HIMSS 2024 Dr Jacqueline Naeem

Brian Urban:

Yes, this is the Healthcare Rethink podcast. We are alive still here at HIMSS 2024, talking to the biggest innovators and change makers across the ecosystem. So thankful to have the Senior Medical Director of Parkland Center for Clinical Innovation joining us here, Dr. Jacqueline Naeem. Thank you for being on our little show live here.

Dr. Jacqueline Naeem:

Thank you for having me.

Brian Urban:

This is going to be fun

Dr. Jacqueline Naeem:

Excited to be here.

Brian Urban:

It's going to be so much fun because we haven't had too much time to get to know each other, but you've had an amazing talk that kicked off the show here at HIMSS 2024. So tell us about your talk and what your experience has been so far this year.

Dr. Jacqueline Naeem:

Sure. So this is my second big HIMSS, as we call it, and it's been awesome so far. So on Monday I was part of the behavioral health forum and talked about emerging technologies in behavioral health. Really the aim of that was to look at the various kind of technologies that are emerging or coming around and also thinking about the pros and cons of those technologies and where we need to be thoughtful and careful. But they're all very exciting things that are happening in this space.

Brian Urban:

That's really exciting. It's an emerging space, it's niche, it's something in terms of mental, behavioral healthcare that there's no strong infrastructure in the U.S.

Dr. Jacqueline Naeem:

Right.

Brian Urban:

So thinking about that in digital transformation, are there so many players entering this space now to have, not only an impact in terms of business, but to actually serve populations that are struggling with mental health and behavioral health in a more meaningful way?

Dr. Jacqueline Naeem:

Yeah. One of the things I thought was really interesting, so the night before my presentation, I Googled to make sure the numbers were still correct, but there's about 20,000 mental health apps.

Brian Urban:

Wow.

Dr. Jacqueline Naeem:

If you search for mental health apps right now there are 20,000, which on the one hand, that's great, there's a large interest in it. On the other hand, it's a little bit scary because what are those apps, what are they doing and who's overseeing those apps? There's pros and cons along the way. I think the other thing that we often lump together is mental health and wellness, so there's not a clear distinction between the two. So really trying to make it a lot clearer for people who are wanting to use these technologies, what the actual intent is, if it's something just to help your overall well-being or is it trying to treat a mental health condition. I think those are things we have to be really thoughtful and careful about when looking at these sorts of things.

Brian Urban:

It seems like there is a bit of blurriness and it seems like there is an overwhelming ... I didn't think 20,000 apps.

Dr. Jacqueline Naeem:

I know, I know. I was shocked.

Brian Urban:

Oh my gosh. And I think about the connection into care that is outside of mental health, behavior health and how is that coordinated? Are you seeing that because there's a huge amount of apps, there's strong connection into care coordination, or is it just all siloed and just different here and there?

Dr. Jacqueline Naeem:

I think that there are some apps that do provide that kind of connection and they are providing the outside of traditional healthcare support. I think though, many of them are siloed, and so if I was a patient or just a person using an app in the community, that information isn't being fed to my clinical team or anything that knows about my background, my treatment, anything that's happening. So I think that, again, there's opportunities to bring this information together in a meaningful way and a thoughtful way that's not overwhelming to the care teams as well. As you can imagine, if I sign up for 30 of the apps and all that information is coming to you as a provider for one person you're going to be like, "This is a lot." I think it's figuring out that balance between the two.

Brian Urban:

I think that's so difficult in terms of being able to manage the data and then effectively using it to actually help the person that is in your care purview. So it's interesting, Dr. Naeem, when I think about your background, you were in psychiatry as a resident, but before that you were in OR rooms, Med-Surg, you were all over the place.

Dr. Jacqueline Naeem:

Yeah.

Brian Urban:

What's evolved for you in terms of the digital transformation with actually connecting and having a deeper engagement with the lives being served in healthcare?

Dr. Jacqueline Naeem:

So the reason for my not straight line journey, if you put it that way, so I attended medical school and trained in England and the way the training system there works is it's very broad based. There's a very holistic approach to patient care. So we always think about the bio-psycho-social approach for every single person, no matter what specialty you're in. Once you finish medical school for the first two years, you're placed in training jobs and you don't get to pick what you do. So that's how I ended up doing orthopedic surgery. I did some emergency room. I did general surgery. It's to provide you insight in what it's like to be in the different specialties. I think it really creates more understanding and empathy when you're receiving referrals for those patients when you're on the other end of the phone and you can really relate to your colleagues and remember what it's like to be in those environments and how difficult it is to manage patients that aren't in your specialty and you're trying to get help from those other specialties.

Brian Urban:

Wow.

Dr. Jacqueline Naeem:

I think that is a really cool approach. It's given me a really nice overview of lots of specialties as well, but obviously psychiatry is my passion and that's where I wanted to land. In terms of emerging technologies, when I started training, there wasn't really apps. We were doing telephone calls, but not really telemedicine, not video and virtual visits. So particularly since COVID, you've seen a massive shift into the role of telemedicine, even remote monitoring and devices. There's so much now that can happen outside of the hospital, traditional settings. I think it's really exciting to see how we're really looking after the patient beyond just in the hospital.

Brian Urban:

Yes. Yeah. It's amazing, because just before we started the show here, we were talking about what happens in life is not inside the four walls-

Dr. Jacqueline Naeem:

Right. Exactly.

Brian Urban:

... of a physician's office. I love that your training background in terms of the international impact that you've had is a big presence here at HIMSS '24 this year, the international flavor, and that's shown you the holistic approach to healthcare. That's something that finally, the US healthcare ecosystem is starting to catch up on knowing that social health, determinants of health is actually correlated to spend and right-sizing healthcare. With your work at Parkland Center for Clinical Innovation, are you starting to integrate a lot of different SDoH data sources to be able to help some of your research and some of the things that you're putting out into the world?

Dr. Jacqueline Naeem:

Yeah. Yeah, definitely. So that was really the intent behind the PCCI, at Parkland Center for Clinical Innovation, was really understanding those social determinants of health and how they impact health. There was recognition early on, I think we're 11 years old now-

Brian Urban:

Wow.

Dr. Jacqueline Naeem:

... so we were thinking about these things for a while now. When we build predictive models and we do things, we pull in data, those SDoH data pieces because we know those influence health outcomes. That's part of what we really focus on and do at PCCI as well. We also think about the person is still a person, whether they're at home, whether they're in the hospital, wherever they are, and so is there a way to provide the data from various sources to really understand what's happening around that person, so their environment as well as the individual.

Brian Urban:

That is so promising and amazing to hear you say that because your work now is spanning over a decade.

Dr. Jacqueline Naeem:

Yeah.

Brian Urban:

You're deep into the double digits of existence here in terms of time. The work that you are doing has real impact, can you give us a little bit of insight into some projects that are really, up and running right now that are showing some promising movement?

Dr. Jacqueline Naeem:

I think one of the projects that we're really proud of is we are part of the CMSAHC program, which is Accountable Health Communities program. That was really testing whether you systematically address those health related social needs or social determinant of health. Does that impact ED utilization and does it impact inpatient hospitalizations? It was a five-year grant where we screened individuals for those needs. If they had needs, we had navigators, community health workers that would send them to the resources they needed and they do monthly follow-ups with the person. We found amazing results with that program.

Brian Urban:

I love to hear that because it makes, I think a lot of populations that have hesitancy and trust as a barrier to healthcare start to understand that they're services that are health-oriented and that aren't being talked down to them from the traditional ways of how healthcare was delivered, we can say back in the day.

Dr. Jacqueline Naeem:

Yeah, exactly.

Brian Urban:

Are you starting to see the trust component change a little bit, too?

Dr. Jacqueline Naeem:

I think absolutely. We had a phenomenal team of community health workers who are all from the Dallas area, they know the neighborhoods, they know the populations, they're bilingual, so can speak to the person in the language of their choice so they're able to build those trusted relationships really quickly and they're able to do it over the phone, which is quite impressive really when you think about it. I think those trusted relationships are absolutely key. I think having people that know the population is really important for that building that rapport quickly as well.

Brian Urban:

Yeah, the cultural competency is critical-

Dr. Jacqueline Naeem:

Absolutely.

Brian Urban:

... to being able to relate to someone else, their scenario, but also their background, their culture of health and their literacy in those terms as well. So I'm curious, Dr. Naeem, your work obviously is going to be having an impact towards digital transformation. I see a lot of your work informing what is getting put into an electronic health record, helping a physician take actions, not just informing them and then on an island to figure out their own work, but also probably to the ecosystem of this exploding app space here too. I'm curious of what some of your impact has meant in digital transformation so far. Are you feeding some of your insights to these private health tech startups that have apps? Are you feeding it into healthcare right now, obviously at Parkland, where is it really being impacted mainly?

Dr. Jacqueline Naeem:

Yeah, so we're not feeding it into any apps or any startups right now, but we are using that data to push into our predictive models within Parkland. So that's able to give even more insights, so beyond just the EHR data, we're able to pull in that information as well, which is really cool. I think other health systems we're looking at talking with them about doing the same sort of thing because there is a massive benefit. I think the more data you have about somebody that's useful data, that's the key piece, I think that can really affect patient care and outcomes. Also, you mentioned the cultural competency, but I think if you can understand things about a patient before you even go in the room, it gives you a place to start from and you're able to establish those relationships, that trusted relationship quickly.

Brian Urban:

I love that your innovation center sits within Parkland because that relationship just makes total sense and I hope it's replicated, hope you're influencing other health systems to be able to adopt, not only their own innovation center, but their own way of feeding insights. To what you just said, Jacqueline, having a sense of what someone's struggling with or challenged with on a daily basis before a physician, specialist, primary care, OB, et cetera, sees them is so influential. We talk about outcomes so much in healthcare and how tech is helping close those challenges of getting to healthy outcomes, but it's really about the journey, I'm hearing from you. We don't want to close things off. We want to continually maintain information about a patient. Do you see your center of innovation at Parkland continuing to really evolve what the EHR will look like in the future or are you going to maybe have an impacted payment structure? What's the vision? I want to know, take me a couple years out.

Dr. Jacqueline Naeem:

Yeah, those are big questions. I think that really what we would like to do is be able to influence the health of people, so that's everything around them. If we can improve their health while they're in the hospital and beyond and understand them more, I think that's really the overall goal. Our mission is serving the vulnerable population, so we want to help the people that often are the ones who need the most help. I think that's exciting that we get to do that. One thing I have heard repeatedly at HIMSS that I love and that we talk about all the time is, it's not a technology solution. It's not a people solution, it's technology plus people and at HIMSS they've added and the process. I love that. I think that's my key takeaway from here is we now have a third leg to our stool, if you will. I think it's really exciting to hear that everybody's recognizing that now. You can't just use technology on its own, you have to have the people component too as well, and the process.

Brian Urban:

And the process. Yeah, the third leg here is a critical component, another big theme with HIMSS 2024.

Dr. Jacqueline Naeem:

Yeah.

Brian Urban:

Something that you said earlier really struck with me here is it's the bio-social-psych model that you were educated in terms of your medical education abroad. I think that's still, again, slowly filtering into the medical education system here in the U.S. It makes me think of epigenetics as well, the behavior and the influences that sit on top of our genetics. Is that type of curriculum going to be advancing, do you think, more of the work you're doing or is that just slower, longer, maybe just the adoption's not there yet?

Dr. Jacqueline Naeem:

I don't know, for us, I'll be truthful. I don't know if, for us, I think it'd be amazing if we could incorporate that in. I don't know how long that will take us to get there, I think.

Brian Urban:

Yeah, as a standard.

Dr. Jacqueline Naeem:

Yeah.

Brian Urban:

Yeah, I agree. Well, I'm hoping there's continued work coming out of your center of innovation that's going to influence that, not only in academia, but healthcare and also in tech as well. So I'm curious, Dr. Naeem, you look at HIMSS '24, we still have a couple days left, but the conversations that have happened here, the insights that you're gathering, is there anything that you're going to take away that might impact your work the rest of this year or beyond?

Dr. Jacqueline Naeem:

I just feel really excited that people's passion seems to be to improve health. I think that makes me really happy. It is about the next cool thing, but it's also because that next cool thing's really going to change the way that people receive care or other outcomes. That for me is really exciting and it's been a theme throughout all the people I've spoken to.

Brian Urban:

Well, the next cool things are definitely coming out of the Parkland Center for Clinical Innovation. Dr. Jacqueline Naeem, thank you so much for joining our little show here today.

Dr. Jacqueline Naeem:

Thank you, it's been great. Thank you so much.

Brian Urban:

Thank you.