HLTH_Theresa Demeter: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Saul Marquez:
Hey everybody! Saul Marquez with the HLTH Matters podcast. Welcome back once again to another great episode with a leader in today’s healthcare space that’s making a huge difference. And if this is your first time joining us, I want to welcome you and remind you to hit the subscribe button. That’s how we get all these interviews straight to your inbox. Straight from the HLTH show floor this year in Las Vegas, I want to welcome Theresa Demeter. She is an entrepreneurial executive administrator with 30 years of healthcare performance and operational expertise. In her role as a managing director at Tegria, she brings her passion for conceptualizing and implementing innovative solutions that drive quality and performance improvement to optimize patient outcomes. Theresa developed Tegria’s offering that helps healthcare organizations prioritize and operationalize their health equity strategy and mitigate the harmful effects of implicit bias through macro simulation. Prior to joining Tegria, Theresa drove the formation and expansion of InSytu, a national leader in health clinical process improvement powered by macro simulation. She also served as the director of Women and Infants Outpatient Services at Swedish Health Services in Seattle. I want to welcome her to the podcast. It’s going to be a great discussion around the work that they’re doing around health equity and things that we could think about. Theresa, thank you so much for being with us.
Theresa Demeter:
Great to be here, thank you.
Saul Marquez:
Yeah, so it’s been several months since we were together at ViVe, and it’s so great to see you again here at the HLTH event. It’s always worth level-setting. Folks, if you haven’t had a chance to meet Theresa, number one, I’m going to link up the interview that we did at ViVe in the show notes. You’ll have to listen to that because that was a great interview. And number two, this is a great chance to just recap. So Theresa, why don’t you tell us what inspires your work in healthcare?
Theresa Demeter:
Many years ago I was a childbirth educator and a doula, that’s how I got started in healthcare. And I never really aspired to be a nurse or a physician, but I knew I wanted to be in a space to take care of people. So I became a childbirth educator and a doula, and from there got to see the difference between what really good care looks like and what maybe mediocre care looks like, and then just set a path to kind of help improve care along the way. From a childbirth educator and a doula, I kind of moved up into being the director of our Women’s and Infants Outpatient Services at a hospital in the Seattle area, but got really interested in process improvement from there, so more than just taking care of a single patient, helping caregivers better care for all the patients. So got into quality improvement and process improvement, and then at Tegria able to do that at a much larger scale.
Saul Marquez:
I love that. Thank you for sharing that story. And what about at Tegria? You know, how would you summarize the value that Tegria offers to the healthcare ecosystem?
Theresa Demeter:
Well, I think first and foremost, what’s most important to me is that maybe our heart center at Tegria’s humanizing healthcare, and that’s how I look about, look at it as well. No matter if you are using a technology, or you are directly caring for a patient, or you’re in operations supporting all of this to happen, we keep that patient and that human at the center of everything that we do. And that is actually a really good segway into the work that we’re really bringing to life now, which is around health equity. And health equity and quality in care are really the same coin, just different perspectives of the same coin.
Saul Marquez:
Totally agree, and it is about putting it all together and bridging those gaps. So technology access bias is undermining efforts to attain equity in healthcare, but where does that bias come from?
Theresa Demeter:
Well, first of all, I want to start by saying technology has so much potential to change healthcare. We’re creating access and providing access in ways that we’ve never had before, so driving access to many more people. But in the proliferation of technology that’s coming online right now, especially post-COVID, we need to be very careful, we need to be very thoughtful that we’re doing it in a way that doesn’t leave anybody out. Technology is so based right now on your access to broadband services, not just the Internet, but broadband services, so that you can have a virtual care appointment. If you live in a rural area and it’s 2 hours to get to the nearest doctor, virtual care gives you that access so that you can easily see a doctor even though you work full time and you have children and you’ve got other things to do, virtual care makes that care possible, but if you can’t get on the Internet and if you don’t have a speed that makes it possible, you’ve been left behind.
Saul Marquez:
Right, right.
Theresa Demeter:
So we just have to really make sure that we’re very intentional. I like to think about it as starting at the problem. What’s the problem we’re trying to solve? And then from that problem, as we ideate the solution, who is that solution for, and let’s not assume we know what they need. Let’s go and bring them to the table and ask them and talk to them about it, and then really intentionally devise a solution that makes it better for them.
Saul Marquez:
I love that. Yeah, that’s a great example. Yesterday we had a guest talk about an Indian tribe that is deep in the Grand Canyon and how do you deliver care to them. And then on the other end, it’s the urban setting where you don’t have transportation. So it’s putting all these really kind of disparate areas that aren’t receiving that care, finding a way to give it to them.
Theresa Demeter:
It’s so complex, and in the rural setting, it’s often just not having access. In the urban setting, it’s often more of a income-related, it takes a certain income to be able to have that subscription to the broadband or to be able to get to your local coffee shop where you can buy a $5 or $8 now coffee so that you can use theirs. So it’s really a complex set of solutions that we have to come up with to make sure that it’s working for everybody.
Saul Marquez:
Yeah, I love that. And so what is techquity, right? This is a term that’s been, we’re using it a lot lately, especially at this conference, and how can it help ensure the proliferation of technologies that reduce disparities rather than perpetuate those inequities?
Theresa Demeter:
You know, I really am grateful to the HLTH Foundation for really bringing the idea of techquity to light and allowing so many of us to have feedback on what really is techquity. At the core level, techquity is the intentional and thoughtful ideation, design, testing, training of health tech, healthcare-related technology, whether that’s access or patient care devices or remote patient monitoring or your electronic medical record, that we’re being very intentional in how that’s designed to not leave anybody out. But as we bat around that definition, we’re realizing it’s not the full definition yet and we’re adding to it and refining it as we go to make sure that we have a really clear understanding of what techquity is. And again, at the core, it means that the health technology benefits everyone and doesn’t make health inequities, health outcomes worse, create more disparities than exist today.
Saul Marquez:
Got it, thank you, Theresa, I really appreciate that, and there are so many questions left. I always enjoy hearing examples. Do you have an example, something that Tegria has done with a customer or anybody out there to help with techquity?
Theresa Demeter:
Yeah, definitely, one of our favorite stories right now is an organization in southeast Alaska, called the Southeast Alaska Regional Health Collaborative, and they serve very remote communities all over southeast Alaska, so remote that you have to take a floatplane to get there, and you can only get there in good weather. And so the ins and outs of these communities are narrow, you can only get there during certain parts of the day or the week or whenever the weather allows you. And they wanted us to help them better prepare for different types of emergencies, mass casualty events, or critically injured or sick patients that the facility in a very remote area of Alaska wasn’t prepared to care for, meaning that that patient would need to be moved probably via floatplane to a hospital, possibly hours away from where that person lived, that means taking them out of their community. So we went up to southeast Alaska on four different occasions to go.
Saul Marquez:
Did you go there too?
Theresa Demeter:
I have to say, I didn’t get to go. No, my team got to go.
Saul Marquez:
I was like, whoa, this is adventurous.
Theresa Demeter:
Well, I was really disappointed, but floatplanes are small.
Saul Marquez:
Oh, are they?
Theresa Demeter:
Yeah, and so my team that needed to go to actually do the work, took up all the seats on the float plane and I was the extra that didn’t get to be on the plane, but I’ve got all the photos and all the video and all of the.
Saul Marquez:
Hey, what an experience. I mean, I’m there in my mind and it’s beautiful and you’re helping these people, and so you have pictures.
Theresa Demeter:
We’ve got pictures.
Saul Marquez:
Oh, my God. Can we link these up to the podcast?
Theresa Demeter:
Yeah, happy to, it is such a beautiful part of the world, but it’s a very remote part of the world, and you can see that, you know, beautiful rivers and we see bears and moose and it’s very remote. And the people that live there are native Alaskans and they have deep roots, deep culture there, and so part of what we were doing in our work to help them better prepare for their emergency response, mass casualty, which in remote Alaska, a mass casualty could be a floatplane accident. So you’ve got four critically injured people, but the small facility there, that overwhelms their resources, and so we were helping to upskill their resources and just help them better prepare. But keeping in mind, how do we use technology at its highest level to do the best to keep people at home, to keep them well, to treat them if weather prevents them from being able to get higher level of care or if possible, can we use other technology, remote patient monitoring, physician consults to keep people in their communities. Because we know people do better when they’re able to stay at home, in their community, where people really understand them rather than moving them. So it’s still a work in progress, we’ll go back and do more of this work, but it’s a really good start to help them better prepare their emergency response and then also keep their communities at the heart of the work.
Saul Marquez:
Wow, what a great example, and huge kudos to you and the Tegria team for being able to help communities like that. How can industry work with stakeholder communities to build more equitable health tech?
Theresa Demeter:
Great question and another complex question that has levels. So when we speak about industry, if we’re talking about technology, that’s where techquity really sits and we really want to encourage, and part of Tegria’s role is helping to reinforce the idea that, to pause, and in a conversation yesterday, I said pause and be humble. Because I think it’s so easy for any of us to make the assumption that I know what you need, and I probably don’t. I don’t know your history, I don’t know your lived experience, I don’t know your social determinants of health that make you who you are. And so as we develop technology, we just want to pause and realize we don’t know all of that, and what that means is asking. It means being very intentional to seek out sometimes hard-to-find groups of people, hard-to-find communities because they’re the most likely to be left behind. And sometimes it takes using someone from their community to make that introduction. We call them health advocates, and they are the bridge into those communities to say, what do you need to build trust with your healthcare system? What do you need in this technology? How will you access it? So when we’re talking about technology as the industry, really focusing on equity, when we’re talking about healthcare as the industry, we’re encouraging healthcare to think more about partnerships because healthcare can only do so much, you know, healthcare does a great job but can’t do everything, and so we’re encouraging healthcare to partner with different industries to help meet their patients where they’re at. It might be food insecurities, education, income, shelter, language, cultural sensitivity, but healthcare is just starting down that path to partner with other industries to focus on whole-person care, is what we call it, and really making sure that we’re meeting each patient where they’re at, and then also realizing that not everything can be done through technology. And at the end of the day, those health advocates are a really important part of pulling it all together, because sometimes it really is an individual person going to a community to say, this is good for you. We saw that a lot during COVID, where the cool thing about COVID was we had so much real-time data and we could see who was being left behind in terms of vaccines and in terms of outcomes. During COVID, and we could see very clearly which populations were lagging behind in terms of getting their vaccines, so we used healthcare advocates and we trained them, they understood the benefit of the vaccine, they built trust with the healthcare system, with specific providers, and then a lot of healthcare systems brought the vaccines to those communities, which took out the transportation questions, made it very easy to access, and that all happened through the advocates. So there’s multiple layers.
Saul Marquez:
That’s fantastic, and some great examples, Theresa, that we could be thinking about. How do we make an impact? What actions can we take to make healthcare more equitable with technology, with advocates, and really just thinking about how to do it with our organizations? Theresa, thank you so much for today. This has been such a great conversation.
Theresa Demeter:
Thank you.
Saul Marquez:
I appreciate your passion for this. What closing thought would you leave our listeners with today?
Theresa Demeter:
Well, I have so many, but let’s see if we can boil that down. I guess my closing thought would be maybe a thank you to the people at the HLTH Foundation and also organizations like the Office of the National Coordinator and Miki Tripathy, who are really helping industry focus on health equity by design and techquity to create that path for everyone else to follow, creating the standards and the best practices. Because right now it’s a little bit of a guessing game in how we do this, and what we really need is some directions, some feedback, some best practices for us to, all, to follow so that we know that we’re going in the right direction, and that helps us to ensure that we aren’t leaving anyone behind.
Saul Marquez:
That’s fantastic, thank you for that. And folks, just as a reminder, in the show notes, you’ll see all the links to our interview with Theresa from ViVe, links to Tegria, a link to the HLTH Foundation, as well as other things that we’ve discussed. Make sure you subscribe to the podcast because that’s how you catch every single one of these amazing health leaders like Theresa. You’re not going to want to miss it. Theresa, thank you so much for being with us.
Theresa Demeter:
Thank you, it was fun. Thank you.
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