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description. We are excited to welcome you in October.
This is Laura Deda with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Dr. Nadine Ibai,
physician director of innovation and care models at North Shore Edward Elmhurst
Health Hospital. Nadine, it's a pleasure to have you on the podcast today.
Thank you, Laura. Thanks for having me.
Now, I know we've got a lot to talk about.
There's so much happening in healthcare right now,
and especially it is such a fascinating time with how technology is really, uh,
driving forward some really big trends and exciting things in the healthcare
space. But before we dive into my questions,
can you tell us a little bit more about yourself and your background?
Yeah, absolutely. I have,
I think both a traditional and somewhat non-traditional entry into,
into medicine. I went through,
through med school residency without taking any time off. And then prior to, um,
starting my work here 12 years ago, I, I,
I knew that I'd wanna start with my pa uh, my patient panel and,
and stay with them for the entirety of my career. So I decided to do,
do a year of travel, kind of took a,
took a break between residency and starting this job, uh,
and volunteered and traveled around the world, uh, 19 different countries.
I went with my wife and actually had my first job as a physician in New Zealand
as a locums doctor for, for three months on the south island of New Zealand,
which was really, uh, a transformational experience for me. Um, in addition to,
to some work I did in other countries as well. Sore really, um,
neat opportunity and, and gave me some perspective going into my career. Um,
and, and really have been grateful and thankful to be with the,
the same patients, uh, since I started here at North Shore, Edward Elmer Health,
uh, 12 years ago. Um, and since that time I've had really, again,
grateful to have lots of different roles. Um, I, I've been a physician advisor,
um, working on complexity capture, HCCs, um, in the primary care space,
uh, also as have helped stand up our personalized medicine, um, program,
which is, is really something we're very proud of, uh, in, in, you know,
incorporating genetics and genomics into, into primary care. Um, and,
and also had, uh, opportunities to work, uh, with our University of Chicago, uh,
medical students and, uh, the medical student rotation here for family medicine.
So, um, that's all to say, yeah, I'm a family doctor and that's,
that's something I'm very passionate about and have maintained that practice.
Um, my current roles, you mentioned the innovation and care model redesign. Uh,
I also chair our medical groups Physician Engagement and Wellbeing committee,
uh, which has been really an honor for me as well for the last, uh, four years.
That's amazing to hear.
What's great experiences and background you have both in practicing medicine as
well as connecting with patients and then now working with, um,
up and coming physicians and clinicians and care teams as well.
That's amazing to hear.
And I was particularly interested when you were talking about standing up the
personalized medicine program and incorporating that into primary care. Um,
could you touch a little bit more on that in, you know,
how you built the program, what you were able to do, um, at,
with the technology at the time, and how it's progressed since then? Yeah.
No, great question. And honestly, a lot, lot of credit to the, to the,
the geneticists and, and,
and many members of our administrative and operational team, they,
they brought me on after they had really stood up the concept of personalized
medicine. Uh, and something this organization's been really, uh, keen on for,
for many years. And,
and really what's different and unique about it is that it's incorporated or
questions that are along the lines of family history questionnaires are
administered to our patients ahead of time, of their physical. And we've, um,
got an incredible team that's put together workflows in the technology within
our EMR to allow the physician at the point of care to not only have information
available for them for counseling,
cuz every physician has a different level of understanding and, um,
comfort with genomics, uh, especially in the primary care space.
And so this really was a way for us to be able to give our physicians the
opportunity to, uh, guide their patients on evidence-based, uh,
genetic testing and provide that, um, uh, really at a,
at a pretty low cost and then have the, uh,
backend work and workflows to, to result those, um,
and that information to our patients and get them to the right care team members
for, for their care. So, you know, we have had, um, really, uh, a ton,
uh, uh, of, um, our numbers have been very,
very high in terms of the number of patients that have completed the testing.
I think over 31,000 have done the testing. Um, these questionnaires,
I think around 250,000, uh, and over 3000 patients.
This is the most relevant of course, cuz it's clinically relevant,
which is that over 3000 patients have been found to have, uh, a variant, uh,
a a genetic variant. And that does not include pharmacogenomics, which is, uh,
some of the testing we were doing as well.
Got it. That's fascinating.
Thank you so much for sharing a little bit about the program with us. Now,
I'm wondering from your vantage point,
especially looking at the innovation in in care models,
where are some of the big opportunities that you are seeing ahead of,
as well as the headwinds that you've got your eye on?
Yeah, listen, I think the headwinds, uh, are, are the,
are similar to what every, um,
healthcare organization's experiencing in terms of,
of cost and decreased reimbursement and, and staffing. Um,
I'm particularly focused on joy in practice and top of license
work. You know,
obviously pre pandemic burnout rates for physicians and clinicians in general
was, was already pretty high, uh, relative to other professions. Uh, and,
and part of that was the moral injury of feeling like there was so much you
wanted to do for your patient, um,
but having so many of the clerical and administrative tasks that were really
preventing you from doing that the way you wanted to and maintaining a good
work-life balance. And so that,
that is the one I'm focused on the most and have been really focused on the most
too. Uh, and, and really the wellbeing of our team members, I think is,
is paramount to, um, translating to a good, uh,
patient experience as well and good clinical care. So, so with the headwinds,
uh, that have accelerated over the, the last three years and with the pandemic,
I would say there's obviously, um,
a lot of opportunity that has come around with that. Uh,
and part of that is leveraging technology to really offload some of that
clerical work that we were talking about,
some of the things that don't really bring, um, joy or purpose to our every day.
So, you know, I, I think trying to find those points, uh,
for all of our team members is really gonna translate into just better wellbeing
and, and, and joy and work. We spend tons of our life in work lots,
a huge percent of our, our life is in our jobs.
And so you want everyone you're working with to enjoy it and feel like there's
purpose in that work. Um, our, our Edward, I'm sorry, Elmhurst Hospital,
for example, um, brought in a robot called Moxie. Um,
this is an example of, you know, uh, a robot that's able to take, uh,
medications and, and, and other, uh, instruments, uh, across the hospital and,
and a very simple and straightforward example of how, um, you know,
we can leverage technology to take work off the plate of our,
of our team members that isn't really purposeful or meaningful. Um,
and another part of the opportunity I see here is obviously we've been able to
engage our patients in different ways and at times and places that is more
convenient to them.
So there's huge opportunity there because traditionally I think medicine within
the four walls of our healthcare system, you know,
felt more transactional and we're really having an opportunity here to,
to impact health. And health is so much more than just when the patient is in,
whether it's for prevention for a six visit, you know,
health is is really what we do in the community,
what we do when we're not seeing the patient. Uh, and recently we had a,
a really nice partnership, uh, and opportunity to develop, uh,
cardiac rehab. It's the first in-home virtual cardiac, um,
recovery program with a company called Motive. Um,
and it's really an example of, uh, I think, uh, innovative and, um,
opportunistic,
meaning the opportunity based on the virtual care offerings that we have to,
to help patients in a place that's convenient for them, uh, and,
and really very holistic as well.
I love that. I, I think there's just so much there in terms of, um,
troubleshooting some of the big challenges in leveraging technology in order to
fill some of the gaps that, you know, we're seeing in healthcare,
whether it's the staffing shortages and, and the challenges on that front,
or really being able to optimize the outcomes, um,
in care delivery in the best way possible. And so I really appreciate, um,
everything that you're talking about here. And I, I know too, um,
in terms of connecting with patients and engaging them in different ways,
it seems like there's certainly a push in healthcare right now, um, to,
to really focus on the patient and their family and the expectations of the care
experience and, um, you know,
having them become more of part of their care journey as well. Uh,
how do you see that playing out in really, you know,
what from your perspective is essential for hospitals and health systems to be
thinking about, you know, when they,
they have an eye on that patient experience in,
in that journey and engagement within their own care?
Yeah, I, I love that question because I, I think some may see it as,
um, potentially threatening, right? When you think about consumerization of,
of medicine and the patient experience, um, that that's, uh,
that's a big deal because, you know,
what we're ultimately trying to do is provide the best health to our patients,
but sometimes they perceive that in different ways, right?
Or how they want to get their healthcare, um,
when and what health means to them. So,
so I actually really like this concept because,
and I actually think this is gonna be one of the keys to success,
is that we really start to, to hone in on patients, um,
with that very personalized touch in mind. And so, so for me,
that means both precision medicine in regards to genomics, uh,
polygenic risk scores, things like that. Uh, but also very personalized that,
you know, familiar touch points with the healthcare system that does not feel
transactional at all.
And that's exactly where I think team-based care comes into play here,
is that if we have a group of individuals that are really the,
the, the same people that, that are,
are hearing or that the patient is hearing from in the health system,
or that at most points in the patient's interaction with the healthcare system,
they feel like they're known to the system.
That I think has tremendous implications and potential for better health
because, you know, we, we know that we can give our patient guidance and, and,
and recommendations in the office,
but how hard is it to really implement those changes in one's behavior or health
once they leave the office? Uh,
and I think this is a chance for us to really ask patients how we can do that
best for them, uh, and it's a win-win for everybody.
That's amazing to hear and definitely such a helpful perspective.
Now from your vantage point,
how do you think about growth and adding value to the health system overall?
What does that look like for you and the teams that you work with?
Yeah, I think it, you know,
it goes back a little bit and I wanna be too repetitive, Laura, about this,
but I, I think, um, for me, you can look at value. If you look at it as,
you know, quality over cost. There,
there are definitely efficiencies that can be gained by the team-based care
model. Um, so I think, again,
everyone working at the top of their license and doing it in a collaborative way
and doing it a way, uh,
that's reproducible so that way the patient has the same experience every time,
regardless of who the patient is. Uh,
it is really something that I think team-based care can, can work towards. Um,
and along that same vein, if you look at, um, again, value considering quality,
uh, and cost, you know, the approach reduces, uh, reduces burnout.
It reduces turnover. Um, it really does improve the patient experience.
And I think by providing that value, value, um, we will, we will have growth.
Fantastic. I, I,
I really think that that value equation is a great way to look at it and making
sure that you have your eye on the prize and focus on the right things.
And you know, too, when, um, we're, we're talking about healthcare today,
there's a lot of anxiety around some of the financial challenges that, you know,
mm-hmm.
economic situation is tough for many organizations across the
country and, and resources are slim.
So where do you see as being important areas to continue to invest? Um,
even if budgets are a little bit tighter than they have been in the past, I.
Think it's gonna be in those,
those tools that help us automate and do the redundant work, um,
the, the same and with technology every time because we, you know,
this is an example of where technology can supplement but not replace the
people.
And so when our organization is able to focus on the patient right in front of
the clinician or in front of the medical assistant, um,
or in front of anybody for that matter, i, I, I think that's,
that's exactly what we need to put our bets on.
And so any technology that allows for that to happen, um,
I think is worth looking into and investing. And, and so for example,
ambient listening, that that might be, you know, a good, um,
I wouldn't say necessarily risk,
but that could be a very good investment when you think about what it does, um,
for both the, the clinician and the patient and,
and the value of the care that they are provided. Um,
that I think will pay dividends, uh, over time for sure,
and is a worthwhile investment. Um, you know, in terms of risk, I,
I, I'm probably, I'm obviously not the first person that's on your podcast,
I'm sure to talk about a ai,
but I really do think this is an area where when we know how fast
this has accelerated over the last year or two, um, you know,
faster than anything,
most of us did anticipate we should start thinking about how the next few years
we can just almost consider it a given that it is going to be a part,
maybe at first, uh, of how we do some of the other clerical work,
but then ultimately get, helps us, uh,
our patients get to the right point of care at the right time, uh,
and really again, supplements the work that we're doing. So it's, it's a,
it's a risk, uh, for many reasons,
but I think it's a risk definitely worth investing in.
Absolutely. And I, I think too, looking at ai,
there's a lot of different opportunities with the technology, but certainly, um,
being able to use it to your advantage and not, um, get to a point where it,
it's not beneficial for healthcare, I think is important, as you mentioned.
Exactly. Um, well before we wrap up our conversation, I just wanted to ask,
where do you see some of the best opportunities for growth and development for
you as well as the teams that you work with?
Um, so you, you know, we're, we're now a nine, uh, an eight, uh,
or nine hospital, uh, system, right nine because we have a, a mental health, uh,
inpatient, uh, hospital. Um, and,
and we're still focused and we'll continue to focus on being community
connected. And I really feel, going back to what I was mentioning earlier about,
uh, transactional care versus, you know, continuous care. Our, our mission is,
is to help everyone in their communities be their best.
And that means we have to be involved in our communities in as many ways as
possible. And by investing in our communities, which we've been doing, um,
I really think that gives us opportunities for growth. And so that means, um,
that the people that work with and for us are coming from the communities we
serve, um,
making sure that we are investing in the things that matter to the communities
and really finding ways, and this is where we should and can be creative, uh,
about, um, the care that patients receive, being much more about prevention,
uh, and, and, and, and, and helping them be as healthy as they can be. Uh, so,
so that they live really their best lives.
I love it. Nadia, thank you so much for joining us on the podcast today.
This has been such a fun conversation and I'm excited to see you in person at
our event this October. Um, the Health IT,
digital Health and Revenue Cycle event, it's gonna be such a fun, um,
space to be in. And a lot of these themes,
I know we're talking about very closely with the mix of clinical and technology
in where really healthcare is headed. So I'm looking forward to that very much.
Me too, Laura. Thank you. I really appreciate that.