Latest / Becker’s Healthcare Podcast / Alyssia Crews, MBA, FACHE, Vice President of Orlando Health Cancer Institute

Transcript

Alyssia Crews, MBA, FACHE, Vice President of Orlando Health Cancer Institute · Becker’s Healthcare Podcast

• 0:02
  - There's a small circle of people who truly
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  - For the agenda and event details,
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  - visit beckershospitalreview.com
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  - and click on the events tab in the
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  - upper right.
• 0:52
  - Hello, and thank you so much for tuning
• 0:54
  - in to the Becker's Oncology Leadership Podcast.
• 0:57
  - I'm Elizabeth Gregersen, a reporter here at Becker's.
• 1:00
  - And today, I am talking to Alicia Cruz,
• 1:04
  - vice president of the Orlando Health Cancer Institute.
• 1:07
  - Alicia, thank you so much for taking the
• 1:09
  - time to speak with me today.
• 1:11
  - No. Absolutely.
• 1:13
  - Thank you for taking the time to talk
• 1:14
  - to me. It's been an absolute pleasure getting
• 1:16
  - to know you through Becker's Oncology.
• 1:19
  - Aw. Thank you so much. I know. I'm
• 1:21
  - always grateful to share your insights, so I'm
• 1:22
  - excited that our podcast audience now gets to
• 1:25
  - meet you. Before I dive into my questions,
• 1:28
  - I'd love if you could share a bit
• 1:30
  - about just your background and your role at
• 1:32
  - Orlando Health for our listeners.
• 1:34
  - Absolutely. So I've been in health care operations
• 1:38
  - leadership for about twenty six years.
• 1:41
  - I think I've done every specialty
• 1:43
  - beyond ortho,
• 1:45
  - and I'm gonna leave that alone other than
• 1:46
  - ortho oncology.
• 1:48
  - But about sixteen years ago,
• 1:52
  - I ended up losing my brother to colon
• 1:54
  - cancer and decided I needed to leave the
• 1:57
  - Northeast,
• 1:58
  - applied to a job in the Sunshine State,
• 2:01
  - at the University of Miami to just get
• 2:03
  - out of the Northeast gray. And
• 2:06
  - within
• 2:07
  - nine months, got kind of lured over
• 2:10
  - to talk about a role at a can
• 2:12
  - the cancer institute, so at Sylvester.
• 2:14
  - And just
• 2:16
  - absolutely took a dive, considered it a sign,
• 2:19
  - and for the first time in health care,
• 2:21
  - really fell in love with what I was
• 2:23
  - doing.
• 2:24
  - So I've been in oncology ever since.
• 2:27
  - And, there's no looking back for me. This
• 2:29
  - is my passion plus purpose role. I get
• 2:31
  - to create for patients and their families
• 2:34
  - in everything that we do.
• 2:36
  - And now I also enjoy really building up
• 2:39
  - leaders and building teams and doing startup programs.
• 2:42
  - So it's become a true passion plus purpose
• 2:45
  - career, and I plan to stay oncology for
• 2:48
  - the long haul.
• 2:49
  - Amazing. Thank you so much. And and as
• 2:52
  - you kind of hint at some of the
• 2:54
  - things you're most excited about that you're working
• 2:56
  - on,
• 2:57
  - at Orlando Health,
• 3:00
  - are you able to narrow it down to
• 3:02
  - maybe what your biggest priority is right now?
• 3:05
  - Yes. Absolutely.
• 3:07
  - As we've seen in throughout the state of
• 3:09
  - Florida, and I'm assuming it's everywhere,
• 3:11
  - a lot of population growth, which also means
• 3:14
  - a lot of cancer diagnoses,
• 3:16
  - early cancer diagnosed, late stage still
• 3:19
  - in much
• 3:20
  - earlier populations like younger populations. So for me,
• 3:23
  - it's access,
• 3:25
  - making sure that if someone is thinking
• 3:28
  - that they have cancer or quickly
• 3:30
  - getting to someone who is diagnosed, like, making
• 3:32
  - sure they can get into the door and
• 3:34
  - meet with an expert
• 3:36
  - to alleviate that anxiety.
• 3:37
  - You know, we keep getting bigger and bigger,
• 3:39
  - but sometimes when you get larger and larger,
• 3:42
  - you forget that that that critical time window
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  - of getting someone in,
• 3:47
  - is the most important thing you can do.
• 3:49
  - And if you can't do it, they will
• 3:51
  - vote with their feet and go somewhere whether
• 3:53
  - they have better quality, worse quality.
• 3:56
  - They are not looking at scores. They're looking
• 3:58
  - at how can I get in and who
• 4:00
  - did my neighbor go and see and how
• 4:01
  - quickly can I get into them,
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  - so they can alleviate that fear of what
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  - does this mean for me?
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  - So we are heavily focused on access right
• 4:10
  - now and making sure that time window is
• 4:13
  - the right window.
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  - And then in some of those diagnoses
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  - that, you know, you've been in the oncology
• 4:18
  - space for a long time,
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  - we are not MD Anderson or Sloan Kettering
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  - where we only take a cancer diagnosis.
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  - We also have a lot of workup opportunities
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  - and a lot of referrals that may not
• 4:31
  - to be or they might be high risk.
• 4:33
  - So just making sure those are appropriately
• 4:36
  - kind too. So just making sure
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  - that we're getting patients throughout the communities in
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  - which we serve in a timely essence, really
• 4:45
  - taking care of their needs. So
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  - the other piece of that is access to
• 4:50
  - clinical trials. Right? So in oncology today, if
• 4:53
  - you don't have trials, you're really not offering
• 4:56
  - the treatment you should be offering the way
• 4:58
  - that we continue to evolve.
• 5:00
  - So if you're doing
• 5:02
  - tomorrow's treatments today, that means you're offering the
• 5:05
  - robust clinical trial portfolio.
• 5:08
  - And that's something we have hyper focused on
• 5:10
  - as well, making sure that our patients don't
• 5:13
  - have to go outside of their community, outside
• 5:16
  - of their state
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  - to get the same access to the latest
• 5:20
  - and greatest, the innovative,
• 5:21
  - the Till therapy, the you know, any of
• 5:24
  - the things
• 5:25
  - that are not your typical standard of care
• 5:27
  - at this point. So those are our big
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  - ones. So access and then, of course, clinical
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  - trial access and having a portfolio that matches
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  - our community.
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  - Absolutely. And I I think the way you,
• 5:39
  - you phrased it with, you know, patients will
• 5:41
  - vote with their feet and walk somewhere else,
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  - I think, is something, you know, leaders across
• 5:47
  - all specialties can can relate to,
• 5:51
  - specifically when it comes to, you know, oncology
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  - service lines and cancer centers.
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  - You mentioned kind of the growing patient population,
• 5:58
  - clinical trials.
• 5:59
  - So
• 6:00
  - those might be incorporated in your answer to
• 6:03
  - the question I'm about to ask you. But
• 6:05
  - is there any kind of pressure that you
• 6:06
  - feel
• 6:08
  - cancer centers are facing right now that is
• 6:11
  - not getting talked about enough?
• 6:15
  - I don't know that it's not being talked
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  - about, but
• 6:18
  - globally being shared,
• 6:20
  - just in passing a few just seeing leaders
• 6:23
  - and being on some exchanges.
• 6:25
  - The drug shortages that are happening right now,
• 6:28
  - the growing drug expense where some of your
• 6:31
  - smaller
• 6:33
  - we're lucky we're a large system.
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  - We've got that benefit of a very large
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  - supply chain to help us negotiate, you know,
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  - at a large scale
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  - and then also having that inventory.
• 6:43
  - But I think it was earlier this week,
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  - we were on a leadership exchange, and some
• 6:47
  - of the smaller programs are really struggling and
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  - having to
• 6:51
  - stratify
• 6:52
  - if we only have, say, 30 doses,
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  - what 30 patients are we gonna be able
• 6:57
  - to give this to? How do you pick?
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  - Right? Because you have 60 patients.
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  - And those choices are very difficult.
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  - So I think people are feeling it and
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  - struggling, and,
• 7:06
  - they're each struggling in their own arena right
• 7:09
  - now. So I think that's always a hard
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  - one. And we're gonna see more of that
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  - as the drug expenses seem to continue to
• 7:16
  - grow up.
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  - And, of course, everything we're doing right now,
• 7:19
  - all the new developments,
• 7:21
  - some of those drugs are very expensive. When
• 7:23
  - you look at cellular therapy and gene therapy,
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  - they're not cheap. So making sure you have
• 7:29
  - the team behind that
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  - so you don't get stuck with a huge
• 7:34
  - expense. And, yes, you you gave someone life
• 7:36
  - altering treatment, but then you also incurred an
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  - expense with no reimbursement. That is a scary
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  - dilemma in the wrong, like, environment.
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  - So I think around the drugs and expenses
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  - and where we're going, that's one complication and
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  - pressure.
• 7:52
  - Then there's always this staffing challenge.
• 7:56
  - It's just a very different
• 7:58
  - working group at this point. You have a
• 8:01
  - new generation of folks who
• 8:03
  - they really do love that work life integration.
• 8:06
  - And post COVID,
• 8:08
  - when it's complicated,
• 8:09
  - sometimes they'll just jump ship and go do
• 8:12
  - something else.
• 8:13
  - So keeping that team to support, you know,
• 8:16
  - the physicians and APPs are not the ones
• 8:18
  - that typically jump every one or two years.
• 8:20
  - But building that really strong team around you
• 8:23
  - to be able to deliver the care,
• 8:25
  - that continues
• 8:26
  - to be a challenge.
• 8:28
  - Even in the systems where, you know, you
• 8:29
  - have great benefits and you might pay competitively.
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  - If if there's the assumption or the feeling
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  - perception
• 8:37
  - that it's complicated,
• 8:39
  - then they can do the same thing working
• 8:40
  - in a less complex
• 8:42
  - specialty,
• 8:43
  - we still lose them every day. So for
• 8:45
  - the long haul, I think that's where we
• 8:47
  - start to dive into the AI space. Right?
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  - When you have less of those experts who
• 8:52
  - are staying to support the team,
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  - How do you how do you have the
• 8:58
  - systems around that? So instead of just humans,
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  - you've got the tech to help with some
• 9:02
  - of the workflow.
• 9:05
  - Absolutely. And I'd love to kind of pick
• 9:06
  - your brain about how you're navigating
• 9:09
  - AI right now. You know, I know everyone
• 9:11
  - kind of has a different mindset, different strategy.
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  - I think,
• 9:15
  - overall, I've heard there's places where it's, you
• 9:18
  - know, changing
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  - the game and then other times where maybe
• 9:21
  - it's overhyped.
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  - Safety concerns, of course, are always the caveat
• 9:26
  - everybody shares their opinion with, but I I'd
• 9:29
  - love to to see how you are looking
• 9:30
  - at AI right now.
• 9:32
  - Yeah. Absolutely. I think for our system, overarching,
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  - Orlando Health has been at the cutting edge
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  - kind of they've been there and
• 9:41
  - trying to make sure that we have the
• 9:43
  - most
• 9:45
  - innovation in every space.
• 9:47
  - So that's been great for us because we've
• 9:49
  - been able to
• 9:51
  - turn on our AI lung incidental program,
• 9:54
  - which then now can be turned on for
• 9:56
  - other modalities.
• 9:58
  - And what that did was identify patients that
• 10:01
  - you would miss. You know, they showed up
• 10:03
  - to the ED after a car crash.
• 10:06
  - And it's something showed on a chest except,
• 10:08
  - but no one was looking for an incidental.
• 10:10
  - Right? So finding a lung cancer early, that's
• 10:13
  - pretty incredible.
• 10:15
  - We have AI turned on within our EMR
• 10:18
  - to help, you know, the infusion capacity piece.
• 10:20
  - It's huge. Where we used to think we
• 10:22
  - were full because you had people manually trying
• 10:25
  - to arrange a schedule. Well, you take that
• 10:27
  - out and let the tech come in and
• 10:29
  - all of a sudden,
• 10:30
  - you 30% more volume without
• 10:33
  - going into overtime, without stretching your nurses too
• 10:36
  - much over lunch, all of the things.
• 10:38
  - Huge impact there.
• 10:40
  - Of course, there's 7,000
• 10:42
  - solutions for every problem you have. So trying
• 10:45
  - to find the right
• 10:47
  - vendor or player or stakeholder to work with
• 10:50
  - you within your EMR and within your system,
• 10:54
  - it's not quick. So
• 10:57
  - turning some of those on took a while,
• 11:00
  - And you see some of the vendors, you
• 11:03
  - know, now they're starting to absorb one another.
• 11:06
  - So it gets a little complex. And for
• 11:08
  - us, we never like to operate outside of
• 11:11
  - our EMR too much because once you have
• 11:13
  - to log in to something else,
• 11:15
  - that's more clicks, that's more logins, that's more
• 11:18
  - everything.
• 11:19
  - So we're pretty straightforward
• 11:21
  - with
• 11:23
  - our IT governance and steering committees, and they
• 11:25
  - also have an AI governance committee.
• 11:28
  - So they really sets out the things that
• 11:30
  - are not appropriate from a safety lens and
• 11:33
  - what is doable from an IT lens for
• 11:35
  - us. But when it's really important,
• 11:38
  - say, for our specialty,
• 11:40
  - we do have a chief informatics officer that's
• 11:42
  - also a head and neck surgeon on our
• 11:44
  - team. And so we
• 11:47
  - together,
• 11:48
  - we kind of vet out what will work,
• 11:49
  - what won't work, and we've been able to
• 11:51
  - be nimble by having all the right stakeholders
• 11:54
  - there. We are blessed and that we have
• 11:56
  - a strong oncology informatics team. So when we
• 11:59
  - do finally get that green light, we can
• 12:01
  - implement
• 12:02
  - fairly quickly. Usually, it's that pre process that,
• 12:06
  - you know, it has to go to supply
• 12:07
  - chain, has to go to finance, has to
• 12:09
  - go all around, get vetted out. But Yeah.
• 12:11
  - I I really pride our organization on allowing
• 12:14
  - us to use these tools because
• 12:16
  - the the inbox management for the team messaging,
• 12:20
  - you know, handling patient messages,
• 12:22
  - that reduces their time. The things that they're
• 12:24
  - finding for screenings and incidentals,
• 12:26
  - that just identifies patients early. Puts it in
• 12:29
  - a workable list. So it's pretty incredible what
• 12:31
  - it can do. And then our system turned
• 12:34
  - on, for us, Copilot, and now we have
• 12:36
  - access to Claude and ChatGPT.
• 12:39
  - So
• 12:40
  - how that reduces even the administrator burden. Right?
• 12:43
  - Mhmm. Nespar need this. Hey. What are the
• 12:45
  - last 15 emails I've missed? Can you summarize
• 12:48
  - who I need to get back to? And
• 12:51
  - it's taking hours of days. So then you
• 12:53
  - can spend it purposely rounding with your teams
• 12:56
  - and finding out what do you need, what
• 12:57
  - do you not need, what's broken. So I
• 12:59
  - think it's completely shifting
• 13:01
  - how we do our work as administrators too.
• 13:05
  - Perfect. And I love all those concrete examples
• 13:07
  - because I know our listeners love them as
• 13:10
  - well of just how, you know, the technology
• 13:12
  - is actually
• 13:14
  - changing things
• 13:15
  - in your day to day, you know, workflow
• 13:18
  - and
• 13:19
  - and broader, you know, when it comes to
• 13:21
  - diagnostics and everything. So I'm excited to see
• 13:24
  - what what comes next out of Orlando Health
• 13:26
  - there.
• 13:27
  - Yeah.
• 13:29
  - Absolutely. Yeah.
• 13:30
  - And I'm kind of phrasing this question to
• 13:32
  - leaders as a forward looking
• 13:36
  - leadership
• 13:37
  - question. So
• 13:39
  - when you look towards the next generation of
• 13:41
  - oncology leaders
• 13:43
  - who maybe are just joining the field or
• 13:45
  - on their way up,
• 13:46
  - is there a challenge that you think will
• 13:49
  - be left in their hands that they're going
• 13:51
  - to need to solve that maybe the field
• 13:55
  - hasn't fully tackled yet or isn't taking seriously
• 13:58
  - enough today
• 13:59
  - that you see the future generation having to
• 14:02
  - face?
• 14:03
  - Yeah. It's gonna sound old school, but
• 14:06
  - with all of the tech and how fast
• 14:09
  - we are moving,
• 14:10
  - really making sure we still keep that balance
• 14:13
  - of a personal touch and the communication.
• 14:17
  - It
• 14:18
  - you know, you can send me 7,000,000 emails
• 14:21
  - in a day, but if if I'm out
• 14:22
  - there and I'm supposed to be rounding on
• 14:24
  - teams and talking to them and sharing information,
• 14:27
  - it's just the the speed of which we're
• 14:29
  - getting all of this new info
• 14:31
  - and how quickly you can
• 14:34
  - not communicate important things to the entire group.
• 14:38
  - So every time we have our town halls
• 14:39
  - or med staff meetings or our pod meetings,
• 14:43
  - you find out that you think you've communicated
• 14:45
  - things well and everyone is up to speed,
• 14:48
  - but there's so much information coming at everyone.
• 14:51
  - You do have to have those intentional conversations.
• 14:54
  - So it's I've said it a few times
• 14:57
  - in the last two years. It's almost like
• 14:58
  - back to basics. Don't forget
• 15:01
  - that personal touch to find out what is
• 15:03
  - working with your patients, what is working with
• 15:05
  - your teams.
• 15:07
  - And we find sometimes that, okay. Great. Now
• 15:10
  - we have this new tool that helps us
• 15:11
  - send more MyChart messages to patients. Some patients
• 15:14
  - hate using MyChart and messaging.
• 15:17
  - They would prefer you call them back, but
• 15:19
  - instead they're getting a message and they have
• 15:21
  - six more questions.
• 15:23
  - So it's really not losing sight of
• 15:26
  - how are we making sure we're communicating to
• 15:28
  - everyone in the way they receive communication
• 15:31
  - and not assuming.
• 15:33
  - Yeah. It's kind of like don't let the
• 15:34
  - pendulum swing all the way in the other
• 15:37
  - direction.
• 15:38
  - Kind of find that that happy middle ground.
• 15:41
  - Exactly.
• 15:42
  - And if anyone's listening to the podcast,
• 15:45
  - I'm sure you know what my last question
• 15:46
  - is gonna be. I always like to ask
• 15:48
  - the oncology leaders what is giving them hope
• 15:51
  - when they look towards the future of cancer
• 15:53
  - care and what, you know, is giving them
• 15:55
  - optimism about what oncology will look like in
• 15:58
  - the next years.
• 16:00
  - I'd love to hear your perspective.
• 16:03
  - For me, I keep calling it the most
• 16:04
  - exciting time to be in this space because,
• 16:08
  - you know, you you hear people you talk
• 16:10
  - and, like, I'm from a small town back
• 16:12
  - in Illinois, and I go home and they're
• 16:13
  - like, oh, yeah. You guys don't wanna cure
• 16:15
  - cancer. You just wanna keep treating so you
• 16:16
  - can make money. But they don't understand the
• 16:19
  - science and what has been discovered and what
• 16:21
  - is going on.
• 16:23
  - And to I was telling my mom a
• 16:25
  - few months ago, like, went to a Caris
• 16:27
  - talk and, you know, you're treating two patients
• 16:29
  - with the same treatment and they're not having
• 16:31
  - the same results. Well, now you can do
• 16:33
  - a liquid biopsy or
• 16:35
  - different testing and find out, well, yeah, the
• 16:38
  - one's not responding because it's a completely different
• 16:40
  - cancer with a completely different genetic system and
• 16:44
  - mutation that's impacting how they, you know, they
• 16:46
  - receive treatment.
• 16:47
  - And so being able to get precision medicine
• 16:50
  - and get down to
• 16:52
  - treating that person based on their genetic makeup
• 16:55
  - and that biopsy is pretty phenomenal.
• 16:58
  - And even watching what they've done in the
• 17:00
  - melanoma space, watching terminal,
• 17:02
  - stage four terminal melanoma patients
• 17:05
  - suddenly having a chance of, like, they're completely
• 17:07
  - eradicating their cancer.
• 17:09
  - Just went through this with one of my
• 17:11
  - best friends, my old neighbor in Miami,
• 17:13
  - last year December telling me, oh my god.
• 17:17
  - I have
• 17:18
  - metastatic
• 17:19
  - melanoma,
• 17:20
  - and I think this is it.
• 17:23
  - And
• 17:24
  - two months ago, finding out that he's in
• 17:26
  - remission, cancer free, and he was on a
• 17:29
  - trial down in Miami, and
• 17:32
  - that is what gives me hope about what
• 17:34
  - we're doing and where we're headed, and it's
• 17:37
  - just an exciting time to see that impact.
• 17:40
  - Absolutely. And I think, you know, being able
• 17:43
  - to
• 17:44
  - to talk about your friends and and and
• 17:46
  - have that connection of all these kind of
• 17:48
  - broader innovations and the excitement about the future
• 17:51
  - and and tying it back to, you know,
• 17:53
  - your friend and and the patients that Orlando
• 17:56
  - Health is serving is
• 17:58
  - is such a great way to end the
• 17:59
  - podcast. So I'm grateful,
• 18:01
  - for you looping us in on that, and
• 18:03
  - I hope your friend's doing well.
• 18:06
  - But thank you so much. And that's why
• 18:08
  - it's it's such a personal connection to the
• 18:10
  - field and such an exciting time to help.
• 18:13
  - So just honored to serve in the role.
• 18:15
  - Absolutely. Well, thank you again, Alicia, for coming
• 18:18
  - on the podcast and taking the time to
• 18:20
  - share your insights with our audience.
• 18:22
  - Truly a pleasure. Thank you for having
• 18:36
  - me.