Digital Health Talks - Changemakers Focused on Fixing Healthcare

Pioneering Care Delivery Transformation: Reducing Avoidable Hospitalizations and Driving Value-Based Care

Episode Notes

Join us for an insightful interview with Dr. Amy Boutwell, a leading expert in healthcare delivery transformation. As a practicing physician with deep experience in public policy, process improvement, and serving vulnerable populations, Dr. Boutwell has dedicated her career to designing and implementing innovative care models that reduce avoidable hospitalizations and emergency department visits.

In this session, Dr. Boutwell will share her groundbreaking work developing practical, effective strategies used nationally, including:

She'll discuss how her unique approach engages providers in critical thinking and problem solving to create meaningful, sustainable change. Dr. Boutwell will also share lessons learned from coaching over 1,000 teams across the country to transform care in ways that are data-informed, systems-based, clinically credible and measurably effective.

This is a rare opportunity to hear directly from a pioneer working at the forefront of value-based care. Whether you're a healthcare executive, clinician, policymaker or innovator, you'll come away with actionable insights for redesigning care to achieve better outcomes at lower costs.

Amy Boutwell, MD, MPP - Healthcare Delivery Transformation Strategist & Leader of Interdisciplinary Cross-Continuum Care Transformation Initiatives | Collaborative Healthcare Strategies

Megan Antonelli, Chief Executive Officer, HealthIMPACT

Episode Transcription

[00:00:00] VO- Welcome to Digital Health talks. Each week, we meet with the healthcare leaders making an immeasurable difference in equity, access and quality. Hear about what tech is worth investing in and what isn't. As we focus on the innovations that deliver. Join Megan Antonelli, Janae sharp and Shahid Shah for a weekly no BS deep dive on what's really making an impact in healthcare.

[00:00:30] Megan Antonelli: Welcome to Health Impact, live digital health talks. I'm Megan Antonelli, and I'm thrilled to introduce our guest today, Dr Amy Boutwell. Dr Boutwell is a true healthcare Changemaker as a practicing physician with a background in public policy from Harvard, she has devoted her career to designing and delivering whole person healthcare, especially for our most vulnerable populations. Dr Bowell served as the first director of the health policy and strategy at the Institute for Healthcare Improvement, where she designed and led a groundbreaking multi state initiative to reduce hospital admissions. It's an honor to have Dr Boutwell with us today to share her insights on shaping healthcare delivery to improve outcomes and lower cost. Please join me in welcoming Dr Amy Boutwell, Hi, Amy, how are you today?

[00:01:15] Amy Boutwell: I'm great. Megan, how are you today?

[00:01:17] Megan Antonelli: Good, good. You know I have followed your work for many years through your you know, your work at the Institute for Health Care Improvement, and I'm just so excited to have you here, because I think it's a real you know, we've reached a critical time in value based care. But tell me a little bit about, you know, what initially inspired you to focus your career on redesigning health care, and you know, your focus particularly on vulnerable populations.

[00:01:43] Amy Boutwell: Thanks. You know, everyone has an origin story, and mine goes, goes back to my childhood. Actually. I was about a 10 year old when the Ethiopian famine was happening in the mid 80s, and I remember at that point in time learning that while there was enough food in the world, the there the food wasn't able to get to the people who needed it, and that was just a perplexing and challenging reality for me to grapple with as a young kid. And so really, as I became interested in healthcare and becoming a physician, that abiding passion around how systems work and re engineering systems so that the need is met is really at the core of how I've pursued my career. And naturally, systems don't work well enough for any of us, but in particular, a place to really see the impact of redesigning systems and improving systems is for the people for whom it is working the least well, which which is vulnerable populations of a variety of sorts, right? So people with behavioral health and mental illness, regardless of socioeconomic status. People elders, regardless of socioeconomic status. And of course, people who live with poverty and other social stressors, all of these different types of groups are poorly served by our existing system.

[00:03:15] Megan Antonelli: Oh, wow, I didn't realize that. And, you know, I grew up around the same time, and it was such a, you know, I mean, powerful and impactful part of our, the shaping of our growing up. And I think, you know, it's interesting now to see, you know, the kind of that food is medicine movement coming in. I mean, certainly with all the social determinants of health discussion, you know, and then food is medicine, and how we can, you know, really make an impact. And that brings us to, sort of back to that discussion of value based care. What is value based care? Tell me a little bit about how you, you know, look at that and you know, sort of the value based care outcomes and what the elements you know we need to get there.

[00:03:54] Amy Boutwell: So, you know, one I worked at a particular interface of of that value equation, which I think is just just really ripe for describing what we're trying to do in value based care. So I work at the at the intersection of trying to improve care in ways that reduce costs, right? That's the value equation, and in the clearest way to reduce costs is to reduce avoidable hospital use. It is the single largest fragment of the healthcare spending pie is hospital cost. And so that is really where I've worked since I was at IHI and designed the statewide strategy to reduce readmissions at the state level. And then, since the Affordable Care Act passed, leading efforts to reduce what I now call recurrent hospital use, meaning ED visits, hospital admissions, hospital readmissions, kind of the full suite of reducing acute care use. Yes, and you know, it doesn't really matter what stat or study you look at, we all know that hospitals and emergency rooms are being used not for acute care. They're being used as a place where people go and they have needs, but not acute medical needs per se. So there's just a ton of opportunity, and that's the slice of the value based care spectrum that I work in, right?

[00:05:26] Megan Antonelli: That's great. I mean, I, you know, I think there, when you talk, when we talk a lot about value based care there, you know, obviously that's sort of where it started. That's where the policy impact has been. But there's, you know, such a spectrum of where we could see it impacting and having value. You know, healthcare loves our acronyms. And I know that you in your work, have, you know, developed a number of methodologies around this? Can you tell us a little bit about those and and kind of where they, you know, where they fit into this continuum?

[00:05:57] Amy Boutwell: Oh, gosh. Oh gosh. Well, I love that. I love that intro. We love our acronym. So, yes, so over the course of my 15 years in reducing recurrent hospital use, I like to think of three primary methods that I've contributed to the field. The first, it's called, this is an acronym called the Star initiative. And really that's just a strategy. It's a strategic approach to reducing readmissions, taking the state as the unit of interest. And the reason why this is important is because a lot of times we talk about models of care or roles and responsibilities and staffing models, as if a certain number of nurses or case managers to a certain number of patients is the only question to ask? And the cool thing about the star initiative is it took that bird's eye view to how the system is functioning at a statewide level and identified actionable, meaningful and impactful ways to align stakeholder groups to move in the same direction. So, you know, that would be, you know, obviously, state policy makers, state data agencies, professional associations, industry associations and frontline teams. So the key thing that came out of the star initiative. Two key things, number one, was to not just look at one rule type or one disease condition. We were looking at all that was very powerful and very different at the time. And number two, it was to to well. It was to view readmissions in that, in that example, as a function of how the system was operating. And so again, that system engineering systems based approach, okay. Number two is the Aspire method. And this was a natural outgrowth from star where, instead of the state, we took a population. The population, in this case was a hospital, sometimes an ACO and and essentially what I did with the Aspire method was the Agency for Healthcare, Research and Quality, gave me and my team a five year grant to identify the ways that the strategies to reduce Medicare readmissions needed to be adapted or modified to better serve Medicaid. Well, when 80% of all readmissions in the country are Medicare or Medicaid, if you can align a strategy that helps Medicare and Medicaid, then you have a whole population approach. So Aspire is a whole population approach, and the it's an acronym for six parts of this comprehensive data informed system redesign strategy. And the cool thing about the Aspire method is, thanks to the CMS partnership for patients and many of the district initiatives at the state level, the Aspire method has been used by 1000s of teams in all 50 states. So that's just been really exciting to to be part of in my career. And then the final method that I'll just mention is every single population struggles to get population wide results if they do not have an effective strategy for high utilizers. And so I call high utilizers multi visit patients and MVPs and coming out of work in a statewide initiative I did in Massachusetts, and then a statewide initiative for Medicaid in New York State, we have the MVP method, which is a differentiated care pathway specifically effective for high utilizers of the hospital and the emergency room. So that's the portfolio that goes from state to population to subpopulation, and my work just really. Fluidly moves in between those methods, depending on what the job is to be done,

[00:10:06] Megan Antonelli: Right? So, star, aspire and MVP, I love it, yeah. And, you know, I think it speaks to the the years of health care, of that you've put to health care that you can't came up with these acronyms that are, are, you know, exemplify that. And I love, I love that MVP is, is not, you know, most valuable player, but multi visit patients. So that makes, makes a lot of sense, excuse me. And then you know, around that, I mean, you mentioned, you know, Medicare and Medicaid is where so much of the readmissions happen, right? And, you know. And that's how I what I've always said is, you know, if you can fix it in Medicaid or Medicare, you can fix it anywhere, right? So when you look at kind of the work around reducing hospital readmissions, you know, what are you seeing as the root causes? You know, what are, what's, you know, what do we need to address to kind of come around that? And I know it's different for both populations and all of that. But you know, what are some of the main things you're seeing?

[00:11:06] Amy Boutwell: Yeah, first and foremost is what's missing is taking a data informed approach. Now you might say, what? How's that possible in the United States in 2024 sadly, it is the the most common mistake I see organizations make is they jump in to an assumption. Oh, there's an assumption that we have to work on chronic disease. There's an assumption that we need to work on the transition from hospital to home. There's an assumption around that leads teams into starting at a particular interface, instead of starting at looking at the what I call the epidemiology, the actual data of who is in and out of the hospital, and what are those subgroups? Without pre defining what those subgroups are, or presupposing that we know. So a great example just came from last year. I was leading a an initiative in rural Alaska, among hospitals in rural Alaska, and you know, their job was to reduce readmissions. They wanted to reduce readmissions. And everybody has the same answer, oh, hospital to home and heart failure. Okay, this is the these are the two assumptions that have held us back. And I can say more about that, but I said, No, no, no, before you decide what you're going to focus on, heart failure discharges to home. Take a look at your data. We came back one week later, and all 10 rural hospitals in Alaska in this collaborative had the same aha moment. They looked at their the number one condition leading to the most readmissions in their hospitals alcohol. So how can we possibly make progress if we are not looking at our data first and then designing our strategies accordingly? Now they came up flat footed, as all hospitals do when they look at data and they see something like, alcohol is a major cause, a major contributor to readmissions. But then we just ask, okay, so what's, you know, what's the root cause there? What would we need to do? What practices, processes and skills do we need to have? And then we can build, we can build around that. And so, so. So I would say that when we when we think of a population wide approach, which is predominantly Medicare and Medicaid, the the number one thing is look at who's coming back with high rates, and then design your program. And for some reason, Megan, we're just not doing that on a routine basis across this country.

[00:14:04] Megan Antonelli: Wow, yeah, no, that's so interesting. I mean, you know, and I think a lot about it says it speaks a lot about assumptions, right? And the assumptions that we make in healthcare. I mean, I'd love to hear a little bit more about, you know, sort of your thoughts around, you know, why those assumptions are in place, you know, and and kind of what, what we can do. I mean, obviously the data approach,

[00:14:27] Amy Boutwell: I'd love to jump in on that for a minute, because it's a, it's a, it's really where my, I hope my contributions to the field have been differentiated from, from, from, from those of others in the sense of, why do these assumptions exist? There's a this, this really comes to equity, to an equity issue, and there is a prevailing um. Um wisdom in quality improvement, population health and healthcare operations that we can only work on things we know how to help, right and so, Caucasian English speaking people who have a chronic illness well understood, like heart failure or diabetes, feel like they are within a zone of influence. And I will say, I have worked with 1000s of very well meaning quality and population health and operational leaders, and there is this equity bias around impactable And what we perceive to be unimpactable. And for those of you who have read any of my posts on LinkedIn, you'll know that I phrase my work as anti unimpactable. I do not believe that there's actually anything that is unimpactable. It's our bias around what we think we can and cannot do. But we can impact everything that I've come across in human in the human condition, and there's a lot more capable people out there than I am so I know that we can have a readmission reduction strategy that focuses on people who are in and out of the hospital with alcohol related issues. Absolutely we can. Just because we haven't before doesn't mean we can. And so I believe that part of or I know that part of why we are avoiding, embracing using data and root cause analysis to develop data and root cause analysis focused strategies is because of this impact ability bias that we have just in our operators. So education and skill development. Can, you know? Can can help with that?

[00:16:56] Megan Antonelli: Well, you know, I will say the given that the name of our organization is health impact. I you know, I didn't actually pay you to come on and say that there's nothing that's unimpactable. But I love it, you know. And I think that that you know it is that in healthcare, you know, whether it's drug addiction, alcohol, these things that you know. And that really opens the book on Social Determinants of Health, where it becomes, what is the purview of the health system and the healthcare organization to impact, you know, the things that aren't traditionally within their you know, diagnostic codes, right, right? So, but that's that is great, and such an important point around that. And, you know, at the end of the day, looking at the data, which, of course, with our community, who's very focused on data and technology, you know, but also listening to their providers and listening to the clinicians and their quality folks of what they need to look at. You know that the data tells the story of where they need to focus, so that that's all really important stuff when it comes to that, where, you know, you're talking about collaboration between the teams, you know, and getting, you know, making sure that that data gets in the right hands, you know, tell us a little bit about what your experience has been working with all these hospitals around, you know, cross continual Collaboration, and what that looks like in practice.

[00:18:21] Amy Boutwell: So, so, so, really, the link is right there where you just took us Megan, which is when we look at our data and we understand the systems issues that are causing people in certain subgroups to come back to the hospital frequently, the very next thing we do is we ask, okay, so what resources exist and and goes back to my days in the star initiative, taking the bird's eye view. It's not what resources do I have? It's not what can I do in my box as a social worker, case manager, doctor in a hospital or in a clinic or with two and a half minutes, it's what resources exist. So we take that bird's eye view in response to the data, and we say what exists. And that is the very beginning of cross continuing collaboration. Because what we do is we give teams, take hospital teams or healthcare teams, permission to say you do not need to meet all of the human and social needs. You just need to know what your patients are experiencing and then form the partnerships and processes and collaborations accordingly and and so this started way back when the Affordable Care Act was passed in there was the whole Medicare readmission things, and we started in the star initiative states. We started the first hospital and skilled nursing facility cross continuum collaboratives. And they would meet, and they would talk, and they would talk about process and root causes of readmissions and working better together. And that was in 2007 I can't believe it. 2008 and just today, now in California, I'm launching another cross continuum collaborative to bring hospitals and Medicaid community based care management organizations. It's called Enhanced care management in in in Cal aim, we are doing the same thing, matchmaking between hospital teams and community based Medicaid ECM teams. Bring them together and start to co develop processes where we can find people with needs and link them to services so cross continuum. Collaboration is the action step that follows from look at your data, understand what your population needs, and then release yourself from the sense that you, you or your team or your entity must meet all needs, and rather form those processes to link people to the organizations in The community that does exist and that gets results. And

[00:21:03] Megan Antonelli: It sounds, it sounds easy, but I get the sense from healthcare and from, you know, collaboration in general, that, you know, it's hard to get there, you know. And I think whether it's, I mean, we're certainly cross organization, which is, you know, I think what you're talking about there, you know, and bringing that in, tell us, tell me a little bit about how you're working with those organizations to, really, you know, get them to change their mindset, to get them to embrace that kind of bringing, you know, I mean, we, we talk a lot of about, you know, even with respect to social determinants of health, it's like Asking the hospitals, the providers, to do one more thing, right? So how do you get these teams to kind of say, okay, collaboration is going to help you, not not hinder you.

[00:21:49] Amy Boutwell: Okay, it is it. I'm only pausing because I don't want this to sound overly simplistic, but it is about articulating the Win, win and the short term energy that in effort that needs to be expended, but that the short term energy in creating better cross continuum working processes, which is something that can be done in, you know, 90 days it, you know, pays off on the back end in terms of a more fluid and fruitful operating reality for both entities. So what do I specifically mean by that? I'll use the example in the calaim Collaborative in California that I'm running right now. Hospital case managers and social workers every day are at the bedside with patients who have health related social needs, and the most common stressor in their day is feeling that there are, quote, no resources in the community to help these people, and so they are taking on either Herculean efforts in trying to individually problem solve and mobilize resources, and, you know, on an individual level, which is exhausting, or they're throwing up their hands and saying, This isn't my problem. It's the system that's broken, and they're experiencing moral injury and and so on the on on that side of the equation, we have a lot of need and a lot of work effort or a lot of burnout that's happening on the Community Based Care Management Organization side, these are organizations that are otherwise doing cold outreach to people in the community, and their enrollment numbers are low, and their business models are not thriving because they are not getting the volume that has been expected, because we all know there's a lot of people With a lot of needs, but cold outreach is like the worst possible strategy, actually. And so when we bring a cross continuum collaboration together to say, here's a setting that is saturated with humans with needs, and here's an organization that would like to serve more humans, it's a very clear win, win. Now we're going to put in 90 days of effort to co design a workflow that works for the hospitals and works for the community providers, and yes, I'm asking hours of their time to do that, but once the basics of that workflow are in place, it will not require that same time and effort, obviously, continuous improvement and good you know, collegial relationships will need to be strengthened over time, but that's it, and it's the same thing I've done with hospitals and behavioral health clinics in the community, hospitals and skilled nursing facilities, as I mentioned, hospitals and. And ACOs in the community. So it's just cross continuum. Collaboration does not exist until we build it. We need to put in time and effort to build it. But when once we build it, it is a win win for both parties, right?

[00:25:15] Megan Antonelli: That's great. I mean, you know, and I think that it's such an important message to kind of send to everybody in terms of that, you know, so upfront work that then pays off and droves later around. You know, you work in Massachusetts, Alaska, California, you've implemented these programs everywhere at the local, state and national level. You know, tell us about some of the unique challenges you've faced in in doing so and, and kind of where you think, you know, there's opportunities at each level for, for moving this along.

[00:25:47] Amy Boutwell: Yeah, I think the the, well, let me start in kind of a in a middle phase my, my privilege has been to mobilize groups of teams, groups of organizations. You know, whether that's in Central Massachusetts or the entire state of Michigan or the country, like with viziance or other national organizations, it's always mobilizing a group of teams. And the reason why I wanted to start there Megan is because when we when we mobilize a group of teams, it is a very powerful catalyst to action to overcome the challenge at the individual organization level of we don't have time, we don't have money, we don't have resources. We have competing priorities. We have too many fires to put out. So the worst place to work is at the individual organization level, because we can't get out of our own way. But when we work, when I work at this aggregator level, convener, catalyst, mobilizer. Then teams are invited, basically to join an initiative that's moving forward and that has been so powerful, and I hope I never have to read this particular interface, because it has been so powerful to overcome the inertia to change that happens at the individual organization level. So, so. So I think that that the the unique challenges are prioritizing and creating time and space to do change at the individual level. And antidote to that is State and National Convening. Now there's, there's a lot more similar. Again, the one of the neat things from having worked in rural Alaska to inner city, Baltimore and everywhere in between, all day, every day, for 15 years, is essentially, I see that almost all the problems are the same, and, and we've, we've touched on on some of them, actually, and, and so maybe I'm a very simple minded person, but essentially, when I meet a team In whatever geography with whatever payer mix, with whatever local richness of resources or poverty of resources, the the organizational willingness to change is a universal question, the willingness to look At and respond to data, and the willingness to engage in cross continued collaboration are really foundational in any of these environments. And the neat thing is, I have, gosh, a bag full of stories I can think, from rural Alaska, from Frederick, Maryland, which is suburban rural Maryland, to inner city, Houston, where the first step for each and every single team. When we looked at our data and we said, Who do we call? Who do we know to be our community partner for behavioral health or substance use, everyone looks right and looks left and says, I'm so embarrassed I don't think I know who to call. These are VPs of care management in hospitals, and what I what I coach them to do, is just say it's okay. Let's google it. Literally, Google right? Substance use, Houston, Texas, substance use, Frederick, Maryland. And we find a the, you know, kind of the largest multi service organization that comes up. We call the executive director, and again, more similar than different, each and every single time that executive director is thrilled to receive the phone call and could not. Be more delighted to start a collaborative relationship. And so that's kind of the space I work in, is, is, is helping teams know that, yeah, your organization has its own unique, you know, history and resourcing and and and and whatnot. But there's a lot more similar than different across the board, right?

[00:30:20] Megan Antonelli: What would you say? I mean, when it comes to that, what that reason behind the at the end, visual organization level, that it's the change is hardest, you know, is that, just because everybody thinks they're so different and thinks it's so hard, but when they then partner, they realize that they're to, you know, that they're together in this but, or is it more is it more complicated than that? Am I oversimplifying?

[00:30:45] Amy Boutwell: So I think that there's two things. So number one is in it. Number one is inviting operators, not executives and and so when I when in my work, I'm often inviting operators, managers of departments, managers of teams, people who have responsibility or accountability for achieving a measurable aim, like a readmission rate or something similar. And those are managers and operators. And so when they are offered the opportunity to do better in their job, they will take it. Whereas, if the request goes to the executive team, it's in the queue with, you know, capital you know, you know capital improvements, and you know many other big you know, decisions and priorities and so operational improvements pale by comparison sometimes and so again, one of the things I've loved about the space where I work is, of course, everybody always needs their executive champion to to support the work, but empowering managers and operators to make change within their operating environment to get better results, so that, that's, that's one of that, that's, I would say, that's a lever that I have stumbled upon and and happily support the mobilization of of of actual doers,

[00:32:20] Megan Antonelli: right? Well, and that's, I mean, I think always about, you know, kind of, you have your executive leadership, and then the management, and then also, of course, you're, you know, the the frontline clinicians. And I think when we think about value based care and how, you know, it's, it's come from that, you know, it's come from, sort of, the policy, the world of policy, and how it's been translated to the organizations. And I think, as you said, it's like we've taken some assumptions and maybe not done the right things to address it and to foster it, but in terms of how you support your clinicians in that from the organization, are there, are there, you know, lessons that you've learned around that in terms of even just communicating what it is and what it means. Because I think they have often looked at it as, you know, again, another checklist or another thing they have to, you know, adapt to. Are there, you know, for those clinicians, a way to support them?

[00:33:13] Amy Boutwell  33:13: Yeah, for sure. This is one of of the great things about being a practicing hospital based doctor is, you know, I, I, you know, I speak the language of my colleagues, right? And so what, what I don't talk about is value based care. You may be surprised, leader of some of the most initiatives that help with value based care as anyone in the country, but I don't use that term, and because what the frontline wants is better care for their patients. And that is a true north that doesn't fade and that does not have, does not difficult to communicate. And so, you know the why might be a why are we reducing readmissions? But, you know, in but really in terms of the front line, it is to harness those immediately, those patient stories, or those staff stories, where, you know, someone comes back and there's really no good reason, and we're like, this is such a waste. And we recognize, we implicitly recognize that when someone comes back to the hospital where we are 24/7, nursing care, telemetry and AND, OR is ready to go, and someone doesn't need to be here, you don't have to teach the front line that that's waste. And so that's really where the honoring the the the existing, you know, wisdom and horse sense of of the front line comes into play. And then just say, so you know what, let's create a better way so that this doesn't happen so much. And really, it's, it's, it's that, it's, it's not, it's not simplifying value based care. It's really just prioritizing what we. Maybe leaders, administrators, policy makers say is value based care, but what the front lines know is just better care. It's better care. And so that's a great interface for anyone who's listening, is just to connect with your clinicians, and saying what we're doing isn't working, it doesn't make sense, it's not efficient, it's not effective. Let's try to make it better, and we're going to make it better in ways that result in this outcome called people don't come back so very much. And that really makes sense to the 10s of 1000s of people that I've been fortunate to serve in my programs.

[00:35:36] Megan Antonelli: Of course, yeah, better patients. Better care for the patients, absolutely. So 100% so we always like to talk about good things in healthcare and the promising opportunities, I think, you know, as we've discussed, I mean, you've done such amazing work, and there's so much happening. And I think this, this shift to data, this ease of use of data, also, you know, turning around some of these assumptions. But what are some of the most Yeah, what are you most excited about as you look at the coming years ahead, with all this transformation that's happening?

[00:36:07] Amy Boutwell: Yeah, I think that, you know, you've mentioned some at the beginning, and kind of in our why around food is medicine and health related social needs and, you know, Karen, care, coordination across the continuum. I'm excited about enabling technology making this work better, faster, quicker and and what, what, what in particular I'm excited about is enabling technology to help foster highly reliable processes. So right now, in programs, we have highly variable processes. We sometimes identify people with high needs, and we sometimes do something for them. And what we can do with enabling technology with regard to high reliability is we can always identify people and we can always apply certain services and supports to their care, so that we always are driving a better process. So I am very focused on enabling technology, driving high reliability and reducing variation. The other thing I'm excited about with with enabling technology is to reduce the time and work effort of the frontline clinician in doing all of the things we've talked about in this in this session together, so identifying people with with needs, pulling together information from a variety of sources to create a profile of what the person is and is not receiving or is or is not eligible for, without having hours of Social Work, community health worker, case manager, work effort, go into that there's we can take back so much time. If we can take back time for the front lines, then we will gain their buy in in executing the process. So we, let's, let's use our technology to reduce some of this information, searching and gathering some of this information around you know who is and who isn't eligible what resources do or do not exist, so that we can package that up to not only doctors, we often think about serving physicians, but not only docs, but to our entire healthcare team, so that they can see A person gather, have information synthesized and presented to them that then they can take that next step at the bedside with the patient and the family and their cross continuing collaborators to make next actions happen. So I know that that when we can use technology to do these things, we will get we will get a lot better performance out of our healthcare system, and that's what I'm focused on, is the performance,

[00:39:04] Megan Antonelli: yes, and a data, a very data driven approach to it, which I love, and I think, you know, you really laid a very powerful roadmap for that. So I feel like I could keep asking questions and learning about what you're doing, because it's just so impactful, and I love it. But thank you so much for joining us. Amy, tell us a little bit about you know how our guests can get in touch with you. I know there's hospital executives listening who want to know how you can help them.

[00:39:29] Amy Boutwell: Oh, sure. Well, I love it when people connect with me on LinkedIn. Just connect with me. Subscribe to my newsletter. Message me. I'm super open to to meeting new people through that way. Also, of course, my firm is called collaborative health care strategies, which is a mouthful, but that you can visit our website and really on the website and mostly focus on the experience of patients, staff and executives of. Um, in how they have benefited from the programs that that we've done together. And so that's a good resource if you're wondering. You know, how does this work for people like you in your position?

[00:40:16] Megan Antonelli: Perfect. Well, thanks again. Amy, I look forward to connecting, hopefully having you at an event sometime soon, and seeing you around as you're you're doing some really important, important work.

[00:40:27] Amy Boutwell: Thank you so much. It's been a great conversation. Thanks for having me on today. Megan,

[00:40:31] Megan Antonelli: Absolutely. Let's give a big thank you to Dr Amy Boutwell  as we've heard today, tackling our Healthcare System's biggest challenge requires innovative thinking, a data driven approach and cross continuum collaboration. Dr Boultwell, systems based approach offers a powerful roadmap for teams looking to make a meaningful impact. Thank you so much for joining us, and stay tuned for the next episode.

[00:40:56] VO: Thank you for joining us for this week's health impacts digital health talk. Don't miss another podcast. Subscribe@digitalhealthtalks.com and to join us at our next face to face event. Visit HealthImpactlive.com