From the Archives with Abby Sears

On this episode of Digital Squared: From the Archives, Tom revisits his 2020 conversation with Abby Sears, President and CEO of OCHIN, a non-profit organization nationally recognized for their work in health equity and a leader in demonstrating how data and technology can make a big difference in closing the equity gaps. Together they discuss data-driven insights around healthcare inequities, what it’s like being a female CEO of a tech company, and Abby’s take on what we can all do to close the health equity gap in our society.

Transcript

Intro 00:01
Welcome to Digital squared, a podcast that explores the implications of living in an increasingly digital world. We're on a mission to inspire our listeners to use technology and data for good. Your host Tom Andriola is the Vice Chancellor for Information Technology and data and Chief Digital Officer at the University of California at Irvine. Join us as Tom and fellow leaders discuss the technological, cultural and societal trends that are shaping our world. Please enjoy this episode from the archives.

Tom 00:36
My guest today is Abby Sears, CEO of OCHIN a nonprofit healthcare innovation center designed to provide knowledge solutions that promote quality, affordable health care for all and is nationally recognized for their work in health equity. Full disclosure, I have been on the board at OCHIN since 2017. Abby, thank you for joining us today. And welcome to the podcast.

Abby 00:58
Thank you for having me, Tom. I'm excited to be able to sit here and have a conversation with you. 

Tom 01:03
Absolutely, absolutely. So tell us a little bit more about OCHIN.

Abby 01:08
Sure, I'd love to. We've been around for 20 years, we're a not for profit health IT organization, which is a little bit of a unique bird. What we focus on is advancing technology. We have a large research division, and we do a lot of deep technical assistance. We touch about 500 organizations, both urban and rural all across the country. We touch about 20,000 providers in 47 states, we have 5 million patients that are actively being seen across our network. And they're some of the most complex and diverse patients in the country, about 50% are at or below the federal poverty level. And they come from some of the most vulnerable patients such as women, children, black, Indigenous and People of Color communities.

Tom 01:59
Yeah, so you've been with OCHIN, from the very beginning. And since being on the board, I've been so impressed with the way the organization has run the mission. In your 20 years with fortune in serving this mission. Where have you felt we've made progress on health equity? And where do we still have a lot of work to do?

Abby 02:18
Well, there are a couple places that that I think come to mind around where progress has been made. One is to be able to deploy a product like epic into environments, such as community health centers, mental health departments, corrections, youth authorities, I think that's a privilege to be able to take the quality of the products and be able to make sure there's not a have an app not related to technology, as well as bringing subsidies for broadband and creating access in rural areas. So I think that in those ways, I think we're making a lot of progress. The other ways I think we're making progress are being able to capture data on this patient population and to use data to actually be able to describe what's going on. I think that those are really powerful examples. I think, being innovative, and being some of the first organizations to be doing some of the most innovative work across the country, on behalf of this patient population is also a real success factor. I think where we haven't been able to make some of the really significant differences we'd like to see is to really see significant changes in outcomes in a large aggregated way. What we do see is we're being able to maybe control some of the chronic diseases that our patient population has, we're being able to keep them out of the emergency room where we haven't been able to in the past, but wouldn't it be great if they didn't have those chronic diseases, and have the significant rates of the social factors and challenges that our patient population has? That's where I think we have a lot long way to go to preventing those from even existing in the first place.

Tom 03:57
I think if if we pivot to the, let's say, the two biggest topics on the minds of Americans today, that being COVID, and anti-blackness, OCHIN came out very early with some communication with your membership with the board in sharing some really glaring statistics like in your clinics that you're supporting. It's two and a half more times likely for African American to have a positive diagnosis of COVID. I love that you came out, you know, with such a strong statement. I mean, have you had reactions to some of those statements? And is it something you've expected or unexpected aspects to coming out being so vocal about it?

Abby 04:39
We've only had really good outcomes from actually the data that we've been presenting about all of this. We're being asked to present more and more on the National Front. I think we have some of the most robust data that exists on this patient population. And so people are asking us to come in and talk about what we're experiencing and I think that's where Really good. But the proof will be in the pudding around what that actually can translate into something being different. And that's where I think we're starting to really ask ourselves, Okay, where can we present? Where can we get this information into the right hands at the right place, and to really have the largest impact around creating a more equitable playing field for everyone in the country around health care access?

Tom 05:24
Yeah, as you said earlier, you know, you're a tech company at the end of the day and data that OCHIN has on its membership is, you know, very, very diverse, it also is representative across the entire US. What are you finding that you're able to do with the data? And how are you presenting opportunities to do research around that data? That is different from what other organizations can do?

Abby 05:48
Great question. We were one of the first organizations to implement electronic case reporting, which creates the ability for public health agencies around the country to get access to our clinical data on our patients around positive COVID. Testing, immediately, it moves in a real time way. And it's accessible to everyone at the same time. And so being able to do that and show that it can happen, and to show that innovation and pave a way for all of healthcare to do that has been really powerful. And I think transformational as a change agent, we see ourselves as a change agent. So that's one example. And we do a lot of things that are very similar to that, on the research front, what we have the ability to do is really do great comparative effectiveness studies. And also get down to granularity around food insecurity, geography, educational challenges.

Tom 06:47
So those social determinants of health that we all talk about, you have real data that you're able to dig into?

Abby 06:53
correct. So we can take the research the healthcare research that everyone does, and we can take it to a whole other level related to our ability to show impact related to different social factors as well. And that's a very unique capability that not very many organizations have at our level, or have across the entire country, the way that we do that

Tom 07:15
these urgent, truly different is the fact that it's representative across the entire country where if you look at, you know, for example, the organization, I'm a part of the University of California, we've got great diversity that we can look at in our data, but it is only California at the end of the day, you know, it's the largest state from a population perspective. But as you know, from your data set, you know, there are real regional differences. And depending on the politics of the state, and also the unique economy that each state has,

Abby 07:44
it's been great to look at whether somebody expands Medicaid or doesn't expand Medicaid, and what are the disparities or the ethnic diversities of the different states? And how does that impact outcomes. And so we have just such a robust data set, that we're building partnerships all over the country. And it's really important that people are accessing this data set so that we can really see what's going on with our our public policies and with the investments in healthcare that we're making as a nation. 

Tom 08:15
And that put us in a position where it's getting more involved in commenting and providing input into public policy?

Abby 08:21
Absolutely, it wasn't something we did in our first 10 to 15 years in the in the way that we are now. But we have such a unique voice and such a unique lens. There are very few of us in the country that can communicate some of what we're seeing. And we see it as a real social responsibility to be communicating what's going well, what isn't going well, and prioritizing what might be most helpful as well.

Tom 08:48
Right, right. Let's turn the diversity lens on ourselves. You know, I've been in my career part of the technology sector in one way, shape, or form. helping organizations bring technology to use consulting. And to me the technology sector has been one of the most and diverse of any function. If you look at the numbers, I've been involved in healthcare and higher education conversations, talking about that fact, and how we need to do a better job. You run a tech company, you're a woman, would you be willing to share some of your experiences about what that's been like? And what do you think we need to do better at?

Abby 09:31
Well, that is a great question. I think that 

Tom 09:35
but I'm putting you on the spot.

Abby 09:40
You know, what I think it's really done is one I feel real responsibility for women leaders, I think of my daughter and I think of the other young women out there that you can be a successful female in a technology driven organization. And I love that I get to do that and I love that I get to show that it is possible. So I find that part one of the best parts of my job, no leader, and anyone that I know doesn't get to where they're at one from hard work, but mostly because somebody gave you an opportunity. And that that opportunity, somebody opened the door. And people have been supporting me along the way. And I feel like it's really important that I create an environment that does that for other people as well. And the other thing I think it's really taught me is to think about who's the right person to have which conversation at which time and to kind of set aside your ego as much as you can to send out the right person to different environments and to different meetings. And so I've gotten, I think better and better about thinking about who the right person is to be communicating whatever message we need to be sending. And I think that's a skill set. That's important. And I don't think that's just a male or female. And the last thing I'd say is, I tend to just not see things in gender ways. I think I just had a really great upbringing with a very strong mother that told me there was nothing that you can't do. So I don't think about it, when I go out. I just think about what's most important, which is the mission of what we're trying to accomplish. And if I can't get at it straight on, I will go at it sideways, or on another way, or I'll wait until the timing is the right timing for somebody to hear the conversation that we're trying to have.

 Tom 11:27
You look at things through your password. You know, as a woman, technology leader, you've felt those slights and those comments along the way that that you've had to brush off and push past.

Abby 11:38
Absolutely. I remember when I was a chemist, before I became a leader, I used to sit in a male room of chemists and the guy next to me would repeat what I said every time and he would be heard and I wouldn't, and it just drives me crazy. But you can't let those things get to you. You just you've got to be thinking about what you're trying to accomplish and not lose sight of the end goal. Because that's way more important than however that felt in that moment. 

Tom 12:04 
I know I have a daughter of my own. And we try to talk to her about these things. She wants to go into medicine of all fields. And I've tried to impart some of what I think she'll experience along the way, saying, I don't believe that it's right. But I think you're going to experience people out there who are going to put you down try to keep you in a place. And did you have to have the persistence to push through that. And as I talked to my colleagues about this, it's kind of trying to have her not be surprised when it happens. Because especially I think, you know, for her growing up, there's been nothing but supportive comments about you can do you know, the world is your oyster. And that won't always be the case. And so just trying to prepare her for some of those realities is something I tried to do. I don't know if any of it sinks in, but very true. All right, got one more question for you. It is one in every one of our guests, guests, I tell the story you can, I came across this philosophy that was shared actually with one of one of my children about the concept of small incremental improvements that he called the 1% better model, this has to do with a little league baseball coach talking to his kids about the goal of practices to get 1% better at this game. And over the course of the season, you'll see so much improvement, you'll be so much better player. And I just adopted that model for myself. And I actually have found it tremendously powerful concept in leadership. And as I've been responsible for larger organizations, and basically saying, If I can instill the concept of a 1% better model into this large group of people, it can actually create us a you know, a wave of change for the organization in terms of where we're trying to go. So I'm trying to apply this now to you know, the concept of diversity, equity and inclusion, health inequities, I guess, around the topics we're talking today. You know, if we talk about health inequities, what are the maybe one, two or three things you can leave for the people who listen to this podcast that they can take on for a personal accountability to go out and make a difference around health and equity or better health equity every day? What can you leave our listeners to?

Abby 14:14
Another great question. 

Tom 14:15
I only come up with good questions. Only for you. 

Abby 14:16
Well, thank you. Thank you very much. Um, I think there are a couple of things. One, I have this real belief that we can do more related to workforce. We can do more about being flexible and creative around creating opportunities. A lot of poverty comes from single mothers or disabilities, mental health issues, situations where it's very difficult. So how do we create a work environment where we have more flexibility and we're more welcoming of those situations? So I think about that and I would really challenge us as employers To be more creative and be more patient and be more open, because I think that that we go a long way around creating healthcare access until we have health care access for all in this country, it comes from employers and employers have to do more. And I think we can do more. And we have to be willing to take maybe less profit or less pay or repurpose some of the pay to create those that type of an environment and that I'm really passionate around that I don't know anyone that is born into the world that doesn't want to be a meaningful citizen in their world. And we don't make that easy. So I would start with that's one thing. And then the second I would say is, how do we make sure that healthcare is a right, because if you're not healthy, I don't know how you go to school to become educated. To be able to be part of the workforce, people need to feel like they're healthy. And that is mind, body and spirit, not just the physical components of it. And if we don't start to unravel the social factors that are creating barriers to strong health care, like transportation issues where telehealth can be such an important component, so we've got to embrace telehealth we've got to embrace the technology that we are deploying in the world. And the last thing I would say is that I would challenge us as technologists in the technology industry to be social, more socially competent, and more sensitive to cultural differences, because we're simply not. So the tools need to be at the right educational level, the tools need to be more sensitive to language issues and barriers and to different populations that feel different about Western and Eastern medicine approaches. So that's what we need to be able to blend all of that and not have the silos of the thinking that we have in it.

Tom 17:00
Abby, thank you so much for being here. It's been a pleasure and a privilege to serve on on your board for the last three plus years now. And there's a saying from my professional career, one of my mentors, you know, he's named Steve Rusckowski, he was CEO of Philips healthcare when I worked there. And he used to say, the more we do, the more good we do talking about the role in healthcare when I think of OCHIN and the important role that they play and all the discussions we have at your board meetings. I just keep coming back to the more one does, the more good they do. And so thank you for everything you're doing at OCHIN. Thank you for joining us here today, and we look forward to hearing more from you in the future.

Abby 17:43
Thanks, Tom. I really appreciate the opportunity to talk today.