emergency
• 10:41
  right now? What are you seeing,
• 10:43
  at the hospitals that that you oversee?
• 10:46
  Right. So over the last year, we we
• 10:48
  have been working to transforming
• 10:50
  to a new model of care for for
• 10:52
  labor and delivery and for women's services
• 10:54
  across Potter And Tioga Counties.
• 10:57
  You know, Brendan talked about the financial pressures,
• 10:59
  and they're real. I have never seen in
• 11:01
  my forty plus years in health care this
• 11:03
  level of financial pressure, but that is not
• 11:05
  the only thing. The workforce is
• 11:08
  is definitely one of the factors that's really
• 11:10
  causing us to rethink some of our our
• 11:12
  care delivery and how we do it. For
• 11:14
  instance, in Potter County, we had a labor
• 11:17
  and delivery unit that we
• 11:19
  regionalized with UPMC Wellsboro, which had a labor
• 11:22
  and delivery unit about forty five minutes away
• 11:24
  because we had been recruiting for an OBGYN
• 11:26
  doctor for over two years
• 11:29
  with zero recruits.
• 11:31
  And so it we we really had to
• 11:33
  critically look at that with declining, you you
• 11:35
  know,
• 11:38
  reinvent care. So it's easy to just say
• 11:41
  we're gonna stop doing something. It's hard to
• 11:43
  say, how can we meet the needs of
• 11:45
  the community but in a different way? And
• 11:47
  so that's what we've been doing in this
• 11:49
  space in my market. And so we're really
• 11:51
  double down on prenatal care, on getting people
• 11:54
  to those appointments, and having a care team
• 11:57
  that they can see in their their community,
• 11:59
  you know, close to home for all of
• 12:01
  their prenatal care. But when they it's time
• 12:03
  for delivery, making sure they have a planned
• 12:05
  delivery and that they have the same care
• 12:06
  team they're seeing in the office when they
• 12:08
  come to the hospital for delivery.
• 12:10
  And looking at that full continuum of care
• 12:13
  and and access in all areas is is
• 12:15
  what's really important. And these are hard decisions,
• 12:18
  but we're seeing it work, and we're seeing
• 12:20
  women really step up. And what we've been
• 12:22
  able to do in that market is we've
• 12:24
  been able to stabilize the workforce.
• 12:26
  We've been able to recruit to to this
• 12:28
  model in Wellsboro. We've been able to hire,
• 12:31
  our first,
• 12:32
  family medicine obstetrics doctor that we've not had
• 12:35
  before
• 12:36
  into this model under the leadership of our
• 12:38
  our OB GYN lead doctor there. So it
• 12:41
  is about doing it differently, and and that's
• 12:43
  the hard part for communities to understand
• 12:46
  is we've always had this. But with what's
• 12:48
  facing us moving forward, how do we reinvent
• 12:51
  and how do we deliver care in a
• 12:52
  different and hopefully better way? I think the
• 12:55
  work that we're doing around prenatal care and
• 12:58
  and doing more and and opening up more
• 13:00
  access access
• 13:01
  there
• 13:02
  is helping the community and is improving outcomes.
• 13:04
  And, Patty, sticking on this topic, but but
• 13:06
  expanding a little bit beyond maternal and prenatal
• 13:08
  care, can you talk a little bit about
• 13:10
  UPMC's
• 13:11
  work and some of the outcomes you're seeing
• 13:13
  around areas like dementia, diagnosis, behavioral health access
• 13:17
  in the markets you serve as well.
• 13:19
  Sure. So, you know, so much of the
• 13:21
  work we do is outside the walls of
• 13:23
  our facility. So the more we are out
• 13:25
  there so we have a mobile health unit
• 13:26
  that we deployed in Tioga County and Potter
• 13:29
  County,
• 13:30
  And, they're doing things to get out to
• 13:33
  the people. Brendan said it exactly right. You
• 13:35
  gotta go to where people are. And, they're
• 13:38
  bringing out providers. They're bringing out our our,
• 13:40
  you know, community health workers. And we're educating
• 13:44
  people, and we're getting to them, you know,
• 13:45
  about early diagnosis with dementia. We know if
• 13:48
  that we can educate them on what to
• 13:49
  look for, get them to that primary care
• 13:51
  doctor quicker.
• 13:53
  We're going to see better outcomes with them.
• 13:55
  Same things around prenatal care.
• 13:57
  I'll I'll share an interesting story, something that
• 14:00
  that is a a simple innovation
• 14:03
  is food insecurity
• 14:04
  is rampant throughout all of the communities that
• 14:06
  I serve, and food is is health. Right?
• 14:09
  Food is is medical.
• 14:11
  You need, you know, to have good nutrition
• 14:13
  and access to food to be healthy.
• 14:16
  And so we partnered with the local food
• 14:18
  banks, and we do two different programs. We
• 14:20
  use our mobile health unit to go out.
• 14:22
  And while we're doing that education, we distribute
• 14:25
  food boxes, boxes and we
• 14:27
  distribute food to those communities, and it's wildly
• 14:30
  successful.
• 14:31
  In addition, we have an emergency food box
• 14:33
  program in all of our hospitals. So if
• 14:36
  you come to any of our hospitals or
• 14:37
  physician practices and
• 14:40
  you we ask the question, you know, do
• 14:41
  you have access to food? Do you have
• 14:43
  something to eat when you go home? If
• 14:45
  the answer is no, they'd leave our facility
• 14:47
  with a box, and we enroll them with
• 14:49
  the local food bank to make sure they
• 14:51
  continue that access to food. And that is
• 14:53
  one of the ways we improve outcomes because,
• 14:55
  you know, if I talk to I had
• 14:57
  an interesting conversation with one of my dietitians
• 14:59
  not too long ago,
• 15:01
  and they see people coming in here in
• 15:03
  cardiac arrest and diabetic, you know,
• 15:06
  shock and things like that. And they said,
• 15:08
  you know, when they sit down and meet
• 15:09
  with these patients,
• 15:10
  they believe that that could have been avoided,
• 15:12
  but it was the food insecurity that triggered,
• 15:15
  you know, that that increase in in that
• 15:17
  disease state that got them into the emergency
• 15:19
  department.
• 15:20
  So so that's a a way that we're
• 15:21
  improving outcomes is is getting out and about
• 15:23
  to the community, meeting them where they are,
• 15:26
  providing them with information, and then help connect
• 15:28
  them to the care that they need.
• 15:30
  Well, Brandon, let me come back to you
• 15:32
  and talk a little bit about other things
• 15:34
  that the rural health transformation program
• 15:36
  will be funding or providing grants to around
• 15:40
  technology development and adoption
• 15:42
  in rural areas.
• 15:44
  I know telehealth,
• 15:45
  econsults,
• 15:46
  remote monitoring are a big piece
• 15:49
  of UPMC's
• 15:50
  rural work and and strategy.
• 15:52
  So can you talk to us a little
• 15:53
  bit about how those technologies are helping bridge
• 15:56
  some of the geographic gaps,
• 15:58
  without displacing the local care teams that you're
• 16:01
  trying to build up right now?
• 16:03
  Well, and I think that's
• 16:05
  at the end of the day, it's it's
• 16:06
  not about replacing the local care teams. It's
• 16:08
  about supplementing it. Ultimately, it's an access multiplier,
• 16:11
  but it's not a replacement for that local
• 16:13
  care. You still need that local care and
• 16:15
  that local, presence.
• 16:17
  But one of the great things about telehealth
• 16:19
  and econsults,
• 16:20
  remote monitoring is another one.
• 16:23
  It's extending the reach of our providers
• 16:26
  into places they otherwise would not be able
• 16:28
  to go, and that would otherwise be in
• 16:30
  isolation.
• 16:31
  And we've actually brought a lot of telehealth
• 16:34
  into some of our rural hospitals here in
• 16:36
  Western Pennsylvania,
• 16:38
  with, one of our facilities in the Northwest
• 16:40
  where, you know, you've got a local care
• 16:42
  team there, but they're able to then access
• 16:45
  a lot of incredible infrastructure and specialists,
• 16:49
  to really stabilize patients in the population.
• 16:51
  And and the goal isn't to centralize that
• 16:53
  care. It's to support the local teams with
• 16:55
  that specialty expertise,
• 16:57
  and real time backup so that patients can
• 16:59
  stay in their communities whenever possible. And we
• 17:01
  see this happening also with behavioral health.
• 17:04
  Telepsych
• 17:05
  and consults that are happening have extended the
• 17:08
  the the reach of behavioral health providers,
• 17:10
  into a lot of these communities, but
• 17:13
  you also need to make sure that the
• 17:14
  local care teams,
• 17:16
  are supported and and having initiatives
• 17:19
  that really provide consult services,
• 17:21
  but also give them additional support and expertise
• 17:24
  to be able to provide that care and
• 17:26
  get the patients and the population stabilized locally.
• 17:29
  So I think that's really a lot of
• 17:31
  where our focus has been through the years
• 17:34
  is how can we develop that that infrastructure
• 17:36
  to really connect into some of those specialists
• 17:39
  and really be that extension.
• 17:41
  Because
• 17:42
  to to a lot of Patty's points, you
• 17:44
  know, trying to bring that workforce into some
• 17:46
  of these rural communities gets very difficult. But
• 17:48
  if you can extend it from an area
• 17:50
  where they are, it opens up a world
• 17:52
  of possibilities that you can bring that infrastructure
• 17:54
  locally and and really meet people in those
• 17:57
  rural communities.
• 17:58
  Absolutely. And Patty,
• 18:00
  talking about this from from the perspective of
• 18:03
  how this impacts older adults, what would you
• 18:05
  add there in terms of what Brandon just
• 18:07
  laid out and and how you're now able
• 18:09
  to better or will be able to better
• 18:10
  reach seniors who, of course, you know, face
• 18:13
  travel challenges across long distances, trying to reach
• 18:16
  your brick and mortar facilities.
• 18:18
  What does that all mean for them?
• 18:20
  Yeah. So it's interesting. You know, pre 2020,
• 18:23
  we've said people aren't gonna do it. Right?
• 18:25
  They're not gonna adopt telemedicine. They're not gonna
• 18:27
  do video visits with their doctors. And then,
• 18:29
  you know, a global pandemic happened, and it
• 18:32
  catapulted forward people's adoption of this kind of
• 18:35
  technology.
• 18:36
  And the older adults were probably the most
• 18:38
  resistant, but I you know, fast forward to
• 18:40
  where we are today, they love it. It.
• 18:41
  They love the ability to to get that
• 18:43
  access and and to be able to do
• 18:45
  the video visit. And, you know, we do
• 18:47
  some training and some education with them, but
• 18:49
  they love that access.
• 18:51
  You know, this ties directly into the work
• 18:53
  we're doing with our emergency, you know, medicine
• 18:54
  professionals in the field, our EMS workers. You
• 18:54
  know, they can go into a home of
• 18:55
  of
• 18:56
  workers.
• 18:57
  You
• 18:58
  know, they can go into
• 18:59
  a home of of an older adult who
• 19:01
  maybe, you know, can't leave their home easily,
• 19:03
  and they can do a video visit back
• 19:05
  to their primary care doctor or their specialist
• 19:08
  and, you know, can be the intermediary to
• 19:10
  make sure that they're they're getting the care
• 19:12
  they need and and help get them checked
• 19:14
  out. So it's really helpful, and it's it's
• 19:17
  not just, you know, the
• 19:19
  the visit, the primary care doctor visit or
• 19:21
  the specialty doctor visit. There's education that can
• 19:24
  be done. We can do med checks. We
• 19:25
  can do
• 19:26
  diabetic education.
• 19:27
  We can do falls and risk management, you
• 19:29
  know, via video visit in talking to people
• 19:32
  and talk them through what they need to
• 19:34
  look for. And the other great thing about
• 19:35
  it is it's easy for families to participate.
• 19:38
  So sometimes, you know, maybe that caregiver isn't
• 19:40
  in the same location as their their mother
• 19:43
  or grandparent is. And when you do the
• 19:45
  video visit, they can participate in their care.
• 19:47
  So it's really opened up a new world
• 19:49
  of possibilities, and adoption is going very well.
• 19:53
  That's amazing to hear, and it's so great
• 19:55
  to hear that you've also been seeing older
• 19:57
  adults really pick up the use of this
• 19:59
  technology,
• 20:00
  Patty.
• 20:01
  Brendan, before we go, you know, we've touched
• 20:04
  on a lot of different things today. I
• 20:05
  know we could have a much longer conversation
• 20:08
  about this program and and the trickle down
• 20:10
  effects for your patients. But if we're looking,
• 20:12
  as you mentioned, it's a five year program.
• 20:14
  So if we're looking at that timeline five
• 20:16
  years out from now, how does UPMC measure
• 20:19
  success here? And what should some of your
• 20:21
  rural patients be expecting
• 20:23
  on the ground
• 20:24
  over this timeline?
• 20:26
  I mean, I think over the next five
• 20:28
  years and and you're absolutely right. We could
• 20:29
  be going on and on for quite some
• 20:31
  time about this. But but, really, I I
• 20:33
  mean, I think when you look at the
• 20:35
  opportunity before us, and a lot of what
• 20:37
  Patty has put into place and what what
• 20:39
  we've done across UPMC
• 20:41
  is success is gonna be measured in practical
• 20:43
  terms. I think that's really where a lot
• 20:45
  of this comes in. It's more local access
• 20:47
  points, maybe not through the traditional means, but
• 20:50
  through telehealth and some of the other things
• 20:52
  that we talked about here. It's a stronger
• 20:54
  rural workforce.
• 20:55
  We know individuals
• 20:57
  who come and work in those rural communities
• 20:59
  oftentimes wanna stay there. And when you invest
• 21:01
  in them and invest in that, it can
• 21:03
  go a long way. You know, trying to
• 21:05
  look at fewer avoidable emergencies, I think, to
• 21:07
  to Patty's earlier point, it's meeting people where
• 21:10
  they are and going to them so that
• 21:12
  care is not just defaulting to the emergency
• 21:15
  department.
• 21:16
  And having some of those mobile opportunities
• 21:18
  and and, you know, really looking at how
• 21:20
  you can bring some of that care to
• 21:22
  them. And and really for for the residents,
• 21:24
  it's it the hope is that there's gonna
• 21:26
  be less fragmentation with this. Again, a lot
• 21:28
  of this is really looking at the overall
• 21:31
  continuum and all of us coming together
• 21:33
  to really solve the the core issues, which
• 21:36
  means hopefully less long drives,
• 21:39
  and and having that care accessible and local.
• 21:43
  And, you know, it's not how many programs
• 21:45
  we launch. It's how many are still working
• 21:47
  and growing at the end of that point.
• 21:50
  Because, again, back to the the funding that's
• 21:53
  coming through this, it's it's some start up
• 21:55
  capital, but we need to be able to
• 21:57
  sustain this by models that actually make sense
• 21:59
  and really
• 22:00
  provide the true supports that our communities,
• 22:04
  need and deserve.
• 22:06
  And, Patty, your final thoughts for us and
• 22:08
  and how this all shakes out over the
• 22:10
  next five years?
• 22:11
  Yeah. I mean, I feel a tremendous need
• 22:14
  to to really advocate and and share just
• 22:17
  like I'm doing here today, you know, what
• 22:19
  the needs are in these rural communities. And
• 22:21
  and, you know, we need to maintain the
• 22:23
  funding that we currently get, but the real
• 22:25
  health transformation
• 22:26
  funds is exactly what Brendan said. It allows
• 22:29
  us to really find another avenue to reinvent
• 22:33
  the care models.
• 22:34
  You know, if there's one thing I can
• 22:36
  tell you for sure,
• 22:38
  the future of health care and hospitals is
• 22:40
  gonna look very different. And for us to
• 22:42
  make sure that difference includes great access, great
• 22:45
  care, and a thriving health care network,
• 22:48
  it's going to be these new models of
• 22:50
  care. So some of the work that these
• 22:52
  funds will enable us to do with workforce
• 22:54
  development,
• 22:55
  with
• 22:56
  education and prevention and wellness,
• 22:58
  with getting access through nonconventional methods like different
• 23:02
  telemedicine centers, video visits. And a big piece
• 23:05
  of what we're looking for in our rural
• 23:07
  communities is really bolstering that EMS profession. Because
• 23:10
  when you talk about hospital at home and
• 23:12
  and taking care of where the people are,
• 23:14
  they're gonna be critical to that. And so
• 23:16
  these funds are gonna allow us to sort
• 23:18
  of forward
• 23:19
  in a in a quicker way some of
• 23:21
  those initiatives around our our EMS, you know,
• 23:24
  that serves these very critical rural regions.
• 23:27
  Wonderful. Well, Brendan, Patty, thank you both very
• 23:30
  much for being with us today and for
• 23:33
  sharing about the latest strategies going on under
• 23:35
  your leadership, to provide this high quality care
• 23:38
  in rural areas. We really, really appreciate it.
• 23:40
  Thank you. Thank you. And to our listeners,
• 23:43
  if you'd like to listen to more podcasts
• 23:45
  from Becker's Healthcare, you can visit beckershospitalreview.com.