Healthcare Unbound_Katie Kaney: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Intro/Outro:
Welcome to Healthcare Unbound, a podcast powered by Clarify Health, where healthcare's changemakers discuss ways to advance care outcomes, cost, and affordability.
Saul Marquez:
Hello, everyone, and welcome back to another episode of Healthcare Unbound. I'm Saul Marquez, CEO of Outcomes Rocket and host of the Healthcare Unbound series of podcasts. Today, I have the privilege of hosting Dr. Katie Kaney with us. She is a thought leader with 25 years of experience spanning public health, healthcare, and business. She's the founder of Whole Person Index and the author of a recently published book, Both/And: Medicine and Public Health Together, and she's also the CEO of LovEvolve. Dr. Katie's resume includes 25 years as a chief administrative officer at Atrium Health, and I'm super excited to have her with us. So, Dr. Kaney, thank you so much for being with us on Healthcare Unbound.
Katie Kaney:
Thank you. Happy to be here.
Saul Marquez:
It's our privilege to have you here. And look, you've worn so many hats in this space now as an entrepreneur, but you've been an administrator, a provider. Tell us what inspires your work in healthcare.
Katie Kaney:
Yeah, it's been great. I mean, it's kind of hard to believe it's been 25 years. But when I was young, they saved my life at Children's Hospital in Buffalo, New York. So I've always had an affinity towards healthcare, trying to help, beware, you know, can make a difference. And I would say the motivation has always been, how do we help the people that are taking care of patients or people and then also help people, right? I mean, that's what healthcare is supposed to do.
Saul Marquez:
I love that you started as a child, and now you're giving back. So that's just a beautiful thing. And look, a big part of what you mentioned is taking care of providers that take care of all of us. What are your goals to make healthcare better?
Katie Kaney:
Yeah, and I would say providers when I started, and since I have such a deep experience with healthcare, I would say providers would be physicians, nurses, respiratory therapists, and paramedics. But when I say providers, especially in this new chapter, it's all public health professionals, too, and all volunteers; people are out there really trying to knit together a pretty confusing system, right, so that people can have as happy and healthy of life as they would like. So I would say my goal, specifically what I've learned, especially over the last couple of years, is that we are not defining health correctly. So, if we actually want to have better outcomes and we want to be able to improve something, we have to know how to define it. You have to agree on the definition and then measure it. And so, while I wrote my book, I actually in the research, identified our drivers of health, and again, this is not new. It's been out there for decades. Our clinical, social, genetic and then our personal behavior choices. And if you look at America, 80% of the funds that we spend on healthcare are on clinical. So, I would say my goal is that we need to look at that definition, make sure that we have a toolkit that spans solutions across all those drivers, and then actually pay for those solutions.
Saul Marquez:
I love that, and we talk a lot about value-based healthcare here on the podcast and, in general, in the industry. Better outcomes at a lower cost. What do we need to do to get there?
Katie Kaney:
Yeah, I think, you know, all of us who were around when value-based care was beginning to be talked about. I think we've been disappointed. If you're really trying to do better for patients and communities and people in general; how slow has it been? And I think the incentive system's not set up the right way, right? So, not everything is necessarily about money, but incentives certainly help. So to me, one of the key parts and I'm not new, there's a lot of people who believe this. The incentive system has to be better. But what I will say is that the incentive system just to talk about social determinants of health or dabble in genetics, right, or say, hey, personal behavior, that's not going to get it. So that's why the Whole Person Index was founded, is that we need to have a discrete data set across all of those drivers so we can measure things together. Then we can repeat the measurement and be able to track our outcomes and be accountable for what's improving and accountable for what's not improving. So value based care to me is a good concept. I think if it aligns with incentives, it will be very helpful. But if we keep using the same measuring stick, we're actually not going to systemically make it better for people. And we're also not going to eliminate what's not working in the system, which is really how you save money.
Saul Marquez:
I love that. So, Katie, if you could break down this Whole Person Index for me the elements and then look, our audience is, they're healthcare leaders, right, at the payer systems, at the health systems. Talk to us about who uses it and what the benefit is.
Katie Kaney:
Sure, yeah. You know, one thing you find, you know, through your career is what you're good at and what you're not, so I'm not actually good at inventing anything. So the whole person, right? You know, the strength. It actually is a set of curated research that's already out there. So if you look at the data set underneath each of the drivers, clinical, social, genetic, and behavior or personal behavior choices, there are data sets that exist out there that are deeply researched that really if you answer them from a person perspective or even from the clinician perspective, will give you a framework for your health. So again, we live in a largely episodic sick system, which is a lot of where the 80 percent goes. So what we are trying to do is trying to say there is a set of questions. They're not complicated. They're binary. And what it does, it doesn't give you all the details, but it gives you the framework by which you need to view your health, so that if I am pre-diabetic and genetically I'm predisposed for diabetes and I really don't do a great job eating my fruits and vegetables, those three things together are important to know so that my solution set is not just skewed towards one or the other. And then the science comes in is that as our data set begins to get deeper, you get to see the correlations amongst the four drivers and the factors. And then let's face it, you know, there's limited money and limited ability to change. So what we're really trying to get to is how do we keep it simple. And how do we actually say your highest, best use of limited money and limited ability to change? All of us have limited ability to change. How do we actually match those resources there for you and give you the best chance to achieve the best health possible?
Saul Marquez:
Love that. Sounds like a very useful tool. And folks, if you're curious about it, we'll definitely be linking it up here in the show notes of today's episode with Dr. Kaney. Look, the global pandemic, it created and brought attention to the enormous changes that really need to happen in medicine and public health, as you brought up. Perhaps most importantly, it's the relentless of really everybody in health healthcare professionals to make these changes and make it better. Tell me more about how this is impacting healthcare right now.
Katie Kaney:
It's true. You know, there's so many good people. And everywhere I go, I'm meeting good people. I think what we have to do is admit that the system by which we're working in is not working, right? And that's what we saw through the pandemic. I mean, folks that lived in vulnerable populations or had limited access to Wi-Fi, or fresh food, or education, or trust in the system, it was just amplified the impact of the pandemic. And it really was a great equalizer because nobody was immune to what the pandemic did. Everybody had something in their life that was different because of the pandemic. So I think what was nice during the pandemic is that you did see public health and medical professionals. You know, I was one on the team that was in charge of the surge and reentry at my system during the pandemic, and it was a great honor to serve. But there was a lot of duplication, and there was a lot of there really wasn't a lot of knowledge about what each could bring to the table. So I think the restlessness we have is that there is different skill sets in each of those that actually complement each other, don't compete. Public health and medicine do not compete with each other, but I don't think that conversations have continued the way that they need to post-pandemic. And some of that is because everybody's day-to-day job is hard, right? Some of it is because the incentives haven't changed. And I think some of it honestly, is that we just don't have the same scoreboard that we're trying to win to public health and medicine. And so that's part of why we're trying to level that playing field and have a transparent scorecard so we can try to win.
Saul Marquez:
That's great. I love the idea of a transparent scorecard, one that's aligned. And at the end of the day, health is the end game, right? For communities, individuals in your book, it's both and medicine and public health together. You talk about this ideal partnership between medicine and public health. Let's talk about that a little bit more. And what are some of the possible solutions?
Katie Kaney:
Sure. The reason why I wrote the book, I mean, it kind of makes me laugh. I'm not the best writer. You know, you get your doctorate, so you have to write your dissertation. And I can tell you how much read, I had all over my dissertation, which I wrote my dissertation on telemedicine, actually, in the.
Saul Marquez:
Oh, you did?
Katie Kaney:
Yeah, back in 2013. So wow. I would have said a pandemic would have helped it.
Saul Marquez:
Vision, its vision.
Katie Kaney:
But, you know, I think when the book was written, because if you're going to actually change, you have to have a level set of education. It's hard to talk to people about things you don't know. Physicians are very well trained, obviously, in their curriculum. Public health professionals are well-trained. And so how do you level the playing field? And that's what the book is supposed to do. Let's just kind of talk about what each of those disciplines do and then how they can come together. And so the best way I think, you know, I've been talking about this now for, you know, a year and a half or so, is to give a couple examples for how medicine and public health have come together because that seems to resonate with folks. So I was lucky. I ran the emergency department, a really busy emergency department, in my 20s and 30s with a great group of physicians and clinical folks. And so I had a couple of my physicians, female physicians come to me and say, you know, Katie, we've got a real big issue with the number of people that are coming here that are impacted by interpersonal violence, domestic violence. And I'm like, well, okay, you know, as part of an academic institution, we did a lot of research. And so these folks, they knew what they were talking about. But when I looked at my data set from what I had in the emergency department, chief complaint, and diagnosis, I couldn't find interpersonal violence anywhere. You know, it was not one of the things that we typically coded or typically found. You could find it in the narrative of the chart, but finding those discrete data sets that could tell us how many people were impacted by interpersonal violence was difficult to find. So what we did, yeah, I mean, it was, and I think anybody who's out there running big systems would say that, right? Some of these secondary social determinants now that we're talking about are not always easy to find and discretely tracked. So we went I talked to the physicians and I was like, you know, where do you think we need to find this data? And so thanks to them, you know, we went to public health sources, and we went to the community experts about domestic violence and those that were sponsoring people who were trying to get out of their situation, provide resources. And so then we were able to match what that organization had, what the county public health information had, and then what we had from the medical perspective. And so, out of that, we actually joined forces. We did not compete with each other. We brought the other healthcare system in. And what, we founded, a forensic medicine community-based group by which we did universal screening in the emergency department. We were one of the first in the whole country that did it. We did two questions to screen for domestic violence in order to be able to now track it in the record. But if they screened in, you know, my nurses were like, well, my goodness, I'm so busy, how am I going to do this? So the local agency that was trained in domestic violence, they provided volunteers. So if you screened in, our team would call the volunteer to come in, who was from the community organization, the public health and community-based organization, to match with our nurse and physician team so that they would handle the sponsorship and the advocacy and what needed to happen once they were discharged and the medical team actually handled what if there was medical issues lots of time. The medical issues were not necessarily directly related to interpersonal violence, but it was exacerbated through those situations. So it's been around now for 20 years, and it was wildly successful during the pandemic, and now it's just simply how we take care of people. We work together as a team. It costs $100,000 to do that program.
Saul Marquez:
No brainer.
Katie Kaney:
No brainer. And the amount of savings, you know, was always hard to track recidivism, things like that. But it really is now one of the cornerstones of how this community takes care of people. And quite frankly, I think sets the gold standard.
Saul Marquez:
I love that, you know, that is such a great example, Doctor Kaney, of how medicine and public health can work together. I did a series on nursing a few years back, and that one highlighted the opportunity around human trafficking, asking those questions because it's a very real thing, and it could be found. So I think you are planting a seed for all of us to think about the ripples we can make. If we can combine these two disciplines. The promise is big. So a question for you. What would you say is one healthcare trend or technology that you think is going to change healthcare as we know it today?
Katie Kaney:
I think price transparency. We talk about consumers and healthcare, but we're really not consumer-driven. I mean, we try to be, but it's really not the way our industry was raised. You know, we build our systems around the clinical teams, I think, and the way that the operations need to work. And I think price transparency and accountability for what you get for that price will really help consumerism come to the forefront. And have we as people be more partners in a system, not just a healthcare system, but the public health system? Because I have a part in it, too. You know, my personal behavior and my choices. I don't get a get out of jail free, right? We all have to be able to come and be part of the team and part of the solution. But I think price transparency will help level the playing field a bit.
Saul Marquez:
Love it. Couldn't agree with you more. Big one. Well, look, we could hang out here for a long time, Katie. I really have enjoyed our time together. I'd love if you could just leave us with a closing thought and the best place our listeners and viewers could connect with you and follow you.
Katie Kaney:
Sure. I spend a lot of time talking to younger folks. You know, I guess I don't feel like I'm that old, right? But I just had a conversation yesterday with a physician that's in his training at Moorhead. And so one of the things that I want us to do is that there's a lot of people who see that the system needs to be changed, but when you're earlier on in your career, and you go into the system that operates that way, it's hard to change the system. So leaders need to be willing to question what we're doing, and it doesn't mean it's all bad. You know, I love clinical. I love what physicians do. I love what the system does, but it's not operating the way it needs to help people the way it should. And so to me, I think from a leadership perspective, we need to be open-minded, to be able to be critical of what we're doing so we can help make the change and help some of these younger generations really come up and make the changes that they want to.
Saul Marquez:
I love that, Doctor Kaney. It's a great call to action for all of us. Let's be open to those ideas that could help us evolve and be more consumer centric and open to the ideas of the younger generations. I think it's a great way to close. I want to thank you again, Doctor Kaney, for being with us. This has been a lot of fun. Appreciate you being on the podcast with us.
Katie Kaney:
Thank you so much.
Saul Marquez:
It's our pleasure. And by the way, for all the listeners and viewers. Make sure you check out the show notes. As we mentioned, we'll leave links to Doctor Kaney's book, The Whole Person Index, as well as other shortcuts to get the resources we've discussed on today's podcast. Thank you all for tuning in. And Katie, thank you for being with us.
Intro/Outro:
Thank you for listening to Healthcare Unbound. We hope today's episode was insightful. If you want more information on how Clarify Health can help you, please visit ClarifyHealth.com.
Sonix has many features that you'd love including automated subtitles, advanced search, automated translation, secure transcription and file storage, and easily transcribe your Zoom meetings. Try Sonix for free today.
