Gegg Masters  00:07  This episode of PopHealth Week is sponsored by Health Innovation Media. Health Innovation Media brings your brand narrative alive both on the ground and in the virtual space for major trade show conference and innovation summits via our signature pop up studio connect with us at www.popupstudio.productions. I’m Gregg Masters Managing Director of Health Innovation Media and the producer co-host of PopHealth Week flying solo today. Our guest making an encore parents is Michael Peterson, MD senior manager and the health equity and health innovation lead at Accenture, health and public service for North America. Dr. Peterson is a transformative physician executive who focuses on helping clients solve complex problems, such as promoting health equity by focusing on key social determinants of health through data and analytics. As a seasoned physician executive. He has more than 15 years of clinical experience as an emergency medicine pediatrician at SSM health systems St. Luke’s Hospital and Barnes Jewish St. Peter’s Hospital, where he spent five years as the Chief of Pediatrics, he developed his proven leadership skills while serving in the United States Army. Michael, welcome to PopHealth week.

Michael Petersen  01:32  Hi, thanks for having me. Glad to be here.

Gregg Masters  01:35  Delighted you can schedule time on your busy schedule. So before we get started, because there’s a lot to cover, first up, give us a a thumbnail about you your your glide path, what drew you to medicine, perhaps and now what caused you to your current role at Accenture health and tell us a little bit about what that is.

Michael Petersen  01:57  But we don’t have enough time to go through the whole fingerprint of my life. But I will just give you the quick and dirty. Just the calling to pediatrics as a result of me being adopted when I was two really led me to this career in journey just so that I could continue to pay it forward. So 12 years of pediatric emergency medicine, put me in the frontlines of poverty, socio-economic despair in terms of the patients that I was taking care of. And it just really was an amazing experience. And I just felt that what got me to Accenture was just the idea that instead of a transactional experience of one patient at a time, which are incredibly meaningful, and wouldn’t have been a humbling privilege to have that experience. I felt I wanted to sort of widen the angle lens, a little bit about what I could do. And Accenture is afforded me this. I’m a principal of which, in our North America practice, and I lead social determinants of health or health equity practice. But I’ll also get to play in our innovation space. So I really sit in our health practice, which includes payer, and the provider health hospital systems, and I have a lot of cross-industry roles into life sciences, and public service, public health, which is really great, because the confluence of all these entities are being as you know, thrown together. So I get to play a role us bringing the social determinants of health, health factors and influencers, knowledge into all these different aspects of industry. What I’m trying to do is bring a lens of how might we help our clients solve health equity in a space that been struggling, as we all know, soial determinants of health is a very ubiquitous term in the last five to 10 years, but recently has gained a lot of sort of accelerated visibility in the language. But really, it’s really around that our clients are trying to do the work, an altruistic mission, whether they’re a payer or provider. And so what I want to bring is a set of capabilities and industry expertise, to helping them accelerate or catalyze their efforts of where they’re at in the social determinants of health journey, or in the patient engagement journey of their attempts or mission to try and reach a vulnerable population. So what I get to do is have these conversations, but also bring our way of solving it through. What we like to think through is around Person-Centered health, which is kind of the theme now, but really around also getting smarter about how you look at a population of people from a trusted culturally competent perspective. And it’s taking the intersection of where patients will be getting help naturally as a health system, but connecting them to social services and the help that they would need so that we can address these inequities, but really at a community level through these pieces, you know, like a cohesive ecosystem of partners.

Gregg Masters  03:08  And we’ve been talking about population health and the social determinants of health for quite some time, however, I believe we’ve been dealt a severe blow by these covid 19 pandemic, which is a disruption at global scale, unlike perhaps anything we’ve seen, certainly my lifetime, but talk a little bit about what you’re seeing, and what some of the companies that you’re aware of or working with, are doing to, shall we say, survive and eventually thrive?

Michael Petersen  05:28  It’s a great question, Greg, I do think it’s a whole new world, what we knew before COVID break broke out is not the world we’re dealing with now. So I would say that, you know, in we use the word disruptive a lot, I think it’s a really overused use term in health, we kind of think of it as technology, just, you know, and I would say that what COVID has done is, we’ve already had all the pieces of health that sat around to truly try and solve very complicated problems. But with COVID has really done as it’s accelerated, it’s been more of an accelerant to activating, as you saw there, as we’ve all seen, just the way health is delivered in what what I mean by that is, there’s several sort of impacts. One is the new new normal, right, we go from a sort of what I would call the pre COVID. But now the new normal is that we’re trying to build a place where people are safe, and they have the social distance and the way you think through interacting with the population, and we know that trust is going to be a huge issue, whether you trust the restaurant you go to, or you trust the exposure that you might get from an interaction in a community setting. So from that perspective, what we seen is that there’s this whole new world is really going to this, especially in how this new virtual space, right, and so the big, I would say, output of what we’ve learned in COVID, is that telehealth telemedicine is just skyrocketed in its adoption and usage. Right. And if there was no COVID, I think health would have taken its sweet time getting there. And so I think it is an accelerant to that technology. But we have to be realistic. And as we think about health equity, there is a untoward side effect of this technology to keep people safe and being able to see their clinicians, but also at the same time that everybody has equal access. So digital inequity exists. So the issue around the health inequities on digital access was seen not just in health, but also in education. So parents who had to keep their kids home, he saw that not all children have access to Wi-Fi or broadband, laptop computers. And so in that same concept, how might we think differently around how to build better equity for those who don’t have access to a digital apps or a hospital system? So we have to kind of think through what does health equity mean in that space. So we learned that in COVID, that’s not all, not everybody had that same access. So you know, as the accelerant to these problems, we’ve also started to see, you know, have lots of friends on the frontlines in New York and all across the United States, that really started to see a disproportionate impact. And we’ve all seen and know for a fact that African Americans or people of color, populations were absolutely devastated by the statistics that illuminated, if you will, the sort of the public health infrastructure and health infrastructure that wasn’t fully solvent, I would say, in order to have its fractures in the system. And so when you see that, you know, 60% of Native Americans are impacted in New Mexico or, you know, 22% of the US counties were disproportionately black and 58% of that 22% were COVID related mortality. There’s tons of facts that we saw, but most public health experts would say they’re not surprised by the risk and the sort of impact involve populations because the the same populations are who are impacted who were impacted before COVID. So it’s commonly said that COVID is a pandemic on top of an epidemic of poverty and socio-economic vulnerability. And I think, when you think through why people are having such a higher rate of mortality, it starts to look back and you you start to find focus on the lens here and you start to see that these inequities existed well before COVID hit, and it’s a problem we have to fault. And so I think when you think through the pandemic now, which is still ongoing. I’m in Texas, and it’s becoming quickly the epicenter similar to New York City, we are not out of the woods. And I think that as a health industry, you match it with the racial social justice conversation, the light is shown even more that the opportunity to solve health equity, if not now, when it’s kind of the question I often ask and we have to do it together.

Gregg Masters  09:34  Absolutely. A pandemic on top of an epidemic of essentially we use the term health equity but in truth it’s really more health inequities that we’re trying to put the lens on now.

Michael Petersen  09:48  Yeah, absolutely. It is. There are so many. And you know, when you think of Dr. Boyce from the chief of the Division of developmental medicine, and UCSF said that socioeconomic status is the most powerful predictor predictor of disease. It’s kind of intuitive, we would normally think about that. But what we, we often forget is that the confluence or that intersection of where patients get help if we just solve the ear infection or the, you know, reactive transactional experience of why they came to visit us without solving other things, and taking that opportunity to help understand which socio-economic or inequity could we help solve for if it’s transportation, if it’s food insecurity, at that point of care, even though one would argue that that’s not the place to do it, but it’s a place it’s going to happen. And in our, you know, what we see as it helps new future, there is going to be this, I would say, society is going to be you know, we’re gonna wrap connect people to these community services in the future to public and private sectors, as you’ve seen this massive philanthropic commitment from a lot of the health payers as well as private industry technology companies to really solve racial injustice, but also that’s going to spill into health. And it’s that, I would say that health and social services will forever be linked at these points of care. And there is an opportunity to take the moment and the heroism of my colleagues on the front lines, take that energy and that hero status and just let’s take that opportunity for them to help drive some of these health inequities. They’ve done it right, you’ve seen the white coats for Black Lives, sort of all throughout all our hospital systems. It’s just an amazing statement. But let’s get beyond sort of the knowing and doing and we all know this exists. So I think it’s the inequities are not unsolvable, I think they are the opportunity to solve them is now it’s just a matter of activating and catalyzing the things that existed before, and just bringing the right sets of ideas and the right people around a problem that they can solve. So we, you know, from our last conversation in September, I think one thing I said is, you’re not going to solve it all you can’t, it’s not possible. So the only way to really think through solving health inequities is to find the one thing you know, I would say, just take your spot and build the right ecosystem and the right sets of data, sets of experiences that you want to solve for. But you have to do it with the community. And I think if you don’t, these inequities will never be solved, because it’ll be just the high level trying to solve, send down a solution from on high that they think it’s going to have engagement when you don’t have this person-centered experience design in the beginning, involving the community and connecting to the community meaningfully with trust, I think you would have, you’ll continue to have challenges. And I think we’ve seen that in sort of, you look back retrospectively at how health has tried to solve some of these, what’s often missing is the Anthropoligic or ethnographic perspective of the people you’re trying to help.

Gregg Masters  13:04 And if you’re just tuning in, you’re listening to PopHealth Week. Our guest is Michael Petersen, MD senior manager, and health equity and health innovation lead at Accenture health and public service. So we’re in a stress test of an unprecedented nature right now in Houston, a COVID hotbed at the moment, the Texas Medical Center, huge campus, tons of competing organizations. I have no idea what the bed count is. But I heard the county executives say that they’re at somewhere between 97 and 98% of ICU bed capacity. It’s hard for the mind to understand how that can happen so quickly, when you have a market with such capacity. Is there anything you can share about what that means? Both in terms of the pandemic as well as the stress? Yeah, US health systems?

Michael Petersen  14:02  You know, I think that’s a great observation. I did go to medical school in Houston. So I’m very familiar with the Texas Medical Center. And I could tell you at least 50 times I explain, or at least share with a tourist or someone that’s familiar with areas that that was not downtown. It’s that big. It looks like it’s downtown. To your point, I think a lot of this has to do with you know, let’s just go to basic science when the Texas Medical Center, the largest Medical Center in the world is at stress. It’s not just the Bed Availability, that stress right? It is the frontline workers and the people who work in that hospital from the person who is the security guard all the way to the surgeon or the doctors that are working on patient ICU doctors and the there’s a stress on their mental health, stamina and capability. When you think of how crazy it sounds. It seems unreasonable. But if you go we were in conversations with a lot of the health entities and they were thinking about this they knew this day was coming I think what ends up happening is that when they look back at what happened New York, I think there’s this thinking that that’s in New York, and our counts here are low. What is challenging? And how this happens is that you have sort of a, I think Governor of California has that it does is that the dimmer switch for opening-closing, but you know, their philosophy from a government perspective, is this balance of how do I keep people safe? But at the same time, how do we keep them economically safe? And, you know, skirting that whole political, economic discussion, I would say that what we’re challenged with now is that it’s happened. So the governor open the state, there are a set of public health circumstances, and I would say, downstream effects that are impacting right now, but at the end of the day, it’s also around, I would say, our own personal responsibility. What we’re seeing is just the virus itself is, is pervasive, it spreads rapidly. And I think what’s happening in Houston and Dallas now, as well as what you’re familiar with, even in Austin, is that you’re starting, there’s such a lag in the data. So if you’re trying to be smart about where you’re going to track and trace or even understand where an outbreak or an epicenter is, lagging in some of the data is so far behind that you actually have to predict at least two weeks in advance, because you’re not going to see some of the outcomes and negative outcomes of just infectivity. But then the mortality piece, it’s such a lagging indicator, as well. So when you look at this bed space, and I think the example you’re almost going to bring up, I’m going to guess with that children’s house, Texas Children’s Hospital starting to admit adults into the ICU, I think the Texas Medical Center has been in prepared for this as best they can. I just think that when it’s happening is the virus itself and the impact it has on communities. And we were having discussions around communities of color for vulnerable populations is that how did they think through trying to keep them safe? Right, I think the safest thing for people who are vulnerable is obviously to stay home. And how do you get that messaging out? So I, I don’t have an answer to that. I can only tell you that, you know, I’m a volunteer, to go back into practice. I still licensed in Texas, and I’m ready to go if needed. I think it is a it is a serious issue in terms of resources. And in terms of availability, that I think it’s really wrapped around how does government together with hospital systems, together with private industry really try to think through keeping people safe, but also minimizing the usage of or the, I would say the utilization of the health system. And the only way that to really do that is to go old school and go back to 1918. And socially distance. Oh, and also wear a mask.

Gregg Masters  17:46  Good advice. So the stressors, obviously hit on labor impact, we have certain elasticity in the in the labor pool. But there are capacity strengths, we know about the supply chain problems associated with personal protective equipment PPE.  Let’s also talk about the digital angle here. Obviously, we’ve been in an innovation economy now for perhaps close to a decade, there’s been a lot of discussion about hacking healthcare, and leveraging digital tools. What are you seeing there? Are Is there a digital divide? And does the matter of ethics pop up here? at any level?

Michael Petersen  18:30  It’s funny, you said that I just had that discussion this week with some Accenture colleagues. I do think, you know, when we think about hacking this pandemic, hackathon for nurses that I was involved with in May, which was really brilliant, and how do they How do you come up with solutions that keep in with the nurses, this organization really thought through? Was that the impact of the mental health impact on the frontline workers? And how to how do you solve for minimizing their mental health, stress, and negative untoward effects of this COVID virus. So to the point around a digital capabilities, they do exist, and what I think is going to happen is let’s just think future forwards and then address the sort of digital ethics is that from a future-forward perspective in the in the future we’re thinking through, which is that in the world of trust, safety, distance, all of those really core tenants of someone’s consumption of how we’re going to see that that is going to be pushed more and more as much as possible in the spaces where someone does not have to touch a patient in order to help with the diagnosis or complete a procedure, right. So it’s going to there’s going to be some limited use, it’s not going to be ubiquitous across the whole healthcare spectrum. But there is going to be significant push towards that digital, I would say capability but let’s be realistic to in the way that we probably weren’t prepared really well for PPE and everyone having had to go straight to electronic health records, and just finishing all of that implementation now comes this need. And also an understanding that there are challenges associated with the technical debt where the legacy systems can’t support these really advanced digital experiences. So there’s challenges internally for some of these health systems in payer and provider that just may not help with the utilization of even telehealth or telemedicine. So they need to sort of look through their own sort of organizations and see where they’re lacking. And in talking about some that are not even in the cloud, right. So if you think through that transformation, there’s going to be that transformation moving forward, we’re going to see a lot of activity around that around the ethics. I’m glad you said that. I mean, I think you know, Accenture has been a leading luminary in the thought of ethical AI. And in the same vein, we really do have to think about ethics in the digital base. So yes, we do think that a telehealth telemedicine experience for vulnerable populations would be an ideal way to keep them safe. But at the same time, they’re challenged with not having Wi-Fi, broadband or data plans that could support that tool. So we have to think of these private-public partnerships. Really, if you’re going to solve digital equity, it has to be really thought through in the sense that everybody has access to the tools. Now, to your point about digital ethics, I think that’s so important because when you design a digital tool, I think by its very inception of that design, it leaves out a certain population. And so when you when you’re designing this tool and has to really kind of be inclusive in the sense that the language of how the tool and how people are going to interact with it engage and I think gets down to this really granular level of how people consume health. And it’s about the tool that people know work well for them, or works well for them where they can get the help they need is the one that’s going to be successful, it’s going to be a trusted experience. And we’re seeing a huge push in the industry towards experience. And I think that the firm’s or the health system that comes up with an experience that seamless, trusted, provides the right information, provides a sense of racial equity, a sense of access, a sense of parity, and then how and how they were treated. All of those things put together, whoever comes with that is going to really think then the curve, in helping solve some of these inequities that we described, from an ethics perspective, that very initial design of whatever digital experience or digital platform has to include or think through the ethical, downstream ethical implications it has on communities. It’s almost similar to the redlining that some other tech companies said that I worked with some tech companies had, like Amazon, when they were trying to think through where they’re going to put amazon prime. It’s, it’s getting ahead of that, that I think will help bring some equality. Now, let’s just, you know, think through, when you think through and Martin Luther King was marching, it took a minute, and even today, it hasn’t truly been solved. So if we think about how we’re going to start to plant the seeds of digital equity, now, we have to seize this moment. And this moment isn’t going to last forever. And I think if we don’t grab it, and try to make an effort to transform how we deliver health. So that’s equitable for all populations of the people we serve. I think we will be in the same spot. So I do think that we have to take that moment now to do it in a incredibly empathetic, very culturally competent point of view.

Gregg Masters  23:47  Well, Michael, in the remaining 60 seconds of our conversation, I’ve so many more questions for you, we’ve just scratched the surface, but in the mode of I really wanted to get to the resilience of the healthcare system in that all healthcare systems are not equally created. Some will endure this, particularly those who assume who have assumed risk who are not who are pursuing value-based health might come out on the other side a little better than the others. But any final thoughts as we wrap up this, this exchange?

Michael Petersen  24:18  Yeah, this went by fast we both knew that it was going to happen. No, thank you for the opportunity. I would say as a final thought, I feel like what COVID did it it helped accelerate these the some of the put in some of the pieces that did exist. I think what we’re going to see more is really wrapped around, I think down to the future of healthcare, which will be a lot of it remote, a lot of it with a lot of remote devices. I think what we have to think through is not just the tools that are digital and that are technologic technology. Those are enablers, right, the analytics and all of that. I think we also have to think about health policy. And I know we didn’t get into that, but there needs to be and should be a significant rethink of how data can inform health policy because some of these policies inhibit some of the innovation that we want to do and health and some of them are, are dated. And so I would say that’s something we would have to do is to, you know, change that, I would also say that companies need to think big act fast, they have to catalyze this change. We have to do it together. And we all need a call of action. So let’s take this moment. And I think that if we do that, we can at least start and I just think about my kids and their kids, kids. So the things we’re doing now so and to see that hopefully, the society that surrounds them, when they’re older, is a society that where there’s more equitable access.

Gregg Masters  25:40  And that’ll be the last word on today’s broadcast. I do want to thank Dr. Michael Petersen, Senior Manager and Health Equity and Health Innovation Lead at Accenture, Health and Public Service for his time and insights today. For more information on Dr. Petersen’s and Accenture’s Health work in this space. do follow them on Twitter via @MPetersen_MD that’s P E T E R S E N underscore MD and  @AccentureHealth respectively. And for more information on Accenture go to www.accenture.com and click on the industries tab. For PopHealth Week, my colleague Fred Goldstein and Health Innovation Media. This is Gregg Masters saying please stay safe everyone we’re in this together and we will get through this together if we toe the line on social distancing. proper hygiene and by all means do wear those masks when in public. Bye now