1 00:00:00,000 --> 00:00:02,000 This is Carly Beam with the Becker Spine 2 00:00:02,000 --> 00:00:04,400 and Orthopedics podcast, and I'm thrilled to be 3 00:00:04,400 --> 00:00:06,179 joined today by Allison Redidi, 4 00:00:06,559 --> 00:00:10,080 vice president of orthopedics at Catholic Health. Allison, 5 00:00:10,080 --> 00:00:11,839 thank you so much for jo for joining 6 00:00:11,839 --> 00:00:13,934 us today. Thanks for having me, Carly. I'm 7 00:00:13,934 --> 00:00:15,314 excited to speak with you. 8 00:00:15,695 --> 00:00:18,015 Absolutely. And before we dive to our questions, 9 00:00:18,015 --> 00:00:19,934 could you just introduce yourself and share a 10 00:00:19,934 --> 00:00:22,734 bit about all of your work? Sure. I'm 11 00:00:22,734 --> 00:00:25,500 the vice president for the orthopedic service line 12 00:00:25,579 --> 00:00:28,059 at Catholic Health. We are a six hospital 13 00:00:28,059 --> 00:00:28,879 health system 14 00:00:29,179 --> 00:00:31,100 based in Long Island, New York. We have 15 00:00:31,100 --> 00:00:32,299 about 17,000 16 00:00:32,299 --> 00:00:35,340 employees, and we also have services spanning from 17 00:00:35,340 --> 00:00:35,840 rehabilitation, 18 00:00:36,460 --> 00:00:37,679 home health, hospice, 19 00:00:38,140 --> 00:00:39,420 ambulatory sites, 20 00:00:39,979 --> 00:00:40,479 ASCs. 21 00:00:41,255 --> 00:00:43,114 And we are a at least in orthopedics, 22 00:00:43,254 --> 00:00:45,174 we have a combination of folks who are 23 00:00:45,174 --> 00:00:46,554 employed in terms of physicians 24 00:00:46,934 --> 00:00:49,174 as well as several large orthopedic groups that 25 00:00:49,174 --> 00:00:51,835 we partner with in our various hospitals. 26 00:00:52,295 --> 00:00:54,534 My three year anniversary with Catholic Health is 27 00:00:54,534 --> 00:00:57,729 actually coming up next month. Hey. That's congratulations. 28 00:00:57,869 --> 00:01:00,269 That's awesome. Thank you. You know, one thing 29 00:01:00,269 --> 00:01:02,589 I'd love to, touch on, and you mentioned, 30 00:01:02,589 --> 00:01:04,829 you know, you're working with practices and you 31 00:01:04,829 --> 00:01:05,969 have employed physicians. 32 00:01:06,349 --> 00:01:08,509 How are you, I guess, kind of keeping 33 00:01:08,509 --> 00:01:09,569 a a cohesive 34 00:01:09,954 --> 00:01:11,015 culture and keeping 35 00:01:11,555 --> 00:01:13,334 physicians in the different settings 36 00:01:13,795 --> 00:01:15,015 feeling unified? 37 00:01:15,715 --> 00:01:17,954 Yeah. So one of the things that we're 38 00:01:17,954 --> 00:01:20,274 we're focusing on right now so I I 39 00:01:20,274 --> 00:01:21,875 will just preface this with when I when 40 00:01:21,875 --> 00:01:22,530 I came to Catholic 41 00:01:23,729 --> 00:01:26,310 employed or nine employed physicians across the musculoskeletal 42 00:01:26,769 --> 00:01:27,269 spectrum. 43 00:01:27,890 --> 00:01:29,729 Mhmm. And one of my first orders of 44 00:01:29,729 --> 00:01:31,810 business was to start to boost that faculty 45 00:01:31,810 --> 00:01:34,369 a little bit, starting with our nonoperative primary 46 00:01:34,369 --> 00:01:36,450 sports medicine physicians. We did not have any 47 00:01:36,450 --> 00:01:36,950 faculty 48 00:01:37,665 --> 00:01:37,984 who, 49 00:01:38,465 --> 00:01:40,165 had that subspecialty training. 50 00:01:40,625 --> 00:01:41,125 So 51 00:01:41,424 --> 00:01:44,064 flash forward to today, we have nearly 40 52 00:01:44,064 --> 00:01:45,444 faculty on staff, 53 00:01:45,745 --> 00:01:48,245 which is a huge increase over three years. 54 00:01:48,465 --> 00:01:50,385 So we've really made an effort, first, to 55 00:01:50,385 --> 00:01:52,420 boost our faculty, because that's always key and 56 00:01:52,420 --> 00:01:54,200 critical to have in any health system. 57 00:01:54,579 --> 00:01:56,899 And the second thing that we engaged in 58 00:01:56,899 --> 00:01:59,060 starting last year, we've been laying the groundwork 59 00:01:59,060 --> 00:02:01,560 and we will continue this into this year, 60 00:02:01,859 --> 00:02:03,939 is to work with our partners in these 61 00:02:03,939 --> 00:02:05,239 large orthopedic groups 62 00:02:05,805 --> 00:02:08,844 and partner with them on strategic initiatives at 63 00:02:08,844 --> 00:02:09,584 our hospitals. 64 00:02:10,205 --> 00:02:13,084 So really trying to make them feel that 65 00:02:13,084 --> 00:02:14,544 we are all one team. 66 00:02:14,844 --> 00:02:16,944 It's not faculty versus voluntary. 67 00:02:17,840 --> 00:02:19,520 My my goal and I liken it to 68 00:02:19,520 --> 00:02:21,360 to clothing, but it's like we should all 69 00:02:21,360 --> 00:02:23,439 wear the same hoodie that says, you know, 70 00:02:23,439 --> 00:02:25,219 orthopedics at Catholic Health. 71 00:02:25,599 --> 00:02:27,520 And so we have a variety of things 72 00:02:27,520 --> 00:02:29,680 that we're looking at to sort of bridge 73 00:02:29,680 --> 00:02:31,139 the gap and and bring folks 74 00:02:31,520 --> 00:02:32,020 together. 75 00:02:32,675 --> 00:02:35,794 Some of which involves looking at the various 76 00:02:35,794 --> 00:02:36,854 orthopedic subspecialties 77 00:02:37,155 --> 00:02:38,754 and whether or not we need to hire 78 00:02:38,754 --> 00:02:42,115 additional faculty or if the organizations we're partnering 79 00:02:42,115 --> 00:02:43,014 with those practices 80 00:02:43,715 --> 00:02:45,155 would prefer to be the ones to hire 81 00:02:45,155 --> 00:02:46,354 them, yet they are going to do their 82 00:02:46,354 --> 00:02:48,409 work in our hospitals. So we've started the 83 00:02:48,409 --> 00:02:49,710 groundwork for those conversations, 84 00:02:50,330 --> 00:02:52,250 and we've been meeting very actively with a 85 00:02:52,250 --> 00:02:53,150 lot of those groups 86 00:02:53,530 --> 00:02:55,770 and, coming up with ways that we can 87 00:02:55,770 --> 00:02:56,830 support each other 88 00:02:57,209 --> 00:02:59,949 and have our faculty talk to their faculty, 89 00:03:00,090 --> 00:03:02,270 look at things around quality. 90 00:03:03,185 --> 00:03:04,544 One of the things that we all have 91 00:03:04,544 --> 00:03:07,105 to partner on are these CMS mandates that 92 00:03:07,105 --> 00:03:08,865 have come down. So we had the CJR 93 00:03:08,865 --> 00:03:11,205 initiative around joint replacement for the last 94 00:03:11,504 --> 00:03:13,125 five or six years, I believe. 95 00:03:13,425 --> 00:03:15,185 And now we have teams coming on board, 96 00:03:15,185 --> 00:03:17,125 which expands the scope of that 97 00:03:17,449 --> 00:03:19,930 for orthopedics into spine along with I think 98 00:03:19,930 --> 00:03:21,610 we're still keeping hips and a few other 99 00:03:21,610 --> 00:03:24,189 things. We also have other service lines involved. 100 00:03:24,250 --> 00:03:25,930 So it's been a great opportunity to sort 101 00:03:25,930 --> 00:03:27,289 of talk to everyone and say, okay. How 102 00:03:27,289 --> 00:03:28,810 can we build upon what we did with 103 00:03:28,810 --> 00:03:31,129 with strictly with joint replacement and do this 104 00:03:31,129 --> 00:03:31,629 together? 105 00:03:32,415 --> 00:03:34,735 Yeah. And how are you navigating all the 106 00:03:34,735 --> 00:03:35,235 different 107 00:03:35,694 --> 00:03:39,375 changes with CMS and health care policy? How 108 00:03:39,375 --> 00:03:41,694 are you navigating all that and staying ahead 109 00:03:41,694 --> 00:03:42,354 of it? 110 00:03:42,814 --> 00:03:43,314 Carefully. 111 00:03:44,895 --> 00:03:47,400 Doing our best. So what we've done is 112 00:03:47,560 --> 00:03:49,479 with CJR, we were we we already have 113 00:03:49,479 --> 00:03:51,079 the groundwork for a lot of this through 114 00:03:51,079 --> 00:03:53,239 our participation in CJR. So that's a that's 115 00:03:53,239 --> 00:03:53,819 a benefit. 116 00:03:54,439 --> 00:03:56,759 And now we are looking to the other 117 00:03:56,759 --> 00:03:58,539 service lines are looking to us in orthopedics 118 00:03:58,599 --> 00:03:59,879 to say, okay. How did you do this? 119 00:03:59,879 --> 00:04:01,579 How did you get consensus around 120 00:04:01,974 --> 00:04:03,974 the measures you're you're building, and how do 121 00:04:03,974 --> 00:04:06,935 you coordinate patient care? So we've involved folks 122 00:04:06,935 --> 00:04:09,415 from care coordination at the system level, our 123 00:04:09,415 --> 00:04:12,135 payer strategy team, our quality team who've already 124 00:04:12,135 --> 00:04:12,875 been involved. 125 00:04:13,175 --> 00:04:15,014 And there are there's a larger structure at 126 00:04:15,014 --> 00:04:16,955 the system level for teams specifically. 127 00:04:17,610 --> 00:04:19,370 So we knew it was coming. We're building 128 00:04:19,370 --> 00:04:21,389 upon what we have. And then we're leveraging 129 00:04:21,529 --> 00:04:22,970 some of the tech and tools that we 130 00:04:22,970 --> 00:04:24,810 have within our medical records. So we're an 131 00:04:24,810 --> 00:04:25,629 epic shop. 132 00:04:26,250 --> 00:04:27,229 And we are able 133 00:04:28,089 --> 00:04:30,569 to use that to run certain reports and 134 00:04:30,569 --> 00:04:33,675 automate a few processes, which up until very 135 00:04:33,675 --> 00:04:35,694 recently, we've been doing pretty manually, 136 00:04:36,314 --> 00:04:37,834 which we could kinda get away with, 137 00:04:38,394 --> 00:04:40,154 for a little bit. But at this point, 138 00:04:40,154 --> 00:04:42,235 the way these programs are expanding and and 139 00:04:42,235 --> 00:04:44,735 the way that our volume has been increasing, 140 00:04:45,194 --> 00:04:47,439 it's not manageable to do that anymore. So 141 00:04:47,439 --> 00:04:48,800 we're trying to leverage some of the tools 142 00:04:48,800 --> 00:04:50,560 within Epic, to help us do that and 143 00:04:50,560 --> 00:04:52,240 do some of the patient tracking, the quality 144 00:04:52,240 --> 00:04:53,620 metric tracking, etcetera. 145 00:04:54,079 --> 00:04:56,160 And then we also have outside, you know, 146 00:04:56,160 --> 00:04:57,919 thought groups that we sort of participate in 147 00:04:57,919 --> 00:04:59,519 and and go to as many webinars as 148 00:04:59,519 --> 00:05:01,764 we can to learn about these measures and 149 00:05:01,764 --> 00:05:03,604 also see what other best practices are out 150 00:05:03,604 --> 00:05:04,584 there in the country 151 00:05:05,044 --> 00:05:06,805 to see how we can make sure that 152 00:05:06,805 --> 00:05:08,564 we are, you know, meeting the goals, being 153 00:05:08,564 --> 00:05:10,345 as competitive as as possible. 154 00:05:11,284 --> 00:05:12,724 Got it. And I was wondering if you 155 00:05:12,724 --> 00:05:14,024 could touch on any other 156 00:05:14,459 --> 00:05:16,939 big, important initiatives that you've led in the 157 00:05:16,939 --> 00:05:20,000 last year and how those have turned out. 158 00:05:20,300 --> 00:05:20,800 Sure. 159 00:05:21,180 --> 00:05:23,100 So one of the things that we have 160 00:05:23,100 --> 00:05:25,500 laid the groundwork for is looking at how 161 00:05:25,500 --> 00:05:27,420 do we transition and stay on top of 162 00:05:27,420 --> 00:05:29,019 the fact that a lot of orthopedics is 163 00:05:29,019 --> 00:05:31,555 going towards the outpatient arena. Mhmm. We have 164 00:05:31,555 --> 00:05:32,055 several 165 00:05:32,435 --> 00:05:35,795 ambulatory surgical centers that we partner with folks 166 00:05:35,795 --> 00:05:37,415 on in our system. 167 00:05:37,795 --> 00:05:39,875 And so we are trying to maintain a 168 00:05:39,875 --> 00:05:42,035 good balance between what goes there and what 169 00:05:42,035 --> 00:05:44,035 is should be done there versus what stays 170 00:05:44,035 --> 00:05:45,814 in the traditional hospital setting. 171 00:05:46,430 --> 00:05:48,430 We just actually got some data from advisory 172 00:05:48,430 --> 00:05:50,990 board, and it's about an average of 15% 173 00:05:50,990 --> 00:05:53,250 growth in that outpatient arena for orthopedic. 174 00:05:53,789 --> 00:05:55,709 And joint replacement is actually as high as 175 00:05:55,709 --> 00:05:56,689 thirty two percent. 176 00:05:57,069 --> 00:05:58,750 Wow. So yeah. It's I was I was 177 00:05:58,750 --> 00:06:00,110 actually a little shocked when I saw those 178 00:06:00,110 --> 00:06:01,789 numbers because we assumed we had heard, you 179 00:06:01,789 --> 00:06:02,925 know, for the last few years, it was 180 00:06:02,925 --> 00:06:04,524 like, oh, five or ten percent is gonna 181 00:06:04,524 --> 00:06:05,105 go outpatient. 182 00:06:05,485 --> 00:06:07,824 We're looking at much higher numbers than that. 183 00:06:08,365 --> 00:06:09,725 And so a lot of what we've been 184 00:06:09,725 --> 00:06:11,564 doing is setting the groundwork for looking at 185 00:06:11,564 --> 00:06:12,865 a more regional strategy. 186 00:06:13,245 --> 00:06:13,985 And so 187 00:06:14,285 --> 00:06:16,944 we've been partnering with, our hospital presidents 188 00:06:17,560 --> 00:06:19,479 in various regions to say, what is our 189 00:06:19,479 --> 00:06:21,079 current book of business at each of these 190 00:06:21,079 --> 00:06:21,579 locations? 191 00:06:21,879 --> 00:06:24,120 How do we potentially shift things over the 192 00:06:24,120 --> 00:06:25,979 next one to three years 193 00:06:26,439 --> 00:06:27,419 to be more efficient 194 00:06:27,879 --> 00:06:28,860 to cohort 195 00:06:29,160 --> 00:06:31,740 like types of services in one place? 196 00:06:32,394 --> 00:06:34,314 Take advantage of the fact that maybe we 197 00:06:34,314 --> 00:06:36,394 have ORs where we've got enough and we 198 00:06:36,394 --> 00:06:37,995 can almost set up, like, a mini ASC 199 00:06:37,995 --> 00:06:39,935 within the hospital proper if we can't 200 00:06:40,394 --> 00:06:42,314 build a new an ASC or or, you 201 00:06:42,314 --> 00:06:44,394 know, do that capital investment. What can we 202 00:06:44,394 --> 00:06:46,040 do with the resources that we have? How 203 00:06:46,040 --> 00:06:47,800 can we become really efficient at what we 204 00:06:47,800 --> 00:06:49,240 do? And so I think that's one of 205 00:06:49,240 --> 00:06:51,339 the things we've been setting the groundwork for, 206 00:06:51,399 --> 00:06:53,800 and we're looking forward to expanding upon next 207 00:06:53,800 --> 00:06:54,300 year. 208 00:06:54,759 --> 00:06:57,240 The other really interesting thing, and it may 209 00:06:57,240 --> 00:06:59,204 seem like a very small thing when when 210 00:06:59,204 --> 00:07:01,204 people are listening to this, but I'm really 211 00:07:01,204 --> 00:07:03,685 excited about it, is we were able to 212 00:07:03,685 --> 00:07:04,185 standardize 213 00:07:04,644 --> 00:07:05,544 our education 214 00:07:05,845 --> 00:07:07,384 for all of our joint replacement 215 00:07:07,845 --> 00:07:10,165 practices and also for all of our our 216 00:07:10,165 --> 00:07:13,125 faculty, our nurses, our care coordinators, anyone who 217 00:07:13,125 --> 00:07:14,745 touches the joint replacement process. 218 00:07:15,180 --> 00:07:17,580 And that may sound like something very, very 219 00:07:17,580 --> 00:07:19,660 small, but when you look across the health 220 00:07:19,660 --> 00:07:20,160 system, 221 00:07:20,860 --> 00:07:23,740 it's it was very fragmented. People were getting 222 00:07:23,740 --> 00:07:25,519 different education at different places. 223 00:07:25,899 --> 00:07:28,300 And with with the growing number of patients 224 00:07:28,300 --> 00:07:30,314 that we're seeing and the growing number of 225 00:07:30,394 --> 00:07:32,394 accreditations that are available and the standards that 226 00:07:32,394 --> 00:07:34,154 are coming out, we felt it was really 227 00:07:34,154 --> 00:07:36,175 important to do this across the system. 228 00:07:36,634 --> 00:07:37,455 And so 229 00:07:38,074 --> 00:07:39,675 what it what it says to me is 230 00:07:39,675 --> 00:07:42,154 that we have now built a system in 231 00:07:42,154 --> 00:07:45,300 the orthopedics world where we've got teams across 232 00:07:45,300 --> 00:07:47,699 all of our locations that are cooperating. So 233 00:07:47,699 --> 00:07:49,000 we now meet monthly. 234 00:07:49,379 --> 00:07:50,599 I started this probably 235 00:07:51,219 --> 00:07:53,779 six months into my tenure here. We've we've 236 00:07:53,779 --> 00:07:55,939 brought all the orthopedic coordinators together, and we 237 00:07:55,939 --> 00:07:58,039 started meeting monthly. And it was so wonderful 238 00:07:58,495 --> 00:08:00,175 because some of them had never even met 239 00:08:00,175 --> 00:08:00,754 each other. 240 00:08:01,214 --> 00:08:02,814 And it it's this is all part of 241 00:08:02,814 --> 00:08:04,574 growing as a health system and coming together 242 00:08:04,574 --> 00:08:06,995 and really becoming functional as a system. 243 00:08:07,535 --> 00:08:10,495 So it was great. And after maybe five 244 00:08:10,495 --> 00:08:12,654 months of meetings, I started noticing emails that 245 00:08:12,654 --> 00:08:14,850 people would cc me on, and they were 246 00:08:14,850 --> 00:08:16,610 just talking to each other without me having 247 00:08:16,610 --> 00:08:18,129 to have the monthly meeting and everything else. 248 00:08:18,129 --> 00:08:20,290 And they were like, oh, hey, Kevin. What 249 00:08:20,290 --> 00:08:22,129 are you doing at this hospital? And and, 250 00:08:22,129 --> 00:08:23,889 oh, you know, Patty, what are you doing 251 00:08:23,889 --> 00:08:25,490 at this hospital? And I just thought it 252 00:08:25,490 --> 00:08:27,009 was such a great way to bring people 253 00:08:27,009 --> 00:08:29,055 together, make them feel like they're part of 254 00:08:29,055 --> 00:08:31,294 something bigger, and let them be resources for 255 00:08:31,294 --> 00:08:34,174 each other. And we're continuing that now this 256 00:08:34,174 --> 00:08:35,315 year into spine, 257 00:08:36,014 --> 00:08:38,174 specifically. So we are going to be doing 258 00:08:38,174 --> 00:08:40,495 the same process for spine as well as 259 00:08:40,495 --> 00:08:42,990 continuing our efforts on the joint replacement front 260 00:08:43,309 --> 00:08:44,529 with patient education. 261 00:08:44,990 --> 00:08:47,490 So we have a semi standard patient education 262 00:08:47,629 --> 00:08:49,870 across the system we've worked on, and we 263 00:08:49,870 --> 00:08:51,470 have a few little bits and pieces we 264 00:08:51,470 --> 00:08:53,490 wanna tweak so that it really truly is 265 00:08:53,789 --> 00:08:55,789 something that every single patient that comes in 266 00:08:55,789 --> 00:08:57,629 will get exactly the same package when they 267 00:08:57,629 --> 00:08:59,735 come to Catholic Health. So they're always getting 268 00:08:59,735 --> 00:09:01,335 all the info they need, but it's always 269 00:09:01,335 --> 00:09:03,674 added a little bit manually by each, hospital. 270 00:09:03,975 --> 00:09:05,735 And we're really trying to make it, a, 271 00:09:05,735 --> 00:09:07,975 very easy for our orthopedic coordinators, for our 272 00:09:07,975 --> 00:09:09,355 physicians, for our APPs 273 00:09:09,654 --> 00:09:11,409 to give all of that education. And And 274 00:09:11,409 --> 00:09:12,929 we wanna make it uniform so that no 275 00:09:12,929 --> 00:09:14,529 matter where you touch our health system, you're 276 00:09:14,529 --> 00:09:16,210 getting the same experience. And I think that 277 00:09:16,210 --> 00:09:18,210 speaks to what we're also trying to do 278 00:09:18,210 --> 00:09:20,610 to continually elevate our patient experience when you 279 00:09:20,610 --> 00:09:21,750 come to Catholic Health. 280 00:09:22,210 --> 00:09:23,970 Absolutely. And and there's a couple of things 281 00:09:23,970 --> 00:09:26,210 I wanted to follow-up on here. Sounds I 282 00:09:26,210 --> 00:09:29,204 really wanted to first zero in on your 283 00:09:29,424 --> 00:09:32,304 outpatient total joint work. Mhmm. And what are 284 00:09:32,304 --> 00:09:33,125 some of the 285 00:09:33,504 --> 00:09:34,725 protocols, practices, 286 00:09:35,105 --> 00:09:37,745 any of the biggest factors that you think 287 00:09:37,745 --> 00:09:37,904 really, 288 00:09:39,389 --> 00:09:41,950 can credit this, you know, explosive growth, it 289 00:09:41,950 --> 00:09:44,210 sounds like, in outpatient total joints? 290 00:09:44,670 --> 00:09:46,110 Yeah. I I will say I think some 291 00:09:46,110 --> 00:09:48,430 of it is stemming from the pairs. So 292 00:09:48,430 --> 00:09:50,509 they are pushing to have more and more 293 00:09:50,509 --> 00:09:52,670 procedures done in the outpatient arena, and that's 294 00:09:52,670 --> 00:09:54,529 just something we've seen across the industry. 295 00:09:54,945 --> 00:09:56,165 I think the other thing 296 00:09:56,545 --> 00:09:58,384 that people are starting to look into is 297 00:09:58,384 --> 00:10:00,545 the impact of GLP ones, believe it or 298 00:10:00,545 --> 00:10:03,764 not. So crossing crossing sort of specialties here 299 00:10:03,904 --> 00:10:05,684 on the orthopedic joint replacement, 300 00:10:06,705 --> 00:10:07,924 population. And so 301 00:10:08,330 --> 00:10:09,850 as more and more people are taking the 302 00:10:09,850 --> 00:10:11,389 GLP ones and potentially, 303 00:10:11,929 --> 00:10:15,129 reducing their risks from obesity or maybe being 304 00:10:15,129 --> 00:10:17,370 a little bit more sedentary, and they're moving 305 00:10:17,370 --> 00:10:19,370 more and they're having less weight and less 306 00:10:19,370 --> 00:10:20,750 strain put on their joints, 307 00:10:21,184 --> 00:10:23,184 we may be seeing an impact that this 308 00:10:23,184 --> 00:10:25,584 is either delaying people needing full on joint 309 00:10:25,584 --> 00:10:26,084 replacements 310 00:10:26,704 --> 00:10:28,865 or maybe also enhancing our, 311 00:10:29,345 --> 00:10:29,845 outcomes 312 00:10:30,225 --> 00:10:32,625 and that people are having more successful joint 313 00:10:32,625 --> 00:10:35,105 replacements because their BMIs and their weight might 314 00:10:35,105 --> 00:10:36,899 be lower. They might be more active prior 315 00:10:36,899 --> 00:10:39,300 to surgery. So there's some interesting studies right 316 00:10:39,300 --> 00:10:40,740 now that are out there. I haven't quite 317 00:10:40,740 --> 00:10:42,200 gotten to read all of them, but, 318 00:10:42,660 --> 00:10:44,660 there is definitely a body of research that 319 00:10:44,660 --> 00:10:47,860 is now growing amongst this. So one of 320 00:10:47,860 --> 00:10:49,735 those other things is that if people 321 00:10:50,115 --> 00:10:51,414 have fewer risk factors, 322 00:10:51,794 --> 00:10:54,034 there's a greater chance that their joint replacement 323 00:10:54,034 --> 00:10:56,115 or other orthopedic procedure could be done in 324 00:10:56,115 --> 00:10:58,595 the outpatient arena. So it is it is 325 00:10:58,595 --> 00:11:01,389 possible that we are also seeing this high 326 00:11:01,389 --> 00:11:03,709 increase so that more people are actually becoming 327 00:11:03,709 --> 00:11:04,209 eligible 328 00:11:04,750 --> 00:11:06,990 for that outpatient arena versus having to be 329 00:11:06,990 --> 00:11:09,230 done in the traditional hospital where we can 330 00:11:09,230 --> 00:11:10,769 better manage some of the comorbidities, 331 00:11:11,389 --> 00:11:12,690 associated with these surgeries. 332 00:11:13,695 --> 00:11:15,375 Got it. And then, you know, in terms 333 00:11:15,375 --> 00:11:17,695 of spine surgery and outpatient spine, I'd love 334 00:11:17,695 --> 00:11:19,134 if you could just kind of dive in 335 00:11:19,134 --> 00:11:19,955 more into 336 00:11:20,495 --> 00:11:22,815 your plan of attack with that and your 337 00:11:22,815 --> 00:11:25,554 goals for, increasing that as well. 338 00:11:26,360 --> 00:11:28,540 So for inpatient spine, there's still 339 00:11:29,240 --> 00:11:31,720 a few procedures they that the surgeons will 340 00:11:31,720 --> 00:11:34,279 do on the outpatient side. It's still very 341 00:11:34,279 --> 00:11:35,259 heavily inpatient. 342 00:11:35,800 --> 00:11:37,399 I I do think that there will be 343 00:11:37,399 --> 00:11:39,660 a trend as more and more places 344 00:11:40,040 --> 00:11:41,820 try this and see that it's safe. 345 00:11:42,335 --> 00:11:44,754 But my clinicians here are definitely 346 00:11:45,295 --> 00:11:47,154 focusing still on the inpatient 347 00:11:47,934 --> 00:11:50,415 side of spine. However, in doing so, they 348 00:11:50,415 --> 00:11:52,894 are also, you know, ensuring that things are 349 00:11:52,894 --> 00:11:54,975 very efficient. Patients are definitely staying in the 350 00:11:54,975 --> 00:11:56,915 hospital for fewer days, 351 00:11:57,370 --> 00:11:58,889 and we are really trying for when they 352 00:11:58,889 --> 00:12:00,649 are in the hospital to offer an excellent 353 00:12:00,649 --> 00:12:02,410 experience for them so that they can get 354 00:12:02,410 --> 00:12:03,769 up and get back to doing what they 355 00:12:03,769 --> 00:12:05,690 like as soon as possible. But I think 356 00:12:05,690 --> 00:12:07,470 on the spine side, that is still, 357 00:12:08,250 --> 00:12:09,929 in the arena where it's probably one of 358 00:12:09,929 --> 00:12:12,825 the last arenas where, inpatient is really still 359 00:12:12,825 --> 00:12:14,985 ruling. Although, I'm sure if we have this 360 00:12:14,985 --> 00:12:16,904 conversation in another couple of years, we may 361 00:12:16,904 --> 00:12:18,605 be seeing something completely different. 362 00:12:19,384 --> 00:12:19,884 Definitely. 363 00:12:20,345 --> 00:12:21,945 And then just last question I had for 364 00:12:21,945 --> 00:12:23,085 you, Allison, is 365 00:12:23,465 --> 00:12:25,404 what's one thing that all 366 00:12:25,785 --> 00:12:28,700 orthopedic leaders such as yourself should do this 367 00:12:28,700 --> 00:12:30,399 year to really thrive? 368 00:12:31,419 --> 00:12:33,500 Sure. I think there's a couple of things 369 00:12:33,500 --> 00:12:34,940 I think that we can do so that 370 00:12:34,940 --> 00:12:37,740 we have resilient orthopedic service lines. I think 371 00:12:37,740 --> 00:12:39,679 we need to look at building multidisciplinary 372 00:12:40,139 --> 00:12:43,384 hubs. Patients are really craving one stop shopping. 373 00:12:43,524 --> 00:12:44,965 They wanna go in. They wanna be able 374 00:12:44,965 --> 00:12:47,285 to get their radiology studies, maybe their labs 375 00:12:47,285 --> 00:12:49,684 drawn, maybe even see a couple providers in 376 00:12:49,684 --> 00:12:52,085 a day if that's possible scheduling wise. So 377 00:12:52,085 --> 00:12:53,684 I think looking at how you set up 378 00:12:53,684 --> 00:12:57,070 your out outpatient ambulatory practices to provide that 379 00:12:57,070 --> 00:12:58,590 experience, I think it's going to be really 380 00:12:58,590 --> 00:12:59,090 important. 381 00:12:59,629 --> 00:13:02,190 Ease of access to care is critical. Patients 382 00:13:02,190 --> 00:13:03,710 want to get in. They wanna get in 383 00:13:03,710 --> 00:13:06,110 quickly. And so the the more that an 384 00:13:06,110 --> 00:13:08,269 organization can do that, the the better off 385 00:13:08,269 --> 00:13:10,745 that they will be. And I think they 386 00:13:10,745 --> 00:13:13,165 also have to look at beyond the ambulatory 387 00:13:13,465 --> 00:13:15,225 arena and take a critical look at their 388 00:13:15,225 --> 00:13:17,545 system just as we're doing at Catholic Health 389 00:13:17,545 --> 00:13:19,465 and say, what do we want to do 390 00:13:19,465 --> 00:13:21,545 where and how does this make sense? Does 391 00:13:21,545 --> 00:13:23,865 it make sense to do high level joint 392 00:13:23,865 --> 00:13:26,399 replacements and revisions and spine in every single 393 00:13:26,399 --> 00:13:28,639 one of our six hospitals? The answer is 394 00:13:28,639 --> 00:13:31,139 probably not. So how do we look regionally 395 00:13:31,360 --> 00:13:32,100 and say, 396 00:13:32,639 --> 00:13:35,220 how do we build centers of excellence where 397 00:13:35,440 --> 00:13:37,940 you can get certain procedures and certain categories 398 00:13:38,480 --> 00:13:39,700 of, treatment 399 00:13:40,034 --> 00:13:41,475 all in one place and it's at a 400 00:13:41,475 --> 00:13:43,475 very, very high level, and we can get 401 00:13:43,475 --> 00:13:45,075 you there no matter where you enter our 402 00:13:45,075 --> 00:13:45,575 system. 403 00:13:46,034 --> 00:13:47,634 So when you wanna when you regionalize, you 404 00:13:47,634 --> 00:13:49,075 really wanna make sure that no matter where 405 00:13:49,075 --> 00:13:51,075 the patient touches your system, they get to 406 00:13:51,075 --> 00:13:52,995 the right care at the right time with 407 00:13:52,995 --> 00:13:54,879 the right providers. And so I think as 408 00:13:54,879 --> 00:13:56,799 long as you can build those systems in 409 00:13:56,799 --> 00:13:58,959 and the procedures in, you're gonna be in 410 00:13:58,959 --> 00:14:00,320 a good place. So one of the things 411 00:14:00,320 --> 00:14:02,559 we're trying to do right now is there's 412 00:14:02,559 --> 00:14:04,980 a big push with our in network utilization 413 00:14:05,120 --> 00:14:06,879 and making sure that our patients have a 414 00:14:06,879 --> 00:14:08,100 very seamless transition 415 00:14:08,674 --> 00:14:10,454 from our primary care providers 416 00:14:10,754 --> 00:14:13,074 to any specialist that they need. So we're 417 00:14:13,074 --> 00:14:14,995 making sure that, you know, to the point 418 00:14:14,995 --> 00:14:16,355 where you might even be able to get 419 00:14:16,355 --> 00:14:18,754 your orthopedic appointment as you leave your primary 420 00:14:18,754 --> 00:14:20,595 care doctor's office. Or if you need an 421 00:14:20,595 --> 00:14:21,095 x-ray 422 00:14:21,620 --> 00:14:24,179 from your orthopedic specialist, you can leave with 423 00:14:24,179 --> 00:14:26,100 that x-ray appointment. And a lot of health 424 00:14:26,100 --> 00:14:28,500 systems do this. This isn't rocket science or 425 00:14:28,500 --> 00:14:30,519 anything, but I think, you know, the implementation 426 00:14:30,740 --> 00:14:32,259 of it and the the way in which 427 00:14:32,259 --> 00:14:33,379 you do it and how you make it 428 00:14:33,379 --> 00:14:35,299 accessible for your patients is really where you're 429 00:14:35,299 --> 00:14:38,144 going to have have success or maybe not. 430 00:14:38,605 --> 00:14:39,964 And then I think, finally, I think you 431 00:14:39,964 --> 00:14:41,985 always have to go back to your people. 432 00:14:42,125 --> 00:14:43,964 And this is something I've said, in some 433 00:14:43,964 --> 00:14:46,044 of the talks I've given, but you have 434 00:14:46,044 --> 00:14:48,444 to hire really good people because we are 435 00:14:48,444 --> 00:14:50,440 in a people business. We take care of 436 00:14:50,440 --> 00:14:52,679 people. That is our core business. And I 437 00:14:52,679 --> 00:14:54,600 think as long as you keep that as 438 00:14:54,600 --> 00:14:56,539 your forefront and your guiding principle, 439 00:14:57,080 --> 00:14:59,500 you'll hire good people, whether it's your physicians, 440 00:14:59,559 --> 00:15:02,200 your APPs, your nursing staff, even the people 441 00:15:02,200 --> 00:15:04,954 that answer your phones or, you know, are 442 00:15:04,954 --> 00:15:05,615 your housekeepers. 443 00:15:06,315 --> 00:15:07,754 If you have good people, you'll have a 444 00:15:07,754 --> 00:15:09,355 good culture and people will want to come 445 00:15:09,355 --> 00:15:11,514 to you. And so I think that's something 446 00:15:11,514 --> 00:15:13,214 you always have to keep in mind. 447 00:15:13,754 --> 00:15:15,434 We do it with our physicians as well. 448 00:15:15,434 --> 00:15:18,540 We are hire we've hired some amazingly talented 449 00:15:18,540 --> 00:15:19,040 physicians, 450 00:15:19,500 --> 00:15:22,300 but they're also genuinely nice people. And I 451 00:15:22,300 --> 00:15:24,139 really enjoy speaking with them, and I'm I'm 452 00:15:24,139 --> 00:15:25,580 setting up all my one to ones right 453 00:15:25,580 --> 00:15:27,580 now for this year. And I'm so excited 454 00:15:27,580 --> 00:15:29,714 because I just think we've found a whole 455 00:15:29,714 --> 00:15:31,634 new group of of physicians. We've found a 456 00:15:31,634 --> 00:15:32,534 group of APP, 457 00:15:32,914 --> 00:15:35,735 and they're really special. And they're just genuinely 458 00:15:35,954 --> 00:15:36,695 good people. 459 00:15:37,394 --> 00:15:39,075 That's excellent. And, you know, I hope you 460 00:15:39,075 --> 00:15:41,920 can definitely follow-up and hear more about, what 461 00:15:41,920 --> 00:15:44,240 you're doing over there at Catholic Health. And 462 00:15:44,240 --> 00:15:46,399 thank you again for joining us on today's 463 00:15:46,399 --> 00:15:47,860 podcast. I hope you, 464 00:15:48,480 --> 00:15:49,779 stay warm, and 465 00:15:50,240 --> 00:15:51,759 I look forward to connecting again in the 466 00:15:51,759 --> 00:15:53,920 future. Sounds good. It was a pleasure talking 467 00:15:53,920 --> 00:15:55,200 to you today, and I hope you have 468 00:15:55,200 --> 00:15:56,469 a a great rest of the day.