This transcript has been auto generated
00;00;05;01 - 00;00;31;10
Meg Pekarske
Hello and welcome to Hospice Insights: The Law and Beyond where we connect you to what matters in the ever changing world of hospice and palliative care. Hospice Innovator Series, Stories of Successful Hospice Leadership: The CEO and Chief Medical Officer Relationship. Diana and Ed, I've been wanting to do this podcast since before COVID, and here you are. So thank you for joining me today.
00;00;32;03 - 00;00;33;22
Diana Franchitto
Well, my pleasure to be here.
00;00;34;16 - 00;00;53;20
Meg Pekarske
Yeah, well well, I've known both of you for a really long time and really admired the relationship that the two of you have forged together. And maybe for our listeners, you could talk a little bit about your origin story of working together, and then we can sort of talk about that, how that's evolved over time.
00;00;54;24 - 00;01;24;05
Diana Franchitto
Hello, everyone. I'm Diana Franchitto and I began in hospice around 15 years ago. Prior to that, I spent a few decades in the acute care hospital world and transitioned over to hospice. And it was in an acting CEO role. And and the first thing I did once I got the permanent job was that I immediately called Ed Martin, And even before I notified my husband, and let him know that I really needed a full time chief medical officer.
00;01;24;05 - 00;01;43;01
Diana Franchitto
He was only part time at that time and and said he'd think about it overnight and he'd say first thing the next morning. And then I told my husband, like, oh, so, so we've been working together now for a good 15 years and we'll certainly delve into that in a few minutes.
00;01;43;02 - 00;02;08;26
Meg Pekarske
Yeah, well, I found I never I remember where I was when you first told me the story. We were at an NPHI meeting and I just found it fascinating because I think that looking at hospice today, people would say, oh, of course your physician is your right hand. And that role is is so critical to the organization in so many different ways.
00;02;08;26 - 00;02;12;06
Meg Pekarske
But I think you really saw that because how many years ago was that?
00;02;12;06 - 00;02;35;20
Diana Franchitto
Diana 15. And, you know, coming from a hospital background, you know, your physician partnership is so critical. And when I came transition to hospice, it was very transactional and kind of approval and administrative back then. And it just seemed odd that, you know, you wouldn't have a dyad, so to speak, between your CMO and your CEO.
00;02;35;27 - 00;02;54;19
Meg Pekarske
Yeah. So, Ed, you got that phone call 15 years ago and you took the night to think about it. And so clearly, the fact that she she asked you so early on knowing that you were going to be an instrumental player, I guess, how did you feel about that?
00;02;55;02 - 00;03;22;14
Dr. Edward Martin
It was great news for me. You know, as Diana said, I was part time of day. I started in hospice in 1987 and a very powerful that, you know, gradually grew over the years. But I was still part time when Diana called. And I think historically in hospice, at times, the medical directors role has been our position role has been, you know, come sign the forms that died and and and that that'll do it.
00;03;23;16 - 00;03;33;13
Dr. Edward Martin
And I think Diana's vision was it was a much more active and involved, you know, medical director, which seemed great to me. So I was thrilled to have the opportunity.
00;03;34;09 - 00;03;44;06
Meg Pekarske
So what were you doing? AD You're doing the hospice part time in 1987 and then you're doing other stuff. So what was your background coming to have this work?
00;03;44;06 - 00;04;08;07
Dr. Edward Martin
Well, I was in primary care. I was a primary care physician. I was doing some work with addiction medicine. I was doing some work with a long term goal, a geriatrics hospital. And as my hospice working priest over the years, I gradually, you know, reduced some of the others. But in 2008, after with Diane, I made a clean break and went, you know, was able to go full time.
00;04;08;26 - 00;04;36;25
Meg Pekarske
Yeah. So well, it's such a wonderful story about how you, you came together. And then I think when you say 2008, I mean, that is so what I mean in hospice here is like light years away because in 2008 we were talking about the new cops came out, right? That was like a big deal. And now in terms of, you know, where we are now and the amount of enforcement we're dealing with and all that stuff.
00;04;36;25 - 00;05;06;11
Meg Pekarske
So but let's talk a little bit about so we're we're back 15 years. How did you come to forge this relationship? And and then we can sort of talk about nuts and bolts kinds of things about how you guys work together. But and maybe just for our listeners, David, about you could give us a little background about hope a little bit so we can, which I think now it's hopeful.
00;05;06;11 - 00;05;17;02
Meg Pekarske
But why don't you tell our listeners a little bit about the program? Because I think some of the ways you've partnered together is is reflective of how you've been able to grow and expand in new and different ways.
00;05;18;02 - 00;05;45;20
Diana Franchitto
Sure. So Hope House is a hospice and palliative care organization formerly known as Home Health, Hospice and Palliative Care. And our geographic territory is from the Boston City Limits to Block Island in Rhode Island, which is all the way the southern part of the state. So two states we covered, our census is about 750 average daily census. And we have a very strong and robust palliative care organization.
00;05;45;20 - 00;06;09;21
Diana Franchitto
And I think the census for palliative care is closer to 1000 and and we have about 50 providers having nurse practitioners and the other half physicians. And we are the academic affiliate of the Warren Alpert Medical School of Brown University for Hospice and Palliative Care. Meaning we have the privilege of training all of the learners at Brown on end of all.
00;06;10;02 - 00;06;34;29
Diana Franchitto
And it is a fairly robust contractual agreement that we have with Brown to do such. And Ed has been the leading force behind that over the years. So very academically focused organization as well. So that's kind of a hopeful theory at a very high level. And then in terms of our working relationship, by way of background, I am not a clinician, so I have an MBA.
00;06;34;29 - 00;07;00;07
Diana Franchitto
I'm a fellow of the American College of Health Care Executives. And so it was really important for me to have a chief medical officer, one obviously that I trusted, but that had very deep and sound clinical expertise and not just clinical expertise, but really good judgment. And so that was what led me to further discussion about at Joining Hope Health full time.
00;07;00;17 - 00;07;25;03
Diana Franchitto
And so that's really what I was looking for because I needed to be able to trust, particularly not having a clinical background and this pros and cons to having the CEO, CMO balanced with a clinician or not a clinician. And and that has been a really important priority for me as the medical team at Hope Health has evolved over the years.
00;07;25;15 - 00;07;56;01
Meg Pekarske
That trust and judgment that is so, so critical because you work collaboratively, but you have very different per views in terms of what you're you're doing. And I know when we were prepping for this podcast, I was looking back through my notes and Ed was saying that that Diane, I get stuff done. You know, you are, you know, have vision and really passionate and getting stuff done, I guess.
00;07;56;01 - 00;08;07;17
Meg Pekarske
Ed, how do you how do you balance that or how do you play into that? And where is the line of what you do versus Diana does as it relates to how you intersect?
00;08;07;27 - 00;08;31;25
Dr. Edward Martin
Well, I've learned my emails are even more effective if I copy Diana to take care of organizations. But I mean, Diana has been very supportive of sort of the independent medical judgment of the of the medical staff. And I and I know some of my colleagues find they're often pressured to admit a patient who they don't think is knowledgeable and not to discharge a patient they don't think is eligible to make reason gap.
00;08;31;25 - 00;08;52;25
Dr. Edward Martin
They don't think major. And I can I can say I've never had that from Diana. And so I really respect the, you know, the boundaries we've had in that regard. And she says she's she trusts the judgment of I mean, we we're very fortunate, have a great clinical staff, great provider staff. And she trusts our judgment. So that's that's been so helpful.
00;08;52;25 - 00;09;08;03
Dr. Edward Martin
And I say, I mean, if we have initiative that needs to happen, Diana, we'll make sure it happens. And that's who who needs to be at the table, what needs to happen now? It needs to get supported. So so that's been, you know, from my perspective that's been has been great.
00;09;08;25 - 00;09;36;01
Meg Pekarske
And I think in today's enforcement climate, where I think every hospice in the country of any size has had multiple different reviews, it also means standing by your physicians and defending that clinical judgment through the appeal process and other things, which I think is really important because, you know, well, I think being pragmatic is helpful, like, you know, what's the cost benefit?
00;09;36;01 - 00;10;05;28
Meg Pekarske
But I also think, you know, standing by your physician means, you know, we're going to defend the clinical decisions you make and appeal things that should be appealed. And and I know, Ed, you play a big role in that in terms of, you know, you have a lot of experience testifying if need be or other things. And so so tell me how you approach it, because Diana was just saying 50 50 clinicians.
00;10;05;28 - 00;10;10;01
Meg Pekarske
So that's NPs and physicians. Do you have any PAs?
00;10;10;23 - 00;10;29;19
Dr. Edward Martin
We don't have PAs in hospice. Their work is restricted. So we we don't have any PAs. But I think from you know, in terms of the on the hospice side, because this came up last week, one of the physicians asked me, gee, I'm not sure about you know, we sort of have the standards changed. I hear about all this review.
00;10;29;21 - 00;10;52;21
Dr. Edward Martin
Yeah. And my standard has always been were you do you feel confident sitting down and explaining to an administrative law judge why you thought this patient had a prognosis of six months or less? If the patient and if you feel confident, if you say, yes, absolutely, that's something I can do. Now, if you think, oh, boy, I'm not you know, I I'm not sure I'd want to tell, you know, then, you know, we can't be, you know, recertifying that patient.
00;10;53;05 - 00;11;11;03
Dr. Edward Martin
And so that's, you know, from a regulatory standpoint, that's always the judgment I've tried to make is, you know, are these sound clinical decisions that are defensible clinically, but then ultimately that you would be willing to argue, you know, and if another physician shows up at the hearing that you'd be able to argue with that position and make your case.
00;11;11;14 - 00;11;39;13
Dr. Edward Martin
In my judgment, this patient absolutely was eligible for hospice services. And here are my reasons or was eligible for general in-patient GP level services and these are my reasons. So so that's been sort of the bottom line clinically palliative care has been that's been sort of a wonderful expansion. That's, you know, years ago, I think, you know, oncologists were a little bit anxious about having palliative care docs in their centers, thinking we would help everyone out of treatment and make everybody go home and hospice.
00;11;39;13 - 00;12;03;23
Dr. Edward Martin
And and and now, you know, as of today, we have, you know, four full time docs in our in our academic cancer center. And their work is tremendously valued by our oncology team. So I think, you know, things are things have certainly changed. And there's there's such you know, in in the hospitals, again, things have changed so much in terms of the value of palliative care, the importance of palliative care.
00;12;04;03 - 00;12;23;07
Dr. Edward Martin
You know, we launched this past year in the emergency department at one of our hospitals, and we had a meeting last week where they presented to the results to the board, and they found that the length of stay, if we initiated the palliative care concept in the ED with our BR, it boarded by purported physician and emergency department.
00;12;23;07 - 00;12;49;24
Dr. Edward Martin
Their length of stay was about half of what what what it would be had the council started when they were up on a unit, they thought it prevented, you know, 200 admissions and said the departed and saved a couple million dollars. So it was a great investment for them to support our physician down in the emergency department. So I think there's you know, there's been you know, we've been, you know, certainly welcomed by the by the medical community here.
00;12;49;24 - 00;12;54;19
Dr. Edward Martin
And we've had great support from Hope and from Diana in terms of, you know, launching these initiatives.
00;12;54;29 - 00;13;19;00
Meg Pekarske
So switching gears, like, okay, who comes up with that idea and how do you work together on that? Like, that's take you know, either the emergency department maybe that start there because I haven't heard someone doing something as structured as you did. Like how did you cook that up? Whose idea was it? How did you partner together? Walk us through that.
00;13;20;01 - 00;13;21;28
Dr. Edward Martin
You know, Diana do you want to share?
00;13;22;00 - 00;13;56;28
Diana Franchitto
So so, you know, I just want to go back 1/2 to your question about kind of the balance between your CMO and CEO. And, you know, in the early days when we started working together, I would often say to Ed, well, what do you do with those great hospice patients? And you're not sure if they should be admitted to hospice or not and just, you know, eligibility, but boy, am I ever so grateful that we stayed on this the the right side, particularly given this incredibly aggressive oversight and regulatory environment that we're in now.
00;13;56;28 - 00;14;24;27
Diana Franchitto
So that has been in just your call. You are the chief medical officer, your call. And so that has really been an important strategy and getting toward to, you know, these strategic investments that we make. Sometimes it comes from our partners. Other times it comes from, you know, one of the other providers, our physicians, our VP of medical staff services or ED, you know, and and it just depends.
00;14;24;27 - 00;14;45;16
Diana Franchitto
And we we meet very regularly with our health care partners. And if there is a need that they're identifying a concern or a problem they have, they may not know the solution before. I could hope health be a part of the solution. That's where we you know, health care systems, number one pain point length of stay. Yeah yeah, yeah.
00;14;45;16 - 00;15;08;03
Diana Franchitto
You know, there's a there's there's there is a potential solution for that. And so we figure out what's going what it's going to take from an investment and how we would how we would make that. And I'd have to say palliative care is one of the our top strategic investments over the years. Other hospice and health, other hospice and palliative care organizations often go in different different directions.
00;15;08;03 - 00;15;13;00
Diana Franchitto
Our our growth in palliative care has led to a significant growth in hospice.
00;15;13;17 - 00;15;37;16
Meg Pekarske
Yeah. Well, I think, you know, that outcome you're talking about with this emergency department visit because oftentimes you're talking about palliative care in the hospital. And it's like, I've been here for three weeks and now I get a palliative care visit and we're there, you know, nearly at the end of life. And I think probably not the best sort of for everyone.
00;15;37;16 - 00;16;02;23
Meg Pekarske
I mean, glad they got a palliative care visit. But, you know, when's that right time? And I think that health care is not immune to sort of the fiefdoms. We have the silos. And so, you know, and I'd imagine in my experience when you have a physician needs to get buy in from other physicians and you can't just be the business leader saying, hey, this is a good thing, right?
00;16;02;23 - 00;16;30;23
Meg Pekarske
So so how in terms of because you have your academic medical center with Brown that fellowship program and this like how do you team that approach? Because you've obviously developed really strong partnerships that they didn't see it as competing with. But essentially we're going to all do this better together and this plays into our you know, large strength.
00;16;30;23 - 00;16;44;16
Meg Pekarske
Like, how do you how do you do that? Because I think you've done it really successfully. And I think other folks sort of struggle to it to sometimes get that collaboration going on with hospital partners and others.
00;16;45;16 - 00;16;46;09
Dr. Edward Martin
And you want to.
00;16;46;18 - 00;16;49;10
Diana Franchitto
Know where that.
00;16;49;10 - 00;17;10;05
Dr. Edward Martin
I think in terms of, you know, academic partners, I mean, it was I think there's a recognition this is such an important, you know, information for their students and residents. And to get you know, we had a strong partnership with the division of geriatrics, which is now the division of geriatrics and palliative medicine, actually. So we had an academic home at Brown.
00;17;10;19 - 00;17;35;22
Dr. Edward Martin
And, you know, for years we had been training a lot of their medical students and their residents. And so I think this was really a more formal recognition. The fact that they actually made us a formal affiliate, recognized all the work we do. It's rare that one of our providers in the hospitals, in the academic hospitals, doesn't have a learner with them either a medical student, a medical resident, a family medicine resident, surgical resident.
00;17;36;17 - 00;17;58;01
Dr. Edward Martin
So I think we do a tremendous amount of teaching and it's sort of the formalization of the you know, the I think making us an academic partner really recognized that. But I think the tremendous value we bring in terms of the fellowship, I mean, we basically provide the training for the for the fellows. And so I think it was a great opportunity to partner with Brown in the Department of Medicine and Division.
00;17;58;01 - 00;18;13;14
Dr. Edward Martin
If you're asking about a medicine to create a fellow, I mean, first we started in 2012 with one fellow and a couple years later we had two fellows. Last year we got up to four fellows. We had 40 for four. So there's been, you know, tremendous growth in that area as well.
00;18;14;13 - 00;18;41;06
Meg Pekarske
When we were talking about this, it's so exciting because talk about making change from the inside out, right? If we don't change physician training and all of those things, then we're not really going to really advance end of life care in our country. So, you know, which I think at the end of the day, don't we all want to make a difference, not just at a patient level, but sort of a structural level?
00;18;41;06 - 00;19;09;25
Meg Pekarske
Because I think we've always been sort of well, that's hospice and palliative care, not really truly integrated. And and so so anyway, that's super exciting. And I'd imagine that takes a lot of work to do. And that's not something. Diana, you can just go meet with the CEO and say, hey, this is great idea. We have you need someone like AD at your side doing that.
00;19;10;21 - 00;19;37;10
Meg Pekarske
So how do you work together now? I've seen your offices are right next to each other. Right. And so how do you work together? Is it do you have structured meetings and how and do you have agendas? Like how do you guys work together? And I'm sure it's evolved over time. How did it start and where is it now?
00;19;37;12 - 00;19;37;21
Meg Pekarske
Yeah.
00;19;38;10 - 00;20;06;15
Diana Franchitto
Well, I would say it's the daily drive bys that, you know, our offices are adjacent to one another and so with that we have a lot of face time that we can check in with one another. You know, we do meet regularly whether with other leaders on the staff or with our VP of Medical Staff Services, where we we have more deliberate time talking, whether it's about provider staffing, whether it's about a certain strategic initiative.
00;20;07;00 - 00;20;29;24
Diana Franchitto
But it's so important, given the role of the CMO, that it's not restricted to the first and third Thursday of the month. Things ramp so quickly and it's so important that we're in lockstep with one another. So I you know, and then particularly with the the regulatory environment, I just think this, you know, these daily check ins are are are critical.
00;20;29;24 - 00;21;06;10
Diana Franchitto
And and sometimes we need to spend 15 minutes with each other and other times, you know, all good, great, good. Yeah. And, and we move on. But I find that that's really important. And the other piece as well, it's really helpful to have a trusted CMO that has inordinate judgment that I can collaborate with. And particularly as we're trying to talk with our board of directors, the Hope Health Board of directors about a new initiative, a new strategic investment that he brings, that clinical perspective, that, you know, yes, I appreciate it and understand it.
00;21;06;10 - 00;21;16;06
Diana Franchitto
But particularly Ed is still a practicing palliative care physician that it's really helpful. Or if it's about our affiliation with Brown, it's really, really helpful to have that.
00;21;17;02 - 00;21;50;20
Meg Pekarske
And something I've always really admired about you AD is that you are still very hands on. I mean, you have obviously a leadership role and know, but you're balancing that with hands on care because I'd imagine you think that's important but also probably feeds your your soul, so to speak, because, you know, sometimes when you get more removed and everything becomes administrative, you know, I know even in my job, you're like, hey, but, but I was a really good physician or, you know, whatever that is.
00;21;50;20 - 00;21;56;12
Meg Pekarske
And so tell me about why you continue to take a patient load.
00;21;56;24 - 00;22;16;08
Dr. Edward Martin
Now, one that's what I love doing is taking care of patients. So if I gave that mean, it would make no sense to me to give that up. And I think it makes me a much better leader in terms of I mean, because I mean, I take call I take regular call at nights and weekends. And so I don't ask White Fridays to do what I'm not doing.
00;22;17;02 - 00;22;46;05
Dr. Edward Martin
And I think that's I think that's important. And and I think, you know, I make home visits. I say I try and do some, you know, and get because it often makes me aware of think, gee, this could be you know, this could be done a little better. And, you know, during COVID to care recovered patients and you know, again, I just think it's it's what I enjoy so fortunate is what I enjoy and also as has other benefits as well.
00;22;46;27 - 00;23;07;14
Meg Pekarske
Yeah. Well, tell me, what are some of the other things that you're you're cooking up if you can talk about them, like where do you see things going? I mean, because we talk about audit and enforcement and all that stuff. And obviously I do lots of that. But as I always say this, you can't run your business right?
00;23;07;14 - 00;23;30;14
Meg Pekarske
Like you can get so caught up and like let that define like what you spend all of your time doing. So you need to come up with new strategic initiatives and new all this other stuff. So I guess where do you see the future? I mean, you've talked some about palliative care and I know you guys have home health, too.
00;23;30;14 - 00;23;55;26
Meg Pekarske
And so, like, I feel like we're really siloed right now. And like there is hospice and then there's home health and then palliative care, which no one really understands, like where do you think things are going? And, you know, because obviously you have several different business lines. Do you see all of that converging in some way or like, what's your vision?
00;23;56;22 - 00;24;40;17
Diana Franchitto
Well, I'll take a stab at it. And then and feel free to chime in. So clearly the regulatory world will be with us for the foreseeable future. It will shift. It will change some. It may scale back only in our dreams, but it will always be there. And I've often said and has has an honorary JD behind his other credentials and initials as well because of the defense that he's had to do for the care of our patients has been just inordinate and so so that's there, whether we call it strategy or not, it's really you have to have a very sound approach to your from the regular regulatory side, be that as it may,
00;24;40;17 - 00;25;24;27
Diana Franchitto
I think, you know, one of the interesting things about New England is it's things things kind of starting on the West Coast of the Midwest, and then they come forward. So what I find really helpful is, you know, particularly with our alignment is, you know, what are the experiences of our colleagues in other regions of the United States, whether it's the bid, whether it's a very aggressive payer community and learning from them, but before it kind of hits the New England area, it's and so I'm I'm we are very focused on developing those payer networks and relationships that are going to be so much more critical in the future.
00;25;24;27 - 00;25;47;06
Diana Franchitto
And and, you know, we're always thinking about, you know, another other ways to grow our hospice program and our palliative care program. But I think, you know, in seeing, you know, home health, for example, it has really been commoditized. And I worry that it will happen to hospice, you know, and will at some point happen to palliative care.
00;25;47;06 - 00;26;21;06
Diana Franchitto
And so I think those are the things that we're very focused on as we as we move forward. But, you know, regardless of the strategy and has great just an intuitive sense of does this make sense? Should we be moving in this direction or not, whether it's informed by our market and our health care partners, but just having just good a good whether it's intuition or instinct, I should say, is really kind of one of the things that I most value in working with and.
00;26;21;25 - 00;26;45;21
Meg Pekarske
Does it make sense and I don't many, you know, readings when I go on and on does this make sense? Right like that, that sort of pragmatic and because we can all get into theoretical stuff. But sometimes I feel like time is wasted because like does this actually make sense, though, to have someone be able to say, but does this make sense?
00;26;46;02 - 00;27;13;25
Meg Pekarske
You know, and then we can save hours of our lives not being and sometimes countless meetings or initiatives that and I think from a leadership standpoint, I don't know how this bears out for you, but sometimes, yeah, you cook up a great idea and then it's not working and it's okay to say, Yeah, this didn't work, let's move on to something else instead of, you know, doubling down and and then, you know, a year passes.
00;27;13;25 - 00;27;16;26
Meg Pekarske
So I love. Does this make sense?
00;27;16;26 - 00;27;26;08
Diana Franchitto
Well, you know, a perfect example, Meg, is remember when CMMI came out with that model, what was what was the name of the model? And it was the, you know, the monthly.
00;27;26;09 - 00;27;27;29
Meg Pekarske
Medicare care choices.
00;27;28;03 - 00;27;49;26
Diana Franchitto
So Medicare care choices. And so the the turnaround on that was pretty quick. And, you know, I took a couple of days to read through it a couple of times, and Ed and I talked and we just said, no, it's going to cannibalize our census. And it's just in such a short length of stay in our region where we are anyway, that we just said no, but we didn't take a long time.
00;27;49;26 - 00;27;56;10
Diana Franchitto
We just we read it and we just made the decision and for us, really glad that we chose not to participate in it.
00;27;56;19 - 00;27;57;02
Meg Pekarske
Yeah.
00;27;57;19 - 00;28;04;20
Dr. Edward Martin
The demonstration project to demonstrate in hospice. She provided for $12 a day and we realize that. What is that.
00;28;04;20 - 00;28;37;16
Meg Pekarske
Like? Oh, yeah, $400. Do everything you normally do, but then you just don't have to cover the drugs and the DME, but, like, do everything else. Yeah, yeah. No, you could see where that was headed. Right. Is like but well I think having a, as you said, trusted partner because I think being a boss can be sometimes lonely and you need a strong C-suite team to really like compliment you and right.
00;28;37;20 - 00;29;12;17
Meg Pekarske
That the best team is going to have. You know, we all have weaknesses. We all have strengths and how you balance each other out and you guys balance each other out in a really great way. Not just like obviously your substantive skills are different, but I mean, your peer to peer. And so I'm sure Ed can say things to you that other people can't say to you and vice versa, like it's really good to have that partnership because, you know, when you're weathering storms, you really do want to have, you know, a partner and someone you trust to do that.
00;29;12;17 - 00;29;33;23
Meg Pekarske
Because I think, you know, the last five years have seen so much change and then just more to come, which I mean, I think it is a land of opportunity, but it is also, I think, somewhat scary. I mean, as positive as we all might want to be about, well, the future and maybe, you know, we can serve more people and we get out of our silo.
00;29;33;23 - 00;30;00;15
Meg Pekarske
There's also this, as you said, commoditization, what it is that we do. And if we move into the, you know, the bad and the carbon happens, like what does hospice look like then and so. So anyway, I mean, I think having someone you trust to bring those things out of what makes sense for you because as we know you can listen to, hey, this was really successful for other people, but it's just not going to work for you.
00;30;00;15 - 00;30;11;10
Meg Pekarske
So. So anyway, I'm sure you guys all made the agreement. You can't retire, right? Yeah, retire. You have that in writing? Have a retire.
00;30;11;10 - 00;30;34;25
Dr. Edward Martin
And you know, one other thing I'll mention is one other thing I'm grateful for. Diana is the leadership team she's assembled is just so great to work with such a such a great team. And I'm fortunate to be the VP for my, you know, for clinical services, you know. Dr. Jenn Read. So she does so much of the work that I would otherwise have to do from an administrative standpoint that then frees me to do the clinical work I do.
00;30;34;25 - 00;30;47;10
Dr. Edward Martin
But but if you look around the table at our senior leadership meetings, I mean, I'm just so grateful for this group that Diane has assembled. It's such great expertize and talent and commitment to the organization. It's just very gratifying to work with.
00;30;48;02 - 00;31;03;22
Meg Pekarske
Yeah, you've grown something really, really incredible and and I think you guys have fun doing that. Right, which right. But is it we spend too much time at work, not too to also enjoy what we're doing.
00;31;04;07 - 00;31;26;06
Diana Franchitto
It was Ed was talking about the team that we had assembled. So Ed and I, this is quite a while ago we were at the OpCo Management Leadership Conference, oh, probably about eight years ago. And if you recall, Patrick Funzioni was the keynote speaker and his topic was Trust at the Speed of Light. And it was just kind of like this aha moment.
00;31;26;06 - 00;31;49;24
Diana Franchitto
And we both recognized that there was a key member of the senior leadership team that that trusted this. And then one day we had that very uncomfortable conversation and this was a while ago and she was gone. But but it was you really recognized and I know it sounds trite, but if there's no trust among or minimal trust among the CMO and the CEO, it's going to be hard days, you know?
00;31;49;24 - 00;31;53;21
Diana Franchitto
And so I'm really grateful. It's a good, solid working relationship.
00;31;53;29 - 00;32;39;17
Meg Pekarske
Yeah, I couldn't agree with you more. I mean, that is I mean, judgment, trust, you know, and then, you know, putting in the time and doing the work, you know, and that's what you expect of one another. And that's what you do. You do so well. This has been such a pleasure and I can't wait to hear what you guys are going to be cooking up next, because, I mean, you guys are really doing a lot of exciting stuff and I feel like we have that balance of reactionary things we need to do, but then also balancing that with like at the strategic and how we can be better and blah, blah, blah.
00;32;39;17 - 00;33;08;01
Meg Pekarske
And when you were talking, I was just thinking about, you know, everything's about data analytics these days. And so maybe I'll just throw in one last question because I wrote it down. But like, how do you measure success on these these projects that you're working on? Because it sounds like with your emergency department thing, you're able to deliver a ton of data and how?
00;33;08;05 - 00;33;30;15
Meg Pekarske
Because obviously to be able to do that, you need to have the right EMR and all these other things like how do you manage or how to use data to manage the things that you're doing. So does this make sense? Isn't Yes, there's some gut feel, but like, show me. Right, this makes sense. So maybe before we leave, can you just, you know, chime in on that?
00;33;31;00 - 00;33;56;19
Diana Franchitto
Sure, I'll I'll take that one. Absolutely. The data has to support all of our strategic and initial initiatives. And in fact, first Thursday of every month, our senior leadership has Dashboard Thursday and we review all of our dashboard or I think it's the third Thursday of every month we review all of our dashboards for all of our strategic initiatives, all of our partnerships with our various health care partners.
00;33;56;19 - 00;34;17;02
Diana Franchitto
And what trends are we noticing? Is this something that we need to and inevitably with, we always come back, know we need to slice and dice this a little different. And these this is these are the dashboards we share with our partners as well. And and so it's really important. So from a resource, you have to commit to a department of analytics within your organization.
00;34;17;02 - 00;34;41;25
Diana Franchitto
And, you know, it's but and we can share those dashboards, whether within our board or to our middle management. And and our I have to say, our partners have been so appreciative of the dashboards because those dashboards allow them to take an initiative, whether to expand it or change it in some way to their to their leadership team.
00;34;41;25 - 00;34;49;11
Diana Franchitto
So it's been really a really important exercise wise. And it's it's how we are hardwired here at Hope Health.
00;34;49;11 - 00;34;50;18
Meg Pekarske
Yeah, well.
00;34;51;01 - 00;35;02;21
Dr. Edward Martin
No, I agree completely. I mean, just in just having the you know, having the data, as you know, oftentimes mean you can't just be saying, oh, we do God's work here. You know, we need data.
00;35;03;12 - 00;35;22;01
Meg Pekarske
Yeah. And and I think some people are still in that old camp and it's like, but you got to prove it. And going back to what you said about payers and networks and I mean, you got to be able to prove your value. People want to know the cost of your care. People want to know, you know, what outcomes you know, matter.
00;35;22;01 - 00;35;33;27
Meg Pekarske
And I think to just focus on things the government focuses on isn't going to lead you into, you know, a successful business because that's reactionary data analytics, right?
00;35;34;16 - 00;35;56;01
Diana Franchitto
Meaning think about this way. You know, all of the health care systems in the country are under inordinate financial pressure. And because of that pressure, they are going to absolutely data and dashboards. And how can they do things either with a partner or on their own? And and as a partner, we have an obligation to give them data.
00;35;56;01 - 00;36;01;19
Diana Franchitto
And so I, I, I think it will only continue to increase. Mm hmm.
00;36;02;10 - 00;36;41;03
Meg Pekarske
Yeah. I think that it seems like the pendulum is always swinging back and forth. Sometimes hospitals want to be in the business of hospice, and then then they sell off their hospice. And I it just I do think it's always if you have a great partner out there, I mean, to not have the headache, as we can all attest to, of running this business, because I think even hospitals don't appreciate all of the things that go into running this business, which is very different than running a hospital, you know, or physician practice or whatever it may be.
00;36;41;03 - 00;37;06;28
Meg Pekarske
So well, you two are two people I, I really respect and learn a lot from. And I've known, known you both for a long time, but also just add your leadership from a clinical standpoint is just always really inspiring to me. Thanks, Meg. And your rumble one needed to obviously with a smile and a bow tie. But you know when
00;37;06;28 - 00;37;27;24
Meg Pekarske
I hear you you talk about clinical issues. You it comes from both like this heartfelt place that you know what it is to take care of these people. And, you know, when you're talking to someone who's never going to lay eyes on someone and, you know, doesn't bring your expertize, I mean, I will always bet on you. And so.
00;37;27;24 - 00;37;28;28
Dr. Edward Martin
Yeah. Thank you.
00;37;29;06 - 00;37;29;27
Diana Franchitto
So will I.
00;37;30;08 - 00;37;40;26
Meg Pekarske
Yeah, exactly. Exactly. So well, I really appreciate both of you taking the time. This has been a really fun conversation and thanks for sharing how you make the magic.
00;37;42;01 - 00;37;43;03
Diana Franchitto
Take care. Thanks, Meg.
00;37;43;07 - 00;37;46;16
Dr. Edward Martin
Yeah, thanks, Meg.
00;37;46;16 - 00;38;09;23
Meg Pekarske
Well, that's it for today's episode of Hospice Insights: The Law and Beyond. Thank you for joining the conversation. To subscribe our podcast, visit our website, huschblackwell.com or sign up wherever you get your podcasts. Until next time, may the wind be at your back.