NewYork-Presbyterian’s chief medical officer talks about ‘meeting patients where they are’

Deepa Kumaraiah spoke with Chief Healthcare Executive about using data to provide better care, new approaches from the COVID-19 pandemic, and caring for staff.

Deepa Kumaraiah talks enthusiastically about taking patient care beyond the four walls of the hospital.

Kumaraiah was named chief medical officer of NewYork-Presbyterian in January 2022. In an interview with Chief Healthcare Executive, she talked about the 11-hospital system’s efforts to use data to offer better healthcare, how the system found new ways to treat patients in the COVID-19 pandemic, health equity, and the importance of taking care of doctors and nurses.

“It’s a privilege in practicing in New York City to care for such a diverse patient population,” Kumaraiah says. “We hope that we can use this data to find, whether its treatments, care paradigms, that meet patients not only where they are but for who they are.”

NewYork-Presbyterian is aiming to update its data by getting information from patients themselves. By getting better data, the system can find better ways to treat patients.

“If we are able to use our healthcare data well, we can begin to care for patients out of the hospital system,” she says. (The story continues after the video.)

Reaching out to patients

NewYork-Presbyeterian operated in ground zero of the initial wave of the coronavirus in early 2020, when New York City hospitals were inundated with patients. Since the pandemic began, the system has treated nearly 40,000 COVID-19 patients.

Kumaraiah, who continues clinical practice as a cardiologist at Columbia University Irving Medical Center, said the system had to adapt out of necessity in the early stages of the COVID-19 pandemic. But the system also devised novel ways of treating patients that have continued beyond the crisis period, Kumaraiah says.

With a heart transplant program that has operated for nearly 50 years, NewYork-Presbyterian serves many patients with chronic heart failure. Early in the pandemic, the system wasn’t able to bring those patients to facilities, but doctors knew they had to monitor those patients.

NewYork-Presbyterian had been planning a remote patient monitoring program for those patients, but the pandemic spurred the system to accelerate those plans, Kumaraiah says. In May 2020, the system began its remote monitoring program.

“We proactively reached out to patients that we cared for,” Kumaraiah says.

The system expanded the remote monitoring to any patients at any provider in the system. NewYork-Presbyterian provided patients with blood pressure cuffs, scales and other technology so patients could be managed at home.

“That program allowed us to show a 37% reduction in readmissions for heart failure patients,” she says. “Heart failure readmissions are a chronic problem in the healthcare system.”

NewYork-Presbyterian has since expanded the heart failure program across the enterprise.

“We were sort of forced to do this and meet patients where they were,” she says.

“The pandemic taught us something in how we can take this model and extend it beyond the pandemic.”

Those lessons have informed the system’s approach to serving patients.

“NewYork-Presyberian is focused on meeting patients where they are,” Kumaraiah says. “The pandemic has changed everyone’s interaction with the healthcare system. We feel it’s our responsibility as a large healthcare system in New York City and the metro area to meet consumers and patients where they are, which is sometimes not the hospital.”

Thinking holistically

The system has also taken that mindset in improving its outreach to helping new mothers.

Women often engage with the hospital for the first time when they give birth. But the system noted that 40% of women didn’t make it to their first postpartum appointment. “They don’t make their first visit after delivery because they’re caring for a newborn at home,” Kumaraiah says.

Across the system’s 11 hospitals, clinicians said women needed lactation consultation.

The system began offering lactation consultation via telehealth and also during in-person visits when they took their babies to pediatric offices.

“If 40% of moms are not making it to their OB/GYN, thankfully many more of them are making it to their kids’ pediatric office,” Kumaraiah says.

“Meet the moms where they are.”

Kumaraiah sees it as another example of how the system is evolving to deliver care in different ways. “How can we think again more holistically about the care delivery,” she says, “as opposed to, you go to one physician and get one set of services.”

She talks about using the power of data to help patients. That’s why the system is working to get more data, and better data, on its patient population.

The Dalio Center for Health Justice, which is working to understand inequities in healthcare, is working with the system to ensure it has the right data on its patients when it comes to race, ethnicity, gender and their preferred language. She said it’s critical to get that data directly from patients, so the system has the most accurate records on race and ethnicity.

With better data, Kumaraiah says, “we can in fact use it to make the right insights in our patient populations so we can provide the right care.”

Lessons for other systems

As NewYork-Presbyterian offers different services, Kumaraiah says the system aims to ensure they can work across its incredibly diverse patient population.

“We are always asking ourselves the question, there are inequities in healthcare: How are we a part of the solution in closing those inequities in healthcare and how are we ensuring technology isn’t opening that gap up?”

As health systems look to expand patient care options in the home setting, providers need to look at the patients’ home environments. For example, providers need to be sure patients can get to the pharmacy, and if they have sufficient support if they need oxygen.

“Clinicians, physicians are great at understanding what a patient needs, whether it’s a particular medication or a particular monitoring,” Kumaraiah says. “I think we have to be equally comfortable asking the question: what social supports may a patient need?

“It’s not simply taking a look at the patients and what you’re providing them in the hospital and equaling that into the home setting,” she adds.

‘Giving time back’

More than two years into the pandemic, NewYork-Presbyterian isn’t dealing with the constant state of emergency during the peak of hospitalizations.

Still, the system’s doctors, nurses and other staff have definitely felt the toll.

“Our physicians and nurses and advanced practice providers and staff were tirelessly working in 2020. And with each COVID spike we’ve had, they’ve continued to provide 24/7, excellent care for patients,” Kumaraiah says.

Still, she conceded, “It would be false to say that the teams are not tired. They’re burned out. Healthcare workers are burned out everywhere.”

NewYork-Presbyterian has been offering free mental health support for team members. The system is working to create space for staff who need to talk with a mental health provider or simply another colleague, Kumaraiah says.

“I think we have the most resilient, brilliant and smart clinical staff and team anywhere,” she says. “Our teams are tired and we’re trying to do everything we can to listen to them and provide them support in exactly the ways they need.”

As chief medical officer, Kumaraiah says she thinks a great deal about burnout. Even as the system looks at new methods of healthcare delivery or adopting new technology, Kumaraiah says she’s focused on enabling staff to spend more time on patient care.

“I believe it’s incumbent upon a healthcare system to ask the question: Am I actually making it easier to also deliver care?” Kumaraiahs says.

“We want to be patient centric,” she says. “We want to be consumer-centric. We want to ensure that the experience is great. But just as important, at the same token, is it easier than it was before for my physician, or my nurse, or my advanced practice provider, my n.p. or p.a., to provide that care?’

Kumaraiah says that should be a key goal for healthcare systems: making it easier to deliver patient care. “It’s going to be important for that to be a metric in a way that healthcare systems hold themselves accountable to.”

She says she is focused on helping clinicians get more time.

“I think that’s the thing the pandemic has stolen from everybody: it’s time,” she says. “Time with their families, time doing work because there’s more reporting.

“As a health system, we are committed to giving time back to our teams and using technology to help give them back time.”