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Welcome everyone to the Becker's Healthcare podcast series.
I'm Mariah Muhammad, writer and moderator with Becker's
Healthcare. And I'm thrilled to have with miss
today Himanshu Tewadri,
director of quality and risk management at Sun
Life Health Medical and Dental. Himanshu, welcome to
Beckers Health Care podcast. We're very excited to
have you join us today. To get us
started, would you mind please introducing yourself and
telling us a bit about your background?
Sure.
So hi. I'm Himanshu Tewari.
By, training and practice. I'm a physician.
I it's an I've been in, you know,
world of quality and, risk management for last,
15 plus years. I've been in,
hospital settings, academic health setting health center settings,
and and ambulatory
settings as well. So,
bugged in different,
types of settings in health care, for a
reasonable period of time.
For last
two and a half year or so, I've
been with the Sun Life Health,
which is large one of the large.
Ambulatory healthcare settings and also federally qualified healthcare
settings
in Arizona.
So I, I'm,
serving them,
as a director of quality and
risk management. Before that,
I was in Washington state,
with another,
federally qualified health care center at QHC,
for,
almost, like, 7 to 8 years.
So
this is,
who I am,
like I told you by training on my
position. So I did my MD from India,
But,
most of the most of my career, I
was,
involved with quality and risk because,
that's where my heart is.
Wonderful. Wonderful. Thank you so much for giving
us that background.
So with all the experience that you've had,
I'm sure you're kind of a expert in
a little bit of everything.
What are some of the biggest issues you're
following in dental right now?
So,
as part of the ambulatory and, federally qualified
health center, I I was lucky to get,
you know,
involved with dental,
and behavioral health and medical, all aspects of
health.
With dental,
what I have seen,
you know, the biggest issues in last
7, 8 years
are one of those is the quality matrix.
So,
as you know, in medical,
we have well defined quality matrix, which are
kind of governed by,
you know, some of the federal agencies.
It could be,
you know,
it could be,
CMS,
it could be,
any other agency.
For dental,
we don't have a very robust and
a lot of options,
in terms of quality matrix.
And,
that makes me a little, you know, sad
and wonder,
like, why, why can't we have a whole
longer list of metrics and hold,
the organizations accountable?
We do have some, like I said, told
you for, like, UDS majors, unified,
uniform data, system,
from HRSA.
But,
those are not really,
too robust.
So, there was a feeling to, to us
as a quality
people that,
do we really not wanna focus,
on dental health,
or quality of dental health?
So that's one of the, you know,
issues.
Otherwise, like, pay for performance. So, again, we
provide a lot of push on value based
purchasing, pay for performance, and medical side.
I think
it is a time that we should be
doing the same kind of push
for dental
to make sure that, the quality of services
provided to the patients
is, at that level.
And,
and we get paid because,
we are meeting those goals,
and then giving the best services to the,
to the patient.
Now, one more thing,
which kind of ties with this is the
integration. So
I've been,
you know,
listening about this for a long period of
time, dental, medical,
perhaps behavioral health, and maybe,
WIC,
integration.
And I have seen that, in some of
the organizations doing it very nicely,
but some,
still though, a lot, with that kind of
integration,
which
the concept of medical, dental,
integration makes a lot of sense to me
because,
when the patient is actually at your clinic
and if you have both services available by,
by your facility,
that's an opportunity for you to,
provide that additional services to that patient. And
from the patient standpoint, that's really good that
they are, getting all those services under one
roof.
And,
with the with the familiar stuff and with
the,
you know, at at one, it's kind of
a one stop, shopping,
for them.
And,
it's good for the
medical staff as well as dental
from,
managing the patient standpoint. Because if you have
an EMR, which is, like, integrated as well,
and you have,
the patient as a medical patient under you,
and then,
you,
your
dentist can access their medical,
challenges or records
or their medication,
their allergies,
all those things,
as
good and as equal as the medical, you
know, doctor can and and the it's vice
versa. Like, the the medical doctor can access
quality matrix, there are so many out there,
like a one c, like,
blood pressure,
where on the medical side, you get paid
because if you, if you meet the goals.
And patient is a patient, whether it's a
patient in a dental. So the patient comes
to dental and you take, their their blood
pressure and then that blood pressure is, you
know, kind of documented correctly and if there
is an opportunity to address that blood pressure
for this patient
right away,
you can,
do some sort of, you know,
warm hand off to the to the med
medical doctor
the medical doctor is also their PCP in
the same facility
or give an option to the patient
to,
how
seen by the medical doctor in the same,
facility, and and
it's a win win situation for for the
patient as well as for the,
for the military care setting or any setting
which has those patients.
Another is,
and the patients come let let's say for
OBGYN,
when they come,
and they come for their frequent visits for,
during the pregnancy,
that's an opportunity to connect them with the
dental,
you know,
dental services as well if you have those,
under your umbrella,
and give the best care to those patients
during pregnancy. And,
potentially,
once they have the baby,
maybe the baby needs, you know, those, similar
services with your,
with their dental care, and, you can actually
have,
you know, that patient also potential patient for
your clinic and, take care of that patient
as well. So, integration,
in my,
opinion, is is huge.
The issue with that is, are we 100%
integrated?
Are all the organizations
100% integrated?
It's like a hit and miss.
It's scattered all over the, map. So those
who are doing it really effectively, those who
are doing it properly,
they are actually,
very successful. They are making, you know, most
out of it.
And those who are not or struggling,
it's an opportunity for them.
Yeah. Yeah. Absolutely. I think you brought up
a lot of great points, that I think
we'll hit on a bit later also.
I see that that, you know, integration can
kinda mix people nervous and, you know, excited.
Is there anything else that's making you nervous
or excited, either something that you're seeing in
the news or something that you're doing within
the organization?
Yeah. You're right. I mean,
you know, the one thing which may makes
me nervous even if I, understand this whole
concept of integration
and it is the right thing to do
for you and your patient,
in in the world of health care, we
we always,
I don't know if it's the nature of
health care that, we always think in silos.
We always think, like, this is medical, this
is dental, this is behavioral health. And,
breaking those those silos is is a huge
deal, which,
definitely makes me,
you know, nervous. But at the same time,
it is, it makes me, you know, excited
as well because I see the opportunity there.
But, it's it's not easy, yeah, to to
break the silos and bring all those together.
There are so many things which are, you
know, deep rooted and and the culture,
of practices,
we are doctors, we doctors. We have medical
doctors.
That's dentists.
Who's gonna, you know, drive the whole
workflow?
How is this
possible?
Am I gonna give the control,
away,
of my of my patient to
someone else?
Who's who's gonna be responsible for this part
and that part. So there are some really
good models out there,
if we can,
you know, pick and choose and and follow
those models in in terms of,
the integration,
and and
maybe as per the need of the clinic,
creep and make changes, to those models or
workflows,
that that's gonna work.
I have seen some clinics doing very, very,
effectively.
We are actually at Sun Life Health. We
are,
in in a very initial stage of,
introducing that kind of integration.
We we did the pilot, project with
blood pressure
hypertension,
which was very successful. And, now we are
rolling it out, into hemoglobin a one c
and blood, you know, blood glucose
monitoring
and eventually maybe in other areas as well.
So it takes a lot of effort,
a lot of leadership, you know, involvement,
their buy in.
So that's that's where,
my nervousness and excitement both are,
to bring the leadership together to,
to,
make providers understand that it is
not gonna interfere with your daily routine, but
at the same time, it's gonna help you
improve your numbers, your reimbursement.
That that's that's where my thoughts are.
Yeah. Thank you so much for sharing that.
And and very quickly, the last thing I
really wanted to ask you is,
in your opinion, what will the most effective
health care leaders need in order to be
successful in the next 2 to 3 years,
do you think?
Yeah. I mean,
there are a couple of things that,
that I feel,
as a health care leaders, we need to
focus on, managing the
continuity of care.
When the patient come to your, your health
care setting,
they go to hospitals or they're, you know,
at the ER or something.
How effectively
can we
have that
communication going back and forth,
interoperability
of your, medical records,
your information?
I think that's the huge challenge. We we
hear all the time with our with our
hospital systems or health care systems.
Oh, we we lost this patient,
and follow-up. Or, oh, this patient went to
ER and and the primary care provider had
no idea or dentist had no idea the
patient was actually in ER because of this
this this
issue. So that kind of disconnect,
affects both the good quality of care for
the patient, and it's also not good for,
the reputation of,
this the, you know, health care system and
health care as
in general.
So that's,
one of my, you know, one of the
challenges,
of further health care leaders,
or effective health care leader I see.
Cost effectiveness
is another one.
As we see more and more, you know,
regulations come around quality measures and and the
services
with CMS or with, other federal organizations,
the cost effectiveness becomes
or is, becoming
more of a challenge for health care leaders,
to keep their hospitals, to keep their, you
know, health care facility open
with providing good level of service, not getting
enough reimbursements,
and still your overheads and your cost is,
very high.
So that that is another challenge. If you
can manage that effectively,
that's the key.
And then third thing I would say is,
which kind of, you know, feeds into the
same, managing your financial challenges. So,
patient satisfaction,
and quality is huge.
And, you we all need to understand and
remember that,
the patient is
our best partner,
in in all this, you know, all this
struggle. So understanding your patient and making sure,
we have well informed patient
who,
who understands what kind of services are we
providing and what is the quality we are
giving to them,
reaching out back to them, follow-up.
And and from the leadership standpoint, pushing for
that,
and creating that culture in the organization
so that the patients feel
comfortable as well as,
well taken care of.
I think those are the big three challenges
I can think of, from health care standpoint
coming
at 2 or 3 years. Yeah. Yeah. Absolutely.
Thank you so much for those final thoughts.
It's definitely been
a a very, very informative discussion. So, again,
I really wanna thank you all for coming
on Becker Healthcare, and I look forward to
connecting, with you again soon.
Thank you so much. I appreciate that.