Latest / Becker’s Healthcare Podcast / Vimal Ramjee, MD, FACHE, Physician Executive, CommonSpirit Health, Division Board President-Elect, American Heart Association

Transcript

Vimal Ramjee, MD, FACHE, Physician Executive, CommonSpirit Health, Division Board President-Elect, American Heart Association · Becker’s Healthcare Podcast

• 0:00
  This is Scott Becker
• 0:02
  with the Becker's Healthcare Podcast.
• 0:05
  I'm thrilled today to be joined by a
• 0:06
  brilliant physician leader.
• 0:08
  We're joined today by doctor Vimal
• 0:11
  Ramji,
• 0:12
  and doctor Ramji has had so many interesting
• 0:14
  roles in his professional career. He currently serves
• 0:18
  at CommonSpirit
• 0:19
  Health. He's got a brilliant career,
• 0:21
  and CommonSpirit's
• 0:22
  one of our favorite systems, a a tremendous
• 0:25
  faith based system that both does fantastic care
• 0:29
  and safety net care in a ton of
• 0:31
  states throughout the country.
• 0:33
  Doctor Ramshi, can you take a moment and
• 0:36
  and introduce yourself and tell us a little
• 0:39
  bit what you do at CommonSpirit?
• 0:40
  Then we'll talk about so many of the
• 0:42
  roles you had throughout your career and and
• 0:44
  what you're most excited about currently.
• 0:46
  Thanks, Scott. It's great to be here, and,
• 0:49
  I appreciate the introduction.
• 0:51
  I'm a cardiologist
• 0:53
  and physician executive with CommonSpirit Health.
• 0:57
  CommonSpirit Health is one of the largest nonprofit
• 1:00
  health systems in the country.
• 1:02
  The system is comprised of about a 140
• 1:05
  hospitals
• 1:07
  and over 2,200
• 1:09
  care sites that spans
• 1:11
  coast to coast about 24 states.
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  And we're proud as a system to touch
• 1:17
  the lives of about 20,000,000
• 1:19
  patients on an annual basis.
• 1:22
  I've been with the system for about a
• 1:24
  decade now, including through the merger that brought
• 1:27
  together two large Catholic ministries
• 1:30
  at that time in 2019,
• 1:32
  Catholic health initiatives and Dignity Health.
• 1:36
  Having the opportunity to serve through the merger
• 1:38
  has given me quite a practical view of
• 1:40
  what it takes to deliver care at scale,
• 1:43
  not only operationally and clinically, but also from
• 1:46
  a cultural standpoint, which as you know, makes
• 1:49
  an incredible difference in the value that we
• 1:51
  can produce
• 1:53
  across the enterprise.
• 1:54
  And so over the past, several years, I've
• 1:57
  had the,
• 1:58
  opportunity to work both at the market,
• 2:02
  region and enterprise levels,
• 2:04
  being able to partner with clinical,
• 2:07
  operational, and executive leaders on
• 2:09
  enterprise,
• 2:10
  clinical governance,
• 2:12
  care design,
• 2:13
  responsible innovation.
• 2:15
  And I'll tell you, doing this work,
• 2:17
  for the system and and within our markets
• 2:20
  has been quite rewarding. We're able to
• 2:22
  bring high quality care to
• 2:25
  extremely heterogeneous,
• 2:27
  markets that represent urban, rural, as well as
• 2:30
  safety net communities.
• 2:32
  And so this has really shaped how we
• 2:34
  think about access,
• 2:35
  you know, workforce sustainability,
• 2:37
  delivering meaningful impact at scale, some of the
• 2:40
  things that perhaps we'll talk about, in in
• 2:42
  moments ahead.
• 2:44
  Thank you. And you've got this incredible background
• 2:47
  between
• 2:48
  Emory, Johns Hopkins,
• 2:50
  University of Pennsylvania,
• 2:51
  serving as the president of the American Heart
• 2:54
  Association in your area for a period of
• 2:56
  time or maybe nationally.
• 2:58
  Also, you've got a number of entrepreneurial things.
• 3:00
  Take a moment and talk about some of
• 3:02
  the interesting parts of your career
• 3:04
  or your professional life that you've enjoyed greatly.
• 3:08
  Yes. I've been blessed to be able to
• 3:10
  contribute to a number of different initiatives, both
• 3:13
  on the academic
• 3:15
  front, but also,
• 3:16
  of course, a common spirit really delivering care
• 3:19
  to communities
• 3:20
  that are largely,
• 3:22
  rural and in high areas of need, which
• 3:25
  has been quite fulfilling. And then as you
• 3:27
  mentioned,
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  working with external organizations
• 3:30
  in governance capacities
• 3:33
  who have highly aligned
• 3:35
  organizational,
• 3:36
  mission, really,
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  to bring better care, higher quality care,
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  higher,
• 3:42
  reliability
• 3:43
  care, and more and more safety to these
• 3:46
  communities that are in in great need. And
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  so I think, you know, the thing I've
• 3:50
  really enjoyed about this work is that,
• 3:52
  and especially now is that we're better together.
• 3:55
  And, really, what I've learned is that we
• 3:57
  all,
• 3:58
  are in different lanes historically,
• 4:01
  but there's so much to learn from each
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  other,
• 4:05
  that really elevates the mission and strategy
• 4:08
  and approach,
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  that we all take in our in our
• 4:12
  own respective domains. And so I've greatly enjoyed,
• 4:16
  being a voice and being an advocate for
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  really the same mission that we're all on,
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  which is to provide
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  the best quality, most effective,
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  care for,
• 4:27
  as many people as possible. And so that's
• 4:30
  been it's been a a a journey that
• 4:32
  I'm I'm blessed to have and and just
• 4:34
  grateful to to be able to serve in
• 4:36
  in in these different ways.
• 4:39
  Let me ask you an off base question
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  for a second,
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  if if that's okay. Sure.
• 4:45
  We have my sister's son, Justin,
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  is about to start at Emory Medical School
• 4:51
  this coming fall, I believe. Is it a
• 4:53
  lot easier to get into Emory today than
• 4:56
  it used to be?
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  That's an interesting question. I'm not certain that
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  I can say with, with eye confidence as
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  this is probably a good amount removed from
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  where I am currently,
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  just, you know, being in, in leadership and
• 5:12
  less in the, you know, academic arena at
• 5:15
  this time.
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  But I would say in my conversations,
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  with,
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  those
• 5:22
  who are closer to academic organizations and with
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  the medical schools,
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  it's actually considerably
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  harder.
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  And
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  it's
• 5:32
  a highly dynamic time. I think there's a
• 5:34
  great amount of uncertainty about really, well, what
• 5:37
  direction do we take for these, young graduates
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  from from, high school,
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  who are entering college and trying to figure
• 5:45
  out what they should be when they grow
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  up.
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  Or as you mentioned, for those who are
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  who have done such a great job at,
• 5:52
  at the collegiate level and are moving towards
• 5:55
  medicine, there's a fair amount of uncertainty, but
• 5:58
  I don't think it's necessarily industry specific. I
• 6:01
  think this is fairly broad.
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  And,
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  what I would say, it doesn't change the
• 6:06
  fundamentals, which is
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  follow your passion
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  and follow what you what you really enjoy
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  doing where you see that you can bring
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  the greatest value to humanity.
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  And so I I think that, to answer
• 6:19
  your question as far as medical school,
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  I believe it may be more competitive,
• 6:24
  but, certainly not don't quote me on that
• 6:27
  one. I think I think best to ask
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  them No. He's I I yeah. I joke,
• 6:31
  of course. He's a brilliant, brilliant young man.
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  So I I just, it it's it's not
• 6:37
  my kid, so I could say it. He's
• 6:38
  my sister and my brother in law's
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  son, but a brilliant young man. So, no,
• 6:43
  he gets a shout out for his admission
• 6:44
  to med school and how just what a
• 6:46
  terrific young man he Yes. So let me
• 6:48
  ask you. What are you most focused on
• 6:50
  and excited about coming into 2026?
• 6:53
  Yeah. I think that there are many things.
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  As I mentioned at CommonSpirit,
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  you know, we're really dialed into our core
• 7:00
  mission, which is delivering effective evidence based care
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  to the communities that we serve at scale.
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  And that's a big part of our our
• 7:06
  organizational
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  strategy and and it really informs everything we
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  do, including probably the greatest area of focus
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  right now,
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  which is modernizing our digital
• 7:17
  infrastructure
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  to allow for,
• 7:20
  unified interoperable patient record. And this really is
• 7:24
  foundational
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  so that we can affect better
• 7:28
  care, so that we can,
• 7:30
  gain better insights in terms of
• 7:33
  forecasting
• 7:34
  and predictive analytics.
• 7:36
  It affects every function for the organization
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  from supply chain to finances to clinical.
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  And so this is a key area,
• 7:44
  that we're pushing forward with as a system,
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  in terms of, priorities.
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  Another thing that's top of mind for me,
• 7:53
  I would say, just because it happened quite
• 7:55
  honestly and is that we have just opened
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  a new 64 bed state of the art
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  smart hospital
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  in an area of the country that's an
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  extremely
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  high area of need in North Georgia.
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  Exceptional prevalence of cardiovascular
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  disease and of other chronic,
• 8:14
  medical conditions that otherwise did not have
• 8:18
  high quality reliable care. And so in this
• 8:20
  margin pressured environment,
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  I would tell you that we're quite proud
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  of that at CommonSpirit. We're very proud of
• 8:26
  that in the South Region here, and we're
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  very excited to bring,
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  quite honestly, gold standard cutting edge technology
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  to communities who really need it right now.
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  Fantastic.
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  And talk a little bit about in cardiovascular
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  care,
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  what's new? What's interesting?
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  What's working?
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  Where are we moving the needle positively on
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  cardiovascular care and heart disease?
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  A great question, and I think that there's
• 8:53
  so much tucked into that. As you know,
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  sustained margin pressure is the defining challenge of
• 9:00
  this era. From what I've observed, this is
• 9:02
  not cyclical,
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  and it's here to stay, Scott. I mean,
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  you know, we've got reimbursement tightening,
• 9:07
  the cost of care is going up, we've
• 9:09
  got ongoing capital costs, but
• 9:12
  why this is important is because it really
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  underscores the need for clinically led efficiency.
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  So what I mean by that and what
• 9:20
  we've seen is that if we design care
• 9:23
  to deliver the right outcomes
• 9:25
  at the right time for our communities, then
• 9:28
  EBITDA follows
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  as a result of doing the best thing
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  for our patients.
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  And so one example of that is us
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  pioneering
• 9:36
  a single nurse led program
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  that has allowed us to deploy
• 9:41
  evidence based surveillance
• 9:43
  protocols for a number of life threatening cardiovascular
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  conditions,
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  including coronary artery disease, aortic aneurysms, and valvular
• 9:52
  disease
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  to help thousands of patients.
• 9:57
  And this is really something that we're proud
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  of because it allows us to deliver better
• 10:01
  care with high leverage and with minimal to
• 10:04
  no additional capital costs.
• 10:07
  I think the other part that, is really
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  working in cardiovascular medicine, but also I'd say
• 10:12
  just from a clinical broader lens is in
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  responsible innovation.
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  As you know, I mean, at its foundation,
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  this is predicated on providing effective, efficient, and
• 10:22
  reliable care in ways that are not as
• 10:25
  capital intensive.
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  And so there's many discussions going on about
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  artificial intelligence.
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  I can tell you as a clinic a
• 10:34
  clinician,
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  who uses AI today
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  that it's not always necessary,
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  and we have to be judicious
• 10:42
  and thoughtful about when and where we use
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  these solutions.
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  I think a big part of that is
• 10:48
  they are dominantly
• 10:50
  subscription based
• 10:51
  software as a service
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  model and, therefore,
• 10:55
  can accrue quite a bit of cost on
• 10:56
  a on a volume click scanner time basis.
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  And so they have a tremendous
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  potential
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  to drive up health system costs,
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  specifically the operating expenses.
• 11:09
  And so I think when we think about,
• 11:11
  AI enabled solutions, not only from a cardiovascular
• 11:14
  service line, but also broadly in terms of
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  clinical
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  care, engaging
• 11:19
  multidisciplinary
• 11:21
  teams to pursue high ROI initiatives
• 11:24
  that are in alignment with the broader organizational
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  strategy is critical.
• 11:29
  And so one thing we've been able to
• 11:31
  do is build one of the largest AI
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  enabled cardiovascular
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  CT programs in the nation.
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  And, we're quite proud of it. Not only
• 11:39
  have we been able to achieve a large
• 11:42
  scale within the system,
• 11:44
  but tremendous
• 11:45
  value by running the program with operational discipline
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  and demonstrating sustainability
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  with healthy operating margins. And so this deep
• 11:53
  learning technology
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  that we use very carefully and benchmark very
• 11:58
  cautiously
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  is able to detect coronary obstructions,
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  what causes heart attacks before a heart attack
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  and allows us to intervene,
• 12:07
  with appropriate gold standard care before a major
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  adverse cardiovascular event. So quite literally is saving
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  lives, and we're quite proud of that as
• 12:15
  well.
• 12:16
  But it's amazing that the entire footprint and
• 12:19
  what the common spirit system does is so
• 12:22
  impressive and so fantastic.
• 12:24
  Talk for a moment, doctor Ramji. You've had
• 12:26
  this fantastic leadership career
• 12:29
  and a very innovative career.
• 12:31
  Talk a bit about what advice would you
• 12:33
  give to emerging physicians, emerging leaders, about having
• 12:37
  impactful and terrific careers.
• 12:39
  I would say that,
• 12:41
  look. I mean, there's no shortage of challenges
• 12:44
  where we've got quite a lot of headwinds
• 12:46
  in health care, but I think that this
• 12:49
  really underscores
• 12:50
  an amazing
• 12:51
  opportunity to lean in and to learn and
• 12:54
  to be creative. And so I think probably
• 12:56
  one of the,
• 12:57
  most important skill sets, particularly from a clinician
• 13:01
  leadership standpoint that I've observed to be of
• 13:04
  great value
• 13:05
  is in developing
• 13:07
  cross functional fluency.
• 13:09
  You know, now more than ever, working across
• 13:12
  departments closely with finance, executive leadership,
• 13:16
  supply chain,
• 13:18
  informatics.
• 13:19
  Altogether,
• 13:20
  working as a team truly and closely
• 13:23
  really is what I've seen to deliver incredible
• 13:26
  value on large scale initiatives when we're talking
• 13:29
  about health systems
• 13:30
  and even on, honestly, on a single hospital
• 13:33
  basis.
• 13:34
  The second part that evolving leaders need to
• 13:37
  be thoughtful about is
• 13:39
  understanding leverage.
• 13:40
  As I mentioned,
• 13:42
  margin pressure is a defining challenge at this
• 13:45
  time. And so being able to think creatively
• 13:48
  and using the resources that we currently have,
• 13:52
  like in our single nurse led program that's
• 13:54
  serving care to 7,000, 8,000 people in our
• 13:57
  region,
• 13:58
  is something that's going to be
• 14:01
  necessary as well as a key part of
• 14:04
  strategic
• 14:05
  impact and growth at an organizational level. So
• 14:08
  understanding leverage, being able to think out of
• 14:10
  the box
• 14:11
  about innovation being more than just technology, innovation
• 14:15
  being more than just AI,
• 14:17
  as much attention and value as there is
• 14:20
  in AI. There are incredible ways to innovate
• 14:23
  with the resources at hand, and so I
• 14:25
  think challenging ourselves to do that. And
• 14:28
  finally, there's no shortage of challenges that I
• 14:30
  started with, and so dig in. I think
• 14:33
  the willingness to roll up your sleeves and
• 14:35
  solve problems,
• 14:37
  solve the inefficiencies that we're facing today
• 14:40
  is extremely valuable
• 14:42
  and something that continues to teach me new
• 14:45
  things every day in the work that I
• 14:47
  am blessed to do with this system.
• 14:49
  Fantastic.
• 14:50
  Doctor Amherjee, what an amazing career. I can't
• 14:53
  tell you how thankful I am for for
• 14:54
  all that common spirit does to support our
• 14:56
  country's health care needs. Really remarkable system. Thank
• 14:59
  you so much for taking the time to
• 15:01
  join us this afternoon. We really appreciate it.
• 15:03
  Hey. Thanks so much, Scott. I look forward
• 15:05
  to seeing you at the meeting.