- This is Laura Dedo with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Dr.
Mark Gorlick, president
and Chief Executive Officer of Children's Minnesota.
Dr. Gorlick, it's a pleasure
to have you on the podcast today.
- Thank you. It's a pleasure to be here.
Appreciate being invited.
- Now, I'm really looking forward to talking
with you more about what you're
doing at Children's Minnesota.
I know you've got some really fascinating things happening
there, and so this will be an amazing discussion.
But before we dive into that,
can you tell me a little bit more
about yourself and your background?
- Yeah, sure. Delighted to, um, you know,
my entire career has been in children's healthcare.
I began as a pediatric emergency medicine physician,
and I practiced that for about 25 years
before I moved into full-time healthcare leadership.
And, uh, I've done
that at several different hospitals around the country.
I've been here at Children's Minnesota,
this month will be seven years,
so I'm very excited about that.
For your listeners who may not be familiar with,
with our organization,
children's Minnesota is an independent
pediatric health system.
Uh, we are based here in the Twin Cities of Minneapolis, St.
Paul. Uh, we have two hospitals,
one in Minneapolis, one in St.
Paul, and we an ambulatory surgery center
and over a dozen clinic locations.
And between our two hospitals, we have about 460 beds,
which makes us one of the 10 largest children's health
systems in the United States.
And we serve kids from, uh, throughout Minnesota
and the surrounding states.
We're the, we're actually the largest
pediatric specialty provider in the upper Midwest.
And importantly, I should note,
we are celebrating our 100th anniversary this year.
Uh, so we started in a little house in St. Paul in 1924.
Now we've grown into this, you know,
comprehensive pediatric health system,
which we're very proud of, and, um, very proud
to have served this community for the last century,
and really excited to think about how we continue
to serve this community for at least the next century.
- Well, that's an amazing milestone
and certainly excited, um, to, as you mentioned,
have such a long and rich history in the community.
And, you know, given, um, that reputation that you have,
what are some of the trends
that you're following most closely right now?
What are you really, um, spending most of your time on?
- Yeah, you know, it's, and when I think about trends,
and it's timely, right?
We're celebrating a hundredth anniversary, we're going
through a strategic planning process.
So certainly looking at, at trends is, is critical.
So it's a really important question,
and I think there are a few trends that,
that we have our eyes on
that are particularly relevant to what we're we are doing.
You know, one is a trend around, um, what's happening
with diversity, equity, and inclusion.
So back in 2016, in our community health needs assessment,
um, uh, systemic racism
and health disparities were identified as two
of the five top health issues facing kids in our community
by the members of our community as part of that assessment.
And that was a real wake up for us.
And, and really, so since then, since I've been here, uh,
early 2017, we have made, um, diversity, equity
and inclusion a, a priority, uh, for children's Minnesota.
I think in the last few years, certainly in the aftermath
of the killing of George Floyd
by a Minneapolis police officer,
which happened literally 12 blocks from
where I am right now in our Minneapolis hospital.
Um, we saw real, uh, um, increase in, in activity
and commitment around diversity, equity,
and inclusion, not only across our industry,
but across, you know, other
industries in our entire community.
And it was really great
because we found a lot of willing partners that wanted
to work with us to address those issues
that our community's been facing.
And in the last year
or so, we've really started to see,
I would think a certain amount of pullback
and retrenchment from that.
The organizations talking less often, um,
about diversity, equity, inclusion.
We see the magnitude of the commitments
that were made being paired back a little bit.
We see other states where, where school districts and cities
and states even are passing laws that limit the ability
of organizations like ours
to address this very real issue of health disparities.
And, you know, the data are pretty clear.
I mean, there are enormous health disparities,
particularly among kids.
Minnesota happens to be among the worst,
but it is a national problem.
And so this trend of sort of backing off from,
from our efforts to address this, I think is something that,
um, I view as some concern.
I'll tell you that at Children's Minnesota, we are remain
as committed as ever to advancing diversity, equity,
and inclusion and, and serving the very diverse population,
uh, that we have here in the Twin
Cities and, and in the state.
So that's one trend. Um, another trend
that is I think is similarly concerning is the trend
that we're seeing nationally around, uh,
gender affirming care, particularly for .
I, I think, um, uh,
although we, you know, in my 35 year career in, in,
in children's health, um, this is a relatively new issue
that we are dealing with, but it's not a new
thing, not a fad.
Um, it's not something that all of a sudden started in,
you know, the two thousands.
Um, but our ability to talk about it
and address it, I think is really accelerated.
And, um, what I view as some concern is
that this has gone from being a children's health issue
to being a partisan political issue, um, that creates a lot
of divisiveness, and again,
seeing what's happening in some places, um, with limitations
of access to, uh, gender affirming care that we know for,
uh, for kids who are either transgender, gender diverse,
non-binary, that, that, um, they have significant, uh,
health issues that they need to address,
including physical and mental health issues.
And having lack of access to those resources,
um, is harmful.
So we have a gender health program here at Children's
Minnesota that we've had for a number of years.
Um, we are now starting to get, uh,
we serve kids from throughout the state, um,
but we are starting to get a lot of referrals from
outside the state in response to efforts
to limit access to that care.
And, uh, you know, we can barely meet the needs of,
of kids in our own community.
And so seeing this trend nationally is concerning.
I will tell you that, you know, the, the, the care
that we provide is, um, it's evidence-based.
It is consistent with
and supported by, you know,
all the major professional organizations, um, such
as the American Academy of Pediatrics.
And what's interesting is we've, within our own community,
we've certainly had, uh,
community members donors raise questions
and concerns about it based on what they see in the media.
When we sit down and talk with them
and explain about gender affirming care, um, I find
that they have a lot of misperceptions about what we do
and don't do what it does and doesn't involve.
And, uh, what I, what I hope to see the trend reversed to is
to get away from the partisanship
and to get down to that ability
to have conversations grounded in facts, grounded in, in,
uh, evidence grounded in reality.
Uh, because when we do that, we find
that we actually have a lot more common ground than I think
we're seeing, uh, on the front pages
of the papers and in social media.
Um, and then the third trend I would say that, um, is, uh,
probably one that you a lot of your, uh,
interviewees probably addressed,
and that's, you know, how we're,
how are we thinking about the use
of artificial intelligence in healthcare?
And, um, you know, to me, I think there's certainly,
um, a, a lot of concerns that have been raised.
Um, but there's so much promise.
And I think when, when we think about the use
of artificial intelligence, whether for clinical
or nonclinical tasks, I think about it in terms of
how can it help us advance quality of care
and thinking about quality holistically.
In terms of the six domains
of quality identified by the Institute of Medicine.
The obvious ones are AI has the potential
to really dramatically increase efficiency and timeliness,
and there's certainly some evidence that it's, um,
more effective, right?
You studies that have shown, uh, AI tools
that deliver greater diagnostic accuracy
than a human clinician can.
I think what we need to make sure is
that we're also focusing on those other domains of quality,
that we're focusing on safety, that we're focusing on
patient-centeredness, and we're focusing on equity.
But in my own opinion is if we do this right,
I think we have the ability to really advance quality in all
of those domains with the use of AI tools,
again, done properly.
And while I certainly understand and appreciate
and agree with the concerns about equity
and bias, human intelligence has been demonstrated
to be a significantly biased tool.
And if it's done right, I think we actually can use this
as a way to address some of the biases
that have been built into our
healthcare system over decades.
So those are my three trends.
- Absolutely. I, I think, you know, it's so important
as you laid out all of those trends there, looking at some
of the DEI work and as you mentioned, keeping that front
and center, even though in some ways, um, some organizations
and states have been backing away from it.
And then too, looking at the gender affirming care,
which has become extremely controversial in some places.
I can imagine, as you mentioned, having some
of those conversations and being able to bring, you know,
understanding to what you're doing
and how important that is, children's healthcare, um,
is extremely, um, helpful, um, for the community at large.
And then AI as well, like you mentioned being something, um,
that so many healthcare organizations are trying
to understand and troubleshoot
and figure out as, um, the technology evolves quickly
and making sure they're using it appropriately in a way
that, um, really can best serve their patients
and, and teammates.
Um, you know, big issues here, when you look at all
of these things together, I, I think it really, um,
stems into being able to care for your teams
and community, um, in a really, really important way.
I'm wondering, you know, for the, um, as,
as you were mentioning DEI
and then the gender affirming care as well, how do you, um,
really make sure that, you know, your teams feel supported,
um, through, you know, some of these challenging times, um,
as some of these issues
and areas are, you know, kind of have become politicized
as you mentioned, um,
and really, you know, they can understand that, um,
what your philosophy around it is at Children's Minnesota
and how they can be supported in moving forward, um,
with that philosophy?
- Yeah, I think it comes down to being rooted in our vision
and mission and values.
You know, our vision is to be every family's essential
partner in raising healthier children.
And when I talk about that,
starting from new employee orientation, I say,
when we say every family, we mean every family,
every family, no matter who they are, no matter
what they look like, no matter where they're from, no matter
what language they speak, no matter how,
whether they can pay
for their healthcare, we mean every family.
And so when we rooted in that, then, then
that drives the why do we care about
diversity, equity, and inclusion?
Why are we caring about making sure that, um,
we're providing gender affirming care?
Um, and, and all the other things we do,
it's rooted in our why
and in our values of, of, you know,
being respectful and inclusive.
And so, um,
that goes a long way towards helping people understand
and then, you know, demonstrating
that it is actually truly important to the organization
and not just something that we say.
And when we look at our strategic scorecard of, uh,
how are we measuring progress against our
strategy, we have six metrics.
Two of those six metrics are related
to diversity, equity, and inclusion.
One is around the diversity of our workforce,
and one is around decreasing disparities
for patients within our system.
And so, and you know, that is something that we report on
to our staff at our town hall meetings.
How are we doing on our strategic metrics?
Um, for our leaders, part of their compensation is tied to,
uh, meeting those organizational goals.
So I think rooting it in why, you know, in the why
of Children's Minnesota
and demonstrating that we are serious about it, I think are,
are the two approaches that we've taken.
- Well, that's great to hear.
And you know, now zeroing in a little bit more,
could you tell me a little bit about a project
or initiative that you're most proud of from the last year?
- Um, yeah, maybe I'll, I'll have a couple
and I'll, I'll tie it back to
what I previously talked about.
So again, DEI has been a priority for our organization.
I already told you that It makes up one third of our
strategic scorecard and,
and one third of our, um, incentive, uh, plan.
Um, and we've made a lot of progress on that.
So on having,
and we know, I mean, there, there's, the, the thing is,
there's research evidence that shows
that if you have a more diverse healthcare workforce
that better reflects the community that you're serving,
you will do a better job of serving that community.
You will have better outcomes,
you'll have fewer disparities.
And so, you know, we're not just doing this
because, you know, it's the woke thing to do.
We're doing it because the evidence says
that this is the way we're going to get better outcomes.
And so we've made significant efforts
and we've made significant strides.
So in 2019, 19% of our workforce identified as people
of color, we had a goal of increasing that to 34%.
Uh, by the end of next year, we're now at 30%.
So just in that short period of time,
we've made a tremendous,
and we've done it through, um, more expansive recruitment
and better job of, of retention.
And, um, I'm very proud of that progress.
And that's true at all levels. So, uh, we went from 0%
of our executive team to one third of our executive team
identifying as people of color, 30% of the next level
of leaders, and again, 30% of the entire organization.
So I'm very proud of that, very proud
of the progress we've made on, on decreasing disparities.
Um, we have, uh, identified three clinical outcomes
that, uh, where we have gaps based on race,
and we've combined those into
what we call our health equity index.
And each year we have a goal
of decreasing the disparities in those outcomes,
those outcomes being immunizations, being up to date,
asthma being under good control
and a patient experience measure.
And through a variety of efforts, we have managed
to narrow those gaps.
Honestly, we still have a lot of work to do,
we all do in this industry,
but I'm proud of the fact that we're focusing on it
and that we've started to move the needle on that.
Um, and you know, these become mutually reinforcing.
It's kind of interesting. Um, you know, people,
I talk about this with colleagues
and they say, well, how did you make such huge strides in,
in diversity of your workforce?
And how are you recruiting people?
And I say, you know, not uncommonly at
new employee orientation.
People say to me, I came here
to work at Children's Minnesota
because of the stand you are taking on health equity
because of the way you are showing up in the community
to advocate and to, to be sincere about this.
And that's what attracted me here.
So these become mutually reinforcing things.
And then we have not really done much with ai,
but we have done some, I think, interesting things
with technology in the last year that, um,
are really helping us to deliver
better outcomes for patients.
And I'm gonna highlight two of them.
One, actually one
of our physicians talked about on your past not too long
ago, um, uh, Dr.
Mark Bergeron, who's the medical director of our, um, uh,
neonatal telehealth program.
And we've instituted
what we call our kid experts at home program
that has allowed us to discharge
patients from our neonatal ICU earlier with
as good or better outcomes.
So decreasing length of stay, getting them home sooner, um,
and, and still on track to, to have as good
or better outcomes, um, despite that through the use of,
of remote monitoring and telehealth.
And that's been really exciting
and that opens us up
to then having really good conversations with payers
because we have a mutual interest in keeping kids outta the
hospital, um, when they don't need to be.
And so that's been exciting.
And then we opened, uh,
a new intraoperative MRI suite last year,
and while intraoperative MRI is not necessarily itself a new
technology, we've actually had it for some time.
Um, our kit experts had, um, constraints
that they were discovering with the way it was being used,
and they came up with a really innovative solution, um,
to how we configure this.
And it's actually, it's, we worked with a, a,
a company to help us build this.
It's only, it's the first one in North America
with this configuration
that allows us across a three room suite to have an MRI
that is mounted on a rail system, so it can move from room
to room, depending on the clinical circumstance.
We can either move the patient into the scanner
or the scanner to the patient without having
to leave the operating room, without having
to break anesthesia or, or sterile conditions,
and, um, enables them to do imaging from brain all the way
through spine in a way
that's more effective and more efficient.
And it's very exciting to,
to see the growth in that program.
- That's amazing. Wow.
I, I can imagine, you know, it's just such a, um,
big game changer, I guess, to be able to do that
with the MRI machine and certainly everything else.
You mentioned it, it's inspiring to know
that people are paying attention
to the work you're doing in the community with health equity
and how, you know, you're really framing your stance on some
of these issues, and that is attractive to folks.
Um, that was gonna be one of my questions is, you know,
what do you feel like, um, you, you really are unique in,
in terms of being able to make such a significant process
or progress, excuse me, towards your goal
of a more diverse workforce?
And especially on the leadership side of things, I think,
um, you know, there's a lot of, uh, um, organizations
that would like to be in a similar position.
And so it's great to hear that that's been a,
a really crucial part of how you've been able to grow
and develop over the last three or four years.
- Yeah. - Excellent.
Well, you know, before we wrap up here, I'm wondering,
you know, considering we've talked a lot about DEI as well
as AI and some other areas,
how are you thinking about growth
and development for the future?
What do you see as being ahead
for the next two, three or five years?
- Yeah, you know, when, when we think about growth,
we often just think about it in terms of size, right?
More revenue, more patients, et cetera.
And that is certainly a dimension of growth.
We are thinking about how can we serve more patients, um,
how are we thinking about, you know,
what services we offer and where we offer them.
And, and we've certainly got plans for growth in that way.
I also just think about growth in terms of, um,
depth, greater depth.
And I've always believed that one of the things
that distinguishes a children's hospital is that
as the kid experts, we recognize
that kids are not just small adults, they have unique needs,
physical, emotional, social needs,
and we have the infrastructure
and the services to meet those needs.
And so that really is about the experience
of being in a children's hospital.
And I think what we have in line for the next 10 years is
to really double down on that
and really make the Children's Minnesota experience one
that is highly differentiated.
Um, you know,
a really comprehensively outstanding experience, you know,
in all encounters, whether they're clinic visits
or appointment making or, or referrals for our patients
and families and for our staff
and for the rest of our community.
And so that's something that we will be working on the next
10 years is growing, um, our experience as one
of the ways that we will also then grow to be able
to serve more patients and, and, um, uh,
and more of our community.
- I love that. Dr. Gole, thank you so much
for joining us on the podcast today.
This has been such a fun and interesting conversation,
and I look forward to connecting with you again soon.
- Thank you, Laura. It's Belin been a pleasure.