Selected Podcast
Ep. 14: Rethinking Sites of Care
Roxanna Gapstur, President and CEO of WellSpan Health, is joined by Vicky Diamond, SVP, WellSpan Health and President, WellSpan Surgery & Rehabilitation Hospital to discuss what sites of service means, how WellSpan is making care more affordable, and what programs and services are being provided.
Featuring:
Diamond has been with WellSpan since 2015, and previously served as vice president of ancillary services for the health system, where she led the planning, development and opening of the WellSpan Health and Surgery Center in Hanover. Prior to that, she served as vice president and chief operating officer of WellSpan York Hospital. As president of WellSpan Surgery and Rehabilitation Hospital and senior leader for WellSpan VNA Home Care, she serves as lead executive for WellSpan Specialty Services Board of Directors. Diamond will leads WellSpan’s ancillary services, including ambulatory surgery services, laboratory and imaging services, outpatient pharmacy, rehabilitation services, employer services and occupational health, among others. Diamond has a master’s degree in public administration from New York University’s Robert F. Wagner Graduate School of Public Service and a bachelor’s degree in political science from Queens College, City University of New York.
Vicky Diamond, MPA | Roxanna Gapstur
Vicky Diamond is senior vice president for the WellSpan Health, and president of WellSpan Surgery and Rehabilitation Hospital.Diamond has been with WellSpan since 2015, and previously served as vice president of ancillary services for the health system, where she led the planning, development and opening of the WellSpan Health and Surgery Center in Hanover. Prior to that, she served as vice president and chief operating officer of WellSpan York Hospital. As president of WellSpan Surgery and Rehabilitation Hospital and senior leader for WellSpan VNA Home Care, she serves as lead executive for WellSpan Specialty Services Board of Directors. Diamond will leads WellSpan’s ancillary services, including ambulatory surgery services, laboratory and imaging services, outpatient pharmacy, rehabilitation services, employer services and occupational health, among others. Diamond has a master’s degree in public administration from New York University’s Robert F. Wagner Graduate School of Public Service and a bachelor’s degree in political science from Queens College, City University of New York.
Transcription:
Michael Carrese: Welcome to another edition of Inspiring Health, a series of conversations with Roxanna Gapstur, and other Well Span leaders about Well Span 2025. I'm Michael Carrese. And Roxanna, tell me what we're going to be talking about today.
Dr. Roxanna Gapstur: Michael, today we're going to talk about some of our affordability work here at Well Span, and specifically something called site of service.
Host: And who is your special guest?
Dr. Roxanna Gapstur: My special guest today is Vicky Diamond. She's our Senior Vice President at Well Span Health and a President at Well Span Surgery and Rehabilitation Hospital.
Host: Vicky, great to have you with us today.
Vicky Diamond: It's really nice to be here. Michael and Roxanna, thank you for having me.
Dr. Roxanna Gapstur: Absolutely. We're excited to have you, Vicky.
Host: So Roxanna, you've described elements of affordability before, so how is Well Span making care more affordable?
Dr. Roxanna Gapstur: Well Span has four focus areas related to affordability and some of those include the Choosing Wisely Campaign that we talked about recently with Dr. David Hoffman, where we're working to eliminate waste. Other parts of affordability strategy includes reducing clinical variation in our care and then also our pricing strategy. But today we're going to be talking about the fourth area, which is called site of service, and it involves really ensuring that we're providing the right care in the right place at the right time.
Host: So site of service. What does that mean exactly?
Dr. Roxanna Gapstur: It's part of our value proposition at Well Span to make sure that we leverage our comprehensive integrated network of care in the very best way possible to bring value to our patients. We've really spent the last decade creating a continuum of care, which includes hospitals, surgery centers, urgent care locations, primary and specialty care offices, and also post acute care, things like home care. And the goal was to really position Well Span's high quality care close to home for those who live in South Central Pennsylvania. These various care sites are appropriate for different kinds of problems and so choosing the right site of care for the right patient at the right time is going to be our challenge for the future.
Host: So how does that impact value and affordability?
Dr. Roxanna Gapstur: Well, if you look back and consider procedures like knee replacements or hernia repairs, we used to do those procedures only in a hospital setting. But as an industry, we've recognized that these procedures can be safely done outside of the hospital at a lower cost and in a more convenient environment for patients. So we're going to be asking those kinds of questions for our care locations and for our various procedures over the next few years to understand really what is the best site of service, what's the most affordable, most high quality, and what creates a better experience for our friends and neighbors here in South Central Pennsylvania. And the affordability piece matches up because if we can do procedures in a more affordable setting, we can pass those savings on to our patients.
Host: That makes perfect sense. So Vicky as President of a specialty hospital. How does this illustrate the point of site of service?
Vicky Diamond: So Well Span surgery and rehab hospital was designed from the ground up to support specialized services. I would even go as far as saying it's actually more of a destination for orthopedic and inpatient rehabilitation services. In terms of inpatient rehabilitation services, we have the only inpatient brain injury unit in South Central PA. So by focusing on very specific orthopedic procedures along with rehabilitation services, we've been able to ensure, we created a very unique site of care with highly trained and proficient staff from physicians, nurses, therapists, and we've coupled that with a specialized equipment. We've even designed the facility to support the very special needs of patients with acute rehabilitation needs. So in essence we've created a center of excellence environment.
Host: So obviously that sounds like it's better for patients in terms of their experience and their outcomes. How does site of service overlap with being consumer focused in your view?
Vicky Diamond: So the overlap is not only in being high quality and demonstrating value, but it's also ensuring that we're convenient and we provide good access to care. When we think about access and convenience, we really have to think about that from the eyes of our consumers. Why would we travel to a hospital for something that could be done at an outpatient center or even at our doctor's office. And even think about this, in our own home, we're really doing some fantastic work at Well Span and increasing our offerings for different sites of services. For example, we now offer services in the home such as home sleep studies. We began offering those services about a year ago and it's almost unbelievable to think this, but we're on track to complete 4,500 studies in just this year. And that's just one way, one of the many ways that we are thinking about sites of care. Another great example I'd really like to mention is our employer services offerings while at work.
Host: What's that all about?
Vicky Diamond: If you think about this, employers in our region are just another important member of our communities, and over the last year we've surveyed our employer community to understand their needs. And what we've learned is that they want to make sure their employees are healthy and that they have access to care, convenient care. So access and convenience were really key to them. And again, this understanding made us rethink how we provide services. So again, back to this concept of site of care. So we began to offer services to them in many different ways such as pop up clinics, onsite care, and in fact this summer we're going to be offering mobile mammography. And it's interesting because specifically two of our employers in the community requested this service. We've also begun to offer more digital solutions for employees so they don't need to leave work for care. So for example, we've recently sold online urgent care to two of our local employers.
Host: That's a lot of great work. Roxanna, where else is the organization focusing on site of service?
Dr. Roxanna Gapstur: Well, we have a lot of opportunity in this area, Michael. And so we're focusing on site of service as it relates to our ambulatory surgery centers and how we might move cases there from our hospitals. We're focusing on digital health, which is also another site of service if you think about it. So instead of going to a bricks and mortar primary care clinic, you might get your care online. And last of all in Vicky mentioned this, you know, the home is a setting that we think in the future is going to be a place where lots of people will get healthcare, and part of that could be remote monitoring of certain conditions in the home or actually people visiting in the home as we do today with home care.
Host: So as we wrap up, what do you want employees to take away from the discussion today?
Dr. Roxanna Gapstur: Well Span's goal for 2025 is to lead our region in value. And so we need to be focused on our four pillars of affordability to do what we need to do around site of service, choosing wisely, reducing waste, and pricing to make sure that we offer the highest value for our communities. We're looking to provide the highest quality care that will attract and retain loyal patients in an affordable, accessible locations, wherever those locations may be.
Host: Vicky, do you have any final thoughts for us?
Vicky Diamond: Yes. We all need to stay open. Really open to the fact that the sites of care are changing. A year ago when we began to advance offering sleep studies in the home actually sub full folks thought we were a bit crazy. Why would we undertake the demand destruction of our in-lab sleep studies because that's what we were doing, and yet by providing being a site of service that people really appreciated and was so much more convenient, we were really being true to ourselves at Well Span of being patient and consumer focused. And in turn what we're now seeing is better patient compliance or patient engagement in their own care and that is something I think we can all agree is a really good thing.
Host: Well absolutely we are going to have to wrap it up there. I want to tell folks they've been listening to Inspiring Health, a series of conversations with Roxanna Gapstur and other Well Span leaders about Well Span 2025. Roxanna was joined today by Vicky Diamond, Senior Vice President of Well Span Health and President of Well Span Surgery and Rehabilitation Hospital. And if you want to catch this podcast on your mobile device, you can go to wellspan.org/inspiringhealth. Otherwise, join us back here next time. I'm Michael Carrese. Thanks for joining us.
Michael Carrese: Welcome to another edition of Inspiring Health, a series of conversations with Roxanna Gapstur, and other Well Span leaders about Well Span 2025. I'm Michael Carrese. And Roxanna, tell me what we're going to be talking about today.
Dr. Roxanna Gapstur: Michael, today we're going to talk about some of our affordability work here at Well Span, and specifically something called site of service.
Host: And who is your special guest?
Dr. Roxanna Gapstur: My special guest today is Vicky Diamond. She's our Senior Vice President at Well Span Health and a President at Well Span Surgery and Rehabilitation Hospital.
Host: Vicky, great to have you with us today.
Vicky Diamond: It's really nice to be here. Michael and Roxanna, thank you for having me.
Dr. Roxanna Gapstur: Absolutely. We're excited to have you, Vicky.
Host: So Roxanna, you've described elements of affordability before, so how is Well Span making care more affordable?
Dr. Roxanna Gapstur: Well Span has four focus areas related to affordability and some of those include the Choosing Wisely Campaign that we talked about recently with Dr. David Hoffman, where we're working to eliminate waste. Other parts of affordability strategy includes reducing clinical variation in our care and then also our pricing strategy. But today we're going to be talking about the fourth area, which is called site of service, and it involves really ensuring that we're providing the right care in the right place at the right time.
Host: So site of service. What does that mean exactly?
Dr. Roxanna Gapstur: It's part of our value proposition at Well Span to make sure that we leverage our comprehensive integrated network of care in the very best way possible to bring value to our patients. We've really spent the last decade creating a continuum of care, which includes hospitals, surgery centers, urgent care locations, primary and specialty care offices, and also post acute care, things like home care. And the goal was to really position Well Span's high quality care close to home for those who live in South Central Pennsylvania. These various care sites are appropriate for different kinds of problems and so choosing the right site of care for the right patient at the right time is going to be our challenge for the future.
Host: So how does that impact value and affordability?
Dr. Roxanna Gapstur: Well, if you look back and consider procedures like knee replacements or hernia repairs, we used to do those procedures only in a hospital setting. But as an industry, we've recognized that these procedures can be safely done outside of the hospital at a lower cost and in a more convenient environment for patients. So we're going to be asking those kinds of questions for our care locations and for our various procedures over the next few years to understand really what is the best site of service, what's the most affordable, most high quality, and what creates a better experience for our friends and neighbors here in South Central Pennsylvania. And the affordability piece matches up because if we can do procedures in a more affordable setting, we can pass those savings on to our patients.
Host: That makes perfect sense. So Vicky as President of a specialty hospital. How does this illustrate the point of site of service?
Vicky Diamond: So Well Span surgery and rehab hospital was designed from the ground up to support specialized services. I would even go as far as saying it's actually more of a destination for orthopedic and inpatient rehabilitation services. In terms of inpatient rehabilitation services, we have the only inpatient brain injury unit in South Central PA. So by focusing on very specific orthopedic procedures along with rehabilitation services, we've been able to ensure, we created a very unique site of care with highly trained and proficient staff from physicians, nurses, therapists, and we've coupled that with a specialized equipment. We've even designed the facility to support the very special needs of patients with acute rehabilitation needs. So in essence we've created a center of excellence environment.
Host: So obviously that sounds like it's better for patients in terms of their experience and their outcomes. How does site of service overlap with being consumer focused in your view?
Vicky Diamond: So the overlap is not only in being high quality and demonstrating value, but it's also ensuring that we're convenient and we provide good access to care. When we think about access and convenience, we really have to think about that from the eyes of our consumers. Why would we travel to a hospital for something that could be done at an outpatient center or even at our doctor's office. And even think about this, in our own home, we're really doing some fantastic work at Well Span and increasing our offerings for different sites of services. For example, we now offer services in the home such as home sleep studies. We began offering those services about a year ago and it's almost unbelievable to think this, but we're on track to complete 4,500 studies in just this year. And that's just one way, one of the many ways that we are thinking about sites of care. Another great example I'd really like to mention is our employer services offerings while at work.
Host: What's that all about?
Vicky Diamond: If you think about this, employers in our region are just another important member of our communities, and over the last year we've surveyed our employer community to understand their needs. And what we've learned is that they want to make sure their employees are healthy and that they have access to care, convenient care. So access and convenience were really key to them. And again, this understanding made us rethink how we provide services. So again, back to this concept of site of care. So we began to offer services to them in many different ways such as pop up clinics, onsite care, and in fact this summer we're going to be offering mobile mammography. And it's interesting because specifically two of our employers in the community requested this service. We've also begun to offer more digital solutions for employees so they don't need to leave work for care. So for example, we've recently sold online urgent care to two of our local employers.
Host: That's a lot of great work. Roxanna, where else is the organization focusing on site of service?
Dr. Roxanna Gapstur: Well, we have a lot of opportunity in this area, Michael. And so we're focusing on site of service as it relates to our ambulatory surgery centers and how we might move cases there from our hospitals. We're focusing on digital health, which is also another site of service if you think about it. So instead of going to a bricks and mortar primary care clinic, you might get your care online. And last of all in Vicky mentioned this, you know, the home is a setting that we think in the future is going to be a place where lots of people will get healthcare, and part of that could be remote monitoring of certain conditions in the home or actually people visiting in the home as we do today with home care.
Host: So as we wrap up, what do you want employees to take away from the discussion today?
Dr. Roxanna Gapstur: Well Span's goal for 2025 is to lead our region in value. And so we need to be focused on our four pillars of affordability to do what we need to do around site of service, choosing wisely, reducing waste, and pricing to make sure that we offer the highest value for our communities. We're looking to provide the highest quality care that will attract and retain loyal patients in an affordable, accessible locations, wherever those locations may be.
Host: Vicky, do you have any final thoughts for us?
Vicky Diamond: Yes. We all need to stay open. Really open to the fact that the sites of care are changing. A year ago when we began to advance offering sleep studies in the home actually sub full folks thought we were a bit crazy. Why would we undertake the demand destruction of our in-lab sleep studies because that's what we were doing, and yet by providing being a site of service that people really appreciated and was so much more convenient, we were really being true to ourselves at Well Span of being patient and consumer focused. And in turn what we're now seeing is better patient compliance or patient engagement in their own care and that is something I think we can all agree is a really good thing.
Host: Well absolutely we are going to have to wrap it up there. I want to tell folks they've been listening to Inspiring Health, a series of conversations with Roxanna Gapstur and other Well Span leaders about Well Span 2025. Roxanna was joined today by Vicky Diamond, Senior Vice President of Well Span Health and President of Well Span Surgery and Rehabilitation Hospital. And if you want to catch this podcast on your mobile device, you can go to wellspan.org/inspiringhealth. Otherwise, join us back here next time. I'm Michael Carrese. Thanks for joining us.