Nemours Children’s Health Executive Vice President, Corporate Affairs & Enterprise Chief Communications Officer Gina Altieri shares her insights regarding the philosophy behind the enterprise tagline, Well Beyond Medicine, and how these three words represent Nemours Children’s vision and strategy ingeniously.
Carol Vassar, producer
Guest: Gina Altieri, Executive Vice President, Corporate Affairs & Enterprise Chief Communications Officer, Nemours Children’s Health
Carol Vassar, podcast host/producer (00:00):
Welcome to Well Beyond Medicine, the Nemours Children’s Health Podcast. Each week we’ll explore anything and everything related to the 80% of child health impacts that occur outside the doctor’s office. I’m your host, Carol Vassar, and now that you are here, let’s go.
MUSIC: Well Beyond Medicine! (00:26):
Carol Vassar, podcast host/producer (00:27):
I’m joined on this episode by Gina Altieri, another advocate committed to transforming the health of children well beyond medicine. Gina is Nemours’ Executive Vice President for Corporate Affairs and Enterprise Chief Communications Officer. Today we’re exploring the meaning, philosophy, and mission behind three simple words, Well Beyond Medicine, and how standing together, they represent the Nemours strategy and vision in a powerful and ingenious way.
Gina Altieri, Nemours Children’s Health (01:03):
As you know, we have a new strategic plan, and hopefully, most of our associates know that as well. Part of the strategic planning process was also to go through a strategic rebranding, and so we did that, and we did it because we knew that this strategy was going to be transformational for Nemours. We have a new CEO, he has a new vision, and so we were working very closely with our creative partners and the strategic planning to develop what the plan is, what the priorities are. You may have heard strategic pillars and foundational imperatives, and back, I guess 2020, we delivered a hard copy, 200-page, beautiful strategic plan. And 200 pages, that’s a lot of detail. And everybody says this, “That you don’t want this big binder just sitting on a shelf.” We really want to execute this strategy successfully and culture each strategy; you’ve heard that before.
So, we’ve done an awful lot around communicating what the strategy is, and basically, by having a new brand which brings the strategy to life, we also needed to really articulate very succinctly what is the strategy. And so, we took the 200 pages and got it down to three words, which is Well Beyond Medicine. And so that is now the new tagline. So you’ll start to hear that more and see it more on our creative when we advertise and things like that. We started the creative with “It’s a journey” because we were trying to introduce to people that this is something new.
VIDEO VOICEOVER (03:14): Nemours is embarking on something new; we’re redefining children’s health, and the next iteration will be more about Well Beyond Medicine. How far should we go? When it comes to the health of children, we will stop at nothing, focusing on prevention as much as cures. Nemours Children’s Health, Well Beyond Medicine. Join the journey at Nemours.org/beyond.
Carol Vassar, podcast host/producer (03:32):
To you, in terms of your role at Nemours, in terms of personally, professionally, what is meant by the term Well Beyond Medicine?
Gina Altieri, Nemours Children’s Health (03:41):
So I’m glad you emphasized “to you” because it does mean different things to different people. I’ve heard it used a variety of ways, but to me, it means creating healthy generations of children. Population health, if you will. So, not just treating the whole child, which is what we’ve always done, but treating a population of children. So if, for example, there’s a community and the community doesn’t have clean water or good housing or a safe environment, these are all social factors that impact a child’s health. And yes, they can keep coming back to the hospital for an emergency asthma visit, but if you don’t address why the child keeps having an asthma attack, then really, you’re kind of defeating the purpose of it all. Right?
And so that doesn’t mean that we’re going to be doing away with medicine. It just means we are going to go beyond just treating the disease or the symptom to really get to the root cause. And so that’s what Well Beyond Medicine means to me. It’s trying to create this healthy population of children by giving them the best medicine that’s available, but also addressing what’s happening in their community, or in their home, or in their school, and even through government. How can we help with families to provide the best health possible?
Carol Vassar, podcast host/producer (05:33):
And this is cultural change, and cultural change, as we know, is always the most difficult. Let’s pick this apart a little bit. Let’s look at the four strategic areas. Let’s take those individually right now and talk about them. And you’ve mentioned this already, understanding the community. Why is it important? How are we going about knowing our community better?
Gina Altieri, Nemours Children’s Health (05:54):
So, in the past, hospitals are in a community, and they serve the community. With virtual medicine, the community has been expanded, but we still must deliver what a community needs. But what is it that our community needs to help children grow up healthy? So you do need to be working with your community to understand, do they need stronger literacy programs. Do they need help with either nutritional advice or even food, for that matter, right? Some are grocery deserts. And so we have formed a garden club where we are planting food on the grounds and teaching people how to plant food so that communities dedicate some space for gardens.
Carol Vassar, podcast host/producer (06:49):
And in terms of creating children’s health programs, and this is something Nemours has always done, and you see this, it looks like it’s still a major pillar of this plan.
Gina Altieri, Nemours Children’s Health (06:59):
Yes, so you’re right. We had Reading BrightStart! for the longest time because we recognize that literacy plays into the health of a child as well as the productive adult. And so we really did focus on literacy to assess if a child was having literacy issues early on so that by the time they did go to school, they weren’t so behind in their progress and that it was addressed early so that their illiteracy and their testing scores were improved where they needed to be to keep them interested in education.
Carol Vassar, podcast host/producer (07:38):
And of course, you can’t do this in a vacuum. Partners are a really important part of the strategic plan, which is really the third point I wanted to bring up. Talk about that.
Gina Altieri, Nemours Children’s Health (07:48):
Yes, very important because obviously, we don’t want to duplicate services, and we couldn’t anyway, we don’t have unlimited funds, but we do need to do it with other programs jointly. So, investing in the community in ways that help create healthy children, whether it’s housing, work with a housing developer to make sure that things are, let’s say, safe in the house for children, or maybe different flooring rather than carpeting. So, working with your community, working with philanthropy partners, getting other individuals that are interested in helping create healthy generations. Doing that together with donors that’s an important aspect of partnership. Also, partnering with other health systems. Sometimes one health system is serving hundreds of miles, and sometimes there’s four health systems within 10 miles, but partnering together because there’s certainly enough work to go around for everyone.
Carol Vassar, podcast host/producer (09:00):
And finally, the last point I wanted to bring up was the healthcare billing and payments and other policies. You’re looking at reforming those. How are you looking at going about that? I’m
Gina Altieri, Nemours Children’s Health (09:11):
Yeah, so that’s complicated in that we’re trying to change reimbursement models, meaning that you’re not paid for volume. You’re actually rewarded for prevention. And so how can we either share, that’s the value proposition, share in the risk of a population of children and to keep them healthy? So that’s our value-based service organization at Nemours. You do need to have your payers at the same point of readiness as perhaps the providers. So that’s a struggle. Also, government relations, so whether it’s state or federal funding, how do you partner with your government relations to make this happen, if you will? Because right now, it is regulatory, both the payment side, reimbursement side, as well as the provider side. And we’ve seen this with telehealth, working with government providers so that they understand the barriers to access and laws have been changed because of it. So it’s the same idea.
Carol Vassar, podcast host/producer (10:23):
And it’s also working across states. We’re working across four or five, six different states at a minimum, at Nemours. Each one with its own public health code and policies and legislation, and laws. So that’s…
Gina Altieri, Nemours Children’s Health (10:35):
Carol Vassar, podcast host/producer (10:36):
Gina Altieri, Nemours Children’s Health (10:37):
…on where you’re going to get your care, right?
Carol Vassar, podcast host/producer (10:39):
Exactly. So it’s very complicated. It’s not going to happen overnight for sure.
Gina Altieri, Nemours Children’s Health (10:44):
The only reason why it’s complicated, Carol, is because we’re going to live in two worlds financially while this is happening. So we’re still going to be in this fee-for-service world, and we’re also going to be in this value world, and we have to have the data and the analytical skills to understand what’s happening on the reimbursement side so that we are doing this in a way, at a pace that keeps us financially stable.
Carol Vassar, podcast host/producer (11:17):
So let’s take a look at Well Beyond Medicine in terms of the culture of Nemours. How do those two fit together?
Gina Altieri, Nemours Children’s Health (11:24):
So yes, the culture at Nemours is an excellent culture. I’ve been here 25 years because it really is. It’s a very caring culture. We care with everything that we have. We care for our patients and families. We care for Nemours. We care for each other. I see that especially through COVID. This caring attitude is this service level that we have come to be known for so that when people experience Nemours, they experience something very different than other experiences in healthcare. And they keep coming back because of that service level.
And so we don’t want to lose that culture. We just want to expand the caring beyond just the healthcare that we’re providing, but to extend it to the health of the child. And so that’s why it’s important that we engage our associates in this Well Beyond Medicine so that they understand it and they can live it. That is what our associates do best. They live our values, they live our behaviors, they care about health equity and diversity, and they apply it to everything that they do every day because it is who they are.
Carol Vassar, podcast host/producer (12:54):
What are the benefits of Well Beyond Medicine, this strategy, it’s really a philosophy, to ultimately the children and families that we see each and every day?
Gina Altieri, Nemours Children’s Health (13:06):
So the benefit even goes beyond the children and families. It creates a healthy society. Children go up to be adults; they will be more productive adults. We have all these programs for adults, but if we could address some of these issues in childhood, we may actually prevent some of it, which would then create a more productive workforce. So economically, it’s also a smart thing to do, but we have to do it now. It takes 20 years to have a child grow up to be that productive adult, and it will take a fair amount of time to really understand the impact this is having on children as they grow and enter the workforce.
Carol Vassar, podcast host/producer (14:01):
And how are you measuring that impact?
Gina Altieri, Nemours Children’s Health (14:04):
So, right now, there is a value-based service organization. They have a module of Epic that really does help them analyze all the data that exists today. We have measures of success on each of the pillars, and the roadmaps also have their own measures. And so, as time goes on, we will start to report on measures of success. Some of our annual goals will also be measures of children’s health outcomes that will indicate if a particular thing that we’re doing is working or not by looking at health outcomes and then sharing that information across states. We just think that starting in Delaware, because of the size of the state, it’s easy to create a pilot if you will, and then if it’s working to then expand it, which we’ll do, to then Florida, and then who knows, maybe then others will replicate it and it will expand throughout the 50 states.
Carol Vassar, podcast host/producer (15:16):
So give me a good example, a solid example, a visual example that associates can hear about and know this is Well Beyond Medicine in action in my life, in my daily to-dos.
Gina Altieri, Nemours Children’s Health (15:29):
Sure. I can think of two simple examples. So when we have a telehealth visit, you literally get a glimpse into someone’s home. And so now you can actually see some of those things that might be happening that are impacting the health of this child. Well, this kid has asthma or allergies, and I noticed there’s carpeting in the bedroom, and that’s information that you might not necessarily picked up at the visit. We also have a Nemours app, and the value of the Nemours app is it provides data to the providers about stuff that’s going on between visits. So, “Oh, look, it looks like on the third, fourth, and fifth of this month, you had a little spike in whatever your symptom is. Why is that?” And it turns out they were the three days they were visiting grandma who maybe has a pet or something like that.
So having as much information about what’s going on in the child’s life, not just during that visit, is one example of Well Beyond Medicine. Another example, I am aware of many of our pediatricians who are mentors and adult confidants for their patients, and sometimes a patient will text them about a risky decision that they may want to consider, and the doctor is beyond just a friend. Obviously, they are the doctor, but it’s an adult that represents authority, and they trust that individual to share this information with them, and that trust is going Well Beyond Medicine. That’s another example that I can think of.
Carol Vassar, podcast host/producer (17:32):
So where do you see this, Gina, in five years, ten years, 20 years? Where would you like to see this ultimately?
Gina Altieri, Nemours Children’s Health (17:38):
So, in five years, I hope to see those measures of success being shared and analyzed and making a difference. I also hope that we’re able to show the impact that it has on a population of children. I think it’s going to take beyond the five years, maybe the 10, to see it then happen if successful, which we believe that it will be, demonstrated in other areas, maybe throughout the entire state and then the state becomes the example. And then in 10 years, beyond the ten years, we get to the life of the child, and we start to see all those outcome measures that society has: graduating from high school, going to college, less disease, the cost of healthcare, all going in the right direction if you will. Although we say that our vision is creating healthy generations of children, we say that because it is ongoing, never-ending, it’s going to take a long time. This is not one-and-done, okay? Check that, move on. This is really going to take a huge effort by a lot of people to make a difference.
Carol Vassar, podcast host/producer (19:07):
And that includes our associates who may have their own visions of what is meant by Well Beyond Medicine. How are you figuring out what it means to the associates?
Gina Altieri, Nemours Children’s Health (19:17):
So, that’s a great question. We are actually kicking off a survey, an associate survey, to ask them, “Actually, what is your understanding of Well Beyond Medicine? Does it resonate with you? If not, why not?” And maybe we can explain it differently. “If so, why? Give us some examples in your world.” I know a lot of our physicians go well beyond the normal what is expected. And that’s another example of Well Beyond Medicine. I know that when someone needs care now, and they have a full schedule and they’ve already been working 12 hours, they fit that child in because that is what they do. And I know the staff around them see that every day and they see examples of somebody driving two hours to go to a clinic to see two patients that day. These are all examples of Well Beyond Medicine that associates can appreciate. What we just want to do is elevate it and clarify it, relate it to the new brand and how it’s connected to the health, value and equity and this new vision of creating healthy generations of children.
Carol Vassar, podcast host/producer (20:35):
Thanks for listening to our primer on Well Beyond Medicine with me, Carol Vassar, and our guest, Gina Altieri. What are your thoughts? What does Well Beyond Medicine mean to you? Visit Nemourswellbeyond.org to submit a comment or leave us a voicemail. While you’re there, check out our other episodes and be sure to subscribe to the podcast.
Join us next week when we’ll discuss the basics of what’s known as Precision Medicine, the work being done in that area at Nemours, and the potential it has to benefit children across the nation and across the world. Until then, remember, together, we can change children’s health for good, Well Beyond Medicine.
MUSIC: Well Beyond Medicine (21:23)