Latest / Becker’s Healthcare -- Pediatric Leadership Podcast / Dr. Marc Gorelick, President and CEO of Children's Minnesota

Transcript

Dr. Marc Gorelick, President and CEO of Children's Minnesota · Becker’s Healthcare -- Pediatric Leadership Podcast

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  - This is Laura Dedo with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Dr.
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  Mark Gorlick, president
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  and Chief Executive Officer of Children's Minnesota.
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  Dr. Gorlick, it's a pleasure
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  to have you on the podcast today.
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  - Thank you. It's a pleasure to be here.
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  Appreciate being invited.
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  - Now, I'm really looking forward to talking
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  with you more about what you're
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  doing at Children's Minnesota.
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  I know you've got some really fascinating things happening
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  there, and so this will be an amazing discussion.
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  But before we dive into that,
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  can you tell me a little bit more
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  about yourself and your background?
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  - Yeah, sure. Delighted to, um, you know,
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  my entire career has been in children's healthcare.
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  I began as a pediatric emergency medicine physician,
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  and I practiced that for about 25 years
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  before I moved into full-time healthcare leadership.
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  And, uh, I've done
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  that at several different hospitals around the country.
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  I've been here at Children's Minnesota,
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  this month will be seven years,
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  so I'm very excited about that.
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  For your listeners who may not be familiar with,
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  with our organization,
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  children's Minnesota is an independent
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  pediatric health system.
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  Uh, we are based here in the Twin Cities of Minneapolis, St.
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  Paul. Uh, we have two hospitals,
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  one in Minneapolis, one in St.
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  Paul, and we an ambulatory surgery center
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  and over a dozen clinic locations.
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  And between our two hospitals, we have about 460 beds,
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  which makes us one of the 10 largest children's health
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  systems in the United States.
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  And we serve kids from, uh, throughout Minnesota
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  and the surrounding states.
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  We're the, we're actually the largest
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  pediatric specialty provider in the upper Midwest.
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  And importantly, I should note,
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  we are celebrating our 100th anniversary this year.
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  Uh, so we started in a little house in St. Paul in 1924.
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  Now we've grown into this, you know,
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  comprehensive pediatric health system,
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  which we're very proud of, and, um, very proud
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  to have served this community for the last century,
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  and really excited to think about how we continue
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  to serve this community for at least the next century.
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  - Well, that's an amazing milestone
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  and certainly excited, um, to, as you mentioned,
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  have such a long and rich history in the community.
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  And, you know, given, um, that reputation that you have,
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  what are some of the trends
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  that you're following most closely right now?
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  What are you really, um, spending most of your time on?
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  - Yeah, you know, it's, and when I think about trends,
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  and it's timely, right?
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  We're celebrating a hundredth anniversary, we're going
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  through a strategic planning process.
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  So certainly looking at, at trends is, is critical.
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  So it's a really important question,
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  and I think there are a few trends that,
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  that we have our eyes on
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  that are particularly relevant to what we're we are doing.
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  You know, one is a trend around, um, what's happening
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  with diversity, equity, and inclusion.
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  So back in 2016, in our community health needs assessment,
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  um, uh, systemic racism
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  and health disparities were identified as two
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  of the five top health issues facing kids in our community
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  by the members of our community as part of that assessment.
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  And that was a real wake up for us.
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  And, and really, so since then, since I've been here, uh,
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  early 2017, we have made, um, diversity, equity
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  and inclusion a, a priority, uh, for children's Minnesota.
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  I think in the last few years, certainly in the aftermath
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  of the killing of George Floyd
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  by a Minneapolis police officer,
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  which happened literally 12 blocks from
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  where I am right now in our Minneapolis hospital.
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  Um, we saw real, uh, um, increase in, in activity
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  and commitment around diversity, equity,
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  and inclusion, not only across our industry,
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  but across, you know, other
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  industries in our entire community.
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  And it was really great
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  because we found a lot of willing partners that wanted
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  to work with us to address those issues
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  that our community's been facing.
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  And in the last year
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  or so, we've really started to see,
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  I would think a certain amount of pullback
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  and retrenchment from that.
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  The organizations talking less often, um,
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  about diversity, equity, inclusion.
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  We see the magnitude of the commitments
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  that were made being paired back a little bit.
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  We see other states where, where school districts and cities
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  and states even are passing laws that limit the ability
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  of organizations like ours
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  to address this very real issue of health disparities.
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  And, you know, the data are pretty clear.
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  I mean, there are enormous health disparities,
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  particularly among kids.
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  Minnesota happens to be among the worst,
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  but it is a national problem.
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  And so this trend of sort of backing off from,
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  from our efforts to address this, I think is something that,
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  um, I view as some concern.
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  I'll tell you that at Children's Minnesota, we are remain
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  as committed as ever to advancing diversity, equity,
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  and inclusion and, and serving the very diverse population,
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  uh, that we have here in the Twin
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  Cities and, and in the state.
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  So that's one trend. Um, another trend
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  that is I think is similarly concerning is the trend
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  that we're seeing nationally around, uh,
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  gender affirming care, particularly for .
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  I, I think, um, uh,
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  although we, you know, in my 35 year career in, in,
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  in children's health, um, this is a relatively new issue
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  that we are dealing with, but it's not a new
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  thing, not a fad.
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  Um, it's not something that all of a sudden started in,
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  you know, the two thousands.
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  Um, but our ability to talk about it
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  and address it, I think is really accelerated.
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  And, um, what I view as some concern is
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  that this has gone from being a children's health issue
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  to being a partisan political issue, um, that creates a lot
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  of divisiveness, and again,
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  seeing what's happening in some places, um, with limitations
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  of access to, uh, gender affirming care that we know for,
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  uh, for kids who are either transgender, gender diverse,
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  non-binary, that, that, um, they have significant, uh,
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  health issues that they need to address,
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  including physical and mental health issues.
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  And having lack of access to those resources,
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  um, is harmful.
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  So we have a gender health program here at Children's
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  Minnesota that we've had for a number of years.
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  Um, we are now starting to get, uh,
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  we serve kids from throughout the state, um,
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  but we are starting to get a lot of referrals from
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  outside the state in response to efforts
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  to limit access to that care.
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  And, uh, you know, we can barely meet the needs of,
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  of kids in our own community.
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  And so seeing this trend nationally is concerning.
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  I will tell you that, you know, the, the, the care
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  that we provide is, um, it's evidence-based.
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  It is consistent with
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  and supported by, you know,
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  all the major professional organizations, um, such
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  as the American Academy of Pediatrics.
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  And what's interesting is we've, within our own community,
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  we've certainly had, uh,
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  community members donors raise questions
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  and concerns about it based on what they see in the media.
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  When we sit down and talk with them
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  and explain about gender affirming care, um, I find
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  that they have a lot of misperceptions about what we do
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  and don't do what it does and doesn't involve.
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  And, uh, what I, what I hope to see the trend reversed to is
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  to get away from the partisanship
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  and to get down to that ability
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  to have conversations grounded in facts, grounded in, in,
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  uh, evidence grounded in reality.
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  Uh, because when we do that, we find
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  that we actually have a lot more common ground than I think
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  we're seeing, uh, on the front pages
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  of the papers and in social media.
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  Um, and then the third trend I would say that, um, is, uh,
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  probably one that you a lot of your, uh,
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  interviewees probably addressed,
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  and that's, you know, how we're,
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  how are we thinking about the use
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  of artificial intelligence in healthcare?
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  And, um, you know, to me, I think there's certainly,
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  um, a, a lot of concerns that have been raised.
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  Um, but there's so much promise.
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  And I think when, when we think about the use
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  of artificial intelligence, whether for clinical
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  or nonclinical tasks, I think about it in terms of
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  how can it help us advance quality of care
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  and thinking about quality holistically.
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  In terms of the six domains
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  of quality identified by the Institute of Medicine.
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  The obvious ones are AI has the potential
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  to really dramatically increase efficiency and timeliness,
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  and there's certainly some evidence that it's, um,
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  more effective, right?
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  You studies that have shown, uh, AI tools
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  that deliver greater diagnostic accuracy
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  than a human clinician can.
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  I think what we need to make sure is
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  that we're also focusing on those other domains of quality,
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  that we're focusing on safety, that we're focusing on
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  patient-centeredness, and we're focusing on equity.
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  But in my own opinion is if we do this right,
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  I think we have the ability to really advance quality in all
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  of those domains with the use of AI tools,
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  again, done properly.
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  And while I certainly understand and appreciate
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  and agree with the concerns about equity
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  and bias, human intelligence has been demonstrated
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  to be a significantly biased tool.
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  And if it's done right, I think we actually can use this
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  as a way to address some of the biases
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  that have been built into our
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  healthcare system over decades.
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  So those are my three trends.
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  - Absolutely. I, I think, you know, it's so important
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  as you laid out all of those trends there, looking at some
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  of the DEI work and as you mentioned, keeping that front
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  and center, even though in some ways, um, some organizations
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  and states have been backing away from it.
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  And then too, looking at the gender affirming care,
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  which has become extremely controversial in some places.
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  I can imagine, as you mentioned, having some
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  of those conversations and being able to bring, you know,
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  understanding to what you're doing
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  and how important that is, children's healthcare, um,
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  is extremely, um, helpful, um, for the community at large.
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  And then AI as well, like you mentioned being something, um,
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  that so many healthcare organizations are trying
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  to understand and troubleshoot
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  and figure out as, um, the technology evolves quickly
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  and making sure they're using it appropriately in a way
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  that, um, really can best serve their patients
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  and, and teammates.
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  Um, you know, big issues here, when you look at all
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  of these things together, I, I think it really, um,
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  stems into being able to care for your teams
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  and community, um, in a really, really important way.
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  I'm wondering, you know, for the, um, as,
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  as you were mentioning DEI
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  and then the gender affirming care as well, how do you, um,
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  really make sure that, you know, your teams feel supported,
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  um, through, you know, some of these challenging times, um,
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  as some of these issues
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  and areas are, you know, kind of have become politicized
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  as you mentioned, um,
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  and really, you know, they can understand that, um,
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  what your philosophy around it is at Children's Minnesota
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  and how they can be supported in moving forward, um,
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  with that philosophy?
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  - Yeah, I think it comes down to being rooted in our vision
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  and mission and values.
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  You know, our vision is to be every family's essential
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  partner in raising healthier children.
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  And when I talk about that,
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  starting from new employee orientation, I say,
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  when we say every family, we mean every family,
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  every family, no matter who they are, no matter
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  what they look like, no matter where they're from, no matter
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  what language they speak, no matter how,
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  whether they can pay
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  for their healthcare, we mean every family.
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  And so when we rooted in that, then, then
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  that drives the why do we care about
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  diversity, equity, and inclusion?
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  Why are we caring about making sure that, um,
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  we're providing gender affirming care?
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  Um, and, and all the other things we do,
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  it's rooted in our why
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  and in our values of, of, you know,
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  being respectful and inclusive.
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  And so, um,
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  that goes a long way towards helping people understand
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  and then, you know, demonstrating
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  that it is actually truly important to the organization
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  and not just something that we say.
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  And when we look at our strategic scorecard of, uh,
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  how are we measuring progress against our
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  strategy, we have six metrics.
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  Two of those six metrics are related
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  to diversity, equity, and inclusion.
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  One is around the diversity of our workforce,
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  and one is around decreasing disparities
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  for patients within our system.
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  And so, and you know, that is something that we report on
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  to our staff at our town hall meetings.
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  How are we doing on our strategic metrics?
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  Um, for our leaders, part of their compensation is tied to,
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  uh, meeting those organizational goals.
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  So I think rooting it in why, you know, in the why
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  of Children's Minnesota
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  and demonstrating that we are serious about it, I think are,
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  are the two approaches that we've taken.
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  - Well, that's great to hear.
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  And you know, now zeroing in a little bit more,
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  could you tell me a little bit about a project
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  or initiative that you're most proud of from the last year?
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  - Um, yeah, maybe I'll, I'll have a couple
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  and I'll, I'll tie it back to
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  what I previously talked about.
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  So again, DEI has been a priority for our organization.
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  I already told you that It makes up one third of our
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  strategic scorecard and,
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  and one third of our, um, incentive, uh, plan.
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  Um, and we've made a lot of progress on that.
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  So on having,
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  and we know, I mean, there, there's, the, the thing is,
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  there's research evidence that shows
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  that if you have a more diverse healthcare workforce
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  that better reflects the community that you're serving,
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  you will do a better job of serving that community.
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  You will have better outcomes,
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  you'll have fewer disparities.
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  And so, you know, we're not just doing this
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  because, you know, it's the woke thing to do.
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  We're doing it because the evidence says
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  that this is the way we're going to get better outcomes.
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  And so we've made significant efforts
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  and we've made significant strides.
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  So in 2019, 19% of our workforce identified as people
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  of color, we had a goal of increasing that to 34%.
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  Uh, by the end of next year, we're now at 30%.
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  So just in that short period of time,
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  we've made a tremendous,
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  and we've done it through, um, more expansive recruitment
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  and better job of, of retention.
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  And, um, I'm very proud of that progress.
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  And that's true at all levels. So, uh, we went from 0%
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  of our executive team to one third of our executive team
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  identifying as people of color, 30% of the next level
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  of leaders, and again, 30% of the entire organization.
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  So I'm very proud of that, very proud
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  of the progress we've made on, on decreasing disparities.
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  Um, we have, uh, identified three clinical outcomes
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  that, uh, where we have gaps based on race,
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  and we've combined those into
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  what we call our health equity index.
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  And each year we have a goal
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  of decreasing the disparities in those outcomes,
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  those outcomes being immunizations, being up to date,
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  asthma being under good control
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  and a patient experience measure.
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  And through a variety of efforts, we have managed
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  to narrow those gaps.
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  Honestly, we still have a lot of work to do,
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  we all do in this industry,
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  but I'm proud of the fact that we're focusing on it
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  and that we've started to move the needle on that.
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  Um, and you know, these become mutually reinforcing.
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  It's kind of interesting. Um, you know, people,
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  I talk about this with colleagues
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  and they say, well, how did you make such huge strides in,
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  in diversity of your workforce?
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  And how are you recruiting people?
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  And I say, you know, not uncommonly at
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  new employee orientation.
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  People say to me, I came here
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  to work at Children's Minnesota
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  because of the stand you are taking on health equity
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  because of the way you are showing up in the community
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  to advocate and to, to be sincere about this.
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  And that's what attracted me here.
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  So these become mutually reinforcing things.
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  And then we have not really done much with ai,
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  but we have done some, I think, interesting things
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  with technology in the last year that, um,
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  are really helping us to deliver
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  better outcomes for patients.
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  And I'm gonna highlight two of them.
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  One, actually one
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  of our physicians talked about on your past not too long
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  ago, um, uh, Dr.
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  Mark Bergeron, who's the medical director of our, um, uh,
• 15:35
  neonatal telehealth program.
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  And we've instituted
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  what we call our kid experts at home program
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  that has allowed us to discharge
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  patients from our neonatal ICU earlier with
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  as good or better outcomes.
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  So decreasing length of stay, getting them home sooner, um,
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  and, and still on track to, to have as good
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  or better outcomes, um, despite that through the use of,
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  of remote monitoring and telehealth.
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  And that's been really exciting
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  and that opens us up
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  to then having really good conversations with payers
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  because we have a mutual interest in keeping kids outta the
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  hospital, um, when they don't need to be.
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  And so that's been exciting.
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  And then we opened, uh,
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  a new intraoperative MRI suite last year,
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  and while intraoperative MRI is not necessarily itself a new
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  technology, we've actually had it for some time.
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  Um, our kit experts had, um, constraints
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  that they were discovering with the way it was being used,
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  and they came up with a really innovative solution, um,
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  to how we configure this.
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  And it's actually, it's, we worked with a, a,
• 16:38
  a company to help us build this.
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  It's only, it's the first one in North America
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  with this configuration
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  that allows us across a three room suite to have an MRI
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  that is mounted on a rail system, so it can move from room
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  to room, depending on the clinical circumstance.
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  We can either move the patient into the scanner
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  or the scanner to the patient without having
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  to leave the operating room, without having
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  to break anesthesia or, or sterile conditions,
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  and, um, enables them to do imaging from brain all the way
• 17:08
  through spine in a way
• 17:10
  that's more effective and more efficient.
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  And it's very exciting to,
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  to see the growth in that program.
• 17:16
  - That's amazing. Wow.
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  I, I can imagine, you know, it's just such a, um,
• 17:22
  big game changer, I guess, to be able to do that
• 17:24
  with the MRI machine and certainly everything else.
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  You mentioned it, it's inspiring to know
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  that people are paying attention
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  to the work you're doing in the community with health equity
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  and how, you know, you're really framing your stance on some
• 17:36
  of these issues, and that is attractive to folks.
• 17:39
  Um, that was gonna be one of my questions is, you know,
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  what do you feel like, um, you, you really are unique in,
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  in terms of being able to make such a significant process
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  or progress, excuse me, towards your goal
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  of a more diverse workforce?
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  And especially on the leadership side of things, I think,
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  um, you know, there's a lot of, uh, um, organizations
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  that would like to be in a similar position.
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  And so it's great to hear that that's been a,
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  a really crucial part of how you've been able to grow
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  and develop over the last three or four years.
• 18:07
  - Yeah. - Excellent.
• 18:09
  Well, you know, before we wrap up here, I'm wondering,
• 18:11
  you know, considering we've talked a lot about DEI as well
• 18:15
  as AI and some other areas,
• 18:17
  how are you thinking about growth
• 18:18
  and development for the future?
• 18:20
  What do you see as being ahead
• 18:21
  for the next two, three or five years?
• 18:25
  - Yeah, you know, when, when we think about growth,
• 18:27
  we often just think about it in terms of size, right?
• 18:29
  More revenue, more patients, et cetera.
• 18:31
  And that is certainly a dimension of growth.
• 18:32
  We are thinking about how can we serve more patients, um,
• 18:35
  how are we thinking about, you know,
• 18:37
  what services we offer and where we offer them.
• 18:39
  And, and we've certainly got plans for growth in that way.
• 18:42
  I also just think about growth in terms of, um,
• 18:45
  depth, greater depth.
• 18:46
  And I've always believed that one of the things
• 18:50
  that distinguishes a children's hospital is that
• 18:53
  as the kid experts, we recognize
• 18:55
  that kids are not just small adults, they have unique needs,
• 18:58
  physical, emotional, social needs,
• 19:00
  and we have the infrastructure
• 19:03
  and the services to meet those needs.
• 19:05
  And so that really is about the experience
• 19:07
  of being in a children's hospital.
• 19:08
  And I think what we have in line for the next 10 years is
• 19:10
  to really double down on that
• 19:12
  and really make the Children's Minnesota experience one
• 19:15
  that is highly differentiated.
• 19:18
  Um, you know,
• 19:19
  a really comprehensively outstanding experience, you know,
• 19:24
  in all encounters, whether they're clinic visits
• 19:26
  or appointment making or, or referrals for our patients
• 19:30
  and families and for our staff
• 19:32
  and for the rest of our community.
• 19:33
  And so that's something that we will be working on the next
• 19:35
  10 years is growing, um, our experience as one
• 19:40
  of the ways that we will also then grow to be able
• 19:42
  to serve more patients and, and, um, uh,
• 19:45
  and more of our community.
• 19:48
  - I love that. Dr. Gole, thank you so much
• 19:50
  for joining us on the podcast today.
• 19:51
  This has been such a fun and interesting conversation,
• 19:53
  and I look forward to connecting with you again soon.
• 19:56
  - Thank you, Laura. It's Belin been a pleasure.