How did you get into the healthcare industry?
It actually started with my reading of three books in my mid-20s: On Death and Dying by Elizabeth Kubler Ross, Gezundheit by Patch Adams, and the Tibetan Book of Living and Dying. I decided I wanted to work with the dying, a strange desire for someone that age who had not yet experienced any major losses. Through my research, I learned that I needed a MDiv degree for the kind of role I had in mind, but I wasn’t particularly religious. I did however have a relatively new meditation practice, so I went to Naropa University in Boulder, CO for the degree, followed by five years of hospice work in Queens, NY.
You’ve spent a number of years on the provider side. Can you talk about some of the work you’ve done?
Working for hospice was wonderful and gave me a real appreciation for the realities of both patients and caregivers at that stage of life. At some point, I came to see the hospice patients as the fortunate ones compared to those I saw dying in ICUs. Around the same time, I began to get a little intellectually restless, like I was yearning for ways to apply my mind to the larger issues. I applied for MPH programs in Health Policy and Management, and ended up moving out west for UC Berkeley’s program. Soon after graduating, I was hired by Hill Physicians Medical Group, one of the larger IPAs in the country, to develop an advance care planning program for their 4,000+ doctors. This was a huge leap from what I had done previously. A geriatrician, Terry Hill, MD, was a great champion there and paved the way for me to develop a department for the Complex and Serious Illness population. Among other notable initiatives, we partnered with Blue Shield of California on their first statewide rollout in home-based palliative care, created end-of-life quality reports for our practices, did SNF management, and developed readmission reduction programs.
In your role as Director of Client Success at Vynca, what does a typical day look like for you?
Working for a start-up is very different from a large provider system. Working from home allows extra time at the beginning of the day for my morning meditation and smoothie making. But when the workday starts, it’s sometimes unpredictable and can focus on a variety of areas and initiatives. I am on calls with our clients, identifying data needs and resolving issues, strategizing with teammates on product and business development, and lately, knee deep in our database and Excel, analyzing Vynca’s end-of-life outcomes at our client sites. We hope to publish this study, so stay tuned!
You’re also doing some consulting with current clients, as well as other healthcare organizations looking to develop an ACP strategy. Where are they needing the most help?
By now, I think everyone knows that advance care planning is hugely beneficial for patients and is associated with measurable quality care. The struggle is 1) understanding how comfortable providers are at this 2) figuring out if and how to upskill them and 3) get them to do the right ACP for the appropriate patients. I don’t have all the answers, but having faced these same challenges myself at Hill Physicians, I certainly understand the challenges and the opportunity for improvement. For independent physicians, we had to find a way to compensate them for time not spent seeing patients and billing. Each situation is going to different, but one of the unheralded values of Vynca is having the data on who is creating and viewing documents. This is light years ahead of making guesses based on ACP billing codes, which are still unevenly used. Having and knowing the data, you can make important strategic decisions and pivot accordingly.
Thinking back over the past two years, what in the ACP industry has surprised you most?
It used to feel like a special guild of industry folks who would even mention it, but now it’s on most people’s radar — that’s happened in a pretty short period of time. It’s showing up in quality metrics for oncology and incentive payments. You have health systems creating their own metrics around it.
What excites you the most about the future of ACP?
Besides the role VR can play in educating patients about care choices?! I think we’ll finally see ACP being taught in most medical and nursing schools. Real learning, with role play and such, not just a CME on the topic when everyone is exhausted at the end of a long day. This will make a huge difference, and will be part of a much larger push for primary palliative care skills for all practitioners. There’s just no other way the American healthcare system can survive the aging Boomers.