Speaker 0: This is Carly Beam with the Becker Spine and Orthopedics podcast, and I'm thrilled to be joined today by Allison Redidi, vice president of orthopedics at Catholic Health. Allison, thank you so much for jo for joining us today.

Speaker 1: Thanks for having me, Carly. I'm excited to speak with you.

Speaker 0: Absolutely. And before we dive to our questions, could you just introduce yourself and share a bit about all of your work?

Speaker 1: Sure. I'm the vice president for the orthopedic service line at Catholic Health. We are a six hospital health system based in Long Island, New York. We have about 17,000 employees, and we also have services spanning from rehabilitation, home health, hospice, ambulatory sites, ASCs. And we are a at least in orthopedics, we have a combination of folks who are employed in terms of physicians as well as several large orthopedic groups that we partner with in our various hospitals.

My three year anniversary with Catholic Health is actually coming up next month.

Speaker 0: Hey. That's congratulations. That's awesome.

Speaker 1: Thank you. You know, one thing I'd

Speaker 0: love to, touch on, and you mentioned, you know, you're working with practices and you have employed physicians. How are you, I guess, kind of keeping a a cohesive culture and keeping physicians in the different settings feeling unified?

Speaker 1: Yeah. So one of the things that we're we're focusing on right now so I I will just preface this with when I when I came to Catholic employed or nine employed physicians across the musculoskeletal spectrum. Mhmm. And one of my first orders of business was to start to boost that faculty a little bit, starting with our nonoperative primary sports medicine physicians. We did not have any faculty who, had that subspecialty training.

So flash forward to today, we have nearly 40 faculty on staff, which is a huge increase over three years. So we've really made an effort, first, to boost our faculty, because that's always key and critical to have in any health system. And the second thing that we engaged in starting last year, we've been laying the groundwork and we will continue this into this year, is to work with our partners in these large orthopedic groups and partner with them on strategic initiatives at our hospitals. So really trying to make them feel that we are all one team. It's not faculty versus voluntary.

My my goal and I liken it to to clothing, but it's like we should all wear the same hoodie that says, you know, orthopedics at Catholic Health. And so we have a variety of things that we're looking at to sort of bridge the gap and and bring folks together. Some of which involves looking at the various orthopedic subspecialties and whether or not we need to hire additional faculty or if the organizations we're partnering with those practices would prefer to be the ones to hire them, yet they are going to do their work in our hospitals. So we've started the groundwork for those conversations, and we've been meeting very actively with a lot of those groups and, coming up with ways that we can support each other and have our faculty talk to their faculty, look at things around quality. One of the things that we all have to partner on are these CMS mandates that have come down.

So we had the CJR initiative around joint replacement for the last five or six years, I believe. And now we have teams coming on board, which expands the scope of that for orthopedics into spine along with I think we're still keeping hips and a few other things. We also have other service lines involved. So it's been a great opportunity to sort of talk to everyone and say, okay. How can we build upon what we did with with strictly with joint replacement and do this together?

Speaker 0: Yeah. And how are you navigating all the different changes with CMS and health care policy? How are you navigating all that and staying ahead of it?

Speaker 1: Carefully. Doing our best. So what we've done is with CJR, we were we we already have the groundwork for a lot of this through our participation in CJR. So that's a that's a benefit. And now we are looking to the other service lines are looking to us in orthopedics to say, okay.

How did you do this? How did you get consensus around the measures you're you're building, and how do you coordinate patient care? So we've involved folks from care coordination at the system level, our payer strategy team, our quality team who've already been involved. And there are there's a larger structure at the system level for teams specifically. So we knew it was coming.

We're building upon what we have. And then we're leveraging some of the tech and tools that we have within our medical records. So we're an epic shop. And we are able to use that to run certain reports and automate a few processes, which up until very recently, we've been doing pretty manually, which we could kinda get away with, for a little bit. But at this point, the way these programs are expanding and and the way that our volume has been increasing, it's not manageable to do that anymore.

So we're trying to leverage some of the tools within Epic, to help us do that and do some of the patient tracking, the quality metric tracking, etcetera. And then we also have outside, you know, thought groups that we sort of participate in and and go to as many webinars as we can to learn about these measures and also see what other best practices are out there in the country to see how we can make sure that we are, you know, meeting the goals, being as competitive as as possible.

Speaker 0: Got it. And I was wondering if you could touch on any other big, important initiatives that you've led in the last year and how those have turned out.

Speaker 1: Sure. So one of the things that we have laid the groundwork for is looking at how do we transition and stay on top of the fact that a lot of orthopedics is going towards the outpatient arena. Mhmm. We have several ambulatory surgical centers that we partner with folks on in our system. And so we are trying to maintain a good balance between what goes there and what is should be done there versus what stays in the traditional hospital setting.

We just actually got some data from advisory board, and it's about an average of 15% growth in that outpatient arena for orthopedic. And joint replacement is actually as high as thirty two percent. Wow. So yeah. It's I was I was actually a little shocked when I saw those numbers because we assumed we had heard, you know, for the last few years, it was like, oh, five or ten percent is gonna go outpatient.

We're looking at much higher numbers than that. And so a lot of what we've been doing is setting the groundwork for looking at a more regional strategy. And so we've been partnering with, our hospital presidents in various regions to say, what is our current book of business at each of these locations? How do we potentially shift things over the next one to three years to be more efficient to cohort like types of services in one place? Take advantage of the fact that maybe we have ORs where we've got enough and we can almost set up, like, a mini ASC within the hospital proper if we can't build a new an ASC or or, you know, do that capital investment.

What can we do with the resources that we have? How can we become really efficient at what we do? And so I think that's one of the things we've been setting the groundwork for, and we're looking forward to expanding upon next year. The other really interesting thing, and it may seem like a very small thing when when people are listening to this, but I'm really excited about it, is we were able to standardize our education for all of our joint replacement practices and also for all of our our faculty, our nurses, our care coordinators, anyone who touches the joint replacement process. And that may sound like something very, very small, but when you look across the health system, it's it was very fragmented.

People were getting different education at different places. And with with the growing number of patients that we're seeing and the growing number of accreditations that are available and the standards that are coming out, we felt it was really important to do this across the system. And so what it what it says to me is that we have now built a system in the orthopedics world where we've got teams across all of our locations that are cooperating. So we now meet monthly. I started this probably six months into my tenure here.

We've we've brought all the orthopedic coordinators together, and we started meeting monthly. And it was so wonderful because some of them had never even met each other. And it it's this is all part of growing as a health system and coming together and really becoming functional as a system. So it was great. And after maybe five months of meetings, I started noticing emails that people would cc me on, and they were just talking to each other without me having to have the monthly meeting and everything else.

And they were like, oh, hey, Kevin. What are you doing at this hospital? And and, oh, you know, Patty, what are you doing at this hospital? And I just thought it was such a great way to bring people together, make them feel like they're part of something bigger, and let them be resources for each other. And we're continuing that now this year into spine, specifically.

So we are going to be doing the same process for spine as well as continuing our efforts on the joint replacement front with patient education. So we have a semi standard patient education across the system we've worked on, and we have a few little bits and pieces we wanna tweak so that it really truly is something that every single patient that comes in will get exactly the same package when they come to Catholic Health. So they're always getting all the info they need, but it's always added a little bit manually by each, hospital. And we're really trying to make it, a, very easy for our orthopedic coordinators, for our physicians, for our APPs to give all of that education. And And we wanna make it uniform so that no matter where you touch our health system, you're getting the same experience.

And I think that speaks to what we're also trying to do to continually elevate our patient experience when you come to Catholic Health.

Speaker 0: Absolutely. And and there's a couple of things I wanted to follow-up on here. Sounds I really wanted to first zero in on your outpatient total joint work.

Speaker 1: Mhmm.

Speaker 0: And what are some of the protocols, practices, any of the biggest factors that you think really, can credit this, you know, explosive growth, it sounds like, in outpatient total joints?

Speaker 1: Yeah. I I will say I think some of it is stemming from the pairs. So they are pushing to have more and more procedures done in the outpatient arena, and that's just something we've seen across the industry. I think the other thing that people are starting to look into is the impact of GLP ones, believe it or not. So crossing crossing sort of specialties here on the orthopedic joint replacement, population.

And so as more and more people are taking the GLP ones and potentially, reducing their risks from obesity or maybe being a little bit more sedentary, and they're moving more and they're having less weight and less strain put on their joints, we may be seeing an impact that this is either delaying people needing full on joint replacements or maybe also enhancing our, outcomes and that people are having more successful joint replacements because their BMIs and their weight might be lower. They might be more active prior to surgery. So there's some interesting studies right now that are out there. I haven't quite gotten to read all of them, but, there is definitely a body of research that is now growing amongst this. So one of those other things is that if people have fewer risk factors, there's a greater chance that their joint replacement or other orthopedic procedure could be done in the outpatient arena.

So it is it is possible that we are also seeing this high increase so that more people are actually becoming eligible for that outpatient arena versus having to be done in the traditional hospital where we can better manage some of the comorbidities, associated with these surgeries.

Speaker 0: Got it. And then, you know, in terms of spine surgery and outpatient spine, I'd love if you could just kind of dive in more into your plan of attack with that and your goals for, increasing that as well.

Speaker 1: So for inpatient spine, there's still a few procedures they that the surgeons will do on the outpatient side. It's still very heavily inpatient. I I do think that there will be a trend as more and more places try this and see that it's safe. But my clinicians here are definitely focusing still on the inpatient side of spine. However, in doing so, they are also, you know, ensuring that things are very efficient.

Patients are definitely staying in the hospital for fewer days, and we are really trying for when they are in the hospital to offer an excellent experience for them so that they can get up and get back to doing what they like as soon as possible. But I think on the spine side, that is still, in the arena where it's probably one of the last arenas where, inpatient is really still ruling. Although, I'm sure if we have this conversation in another couple of years, we may be seeing something completely different.

Speaker 0: Definitely. And then just last question I had for you, Allison, is what's one thing that all orthopedic leaders such as yourself should do this year to really thrive?

Speaker 1: Sure. I think there's a couple of things I think that we can do so that we have resilient orthopedic service lines. I think we need to look at building multidisciplinary hubs. Patients are really craving one stop shopping. They wanna go in.

They wanna be able to get their radiology studies, maybe their labs drawn, maybe even see a couple providers in a day if that's possible scheduling wise. So I think looking at how you set up your out outpatient ambulatory practices to provide that experience, I think it's going to be really important. Ease of access to care is critical. Patients want to get in. They wanna get in quickly.

And so the the more that an organization can do that, the the better off that they will be. And I think they also have to look at beyond the ambulatory arena and take a critical look at their system just as we're doing at Catholic Health and say, what do we want to do where and how does this make sense? Does it make sense to do high level joint replacements and revisions and spine in every single one of our six hospitals? The answer is probably not. So how do we look regionally and say, how do we build centers of excellence where you can get certain procedures and certain categories of, treatment all in one place and it's at a very, very high level, and we can get you there no matter where you enter our system.

So when you wanna when you regionalize, you really wanna make sure that no matter where the patient touches your system, they get to the right care at the right time with the right providers. And so I think as long as you can build those systems in and the procedures in, you're gonna be in a good place. So one of the things we're trying to do right now is there's a big push with our in network utilization and making sure that our patients have a very seamless transition from our primary care providers to any specialist that they need. So we're making sure that, you know, to the point where you might even be able to get your orthopedic appointment as you leave your primary care doctor's office. Or if you need an x-ray from your orthopedic specialist, you can leave with that x-ray appointment.

And a lot of health systems do this. This isn't rocket science or anything, but I think, you know, the implementation of it and the the way in which you do it and how you make it accessible for your patients is really where you're going to have have success or maybe not. And then I think, finally, I think you always have to go back to your people. And this is something I've said, in some of the talks I've given, but you have to hire really good people because we are in a people business. We take care of people.

That is our core business. And I think as long as you keep that as your forefront and your guiding principle, you'll hire good people, whether it's your physicians, your APPs, your nursing staff, even the people that answer your phones or, you know, are your housekeepers. If you have good people, you'll have a good culture and people will want to come to you. And so I think that's something you always have to keep in mind. We do it with our physicians as well.

We are hire we've hired some amazingly talented physicians, but they're also genuinely nice people. And I really enjoy speaking with them, and I'm I'm setting up all my one to ones right now for this year. And I'm so excited because I just think we've found a whole new group of of physicians. We've found a group of APP, and they're really special. And they're just genuinely good people.

Speaker 0: That's excellent. And, you know, I hope you can definitely follow-up and hear more about, what you're doing over there at Catholic Health. And thank you again for joining us on today's podcast. I hope you, stay warm, and I look forward to connecting again in the future.

Speaker 1: Sounds good. It was a pleasure talking to you today, and I hope you have a a great rest of the day.