1
00:00:01,520 --> 00:00:04,080
Every year, Becker's annual meeting brings health care

2
00:00:04,080 --> 00:00:06,639
leaders together to unpack the most pressing issues

3
00:00:06,639 --> 00:00:07,620
facing the industry.

4
00:00:08,000 --> 00:00:10,820
And every year, those conversations shift in profound

5
00:00:10,880 --> 00:00:12,259
and unexpected ways.

6
00:00:12,625 --> 00:00:14,865
This April, more than 3,500

7
00:00:14,865 --> 00:00:17,984
healthcare executives will return to Chicago for Becker's

8
00:00:17,984 --> 00:00:19,285
sixteenth annual meeting.

9
00:00:19,664 --> 00:00:22,625
Seven ninety five elite speakers will offer new

10
00:00:22,625 --> 00:00:25,664
lessons, new case studies, and predictions about what

11
00:00:25,664 --> 00:00:28,449
comes next. Join us April 13 through the

12
00:00:28,449 --> 00:00:28,949
sixteenth.

13
00:00:29,329 --> 00:00:33,809
For the agenda and event details, visit beckershospitalreview.com

14
00:00:33,809 --> 00:00:35,649
and click on the events tab in the

15
00:00:35,649 --> 00:00:36,469
upper right.

16
00:00:37,729 --> 00:00:40,309
Hi, everyone. You are listening to the Becker's

17
00:00:40,369 --> 00:00:41,509
Healthcare Podcast.

18
00:00:41,875 --> 00:00:44,914
I'm Erica Carbajal, an editor with Becker's Hospital

19
00:00:44,914 --> 00:00:47,475
Review. Thank you so much for tuning into

20
00:00:47,475 --> 00:00:48,295
this episode.

21
00:00:48,914 --> 00:00:50,994
Today, we're lucky to be joined by doctor

22
00:00:50,994 --> 00:00:54,114
Nancy Baron, vice president and chief quality officer

23
00:00:54,114 --> 00:00:54,774
of ambulatory

24
00:00:55,155 --> 00:00:58,619
care at Northwell Health. Doctor Barron, pleasure to

25
00:00:58,619 --> 00:01:00,320
have you on. Thank you for being here.

26
00:01:00,619 --> 00:01:02,000
Thank you for having me.

27
00:01:02,619 --> 00:01:04,379
Well, to start us off, do you mind

28
00:01:04,379 --> 00:01:06,540
sharing a little bit about your background in

29
00:01:06,540 --> 00:01:08,299
health care and the scope of your work

30
00:01:08,299 --> 00:01:09,040
at Northwell?

31
00:01:09,784 --> 00:01:12,765
Sure. I'd be delighted. So, I'm an internist

32
00:01:12,905 --> 00:01:14,364
by training. I

33
00:01:14,665 --> 00:01:17,224
have a women's health practice where we focus

34
00:01:17,224 --> 00:01:19,244
on the internal medicine for women.

35
00:01:19,784 --> 00:01:21,465
It's a practice that I started with a

36
00:01:21,465 --> 00:01:21,944
colleague,

37
00:01:22,265 --> 00:01:23,884
back in 2006.

38
00:01:24,469 --> 00:01:26,630
From there, I helped start a multi specialty

39
00:01:26,630 --> 00:01:28,150
medical group and was the,

40
00:01:28,710 --> 00:01:31,109
chief medical officer of that medical group for

41
00:01:31,109 --> 00:01:32,409
about fourteen years

42
00:01:32,790 --> 00:01:35,930
and focused a lot on quality and ambulatory

43
00:01:36,150 --> 00:01:36,650
quality.

44
00:01:37,725 --> 00:01:39,344
We joined Northwell,

45
00:01:40,045 --> 00:01:41,665
in 2017

46
00:01:42,125 --> 00:01:44,685
with that group, and I started in my

47
00:01:44,685 --> 00:01:47,645
current role as a chief quality officer for

48
00:01:47,645 --> 00:01:48,145
ambulatory

49
00:01:48,765 --> 00:01:50,045
in 2021.

50
00:01:50,045 --> 00:01:51,879
I was the inaugural

51
00:01:52,340 --> 00:01:53,879
person in that role.

52
00:01:55,060 --> 00:01:57,299
Yeah. Doctor Barron, it's interesting to hear too

53
00:01:57,299 --> 00:01:59,539
and and so relevant because I feel like

54
00:01:59,539 --> 00:02:01,619
we've been hearing a lot more and doing

55
00:02:01,619 --> 00:02:03,959
a lot more coverage about quality and safety

56
00:02:04,019 --> 00:02:05,399
in in ambulatory

57
00:02:05,700 --> 00:02:06,200
settings,

58
00:02:06,739 --> 00:02:08,395
and how how, you know, that's just becoming

59
00:02:08,395 --> 00:02:11,435
so much more important in an elevated priority

60
00:02:11,435 --> 00:02:13,215
as more care moves to those settings.

61
00:02:14,155 --> 00:02:16,314
Yeah. You know, what we're seeing, Erica, is

62
00:02:16,314 --> 00:02:18,495
really just the trend of

63
00:02:18,875 --> 00:02:20,555
everything being done at,

64
00:02:21,810 --> 00:02:22,550
the appropriate

65
00:02:22,930 --> 00:02:25,189
level of care. So we're seeing migration

66
00:02:25,810 --> 00:02:27,650
of procedures that could be done in a

67
00:02:27,650 --> 00:02:30,610
hospital, moving to ambulatory surgery centers, things that

68
00:02:30,610 --> 00:02:33,170
are in ambulatory surgery centers that are going

69
00:02:33,170 --> 00:02:33,670
into

70
00:02:34,370 --> 00:02:35,830
office based procedures.

71
00:02:36,935 --> 00:02:38,474
And we're seeing the complexity

72
00:02:38,935 --> 00:02:42,155
of what's being done in the ambulatory environment,

73
00:02:43,495 --> 00:02:43,995
increasing,

74
00:02:44,534 --> 00:02:47,655
and Northwell's footprint continues to increase. So,

75
00:02:48,375 --> 00:02:51,500
over the past several years, we've we've continued

76
00:02:52,120 --> 00:02:53,819
through acquisitions and mergers

77
00:02:54,360 --> 00:02:55,819
to grow in size,

78
00:02:56,439 --> 00:02:59,099
and now we have over a thousand different

79
00:02:59,719 --> 00:03:00,219
ambulatory

80
00:03:00,599 --> 00:03:02,299
sites that my team,

81
00:03:03,159 --> 00:03:03,659
really

82
00:03:04,199 --> 00:03:06,299
is providing support for.

83
00:03:07,215 --> 00:03:09,055
Yeah. It's a it's a big footprint to

84
00:03:09,055 --> 00:03:09,555
oversee.

85
00:03:10,014 --> 00:03:11,935
Doctor Buren, can you share one of the

86
00:03:11,935 --> 00:03:15,474
most important initiatives that you've led in overseeing

87
00:03:15,615 --> 00:03:18,495
ambulatory care over the past year? What was

88
00:03:18,495 --> 00:03:20,034
it, and what were some of the results?

89
00:03:20,689 --> 00:03:23,409
So I'm gonna share two big initiatives that

90
00:03:23,409 --> 00:03:26,050
we led over the past year. One is

91
00:03:26,050 --> 00:03:26,550
really,

92
00:03:27,490 --> 00:03:28,950
on process improvement

93
00:03:29,330 --> 00:03:29,830
and

94
00:03:30,129 --> 00:03:30,629
population

95
00:03:30,930 --> 00:03:31,830
health measure,

96
00:03:32,305 --> 00:03:34,705
and the second was really in how we're

97
00:03:34,705 --> 00:03:37,665
going to be redesigning and evaluating our own

98
00:03:37,665 --> 00:03:38,724
scope and work.

99
00:03:39,185 --> 00:03:41,105
So the first thing that we did was

100
00:03:41,105 --> 00:03:41,844
we initiated

101
00:03:42,224 --> 00:03:43,284
system wide

102
00:03:43,824 --> 00:03:44,965
depression screening,

103
00:03:45,919 --> 00:03:49,379
recognizing that one in five of our population

104
00:03:49,599 --> 00:03:51,060
are suffering from depression,

105
00:03:51,680 --> 00:03:54,240
trying to address the mental health crisis that

106
00:03:54,240 --> 00:03:56,479
we're seeing in New York and throughout the

107
00:03:56,479 --> 00:03:56,979
country.

108
00:03:57,759 --> 00:04:00,264
We really felt strongly as a health system

109
00:04:00,264 --> 00:04:03,084
that it was important to screen for depression.

110
00:04:04,185 --> 00:04:05,965
So we built out workflows

111
00:04:06,504 --> 00:04:09,305
that applied not just to primary care, but

112
00:04:09,305 --> 00:04:10,685
to all of our doctors.

113
00:04:11,030 --> 00:04:13,349
So if you saw a Northwell physician last

114
00:04:13,349 --> 00:04:16,069
year, you were administered at a minimum at

115
00:04:16,069 --> 00:04:18,870
PHQ two. That was the screening the two

116
00:04:18,870 --> 00:04:20,569
screening questions for depression.

117
00:04:21,350 --> 00:04:23,990
If they were positive, you were either referred

118
00:04:23,990 --> 00:04:25,610
to a primary care physician

119
00:04:26,004 --> 00:04:29,125
or to our behavioral health navigation team who

120
00:04:29,125 --> 00:04:30,824
can hook you up with resources.

121
00:04:31,764 --> 00:04:33,925
It's something that we began the work in

122
00:04:33,925 --> 00:04:35,305
2024

123
00:04:35,605 --> 00:04:38,345
with piloting with just one of our specialty

124
00:04:38,910 --> 00:04:41,949
specialty service lines, our ENT service line, and

125
00:04:41,949 --> 00:04:44,670
built out the process. And we worked through

126
00:04:44,670 --> 00:04:47,230
the process with our primary care physicians and

127
00:04:47,230 --> 00:04:50,189
grew what they were doing. And in 2025,

128
00:04:50,189 --> 00:04:52,370
we made it a system wide goal.

129
00:04:53,305 --> 00:04:55,964
We redesigned our electronic medical records

130
00:04:56,345 --> 00:04:59,464
to support the initiative. We had digital interface

131
00:04:59,464 --> 00:05:01,245
with questions wherever possible.

132
00:05:01,704 --> 00:05:04,985
And last year, we screened over 700,000

133
00:05:04,985 --> 00:05:07,004
unique patients for depression

134
00:05:07,544 --> 00:05:10,100
and linked patients that were positive for depression

135
00:05:10,160 --> 00:05:12,180
with care whenever possible.

136
00:05:12,639 --> 00:05:14,639
So it was a huge initiative that we're

137
00:05:14,639 --> 00:05:17,040
incredibly proud of the work. It was partnered

138
00:05:17,040 --> 00:05:20,100
with our behavioral health service line who

139
00:05:20,479 --> 00:05:20,979
correspondingly

140
00:05:21,680 --> 00:05:24,979
built out collaborative care models embedded with our

141
00:05:25,254 --> 00:05:27,274
primary care teams in pediatrics

142
00:05:28,214 --> 00:05:28,855
and in,

143
00:05:29,415 --> 00:05:31,595
internal medicine and in family medicine,

144
00:05:32,134 --> 00:05:34,935
and additionally in some of our specialty offices

145
00:05:34,935 --> 00:05:36,954
where we have licensed clinical social workers

146
00:05:37,509 --> 00:05:38,009
working,

147
00:05:38,389 --> 00:05:40,629
there to do counseling for our patients and

148
00:05:40,629 --> 00:05:44,089
supporting our physicians and our advanced practice providers.

149
00:05:45,189 --> 00:05:45,689
Additionally,

150
00:05:46,709 --> 00:05:49,110
we have the behavioral health service line that

151
00:05:49,110 --> 00:05:51,849
was stood up last year to really enable

152
00:05:51,909 --> 00:05:55,014
trying to to match patients with resources. We

153
00:05:55,014 --> 00:05:57,415
all know how challenging that is in the

154
00:05:57,415 --> 00:06:00,634
mental health environment to get patients the appropriate

155
00:06:00,694 --> 00:06:01,194
resources.

156
00:06:01,895 --> 00:06:04,055
So there were lots of different, so they

157
00:06:04,055 --> 00:06:05,435
would do the evaluation.

158
00:06:06,189 --> 00:06:08,990
They had some access to urgent care in,

159
00:06:09,230 --> 00:06:10,290
some of our markets,

160
00:06:11,069 --> 00:06:13,389
like behavioral health, you know, same day care

161
00:06:13,389 --> 00:06:15,089
or urgent evaluation.

162
00:06:15,870 --> 00:06:17,730
We do have mental health,

163
00:06:18,350 --> 00:06:22,074
resources in terms of hospitals and inpatient admissions,

164
00:06:22,375 --> 00:06:24,854
and then we also partnered with several companies

165
00:06:24,854 --> 00:06:25,995
for telehealth,

166
00:06:27,095 --> 00:06:30,314
to provide services for our patient population. So

167
00:06:30,454 --> 00:06:33,975
really exciting work there on depression screening. It's

168
00:06:33,975 --> 00:06:35,574
one of the things we're really proud of

169
00:06:35,574 --> 00:06:36,394
last year,

170
00:06:37,259 --> 00:06:40,560
and that we've continued into 2026.

171
00:06:41,339 --> 00:06:43,180
I'll pause there in case you have anything

172
00:06:43,180 --> 00:06:44,860
you wanted to ask me about that before

173
00:06:44,860 --> 00:06:47,420
I go into my next big initiative that

174
00:06:47,420 --> 00:06:48,560
we did last year.

175
00:06:48,904 --> 00:06:51,705
Yeah. Doctor Barron, thank you. Really interesting to

176
00:06:51,705 --> 00:06:55,305
hear about scaling that depression screening system wide.

177
00:06:55,305 --> 00:06:55,965
I imagine

178
00:06:56,345 --> 00:06:58,925
such a big undertaking, but but a necessary

179
00:06:58,985 --> 00:07:00,745
and valuable one. I mean, we talk about

180
00:07:00,745 --> 00:07:03,709
so much about care coordination and connecting patients

181
00:07:03,709 --> 00:07:04,209
to

182
00:07:04,509 --> 00:07:07,069
appropriate levels of care and and really sounds

183
00:07:07,069 --> 00:07:09,310
like it starts with being able to do

184
00:07:09,310 --> 00:07:09,790
this,

185
00:07:10,350 --> 00:07:12,189
at at scale and goes a long way

186
00:07:12,189 --> 00:07:13,490
in avoiding unnecessary

187
00:07:14,189 --> 00:07:17,134
or preventable ED visits. So I guess my

188
00:07:17,134 --> 00:07:19,935
follow-up question around around that is, do you

189
00:07:19,935 --> 00:07:21,774
have a sense, or is there any tracking

190
00:07:21,774 --> 00:07:23,235
on that end of what

191
00:07:23,615 --> 00:07:26,014
being able to do this screening system wide

192
00:07:26,014 --> 00:07:27,555
and connect patients with

193
00:07:28,175 --> 00:07:31,074
referrals as early as possible has had downstream

194
00:07:31,375 --> 00:07:32,729
on ED strain?

195
00:07:33,669 --> 00:07:36,009
Hard to tell on ED strain.

196
00:07:36,709 --> 00:07:39,349
We're seeing about a four to five percent

197
00:07:39,349 --> 00:07:41,829
positivity rate, which is lower than, you know,

198
00:07:41,829 --> 00:07:43,990
historically, and I think largely because some of

199
00:07:43,990 --> 00:07:46,665
the screening for depression's typically been done

200
00:07:46,965 --> 00:07:49,045
in primary care offices. So,

201
00:07:49,845 --> 00:07:51,384
I don't think that people always

202
00:07:51,845 --> 00:07:54,564
respond the same when they go perhaps to

203
00:07:54,564 --> 00:07:57,205
see their orthopedist. They're not anticipating that that's

204
00:07:57,205 --> 00:07:59,545
something that they're going to discuss there.

205
00:08:00,420 --> 00:08:02,279
So we've really been focusing on

206
00:08:02,660 --> 00:08:03,720
getting the population

207
00:08:04,180 --> 00:08:04,680
screened

208
00:08:05,139 --> 00:08:06,519
and then subsequently

209
00:08:06,980 --> 00:08:09,139
on making sure we're hooking them up with

210
00:08:09,139 --> 00:08:11,779
care. So we've been tracking the volume at

211
00:08:11,779 --> 00:08:13,399
our behavioral health navigation

212
00:08:13,699 --> 00:08:14,199
center.

213
00:08:14,944 --> 00:08:16,805
I do think it would be really fascinating

214
00:08:17,105 --> 00:08:19,425
to look at ED admissions, but I often

215
00:08:19,425 --> 00:08:22,485
think that, depression is a confounding variable.

216
00:08:23,025 --> 00:08:25,504
So, you know, sometimes patients come in with

217
00:08:25,504 --> 00:08:29,050
anxiety or chest pain or something else where

218
00:08:29,050 --> 00:08:32,169
where the depression is a confounding variable, but

219
00:08:32,169 --> 00:08:35,129
not always the main cause for the ER

220
00:08:35,129 --> 00:08:36,110
visit. So,

221
00:08:36,809 --> 00:08:39,049
it's an interesting thing to think about tracking,

222
00:08:39,049 --> 00:08:40,490
one I'll have to take back to our

223
00:08:40,490 --> 00:08:42,029
team to see what we could do.

224
00:08:43,245 --> 00:08:45,665
Yeah. No. That makes sense. Interesting to hear.

225
00:08:46,365 --> 00:08:47,725
Leah, do you wanna share a little bit

226
00:08:47,725 --> 00:08:49,504
more too around the redesign

227
00:08:49,884 --> 00:08:51,805
that you're that you're looking at in terms

228
00:08:51,805 --> 00:08:52,545
of ambulatory?

229
00:08:53,325 --> 00:08:56,524
Right. So, you know, we we joined a

230
00:08:56,684 --> 00:08:58,879
you know, this my team has been managing,

231
00:08:58,879 --> 00:09:01,519
you know, a large geography and footprint since

232
00:09:01,519 --> 00:09:02,339
I've started,

233
00:09:02,639 --> 00:09:04,339
but that geography and footprint

234
00:09:04,720 --> 00:09:06,100
continues to expand.

235
00:09:06,559 --> 00:09:07,700
Northwell recently,

236
00:09:08,959 --> 00:09:12,019
merged with Nuvance Health, which now brings Northwell,

237
00:09:13,075 --> 00:09:15,254
in the, you know, further north,

238
00:09:15,715 --> 00:09:19,095
in New York and also into Western Connecticut,

239
00:09:19,875 --> 00:09:22,934
our geography becomes less and less drivable.

240
00:09:23,715 --> 00:09:25,554
And one of the things that we really

241
00:09:25,554 --> 00:09:26,490
realized is

242
00:09:26,889 --> 00:09:30,009
that we were often going into offices that

243
00:09:30,009 --> 00:09:33,690
maybe we were filling a nursing gap or

244
00:09:33,690 --> 00:09:36,570
an operational gap in quality. We were trying

245
00:09:36,730 --> 00:09:38,889
there might have been a quality issue, but

246
00:09:38,889 --> 00:09:40,909
the solution didn't really involve

247
00:09:41,684 --> 00:09:42,985
our nursing team.

248
00:09:43,845 --> 00:09:45,684
And we were looking at how do we

249
00:09:45,684 --> 00:09:46,184
evaluate

250
00:09:46,565 --> 00:09:48,424
the right amount of resources

251
00:09:49,445 --> 00:09:50,664
to meet the needs

252
00:09:51,125 --> 00:09:53,865
of an ever growing ambulatory footprint,

253
00:09:55,149 --> 00:09:57,170
and also what are the educational

254
00:09:57,550 --> 00:09:58,929
needs that we have

255
00:09:59,230 --> 00:10:00,929
for our operations

256
00:10:01,309 --> 00:10:01,809
colleagues

257
00:10:02,509 --> 00:10:03,009
within

258
00:10:03,550 --> 00:10:04,370
our market.

259
00:10:04,990 --> 00:10:07,705
And really trying to say, how do we

260
00:10:07,705 --> 00:10:09,725
do this in a way that's thoughtful

261
00:10:10,184 --> 00:10:13,144
and resource, you know, conscious because none of

262
00:10:13,144 --> 00:10:16,024
us can afford to just continue to expand

263
00:10:16,024 --> 00:10:16,764
our resources.

264
00:10:17,545 --> 00:10:18,985
So one of the things that we did

265
00:10:18,985 --> 00:10:21,009
was we started to look at all different

266
00:10:21,009 --> 00:10:23,190
clinical attributes of our practices.

267
00:10:23,809 --> 00:10:25,750
And, you know, when you grow by acquisition,

268
00:10:25,889 --> 00:10:28,529
you sometimes don't always have a great handle

269
00:10:28,529 --> 00:10:31,669
on what's going on in every practice site.

270
00:10:32,129 --> 00:10:34,690
So we spent about six months doing, you

271
00:10:34,690 --> 00:10:35,190
know,

272
00:10:35,875 --> 00:10:38,514
surveys of our practices and really getting a

273
00:10:38,514 --> 00:10:40,754
very good handle on what was going on

274
00:10:40,754 --> 00:10:41,894
in our practices.

275
00:10:42,514 --> 00:10:43,495
So for example,

276
00:10:44,035 --> 00:10:45,654
were they using

277
00:10:46,035 --> 00:10:49,095
something that required high level disinfection or sterilization?

278
00:10:49,790 --> 00:10:52,050
Do we have to think about infection prevention?

279
00:10:52,429 --> 00:10:54,210
Were they distributing meds

280
00:10:54,590 --> 00:10:57,649
or using controlled substances in their practice?

281
00:10:58,029 --> 00:10:59,950
So do we need to have higher level

282
00:10:59,950 --> 00:11:01,965
medication management in there?

283
00:11:02,365 --> 00:11:05,425
Are they reporting or regulated by joint commission,

284
00:11:05,805 --> 00:11:08,125
quad a? Are they an article 28? Those

285
00:11:08,125 --> 00:11:10,764
type of things. How many practices do we

286
00:11:10,764 --> 00:11:12,305
have that are doing that?

287
00:11:13,245 --> 00:11:15,345
And then, you know, were they a dialysis

288
00:11:15,644 --> 00:11:16,830
center? Are they a

289
00:11:18,509 --> 00:11:21,309
doing procedures but no sedation? Are we doing

290
00:11:21,309 --> 00:11:23,710
sedation in that office? So we looked at

291
00:11:23,710 --> 00:11:26,509
all of these different clinical attributes and what

292
00:11:26,509 --> 00:11:28,450
was going on in our practices,

293
00:11:28,830 --> 00:11:31,149
and we came up with a rating and

294
00:11:31,149 --> 00:11:32,210
tiering system

295
00:11:32,595 --> 00:11:34,375
that allows us to evaluate

296
00:11:34,754 --> 00:11:36,934
our practice sites off of tiers.

297
00:11:37,394 --> 00:11:39,394
And then from that, we've been in the

298
00:11:39,394 --> 00:11:41,414
process of saying, what is foundational?

299
00:11:42,274 --> 00:11:45,394
What should our operations teams know in all

300
00:11:45,394 --> 00:11:47,460
sites that is quality related.

301
00:11:48,000 --> 00:11:50,480
And then we're looking at each site as

302
00:11:50,480 --> 00:11:53,779
we increase risk for what's the appropriate clinical

303
00:11:53,840 --> 00:11:55,540
oversight, what's the appropriate

304
00:11:55,920 --> 00:11:59,519
quality oversight, and what's the appropriate racing matrix

305
00:11:59,519 --> 00:12:02,535
with our operations teams to make sure that

306
00:12:02,535 --> 00:12:04,855
our quality nurses are working to the top

307
00:12:04,855 --> 00:12:06,934
of their license, that they're being used as

308
00:12:06,934 --> 00:12:09,195
the resource that we need them to be,

309
00:12:09,575 --> 00:12:10,634
and that similarly,

310
00:12:11,095 --> 00:12:13,274
we are supporting all of our offices.

311
00:12:13,909 --> 00:12:16,230
So we've been in that process, and we

312
00:12:16,230 --> 00:12:19,750
are redesigning this year how we distribute our

313
00:12:19,750 --> 00:12:22,089
staff and how we how we distribute

314
00:12:22,870 --> 00:12:23,850
the offices

315
00:12:24,230 --> 00:12:25,289
that they oversee

316
00:12:25,669 --> 00:12:27,769
and that they carry with targeted

317
00:12:29,384 --> 00:12:30,445
visits and

318
00:12:31,065 --> 00:12:31,565
and,

319
00:12:32,264 --> 00:12:35,644
checklist and oversight for each of those tiers.

320
00:12:35,785 --> 00:12:38,105
So we're making tier one our highest risk,

321
00:12:38,105 --> 00:12:40,504
then tier two, and then tier three is

322
00:12:40,504 --> 00:12:43,419
our lowest risk practice site, and we're lining

323
00:12:43,419 --> 00:12:45,259
that up and looking at how do we

324
00:12:45,259 --> 00:12:47,820
do with that. It enables us that when

325
00:12:47,820 --> 00:12:48,720
we bring on

326
00:12:49,100 --> 00:12:51,899
new practices or a new market, we're able

327
00:12:51,899 --> 00:12:54,220
to take a look at how are they

328
00:12:54,220 --> 00:12:54,720
aligned,

329
00:12:55,100 --> 00:12:57,659
what resources do they have, how can we

330
00:12:57,659 --> 00:12:58,875
be supportive?

331
00:12:59,254 --> 00:13:01,014
What do we need to, you know, perhaps

332
00:13:01,014 --> 00:13:03,735
hire or fill? So it it's really been

333
00:13:03,735 --> 00:13:06,075
a huge initiative for how we are redesigning

334
00:13:06,934 --> 00:13:09,035
our thinking about ambulatory quality.

335
00:13:10,215 --> 00:13:11,355
Yeah. Doctor Baron,

336
00:13:11,735 --> 00:13:14,129
I've heard a lot to quality leaders talk

337
00:13:14,129 --> 00:13:16,850
about the the exact sort of challenge that

338
00:13:16,850 --> 00:13:18,070
you mentioned with

339
00:13:18,529 --> 00:13:19,029
sometimes

340
00:13:19,649 --> 00:13:21,970
systems as they've grown over the years. There's

341
00:13:21,970 --> 00:13:23,429
not just a clear understanding

342
00:13:23,809 --> 00:13:26,164
of what's happening where, and so how this

343
00:13:26,164 --> 00:13:28,404
work really needs to start sometimes with literally

344
00:13:28,404 --> 00:13:30,964
just mapping it out and getting a clear

345
00:13:30,964 --> 00:13:33,204
understanding of what's happening where,

346
00:13:33,684 --> 00:13:34,824
to shore up quality

347
00:13:35,125 --> 00:13:37,924
in these settings. So really interesting to hear

348
00:13:37,924 --> 00:13:38,664
what this

349
00:13:39,044 --> 00:13:40,964
work looks like and how it's actually being

350
00:13:40,964 --> 00:13:41,759
built out.

351
00:13:42,639 --> 00:13:44,720
Yeah. It's trying to use data to drive

352
00:13:44,720 --> 00:13:47,840
change, you know, and and really being thoughtful

353
00:13:47,840 --> 00:13:49,840
and purposeful about it. You know, we are

354
00:13:49,840 --> 00:13:50,340
all,

355
00:13:50,720 --> 00:13:52,660
you know, resource constricted

356
00:13:53,040 --> 00:13:53,540
and

357
00:13:53,919 --> 00:13:55,620
and really trying to do

358
00:13:56,240 --> 00:13:57,220
more and more

359
00:13:57,975 --> 00:14:00,794
with, you know, less. So how do we

360
00:14:00,934 --> 00:14:01,674
how do we

361
00:14:02,534 --> 00:14:05,254
adjust how we work and reform what we're

362
00:14:05,254 --> 00:14:06,794
doing to be efficient

363
00:14:07,334 --> 00:14:09,975
and effective and make sure we're keeping our

364
00:14:09,975 --> 00:14:10,954
patients safe

365
00:14:11,254 --> 00:14:12,154
in our offices?

366
00:14:12,695 --> 00:14:13,195
Mhmm.

367
00:14:14,159 --> 00:14:14,820
Yeah. Absolutely.

368
00:14:15,919 --> 00:14:18,419
Well, throughout this year in 2026,

369
00:14:18,799 --> 00:14:22,080
what is maybe one big priority that you're

370
00:14:22,080 --> 00:14:24,899
focused on and one challenge that you're anticipating

371
00:14:25,279 --> 00:14:26,019
or navigating?

372
00:14:27,205 --> 00:14:29,445
So one big challenge that I think we're

373
00:14:29,445 --> 00:14:31,125
focusing on is one that I think, you

374
00:14:31,125 --> 00:14:33,764
know, focused on in a lot of health

375
00:14:33,764 --> 00:14:36,184
systems, and that is really integrating,

376
00:14:37,125 --> 00:14:40,245
you know, new practice sites, new regions, new

377
00:14:40,245 --> 00:14:40,745
markets,

378
00:14:41,339 --> 00:14:42,240
new health systems

379
00:14:42,620 --> 00:14:43,120
into,

380
00:14:43,500 --> 00:14:45,819
you know, our health system or, you know,

381
00:14:45,819 --> 00:14:46,319
combining

382
00:14:46,620 --> 00:14:47,120
cultures

383
00:14:47,659 --> 00:14:48,879
and really aligning

384
00:14:49,500 --> 00:14:50,879
priorities and goals.

385
00:14:51,419 --> 00:14:53,419
I think that's something that that takes a

386
00:14:53,419 --> 00:14:55,100
lot of time. It takes a lot of

387
00:14:55,100 --> 00:14:56,240
personal time,

388
00:14:56,894 --> 00:14:58,754
to really understand where another

389
00:14:59,375 --> 00:15:02,195
health system is at in their journey

390
00:15:02,574 --> 00:15:04,254
and how do you both, you know, when

391
00:15:04,254 --> 00:15:06,674
you join together, grow faster together,

392
00:15:07,375 --> 00:15:09,634
and and how do you merge your resources

393
00:15:09,774 --> 00:15:11,074
and align your structures.

394
00:15:11,379 --> 00:15:12,819
So I think that is one thing that

395
00:15:12,819 --> 00:15:15,159
is really a priority for us,

396
00:15:15,860 --> 00:15:17,699
and I would say that we're doing that

397
00:15:17,699 --> 00:15:21,779
against a backdrop of a tremendous transformation at

398
00:15:21,779 --> 00:15:22,279
Northwell.

399
00:15:22,899 --> 00:15:25,835
We are making a tremendous digital transformation at

400
00:15:25,835 --> 00:15:27,455
Northwell as we are implementing

401
00:15:27,995 --> 00:15:28,495
EPIC

402
00:15:28,875 --> 00:15:30,414
throughout our health system

403
00:15:30,955 --> 00:15:32,414
and we are sunsetting

404
00:15:32,794 --> 00:15:33,294
multiple

405
00:15:33,595 --> 00:15:34,894
legacy EMRs,

406
00:15:35,674 --> 00:15:38,414
so it's not just the journey of implementing

407
00:15:38,955 --> 00:15:41,730
EPIC, you know, and a new EMR, but

408
00:15:41,730 --> 00:15:45,590
also building the culture around standardization of clinical

409
00:15:45,730 --> 00:15:46,230
workflows,

410
00:15:46,769 --> 00:15:49,029
everybody being on the same system,

411
00:15:49,410 --> 00:15:52,210
that system integrating with so many of the

412
00:15:52,210 --> 00:15:54,769
systems in our area. It's great for patient

413
00:15:54,769 --> 00:15:55,269
care,

414
00:15:55,625 --> 00:15:57,704
but and it also allows us to have

415
00:15:57,704 --> 00:16:00,605
way more of a more rapid digital transformation.

416
00:16:01,384 --> 00:16:03,625
So it's allowing us at Northwell to, you

417
00:16:03,625 --> 00:16:06,924
know, right, go right into online booking

418
00:16:07,304 --> 00:16:08,605
and patient,

419
00:16:09,144 --> 00:16:12,350
improving our patient access and patient experience. So

420
00:16:12,350 --> 00:16:14,850
trying to sustain our momentum

421
00:16:15,389 --> 00:16:17,470
on the work we're doing in depression, on

422
00:16:17,470 --> 00:16:19,789
aligning with new practices that are coming on

423
00:16:19,789 --> 00:16:21,730
in new regions and new health systems

424
00:16:22,590 --> 00:16:25,009
while being in this, you know, kind of

425
00:16:25,389 --> 00:16:26,529
major change,

426
00:16:26,884 --> 00:16:27,705
you know, major institutional

427
00:16:28,325 --> 00:16:30,804
digital change, I think, is is really what

428
00:16:30,804 --> 00:16:31,544
we're facing

429
00:16:32,164 --> 00:16:32,904
this year.

430
00:16:33,924 --> 00:16:36,485
Yeah. Definitely. I know that epic implementation is

431
00:16:36,485 --> 00:16:38,725
a huge project, so I imagine we'll lay

432
00:16:38,725 --> 00:16:41,240
the foundation for what will be just continued

433
00:16:41,299 --> 00:16:43,799
innovation and and patient care and workflows and

434
00:16:43,940 --> 00:16:46,659
being able to enable that. Doctor Baron, what

435
00:16:46,659 --> 00:16:49,959
do you see as the biggest opportunity for

436
00:16:50,259 --> 00:16:52,820
growth at Northwell in the year or several

437
00:16:52,820 --> 00:16:53,639
years ahead?

438
00:16:54,584 --> 00:16:57,325
I think that we have a tremendous footprint

439
00:16:58,264 --> 00:16:58,745
with,

440
00:16:59,544 --> 00:17:00,044
really

441
00:17:00,825 --> 00:17:01,325
talented,

442
00:17:01,784 --> 00:17:02,284
wonderful

443
00:17:03,065 --> 00:17:04,125
clinical teams.

444
00:17:04,984 --> 00:17:08,059
And I think that as we use our

445
00:17:08,059 --> 00:17:09,200
digital transformation

446
00:17:09,820 --> 00:17:10,320
to

447
00:17:11,019 --> 00:17:12,960
streamline the patient experience,

448
00:17:13,500 --> 00:17:14,799
improve our ambulatory

449
00:17:15,180 --> 00:17:15,680
efficiencies,

450
00:17:16,700 --> 00:17:17,200
standardize

451
00:17:17,580 --> 00:17:18,080
care,

452
00:17:18,865 --> 00:17:20,644
improve our referral system,

453
00:17:21,585 --> 00:17:22,565
and ultimately,

454
00:17:22,865 --> 00:17:24,644
you know, drive access.

455
00:17:25,265 --> 00:17:27,924
I think that is really where we will

456
00:17:28,144 --> 00:17:29,525
thrive and grow.

457
00:17:30,065 --> 00:17:32,144
I think it will will make it so

458
00:17:32,144 --> 00:17:32,644
that

459
00:17:33,590 --> 00:17:34,250
as we

460
00:17:35,670 --> 00:17:38,009
as people join us, they know the culture

461
00:17:38,070 --> 00:17:40,250
and the processes that they're joining.

462
00:17:40,869 --> 00:17:43,690
I think we've gone we've grown very rapidly

463
00:17:43,910 --> 00:17:46,945
as I think many health systems are, and

464
00:17:46,945 --> 00:17:48,965
I don't think we're slowing our,

465
00:17:49,585 --> 00:17:52,384
growth at any there's any intention to slow

466
00:17:52,384 --> 00:17:53,924
it, but I do think that there's

467
00:17:54,225 --> 00:17:56,725
intention to grow together more

468
00:17:57,184 --> 00:17:59,845
and to to utilize the opportunities

469
00:18:00,625 --> 00:18:02,005
to to build

470
00:18:02,940 --> 00:18:03,440
programs

471
00:18:03,740 --> 00:18:04,240
and

472
00:18:04,779 --> 00:18:07,839
centers of excellence and to make sure

473
00:18:08,140 --> 00:18:10,619
that people are aware of the amazing programs

474
00:18:10,619 --> 00:18:13,019
and centers of excellence that already exist within

475
00:18:13,019 --> 00:18:13,919
our health system.

476
00:18:14,619 --> 00:18:17,085
I think that's really where our where our

477
00:18:17,085 --> 00:18:17,585
opportunity

478
00:18:18,125 --> 00:18:20,785
really lies in streamlining all of our workflows

479
00:18:20,924 --> 00:18:21,585
and culture,

480
00:18:22,204 --> 00:18:25,964
really making that patient experience seamless and and

481
00:18:25,964 --> 00:18:27,265
high quality and

482
00:18:27,644 --> 00:18:29,105
and really improving access,

483
00:18:29,500 --> 00:18:31,179
which is what we hear about is really

484
00:18:31,179 --> 00:18:32,720
the struggle for our patients.

485
00:18:33,980 --> 00:18:34,799
Yeah. Certainly.

486
00:18:35,980 --> 00:18:38,539
Well, doctor Barron, thank you so much for

487
00:18:38,539 --> 00:18:40,460
joining me, for taking the time out of

488
00:18:40,460 --> 00:18:42,859
what I know is a busy schedule to

489
00:18:42,859 --> 00:18:44,960
share your insights with us. And,

490
00:18:45,474 --> 00:18:47,554
again, we're really looking forward to seeing you

491
00:18:47,554 --> 00:18:49,875
at the April annual meeting and and hearing

492
00:18:49,875 --> 00:18:52,115
from you live. So thank you so much,

493
00:18:52,115 --> 00:18:54,534
and I'm excited to catch up again soon.

494
00:18:55,154 --> 00:18:57,075
Thank you so much, Erica. Looking forward to

495
00:18:57,075 --> 00:18:58,054
seeing you too.