Latest / Becker’s Healthcare - Clinical Leadership Podcast / Virtual Care and Improving Emergency Department Flow at Ochsner Health with Dr. Lisa Fort

Transcript

Virtual Care and Improving Emergency Department Flow at Ochsner Health with Dr. Lisa Fort · Becker’s Healthcare - Clinical Leadership Podcast

• 0:01
  Every year, Becker's annual meeting brings health care
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  leaders together to unpack the most pressing issues
• 0:06
  facing the industry.
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  And every year, those conversations shift in profound
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  and unexpected ways. This April, more than 3,500
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  health care executives will return to Chicago for
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  Becker's sixteenth annual meeting.
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  795
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  elite speakers will offer new lessons, new case
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  studies, and predictions about what comes next. Join
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  us April 13 through the sixteenth.
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  For the agenda and event details, visit beckershospitalreview.com
• 0:33
  and click on the events tab in the
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  upper right.
• 0:38
  This is Laura Dirda with the Becker's Healthcare
• 0:40
  podcast. I'm thrilled today to be joined by
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  doctor Lisa Fort, assistant chief medical information officer
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  and system medical director of the virtual care
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  center at Ochsner Health. Doctor Fort, it's a
• 0:50
  pleasure to have you on the podcast today.
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  Thanks for having me, Laura. Very happy to
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  be here.
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  Absolutely. And, you know, I'm looking forward to
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  our conversation because I know you are a
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  very technology forward health system, and you're leveraging,
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  technology and virtual care in very unique ways.
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  And so it'll be exciting to dig a
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  little bit deeper into that. But before we
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  do, can you tell us a little bit
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  more about yourself and National Health?
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  Absolutely. So I am an emergency physician.
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  That's my clinical background. Still practice and emergency
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  medicine. Typically work about a shift a week.
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  I, I lovingly term it my living laboratory
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  and still really enjoy patient care. It's very
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  grounding. Back to the mission.
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  I currently hold the roles of assistant chief
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  medical information officer
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  for our inpatient services. We
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  have a large integrated delivery network,
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  you know, more than 45 hospitals. And so
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  my responsibilities
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  include our areas, including not just the emergency
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  department, but our inpatient settings, our critical care
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  settings, our procedural settings, kind of everything that
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  happens,
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  within the hospital itself.
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  And my additional role is as our system
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  medical director
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  of our virtual care center, which is our
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  centralized,
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  quote, unquote, care traffic control center that focuses
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  specifically on
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  centralized monitoring as well as, resourcing like our
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  our virtual nursing program.
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  Absolutely. Wow. That's, incredible to hear and, you
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  know, helpful to understand everything that you're accountable
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  for and how that all works together from
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  the clinical side as well as the technology
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  and leadership side too.
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  I'm curious from the last year or so.
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  Could you tell us about, the most important
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  initiative that you led? What did you do,
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  and what were the results?
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  We had a really interesting project that we
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  kicked off actually in October
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  2024,
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  but last year was really the first year
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  first full year that was in place.
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  The challenge that we were presented with was
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  the,
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  the the the problem of ED overcrowding
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  and our observed versus expected ED utilization, our
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  patient population.
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  We're located in the Deep South.
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  We have facilities, you know, especially our inpatient
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  facilities throughout Louisiana into Mississippi, even a little
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  bit in Alabama.
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  And so we have tremendous
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  challenges in terms of patients ability to access
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  medical care, especially preventative medical care.
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  And, you know, it's even worse in rural
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  areas where we have many health deserts. And
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  so
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  what we saw was a lot of patients
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  by default or just having to go to
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  the ED to get care for routine things
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  and not just their bona fide emergencies that
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  they would need to be there for. And
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  so we were challenged by our executive team
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  to think about an innovative
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  way to be able to address that problem.
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  And what we came up with was,
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  virtual emergency department where we have a board
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  certified ED physician working with a navigator, and
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  we do this seven days a week, three
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  hundred sixty five days a year. We're able
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  to take escalations from various different places in
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  our organization, including our nurse on call line,
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  Ochsner on call, as well as our primary
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  care clinics, our urgent care clinics, and our
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  specialty clinics
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  to help to be a layer
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  to be able to determine if a patient
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  may have the ability to get what they
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  need in alternative
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  setting.
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  And so
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  patients that historically were just been referred to
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  the ED,
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  we're able to say, oh, you know, we
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  can we can help to facilitate some of
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  the care orchestration they may need to be
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  able to get
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  maybe a medication that they need, or we
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  can do a virtual visit with them and
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  and do some, you know, additional assessment of
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  what might need be need to be, taken
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  care of for the patient. And then also
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  provide direct linkage to care,
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  within or without our system so that we
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  can make sure we get them the appropriate
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  follow-up.
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  So the first year results were pretty exciting.
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  We saw more than,
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  16,000 patients through that program, and we're able
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  to keep
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  about sixty five percent of them out of
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  the emergency department and and provide alternative care
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  for them. And we were also able to
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  link about eighty two percent of those patients
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  to care so that they got their follow-up
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  steps since the things that we actually recommended
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  that they do. And so I think that
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  shows that patients are really engaged with this.
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  They believe that the advice we give them
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  is the right advice and they're able to
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  complete that. So,
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  very exciting as a whole and something we
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  look to build in 2026.
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  That's amazing to hear. And, you know, what,
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  fantastic results you were able to bring within,
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  you know, just making a few adjustments and
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  thinking about the preventative care side. I'm curious,
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  how much of a culture of mind shift
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  change was that? Or or was it really
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  pretty simple to get the team on board
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  and make those changes once, you know, you
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  decided to have that focus?
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  I think that there you know, we had
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  all these different stakeholders in this, and it
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  was a huge cultural shift. We spent a
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  lot of time, you know, talking about things
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  and and talking to people about what some
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  of the challenges they they saw were within
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  the existing system. One of the most important
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  things was just making this super, super easy
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  for people. And so,
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  the way it works is essentially we take
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  messages through our EHR,
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  and we're able to respond
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  almost immediately. I think we did a time
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  track where it was something like forty forty
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  seconds. And so really getting people real time
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  linkage to
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  assets that help them to manage patients was
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  was really key.
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  It has to be easier than what they
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  were doing or people won't do it, and
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  they have to see the benefit for themselves
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  and for their patients.
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  So I think that as we started, we
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  had,
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  really heavy
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  uptake and use. And our key user group
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  is still our OXENROL Choline. Of course, patients
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  who are experiencing
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  bonafide emergencies, they're having crushing chest pain or
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  having stroke symptoms or sensitive ED without that
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  intervening step. We don't want to delay care.
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  And then patients who have really low acuity
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  things, they can just be scheduled to see
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  their primary care doctor, their pediatricians,
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  that we still you know, that all still
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  happens, but it's all those patients in the
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  middle. And so a lot of it was
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  just describing how we can do those safely
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  and effectively, and then I think we got
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  people to get on board.
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  Got it. That's helpful to understand. Thank you
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  so much for, describing that process and, you
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  know, helping dig a little bit deeper there.
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  Now looking ahead, what are some of your
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  big priorities as well as headwinds for 2026?
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  So apart from just ED utilization, I think
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  one of the things we did really well
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  last year was we were able to impact
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  our framework of inpatient quality. So everything from
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  hospital acquired complications to hospital acquired infections. So
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  know, when patients come into the hospital and
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  they fall or they may acquire pressure entry
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  or they develop
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  a catheter associated urinary tract infection. So truly
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  by leveraging the virtual care center as a
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  whole, which is, you know, a set of
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  different
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  people working in a centralized fashion to be
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  able to help to screen through patients and
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  and put things into place to help them
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  to get out of the hospital quicker and,
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  you know, without experiencing any harm has been
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  a really big initiative, and we were able
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  to really kind of blow away our targets
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  and our goals.
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  I think that as we look at 2026,
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  it's about how to bring all these things
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  together so that we're looking at it, you
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  know, as a continuum of care for patients
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  and not in little buckets. So, you know,
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  to the patient, their care is going to
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  be
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  everything from when they see their doctor to
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  how they manage their chronic disease, to how
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  they take their medication, to how they communicate
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  with the health system and not just their
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  physician, but all the people that they interact
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  with. And then when they do have something
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  that's going on that is, you know, out
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  of their sort of normal,
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  expected course, how do we then
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  provide links to them so that we have
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  clean handoffs and we don't have fragmented care
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  across that journey? So when a patient needs
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  to go to the hospital, you know, how
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  do we make sure everybody on their their
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  care their existing care team knows about it?
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  How do we smoothly get into the hospital,
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  take care of them well,
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  and, you know, get them home as quickly
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  as possible or where wherever they need to
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  best be,
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  and make sure that we don't sort of
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  drop the ball at each step in those
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  processes.
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  And so
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  I think that when you have a large
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  system with a lot of different,
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  competing priorities, sometimes it's difficult to tell that
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  story. But if you reframe it from a
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  patient centric point of view, everyone
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  has experienced a time where perhaps they or
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  a loved one has, has gone through those
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  different stages. And I think they that that
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  frustration resonates with people, and we can see
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  certainly
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  outcomes,
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  that that we wouldn't want if we don't
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  make sure that we make all that a
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  lot more clean and smooth. And so
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  I think technology is gonna be extremely enabling
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  in that space, especially within those transitional moments.
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  And, you know, we're able to really kind
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  of leverage some of those centralized resources
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  on with the technology layered on top to
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  communicate and even evaluate what is the best
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  thing for for an individual. So I think
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  that's what we're looking at doing. It's you
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  know, I think we we expect it to
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  be challenging, but I think we're prepared for
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  it in 2026.
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  That makes a lot of sense. I, you
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  know, think that's really exciting prospect and and
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  definitely appreciate the idea of, you know, kind
• 9:43
  of bringing that story and telling that story,
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  with with your team and so they can,
• 9:47
  you know, really understand what you're trying to
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  do and how important it is, to continue,
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  down this path so, you know, the community
• 9:55
  has access to care, and you're able to
• 9:57
  continue to do things officially and effectively.
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  What do you think the hardest thing you'll
• 10:01
  have to do in the coming year will
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  be?
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  The the hardest thing always to me is
• 10:06
  just picking the things that you wanna work
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  on. We don't have infinite resources. I do
• 10:10
  think that automation, technology,
• 10:12
  all the exciting things that are happening with
• 10:14
  artificial intelligence and, you know, the agents we
• 10:17
  get to work with as sort of trusted
• 10:19
  digital companions in our care delivery
• 10:21
  are going to help us with that. But,
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  you know, ultimately, I think that you only
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  have so much even with those enablement
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  layers. And so I think we just have
• 10:30
  to make sure that we tie everything back
• 10:32
  to what are our north stars, what are
• 10:34
  we looking at from aspirational goal perspective. So,
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  you know, how do we impact the the
• 10:39
  things that matter to our patients the most
• 10:40
  and our system the most so that we
• 10:42
  can stay,
• 10:43
  you know, financially well positioned for what's coming
• 10:45
  in the next couple of years. Another thing
• 10:47
  that I think is difficult to manage, especially
• 10:50
  on the technology side, is it's just happening
• 10:52
  at such a rapid pace that we're asking
• 10:55
  people to think about things different and practice
• 10:58
  differently. And, you know, that doesn't just that
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  doesn't just apply for for
• 11:03
  physicians or clinicians. It's it's true for everyone
• 11:06
  who's kind of done things almost,
• 11:08
  by brute force, I think, over the past
• 11:11
  several,
• 11:12
  decades in health care. And so, you know,
• 11:14
  change is hard, but showing people again, the
• 11:17
  most important thing is what what is in
• 11:19
  it for our patients and and how do
• 11:21
  we make people's lives better and get them
• 11:22
  out of work on time, get them home
• 11:24
  with their families.
• 11:25
  And so I think that we have to
• 11:27
  be able to enable our workforce of the
• 11:30
  future with the technology of today.
• 11:32
  But how to do that is challenging, and
• 11:34
  it's gonna be really different for different types
• 11:36
  of of groups that we need to be
• 11:38
  cognizant about. So but, you know, what's exciting
• 11:41
  about that is now we have this whole
• 11:43
  new set of assets and resources that we
• 11:45
  can use to take better care of people,
• 11:46
  and we can take some of that burdensome
• 11:48
  work, the kind of the death by a
• 11:51
  thousand clicks, I call it, and shift that
• 11:53
  off of our, you know, the backs of
• 11:55
  our our people.
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  And so even though it'll be hard, I
• 11:58
  think it's very, very exciting and looking forward
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  to to seeing it play out.
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  Absolutely. I,
• 12:06
  definitely
• 12:07
  understand how challenging that can be. And I
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  think, you know, looking at,
• 12:11
  AI technologies, there's so many different opportunities that
• 12:14
  come available. I can imagine,
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  from your perspective, you're getting pitches
• 12:18
  and new technologies every single day. So making
• 12:21
  sure that you've got that focus, truly is
• 12:23
  important. And I know every health care minute
• 12:26
  and dollar is precious, and and thinking through
• 12:27
  that lens can,
• 12:29
  you know, really be grounding it, it seems
• 12:31
  like. Now before we wrap up, I wanted
• 12:33
  to ask as well about growth. Where do
• 12:35
  you see some of the best opportunities for
• 12:37
  organizational growth in the future?
• 12:39
  So I I think this kinda goes back
• 12:41
  to that that same concept of the patient
• 12:43
  journey across the different types of the care
• 12:46
  continuum. And so, you know, looking at patients
• 12:48
  that are just, you know,
• 12:50
  seeing their doctor, doing their regular
• 12:52
  visits, getting their preventative care, how do we
• 12:55
  make that really smooth and easy for people?
• 12:58
  And, you know, I think that in that
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  space, what I see is being able to
• 13:02
  apply,
• 13:03
  some large scale population models to be able
• 13:05
  to determine. Okay. So you may have, you
• 13:08
  know, large large group of patients and a
• 13:10
  certain percentage of them have different stages of
• 13:13
  chronic disease.
• 13:14
  Which of the patients that really need to
• 13:15
  be able to see a specialist for that
• 13:18
  particular disease state, and at what point do
• 13:20
  we have the resources that match to it?
• 13:21
  And then how do you think about, you
• 13:24
  know, providing
• 13:26
  virtual or telemedicine access or even asynchronous access,
• 13:30
  to be able to deliver
• 13:32
  care and help to guide,
• 13:34
  local care teams like patients' primary care physicians
• 13:37
  to be able to, you know, manage everything
• 13:39
  up until that point.
• 13:41
  You know, I I I think medicine's been
• 13:42
  incredibly,
• 13:44
  reactive
• 13:45
  historically,
• 13:46
  and we need to be able to use
• 13:48
  these these real assets that we see
• 13:52
  to create systems that are looking at the
• 13:54
  looking at the future and,
• 13:56
  matching patients to the resources they need the
• 13:58
  most and the ones that need it the
• 13:59
  most at the right time. So, truly, it
• 14:02
  all just comes together to think about
• 14:04
  how do we provide that orchestration layer and
• 14:07
  care traffic control to patients in a way
• 14:10
  that,
• 14:11
  partners with them and and does it in
• 14:13
  a way that seems right because it's not
• 14:14
  gonna be one size fits all to everybody.
• 14:16
  We can't just force people to use particular
• 14:18
  types of apps or, you know, not everyone's
• 14:21
  gonna feel comfortable using digital tools in the
• 14:23
  same way.
• 14:24
  But how do we make sure we're thinking
• 14:26
  thoroughly about, you know, who does benefit from
• 14:29
  it and how we get into their hands
• 14:30
  as quickly as possible?
• 14:32
  Got it. That's,
• 14:34
  makes a lot of sense. It is so,
• 14:35
  so helpful to think through that, perspective and
• 14:39
  keep that in mind. Thank you so much
• 14:41
  for joining us on the podcast today, doctor
• 14:42
  Ford. This has been such a fascinating and
• 14:44
  inspiring conversation, and I look forward to connecting
• 14:46
  with you again soon. Thank you so much,
• 14:48
  Laura. It was great talking to you and
• 14:50
  looking forward to, being up in Chicago for
• 14:53
  Becker's event in the next, couple of months
• 14:55
  in April. Oh, absolutely. Yes. I know you'll
• 14:57
  be speaking on a panel, and we'll be
• 14:59
  able to continue much of this conversation,
• 15:01
  and touch on many of these themes too.
• 15:03
  And it's always such a fun opportunity to
• 15:05
  see people in person and, you know, really
• 15:07
  get to know them a little bit more
• 15:08
  deeply. So I'm looking forward to that as
• 15:10
  well. Thank you.