Ohio State Wexner’s Paz: COVID-19 drove innovation

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There’s been no shortage of stories about the stress that the COVID-19 pandemic put on the economy and people’s lives, but it also forced the healthcare industry to rethink processes, workflow and how to more efficiently care for patients. At Ohio State University Wexner Medical Center, like other institutions, the pandemic spurred innovation. The health system, for instance, used 3D printing technology to produce swabs for testing kits when supplies from Italy were running low. Modern Healthcare Managing Editor Matthew Weinstock spoke with Dr. Harold Paz, CEO of Wexner and executive vice president and chancellor for health affairs at OSU, about ways to promote innovation during a crisis.

MH: How do you keep focused on innovation during a pandemic?

Paz: When I came here two years ago from CVS Health … my focus was on how do you create this transformation from a health system to a health platform. We developed a strategic plan early on, working on ways to achieve that vision. Never in my wildest dreams did I ever imagine we would have this past year that would accelerate that move in ways that we’re only beginning to understand today.

And it cuts in a number of different directions. One is the use of data and analytics. Early on, when I arrived here, we created this analytics center where we brought together various parts of the medical center complex, the college of medicine and our James Cancer Hospital to create one analytics center for the whole campus. We thought that was extraordinarily important. We’ve now been able to leverage analytics and get more and more into predictive analytics, to think about the steps that we need to take proactively to address this pandemic and how it’s impacting the broad geographic community across Ohio.

Another (area of innovation is) this move that everyone has talked about … to digital and virtual care. When I got here, we were doing 50 telehealth visits a month. We now do roughly about 2,800 a day. But we’re backing that up with analytics and data and … digital apps. The digital approach is extraordinarily important, including things like autobots, where we have AI embedded in our webpage to guide patients through the vaccination process, for example, to answer their questions in real time. AI is going to play a really important role going forward in this transformation.

And then last but not least, more and more work about driving care into the home. How do we best do that? And again, that reflects some of the earlier work that I had an opportunity to participate in, recognizing that healthcare per se is an incredibly important determinant of health and well-being, including avoiding premature death. But we know there are multiple other determinants—social, behavioral, environmental and genetic.

We acquire the data, then we can think about solutions, beginning in the home. And in the local communities, to leverage assets in those communities to really address social and behavioral determinants of health, and more and more now, environmental determinants of health … with climate change and all those impacts as well, it’s really giving us a holistic understanding … on premature death and equally important, health and well-being for a very diverse community. Diversity and health equity are becoming very important parts of our overall strategy.

MH: How do you take what you’ve learned over the past year on the use of analytics and AI and figure out what the next five years looks like for those types of advances?

Paz: It’s really important to use these technologies and to be nimble with them. I’ll give you an example—vaccinations. This week, we’ll probably approach 100,000 vaccinations at the Wexner Medical Center. We’ve had days where in a matter of hours—two hours—we could load 2,000 patients into the system. Our limitation is the amount of vaccine that we can get access to in a single day. We think that’s incredibly important.

We set up a sister site on the near East Side, a community that is largely underserved, largely minority. We want to make sure that we give our minority populations here in the greater Columbus region access to the vaccine. Using data and analytics, we can identify where those patients are. We can use ZIP code data to align the vaccination process with the patients who have this need.

MH: On diversity and equity, how will you apply the lessons learned from the pandemic to your focus on social determinants going forward?

Paz: Our college of medicine has an exceptionally diverse representation of students who are among the top in the nation in terms of African-American medical students. And this has been something that has been developing over the past several years. We’re all extraordinarily proud of that.

But at the same time, we realized with that background, there is so much more that we have to do in front of us.

Early on in the pandemic, when the issues around structural racism really came to the surface, we decided that we had to do something about that. We thought it’s important to do that for this broad geographic region, but we also thought it was exceptionally important to be a national leader to address this and to really set the bar for the things that need to be done.

We set up our anti-racism action plan, which was an academic health center campus-wide approach, to addressing racism in the local community. We saw enormous opportunities in what we could do. We have two communities on the outskirts of Columbus. One is predominantly white. One is predominantly minority, African-American. They’re one mile apart. And the difference in life expectancy between those two communities is 18.3 years.

There are extraordinary opportunities to go into these underserved communities and really address determinants of health. We said early on that racism is a social determinant of health. There is ample evidence during this pandemic to support that. We all know that the mortality rate for Blacks is higher than for whites with COVID-19.

But when you look at age groups, for example the 45-55 group, the mortality rate is significantly higher for Blacks than for whites, because you’ve excluded the elderly from that analysis.

We also know there’s ample evidence to show that racism causes physiologic stress that leads to oxidative stress that leads to other health conditions as well. Cardiac disease, for example. Poor wound healing, obesity. These are all things that are going to play a role in premature death. And on top of that (you add) COVID and you have a set of circumstances that we feel we have an enormous responsibility to address.

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