Episode 9 : Beyond Shiny Objects:

SCTS_Kristi Henderson.mp3: Audio automatically transcribed by Sonix

SCTS_Kristi Henderson.mp3: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Intro/Outro:
Welcome to the Smart Care Team Spotlight presented by care.ai, the Smart Care Facility, Platform company and leader in AI and ambient intelligence for healthcare. Join Molly McCarthy, former CNO of Microsoft, as she interviews the brightest minds in health care about the transformational promise of AI and ambient intelligence for care teams.

Molly McCarthy:
Too often, technology makes caregivers' lives harder, not easier. It's time for smart technology to empower care with a more human touch. Today, I'm so excited to have Dr. Kristi Henderson, healthcare visionary and digital transformation leader, on the Smart Care Team Spotlight. Dr. Henderson's journey from a bedside nurse practitioner to CEO has been marked by a tireless dedication to enhancing the healthcare experience for patients and clinicians over the past 30 years. As the former CEO of Optum Everycare, Dr. Henderson led a national care delivery organization with virtual and in-person care options that were provided through community clinics, employer worksite clinics, and a national virtual health clinic. Dr. Henderson has also led clinical operations for Amazon Care, where she played a pivotal role in the development and expansion of the company's innovative telehealth and home care program. She also led a National Center for Patient Access, Virtual Care, and Care Coordination for Ascension Health, where she developed and implemented innovative models of care delivery. Christie is also the board chair for the American Telemedicine Association, and she has been a vocal advocate for telehealth expansion and its potential to improve healthcare access and delivery for all. As the new CEO of Confluent Health, Dr. Henderson is committed to building on the organization's legacy of excellence in physical therapy and rehabilitation while also driving innovation and growth across the broader healthcare landscape. Welcome, Christie. It's so great to have you.

Kristi Henderson:
Thanks for having me, Molly. Excited for the conversation.

Molly McCarthy:
I'm going to get right into it. You obviously have an amazing and extensive background within healthcare. I mentioned on the provider side, on the payer side, and the technology side. And so as you think about that journey retrospectively and the evolution of health IT, to really bring us to where we are today. I would love for you to share with our listeners your opinion on what we got right over those years and perhaps what we could have improved upon.

Kristi Henderson:
First of all, Molly, thank you for having me. I'm excited for this conversation because it brings back such a flood of amazing memories. I'm just trying to pioneer and work through, like we're all focused on the same thing. How do we improve health outcomes and how do we make this system easier to interact with? And so there's a lot of great successes, and there are definitely things we could have done differently. And maybe I'll take two that maybe are less expected around the things that we got. First of all, through all of this work, it could have been really easy for us to sacrifice some of our core tenants as healthcare providers and trusted partners in the healthcare industry, but we remain as nurses in particular, the most trusted healthcare professional. And so just we never lost that. And so I just that is that relationship and that trust we have with patients could have easily been put to the wayside for us to try things. And so just we should celebrate that with that. You know, we also never lost our determination and perseverance. I mean, how many times have we tried things it didn't work, or we didn't have the aligned incentives or policies or regulations to really get the traction that we wanted. And myself have been involved in so many different projects that were really a great idea at the wrong time, and but we didn't lose our perseverance. And so I think those are the two things we got right. We're still a trusted healthcare, the most trusted profession, and we are still focused on the right things, which is improving the system and improving outcomes. The things I think we've gotten wrong, and I think we still do it today and maybe we're we'll get better at this. But the first one is change management. And I just think that too often the excitement around new technology omits the complexity of our system and the need for us to slow down and really think through all the stakeholders how they'll be impacted, how a technology may have a dependency on something else. And so I think we miss getting adoption and engagement because we don't do change management. And so I think that we've got to slow down and do the planning and involve patients, clinical team, and others in that decision making. It's so logical. But the first thing that happens every single time is people misstep on a communication and an engagement or a training that's going to be necessary for success and adoption. So that's one. The other is I think we constantly are in our own way, and we are assuming what people want. And we really, until recently, had the ability to really treat people individually and configure solutions to be able to adjust for Kristi or Molly or whoever it may be. You know, our social media pages are all customized to us based on what we've been doing in the system. So healthcare should be the same way, and it should be more intelligent and personalized so that you get that adoption. And that's true for the clinician side as well. Nurses need to have technology that really responds to what their needs are as well. So a lot more flexibility and dynamic nature to the technology and use that intelligence and data that we have to personalize things for both sides so that you can actually make the system work easier. So I think using the data, personalizing it and change management is where I think we've fallen short.

Molly McCarthy:
And just to touch on that last point, because when you started to dig into that, when you first said, we assume what people want, my question was, well, what people? And I love your point about patients, but also clinicians, so that either the person receiving care or giving care or part of that care team, it's personalized to the information that really they need to have and really know to provide better outcomes.

Kristi Henderson:
Well, I'll add one piece to that too. I think that and this came from my experience really working at Amazon, where there's nobody more customer-obsessed than Amazon and the—variants of an individual. Healthcare is different though. What I want may not actually be what's best for me, and so I may need to make sure that we focus on the core piece and sacrifice a star rating because it is what people need. So I think that we have to hold true to we know the standards of care, but we can create experiences that are personalized and adopted and adjusted for what that individual, how they learn, cultural beliefs, language preferences, all of those things can be done. But I just thought of that when you were describing that. I think that there is still this piece where we've got to maintain our trusted relationship because we're advocating for what's best for an individual, even if it might not be what they want.

Molly McCarthy:
And that goes, I'm just going to highlight again what you said at the beginning in terms of what we got right and that trusted health care professional, the relationship with our patients. Nurses continue to rank number one as the most health, most trusted healthcare professional. And then obviously the perseverance and determination. And then I'm just going to close out before I move on to my next question with the change management piece. You really brought up a great point there in terms of multidisciplinary stakeholders from the beginning. Slow down, and doing that hard work in the beginning will pay off. And that's something I couldn't agree with you more in terms of where we continue to struggle. So my follow-up question to that, obviously you've had so many experiences, and I would love to share with our audience how you got from within health systems to tech to chair of the ATA board, as well as your current position as CEO, as Confluent Health.

Kristi Henderson:
Maybe I'll start with the piece ATA because it's held true across all of the different jobs, and I'll use that word, but I've had but actually got involved with ATA. It was probably in 2000 or 2001. I actually need to figure that out because it was a long time ago, but I was working at a medical center and looking to get into telehealth, and went to visit one of their conferences that they had in Orlando. And I can vividly remember the room I walked into and the people sitting on the stage in club chairs talking about the investments in health tech and delivering remote care. And one of the things that holds true today, and the reason I've continued to be involved in the ATA is the membership. And this is hard stuff. We're modernizing policy and regulations. We're advocating for new clinical models. We're networking among each other to figure out best practices. What has worked, how are you solving this problem? And so it's incredibly energizing to be with all those thought-led leaders and people, really pioneering new ways to deliver care. And of course, telehealth became all the craze during the pandemic. But many of us were doing this early in 2000 and really had no reimbursement model. That came because of work from the ATA. And these are things that none of it's easy, but this group is willing to keep knocking away at every little piece of policy, regulation, advocacy, trust building exercises and be on the forefront of advancing technology into healthcare, and it's not about telehealth. It's about technology and healthcare to improve health outcomes and reach. So that's what inspires me about that. We still have a ton of work to do, and so I continue to be excited about my involvement there on the board. Now, my journey from bedside nurse practitioner to academic medical center, you know, Ascension and Amazon and Optum and now Confluent, all of those are really different sectors of the healthcare industry. And so, you know, learning from actual clinical provider, learning from a large system approach nonprofit that then transitioned into big tech and then a payer-provider organization. Every one of those really gave me more insights into how I could be a better leader and and really appreciate all the stakeholders. It doesn't do me any good to just focus on it. From my lens of a clinician, I've got to understand the why, what is causing people to behave a certain way, what is influencing policy? What are there's just so much complexity to the healthcare system, which is what makes it so much fun at the same time, like a big puzzle. So all of those things really excited me about this new role. To be able to bring all of that together into a role of CEO of Confluent Health, which is a national law school skeletal provider that is seeing through about 650 actual physical PTO speech clinics that are in the community. They're locally branded, so no one's heard of Confluent Health. We wanted to maintain that local trust with clinics that have been there oftentimes for 20-plus years, so they're trusted partners. We also have clinics in about 2000 employer sites where we're actually on the injury prevention and safety side. So we may treat conditions, but we're also working upstream to try to prevent those as well. We have hundreds of relationships with health systems where we are actually their physical therapy arm, and providing that because we have a more efficient and effective model and great outcomes. And so integrating into their system of care. And then most don't know that we actually have a educational arm where we're actually training the workforce that we need. We're all challenged with workforce. So we have post-professional PT programs, and we've partnered with universities and our training all over the country as well. So all of that, plus an innovation arm that allows me to integrate technology across the whole musculoskeletal experience, is really getting on value-based care for musculoskeletal. So it's exciting. But all of that, I've been prepared for that because of these other roles in every one of them. Layering a new experience on top.

Molly McCarthy:
Yeah. And you said something previously around the ATA I think it's really applicable as you talk about your journey too. And that's not about telehealth but really about tech and health and how can we improve patient outcomes. And that's so critical as we continue to evolve as a healthcare system.

Kristi Henderson:
I couldn't agree more. Just sorry. I'll add one thing to that. I remember when we have all this data coming from everywhere and say it all the time around, like data for the sake of data does us no good. We have to get insights out of it, so it's actionable. Same thing for tech. The tech is for a purpose for us to reach more people, deliver better outcomes, whatever it may be. So there's a lot of shiny objects out there, but you've got to really back up to where's the pain point and friction that we're really trying to simplify.

Molly McCarthy:
Yeah, we'll talk about shiny objects in a little bit. But we started to touch upon care models. And so I want to delve into that a little bit deeper. And obviously current care models are becoming unsustainable both economically, physically, emotionally. We know the clinician burnout and to some extent clinically. So I have actually two questions for you. So I'll ask them one at a time just so I don't overwhelm you. So as you think about the clinical transformation, which you've obviously been a part of for many years, but it's happening readily right now. What role must nursing have to ensure new care models best serve their patients as well as themselves?

Kristi Henderson:
Come circle back to something I said earlier about that. Nurses being the most trusted healthcare professional. So they have the trust of individuals. They have the trust of the healthcare team, and therefore they have the best visibility, understanding where there's gaps in the current system or what's not working.

Molly McCarthy:
Right.

Kristi Henderson:
And so nurses have been working in across the entire care continuum. And so they have a unique perspective. And they've been solving coming up with creative solutions for these problems. And so if you ever want to know where there's a friction point or something not working well, go to the nurse, wherever that may be, in the clinic, in the hospital, in school, and you'll find a creative entrepreneur, for a lack of a better word, in those spaces, solving for the problems. So they need to be at the table to be able to bring a credible voice, to be able to be the voice of patients, voice of the workflow within the healthcare system so that we make sure that when we roll things out, new technology is implemented, that we're doing so in a way that's going to be well received and that is thoughtful, maintains the relationship and trust with patients, and it gets the outcomes that we want. So there is nobody better to be at the table to help us transform. And they're also the best ones to help with change management as well, because they're so aware of all the different nuances in the healthcare system.

Molly McCarthy:
Yeah, I think that I always beat my drum that nurses need to be involved in the design, development, and deployment of technology really across the care continuum. So I like how you really pulled in the continuum, regardless of where the nurse is, because they're in so many different settings. The second part of this question really is how do you think about technology as an enabler to make new care delivery models possible, to do what we talked about before improve quality, improve safety, equity, and clinical outcomes, while also lowering costs? It sounds like the quintuple aim to me here, but would love your thoughts around that.

Kristi Henderson:
Yeah, my actually flip your question a little bit because in my mind it's not about how can technology be the enabler? I don't know how we have a sustainable, effective healthcare system moving forward without technology being an enabler and really the whole foundation of it. Again, we're not leading with technology; we're just modernizing and making our healthcare system work better for everybody. And so to get the personalization, to get the engagement that we need, we have to have technology. We use it in everything else in our life. We have to do it here as well to get the access to think about treatment adherence. I'll take it from musculoskeletal where I am now, who wants to go to three times a week to physical therapy for six weeks? If I'm not using technology to allow a more convenient way to actually complete the treatment plan, odds are we're not going to have adherence and completion of that, just like we have with all the chronic diseases. It's fatiguing. So we've got to make it simpler. And that allows us to get behavior change and get better outcomes. All about the technology and scalability. All of those things are going to require that. So I would say we really cannot build a model that's sustainable and effective without technology. It's how they use it. And in making sure the design thinking process that goes into development is one that has all the stakeholders at the table helping to design that so that it actually gets adopted.

Molly McCarthy:
Yeah, I think those are all really good points, especially the technology as the backbone in this day and age when we know it's ever present in every other aspect of our lives. Thank you for that. That's some great insights. I wanted to just move on. We talked a little bit about the ATA, and I don't know if you remember, but I met you back in 2015 at the ATA meeting in Los Angeles. I heard you present on telemedicine. I think it was in a diabetic population, perhaps in Mississippi, rural Mississippi. And you even mentioned you started working with ATA back in 2000. And we know that virtual care has been around for quite some time, even before the pandemic. And as we progress in adapt our models of care, what are your thoughts on how virtual nursing should fit within the broader context of creating a smart care team? To your point, earlier, not just data for data's sake, but providing those insights first.

Kristi Henderson:
Just in general, virtual nursing is really essential. Whether it's the reasoning around workforce shortages, it's just about making a more efficient, effective model. So I think virtual nursing is here to stay. I think we still are at the tip of the iceberg of the possibilities of that. But to your question around, is it just a camera in a room, or what does it take to actually develop a virtual nursing program or any technology integration into the healthcare system? I wish it was just as easy as implementing the technology. We would all be a lot further along, and there would be a lot less casualties and pilot projects if it was just about implementing the technology. But it goes back to minimizing the change management complexity of any of these programs, and virtual nursing being one of them. We've got a muscle memory of how we've done any anything in the healthcare system, whether that's patients and how they schedule appointments and where they go to get their healthcare, or whether it's a nurse and how they do their job. Changing how people do their job to make it easier with technology actually is harder than we think. And once people try it and get used to it, then they adopt it. But I think we have got to make sure and give adequate time, training, and even involvement again back in the product development to gain the traction that we need to. And it's one of the hardest things I ever did with virtual nursing is because people are remote and distant. You lose some of that camaraderie that comes with being in the bunker with your team. And so I used to say all the time, how do I recreate the tap on the shoulder and make a virtual tap on the shoulder, where I can collaborate more organically and have this fluid relationship when it actually takes me stopping and remembering there's somebody in the cloud, I just got to click this button to collaborate or monitor. So just just highlighting the complexity of this work. And when you put technology in, it has a downstream ripple effect on the entire workflow and even how teams work together. So being conscious of that and intentional and building that into your change management project is really important.

Molly McCarthy:
And I guess to that last point there, when we think about change management, and I'm sure you've been involved in so many pilots, as have I, how do you move from a pilot to a bigger scale?

Kristi Henderson:
I think the first piece is, is making sure at the very beginning you're defining what you want to learn and what success looks like. And so if it is a pilot for remote monitoring for diabetes or it is a virtual nursing program defining what success is and if you reach success, what are you going to do next really shows the potential of scaling the project. And so if I think so many times, people will go in and send in a pilot, a virtual nursing program, and maybe they skip what the success criteria are and building the buy-in from stakeholders that if I reach this and we prove this, then are we all agreeing that we're going to scale this to the next level? I think people just get tired and they're running busy all day long. And so again, this takes a lot of energy. And if it's off the side of people's desk, I just think that without that framework from the very beginning, it will be another casualty of a pilot project.

Molly McCarthy:
And hopefully I know that we'll both be at the Virtual Nursing Summit in November in Washington, DC. We can definitely explore many of these issues at that time. I do need to wrap up, though. Just one last closing question for our listeners who are primarily healthcare leaders, CNOs, CNIOs, and their respective teams. And obviously, you have an amazing background. I've known you through many of your different roles, had the opportunity to present with you, and you're in a very influential position as a national thought leader. If you could pick out one practical, important piece of advice for our listeners today, what would that be?

Kristi Henderson:
Well, I think first, be a part of the solution and don't wait to be asked to help. I think that we're all committed to improving the healthcare industry. And I mentioned all this change management. But I would say as you step up to the plate to say and raise your hand and say, I'm here to help, I think bringing that expertise and knowledge of the workflow and clinic and the clinical environment that's so critical for change and the life flow of the patient, both of those are so critical for us to be able to implement technology and be successful. So raise your hand. And bring that expertise to the table so that we can really continue to modernize and advance our healthcare delivery system.

Molly McCarthy:
Thank you, Kristi so much. I love that it reminds me of the growth mindset, really having the ability to think differently. And to your point, step up to the plate. Thank you so much today for joining us and look forward to seeing you soon.

Kristi Henderson:
Thank you Molly.

Intro/Outro:
Thanks for listening to the Smart Care Team Spotlight for best practices in AI and Ambient Intelligence, and ways your organization can help lead the era of smart care teams. Visit us at virtualnursing.com. And for information on the leading smart care facility platform, visit care.ai.

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