ZM: There you go. Thank you so much, Ansley. Great to join another symposium today, and a really important one and very broad reaching on health equity, and I’m so pleased to be joined by Geoffrey Roche here in this discussion. And one thing that was a new area for me actually is we think about diversity and DEI in the workforce, but it really goes much beyond that. So I’m pleased to be joined by Geoffrey. Geoffrey, if you could introduce yourself and some areas that you’re working on.

GR: Sure. Thank you, Zina, and thank you for having me. Wonderful to meet all of you. Geoffrey Roche, I serve as the Director of Workforce Development at Siemens Healthineers, and primarily my responsibility in that role is really to work across the country in both the United States and Canada, specifically in North America, as our focus is to really help transform the healthcare workforce and support our hospital and health systems, particularly in all the areas that we have phenomenal technology and medical devices that are used to help in the diagnosis of disease and diagnosis of giving people hope. And so we’ve got to have the workforce, and so a lot of my work is spent in that realm.

ZM: And I think a great way to start off, Geoffrey, at least for me in understanding this better, is what is your definition of health equity?

GR: Yeah. Well, I always tell people. I mean, first and foremost, there’s a phenomenal visual that I always encourage everyone to see, which essentially is two individuals standing and looking at a baseball game, and one has the opportunity and can clearly see – clearly can see. The other is shorter and cannot see. That’s an iconic image that we often use in health equity to help people understand. So in my eyes, health equity really comes down to ensuring that we’re giving individuals the access that meets them where their needs are at so that they can have, in essence, an equitable chance to be as healthy as possible. And so when we think about healthcare, we’ve got to give people the opportunity that they’ve got to have the same level of access to care. They’ve got to have the same level of access to transportation, just like anyone else, if they’re going to have a chance to be as healthy as possible.

ZM: Absolutely. And I think as we see the health inequities, definitely those are problems that need to be solved in order to really bring forward that full health. So when you’re talking about the workforce and building in – some things you talked about is empathetic leadership and how workforce and health workforce engages. Can you talk a little bit more about that, and what that means in terms of diversity in workforce?

GR: Yeah, well, I think even the previous panelist had some really great discussion on this too about listening, right? I think in healthcare, far too often, we have created workspaces and care settings and we’ve taken our clinicians away from truly having the opportunity to listen to their patients and be in a position to help their patients. Similarly, in leadership, we have not trained leaders effectively enough to be first and foremost, a human-centered leader. To be a human-centered leader that demonstrates empathy is to truly intentionally and actively listen, engage with the team, engage with the patient, understand their needs, listen before you speak. And so when I talk about empathetic leadership, it’s really that idea that I’m going to get to know you, walk alongside you, further understand you. And before I tell you what I think I need to tell you, I’m going to listen to you so that I can be as supportive as possible.

ZM: I love that walk alongside. I think that phrase is so impactful and really brings to life the realization of what it means to be empathetic from a healthcare setting and really trying to be the most impactful. So how about recruitment? When we’re trying to develop like in hospitals, clinics, and even trying to consider, I think remote patient monitoring aspect, when the patient is not actually there with you and training how you walk alongside that empathetic leadership. So what’s your view – and experience on recruitment and how that can be built to realize these outcomes?

GR: Yeah, well, I think first and foremost, when we think about healthcare holistically from a recruitment perspective to your question, we have got to do recruitment in the communities that are actually going to best serve our patients. So you can’t just use traditional recruitment lenses. You can’t just go on Indeed, go on LinkedIn, and assume you’ve done enough. You’ve got to intentionally get out to the communities that are going to best identify, represent, and provide what we know is going to be the most equitable care. Whether you’re a health tech company or whether you’re a hospital or a community health center, what we know is that if the team, providers, clinicians, even non-clinical, can relate to the patient, have a direct connection to the patient, understand the needs of the patient because they belong to the same community or they speak the same language or they understand the same language, we see quality of care improve. And it’s crazy to me to sit in 2023 and sit here and still think that we haven’t made as far advancements as we need to in this space and so we’ve got to really intentionally recruit in the communities that are going to best meet the needs of whatever – whoever we’re serving, whether it’s our patients consumers or whatnot depending on our organization, we’ve got to do that.

ZM: Yeah, absolutely. I mean you make a really strong case. And in trying to make that case, what’s your experience in convincing and getting this recognition with c-suite, with the leaders of organizations that this is something – it’s not just check the box but it’s as you said very intentional um but it has to be continuous and can you speak more about also culture, in that competence culture that really just goes beyond um organizational culture.

GR: Yeah, so I think, look, I mean we all know at times it can be challenging but what I would encourage everyone to take a look at is there’s some successful models for example the anchor institution framework is certainly a very impactful model particularly for a health care organization that is part of the community. If you’re not already doing anchor institution work, think about how you do anchor institution work. And there’s a great also, connection to corporate social responsibility within that as well. And so I think to your point culture, in my hospital days, I was blessed to have a CEO who got it. First of all, she grew up in the city in New York City she understood what it was like to truly serve a community, she also understood what it was like to literally walk in the woods to meet the homeless and help meet their needs where their needs were at. And so I was blessed in that way, but I’ve also worked in other organizations in healthcare where that wasn’t the case. And so you have to show data you certainly have to help inform them how your community health needs assessment can truly be a driving strategy of your health care system. And so I tell people all the time if you’re not leveraging your needs assessments you’re not doing a good enough job because the reality of it is, is those needs assessments are data. If you’re going to advance value-based care, pay attention to them, if you’re going to advance population health, pay attention to them, and if you’re going to have a healthy, prosperous, sustainable workforce, pay attention to all of that because ultimately our team are also our patients a lot of the time. And so we’ve got to really intertwine and look at it as we’re taking care of our entire community whether it’s our workforce or those that we have the privilege to serve.

ZM: It’s a very profound thinking here in terms of how we get out of the sick care model as is what we’ve been talking about, and really move towards value-based care and prevention and overall wellness. So what about standardization aspects in terms of how you teach empathy or how you recruit? You had mentioned at one point a tracker, a health equity tracker, I believe, in our previous discussions. Can you explain a little bit more about that, and how can we, as a healthcare industry, kind of look at standardization so that we can make sure we’re making the most out of the outcomes that we’re trying to drive for?

GR: Absolutely. Yeah, so I think for anyone out there that isn’t familiar, I would encourage you to check out the healthequitytracker.org. It was a funded CDC foundation project. Google developed it. I had the privilege to be a part of a team that provided guidance and counsel to it. And it was actually developed out of the Morehouse School of Medicine. So it was a phenomenal initiative that always had health equity in mind. And it truly had some of our most pioneers in healthcare at the table. Dr. David Satcher, for example, was involved, and Daniel Dawes was involved, and former Congresswoman Donna Christensen, who has been a force in the field of health equity, was involved. And that tracker is phenomenal because it provides a national lens, a state lens, and a local lens. And you can actually drill into data, you can see metrics, you can see ways to further advance. I think I’m also encouraged that obviously with the Biden-Harris administration, we’ve seen some great work at CMS, and particularly within HHS, to advance forward health equity. And now, obviously, the Joint Commission has also come out with some standards related to organizations having to put forward agendas related to advancing health equity. And so I’m encouraged from a regulatory end that that’s going to happen because we’ve got to make strides there too. I always encourage everyone to familiarize yourself with the political determinants of health. We talk a lot about the social determinants of health, but we don’t talk enough about the political determinants of health. And if we would focus on that too, we would recognize that we could advance health equity much more fully and successfully because you’ve got to consider all those facets as well.

ZM: Sounds like we really need holistic advocacy in all these areas, not just on one side, purely for healthcare and healthcare use and data use, but also on the political side in terms of how that data is gathered and what is accessible and how standards are applied and legislations are brought forward from that perspective.

GR: And I think to your point, what’s powerful is even when we did the health equity tracker work, one of the things that we as an advisory group made clear is you’ve got to involve the communities that you’re getting that data from. And so, for example, we involve the tribal communities in South Dakota and Colorado because oftentimes they’re not considered as part of a lot of data because there’s just the nature, they haven’t been. We specifically had intentional efforts, again, to engage members of the LGBTQ+ community to ensure that their data was collected. And I’ll give a shout out, my former state, the Commonwealth of Pennsylvania had some phenomenal secretaries of health including Dr. Rachel Levine, including former Secretary Denise Johnson, and they led us to do better collection of this type of data. And ultimately that allows us to have a stronger focus in advancing health equity. We’ve got to have people in public health, and in all settings, doing that type of work or we’re not going to advance it.

ZM: And I think what one of the questions popped up which caught my eye, and it’s something we have talked about as well is the way our health care is incentivized right now is towards the more sick care model. So, how do we incentivize towards health equity?

GR: I mean look this is a long standing debate and discussion, right? I mean because we’ve been talking about value based care for so long, we’ve been talking about shifting this model for so long and we know that while we all love healthcare, healthcare sometimes it’s just too slow to move forward, and oftentimes it’s regulatory in nature as well. From my vantage point, I – look, I get it. I know on the provider side it’s tough to think about how you move to a preventative care model, and one that’s going to advance health equity when the reimbursements are not there. However, I would challenge our providers and our payers to really look at a path here. We know that our patients do better when we advance health equity, we know that quality improves when we advance it. And so barring continued advancements on the regulatory side, I think the entire provider community needs to come together, they need to find a path forward here. To me, it’s called innovation and transformation. And if a payer and a provider community can’t figure that out, I think we’re in a really tough time. But we’ve got to figure this out. We can’t just sit back and say well we’re still in this model so we can’t do it. And look, at the end of the day, we’ve got to do it for those that benefit the most and those that need it the most. And so for me, I go back to why do people come into health care in the first place and it’s to serve. And if we’re not able to do most effectively serve and advance it, then we have the wrong people in it.

ZM: Yeah, absolutely. I think that’s a powerful statement and for sure, the purpose of why people get into healthcare. So we have to remember that even as we’re looking at administrative aspects and trying to run a business. And within the complicated system we have, ultimately, we need to drive towards improvement. One last thought on, someone had also popped up a question about source of data, and how do we make sure that that data is actually clean data and useful data. What’s your view on that in terms of the type of tracking that you look at?

GR: It’s definitely a challenge right and we’ve seen that for quite some time. And I think it’s a very, very good question. It’s certainly one that goes back to the foundation of that we have to make sure whatever data we’re using is foundational. So for example, when we did the health equity tracker work, we had to realize that we would have to look at different government sets of data, at the local, at the state, at the federal level. And depending on the state, not all states have county or as most robust county health departments. And so then it falls to the state. And obviously depending on the state and how it’s resourced in that health department, that data collection may not be as robust as another. And so this is a challenge. And I think if you looked globally, it would be clear that the United States has not invested enough in public health. That’s a fact. And this continues to be a challenge. And I know even in that acute care space where I’ve spent a lot of my career, it’s a very real situation there as well. On the other side of this, we do have a lot of data in acute care. And we’ve got to figure out a way to better leverage that data too. And if we do, I’m confident we can further advance health equity. We’ve just got to better leverage the data, create more interoperability, create more partnerships, create more synergies with our community-based organizations. The closer you are to the community, the better you are in serving the community.

ZM: So I think in summary, what I’m hearing and what you’ve said to me before is it’s about the implementation. Just have to be in action, do it, prove the models, prove that it works, and it does come out with better health outcomes. And you just have to keep at it and demonstrating that. And by being in action, you can actually create the standardization and the right tools through experimentation to see what does work, what actually does make a difference. And it sounds like that would be, to use one of the words from one of the participants in the chat, a bridge, to get from here to there.

GR: Yeah, absolutely. Yeah, and I can’t stress enough about the community-based piece. We’ve got to further engage our community-based organizations because again, they are truly navigators. And I love that idea of a bridge. We need a lot of work for bridging in health equity.

ZM: So thank you so much, Geoffrey. I hope the audience has been inspired about what is possible. And just to be in action and keep doing the best that we can do, and that can just serve everyone better. So, thank you so much for joining us today, Geoffrey.

GR: You’re so welcome. Thank you for having me.

AB: Thank you, both, so much. It was a great, great session with a lot of great insights. So really appreciate you taking the time as usual. Thank you, again, Zina. And we’ll see you again next month.