Kathleen Wessel (Host): Healthcare is evolving faster than ever. Rising patient expectations, workforce shortages, costs demand more than transactions, which is why partnerships between hospitals and med tech innovators are more important than ever.

Hello and welcome to AHA Associates Bringing Value, a podcast from the American Hospital Association. In this series of podcasts, we speak with AHA Associate Program business partners, checking in on their efforts, and learning how they support AHA Hospital and health System members. Join us as we explore how hospitals, health systems, and med tech vendors are transforming traditional supplier relationships into strategic partnerships that drive innovation, improve outcomes, boost efficiency, and build a stronger sustainable future. I'm Kathleen Wessel, Vice President of Business Management and Operations with the AHA. And today, I'm joined by Dr. Stephanie Duggan, Chief Clinical Officer at SSM Health. Stephanie, welcome to the podcast.

Stephanie Duggan, MD: Thank you so much for having me, Kathleen.

Host: This is a big topic for us. And I think we could take this in a lot of different directions, but I'd like to really use our time together to explore and dig into how you and your organization align with partners for success. Again, big question, big topic to kind of dive into, but I'm going to jump right in and, you know, acknowledge that there's a perpetual-- the field is perpetually looking for innovative strategies and solutions. And so, from your experience, when you're evaluating potential partners, what key factors do you consider essential to assure alignment with your goals and values?

Stephanie Duggan, MD: Well, I think it's really important that we take a minute and define partnership, because partnership is a very different implied relationship than a vendor. So, I can work with any number of vendors from the chief clinical officer seat and have satisfactory results. But a partnership implies that both myself and the person with whom I'm working or the company with whom I'm working will have sustained excellent results. Because we won't do anything that won't benefit the other person or company in the partnership. So when I'm looking for hospitals, for vendors, for other clinicians, I want to look for those with whom I want to develop a true partnership. So when I think about the relationships that really work, they're the ones that are built on traditional and values that will continue to grow and benefit both companies or people within the partnership.

Host: So important to make sure that there's alignment there. Thank you for kind of stepping us back and really helping us identify those core elements there. I really actually want to maybe jump back a little bit further and just learn more about you and kind of your role within SSM, how you operate in this space.

Stephanie Duggan, MD: So, I always wanted to be a physician. I have my 12-year-old book report stating my life as a physician. I don't have anyone in my family that is a physician. So, it's been a journey to learn how the health system works, how it operates, how individual clinicians fit in. When I did my training in Detroit, I thought I would be a pediatrician, but as I've learned throughout my years of experience, the medical field truly picks you. And the first day that I entered into the emergency department, being someone that can't stand even R-rated movies because of all the blood and gore, I was captivated. These were my people and I loved the experience.

And so, became an emergency medicine clinician. I really loved to fix things. Never imagined doing anything administratively. And I think that's really important, is that you're truly present in whatever path or part in your career that you find yourself. As a practicing emergency doc, a hundred percent, I embrace the challenges, embrace the learnings because you really have to learn how to coordinate what you need for your patient from the administrative team, what you need for your patient from the nursing team. And it really is a team sport when you are practicing as a clinician.

So as I became known as the fixer, I really wanted to make throughput better. I wanted to make the medical executive committee function more effectively. And I was very blessed to be able to given opportunities where I could continue to grow and continue to learn. And so, I practiced fully for about 15 years, and then became a chief medical officer. But I still maintained my clinical practice, because in the emergency medicine world, I could practice four or five days a month as well as do the administrative duties. So, I feel very blessed that I was a chief medical officer for five years. Then, I became a chief clinical officer and started learning about all of the different aspects of how complicated the business side of medicine truly is. How do you care for a patient and then truly get paid? How does the hospital get paid? Truly, how is coding an end-to-end process? And, you know, continue to learn all of those aspects.

And then, after being a chief clinical officer, I was in a physician where I was asked to take on a CEO role for three hospitals, including the one where I had first been an emergency medicine physician. So, I learned about the CEO role as well. I had that role during COVID, which as a practicing clinician, to be a CEO during COVID, I felt so blessed because I understood the science. I understood how to protect people, and we had great community support of what we needed to do to keep the patients and the hospital safe as well as our staff. So, I really enjoyed that aspect as well.

And finishing that role up, the opportunity to become the chief clinical officer over the national system for SSM was the next step. And I have thoroughly enjoyed that. I've been in this role for two years, and I have the entire clinical enterprise for which I'm responsible. So, quality and safety nursing and the medical group. So, never a dull moment and really enjoying also being able to develop the partnerships and the value partnerships with companies such as Siemens.

Host: I never get tired of listening to the origin stories of how people-- how their careers have evolved. You know, kind of what sparked the interest at the beginning. So, I appreciate your 12-year-old book report that started all of this. That's amazing. Thank you for sharing.

Stephanie Duggan, MD: Thank you for asking.

Host: So, where have partnerships had the greatest impact in your organization? Can you provide examples?

Stephanie Duggan, MD: Partnerships are the backbone on which we can continue to grow and expand our clinical excellence. So, I'm going to give a very specific example. When I joined SSM, there was a partnership called a Value-Based Partnership with Siemens Healthineers that had just been started. And when I came into my role, then I inherited it and became the chief sponsor for that. And so, it was a new kind of partnership that I had yet to experience.

As I said earlier, the people with whom I choose to work, I make sure that our values are aligned because, as long as you can talk through your challenges, you can solve anything and continue to get what your patients need. So, I inherited the Value-Based Partnership. I didn't really know exactly what it meant. But as I began to get to know the team, I learned that they had a Continuous Improvement 2, they called it, because we have continuous improvement teams at SSM as well. So, the Ci2 teams came in. And they evaluated some of our processes within our radiological suites, particularly our MRI Times. And they said, "Hey, you guys have some opportunities to match your times of busyness with your times of staffing, as well as to really standardize your blocks of times in which you're actually caring for patients." So instead of having some blocks be 15, some be 30, some be 20, make all of the blocks standard at 20. And they did a whole timed case study, came and presented it back to the executive team. And we found through that partnership and through listening to their suggestions, we'll be able to add about a hundred MRI spots to our system without adding any staffing, without changing what we're doing, but by adding in the standardization that our partners have experienced by their learnings throughout the entire world. And so, that to me is where we both are gaining value and we're also most importantly improving access for our patients, which is what we need in order to truly move healthcare forward within the communities that we serve.

Host: Yeah, that's a wonderful example. Thank you. You know, in what ways have some of these partnerships reshaped and improved your approach to patient care? Actually, this one example like really helps illustrate some of that, but I'm thinking kind of beyond what you thought was possible.

Stephanie Duggan, MD: That's a great question, Kathleen. And one thing that we're very excited about that we will have nearly online by April is we're going to be partnering with remote MRI scanning. So, we have many rural hospitals and difficult to get staffing kind of fully at the level that we would like. So, sometimes you try and schedule things together. But sometimes when you are a community that may only have a single MRI and a single tech, if there's a complicated exam or an exam that your tech isn't really sure exactly how to administer, through this remote scanning, we're going to be able to log in and have our tech be able to direct the scan with another tech that's supporting them, but the tech that really understands how complicated and the testing that needs to be done will be able to run it remotely. And so, that will actually open up the experience for more patients. And through the timing work we've already done, hopefully, we'll have more access through those spots as well. So, being able to do a remote LED scan is going to be transformative for the rural communities. So, that's something that we're looking forward to through our partnership by April.

Host: So, what kind of distinguishes a truly strategic partnership from some traditional vendor relationships? You mentioned some of this before, but how are you measuring whether it's actually moving the needle on clinical, operational, and financial outcomes?

Stephanie Duggan, MD: So before I get into the actual measurement, I want to share another example of what has meant a lot to SSM, because we are struggling and we want to make certain that we are able to care for our communities and make certain that we have enough staff to do that. Through the partnership with Siemens, we've really leaned into a rad tech opportunity where Siemens can help partner with us to help support some of that and where we're able to actually help develop the curriculum. And so when I think about a value partnership, it's about solving the problems that we see throughout the healthcare system. And to me, that is really a hallmark of the difference between the vendor who's coming to sell me a product and a partner who's saying, "Where are your pain points? Not just with equipment, not just with processes, but where are your pain points that are going to make care for patient's more seamless? And how can we help?" So, having enough techs is a big pain point for not only SSM, but I think everybody out in the country and potentially throughout the world. We're all struggling with that. So, having a partner lean in and help us with that has been really fruitful.

Now, as far as our metrics, I've already mentioned one that I'm very excited about, and that is that we'll be able to open up more than a hundred MRI access spots. So, that will also be an incredible gift for us. The second piece where we're continuing to really improve is by having standard equipment, we're able to streamline the training for our staff. When you have multiple different forms of MRIs, multiple different forms of CAT scans, your staff have to be incredibly nimble on what they're doing. The third piece is with protocolization. And so, we have 23 different acute healthcare hospitals, and we have many more protocols than that on how we actually deliver the care. And so, through Siemens' help and looking at what some of their best practices that they've seen throughout the country and the world, we are actually able to continue to learn what best practices.

Something else that we are really actively working on is we call it Project One. Project One is a massive three-year project that we are working with our Epic partner. And we are taking our Epic systems that we have throughout the hospitals, throughout our ambulatory sites, and we are converging them all back to what's called Epic Foundations. We have so many disparate ways of charting and looking at things, not because anybody was trying to do anything or to change things, but we kind of allowed a lot of non-standard ways and workarounds. So when something new comes out with Epic, we're not able to get to that because our system is not standard to the foundational level. So, some of the cool AI technology and things like that, until we standardize our entire system to the Foundations, we're not able to access some of the newer technology. So, that is also another partnership that we're continuing to improve upon.

Host: At the time you're doing that, some of that organic development seems beneficial until you need to pull everything way back.

Stephanie Duggan, MD: It is moving a lot of cheese. And having a partner that supports you, provide sites where this has worked well in the past is really incredibly helpful. You know, when we kicked off our project one, we had almost 400 people that traveled up to Verona, Wisconsin. And we were able to get everybody in the room, talk about all the new things that we were going and really show the benefits of consistent care, consistent documentation, because it helps your entire healthcare experience from the patient side to have everything more consistent.

Host: Great opportunity to pull all of that together. So, you referenced some workforce challenges, but so much focus on workforce and rethinking care delivery. What examples stand out where partnerships help speed things up? Like adopting technology or improving processes or even opening new care locations. Do you have examples like that that you can share?

Stephanie Duggan, MD: So, I think sometimes it's hard to be an expert in your own backyard. So, partnering with other people that have a really broad look across the continuum of care can really help accelerate the pace at which your organization is able and willing to make the changes. So when I talk about Project One, that is a huge, huge undertaking for us. And at the same time, we're also continuing to work in a project that we call Ministry Acceleration where we are partnering with various other companies in order to be able to accelerate some of our standard processes, such as length of stay work, throughput work in the emergency department. Because 23 different acute care hospitals, getting them all to kind of row in the same direction can be challenging. So, we use our partner relationships in order to accelerate those changes by helping have more boots on the ground to do the change when we have an actual process that we've standardized.

Host: Great examples of trying to pull all of those items together. One kind of final question I want to drill into is: what type of strategic insights can you share with other hospital leaders to ensure that initiatives like these achieve long-term impact in sustainability? How do you really kind of lock in for the future?

Stephanie Duggan, MD: That is such a great question, and I'm going to admit that I may have a slight bias. But I really think longstanding sustainability comes in when the clinicians and the operators can really link arms and understand what the vision is together. I think too often, sometimes, we lean into operations and neglect hearing that clinical input when you're trying to decide where you need to go forward.

So, one of the things that we are doing at SSM is called Clinical Programs 2.0. So, we had clinical programs and we were working with them a little bit. So, you have surgery, you have emergency department, you have hospitalists. But what we've done in Clinical Programs 2.0 is we've been a little more prescriptive in that we're taking only bedside clinicians. We're not taking our administrative clinicians. Our administrative serve as executive sponsors of the clinical programs. But say, in emergency medicine, we have three regions at SSM. So, we have two doctors coming from our St. Louis region, one academic and one community, one physician coming from Wisconsin, and one physician coming from Oklahoma. So, all of those emergency medicine docs get together and talk about what is our evidence-based best practice and then we can bring in our other value partners to help support that work and say, "Here's some of the national best practice on what that looks like." And then, they can decide and then take it back and integrate your medical executive committees and your other operators at the local ministries to be able to actually do the implementation once the system best practice consistent care has been agreed upon. In order to really have things stay in place, we have to capture the hearts and minds of the people providing the care. Really, when you think about partnerships, the old adage that if you want to go fast, go alone. If you want to go far, go together.

Host: I love hearing the examples from a system like yours on how you're pulling things together. I think it's so helpful to share these examples with other AHA members so that we can learn from some of your successes. Dr. Stephanie Duggan, thank you so much for joining the podcast today and sharing insights with AHA members.

If you would like to learn more about anything you've heard on this podcast today, please visit us at sponsor.aha.org. And if you'd like to learn more about Siemens Healthineers, who Stephanie has referenced on the call today, please visit www.siemens-healthineers.com/en-us. This has been AHA Associates Bringing Value Podcast, brought to you by the American Hospital Association. Thanks for listening.