January 13, 2021: Economic issues, societal issues, technology transformation ... 2020 was quite the year. Nancy Ham, CEO of WebPT talks us through the rehab industry’s roller coaster ride. How has this industry been impacted at the various stages of the pandemic? How do you go from 0% tele-rehab visits to 100% in a matter of weeks? What can you do as a CEO to ensure your organization can weather the storm or even thrive? What stage of startups were most vulnerable during the pandemic? What kind of startups benefited the most? And what can you do to ensure diversity inclusion in your company? And in your personal life too. “Diversity is, you're invited to the dance. Inclusion is, you're invited onto the dance floor. Equality is, you got to help pick the music. And at the end of the day, how did you feel when you went home from the dance?”
Rehab Industry in the Pandemic with Nancy Ham
Episode 351: Transcript - January 13, 2021
This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.
[00:00:00] Bill Russell: [00:00:00] Thanks for joining us on This Week in health IT influence. My name is Bill Russell, former healthcare CIO for a 16 hospital system and creator of this week in health. It a channel dedicated to keeping health IT staff current and engaged. Special thanks to our influence show sponsors who are investing in our mission. To develop a next generation of health. It leaders series healthcare and healthier. If you want to be a part of our mission and become a show sponsor, please send an email to [00:00:30] [email protected] A quick note, we launched a new podcast today in health. It where we look at one story. Every weekday morning, check it out. Subscribe wherever you listen to podcasts because they're our website and subscribe there.
[00:00:42] You can just go to Apple, Google, you get the picture. We have a new schedule for our podcast for 2021. Monday we have news Wednesday. We have an influencer solution showcase episode, and every Friday we're going to have an influence episode like this one. Be sure to check back for more great [00:01:00] content. Now onto today's interview.
[00:01:04] All right. Today we have a returning guest, Nancy Ham, the CEO of web PT, returning to the show. Good morning, Nancy. Welcome back.
[00:01:14] Nancy Ham: [00:01:14] It's awesome to be back. Looking forward to another great conversation with you today.
[00:01:18] Bill Russell: [00:01:18] Yeah. I had a, I had a great time talking to you the last time. You have 25 years of healthcare experience. Have you ever experienced anything like what we've [00:01:30] experienced in 2020?
[00:01:32] Nancy Ham: [00:01:32] Not quite. I went through the first dot com crash. I went through the great recession but the confluence of economic issues, societal issues, technology transformation, it's been quite the year. And that, of course, it's been a very interesting year because of those prior crises, we were still working for the offices, but this time we've all been home and our dens or basements or offices or studios since March. So [00:02:00] yeah, it's been a little different this time around.
[00:02:02] Bill Russell: [00:02:02] Yeah. It's just, this really has been this really it's 2020 is, has really been the just interesting from so many different perspectives, which leads me to believe that we're not going to have trouble finding stuff to talk about. So. But before we get there why don't you remind our audience of the work at Web PT and what you guys do?
[00:02:24] Nancy Ham: [00:02:24] Absolutely. So we're a SAS based technology company. We provide the electronic medical [00:02:30] record practice management system and the suite of ancillary products to outpatient physical therapy. We have the honor of serving over 20,000 clinics which is about 40% of the industry.
[00:02:42] Bill Russell: [00:02:42] Wow. And you guys are PE backed?
[00:02:46] Nancy Ham: [00:02:46] We are but maybe since I last talked to you, we became part of the Warburg Pincus family. And that's been really exciting because Warburg has a real thesis around special needs, specific EMR [00:03:00] companies. And so they are investors in for including us modernizing medicine, Qualifacts and Exparity. So we actually have a little a club where we all get together and talk about topics and help one another out.
[00:03:13] So that's been really really helpful during this year. I have my three brothers who are the CEOs of the other three companies. And we talk all the time about what are you doing about this? How you responding to that? What are you doing about black lives matter? What are you doing about your sales [00:03:30] forecast? So that's been really a special thing to have this year.
[00:03:34] Bill Russell: [00:03:34] Yeah. It's nice to have those communities that you can that you can talk to. What would you have done prior to coming together as a community like that. Would you have had those conversations with others or who would you, who did you leaned on in that case?
[00:03:53] Nancy Ham: [00:03:53] I really made networking kind of a hallmark of my career. I enjoy people. I [00:04:00] learn from people and I've grown up in the industry with a cohort of people who are all now CEOs. So I just would have reached out to the people I've been working alongside and growing up with professionally for a long, long time. What made that special was their companies are almost exactly like mine, right? They just serve a different vertical, like urgent care or orthopedics instead of PT.
[00:04:25] Bill Russell: [00:04:25] Yeah. All right. So let's talk about the rehab industry a little bit since it's a, [00:04:30] the place that you serve. How has the, how has that section of the industry been impacted? Actually let's not talk broadly. Let's talk about at different stages, like early on in the pandemic. Maybe the spring. And then how has it progressed throughout 2020?
[00:04:49] Nancy Ham: [00:04:49] Well it's been quite a roller coaster ride because immediately visits to outpatient physical therapy plummeted to around 20% of pre COVID [00:05:00] levels. And I mean over a two week period. Just boom, patient's gone. Now PT was deemed essential. So we did stay open in all 50 States. And so the industry did a really good job of getting that message out, reassuring patients about the safety protocols that they were taking. One thing we were very proud of is people were able to use our automated patient messaging system to communicate what was happening.
[00:05:29] We [00:05:30] saw a 10 fold increase in messages going out to patients. And so patients started coming back very steadily and we saw a climb really through early Thanksgiving until everyone was back in the 90% percentile of where they were pre COVID. But now we're seeing it top back over. So last week we're already seeing visits down 10% again.
[00:05:54] And there's a few reasons for that. Obviously you have elderly patients who are big [00:06:00] consumers of physical therapy who are sheltering in place to protect themselves from COVID. You have a major disruptions to two theaters into physical therapy. So joint replacement surgeries, it's an elective surgeries got placed on hold for a number of months that new patient pipeline dried up and then they reopened and now they're getting crowded out again. And also athletics at all levels. When people are active and moving, which is awesome, they also [00:06:30] get injured and need physical therapy. So the disruption of sports at every level from kids to pros has also had a negative impact.
[00:06:38] Bill Russell: [00:06:38] Wow. Yeah. We did a show pretty early on in the surge with Hospital for Special Surgery out of New York. And they had transitioned their entire hospital from doing orthopedic surgery to being a med surge unit, essentially for COVID patients. And so [00:07:00] that, that sort of phenomenon happened clearly in New York it was necessary, needed to happen. But when we closed down the elective surgeries that really changed the game.
[00:07:14] So moving forward, I mean have we started to do things differently as an industry in order to bring people back. And you gave us this quote the last time we were together and [00:07:30] I've actually used it in that. And you called it the 90% challenge. And you said every year, 128 million adults have a musculoskeletal condition that lasts more than three months that would benefit from physical therapy, but only 10% of them ever start physical therapy. So we call that the 90% challenge, 90% of the people are not getting help. If that was the case prior to the pandemic. We probably have a lot of people that [00:08:00] are not seeking help now, how are we reaching them? How are we besides just texting them and asking them to come in, are there other methods we're using?
[00:08:11] Nancy Ham: [00:08:11] Well there has been a big change in physical therapy in that prior to COVID, there was no reimbursement of physical therapy for rehab. And then all of a sudden there was, under the public health emergency Medicare approved it, then virtually all the private payers followed suit.
[00:08:28] So all of a sudden [00:08:30] you could communicate like you and I are right now with patients at home. The industry did a magnificent job pivoting. Some people went from 0% to a hundred percent telerehab in a matter of a couple of weeks. And I think people have been pleasantly surprised.
[00:08:46] It's not a substitute for manual therapy. Physical therapy is hands on, but you can support patients in their journey to their best health remotely. By checking in with them, observing them, [00:09:00] doing their exercises, correcting them. And so we saw a huge adoption in tele-rehab. Now we're going to have a permanent reimbursement issue. There's only temporary reimbursement during the public health emergency. So we need it to become permanent and then we need it to be reimbursed at a level that's closer to what an in clinic visit is.
[00:09:22] Bill Russell: [00:09:22] What's it at now?
[00:09:24] Nancy Ham: [00:09:24] It's about a third of an inpatient in-clinic visit, which is [00:09:30] too big a gap. And so we need to work on appropriate reimbursement, but patients loved it. There've been some early studies have come out like base state. That patient satisfaction is very high and quality was high. I did tela-rehab during COVID and it was fantastic. I didn't have to get in my car. I didn't have to risk walking into the hospital, which is where my PT is. And I got well, so I hope that's going to be a [00:10:00] permanent change. Cause that's a big part of how we impact that 90% because PT is inconvenient and expensive. You have to get in your car, drive there, be there for an hour. Drive home two times a week or three times a week. And for a lot of people that just doesn't work. They're single parents, they're working families. They can't take the time off from work. They can't afford all those out-of-pockets. So I'm really hopeful that this is a sea change or permanent change in the future of [00:10:30] this industry. And that's how we're going to, in 10 years double that pitiful, 10% of patients coming to physical therapy to 20% would be a great goal.
[00:10:40] Bill Russell: [00:10:40] Are physical therapists, so I'm sort of curious, a bit more than anything on this. Do they see COVID patients or do they wait until they have essentially moved past the infectious [00:11:00] part of the disease. I mean, how did the, how do the physical therapists sort of approach this?
[00:11:06] Nancy Ham: [00:11:06] Well? So one they all have their PPE. They're just like any caregiver. They have to protect themselves because the patient could be asymptomatic and carrying COVID and not know it. So there's a tremendous amount of PPE and safety protocols and cleaning protocols that the industry is following. But I ideally, no, they're not treating people who are actively [00:11:30] symptomatic.
[00:11:31] It's usually fine clinically to not have those visits during that 10 or 14 day period. But at the other side, there's this phenomenon of long haul patients. So many people who have COVID, not so much the ones who are asymptomatic, but people who are sent it to Matic. And for sure people who are hospitalized, they need physical therapy afterwards to recover their [00:12:00] strength.
[00:12:00] It's a very debilitating disease. For some people we don't understand why some people seem to sail through it and other don't. But there are now entire units at hospitals devoted to long haul COVID patients, helping them recover after they technically finish the course of COVID itself. And so there is going to be an regrettably, a boom of patients needing that long-term physical therapy [00:12:30] after COVID.
[00:12:31] Bill Russell: [00:12:31] So I just, I'm going to get to technology here in a minute. I just. Yeah. My last question on this is so the, so you sort of touched on this a little bit, but what's the lasting impact on physical therapy going to be as a result of the pandemic? Do you think?
[00:12:52] Nancy Ham: [00:12:52] Well, one, I do think there is a new class of patients, these long haul COVID patients that we need to understand how to outreach to them and care for them [00:13:00] and support them over what is a many months journey back to their full health. But I think tele-rehab. It's just got to stick and get to an appropriate level of reimbursement. And it took other disciplines like primary care quite a few years to really figure it out and get the 50 state licensing issue resolved and get the reimbursement resolved.
[00:13:21] But I think it's going to be a major impetus to make that change and that's going to help PT reach more patients. [00:13:30] And it's also going to help them reach more patients who are in a socioeconomic classes that are challenged because it will be more accessible and cheaper which will help reach people who don't have the same access to physical therapy as you and I might.
[00:13:47] Bill Russell: [00:13:47] Yeah. So let's talk about technology. Let's start with your product. So you get into this, obviously you're navigating a lot of things, the health of your employees and [00:14:00] work from home and whatnot. But were there any specific requirements that you just immediately out of the shoot, they were, hey, we need these kinds of changes made to your product to the system of record?
[00:14:16] Nancy Ham: [00:14:16] Well, first of all, we had to launch tele-rehab which we did in seven days
[00:14:22] Bill Russell: [00:14:22] Seven days you launched it?
[00:14:24] Nancy Ham: [00:14:24] Seven days. It was a quite, quite an intense seven days, but it's not [00:14:30] just the ability to see the patient visually. It's, now you can bill for it, what are the codes? How do you get that to flow through revenue cycle management? How do you include it in your analytics? So it wasn't just let me get a Zoom session spun up. There's a lot of other things around it. We launched virtual visits. We also have launched touchless intake. Because people don't want to touch pieces of paper. They don't want to touch clipboards or tablets.
[00:14:57] And so we had been working on it, [00:15:00] fortunately because we couldn't have done it in seven days. We've been working on it for quite a while. So we launched touchless digital intake. We saw, as I said, a huge uptick in using our patient relationship management software. Because there's just such an urgency to communicate with patients, communicate your open and what your protocols are that it's safe to come into therapy, but what's different.
[00:15:23] Like wait in your car, we'll text you when it's time to come in. And we launched a lot of new [00:15:30] technology around how do we work with our customers virtually? So normally if we were taking line of a big customer, we would be on site and we can't do that right now. So a whole suite of innovation around our learning management system and how we train clinicians virtually how we do a go live day virtually. That's been super interesting.
[00:15:52] Bill Russell: [00:15:52] Well, I, to, I want to jump into each of those. It's, it's interesting. So the, the one [00:16:00] that jumped out at me the most was patient relationship management. I had somebody once say to me I it was an EHR vendor and we were sorta talking about, Hey, we're thinking of going to Salesforce. They're like, why are you doing that? And your EHR does that. And I sort of looked at him like, I'm not sure you understand what relationship management are. So I want to put you on the spot here. Because when we talk about CRM, customer relationship, we're talking about outreach, meeting them, where they're at, multi-channel, those kinds of things.
[00:16:30] [00:16:29] What kind of things did you put in there so that your your clients could interact with their patients where they live?
[00:16:38] Nancy Ham: [00:16:38] So, first of all, it's of course integrated with the EHR. So we know everything about you. We know. You know why you came to us, what body part is injured. We know your age, we know your gender, so we know your whole persona.
[00:16:54] So we're able to communicate with you throughout your patient journey in a personalized, [00:17:00] clinically relevant way, which Salesforce cannot do. And so let's say you, you throw out your back. So the first message might be we're so sorry. First of all, that you threw out your back, we're looking forward to your first visit.
[00:17:13] Here's what to expect. Here's information about low back pain. Here's information about how your treatment's going to go. And then we're going to communicate with you all along the way, checking in with you, encouraging you, motivating you to complete your course of care. And then we're [00:17:30] going to stay in touch and we can do that in a really personalized way.
[00:17:33] Maybe we met you because you're a runner and you injured yourself. And so you might get drips about how great stretches to do for running or how to train for a marathon safely. So we're able to really engage with you. We also send you on our mobile app, home exercises, PT, you have to do your homework.
[00:17:54] So you have to do your home exercises between visits. So that's part of this patient [00:18:00] automation. And then we did something really different recently. A lot of the outpatient specialties are looking forward to big cuts of reimbursement come January the first 9% for Medicare, for physical therapy.
[00:18:15] So we put out messaging to patients to said, would you mind letting your congressperson know that PT's important to you and you oppose the cut. We've never tried anything like that before. And then one week we have [00:18:30] generated over 16,000 letters to Congress.
[00:18:33] Bill Russell: [00:18:33] Wow.
[00:18:34] Nancy Ham: [00:18:34] It's hugely important. And Salesforce, I mean, we use Salesforce as a company. It's a fine generic tool, but it is not going to do these kinds of things that are clinically specific and relevant and timely,
[00:18:48] Bill Russell: [00:18:48] By the way, thanks for taking that question in that manner. It was meant, which was more informative than a challenge. And I think you're right. I think it's Salesforce is a generic tool and you have to teach it [00:19:00] healthcare. Whereas you have a healthcare tool and you just have to teach it modes of communication.
[00:19:05] Right. So you have to teach it the multi-channel you have to teach it. You essentially have to say, look, we have all this information. We can build experiences around it. Whereas Salesforce you'd have to, first of all, you'd have to lift all that information and move it over to Salesforce. You'd have to make meaning of it in Salesforce. And then you'd have to build all the workflows still on top of it to move forward. So it's really a completely different approach. [00:19:30] And it's another license that you have to buy.
[00:19:35] Nancy Ham: [00:19:35] Yeah. And we have a similar tool for referral relationship management, same thing. Instead of using a generic tool like Salesforce use a tool that's built for physical therapy because we understand what kinds of people send referrals and what information do they want back. So now we are able to say, thank you for sending us a hundred referrals. This many patients started their therapy. Here's their net promoter [00:20:00] score. Here's their outcomes. I'm doing a really good job with these patients. And so it closes the clinical loop, which I think is really important.
[00:20:09] Bill Russell: [00:20:09] Yeah. So your telehealth solution. We talked a lot of health systems that essentially early on were sort of caught flat-footed and they said any way we can instantiate a video visit, that's what we're going to do. And they're going to have on this screen, they're going to have the EHR. On this screen they're going to have the [00:20:30] video visit and given where they were at, what they were trying to do. That was really accessible. I love the fact that what you're, what you said originally is, yeah. I mean, that's like, that's the base instantiating, the video visit is really the easy part. It's how are you going to track it and how are you going to get those codes in there and whatnot. So talk a little bit about that process. How did you think about the, how did you think about, and how did you knit together the entire experience.
[00:21:00] [00:21:00] So that the experience for the care provider, as well as the patient was pretty seamless and really, really beyond acceptable, really desired or preferred.
[00:21:15] Nancy Ham: [00:21:15] Yeah. I think the key was the team that was assembled. So that from the moment we started working on it, we had people representing each of our product lines. We think about products with something we call the golden [00:21:30] thread, which is products don't stand alone anymore. And so you can't just run off and instantiate the video visit without engaging all of the other products and understanding that well, now what? You had the visit. How does the data flow? How does the patient experience flow?
[00:21:46] How do I need new messages in patient automation messaging, because what I want to tell you pre and post a virtual visit is very different than your clinic visit. So it was really just having the right people in the room, I think, [00:22:00] from the launch and remembering it was going to mess up everybody's analytics.
[00:22:06] Because PT, maybe more so than a lot of other parts of health care is extraordinarily KPI focused. Like they all know their KPIs and we knew it was going to completely mess up all the KPIs, but introducing this new category of visits at this dramatically different reimbursement point. And so we knew from the moment we had their first meeting, if we didn't fix the analytics, we were getting a lot of [00:22:30] support calls. So we had to fix it from the beginning.
[00:22:33] Bill Russell: [00:22:33] Yeah, I love that concept of the golden thread. Let's talk about a tech startup for a second. Because you're one of the people I love to ask these questions of. So organizations were at really different stages of their journey with regard to being a tech startup.
[00:22:54] Some could have been early on, just got funded in early 2020 [00:23:00] and others could have been pretty far along. What stage of a startup do you think was most vulnerable during the pandemic and and actually let's start there. What, what stage of a startup you think was most vulnerable during the pandemic?
[00:23:16] Nancy Ham: [00:23:16] Well, I think anyone who's in a negative cashflow situation or in a low cash balance situation, of course, was very vulnerable and the good news is though there weren't so many of those this time around. [00:23:30] Like in the first crash or in 08 there were lots of people who were on fumes and they went under, but the funding environment has been so robust and people have been raising more money than they used to. So instead of raising a few million, they're going for 20. So the portfolios of venture startup companies that I'm associated with, by and large, they were all fine. Financially they had to tighten their belts. They did what they did, but they weren't at risk of just running out of money. So [00:24:00] setting that aside, I think it's people who have long enterprise sales cycles because you just lost a year, basically.
[00:24:10] People weren't in the market to buy new technology. They slashed their budgets for innovation. They postpone go lives. And so if you're in that sort of million dollar plus, or maybe even $500,000 plus enterprise cycle, your role just stopped and you [00:24:30] literally lost a year and that's really discouraging because startups need that positive momentum. But lots of other companies flourished, Bill, on the other side, a lot of people went great gangbusters.
[00:24:42] Bill Russell: [00:24:42] Yeah. And that's yeah. So let's explore that side. What, what startups did benefit the most? I have heard health systems talk about the silver linings. We don't want to really talk about a pandemic like, hey, this was good for this, but it did create an environment where they could thrive because they were supporting the [00:25:00] clinicians. They were supporting contactless care, they all sorts of things. So what kind of startups benefited the most do you think?
[00:25:07] Nancy Ham: [00:25:07] Well, certainly anything "tele" or contact lists went off the charts as we saw, but companies who deal with mental health, stress, resiliency just boomed because whether people were buying it for their own employees or buying it for their beneficiaries or their patients.
[00:25:29] That whole [00:25:30] group did tremendously well and embarrassed to say that EMR's is like mine did really well because ironically, when your patient volume drops to a historic low, if you're thinking about making any technology changes, that's actually a really good time to do it because you have the time and the space.
[00:25:51] And so we took a lot of people live this year. And I hear that from other people in other specialty EMR verticals. [00:26:00] So one of our themes was, well, you can't work in your business right now because you're closed or you have very low volume, but you can work on your business and that will make you stronger and rebound faster. And that's a message that actually really resonated.
[00:26:15] Bill Russell: [00:26:15] Well. So CEO of an organization, talk me through, when did it become apparent to you? That, hey, this is going to be a different year. Things that the pandemic, I mean, we were [00:26:30] talking about the pandemic in late 2019. It felt like it became more real early on in the year. When did it become real to you? And then what steps did you have to take as a CEO early on in the process?
[00:26:45] Nancy Ham: [00:26:45] Well, I think it hit us all in March, right? We went to planning and worrying about it, to boom it's here. And we have to do all these things right now. And that, that changed in about a four day period, honestly.
[00:26:58] I remember distinctly on [00:27:00] Monday I was talking to my project team about a three or four week project to get everyone home. And then on Tuesday I told them they had to do it by Friday. So it was, yeah, I remember that week really clearly. So first of all, of course shipped everybody home. That was easy for part of our company. You're developer, take your laptop and go.
[00:27:19] But for other parts of the company, like revenue cycle management, that was a little different. But we got everybody home. Then we had to reinvent work flows because revenue [00:27:30] cycle management, for example, can be very paper intensive. And we said, well, but you don't get to have a printer at home because that's not HIPAA compliant and there's not a shredder in your house. So we need to be 100% paperless by Monday. So let's figure that out.
[00:27:48] And then we had to, re-engineer like the culture of the company. We had a very strong in office culture. That's how we work. That's how we have fun. That's how we collaborate. And so moving to [00:28:00] Zoom we had to figure that out. But I think it's made us stronger in a lot of ways.
[00:28:08] Almost every team has a daily standup now, and you're all equal on Zoom. Before you might've had some people in the office, some people on the phone, somebody might remember to turn the camera on, but now being all equal and present on Zoom has leveled the playing field. I think the communication from our teams has skyrocketed. [00:28:30] People's learned how to have fun on Zoom.
[00:28:32] Our employee net promoter score doubled during this period, which is not something I would have anticipated. And I mean the outpouring of communication. I think every CEO this year, however much communication they were doing it, it's up by 10x and it needs to stay up by 10x. That's the new normal.
[00:28:54] Bill Russell: [00:28:54] Yeah, we're, we're seeing that. We're seeing that employee satisfaction, net promoter score, [00:29:00] however, they're measuring their employee satisfaction and we're seeing at least a a 7%, seven to 10% bump this year. And you wouldn't anticipate that in, in this environment. And part of it's probably that communication part of it's, obviously people have a little bit more autonomy.
[00:29:18] They can see their kids a little bit more and those kinds of things. But I think we've also added, I don't know about your environment, but it's not uncommon for me to have a [00:29:30] conversation with somebody and their kids are in the background or or those kinds of things. We've become more. Tolerance, not even the right word, we've become more accepting of the fact that people are working in their homes. They have a family life. It's almost more real to us that these are people and they have a life and we've become, I dunno, just more empathetic to people's situations. That's what it feels like to me at this point.
[00:29:57] Nancy Ham: [00:29:57] We've definitely become more human [00:30:00] before this started, I knew maybe 10 employees, the names of their dogs. Cause we had a dog friendly workplace. I know a lot of dogs and cats and kids and spouses now. And I think that's awesome. And the other thing that's been different, at least for us this year, in the past, I didn't communicate a lot emotionally. I didn't talk about love.
[00:30:23] I didn't talk about our family. I didn't talk about myself that much and all that's changed. We're all now much [00:30:30] more authentic who we are. And I'm a much more, I'll say an emotional leader. And I think that's been really important. We have some videographers who work for us, and normally they're at trade shows, doing things, but since there are no trade shows to go to anymore, they've started some web PT TV series. One is every Friday, it's where we work. They film somebody at their house. They filmed through Zoom, but you learn all about [00:31:00] them, which is really cool. And then they started a series called the Feel Good Files in which employees share like the most amazing raw, authentic emotions and the messages it's okay that we're not okay. Nobody's okay. Like don't put up a fake facade. Nobody is okay this year. And I think that's been really different too. People really senior leaders in our company being very sharing about their own struggles has been moving and powerful. I think.
[00:31:30] [00:31:29] Bill Russell: [00:31:29] Yeah. I said when we have a healthcare podcast, I think we focus in a lot on the pandemic, but we also had, we had an election, we have black lives matter. We had just a lot of diversity inclusion conversations and those kinds of things. Talk about, if you could talk about your journey in that area. What are you guys doing? How are you approaching it as a leader?
[00:31:55] Nancy Ham: [00:31:55] Well, what I think it was a huge wake-up call for us because I think we [00:32:00] prided ourselves, before George Floyd, that we were a diverse, inclusive, welcoming company, but we realized we were not equally focused on all communities. And so we were over-invested in some and not at all invested in others. So it's been a huge effort for us. So we are committed to it. As a company, I signed the CEO action pledge with PWC. We have rolled out unconscious bias training. [00:32:30] We've rolled out workshops. We now have nine or 10 new employee resource groups that range from people of color, but also to veterans and people of faith.
[00:32:40] So back to everybody's in a community and we need to embrace and celebrate all those communities. In our regular company meetings, we spotlight different holidays like it's native American month and let's have a native American employee talk about what does that mean to them? Or write [00:33:00] about it in the digest. So we've all learned a lot more. I'll tell you the one that was the most interesting. So we put all these holidays on our corporate calendar and along came national left-hander day. And the dialogue.
[00:33:14] Bill Russell: [00:33:14] I'm sorry. I didn't mean to offend any left-handers out there. It just struck me as, I didn't know, there was a day for that.
[00:33:19] Nancy Ham: [00:33:19] Well, I know, but the dialogue that sprung up in Slack showed it was such a path to empathy. People said, well I always feel like they don't fit in. The world's made for [00:33:30] righties and I have to do a lot to adapt. And then people started thinking, wow, how much harder than for all these other kinds of people to fit into a world that's not made for them. It was the most incredible on-ramp to empathy that one small thing.
[00:33:46] Bill Russell: [00:33:46] Is that really true that the world is designed for right-handed people? Is that, I really hadn't thought about that.
[00:33:53] Nancy Ham: [00:33:53] Well, it's the world is designed for the majority, so yes. And the [00:34:00] other thing that I think has been really important for healthcare is, there's a direct correlation between racial inequality and health inequality. We see it in socioeconomic determinants of health, your zip code, your genetic though are the two most powerful indicators of your risk. It's not the actual healthcare we see COVID impacting communities of color at rates of 200%, 300% more [00:34:30] than a non communities of color. And so there is this direct linkage between racial inequality and health inequality that I think is very important for us as a healthcare community, to keep a focus on, keep talking about in this, can't be a moment.
[00:34:47] This needs to be a permanent movement, and I'm seeing so much amazing work starting to happen in payers and providers in tech vendors, really recognizing that. And so I hope that that's a permanent [00:35:00] change and I'll pick on physical therapy, not a very diverse industry. And so the support from the industry now to recruit more minority students, to help them start their practices too. Engage more with patients of color who a lot of them were in that 90%. I think it's a really permanent positive change and I'm pretty excited about it.
[00:35:24] Bill Russell: [00:35:24] Well, it's interesting that you're, you're fostering those conversations amongst your staff. [00:35:30] Yeah, I mean, cause there's so many, so many questions I would imagine that people have, it's like what, what can I do? It's not like people can't watch the TV and say, I see the problem. But a lot of it is translating into, okay. Wow. This is a huge problem. How do I even start? How do I get engaged? How do I how do I become a part of the solution and what does it look like? I mean, there, there has to be, and that's just the tip of the iceberg for the questions. I'm sure that people have.
[00:36:01] [00:36:00] Nancy Ham: [00:36:01] Yeah, I was raised in a big companies where you didn't talk about certain things at work and all of a sudden these are the most important things to talk about at work. So it was new for me to moderate Zoom with a hundred employees talking about rates and talking about our company and are we doing enough? And what can they do as individuals? And it's a very interesting conversation for us because so many of our employees come from internal referrals. [00:36:30] And so I put a challenge out to all of our employees. You need to broaden your own networks. Like if you want us to be more diverse company, you need to bring that diversity ends through your own personal relationships and the referrals that you make. You can change the needle because we hire employee referrals at a much higher rate than people we interviewed from the outside world. So that was just one very specific thing to get them thinking about. But we also talk a lot about inclusion versus [00:37:00] diversity and I heard a great way to think about it recently.
[00:37:05] And I'm sorry, I don't remember who to attribute to. But diversity is you're invited to the dance. Inclusion is you're invited onto the dance floor. Equality is you got to help pick all the music. And at the end of the day, how did you feel when you went home from the dance? So, one thing I do talk about with the company, diversity is actually rather easy, [00:37:30] but inclusion is very hard because inclusion is human and personal. And every individual can make more of an effort to be more inclusive and Zoom actually helps you do that. It's easier to get all, everybody on the zoom talking and contributing equally.
[00:37:48] Bill Russell: [00:37:48] All right. So closing question, what's the coolest thing you guys have done on Zoom, although my gosh, you're using your videographers to tell those stories. That's gold right there. I mean, that's, that's, I [00:38:00] hope every organization is doing something to that effect. Have you guys done, I mean, I've seen people talk about scavenger hunts and different things that they've, they've done on zoom calls. What's the most fun things that your team has done?
[00:38:13] Nancy Ham: [00:38:13] We did an incredible trivia contest and the team that put it all on put so much thought into the questions, the music, the backdrops, like it was a full on produced show. Kind of like who wants to be a millionaire. Was really fun. [00:38:30] Cooking class was really fun. All the ingredients sent out ahead of time. Everybody learns to cook the meal together, I think was a good one. Painting together. Again, you send out the supplies and you sit there and paint and drink your wine. Is very fun. Today my team is doing a virtual white elephant, so we'll see how that goes.
[00:38:52] Bill Russell: [00:38:52] A virtual white elephant. So you just, you send a gift to somebody else's house. Like they, they can't turn it away.
[00:39:00] [00:38:59] Nancy Ham: [00:38:59] No, you actually, you set up your gifts as virtual gifts. You just take the URL of what it is, and then you wrap it and put it into the game. And then you go through the usual picking and swapping and laughing and teasing, and at the end, whichever gifts you end up with get shipped to you.
[00:39:20] Bill Russell: [00:39:20] Yeah wow. You have a creative line you work with. That's a lot of fun.
[00:39:28] Nancy Ham: [00:39:28] Well our marketing department [00:39:30] who was also not going to trade shows right now, they curated a list of more than 50 activities that you can do virtually so that each team didn't have to figure it out for themselves. So people who have event teams, that's a good thing for your event teams to be working on right now.
[00:39:47] Bill Russell: [00:39:47] That's fantastic. Nancy, I I love having conversations with you. You have challenged me, you have educated me. And I just, I enjoy, [00:40:00] I enjoy our conversations. This is this show isn't going to air until January. So some people are going to say hey, that's a little dated. And it will be just because we were having this conversation a little bit before before the holidays. So I just wanted to put the timestamp on there. So people don't, they have no recognize that. We're talking a little bit before the new year actually kicks in. Thanks. Thanks again for your time. I really appreciate you coming on the show.
[00:40:30] [00:40:29] Nancy Ham: [00:40:29] I always love it. You're so thoughtful about the questions and the topics, and I love that. I never know quite where we're going to go and keeps it fresh and fun. Have an awesome holiday Bill.
[00:40:42] Bill Russell: [00:40:42] Thank you very much.
[00:40:43]What a great discussion. If you know someone that might benefit from our channel, please forward them a note. They can subscribe on our website this week, health.com or wherever you listen [00:41:00] to podcasts, Apple, Google, overcast, Spotify, Stitcher.
[00:41:02] We are out there so they can find us there. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health. It leaders. VMware Hill-Rom and starboard advisors. Thanks for listening. That's all for now.