Speaker 0: This is Laura Deirdre with the Becker's Healthcare podcast. I'm thrilled today to be joined by doctor Ibrahim Barkuda, system chief and regional chief medical officer at Baystate Health. Doctor Barkuda, it's a pleasure to have you on the podcast today.

Speaker 1: Lara, good morning, and it's true privilege to be on Becker's, podcast. Thank you for having me.

Speaker 0: Yeah. My pleasure. My pleasure. And, you know, I'm really excited for our discussion because I I know there's a lot going on at Baystate and truly, fascinating to see some of the cool things that you're doing, on multiple fronts. But before we dive in, I'm wondering, could you tell us a little bit about Baystate Health?

What makes you unique?

Speaker 1: Awesome. So we have many aspects we like to share, with the audience. So, I'm Abraham Barkuda. As you said, the, system chief and the regional, chief medical and quality officer here at Baystate Health in Massachusetts. Massachusetts.

Our organization is not for profit integrated, teaching health care system, headquartered in, Springfield, Massachusetts. We serve closer to a million patients throughout Western New England. We have, integrated academic network of four adult hospitals and one, children's hospital that, we are the leader in our, region. Our workforce, over, 13,000 members, within our system that, spanning closer now, to 90, medical and surgical practices. We do have the full spectrum of health care delivery.

We have, closer to 60,000 discharges annually, closer to 5,000 birth. We serve our community here in Western, New England, closer to, 37,000 surgeries, 80 emergency and urgent care visits. Our network is a leader of, innovations and, health care advancing advancements, and we always strive to improve patient outcomes and experience. My role is, focus or encompasses the, system based, optimization in clinical operations, mostly on the inpatient side, advancing quality initiatives across, our hospitals and enhancing, the resource allocation to know how to serve our patient in the right bed, on the right service with the right, care providers, physician, and clinicians. As you know, I need always to make that, small disclosure.

I'm still privileged to see patients directly, here at Baystate Health and and work with our residents and fellows and, our students from UMass. And and I I find that, clinical and administrative responsibilities, the most fulfilling aspect of what we do in health care to to focus on that foundational purpose of, serving every individual and at the same time, take care also of the families and and and have that enhancement when we, work on a system wide improvement of the health care delivery. I hope that gave, the audience the big picture, what we do here at Baystate, and how we take care of our community, and at large when we, server a region with our integrated, clinical network.

Speaker 0: Oh, absolutely. And, you know, certainly, it's such a great service you provide to the community. It's such a needed, services for the health care system. And certainly, you know, being able to have someone with your type of passion and dedication, really leading the charge for a lot of the different, organizational and clinical things happening there is really amazing. And, you know, I'm wondering from your perspective, what are some of the biggest accomplishments that you had from the last year?

What are you most proud of?

Speaker 1: I'm proud of our team, in health care. Laura, as as we all know, it's it's not the I, it's the we. Our leadership, our, clinical team delivery apparatus achieved many milestones. We start focusing more, on the active management, specifically when we integrate that digital analytics in our clinical delivery and focus on the inpatient volume and the ED flow. It's the midst of the winner.

It's where our hospitals, battling with the the flu, the respiratory illnesses, and the chronic diseases that we need to know how to allocate that, work and resources to serve the patient. And and the goal here is to our team was able to think about how that transition would allow us to think about the clinical challenges and, create optimized pathways in real time. I'm gonna zoom in on, specifications of how we foster that synergy between the ED, our emergency departments across our system, and our inpatient, providers and really bring that patient flow management where, we need to make sure we reduce our ED borders, bring the patients, to receive the care, always faster and better, and really focus on the patient experience and their caregiver's experience. I would like also to bring one of the achievements is is, how we can improve also the documentation and how we can relate it to the quality in, value based care era where we need to make sure also that we're we're allocating the resources and and really put that triage decisions in terms of, how the patient could be served on a sub sub sub specialty and how the general patient would be, also serve and and their, clinical outcomes would fulfill our mission in value based care.

A lot of great stuff. We are able to, work our link to stay, that synergy taking down the silos, among the departments and have that, flow again from the ED to the inpatient to the discharge. We put on more of our digital, dashboards to measure our, outcomes and, really benchmark, regionally and nationally of how, again, can deliver the care faster, and serve our patients and their families.

Speaker 0: I love that. And truly being able to, dig into that value based care side of things, figure out how you can leverage the data, to your advantage, not only on the clinical side, but on the operational side as well. So you have that type of care that really patients deserve. So that that's amazing to hear and and definitely great that you've seen some of the results coming through those efforts and initiatives to work as a team and, really bring forth better outcomes. From your perspective, what are you setting what are the goals that you're setting for 2025?

Speaker 1: We, the team, we have a, I would say, clarity of, what would be, the goals. I'm gonna go back to the value based, care. We we'll be shifting more, and hopefully, departure completely from that fee for service, care delivery where we focus on, the value. The second part, which I always, go back and and reexamine is the the health care delivery should focus on an integrated care networks and take down all the silos and and integrate the primary care to specialist to inpatient services and back to the community health resources. That would be essential of how we can manage chronic diseases.

For this, we start thinking a little bit more of your, in the future. And the the future is just like look. It's probably now the terminology is always around AI, but I would like to bring it more to our patients and and our care providers, the clinicians that if we could do better in 2025 and keep, focusing on how we put the patient in the in the center of our care delivery, we're always closer to that. We have a a lot of tools that 2025 will, definitely, bring to us the prediction model of risk, in terms of population management. I hope we're gonna see and we will see more of, preventing errors and have more of the, administrative tasks that been done for small part by AI, have it more integrated with our workflow.

It's something I've been I've been very passionate about. From our base state, to our community, we want to make sure we deliver more efficient care. We create that inpatient capacity so we can bring the patient again to the inpatient setting and deliver care when they come with an acute on chronic else illnesses. And and make sure these bottlenecks, the, the weight in the ED, the, leaving the ED without being seen, it's a it's an opportunity, for our inpatient services to create that access and bring the patient, closer again to the right bed. Twenty twenty five, will be exciting.

We will know more how to manage these surges in the hospital volume that we see nationwide and and how we could also manage the respiratory illnesses season and also integrate what we learned from the pandemic going forward. Many new trends, coming on. Laura, something relates to digital health, something related of how we can do efficiency. I'm gonna bring back the value based care and say, this is the way to go, and I hope we'll see more of module that would deliver that care to our patients.

Speaker 0: Well, it's fascinating to hear. And, definitely, thinking through how you can, get to that space where you have more value based care where you're able to leverage the technology and digital capabilities in the right way while also, you know, working as a team and and having everyone, on the care team, you know, pulling in the same direction. I'm I'm curious from your perspective, what will it take to really get to that reality where you see, being able to leverage and utilize value based care in a meaningful way or a more meaningful way? Is it really on the technology side? Is it, thinking through, on the, person kind of culture, procedure, policies?

What will it really take to get there?

Speaker 1: Been been thinking about about that integration, Lara, for quite a bit. I think it's a combination. So my my thoughts is for us as as a clinicians, as, care providers, as as physician, we need to start thinking about how we can adopt that data driven mindset. We have a lot of data. Data, is power, but more powerful is what we're gonna do with the data, how we can deploy it to improve the care.

Second is, you touch on the fostering collaboration. Take down the silos. Let's work on it together. It's a multidisciplinary approach in health care. The third part is, we all love the complexity, but it's a time to think about how we can simplify it, simplify in our design, and and bring it down to the simple task, like, how we could, serve our patients at the bedside.

My last part is gonna go back about, how we can stay informed and and bring really the experience from, many, I'm gonna use the term podcast or bigger media outlets or how we can exchange ideas, something, like, our Becker's health care, we need to learn from each other. We need to gauge. We need to start evolving and and leave that again how we, thought about solving problem priori. Let's let's collaborate more. Let's see more of, our, peer review publications.

And, outlets would help us also connect leaders, and, what worked on the West Coast will work on the East Coast if we know how to adopt that mindset of let's collaborate, let's create a multidisciplinary approach, and let's keep thinking about the patient. So it's probably more on us rather than the technology itself. We need to have that agility mindset, and, we need to learn from each other.

Speaker 0: I love that. I really feel like that collaboration you're talking about is so critical. And, you know, your, note on the agility mindset is truly, important, especially as there's so many changes happening in the health care space, rapidly even these days. And so having that ability to move quickly to make changes and really, know where you're at as a team is so critical. Now it seems that there are a lot of opportunities in the next year, but, also, I know there are headwinds and challenges.

What are some of those, potential roadblocks that you're anticipating for the next year or two?

Speaker 1: My focus, Laura, on on main two, domains, how we can think about the cost and, how the cost distribution or allocation in health care would look like. Many,

Speaker 0: aspects of how we will be paid for the

Speaker 1: care, how we will be paid for the care, will be changing, and we need to, bring that closer to our decision making and, think about how that subsidies would come from the payers, how we could be more vigilant of providing a care that is, again, value based. The second part as as a regional chief medical officer, we do have a lot in health care. We owe it to our clinicians in nursing at the bedside, and and the goal is is to start bringing back, the preventing of burnout and and be there at the bedside and hear our teams and rethink about it. The data that came out, at least late, last year in 2024 that probably we made some progress, but we still have a big burnout, across the spectrum of health care delivery. And we need to pay attention to our workforce and how we can, build that, trust so we can sustain our workforce and and build on it from there.

One maybe quick plug, about the headwind is, collaboration and the culture. We need to have, more of innovation. Innovation would require, rethinking how we can collaborate and how we can modify the culture so we can integrate faster. That would happen when we put our clinicians in, that model for us as a leader to take care of our, clinicians of our workforce so they could do, their job and, us as as leaders in health care, be there for them. Burnout went down, but went down in in in one digit.

We're still, trying to struggle with, the 50% that we need to make sure our workforce will be there a decade, two decades, ten decades from now to serve our patients. Maybe, I am optimistic. I I know that we could do it. Our data, showing more promising. We need to open our mind, and, we, the leaders, take care of everybody around us.

Speaker 0: That really makes a lot of sense. And, certainly, having that strong leadership approach to ensure others are, connecting on the right level and, really feel like they're comfortable in their positions. I know you as you mentioned, it can be such a challenge, with the burnout recently and certainly having a lot of, stressful situations in the health care delivery space. And so being able to, really have them, continue to grow and develop and leverage, whatever you're able to, the technology side as well is critical. Now you you might touch on this briefly, but when you think about, everything that will be upcoming over the next few years in the health care space, it takes a a really astute leader, to be successful.

So how are you evolving as a leader given some of these challenges as well as big opportunities?

Speaker 1: I always thought about the humility and being humble on in learning. Me personally, I would say I need to learn more. We need to learn more about, what we could do better and open our eyes and and really reflect back in. One of the one of the newer, I would say, trends is, with AI replace my work as as a a scheduler for a big group or someone who could help the patient navigate the EHR to get their appointments? The answer is what we know, and I'm gonna reflect on at least my experience.

We want to do what we do better, and we will likely see some changes in our workforce, but we need to also be ahead of that innovation. And, Lara, we we talked about it. We're probably at that inflection point that we always mention where we have the traditional care delivery and massive innovation ahead of us. And if we want to thrive, if we want to maintain our commitment to our community, to our patient, We need to rethink about the adaptability and and keep it specifically around, what would be the best for the patient. Think big.

Think about reimagining how we can deliver care. Our population needs our care. Let's keep building on this, and and if you have a great example, share it. I personally will not hold it back. And I'm asking every leader listening to the podcast, exchange your ideas.

This is how we could do better. And my part is I would love to listen, engage, and and take the experience and bring it to my institute.

Speaker 0: That's fantastic. Doctor Barkuda, thank you so much for joining us on the podcast today. This has been a a really fun and fascinating conversation, and we look forward to connecting with you again soon.

Speaker 1: Thank you, Laura, for having me, and I appreciate the opportunity and, the insights that I always learned from Becker's. Thank you very much.