This is Carly Beam with the Becker Spine
and Orthopedics podcast, and I'm thrilled to be
joined today by Allison Redidi,
vice president of orthopedics at Catholic Health. Allison,
thank you so much for jo for joining
us today. Thanks for having me, Carly. I'm
excited to speak with you.
Absolutely. And before we dive to our questions,
could you just introduce yourself and share a
bit about all of your work? Sure. I'm
the vice president for the orthopedic service line
at Catholic Health. We are a six hospital
health system
based in Long Island, New York. We have
about 17,000
employees, and we also have services spanning from
rehabilitation,
home health, hospice,
ambulatory sites,
ASCs.
And we are a at least in orthopedics,
we have a combination of folks who are
employed in terms of physicians
as well as several large orthopedic groups that
we partner with in our various hospitals.
My three year anniversary with Catholic Health is
actually coming up next month. Hey. That's congratulations.
That's awesome. Thank you. You know, one thing
I'd love to, touch on, and you mentioned,
you know, you're working with practices and you
have employed physicians.
How are you, I guess, kind of keeping
a a cohesive
culture and keeping
physicians in the different settings
feeling unified?
Yeah. So one of the things that we're
we're focusing on right now so I I
will just preface this with when I when
I came to Catholic
employed or nine employed physicians across the musculoskeletal
spectrum.
Mhmm. And one of my first orders of
business was to start to boost that faculty
a little bit, starting with our nonoperative primary
sports medicine physicians. We did not have any
faculty
who,
had that subspecialty training.
So
flash forward to today, we have nearly 40
faculty on staff,
which is a huge increase over three years.
So we've really made an effort, first, to
boost our faculty, because that's always key and
critical to have in any health system.
And the second thing that we engaged in
starting last year, we've been laying the groundwork
and we will continue this into this year,
is to work with our partners in these
large orthopedic groups
and partner with them on strategic initiatives at
our hospitals.
So really trying to make them feel that
we are all one team.
It's not faculty versus voluntary.
My my goal and I liken it to
to clothing, but it's like we should all
wear the same hoodie that says, you know,
orthopedics at Catholic Health.
And so we have a variety of things
that we're looking at to sort of bridge
the gap and and bring folks
together.
Some of which involves looking at the various
orthopedic subspecialties
and whether or not we need to hire
additional faculty or if the organizations we're partnering
with those practices
would prefer to be the ones to hire
them, yet they are going to do their
work in our hospitals. So we've started the
groundwork for those conversations,
and we've been meeting very actively with a
lot of those groups
and, coming up with ways that we can
support each other
and have our faculty talk to their faculty,
look at things around quality.
One of the things that we all have
to partner on are these CMS mandates that
have come down. So we had the CJR
initiative around joint replacement for the last
five or six years, I believe.
And now we have teams coming on board,
which expands the scope of that
for orthopedics into spine along with I think
we're still keeping hips and a few other
things. We also have other service lines involved.
So it's been a great opportunity to sort
of talk to everyone and say, okay. How
can we build upon what we did with
with strictly with joint replacement and do this
together?
Yeah. And how are you navigating all the
different
changes with CMS and health care policy? How
are you navigating all that and staying ahead
of it?
Carefully.
Doing our best. So what we've done is
with CJR, we were we we already have
the groundwork for a lot of this through
our participation in CJR. So that's a that's
a benefit.
And now we are looking to the other
service lines are looking to us in orthopedics
to say, okay. How did you do this?
How did you get consensus around
the measures you're you're building, and how do
you coordinate patient care? So we've involved folks
from care coordination at the system level, our
payer strategy team, our quality team who've already
been involved.
And there are there's a larger structure at
the system level for teams specifically.
So we knew it was coming. We're building
upon what we have. And then we're leveraging
some of the tech and tools that we
have within our medical records. So we're an
epic shop.
And we are able
to use that to run certain reports and
automate a few processes, which up until very
recently, we've been doing pretty manually,
which we could kinda get away with,
for a little bit. But at this point,
the way these programs are expanding and and
the way that our volume has been increasing,
it's not manageable to do that anymore. So
we're trying to leverage some of the tools
within Epic, to help us do that and
do some of the patient tracking, the quality
metric tracking, etcetera.
And then we also have outside, you know,
thought groups that we sort of participate in
and and go to as many webinars as
we can to learn about these measures and
also see what other best practices are out
there in the country
to see how we can make sure that
we are, you know, meeting the goals, being
as competitive as as possible.
Got it. And I was wondering if you
could touch on any other
big, important initiatives that you've led in the
last year and how those have turned out.
Sure.
So one of the things that we have
laid the groundwork for is looking at how
do we transition and stay on top of
the fact that a lot of orthopedics is
going towards the outpatient arena. Mhmm. We have
several
ambulatory surgical centers that we partner with folks
on in our system.
And so we are trying to maintain a
good balance between what goes there and what
is should be done there versus what stays
in the traditional hospital setting.
We just actually got some data from advisory
board, and it's about an average of 15%
growth in that outpatient arena for orthopedic.
And joint replacement is actually as high as
thirty two percent.
Wow. So yeah. It's I was I was
actually a little shocked when I saw those
numbers because we assumed we had heard, you
know, for the last few years, it was
like, oh, five or ten percent is gonna
go outpatient.
We're looking at much higher numbers than that.
And so a lot of what we've been
doing is setting the groundwork for looking at
a more regional strategy.
And so
we've been partnering with, our hospital presidents
in various regions to say, what is our
current book of business at each of these
locations?
How do we potentially shift things over the
next one to three years
to be more efficient
to cohort
like types of services in one place?
Take advantage of the fact that maybe we
have ORs where we've got enough and we
can almost set up, like, a mini ASC
within the hospital proper if we can't
build a new an ASC or or, you
know, do that capital investment. What can we
do with the resources that we have? How
can we become really efficient at what we
do? And so I think that's one of
the things we've been setting the groundwork for,
and we're looking forward to expanding upon next
year.
The other really interesting thing, and it may
seem like a very small thing when when
people are listening to this, but I'm really
excited about it, is we were able to
standardize
our education
for all of our joint replacement
practices and also for all of our our
faculty, our nurses, our care coordinators, anyone who
touches the joint replacement process.
And that may sound like something very, very
small, but when you look across the health
system,
it's it was very fragmented. People were getting
different education at different places.
And with with the growing number of patients
that we're seeing and the growing number of
accreditations that are available and the standards that
are coming out, we felt it was really
important to do this across the system.
And so
what it what it says to me is
that we have now built a system in
the orthopedics world where we've got teams across
all of our locations that are cooperating. So
we now meet monthly.
I started this probably
six months into my tenure here. We've we've
brought all the orthopedic coordinators together, and we
started meeting monthly. And it was so wonderful
because some of them had never even met
each other.
And it it's this is all part of
growing as a health system and coming together
and really becoming functional as a system.
So it was great. And after maybe five
months of meetings, I started noticing emails that
people would cc me on, and they were
just talking to each other without me having
to have the monthly meeting and everything else.
And they were like, oh, hey, Kevin. What
are you doing at this hospital? And and,
oh, you know, Patty, what are you doing
at this hospital? And I just thought it
was such a great way to bring people
together, make them feel like they're part of
something bigger, and let them be resources for
each other. And we're continuing that now this
year into spine,
specifically. So we are going to be doing
the same process for spine as well as
continuing our efforts on the joint replacement front
with patient education.
So we have a semi standard patient education
across the system we've worked on, and we
have a few little bits and pieces we
wanna tweak so that it really truly is
something that every single patient that comes in
will get exactly the same package when they
come to Catholic Health. So they're always getting
all the info they need, but it's always
added a little bit manually by each, hospital.
And we're really trying to make it, a,
very easy for our orthopedic coordinators, for our
physicians, for our APPs
to give all of that education. And And
we wanna make it uniform so that no
matter where you touch our health system, you're
getting the same experience. And I think that
speaks to what we're also trying to do
to continually elevate our patient experience when you
come to Catholic Health.
Absolutely. And and there's a couple of things
I wanted to follow-up on here. Sounds I
really wanted to first zero in on your
outpatient total joint work. Mhmm. And what are
some of the
protocols, practices,
any of the biggest factors that you think
really,
can credit this, you know, explosive growth, it
sounds like, in outpatient total joints?
Yeah. I I will say I think some
of it is stemming from the pairs. So
they are pushing to have more and more
procedures done in the outpatient arena, and that's
just something we've seen across the industry.
I think the other thing
that people are starting to look into is
the impact of GLP ones, believe it or
not. So crossing crossing sort of specialties here
on the orthopedic joint replacement,
population. And so
as more and more people are taking the
GLP ones and potentially,
reducing their risks from obesity or maybe being
a little bit more sedentary, and they're moving
more and they're having less weight and less
strain put on their joints,
we may be seeing an impact that this
is either delaying people needing full on joint
replacements
or maybe also enhancing our,
outcomes
and that people are having more successful joint
replacements because their BMIs and their weight might
be lower. They might be more active prior
to surgery. So there's some interesting studies right
now that are out there. I haven't quite
gotten to read all of them, but,
there is definitely a body of research that
is now growing amongst this. So one of
those other things is that if people
have fewer risk factors,
there's a greater chance that their joint replacement
or other orthopedic procedure could be done in
the outpatient arena. So it is it is
possible that we are also seeing this high
increase so that more people are actually becoming
eligible
for that outpatient arena versus having to be
done in the traditional hospital where we can
better manage some of the comorbidities,
associated with these surgeries.
Got it. And then, you know, in terms
of spine surgery and outpatient spine, I'd love
if you could just kind of dive in
more into
your plan of attack with that and your
goals for, increasing that as well.
So for inpatient spine, there's still
a few procedures they that the surgeons will
do on the outpatient side. It's still very
heavily inpatient.
I I do think that there will be
a trend as more and more places
try this and see that it's safe.
But my clinicians here are definitely
focusing still on the inpatient
side of spine. However, in doing so, they
are also, you know, ensuring that things are
very efficient. Patients are definitely staying in the
hospital for fewer days,
and we are really trying for when they
are in the hospital to offer an excellent
experience for them so that they can get
up and get back to doing what they
like as soon as possible. But I think
on the spine side, that is still,
in the arena where it's probably one of
the last arenas where, inpatient is really still
ruling. Although, I'm sure if we have this
conversation in another couple of years, we may
be seeing something completely different.
Definitely.
And then just last question I had for
you, Allison, is
what's one thing that all
orthopedic leaders such as yourself should do this
year to really thrive?
Sure. I think there's a couple of things
I think that we can do so that
we have resilient orthopedic service lines. I think
we need to look at building multidisciplinary
hubs. Patients are really craving one stop shopping.
They wanna go in. They wanna be able
to get their radiology studies, maybe their labs
drawn, maybe even see a couple providers in
a day if that's possible scheduling wise. So
I think looking at how you set up
your out outpatient ambulatory practices to provide that
experience, I think it's going to be really
important.
Ease of access to care is critical. Patients
want to get in. They wanna get in
quickly. And so the the more that an
organization can do that, the the better off
that they will be. And I think they
also have to look at beyond the ambulatory
arena and take a critical look at their
system just as we're doing at Catholic Health
and say, what do we want to do
where and how does this make sense? Does
it make sense to do high level joint
replacements and revisions and spine in every single
one of our six hospitals? The answer is
probably not. So how do we look regionally
and say,
how do we build centers of excellence where
you can get certain procedures and certain categories
of, treatment
all in one place and it's at a
very, very high level, and we can get
you there no matter where you enter our
system.
So when you wanna when you regionalize, you
really wanna make sure that no matter where
the patient touches your system, they get to
the right care at the right time with
the right providers. And so I think as
long as you can build those systems in
and the procedures in, you're gonna be in
a good place. So one of the things
we're trying to do right now is there's
a big push with our in network utilization
and making sure that our patients have a
very seamless transition
from our primary care providers
to any specialist that they need. So we're
making sure that, you know, to the point
where you might even be able to get
your orthopedic appointment as you leave your primary
care doctor's office. Or if you need an
x-ray
from your orthopedic specialist, you can leave with
that x-ray appointment. And a lot of health
systems do this. This isn't rocket science or
anything, but I think, you know, the implementation
of it and the the way in which
you do it and how you make it
accessible for your patients is really where you're
going to have have success or maybe not.
And then I think, finally, I think you
always have to go back to your people.
And this is something I've said, in some
of the talks I've given, but you have
to hire really good people because we are
in a people business. We take care of
people. That is our core business. And I
think as long as you keep that as
your forefront and your guiding principle,
you'll hire good people, whether it's your physicians,
your APPs, your nursing staff, even the people
that answer your phones or, you know, are
your housekeepers.
If you have good people, you'll have a
good culture and people will want to come
to you. And so I think that's something
you always have to keep in mind.
We do it with our physicians as well.
We are hire we've hired some amazingly talented
physicians,
but they're also genuinely nice people. And I
really enjoy speaking with them, and I'm I'm
setting up all my one to ones right
now for this year. And I'm so excited
because I just think we've found a whole
new group of of physicians. We've found a
group of APP,
and they're really special. And they're just genuinely
good people.
That's excellent. And, you know, I hope you
can definitely follow-up and hear more about, what
you're doing over there at Catholic Health. And
thank you again for joining us on today's
podcast. I hope you,
stay warm, and
I look forward to connecting again in the
future. Sounds good. It was a pleasure talking
to you today, and I hope you have
a a great rest of the day.