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TownHall: Healthcare Without Borders and Empowering the Patient with Tracy Elmer

Tracy Elmer: (INTRO) We don't want to be geographically limited. Distance should not be that barrier to care. And so it really does help us bring the service to those who in many ways need it the most

I am Sarah Richardson, a former CIO and President of this Week Health's 2 2 9 community development where we are dedicated to transforming healthcare one connection at a time.

Our Town Hall show is designed to bring insights from practitioners and leaders on the front lines of healthcare. All right, let's jump right into today's episode.

(MAI N)

Not a barrier to quality care. Tracy, welcome to the show. Thank you so much it's an honor to be here with you and just catch up. Well, and thank you for saying yes to the interview. Heck, it was only a couple weeks ago. We were in San Diego together for a city tour dinner, and we sat together, the only females in a room for about 20, and I looked at you.

I'm like, I have got to interview you for our talent series. I appreciate that so much. Well, I love what you're doing at True Care, and I do wanna jump in to digital literacy initiatives because that is a continuous conversation. Yes. You have implemented robust programs to assist your patients in navigating virtual care platforms like MyChart.

Can you elaborate on the strategies that you've employed to enhance digital engagement among patients, and particularly those Tracy with limited technological proficiency?

Just general technology and digital literacy. And, we found early on that our adoption, you know, was slow despite our best efforts. And we recognized that education was really key. And so we created a new pilot program and we introduced it first to our Golden, we call them our Golden Years group, which is a group of seniors who only speak Spanish.

And so we built five sessions that was all about the basics of just navigating with digital. Tools, whether your iPhone, even your computer. And we taught them the basics of logging in, doing, searching. And then eventually through our five core series expanded to tools like of course MyChart, which was really a keen focus, but also just general Zoom and other tools we use for connection with care.

the empowerment they felt that someone was investing in them and their wellbeing beyond their health, and it was just very powerful when I could see firsthand the power of how we are using technology to connect with our patients, but more important, really, again, bringing them into our culture.

meeting them where they are and assuring they feel like they belong and that not only that they're empowered to just take the lead and not have to rely on others to help them so it was a very powerful day and afternoon. We've really seen great success and are continuing to roll that out.

How to log into MyChart, activate it, what features they can leverage so that's also been really helpful. Again, taking the education to them as opposed to just relying on written message, YouTube videos you name it but it's been very successful and we were very honored by our partner OCHIN, to be recognized as an Impact award winner last year.

Again, that empowerment, bridging gaps to better health. So it was very it's work we're very proud of and honored to be able to deliver.

Sarah Richardson: How have you found the adoption of the usage of the portal and the ability for that population to really facilitate the right care coordination and conversations with their care team since you've been adding the extra layers of digital literacy education?

We've plateaued just under 70% for active patients, so we're endeavoring to keep going. But I think we've certainly heard about convenience, right? And it's all part of experience, which is a big focus of course, but really understanding how hard it is to wait on a phone line, on hold, or.

Wait and work through things that if you could do it at the touch of your own, device in front of you within seconds it's just very powerful way to assure you get that appointment when you need it, that you've sent that message to your care provider of something you woke up worried about.

all of those different aspects of it have really been really deemed very effective and impactful for our

[Mic bleed]

Sarah Richardson: I love hearing what you're doing for the community in that aspect, because as the first FQHC in San Diego County to launch Epic. Yeah.

What were some of the key challenges and successes that you found during this transition? I.

But outside of that, I think for me, coming into the organization, brand new, having worked outside in the healthcare health systems that are much larger. I could see immediately they embraced change and innovation, which was beautiful. I think though there was some fear, normal anxiety, if you will, with change.

And really, once we got through that initial aspect of just change management I think the challenges were certainly the timing. We had a couple of different delays because of good, fair reasons with the pandemic, and we ended up going live virtually. So we didn't have anyone from OCHIN onsite with us.

So that was a whole new model for supporting, all of our different sites and using Zoom right as our base, like Zoom rooms for all the different support needs. And I, I will say it was quite innovative and it actually worked quite well. But as you know, like there's nothing that replaces the power of human connection face to face in the same rooms.

They have special teams, channels where they can reach out to our informatics teams. They are part of monthly trainings. They help with the monthly investment of training we do for all. So that, was really one of those key successes that a, it really arose from a challenge where we couldn't have the same service and support model for our go live.

So. Already wanting to rely on super users, it leveled it up even more and it's really proven to be very effective since. So lots of great things that have come since those days. So we're excited about where we are today and really now going into the next layer of innovation, using that as our platform, or having Epic as our

[Mic bleed]

Tracy Elmer: Yeah. It's pretty powerful right? It certainly gave so much of a confidence boost, right? To those who have either. Not been through such an experience before. But it really helped everyone lean into what will our business practice look like. We've gotten through all these things, we have much on our strategic plate to accomplish, and it really helped us lean into really the structure of governance in creating and defining a model where we hope for ownership and decision making at the level of folks who are doing the work every day.

it was all about our partners in the workforce and them really just going forth and wanting to do more. And again, the confidence was there because they went through a lot of hard things together. But then the structure was in place to really allow for that to continue to scale up and out in a really good quality way, right?

Not just getting things done to get it done, but really for really meaningful reasons and with a really highly effective quality approach. I.

Sarah Richardson: And you've done so much for the community in terms of how do you continue to outreach the mobile wellness units. You introduced those expanded access to care for underserved populations.

How are some of the operational aspects of the community impacted by these results?

[Mic bleed]

And while you have other innovative ways to connect, there's nothing again, like the power of taking care to people. And that's really, for us, the mobile program takes us back to our roots. TrueCare started 50 plus years ago. Out of an RV where we would take out, a provider and some other folks out to where folks were working in the fields and the farms and providing vaccinations, providing, wellness checks.

And so it's kind of neat to, to still have that be part of our. Today, but even in a more expanded model and making sure we're delivering both dental as well as medical services out in our community. And we've been really blessed to have wonderful partners who want us there, who will just set up space in their parking lot and advertise.

In those, you know, other unique mobile ways.

Sarah Richardson: You've also recently opened some new health centers. Yes. Expanded services. It has specialized care for older adults. Yeah. How do these types of developments align with your mission and address the community needs?

Tracy Elmer: Great questions. We are so proud and we, in fact, just this week opened up a really new, we call it a new hub of healthcare at our new Vista Way location, where all of our different services come together on one campus and really allow for, again, that convenience of access.

Yes, primary care is where it starts, but specialty care is where and how we continue to intervene and create other supporting services for our patients. And really, again, it goes back to that mission, right? We wanna make sure care is comprehensive, that we're, again, providing that in diverse locations and really focusing on innovative approaches as we go.

Again, we talk about the barrier of transportation. If we can make it easier for them to get there, not just from primary care, but having a dental service even same day potentially. Or if they're receiving care for pain management interventions like acupuncture, that too can be offered on the same campus in the same location.

And certainly looking to our older adult community, we know that we have an aging population, right? And so we are really looking at , what do we need to do to create a more. Specialize isn't the best word, but, unique care experience for them, knowing that there's different needs that will arise with our aging population.

So sometimes it's just as simple as schedule alteration.

Sarah Richardson: Which is harder to implement than most people may realize. True. Being able to create the right scheduling componentry for your physicians to see the patient types. I always figured like physician scheduling and patient scheduling, it's actually one of the trickier things to get right to maximize in an organization, it's not just cut and dried sometimes,

Tracy Elmer: [Mic bleed]

Sarah Richardson: I also love what you do for workforce development. You emphasize professional growth and the cultural humility that's required to serve your populations. How do these values translate into patient care and also the overall culture of the organization? I.

Mantra of taking care of them means we're taking care of everyone. And so I'm very proud of how we've invested in our workforce growth and development through the years. We created a very special focus two different employee led committees, true belonging and wellness within and really focusing on the importance of belonging, right?

Understanding that we believe if folks feel like they belong, that they will, really feel that they can be their best at work. They bring them best selves to work and that transcends beautifully into the patient care experience. And, we are really fortunate to have a strong culture that we define as building great relationships.

And we've certainly seen such a beautiful response that we, you know, of course measure like most organizations, that really shows how valued people feel. They do feel a place of belonging. They do feel safe right? Every day to come to work. And they feel like they're set up for their very best, you know, to do their very best.

And we know how that can then translate to the very best and how they, they, work with our patients and deliver the care and all the support of it

Sarah Richardson: and how employees talk about their employer, it gets out in the community. People know if you're a great place to work, if people are happy working there, right?

They have careers and longevity and the ability to really connect, which really dovetails very well into your community partnerships. Yeah. You've got collaborations such as fresh start surgical gifts, and that's expanded your reach. How do these partnerships enhance service delivery and community engagement?

And I think that some of them, for example, we're very proud of our feeding San Diego partnership without them, we would not have the means to bring food, more food security, and we do food distributions weekly from multiple sites. Without that partnership, we understand, again, when you consider all the social determinants of health, every partner that we have helps us to mitigate the impact of those to assure

Even as I spoke of earlier with our mobile health, if we didn't have partners who said, yes, come and use our space within our location or on our parking lot. We have, partnerships where we actually have opened a small clinic. So for folks who are in the most vulnerable of situations, such as with Casa d Paro, they're afraid to leave their homes.

They're afraid to leave their safe space. We now have created a model of care based on that partner bringing us in, where we've created a beautiful space that they can come and feel safe and trust. Right? And really, if you think about trust in healthcare is critical, but then thinking about how that helps build their trust again in life and others wanting to help.

It's just powerful and again, it's really that fabric that of what community health really represents. That's, exactly how the meaning is interpreted right into this beautiful place of folks coming together again to create better health and wellbeing for everyone.

You think about, you get to see the real time impact every single day on what you're doing for your community, how you are changing people's lives, how in a time of absolute uncertainty, you continue to create a safe space to things that matter the most to them. How do you get to share that with your team and see the impact that you all are having?

'cause sometimes in IT or a few steps removed from the outcomes for the patient. And yet I have to believe at TrueCare you're able to wrap all of those aspects around to share.

Tracy Elmer: we've really been intentional, right? It's a thoughtful, intentional process to assure that while we're in the business of taking care of those, taking care of our patients, we can never forget our why.

And not only do we bring key messages and have program updates from all these different areas that we receive as a leadership team, we then document those and assure we're huddling with our teams and sharing and really are very fortunate to have a partner that has really helped us create some beautiful imagery and videos right, about the impact of our care, which you may have seen on our website.

Those are all accessible and available to our team as well. And I think, it starts with us as leaders, right? To really define working with our team to define our core mission for what services we're delivering to support that of the larger, and you know, I think just there's not one person on the team who doesn't realize or recognize they're having an impact on the patient care process.

And it's something that I take great pride in watching and supporting and I think we've done well with how we've been able to deliver key messaging and like I said, imagery and powerful stories to our team through, through all those different ways.

Sarah Richardson: you've done so much to serve your population, but you also get to lead all the technology and innovation.

So what emerging technologies or initiatives are you looking to explore next, to continue to deliver that level of care and efficiency?

Tracy Elmer: So of course that's the fun part, right? Any one of us in innovation know that we are all about problem solving always, and using our partnerships, our technology new practices.

We've talked about that in our quintuple aim, but now it's actually showing and demonstrating effective results. We've just only begun, we did a great pilot but we've just started rolling it out. But the early adoption. Numbers and just the early commentary that we're getting is demonstrating that it's the right tool or technology company that we're working with.

And again, our wonderful clinical informatics team has really taken the lead in that high touch endeavor to move it out and again I wanna be upfront, we're not focused on capacity, we're not focused on productivity. It is all about wellbeing. Again, going back to that workforce wellness focus and really investing in them and helping to create a better, joyful experience for them as they practice healthcare.

Sarah Richardson: Don't you love that? Since maybe the onset of some of the clinical documentation you and I have been leading for, let's be honest, 25 plus years that. We can now deliver solutions where the physicians and clinicians are excited about it.

Sarah Richardson: listening I feel like is the Valhalla Yeah.

Of what we've all been waiting for a very long time. And as long as we ethically work through it. Yes. And it in a thoughtful manner, Tracy like. All the art of the possible is so far and wide right now with what it can lead us to going forward.

Tracy Elmer: Absolutely. And I think, as we're in a time where there's a lot of things that are uncertain and unclear and uncomfortable, but there's so much promise and potential that it brings.

We know that we're just at the starting point and we know with technology and innovation where things go and how fast they move, but also it takes long time sometimes to see that effect. This is something you're immediately seeing the spark, if not beautiful fireworks, and now you know that there's even gonna be more that's better like

it's a very nice, positive area to focus on for sure.

Sarah Richardson: It is. And speaking of the speed of how things go, I'd love to move into speed round with you.

Tracy Elmer: Okay.

Tracy Elmer: Oh my goodness. You know what comes to mind is my POM pilot. Do you remember those

Sarah Richardson: very much? Because you could, you touch them and they'd share information, which is now like, Ooh, the iPhone does that now too, but.

Tracy Elmer: It was the first tech gadget I owned. I think I still have it 'cause I thought, oh, it's historical.

But just think of, for me it was like, oh, this is so nice. I see my schedule, I see things I need to do. I could take it with me. I don't have to log in somewhere. I don't have to print something. I hated paper even back in the nineties. And so, I don't know, I just think that was one of those tools where I thought, yeah, this is pretty cool.

Like I could see where things are moving.

Sarah Richardson: And you take out the stylist. To me that was like one of the coolest

Tracy Elmer: Yes. The stylist. That's right.

Sarah Richardson: I

Tracy Elmer: forgot

Sarah Richardson: about that. You to write on the screen. Yep. And they were expensive, weren't they? Like four or $500 back in the mid. Yes. Isn't that It's incredible to think about.

Tracy Elmer: I'm blessed to live not too far from the ocean or beach, so for me it's just getting out for a really wonderful walk or a hike along the shore. There's something so powerful about just reflection near the ocean, but it really helps me just unwind and unplug.

It's my favorite go-to.

Sarah Richardson: Especially where you live. San Diego is just about as good as it gets when it comes to,

Tracy Elmer: yeah, I'm so super fortunate. Using

Sarah Richardson: activities, your dream collaboration, if you could be a partner with any tech company to innovate healthcare, who would you choose and why would you choose them?

Tracy Elmer: I was thinking about this question, and of course Apple comes to mind. You think, oh, like their human, their focus on human-centered design is so beautifully aligned with what we're doing in healthcare. But I was thinking about it from a fun perspective and I was thinking more about a company like Lego, for example, and what could we do to build health education kits or find ways to use Lego building to help deliver.

Of course, Nintendo was the third one I was thinking about. We talk about gamification, right? But there's probably something there with combining Nintendo and healthcare and creating ways to motivate people through play and fun. So those are a lot of like different examples, but I don't know. Lots of opportunities.

I love all of them.

Sarah Richardson: Yeah, it makes seem be like musical therapy. It's kinda like, like putting your coffee house playlist on a Sunday morning and you're like, imagine the musical therapy aspect. One of our partners does give out Lego sets at our summits. Oh, I love that. It's so fun. It's a little operating room and it's all about the different aspects of how they help manage that environment and it's great.

I'm like. Are they hard to create? They're like, no, you just call Lego and tell 'em what you want and they'll customize. Oh, that's

Tracy Elmer: really

Exactly. Your universe. Exactly. Great for peds. Yes. Legos are always fun. All right, last question for you. Unexpected skill. What's a skill or hobby you have that might surprise your colleagues? I.

Tracy Elmer: They would probably be surprised to know that I love ice hockey and I'm part of a fantasy league and I did pretty well this last

[Mic bleed]

I love that. I'm a hockey mom. Everyone knows that, probably. But I love it. I just think it's fun. I think hockey's an incredibly smart and strategic and a little gritty of a sport, kind of like what we do in healthIT

Sarah Richardson: it is smart and fun and gritty and a good point. And there are some correlations there.

So you know, your hat trick could be exactly what you just talked about and the three ways to, to engage with some different companies for I love that.

Tracy Elmer: That's great. New

Sarah Richardson: engage. Yeah. There you go. See, I don't follow much hockey, but I do know what a hat trick is, so I was like, I didn't hang out with hockey moms and least have some semblance of a conversation

Tracy Elmer: [Mic bleed]

you so much. Appreciate the opportunity to connect and really again, it's an honor to be here. I appreciate your time.

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