Issue link: https://beckershealthcare.uberflip.com/i/1393415
88 88 THOUGHT LEADERSHIP Vanderbilt CEO: What the telehealth boom makes inexcusable By Lauren Jensik J effrey Balser, MD, PhD, is president and CEO of Nashville, Tenn.-based Vanderbilt University Medical Cen- ter, a position he's held since 2009. Over the course of his 12-year tenure, he has ex- panded the health system from two to five regional campuses, which include seven hospitals, 1,700 beds and 3,000 physicians. Dr. Balser shared with Becker's the most important lessons he's learned from the COVID-19 pandemic and the biggest chal- lenge facing Vanderbilt and healthcare. Editor's note: is interview was edited lightly for clarity. Question: What are some of the biggest lessons you learned during the pandemic? Dr. Jeffrey Balser: I would say the big lesson is around the role trust plays in how health systems function. And there are two kinds of trust I think we've learned about; one is trust between healthcare provider systems and the public. And I think if you look at healthcare back in 2017, 2018, and you looked at how consumers talked about health- care, I think healthcare ranked somewhere below toilet paper brands, and that pretty remarkably changed during the pandemic as people, I think, became less justifiably irritated with a lot of the snafus around insurance approval and all the things that drive people crazy about healthcare, and became focused on the thing that really mattered, and that was how can healthcare help them stay alive. And then as health- care played such a huge role in helping people get vaccinated, I think it changed the way the public feels about healthcare for a period of time. And I hope we can sustain that. I think we also learned that, especially in underrepresented commu- nities, communities that are underserved, the preexisting relationship we have with those communities has a big impact on how successful we are in helping them in a crisis. So we found in Nashville, in areas and communities where we actually had people on the ground already working before the pandemic who were known to that community, we were much more successful then in managing through the challenges they had in a crisis because they already trusted our people. So the other kind of trust we learned about was trust inside the health system. And just like any industry, healthcare systems have silos, pro- fessional silos. So physicians, nurses, pharmacists, all those white-coat professions … we all have professional roots that cause us to have dif- ferent orientations toward problems, and sometimes cause us not to interact and communicate as well as we like. And then it's even more different between what we call the white coats and the blue suits. So the people in the health system that are man- aging finance and HR and all those other areas, and how they think versus how clinicians think, and what I think we found during the crisis was people forgot about all those differences in orientation and training and history, and just focused on figuring out the problem and got to know one another. And we built bridges of trust between groups of folks that never had even met. And I think that was really valuable for us as well. One of the things we're doing at Vanderbilt is working on ways to sustain that growth in cross-disciplinary trust, cross-silo trust, beyond the pandemic. Q: What are some of the biggest challenges Vanderbilt is facing at this time? JB: I would say what we are all now facing in healthcare, especially in large tertiary systems, large quaternary systems like ours, is workforce chal- lenges. Nursing is probably the most acute workforce challenge in U.S. healthcare — inpatient nursing, particularly critical care nursing, because I think we were already in a shortage situation before the pandemic. And I think what we've seen during the pandemic is people's plans to retire were somewhat accelerated. And so now we have — what I read actually in Becker's a few weeks ago — is we have 55 job postings for every nurse and inpatient nurse. And so that's going to be a huge challenge for regional quaternary centers like Vanderbilt, and we're already feeling that. Q: What are your goals and priorities for Vanderbilt for the rest of this year and going into 2022? JB: I would say for the rest of this year, we're heavily focused on the well-being of our people coming out of the pandemic. I don't think people in healthcare have seen anything like this in terms of the level of stress that they've experienced not just at work, but also at home, since the two World Wars. It was like fighting a battle on home territo- ry. It was pretty remarkable. And I think we're all proud of how that's gone, but at the same time, people are physically and emotionally ex- hausted. And I think being attentive to how folks are doing and re- covering over the next six to 12 months is going to be very important. I would also then say beyond that, going into the next year, I think that the digital health care economy and our move into digital health has been dramatically accelerated by the pandemic. I think many of the qualms we had about patients embracing it, and whether the technol- ogies would work … all that went out the window very quickly when we did get it to work, and patients loved it. So now the patients expect it, as they should. And healthcare needs to be about providing digital healthcare services where appropriate as patients desire them, not as we wish to deliver them. And I think that the opportunity there to do more and to serve patients who live in remote communities or are dis- "I don't think people in healthcare have seen anything like this in terms of the level of stress that they've experienced, not just at work, but also at home, since the two World Wars. It was like fighting a battle on home territory." - Dr. Jeffrey Balser, Vanderbilt University Medical Center