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Today on This Week Health.

You think about healthcare, you think about, technology and workflow. That's kind of what we're talking about. The rocket scientist side is like 15%, 85%, getting the people. Be it a provider, be it a patient, be it a staff member, right? To properly utilize a tool to maximize a tool is really the harder part.

Welcome to this week, health Community Town Hall is our show hosted by leaders on the front lines with interviews of people making things happen in healthcare with technology. My name is Bill Russell. I'm creator of this Week Health, A set of channels dedicated to keeping health IT staff current and engaged. For five years now, we've been making podcasts that amplify great thinking to propel Healthcare forward. We wanna thank our show partners for investing in our mission to develop the next generation of health leaders now onto today's.

Welcome to the This Week Health Community Town Hall conversation. I'm Reid Stephan, VP and C at St. Luke's Health System in Boise, Idaho, and I'm joined today by Relo Senior Vice President and c o at Alti Health Services in California. Ray, welcome and thanks for making the time.

Oh, thanks Steven. And thank you to this Weekend Health for including.

You got it. Will you take just a minute, Ray and share just a little bit about Ultimate for our listeners who may not be familiar with who you are and where you are?

Thank you. So, Ed is a Los Angeles based healthcare provider.

We are primarily a Medicaid provider and we really focus in community, community health. We're an fqhc, federally qualified healthcare center, and we've also grown to do managed care senior services, PACE programs. So we've kind of evolved for big F Q H C, providing much needed services in rural and urban areas into more of an integrated Medicaid delivery.

Okay. How long have you been there?

I've been, I only been here five years in January of next year.

Okay. One of the questions I love to ask guests on these shows is just to share a bit about your own career path. Take just a minute and for our listeners, share your education background, your career journey that led you to where you are today.

Well, thank you. So, , by classical training, I have two degrees in engineering both from the University of Southern California. I actually have an electrical engineering degree. I also have a master's in engineering management. Early in my career I worked in aerospace, so I was actually a rocket scientist and moved to the first.com era.

Okay. A rocket scientist. You're the first one that I've interviewed on this show. So a question for you. At UGM Judy had a t-shirt and it said, HIT is like rocket science only harder true or false?

Ooh, that's a good one. It's. Ooh. I think it's harder. I actually think it's harder in rocket science I gotta think about like lunar landings and going around the moon. All that stuff they're talking about that Elon Musk is doing. Again, they have very defined physics and math that define the ellipses and how you do things around there. And there's not a whole lot of change management. In terms of, you know, you, figure out what you're gonna do, your launcher, your satellite, your rocket, and off you go and all your telemetry gives you the information.

You think about healthcare, you think about, technology and workflow. That's kind of what we're talking about. The rocket scientist side is like 15%, 85%, getting the people. Be it a provider, be it a patient, be it a staff member, right? To properly utilize a tool to maximize a tool is really the harder part.

So I would say I agree with Judy, right? When you look at how do you make people be effective with the technology versus doing like a pure technical kind of discovery analysis perspective from.

a rocket science point of view

That was awesome. I was just looking for true or false, but like that was a great answer. So thank you. Well done.

Okay. Let's talk just for a minute about FQHCs. I think you're an expert in this space. I am certainly not. Can you just share a little bit more about what those are, why they're important? Just help our listeners who aren't familiar with them get a better sense of what it means.

Sure. So, FQHCs, so it's answer, federally qualified healthcare.

As the e l A free audio clinic cuz there were no health services provided here. And we've grown right to provide services to anybody and everybody independent of their ability to pay. Mm-hmm . So if you have a need, you can come to an F Q HC and you can be treated. And whether you can pay or not be paid, you will be treat.

For, primary care type of services that are around, we cannot turn them away. HRSA oversees us, right? And we receive HRSA grants to enable us to provide both primary care as well as dental type services to these most needed community members.

Okay. As you're describing that, I just think of health equity and I just love that what you do helps to provide for that.

But then I also think of, especially in this time when a lot of us are financially, there's headwinds we're facing, what are ways that you're using technology to deliver on the quadruple aim, but also to be viable and to make sure you have margin to continue to provide that?

equity

Yeah. So, I gotta go back to the pandemic, let's say February 29th, 2/29 as a date of a pandemic in there.

many FQHCs , we didn't have elevated technology. We did not have mobile engagement platforms. What we provided is we provided. access To patients in the community. And then what Covid and the pandemic allowed us to do is we had to move to a mobile platform, a digital first strategy.

And so opening up the availability of digital to underserved low income, non-English speaking the essential workers. So, we've all read in a press about the folks that could have been a poultry plant manufacturing plant, they have to make a decision, right? Am I going to go to work sick? And not make money and not be able to put food on my table, or, what are the choices around there?

So I think that through the pandemic, through the technology advancements for instance just telehealth which is so pervasive now, really provided a lot of access to people that were in need. That is the first part around there. I think the second part on FQHCs is we're fortunate that we're able to have Epic.

And that we're actually able to raise our quality and our quality measures in there and our CMS ratings and how we're doing in overall he measurements how we're doing in outreach, how we're able to text folks we use patient engagement strategies that include photo telenovelas So when we're asking a native Spanish speaking person who may not understand why you need to come in for colorectal cancer screening, and we're able to simply send out really, it's like, it's like a comic that talks about it and educates them about why you need to engage.

Right? It's, it's much easier for them to understand, right. And able to communicate. So again, you just go back three short years ago, we weren't doing that and we're doing that now, You know, from a provider perspective best practice alerts that are out there, being able to do population health alignment.

We've move. In terms of transitions of care, of having our hospitalist programs define three levels of, service. As you know, our patients are leaving the hospitals, whether we see them once a week, two weeks, or four times a week, whether we implement remote patient monitoring to them as well, so we can monitor them for C H F or C O P D, so we can really move much further ahead in terms of intervention and quality care. 📍

So as you're describing that kind of multimodal digital front door, that method of access, have you had any challenges with that underserved community that you reach out to? Do they have the devices and the, broadband they need to take advantage of that? Or how have you had to kind of bridge that gap potentially?

Yeah. I think everybody's talked about the digital deserts that are out there, and I think that they're misnomers that folks have that low income people don't have cellular devices. Mm-hmm. , the answer is that's wrong. Okay. Okay. If you look at a homeless person on the street, Odds are, they probably do have a cellular device.

They might have a, apple iPhone 14. They may only have an Apple four. Right. And they're gonna kind of jump on and, and be able to communicate with them in there. So I, I think that's one part in there that folks are connected. , right? They may not be video rich connected mm-hmm.

in there, but they have the ability, to text and do some talking, texting around there. The other part when you talk about on the digital desert and kind of like the broadband and the broadband bills that are out there to help people for the different carriers and centers that are provided in there.

It's all well intended, but it's really interesting because as those are rolled out, there's like a small fee and then there's a tax in there. So it's not. always free in terms of what's happening, but you kind of gotta take it back to be able to communicate, with the patient in there, by being able to call them, do a telephonic video versus them having no alternative or going to the ED or, intervention.

It really, again, helps to close the health equity gaps. If I can give you one other example. Yeah. On there in California this year, they launched a program called Cal Aim and ecm, which is enhanced care management, and it's really tied to Medicaid patient population and the top five utilizers in them.

And oftentimes they're homeless. Mm-hmm. They've multiple chronic conditions. They have behavioral health issues, they have drug dependency issues, and how do you find that patient Popul? , how do you serve that patient population? Right. And, and so, Alameda Health in Northern California, ultimate in Southern California, we're actually moving forward with care management and with our doctors in order to reach the patients.

And honestly, a lot of it's through telephonic calls. Right? Yeah. And then how do you, talk to them? And, it's a very hard patient population, but you have to be able to reach out to them. And contact.

Yeah. So last question. As you look to the future, what technology or innovation are you most excited about that you think is gonna really move the needle to allow you to enhance the quality of care and the reach that you provide today?

it's really gonna be how do we utilize our data? I, I think kind of engagement tools are defined. The messaging the MyChart availability of the portals around them. But I think where the gold is really is in the data association of the data, both acute ambulatory and they're doing the predicted analytics in.

you know, The ability for us to be able to understand who the patient is before they come to us so we can intervene with them more quickly and to monitor and manage it better. So to me, I'm looking at how do we actually utilize data better in there and how do we actually do that to intervene with the patient before they get there and have the outreach and then how do we also put that data and then information at the fingertip , the provider.

Great. My guest today has been Ray Lowe, who's the Senior Vice President and CIO at Ultimate Health Services. Ray, thank you for all the great work that you're doing there, and thank you for taking a few minutes here this afternoon. I appreciate you.

Thank you, Steve. That's great.

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