March 31, 2023: City of Hope has been advancing cancer care treatment while maintaining the intentionality between care providers and patients. CIO Beth Lindsay-Wood shares what things have been like since the acquisition of CTCA, how they manage high-quality care across varying regions, and the versatility of the CIO role. How can hospitals improve patient engagement and experience, specifically for cancer patients? How does technology play a role in this process? What strategies can hospitals employ to ensure that they are actively engaging with potential patients and monitoring their progress through their cancer journey?
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Today on This Week Health.
(Intro) that's really the whole purpose of it is that this is what we do all day every day.
We're not primary care, we're not cardiac, we're not those things. Right. This is our focus 📍
all right. Today we are joined by Beth Lindsay Wood CIO at City of Hope. Beth, welcome to the show.
Thank you. It's a pleasure to be here, Phil.
Well, I'm looking forward to it.
We've known each other for a while now, but this is the first time your a ctually on the show you've been with a lot of different health systems. I think the first time we met you were up in the Northeast.
Yeah. Atlantic. Yep. We were
Atlantic. And now you're with City of Hope you did the interim for a while as well.
You did a couple different health systems. Give us a little bit of your journey into the CIO role and how it's taken you across the country. literally
literally. It all started back about 30 plus years ago when I was a computer operator, so at Tampa General.
And was promoted three days in to a supervisor. So my passion for healthcare, and it really stems way back to early in my career. As time went on, I was given more and more responsibility, changed my major in college did all those things to really focus on it. From there, to be honest I was at Campus General for quite a while.
It was public hospital back then. Very challenging from a cost perspective. And went to Sentera Healthcare, which was rapidly growing health system, very large. Now, I was there for about 13 years as the second in command to the CIO running all the provider side, just not the payer side.
So I was there for 13 years and believe it or not, was then asked by Tampa General, which had become private was doing very. In terms of growth asked to come back there as the cio, which I did and stayed there. Up until that point I'd already done two epic implementations.
Then after campus generally decided kids were grown. I would go into consulting and became a partner in a consulting firm, Lenovo, and did that for about five years. Stanford Atlantic Health. I actually did Moffitt at the end and spent time in City of Pope. So I was able to, although a partner, also do interim or executive consulting, which gave me some great perspective on how other organizations operate, having been kind of isolated to two over a period of, 20 years, something like that.
So that was great. And then I ended up as an interim at Moffitt cancer Center and loved the cancer environment from when I did a year and a half out at City of Pope, helping Mark Pulse. And then at at Moffitt, decided to lead the practice and be the CIO at Moffitt. Then got the call about city Hope cio.
Working again with someone I've worked with for quite a while over the years and said yes. So I've been there about a year. It's a long road of a lot of different kinds of experiences in different kinds of settings for healthcare but remain very committed to the healthcare.
love being able to let you tell that story because people are asking me all the time, what does it take to become a cio?
And sometimes it's just being in the right place at the right time. . Other times it's a lot of preparation leading up to something or being the number two at a place for a long period of time. And I'm finding that to be more and more the norm these days that we're seeing the number two they may not be able to be the CIO in their backyard.
They may have to move to another city in those kind of things. But we are seeing a lot more of that city of hope's. Pretty exciting. You guys have a lot of stuff going on. Tell us about City of Hope. .
So City of Hope is based in California near La but have grown very rapidly. And we are currently four hospital cancer hospitals across the nation with the recent acquisition of cancer Treatment Centers of America.
So we now have regions in Atlanta, Chicago, and Phoenix as a result of that recent acquisition, but we also have another affiliate or fully owned, but organization called T, which is translational genomics based out of Arizona that does a lot of genomic laboratory work, but also high-end genomics.
They do a lot of number crunching for us, but they do a lot of data components for us around genomics and running through. All of the different kinds of discoveries we can make as a result of that. So it's a great partnership with our research arm, which is based again, out of California.
And we have a large research organization very focused on cancer, but we also have diabetes and some other areas where we do explore research. Doing a lot of discoveries generally in that. Really looking for a cure. So that's exciting for me as well in terms of just being part of an organization that really has that complete circle of the clinical component, the research piece, and feeding that back into clinical.
It's that real world evidence that we can use to help. Again, the core campus is in Dwak. We just built a nutrient center down in Orange County. We're in the throes of building another hospital down there. We have well over 50 sites that are physician practices or ambulatory type facilities, growing a multi-story ambulatory facility on the main campus.
That construction agenda for us is very large. Our growth agenda also very large in terms of how it needs to support some of the major work that we have, major investments we have over the next few years.
It's amazing because the growth aspect of it is interesting. The research aspect of it is interesting the acquisition Cancer Treatment Centers of America. There's also a patient experience aspect and also a national aspect to the work that you're doing. I mean, there isn't any aspect of the CIO role that I don't think you have. Sometimes when you talk to a academic medical center, they have certain things and or an idea and they have certain things.
City of Hope seems to be really heading in, in a lot of different directions.
Yeah. We also have academic, by the way, so that is part of the whole mix. I think the exciting thing for us is that and our CEO will say it as is democratizing cancer care.
I think that the exciting thing is that with the acquisition of ctca, we can now bring our high end cancer treatments out across the nation instead of everyone having to travel, into California. We also can offer these services out in several of our current locations. And I named some of those.
They're big areas, lot of population. That now will not have to travel to get very high and clinical trial treatments of bone marrow transplants, cellular therapies, those kinds of things. So it's exciting to us that we can offer that out further across the nation, which is unique.
We don't have a lot of NCI designated cancer center that I'm.
This might be a tough question for you, but what are some of your top priorities as the CIO of City of Hope?
Well, if you're talking about right now, I would say that we are in theros of the integration with CT c a and candidly Tigen as well, trying to bring sort of a system view to all of these different components.
Rebranded ctca A to City of Hope very recently. So we now are looking at, in my group specifically, most of the shared services are looking at that integration. So we are actively integrating the teams. In some cases the systems, although that path forward that it's complex and we'll take some time.
But we are in the pros of putting them on our epic m r for example. This year. So I think that very focused on what is our new operating model for it going forward? What is our vision for our future state? And then designing and developing the org structure to kind of leverage both strengths of both groups, but also.
Look at transformation of it and how we deliver, rapid accelerated delivery agile, all those kinds of things that we wanna be able to do. We may not be able to do it today because we have to do this integration, but that's the goal, is to kind of move to a new operating model. So that's a big one, obviously.
We also have that same thing going on across the organization in terms. , some new leaders coming in and looking now at what a refresh of our strategic plan. So we expect that there will be some good work in there for it. But growth alone, just if you think about some of the major projects that we're talking about that are opening either this year up until 25 right now.
And the rapid expansion that is intended. It is a huge lift for it get through that. While we still need to look at advancing across all of the, those entities, things like consolidation of e r P, consolidation of CRMs, all those kinds of. . And while we're doing that, looking at from an organizational perspective, what do we need to do differently even on those platforms?
So if you weren't even including the operational projects and things that people want to get done, there is just a huge, massive lift. And the challenge for us is obviously how do you source that? How do you manage that? All of that work at the same time. And so we're working through that.
One of the things I want to touch on with you, you have a lot of EHR experience, and while it's not overly flashy to talk about the ehr, there's an awful lot that integration you're talking about CTCA a so those are now branded City of Hope, is that Yeah. Yeah. So what do we call that? Like City of Hope?
So we now have regions, and part of my new model actually in it a regional model, but the regions are City of Hope, Atlanta, Chicago, Phoenix, orange County, and la. So we have five regions. Within that piece we, and Tigen is still kind of marked separately. It's based in Arizona as well.
But but it wouldn't be considered part of City of Hope, Arizona. That's more the patient care aspect of those. regions. So, we of course have to do acronyms because that is the way we are, but, so we say City of Hope pack for what used to be CT c a now, because it's kind of a mouthful to, to say all that together.
But we'll all get used to it, over time.
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So let me ask you about just the EHR aspect of it now. Cause it's, you've done a bunch of these. What will lead to a successful. Transition of the treatment centers over to a, let's call it a city of hope build i, I don't know if that's the right word, but Yeah.
It's a good word, bill. So I would say a couple things. One is the reason we did this early, we did it before email, we did it before back office. So the first thing we did was emr. Add some complexity that we don't have infrastructures together and those kinds of things. The reason we did it is because we wanted to deliver those high-end services, and so it's important to be able to put out I will call it our cancer platform, right?
Because even though it is a vendor platform, we have designed it for cancer care complet. Again, high end clinical trials, all of that is built into the epic and again, bmt, those kinds of practices are there. And those were all designed and developed by the critical physicians and researchers that we have that specialize in those things.
So I think from my perspective, putting that out there. At the same time, we're also looking at how do we expand clinical trials using that technology early rather than, they didn't have a system that could possibly, build out any of that. And it wasn't a cancer platform, so this was the main reason why we did it.
So the success for us is obviously, an implementation. Creates that systemness in terms of sharing patient information, putting all of the genomic data, again, more real world evidence for our research side. But a successful implementation, as we all know it, is you're up and running.
Effectively you're back to productivity. Your physicians are engaged in using system, all those things. Yeah. That's like cable space, right? That's an expectation. that we all have and our goals are written that's assu assumed. It's really these other pieces of what we intend to deliver as a result of the technology that we're focused on.
It's really interesting. I mean, cuz when you put City of Hope on the building, you put that placard up there there's almost a brand promise, right? I am engaging with City of Hope, which has, and having served in Southern California I know is a phenomenal brand. and a phenomenal institution in that market.
But now that you're taking that national, when I see them in Florida, my hope, and this is what you're describing, is when I go in there, that same rigor, that same process, all those workflows, all the research that's incorporated in Southern California will now be incorporated around the
And it isn't as simple as sound, right? Because you have to have the right physic. The right nurses to be able to conduct research. So it isn't just you can acquire something and just start doing it. There is a ton of work that has to go on to make sure that we deliver the highest quality of care for the, for these high end treatments that we're doing.
So we have to build that out in every place we go to make sure. It's local and that all those skill sets are there so that we can do it the way it's supposed to be done. Right.
So, yeah. Talk to me about data. So when you have the research side, you have the academic side, and obviously in cancer care the research and the data is so important.
You have to consider building out a data platform? Or does the EHR provide enough of that or is there a data layer even over and above that?
Yeah, there is we've done a pretty good job of using Epic, not as the only source obviously, but really building that out with a lot of data that we need right.
When we get to the research side. We do clinical trials and they're a hundred percent, it's not manual in any way, which it was where I came. So all of this kind of stuff is built in, but we can't just use that's part of our research side. So there's a lot of other sources.
We partner with another firm on our, what we call Poseidon, which is our precision medicine platform. And that allows us to bring in data from different sources, not just our own patients, but other genomics data. We have partnerships in other countries that want to use that platform and for us to provide, again, kind of that democratization of cancer. Where can we help them with the research that we have to, further their expertise in future care.
It's nothing that we own or have any part of, but can we provide some services to them? So it's really taking that data and using it not just within the United States, but outside of the United. So they too can share their data, right? And so we can further analyze and look at social determinants of health and other kinds of things.
That will help us to look at what is precision medicine? It's really looking at what is the best treatment for me based on a number of factors. Genetic spin one, but not the only.
We could go down the path of precision medicine, talk about data for a while, but I've also been following the expansion of City of Hope from your location, which is really in LA down into Orange County.
And it was interesting to me when I was with. St. Joseph Health we saw about a third of the patients in Orange County, and we had the data and it showed how many people would leave Orange County to head up to la right? Because it's not only City of Hope. I mean, UCLA is up there.
There's a lot of a great institutions up there, but they would essentially say, you know what, when it's related to cancer, I'm gonna go to. A specialist and I'm gonna go to, whatever the best cares I could possibly get your movement down into Orange County. That was incredibly strategic.
And I would love to talk about the business aspect of it, but I also wanna talk about opening up a new facility. and the challenges that go along with opening up a new facility. I assume you open that facility, it's already packed , and now you gotta have to grow. So talk to me a little bit about that process of opening that up.
So the cancer center is not inpatient, but it certainly looks and feels like inpatient that we've already opened and that happened last August. So that was a big lift for all of. . And I think to your point, it was the beginning of creating a different model. Our hospital, Onar Bay is Chaka Block full.
I mean, we are full vocal. And so the idea was to, again, it's sort of that move to outpatient or how can you get closer to where the patients live and provide a lot of their treat. . And So in Orange County, what they're seeing and there's an interesting twist on this that I'll get to later on C T C A and their patient acquisition strategy and how that's made a big difference.
So the idea was to provide that care to patients. And so we're bringing up bone marrow transplant, for example. Now they opened, they, we, we had a lot of basic things to work through, but now we're really looking at what are those advanced. Treatments that we want to be able to offer. And so those are the things that we're kind of implementing.
Now, I've done more than my share of major construction, new hospital construction. So it is always a challenge to go through there. It's very interesting. In Orange County, we are using a lot of what we're calling Greenfield. So, new and novel technologies down there that we don't have on the main campus.
Because as you're building a new facility, you have that opportunity to build out, technologies the core in terms of how you design it so that you can now bring in new technologies rather than trying to retrofit. We do have a lot of very interesting technologies down there that we don't have anywhere else yet.
Hopefully we will be able to do that, but there's been a lot of interesting tech partnership as we go through that as well. , I'm grateful that one is up and running. Well, it's beautiful. It's a beautiful building and right next to it is where we're starting up the hospital now.
So again, all that we learned from the cancer center and then how do we now expand that into the hospital setting right next to each other? It's just great because, it's sort of this one central area where you can get both inpatient and ambulatory treat. . And to your point about the people traveling, you know that, I mean, if you have friends, a lot of 'em will say, look, I'm gonna go somewhere else, this famous place to get that because I'm more confident that they have all the things that I need.
We have a lot of very thick cancer patients that come to us and in some cases they're referred from. Facilities or hospitals because they need that kind of a clinical trial that just isn't available anywhere else. Right. So that's really the whole purpose of it is that this is what we do all day every day.
We're not primary care, we're not cardiac, we're not those things. Right. This is our focus and there is this very small group of NCI National Cancer Center. Organizations. It's not a big long list. Right? It is a designation that exists because there's cancer center grants that come in They accreditation, it's like getting an accreditation for most hospitals. IT, joint commission it's like that but much, much more intense. So there is a lot of work that goes into actually getting that designation a lot and it researches a key piece of that. ,
you know, Beth Theresa Meadows was at one of the recent events that we put on and you talk about all the new technology and they had just built a new children's hospital down in Dallas, and she was sharing the pictures and all the thing.
It's amazing what you can do with Greenfield. I wish we had the opportunity to rebuild all these hospitals, but the reality is they're almost Frankenstein at this point. It's like the main building was the main. and then they connected this. There was some of our buildings that I would travel through and it was almost obvious to me that it was like seven different construction projects that I just
I mean that's true. I, when I was at Tampa general, the original building is over a hundred years old, and in some cases that's what it is, and you add on and you can tell because you have to take this elevator when you're on this floor or whatever it might. So it is wonderful to be able to start from scratch.
Hundred years from now, people would think, that we weren't thinking it all the way through. No. But you know, for now, I think you just always have to take advantage of that. And then, if you can, you do that and again things are gonna change. It's funny that I look now at our wireless technology where you can do R F I D with that, and have missed.
And so it's just amazing the kinds of things you can do just with. and you can retrofit some of those things, right? So some of that helps with what our future vision is. But it's not as easy as it would be with a new facility. So,
we'll get back to our show in just a minute. Having a child with cancer is one of the most painful and difficult situations a family can face in 2023 to celebrate five.
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So you mentioned patient acquisition.
I wanna talk about patient engagement and experience. When you're talking about cancer patients, these are people you want to stay connected with throughout the entire experience. You also want to let them know what's available. There's obviously some technology aspects to making that experience better.
Talk a little bit about maybe some of the things that you acquired through the ctca. Acquisition and then some of the things that you're viewing moving forward to make that experience better.
we are expanding that. Right now across all parts of the organization I'll describe, it's not all about technology, there are many things that they do well, but one of the things they're known for doing well is this patient upfront engagement.
the way that it works is there are people it's not using chat g p T or anything else, it's really about just people that are reaching out. If people hit the website, whatever it is, they are reaching out directly to those people with a call and letting them know, what services we have.
So it's that very active engage. and then it's really looking at the entire process of navigating on the front end to become a patient. And every step of the way, there are navigators and people involved in directly reaching out and they're watching, they have a lot of data where they're looking at where that patient is, where the future patient is in their journey with us, and making sure we stay connected because a lot of.
people could be shopping and then move on. But the idea is stay very close to them and monitor that and make sure you stay connected all the way into their first appointment. And then you're monitoring post that they've stayed with you, that, from an experience perspective, that we've done everything we need to do to help them with their cancer.
So it isn't, it is a front end process to look at the best way to bring in patients. But then also keeping the data on,
I love that because if myself or somebody in my family had cancer, I'd want to talk to a person. So I think that, Is listening to the community. I'm gonna push on the technology again one more time cuz it's I know there's not automation per se, and it's not chat g p t, but I assume you're tracking all that stuff in a CRM somehow and making sure that all those touch points are tracked and followed up on.
Yeah, we are doing, and both on the marketing acquisition side. , but also in that patient contact piece where we have those folks that I'll say their whole job is to do nothing but stay in contact with the patients and help them navigate best. We're the best place to get treatment now in this bigger system.
There is there's CRM behind there, there is integration with our EMR to keep track of what's going on. There's a lot of automation and marketing and so the CRM is also used there for marketing campaigns, but also keeping track of where we are on the acquisition side.
So yes, there is a tone of technology behind this. We have sms, we have all those kinds of tools that help with reminders and staying connected. But the deal is, , the one thing that they bring is that person, all along the way, the navigator, so that we stay that, with that personal connection.
Cuz to your point, when it's something like cancer, you don't wanna, press button seven, or get a recording and be redirected to something. . It's not just that they can call that number, those people call them, so we keep that contact. And I think what we saw when Orange County cancer Center opened up, we used that model and the number of patients that we received increased dramatically over what was expected.
And it was not taking patients from Duarte, from our other cancer center. , it was not, what we saw was net new patients that were now coming into that, to the cancer center in Orange County. So that was wonderful, right? Because that's a win for the patients and for us that we're not just saying, well, we used to go to eduard, now you don't have to travel so far.
And that's a net, nothing, right? In terms of increase. But there's the convenience and experience factor. , but it's really saying we're reaching more patients and that's what we're trying to do.
Yep. I love the, being visible and being accessible. Access is such a key part to what we're trying to do.
When I hear you talk about these things, I'm wondering, do you have a consolidated call center or do you have multiple call centers at this point?
So for that new patient piece before they become a patient, and then you're scheduling. Tests and things like that or visits,
it is moving to a central call center. We will be doing that. We've already done it for some areas in Southern California, but by August, once the everyone is up on Epic as well, that will be done, across all of City of Hope. So that's exciting. And again, I think what we're gonna see.
Increased activity both in the other states I'll call it, but also in Southern Health. So don't tell Providence, I'm just kidding. ,
The thing I appreciate in talking to you is one of the things I tell people about the CIO job, they all ask me about it. I'll say, hardest job I've ever had.
They're like, why is it the hardest job? But like, I mean, you have to be an expert on call centers. You have to be an expert on genomic research. You have to be an expert on data. You have to be an expert on the ehr. You, I mean, it just on any given day, you're called into a meeting and they say, Hey, we need new systems in our food service portion portion of our and you're sitting there going, oh, okay.
There's another area I've gotta. Figure out what it looks like to have point of sale machines and track those kinds of things. And you've covered so many topics today and we didn't even dive into them really deep. But that's the nature of the role that you're currently in.
Yeah, it is.
The role of the CIO is changing over time. We need to know operations, we need to understand. How it works. So, I remember at one point being asked if I'd be willing to take a hospital administrator job in one of my places. And I said, no , but you end up knowing so much about operations when you're in it because you have to, that you have to be able to stay current, not just on what's happening in technology, but what's happening in the hospital.
industry and it is ever rapidly changing and cancer care is certainly rapidly changing. So it's, it's fun. I love it. It's challenging. But you have to stay current. You really do. Yeah.
Well, let's close with this. Tell me about your background.
From when I was a child.
No, this background on your screen.
Oh, okay. So this is called the Gold Gate and it is on the Dote campus. And it is one of the key things that we have as a basic tenant of what we do every day. And what it's saying is, there's no point essentially in curing the body if we've destroyed the soul. So Sam Gold is the one that came up with that phrase.
That's a gate that we have in the gardens on the DTE campus. And the intent of that is to, obviously we're trying to treat the whole person, not just the cancer. And that makes it a lot more challenging. We can't forget the rest of the person. And when we do this so
well, Beth, I wanna thank you for your time.
It's great to catch up with you again. We'll have to keep in more contact than every other year or so. It's yes you have a lot going on. I'd love to stay in touch and hear how things are progressing.
Great. Well, I appreciate it and I would love to do that. Thank you for having me.
I really enjoy it. Thank you. Take care. Take care.
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