Care Delivery_Jaime Warren: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Manav Sevak:
Welcome to the Memora Health Care Delivery podcast. Through conversations with industry leaders and innovators, we uncover ways to simplify how patients and care teams navigate complex care delivery.
Matt Troup:
Hello, everyone. This is Matt from Memora Health, one of the medical directors and co-hosts of the Care Delivery podcast. I’m excited to be joined today by Jamie Warren. Jamie, thank you so much for coming on the podcast today. Can you introduce yourself to our listeners?
Jaime Warren:
So first, thank you for having me. My name is Jamie Warren. I am currently working with MedAxiom, which is part of the American College of Cardiology, and excited to be able to have an opportunity to talk about care delivery, especially in the allied health professions.
Matt Troup:
Awesome. And you mentioned a little bit to me about kind of your journey through health care. Can you tell us a little bit more about that and how you got to where you are now?
Jaime Warren:
Sure. I started out as a nuclear medicine technologist, so hands on patient care, doing imaging 20-plus years ago, and have, kind of just when you are a good technologist or you want to be able to be more involved in the imaging world, what usually happens in your pathway is you end up being a lead or a supervisor or a manager. And so kind of worked my way up in those roles and very quickly identified that while I had gone to school to understand this very highly specialized field from a technology perspective, I needed to go back to school and learn how to help lead people. So I did go back and did get my MBA. And I also have obtained my doctorate of education in health care organization and leadership back in the middle of Covid, that was interesting, and then ended up overseeing a service line for cardiovascular imaging for a large health care system based out of Kentucky. So think hospital, outpatient, anything that has to do with cardiovascular imaging, basically touch those pieces. So fast forward to today. The best way to describe what I do is a health care consultant, specifically in the cardiovascular field where I’m able to go in to practices or service lines or even work with industry and help them with best practices, or we call it the science of delivering care, but really looking into the imaging component.
Matt Troup:
Oh awesome. I love that the science of delivering care, I think that’s an education that a lot of us could use, myself included. So what inspires this work that you do? You’re much like me. You spend your entire career in health care and you continue to work hard to make changes within the health care system. Tell me, like, what continues to get you motivated each day?
Jaime Warren:
So it’s always think what gets me up in the morning, right? What gets me up, sits me down, and wants to move things forward. You know, I really, I just want to make health care easy. I want to make it easy for the patient. I want to make it easy for the technologists and sonographer and the nurse that’s working with the patient. I feel like my job is to be able to be, one, their cheerleader, their champion, but also to help remove roadblocks and speed bumps. And why are we making this harder than it needs to be? And where is the easy button to make sure that we can put processes and policies in place just to be able to get the patient from point A to point B. I mean, health care is scary. I spent a lot of time with my team talking that we come to work every day and this is our norm until we become almost numb or immune to what the patient experience is. But especially in the cardiovascular world, if you end up with your doctor saying, hey, I want you to go have some testing because I want to check out your heart, that’s very scary. And so being able to kind of bring that patient back to the center to say, okay, what is their experience as they’re walking in the door and have a good experience for everyone that’s involved in that team.
Matt Troup:
Yeah, I appreciate what you just mentioned, that call out there, and I think this happened a lot in my clinical years as well, is you get so ingrained year after year, this is the norm. But you realize that each patient that walks through that door is really having their own unique experience with the health care system. And it can be very scary for people who aren’t familiar with it. How has that experience changed over your career? Where have you seen big improvements? Are there, I’m sure, but there are still things that are stressful, but where have we made the most gains?
Jaime Warren:
So it’s an onion. And, and the more that you peel back the layers, the more you see opportunities and things that can be evaluated. I think especially in the imaging world, the development in both hardware and software has been impressive in the last ten years. And even I like to talk about hybrid imaging, where you can take two different modalities like you can pair Pet and CT and overlay those images, just the quality of what you can get from a diagnostic tool today versus I mean, really, ten years is like nothing, nothing, right? To be able to put that out. I think that that has really advanced us in patient care and early detection, early way to be able to get them started in treatment. And then let’s talk about treatment. I mean, there is now an insane amount of different ways that you can tackle something that, you know, if you had been provided a diagnosis 20 years ago, it was a totally different pathway than what you look at today.
Matt Troup:
Yeah, 100%. The advancement of medicine is incredible to look at over the span of time. Now, I know that you one of your biggest motivators is process improvement or operationalizing this. Have you found new challenges with the operationalization of getting patients into these tests, and especially with new challenges, with staffing shortages? And how does that look currently in your world?
Jaime Warren:
I like to use the word intentional integration. So sometimes we build these programs or put things in place and you see this philosophy of if we build it, they will come, which out the intentional integration into a program, sometimes it doesn’t get utilized in the capacity that it best could. So I think from a process improvement place, being able to have someone in place that can really help look at the span, maybe come up another 1000 feet versus being too close to it and evaluate, like, let’s get really in the weeds. If I wanted to purchase a CT camera to do cardiac work and I put that into place, you really have to think at it for multiple layers of how does this get ordered? How do we get preserves? How do we bill for it? Does the ER know how to order one of these? Can the ER order one of these? So that’s kind of the first part there. Staffing is a whole other animal right now. Where we saw, nursing, it was communicated, I feel a lot louder with nursing, two years ago, really in the thick of COVID, we were seeing a severe shortage in nursing and the allied health professions, we didn’t hear too much. They were kind of hanging on, it wasn’t the bigger focus. The bigger focus was the larger group of our health care professionals with nursing. But then fast forward to today and we’re seeing a significant shortage in allied health professions. And I will, you could say that what I’m going to say, this statement you could say for any of them, but I will say especially in ultrasound, sonography. This is probably a daily conversation that I have with practices and health care organizations, that it’s how do we get people into these roles? And one of the things that I feel like I’m championing or want to be a champion for is there is a misconception sometimes with these allied health professions, that these are entry level positions and that they could just hire anybody and then be able to train them. But actually these positions do have an educational pathway. They usually lead to a degree and they have to take boards and pass board, can be able to do this. So it’s very similar in a pathway that you would think from a nursing or a PA perspective, being able to get your education. And I think the more that we bring awareness of what their experiences, what their background is, what they’re walking into, when you hire somebody directly out of school, what does that mean? I think it’s shifting the culture of what an allied health profession is and highlighting it in a different way is going to be able to help us with this staffing shortage and identifying the right candidates for these jobs.
Jaime Warren:
Yeah, I appreciate that call out for the allied health staff and you shared with, this with me earlier. But yes, the shortages of nursing that we’ve heard about for many years now as we’re starting to see this throughout health care. And so as you moved into this role where more on the consultant side of things, how are you helping the health systems you’re working with navigate this problem?
Jaime Warren:
So I’m going to stick on culture for a second. I think it is changing the culture. One of the things that is a hot topic right now is making sure that we use the right verbiage to call people what they are, what is their professional title that actually describes them? So I would say, to anyone, is that you usually don’t have a technician when it comes to an allied health profession and being able to articulate really what their background is and being able to use the right verbiage for their scope of practice goes a really long way. It goes a really, really long way and it starts all the way down into job descriptions and job postings and what is the patient care team calling certain people? So that’s the first piece. The second piece is, is, sometimes in the imaging world they feel like they’re in the dark, like literally they’re in the dark, but they feel like they’re in the dark. So sometimes they feel like they’re the last group to get the messaging. And so it’s being able to go into organizations and saying your allied health profession, so pharmacy, PT, OT, your imaging world, your cardiovascular, cardiac rehab, on and on and on, they’re part of that patient care team and it’s important to include them in discussions for changes in policies and procedures or this patient needs to go to this location or that location, but it’s truly including them in that upfront in the patient care team and in the handoffs.
Matt Troup:
Yeah, couldn’t agree more. I feel like the best way to tackle so much of this operational challenges or throughput issues with patients is recognizing that all of these members of the care team have a hand in creating more efficient experiences for patients. Are you seeing the adoption of digital technology in helping with solve this problem? Does it have a place in the work that you do or the work that you consult on?
Jaime Warren:
So I will say that digital technology or even artificial intelligence is playing a large role in what we do. Any time somebody brings up the word AI from both a physician perspective and a staffing perspective, they’re like, oh my goodness, am I going to be out of a job? And the answer is no. I mean, maybe 30 years from now, when it becomes very advanced, you know, we may see different ways of doing workflows, but really it’s more of a collaborative partnership. It’s the ability to work smarter, not harder. AI doesn’t get tired like a human does. So it’s that initial run and being able to catch things that maybe us as humans are not catching. When it comes to AI and processing and post-processing images in the imaging world, it’s really being able to capture something that maybe the human eye is not able to capture. So in the long term, I mean, this is the best things we can do for our patients, which is why we’re here.
Matt Troup:
Agreed. I think a lot about it in my world now on the digital health side of things as trying to create technology that augments the care of care teams, right? Expands their reach, allows them to do their work more efficiently. But it’s not really about replacing them, it’s just giving them better tools to use. And I think we’re just starting to see how this sort of technology can really start to rapidly improve the reach of clinical care teams. And I think AI is going to play a part of that. I know you have a background in, you got your doctorate of education, how has that played a role in thinking how health care can be improved? Has that lens changed anything about what you’ve done in the past or are currently doing now?
Jaime Warren:
So when you go through school for a very technical type of position, the training is very based in math and science, right? It’s the research, proof, those types of things, and so being able to go back to school and learn different philosophies and theories about people and how they think and how being able to manage the best way, I feel like it took me out of the box, it took my blinders off and it allowed me to realize, this just sounds so silly, but it made me realize that not, everybody doesn’t think the same way I think, right? And not everybody communicates the same way that I communicate. And so if I want to be very effective with a large group of people, I need to be able to take a step back and go, what is the best way to evaluate the audience that’s in front of me? To be able to speak to them, to meet them halfway? Where’s the middle in being able to move the needle forward? I feel like we all want to move the needle forward, but sometimes in health care we use the same flavor of the month.
Matt Troup:
Yeah!
Jaime Warren:
And sometimes when you work in an organization, you can even see the team kind of roll their eyes and go, okay, what are we going to do this month? But it’s about being able to take a project or a policy or a new method and being able to explain the why with the group and be able to get buy in with the group. And I do feel like being able to get that management education that has helped me be more effective with group change.
Matt Troup:
Yeah, that makes so much sense. And where have you seen that play out? And other recent examples where you really feel like that sort of perspective has made a big change?
Jaime Warren:
So part of the project that I work on at MedAxiom is going in and helping with strategic planning. And sometimes when you do that, you have to talk to all levels within a health care organization. You’re all the way up in the C-level, all the way down to boots on the ground. And so the same messaging that you would give to somebody in the C-suite, is not an interventional cardiologist, it’s not the cath lab director, and it’s not the cath lab nurse. So it’s being able to really evaluate who is in front of you and be able to create messaging that they feel comfortable talking to you also. So when we go in and I interview certain categories or different groups, it doesn’t need to be an interview where I talk for 30, 45 minutes instead of need to be able to get them to provide me the information. So it’s that and being able to really find the connection with the person that you’re talking with.
Matt Troup:
Yeah, I fully agree. I love that call out too, about seeing the perspectives from the C-suite all the way down to boots on the ground. And I think understanding the experiences of the big barriers that exist and the experiences of all those types of voices makes a lot of difference when you’re trying to think about a solution that fits everyone’s needs.
Jaime Warren:
Yeah.
Matt Troup:
What are the metrics you feel like you look for or you look to improve when you’re starting to think about operations and improving those processes, are there ones that you target or look for more than others to see improvements of outcome?
Jaime Warren:
Yeah, so it’s going to depend on which aspect that we’re looking on. And again, I’ve kind of been picking on imaging, so let’s pick on imaging for this one too. So the kind of the two big ones is access and quality. We want to be able to make sure we can get the patient in. We don’t want a doctor to say, hey, I need a stress test, but it’s going to take four weeks to do it. When that patient is identified that we think they may have something going on with their heart, we want to get them in as quickly as possible. But the second piece of this is, is we want to make sure that when we do that test is the highest quality that we can possibly do. So that is from do I have the highest technology from a hardware-software perspective? Do I have a technologist sonographer who understands what they’re doing? That they’re highly educated and highly skilled and we keep them up with those things? And then do I have a physician that is reading the report in a timely manner and reading with a complete report? So each one of those metrics then dives down into some additional pieces where we can do peer review or we can do correlations, or we can evaluate when’s the next available appointment and do we need to be able to add more slots? It’s those quality metrics, especially in the imaging world.
Matt Troup:
Yeah. Thanks for highlighting that. That makes a lot of sense. And I wonder, does the experience really factor into this as well? Do you think about how this patient experience play a role in that too?
Jaime Warren:
It does. And I think that’s interesting that you pick it up. So what ends up sometimes happening in health care organizations is we use patient experience really from the bedside and that’s it. So it’s a little bit harder to capture. What is that patient experience when they’re coming down to have a test done, that’s not necessarily considered an H-cap, like it’s not a survey, patient survey. I would highly encourage any facility or organization to have a method to track patient experience within your imaging departments. Now you’re going to hear, I’m cold, It’s freezing down here, it’s dark down here, those types of things. But you also get feedback on the technologist was great, this was a really scary test and they walked me through what exactly I could expect and I’m going to be on the table and I know that I can call out to them if I need help. Like MRI’s are really scary, right? So an MRI technologist is going to say, I’m right here, I can hear everything you say. If we need to take a pause, then we can take a pause. I think that’s the biggest piece to that.
Matt Troup:
Yeah, and I’m so glad you called that out because, yeah, I think trying to track or benchmark patient experience throughout the entire process really helps. Yeah, it’s certainly hard and also just provides us this robust checkpoint for us when we think about what’s really going on for the patient at each step. And I think for me, always when I think back to anytime there was patient feedback or patient experience and in the patients that I was caring for, it was always this, okay, so look in the mirror a bit and say, am I, am I actually like coming to work every day and trying to put the patient first and focusing on how they view their own care and their experience within the health system. So lastly, I would just wonder, are there any other industries you look towards when you try to think about, okay, health care has a long way to go, we need to get more like this type of industry, or I can pull experiences or the ways this industry has operations or improved operations. Do you ever look outside of the health care system to get that inspiration?
Jaime Warren:
I think we can get inspiration from a lot of different other industries. The only thing I always caution people on is our business, our commodity is people.
Matt Troup:
Yeah.
Jaime Warren:
So it’s not like a product or a service. I mean, we’re actually treating humans. And so sometimes I am a big component of Lean or Six Sigma and, and evaluating where we’re not being effective and where we might be producing waste. But I also think it’s important to keep that patient in the center of your thoughts as you’re changing policies and procedures or workflows or evaluating that we’re not becoming too lean, that we don’t have the opportunity. And I’ll go back to patient experience to be able to have that moment that is so desperately needed with the patient that it doesn’t become almost a mill, especially in the imaging world where we’re just trying to get patients through, but that the technologist understands they have time, that if you have a really scared patient that you could take that extra couple of minutes just to stop, grab their hand, have a human moment, explain the test to them. So yes, I do think there are pieces that we can take from other industry, but I do think that we also need to keep the patient at the center.
Matt Troup:
Jamie, I love that. Thank you for sharing that perspective. This has been such a wonderful conversation and I’ve really enjoyed the perspective you shared, calling out specifically, you know, how supporting and hearing our allied health professionals and how they play a role in the big picture within health care. When you think about health care right now, what excites you the most? What’s again, we talked a little bit about what keeps you excited each day, but where are you most optimistic and what do you see for the next couple of years in health care?
Jaime Warren:
It’s always going to be an area of growth. It’s always going to be an area where we are striving to get to the core, to the center. And you’re always surrounded by people that are trying to get to new technology and new, you know, new ways of doing things and new treatments. So health care is never going to want to be one of those things where we’re just like, okay, we’re stuck, we’ve reached the end. It’s always growing.
Matt Troup:
Excellent. Well, Jamie, thank you so much for joining me today. This has been a wonderful conversation and I look forward to another chat soon.
Jaime Warren:
Thank you.
Manav Sevak:
Thanks for listening to the Memora Health Care Delivery podcast. For more ideas on simplifying complex care for care teams and patients, visit MemoraHealth.com.
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