This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

TownHall: Healthcare Without Borders and Empowering the Patient with Tracy Elmer

[00:00:00] today on town hall.

Tracy Elmer: (INTRO) We don't want to be geographically limited. Distance should not be that barrier to care. And so it really does help us bring the service to those who in many ways need it the most

I am Sarah Richardson, a former CIO and President of this Week Health's 2 2 9 community development where we are dedicated to transforming healthcare one connection at a time.

Our Town Hall show is designed to bring insights from practitioners and leaders on the front lines of healthcare. All right, let's jump right into today's episode.

(MAI N)

Sarah Richardson: Welcome to Town Hall. In this episode, we're honored to host Tracy Elmer, Chief Innovation Officer at TrueCare. With over 50 years of service, TrueCare stands as a beacon of compassionate, comprehensive, and culturally sensitive healthcare in San Diego and Riverside counties. Under Tracy's leadership, TrueCare has embarked on transformative initiatives in health IT digital literacy, and patient-centered innovation, ensuring that technology serves as a [00:01:00] bridge.

Not a barrier to quality care. Tracy, welcome to the show. Thank you so much it's an honor to be here with you and just catch up. Well, and thank you for saying yes to the interview. Heck, it was only a couple weeks ago. We were in San Diego together for a city tour dinner, and we sat together, the only females in a room for about 20, and I looked at you.

I'm like, I have got to interview you for our talent series. I appreciate that so much. Well, I love what you're doing at True Care, and I do wanna jump in to digital literacy initiatives because that is a continuous conversation. Yes. You have implemented robust programs to assist your patients in navigating virtual care platforms like MyChart.

Can you elaborate on the strategies that you've employed to enhance digital engagement among patients, and particularly those Tracy with limited technological proficiency?

Tracy Elmer: Yes I love talking about TrueCare's digital health literacy program and what we've been doing to really not just create that [00:02:00] connection through MyChart and really assuring our patients can be engaged in part of their care journey, but really empowering them through teaching them more about.

Just general technology and digital literacy. And, we found early on that our adoption, you know, was slow despite our best efforts. And we recognized that education was really key. And so we created a new pilot program and we introduced it first to our Golden, we call them our Golden Years group, which is a group of seniors who only speak Spanish.

And so we built five sessions that was all about the basics of just navigating with digital. Tools, whether your iPhone, even your computer. And we taught them the basics of logging in, doing, searching. And then eventually through our five core series expanded to tools like of course MyChart, which was really a keen focus, but also just general Zoom and other tools we use for connection with care.

And I got to go to their graduation and it was one of the most powerful days of my [00:03:00] career because. I'll tell you something I didn't understand a lot of the language, but I was thankful for our interpreters who were in the room. But I felt all of the emotion that our patients and their family members who were there were putting out there that really was all about

the empowerment they felt that someone was investing in them and their wellbeing beyond their health, and it was just very powerful when I could see firsthand the power of how we are using technology to connect with our patients, but more important, really, again, bringing them into our culture.

meeting them where they are and assuring they feel like they belong and that not only that they're empowered to just take the lead and not have to rely on others to help them so it was a very powerful day and afternoon. We've really seen great success and are continuing to roll that out.

And it's just one of different types of strategies we've employed. The other being we invested in digital health ambassadors who spend time in our waiting rooms with our [00:04:00] patients and family members. And just helping them learn more about ways they can connect to true care outside of being in the clinic.

How to log into MyChart, activate it, what features they can leverage so that's also been really helpful. Again, taking the education to them as opposed to just relying on written message, YouTube videos you name it but it's been very successful and we were very honored by our partner OCHIN, to be recognized as an Impact award winner last year.

Again, that empowerment, bridging gaps to better health. So it was very it's work we're very proud of and honored to be able to deliver.

Sarah Richardson: How have you found the adoption of the usage of the portal and the ability for that population to really facilitate the right care coordination and conversations with their care team since you've been adding the extra layers of digital literacy education?

Tracy Elmer: good question. We've certainly seen an increase and so much of the power of that is really in the value of what we're [00:05:00] serving, right? If we were to just turn it on and allow things just like messaging, but not online scheduling for example it kind of limits its reach. And so I think we've really seen a slow but steady adoption rate over the last few years.

We've plateaued just under 70% for active patients, so we're endeavoring to keep going. But I think we've certainly heard about convenience, right? And it's all part of experience, which is a big focus of course, but really understanding how hard it is to wait on a phone line, on hold, or.

Wait and work through things that if you could do it at the touch of your own, device in front of you within seconds it's just very powerful way to assure you get that appointment when you need it, that you've sent that message to your care provider of something you woke up worried about.

The fact you could actually, in the middle of the night, if you have a sick child, for example, wake up and immediately take an action, like to be able to request an appointment or make the appointment at a QuickCare. That makes you really immediately less anxious knowing you've put forth an action and so[00:06:00]

all of those different aspects of it have really been really deemed very effective and impactful for our

[Mic bleed]

Sarah Richardson: I love hearing what you're doing for the community in that aspect, because as the first FQHC in San Diego County to launch Epic. Yeah.

What were some of the key challenges and successes that you found during this transition? I.

Tracy Elmer: First of all, we launched in 2019 to go live in 2020, and I think, you know what was happening during that time, the pandemic was an interesting time to be implementing Epic but so that was a challenge by its own right.

But outside of that, I think for me, coming into the organization, brand new, having worked outside in the healthcare health systems that are much larger. I could see immediately they embraced change and innovation, which was beautiful. I think though there was some fear, normal anxiety, if you will, with change.

But I think that they were very accustomed culturally to just using what we have and making it work the best way we could. So a lot of that challenge [00:07:00] was really getting beyond the why is this important and really. Creating that vision or painting a picture of what it would bring to us down the road, even though it's hard right now.

And really, once we got through that initial aspect of just change management I think the challenges were certainly the timing. We had a couple of different delays because of good, fair reasons with the pandemic, and we ended up going live virtually. So we didn't have anyone from OCHIN onsite with us.

So that was a whole new model for supporting, all of our different sites and using Zoom right as our base, like Zoom rooms for all the different support needs. And I, I will say it was quite innovative and it actually worked quite well. But as you know, like there's nothing that replaces the power of human connection face to face in the same rooms.

But while it was a challenge, we created opportunities from it. We made it work. We created strong super user model. That was one of our successes early on that really has lived with us or sustained since then, where [00:08:00] we really needed folks within our clinics to have that partnership and ownership. Of really learning and being able to help others and it really created a nice investment that we've maintained monthly with keeping the same super user group intact.

They have special teams, channels where they can reach out to our informatics teams. They are part of monthly trainings. They help with the monthly investment of training we do for all. So that, was really one of those key successes that a, it really arose from a challenge where we couldn't have the same service and support model for our go live.

So. Already wanting to rely on super users, it leveled it up even more and it's really proven to be very effective since. So lots of great things that have come since those days. So we're excited about where we are today and really now going into the next layer of innovation, using that as our platform, or having Epic as our

[Mic bleed]

Sarah Richardson: I have to believe because you did go live during the pandemic and had to really think of innovative ways to still make it successful. [00:09:00] How did that help to create the foundation to your point about doing the next set of initiatives that maybe are actually really hard from a change perspective, but if you did it virtually, you get together back in person, you're like, wow, we can do anything.

Tracy Elmer: Yeah. It's pretty powerful right? It certainly gave so much of a confidence boost, right? To those who have either. Not been through such an experience before. But it really helped everyone lean into what will our business practice look like. We've gotten through all these things, we have much on our strategic plate to accomplish, and it really helped us lean into really the structure of governance in creating and defining a model where we hope for ownership and decision making at the level of folks who are doing the work every day.

we leaned in quickly to changing how we work, right? How we interoperate, we created these partner models, work groups with the right governance structure and decision making, you know where it needed to be, depending on the nature of [00:10:00] it. And you could see that huge uplift of accountability beyond just IT informatics it

it was all about our partners in the workforce and them really just going forth and wanting to do more. And again, the confidence was there because they went through a lot of hard things together. But then the structure was in place to really allow for that to continue to scale up and out in a really good quality way, right?

Not just getting things done to get it done, but really for really meaningful reasons and with a really highly effective quality approach. I.

Sarah Richardson: And you've done so much for the community in terms of how do you continue to outreach the mobile wellness units. You introduced those expanded access to care for underserved populations.

How are some of the operational aspects of the community impacted by these results?

[Mic bleed]

Tracy Elmer: Oh, our mobile program. It's one of those, again, being in community health, it's another, powerful way in which we impact those who are in a care network. And as we know, geography can be a [00:11:00] huge barrier potentially.

And while you have other innovative ways to connect, there's nothing again, like the power of taking care to people. And that's really, for us, the mobile program takes us back to our roots. TrueCare started 50 plus years ago. Out of an RV where we would take out, a provider and some other folks out to where folks were working in the fields and the farms and providing vaccinations, providing, wellness checks.

And so it's kind of neat to, to still have that be part of our. Today, but even in a more expanded model and making sure we're delivering both dental as well as medical services out in our community. And we've been really blessed to have wonderful partners who want us there, who will just set up space in their parking lot and advertise.

We have structure and schedules, right when we go to certain types of places beyond health events that are in the community. But it really is all about, our mission, right? We don't want to be geographically limited. Distance should not be that barrier to care. And so it really does help us bring the service to [00:12:00] those who in many ways need it the most and or have, have fear or means , to leave their communities so we can go there and help and really assure their care and wellbeing

In those, you know, other unique mobile ways.

Sarah Richardson: You've also recently opened some new health centers. Yes. Expanded services. It has specialized care for older adults. Yeah. How do these types of developments align with your mission and address the community needs?

Tracy Elmer: Great questions. We are so proud and we, in fact, just this week opened up a really new, we call it a new hub of healthcare at our new Vista Way location, where all of our different services come together on one campus and really allow for, again, that convenience of access.

Yes, primary care is where it starts, but specialty care is where and how we continue to intervene and create other supporting services for our patients. And really, again, it goes back to that mission, right? We wanna make sure care is comprehensive, that we're, again, providing that in diverse locations and really focusing on innovative approaches as we go.

[00:13:00] And it's so much about experience, right? And making sure that, again, the convenience of access. In the communities where people live and in our model of care, we do look at where our patients that we serve and care for are living and located, and we do our very best to create, as we call them, points of access or care that are close to them.

Again, we talk about the barrier of transportation. If we can make it easier for them to get there, not just from primary care, but having a dental service even same day potentially. Or if they're receiving care for pain management interventions like acupuncture, that too can be offered on the same campus in the same location.

And certainly looking to our older adult community, we know that we have an aging population, right? And so we are really looking at , what do we need to do to create a more. Specialize isn't the best word, but, unique care experience for them, knowing that there's different needs that will arise with our aging population.

So, it could be as simple as just changing the orientation of [00:14:00] our geographic location or the footprint of our buildings where we have, if we have more wheelchair, for example, wider hallways, just easier to move about to make sure that we create longer appointment times. Right. And so. We work in the standard of care delivery where we have 15 minutes, but with older folks, we may have more comprehensive needs to address.

So sometimes it's just as simple as schedule alteration.

Sarah Richardson: Which is harder to implement than most people may realize. True. Being able to create the right scheduling componentry for your physicians to see the patient types. I always figured like physician scheduling and patient scheduling, it's actually one of the trickier things to get right to maximize in an organization, it's not just cut and dried sometimes,

Tracy Elmer: [Mic bleed]

Sarah Richardson: I also love what you do for workforce development. You emphasize professional growth and the cultural humility that's required to serve your populations. How do these values translate into patient care and also the overall culture of the organization? I.

Tracy Elmer: love that question. I love the focus. I think a [00:15:00] lot about my CEO and President Michelle Gonzalez, and she always says and reminds us, the work we do will always start and end with people, right? And we are reminded every day that our workforce represents our community and our patients and so really we lean into that.

Mantra of taking care of them means we're taking care of everyone. And so I'm very proud of how we've invested in our workforce growth and development through the years. We created a very special focus two different employee led committees, true belonging and wellness within and really focusing on the importance of belonging, right?

Understanding that we believe if folks feel like they belong, that they will, really feel that they can be their best at work. They bring them best selves to work and that transcends beautifully into the patient care experience. And, we are really fortunate to have a strong culture that we define as building great relationships.

And it's a continuous investment in ongoing education. Bringing folks in to understanding, what [00:16:00] are we doing to develop their best needs, but also support our patients in both in the clinics and outside and reminding them of their value.

And we've certainly seen such a beautiful response that we, you know, of course measure like most organizations, that really shows how valued people feel. They do feel a place of belonging. They do feel safe right? Every day to come to work. And they feel like they're set up for their very best, you know, to do their very best.

And we know how that can then translate to the very best and how they, they, work with our patients and deliver the care and all the support of it

Sarah Richardson: and how employees talk about their employer, it gets out in the community. People know if you're a great place to work, if people are happy working there, right?

They have careers and longevity and the ability to really connect, which really dovetails very well into your community partnerships. Yeah. You've got collaborations such as fresh start surgical gifts, and that's expanded your reach. How do these partnerships enhance service delivery and community engagement?

Tracy Elmer: It's those partnerships, they [00:17:00] matter so significantly and I really do think that they are what really creates a more unique part of our healthcare delivery focus. It's again, that whole concept of we can't and shouldn't go it alone. And you hear it all the time that we're, we're stronger and better together, but we are so grateful for our community partnerships.

And I think that some of them, for example, we're very proud of our feeding San Diego partnership without them, we would not have the means to bring food, more food security, and we do food distributions weekly from multiple sites. Without that partnership, we understand, again, when you consider all the social determinants of health, every partner that we have helps us to mitigate the impact of those to assure

again, that we're focused on the whole person health and wellbeing. Yes again, it goes back to primary medical care, yet we know that Whole Person Care is really what really helps rise the community together and really has the greatest impact and our [00:18:00] partnerships. Without them, it would be very challenging to deliver care.

Even as I spoke of earlier with our mobile health, if we didn't have partners who said, yes, come and use our space within our location or on our parking lot. We have, partnerships where we actually have opened a small clinic. So for folks who are in the most vulnerable of situations, such as with Casa d Paro, they're afraid to leave their homes.

They're afraid to leave their safe space. We now have created a model of care based on that partner bringing us in, where we've created a beautiful space that they can come and feel safe and trust. Right? And really, if you think about trust in healthcare is critical, but then thinking about how that helps build their trust again in life and others wanting to help.

It's just powerful and again, it's really that fabric that of what community health really represents. That's, exactly how the meaning is interpreted right into this beautiful place of folks coming together again to create better health and wellbeing for everyone.

Sarah Richardson: How do you share those stories with your [00:19:00] team?

You think about, you get to see the real time impact every single day on what you're doing for your community, how you are changing people's lives, how in a time of absolute uncertainty, you continue to create a safe space to things that matter the most to them. How do you get to share that with your team and see the impact that you all are having?

'cause sometimes in IT or a few steps removed from the outcomes for the patient. And yet I have to believe at TrueCare you're able to wrap all of those aspects around to share.

Tracy Elmer: we've really been intentional, right? It's a thoughtful, intentional process to assure that while we're in the business of taking care of those, taking care of our patients, we can never forget our why.

Right? Why are we here? Why does the work we do matter? What's our impact? And we're really fortunate to be provided with structure that we've developed in our organization, again, not just those committees, as I mentioned, true belonging wellness within which several of our IT and informatics folks take part in, but we really make sure that the delivering of those messages is consistent and clear [00:20:00] throughout.

And not only do we bring key messages and have program updates from all these different areas that we receive as a leadership team, we then document those and assure we're huddling with our teams and sharing and really are very fortunate to have a partner that has really helped us create some beautiful imagery and videos right, about the impact of our care, which you may have seen on our website.

Those are all accessible and available to our team as well. And I think, it starts with us as leaders, right? To really define working with our team to define our core mission for what services we're delivering to support that of the larger, and you know, I think just there's not one person on the team who doesn't realize or recognize they're having an impact on the patient care process.

They feel like they are part of the care team, right? They're not in the clinic, but they're connected and they know that if the system doesn't reliably work, if the mobility isn't designed in a way that assures continuity and connection, that has an effect on the experience. every day [00:21:00] the work they do, just as a reflection of how powerful they recognize their role is.

And it's something that I take great pride in watching and supporting and I think we've done well with how we've been able to deliver key messaging and like I said, imagery and powerful stories to our team through, through all those different ways.

Sarah Richardson: you've done so much to serve your population, but you also get to lead all the technology and innovation.

So what emerging technologies or initiatives are you looking to explore next, to continue to deliver that level of care and efficiency?

Tracy Elmer: So of course that's the fun part, right? Any one of us in innovation know that we are all about problem solving always, and using our partnerships, our technology new practices.

Right now I'm really excited we are implementing new ambient AI technology and why I'm excited is we have an amazing partner whose mission aligns so beautifully and strongly with ours, but we're really finally in a way. Helping our providers, right? Really creating what they're calling I guess [00:22:00] refocus on joy in their practice, right?

We've talked about that in our quintuple aim, but now it's actually showing and demonstrating effective results. We've just only begun, we did a great pilot but we've just started rolling it out. But the early adoption. Numbers and just the early commentary that we're getting is demonstrating that it's the right tool or technology company that we're working with.

And again, our wonderful clinical informatics team has really taken the lead in that high touch endeavor to move it out and again I wanna be upfront, we're not focused on capacity, we're not focused on productivity. It is all about wellbeing. Again, going back to that workforce wellness focus and really investing in them and helping to create a better, joyful experience for them as they practice healthcare.

Sarah Richardson: Don't you love that? Since maybe the onset of some of the clinical documentation you and I have been leading for, let's be honest, 25 plus years that. We can now deliver solutions where the physicians and clinicians are excited about it.

Tracy Elmer: It's a [00:23:00] first, I mean, it's a, it's a first, like ambient

Sarah Richardson: listening I feel like is the Valhalla Yeah.

Of what we've all been waiting for a very long time. And as long as we ethically work through it. Yes. And it in a thoughtful manner, Tracy like. All the art of the possible is so far and wide right now with what it can lead us to going forward.

Tracy Elmer: Absolutely. And I think, as we're in a time where there's a lot of things that are uncertain and unclear and uncomfortable, but there's so much promise and potential that it brings.

We know that we're just at the starting point and we know with technology and innovation where things go and how fast they move, but also it takes long time sometimes to see that effect. This is something you're immediately seeing the spark, if not beautiful fireworks, and now you know that there's even gonna be more that's better like

it's a very nice, positive area to focus on for sure.

Sarah Richardson: It is. And speaking of the speed of how things go, I'd love to move into speed round with you.

Tracy Elmer: Okay.

Sarah Richardson: All right. These are the rapid fire questions that are a little bit more fun in nature. Okay. So let's go with your [00:24:00] first tech gadget. What was the first piece of technology you owned that made you think this is the future?

Tracy Elmer: Oh my goodness. You know what comes to mind is my POM pilot. Do you remember those

Sarah Richardson: very much? Because you could, you touch them and they'd share information, which is now like, Ooh, the iPhone does that now too, but.

Tracy Elmer: It was the first tech gadget I owned. I think I still have it 'cause I thought, oh, it's historical.

But just think of, for me it was like, oh, this is so nice. I see my schedule, I see things I need to do. I could take it with me. I don't have to log in somewhere. I don't have to print something. I hated paper even back in the nineties. And so, I don't know, I just think that was one of those tools where I thought, yeah, this is pretty cool.

Like I could see where things are moving.

Sarah Richardson: And you take out the stylist. To me that was like one of the coolest

Tracy Elmer: Yes. The stylist. That's right.

Sarah Richardson: I

Tracy Elmer: forgot

Sarah Richardson: about that. You to write on the screen. Yep. And they were expensive, weren't they? Like four or $500 back in the mid. Yes. Isn't that It's incredible to think about.

It was. They were expensive. Digital detox. When you need a break from [00:25:00] a screen, what's your go-to activity?

Tracy Elmer: I'm blessed to live not too far from the ocean or beach, so for me it's just getting out for a really wonderful walk or a hike along the shore. There's something so powerful about just reflection near the ocean, but it really helps me just unwind and unplug.

It's my favorite go-to.

Sarah Richardson: Especially where you live. San Diego is just about as good as it gets when it comes to,

Tracy Elmer: yeah, I'm so super fortunate. Using

Sarah Richardson: activities, your dream collaboration, if you could be a partner with any tech company to innovate healthcare, who would you choose and why would you choose them?

Tracy Elmer: I was thinking about this question, and of course Apple comes to mind. You think, oh, like their human, their focus on human-centered design is so beautifully aligned with what we're doing in healthcare. But I was thinking about it from a fun perspective and I was thinking more about a company like Lego, for example, and what could we do to build health education kits or find ways to use Lego building to help deliver.

Healthcare, education or support? Right. Just something colorful, something [00:26:00] fun or is it someone like Spotify and creating music therapy? So like I think about some of the larger more popular sectors of our world. Those aren't necessarily tech oriented. But other ways we could partner in care.

Of course, Nintendo was the third one I was thinking about. We talk about gamification, right? But there's probably something there with combining Nintendo and healthcare and creating ways to motivate people through play and fun. So those are a lot of like different examples, but I don't know. Lots of opportunities.

I love all of them.

Sarah Richardson: Yeah, it makes seem be like musical therapy. It's kinda like, like putting your coffee house playlist on a Sunday morning and you're like, imagine the musical therapy aspect. One of our partners does give out Lego sets at our summits. Oh, I love that. It's so fun. It's a little operating room and it's all about the different aspects of how they help manage that environment and it's great.

I'm like. Are they hard to create? They're like, no, you just call Lego and tell 'em what you want and they'll customize. Oh, that's

Tracy Elmer: really

Sarah Richardson: fun. Just about anything. So not that far from Legoland. That's right. You could put some kind of a trickier Lego aspect together to engage, some [00:27:00] of the kiddos.

Exactly. Your universe. Exactly. Great for peds. Yes. Legos are always fun. All right, last question for you. Unexpected skill. What's a skill or hobby you have that might surprise your colleagues? I.

Tracy Elmer: They would probably be surprised to know that I love ice hockey and I'm part of a fantasy league and I did pretty well this last

[Mic bleed]

I love that. I'm a hockey mom. Everyone knows that, probably. But I love it. I just think it's fun. I think hockey's an incredibly smart and strategic and a little gritty of a sport, kind of like what we do in healthIT

Sarah Richardson: it is smart and fun and gritty and a good point. And there are some correlations there.

So you know, your hat trick could be exactly what you just talked about and the three ways to, to engage with some different companies for I love that.

Tracy Elmer: That's great. New

Sarah Richardson: engage. Yeah. There you go. See, I don't follow much hockey, but I do know what a hat trick is, so I was like, I didn't hang out with hockey moms and least have some semblance of a conversation

for sure. Tracy, thank you so much for joining us in this conversation. I love what you are doing at TrueCare. It's such [00:28:00] a specific mission driven organization, a time of absolute need and thank you for having the compassion and the culturally sensitive approach that you do to delivering healthcare.

Tracy Elmer: [Mic bleed]

you so much. Appreciate the opportunity to connect and really again, it's an honor to be here. I appreciate your time.

Thanks for listening to this week's Town Hall. A big thanks to our hosts and content creators. We really couldn't do it without them. We hope that you're going to share this podcast with a peer or a friend. It's a great chance to discuss and even establish a mentoring relationship along the way.

One way you can support this show is to subscribe and leave us a rating. That would be very much appreciated. Thanks for listening. That's all for now.