Narrator: Coming up on Mayo Clinic Q&A, the Department of
Medicine is the largest department at Mayo Clinic and is
leading the way on innovation in patient care.
Dr. Vijay Shah: And we're really starting to think now, not about
a traditional clinic template of eight to five with morning and
afternoon clinic, but just a continuous plan. And we call
that the digital plan, and how do we continuously take care of
patients when they're at home. And that's relevant from
patients leaving the hospital earlier. It's relevant for
patients avoiding visits to Mayo Clinic where we can provide the
care to them. And it's just relevant for our ability to
triage and help patients know when they really need to come.
Narrator: The Department of Medicine is using several
strategies to transform the medical practice by providing
more access to Mayo Clinic.
Natalie Caine: And they're really expanding our reach to
meet patients across both our nation and nationally, in
particular in some of our underserved areas or rural
communities where we have great opportunities now with digital
and new technologies to meet them.
Dr. Halena Gazelka: Welcome, everyone to Mayo Clinic Q&A. I'm
your host Dr. Halena Gazelka. The Department of Medicine is
the largest department at Mayo Clinic and is helping lead the
transformation of healthcare. Important innovations include
moving to digital and virtual care to meet patients where they
are and addressing health equity. Joining us to discuss
this important topic today, our Department of Medicine Chair,
Dr. Vijay Shah, and Associate Administrator, Natalie Caine.
Welcome both of you to the program.
Dr. Vijay Shah: Thank you, Halena.
Dr. Halena Gazelka: Well, it's fun to have you on to talk about
this today. And I learned something already that the
Department of Medicine is the largest department. Okay, my
first question is for both of you. Obviously, caring for
patients is the core of what the Department of Medicine does.
When I think of medicine, I think of you taking care of
patients, it's the core of your mission and work. How do you
keep patients when you have so many things going on at the
center of your research, practice, and educational goals
while you're continuing to lead the largest department at Mayo
Clinic and see a lot of patients?
Dr. Vijay Shah: Well, Halena, actually it's easy because
patients are our North star. We're all about patients all
day, every day. And so, all of our strategies cascade out of
that where we know we want to go. And so, I'll talk a little
bit about what we're doing, broadly that cascades out from
patients. We have a few different pillars that we're
focused on as part of our strategy in terms of our vision
to prevent and cure medical disease worldwide. One of those
pillars is purely about practice innovation. That has a lot of
what is referred to as digital transformation in it, how do we
work smarter, more efficiently, and use technologies to help us
provide better value for our patients. And in addition to
practice innovations there is a major focus on partnering
externally, and Natalie's gonna talk more about that later.
That falls under a pillar we call business development and
platform. Additionally, there's amazing cures going on these
days, you know, molecular biology is transforming. And
that pillar we call cures, and we'll talk more about that as
well. And then the most important pillar is our people
in our culture, because our people are our greatest asset,
and we are nowhere without our people. And so, those are the
four pillars that we build our strategy around. And this year
we actually completed a retreat that focused on new care models.
And maybe Natalie wants to talk a little bit about the themes
that came out of the retreat.
Natalie Caine: Thanks Vijay. I'm really excited about the themes
that emerged in 2022. We have great opportunities to continue
to accelerate our patient experience, really thinking
about immersive opportunities for both when patients are here
on campus, but also reaching them where they are. Other
opportunities we have is to continue to evolve our teams to
meet the needs of our patients, make sure that as we're bringing
in new cures and technologies, we have the right structure and
support. We're investing in our talent and supporting them as
they grow in their careers and have a great opportunity to
really accelerate that work as we move very rapidly post COVID
with digital opportunities. A few other things we're focused
on is really the transition of care. So, rather than thinking
purely about the outpatient or the hospital practice, how we're
supporting patients as they transcend across you know, their
home, through the care journey and then back to their home,
which really is our goal to get them back in their home
environment as healthy as possible and do that in a
seamless way that meets their needs. And then really expanding
our reach to meet patients across both our nation and
nationally, in particular in some of our underserved areas or
rural communities where we have great opportunities now with
digital and new technologies to meet them.
Dr. Halena Gazelka: Wow, that's exciting. That's a lot going on
in the Department of Medicine. And I know that transformation,
it doesn't just happen with your department, you're working with
many other internal partners here at Mayo Clinic, including
the Cancer Center, the Center for Digital Health and Platform,
how do you work with them Vijay, to transform care?
Dr. Vijay Shah: Well, we can do a lot more together than we can
do alone. And so, we have lots of friends. And you mentioned
some of them, Halena. And so, I'll give you some examples.
John Halamka is one of our partners in the Mayo Clinic
Platform. And we have a number of projects ongoing, and those
are external facing. So, you can think about digital
transformation as an external face at Mayo Clinic. And that's
the Mayo Clinic Platform. How do we touch more lives globally,
and that's what that's all about. And we partner with John
on some projects that relate to a GI endoscopy database. We also
partner around radiomics for pulmonary nodules, and a number
of other projects as well. So, the portfolio is quite large,
and the focus there is really about how do we use Mayo Clinic
data and Mayo Clinic knowledge to connect individuals outside
of Mayo Clinic who may value from our data and our knowledge.
And that's simply what our Platform is doing. And then on
the other hand, internally, our digital transformation partners
with the Center for Digital Health, and we have lots of
projects with them. And it's great fun. One of the examples
I will give you is Remedy. And Remedy is a project that really
focuses around how do we meet patients where they are, instead
of making patients meet us where we are. And you can imagine that
if you can monitor a patient and not just do a televisit but do
telemonitoring and you can collect their information and
compile it and make your actions to help them based on the
information that's coming in continuously, then wow you can
really reimagine what a patient visit is going to look like. And
it's going to be much more value for the patient and much more
value for us so that we can make sure that people coming in are
really those that are sickest and really need our help, like
through a surgery or a procedure. So, those are a
couple of examples, and many other partners as well.
Dr. Halena Gazelka: I just love having the opportunity to visit
with people like you, Vijay and Natalie today, because I learned
so much myself about what's going on at Mayo Clinic. It's a
big place, and we don't always know what others are working on.
So, I love this. Natalie, I know that you have partnerships that
extend outside of Mayo Clinic, and I'm wondering how do you use
external connections to transform healthcare?
Natalie Caine: Yeah, thanks for that question. I think, you
know, we're really fortunate to have such amazing colleagues
with phenomenal expertise in what they do in the Department
of Medicine and serve as a connector. So, I think we really
feel obligated to help take that in partnership with our
colleagues in platform and others that Vijay has mentioned,
and really find the right strategic fit that is also
aligned with our values to really help us meet what we feel
is an obligation to expand our reach. You know, many patients
are able to come to Mayo Clinic, not all of them are, and so we
feel there's a great opportunity to maintain connections with
patients, some of which won't have the opportunity or will
come to Mayo periodically. But this gives us great
opportunities to expand that knowledge, technology, and Mayo
Clinic care to them in a variety of ways with partners that we
are strategically aligned with from a value standpoint. And
it's really been exciting to see a number of those opportunities
take off. One partnership, for example, is with R-Zero. That is
a company that focuses on making safe spaces. And so, with our
colleagues and expertise and ID partnering with them, we can
really reimagine what safe spaces in the future we're going
to be in places like schools, gymnasiums, healthcare
facilities, as we're all working to move forward together and
safe spaces, it's really exciting to see what this team
is able to accomplish.
Dr. Halena Gazelka: That's really interesting. Vijay, you
mentioned something earlier that I have thought is one of the
most amazing silver linings of the COVID pandemic, and that is
this use of digital and virtual care. And it's really
accelerated during the pandemic. We almost did no virtual visits
before the pandemic and then have done many, and I've enjoyed
meeting people virtually, patients virtually who would not
have been able to travel to the clinic to see me in person. So,
how do you anticipate implementing digital and virtual
care solutions to reach patients where they are? What does it
look like now today, what I think is pretty amazing, versus
what we'll see in 2030?
Dr. Vijay Shah: So, Halena I think we've heard reached a
tipping point. But what I mean by that is that we're not going
to go backwards now. There are some things pre COVID that were
good, and we are bringing some of those things back, our
ability to interact with colleagues, we all love that,
our ability to go out together and celebrate. We will bring
those things back. But there's other things in healthcare that
we're not going to go backwards. Patients now understand the
value of remote care. And I gave you a vignette of that in terms
of moving from a telehealth visit to continuous 24/7
telemonitoring. But I think that just when I trained, some of the
emerging technologies that really transformed healthcare,
were around cell biology, molecular biology, some around
imaging. Now, there's new opportunities. And those
opportunities are really uncovered by our ability to do
rapid and high throughput sequencing, okay, of DNA, RNA,
protein, all the omics, and also our ability to have a level of
computational firepower that we never imagined. You may
remember, my parents used to work for IBM, and they used to
have like a mainframe that took up like a whole building, and
now the transistors ot all the all of the hardware that used to
go in that, I mean, you could just basically, your laptop
would have the power that would be running those mainframes. So,
really we're at a transition now of how we can take those
emerging technologies in sequencing and computation, and
then accelerate them even further. And I'll give you an
example of what the future might look like. Right now, we can
take single cells from people and sequence them and uncover
all kinds of individualized care pathways. And that's really the
focus of our Center for Individualized Medicine. Can you
imagine a future where we might be able to put the monitor into
the person, and it's just a sentinel that's floating around,
it's able to monitor every single cell in your body and
tell you each day which of those cells might be likely to develop
a cancer, which of those cells might be likely to become
injured. So, even though we're not there yet, you can see that
we're really at a point where the technologies with gene
editing, gene therapies is really paving the way for us to
do much bigger things much faster.
Dr. Halena Gazelka: That is just amazing. What do you see Vijay,
as the biggest areas of growth and development for the
Department of Medicine, say over the next three to five years or
so?
Dr. Vijay Shah: Well, there's lots of things. I think I've
given you a couple of vignettes about how I imagined the patient
encounter. And we're really starting to think now, not about
a traditional clinic template of eight to five with a morning and
an afternoon clinic, but just a continuous clinic. And we call
that the digital clinic. And how do we continuously take care of
patients when they're at home. And that's relevant from
patients leaving the hospital earlier, it's relevant for
patients avoiding visits to Mayo Clinic where we can provide the
care to them. And it's just relevant for our ability to
triage and help patients know when they really need to come.
So, one of the projects now that we're launching is with our
colleagues in Pathology, and it's called Diagnosis at Home.
How can people get the testing they need right in their house,
and maybe they don't have to come to Mayo Clinic just to get
their blood drawn. And probably right now, if they need an
endoscopy we still need them to come. But you can imagine that
we're moving towards a future where we can provide care for
patients in the way that they want it.
Dr. Halena Gazelka: Well, that would just be amazing. I love
learning about this. Natalie a little bit different topic,
diversity, equity, and inclusion efforts are really important to
across the institution at this time and going forward. Can you
share more about how the Department of Medicine is
addressing health equity issues and facilitating community
engagement?
Natalie Caine: Thanks, and I appreciate the opportunity to
talk about such an important and timely topic. I would say we're
really fortunate in the Department of Medicine to have
such amazing leaders that are really committed and passionate
to this topic. And so, we have those leaders in every division
that makes up the department and really are committed to this as
a leadership position. We also have worked a part of our
consultants travel opportunity is to reinvest some of those
days here to do community service within the Rochester
community, and I think that's been well received.
Dr. Halena Gazelka: That's a great idea.
Natalie Caine: Yeah, as you might imagine, we have very
committed and talented colleagues that do a lot to
support our community and so, we want to make that an easier
process for them, and support them in their abilities to do
that, I would say we also have partnerships with a group that
focuses on the homelessness in Rochester. We also partner with
our colleagues in Community Internal Medicine to support a
variety of activities around things with our learners, as
well as the Good Samaritan Clinic in town. And then really
across all the departments working to make sure that we
have an inclusive environment and are supporting all our
patients who bring a variety of needs and recognizing those and
supporting them through our journey. So, it's really been
quite inspiring to be a part of that, and really honored to help
support the commitment both to our community, and our patients,
and creating an inclusive environment.
Dr. Halena Gazelka: That's wonderful. It's been gratifying
to see this become a real focus for all of us who work at Mayo
Clinic. So important. Thank you. Any last words that you'd like
to share? Vijay or Natalie?
Dr. Vijay Shah: Natalie, you go ahead.
Natalie Caine: Well, I just like to, you know, thank you for the
opportunity to share a little bit about what the Department of
Medicine is up to. I think it's really been an honor to support
the team. And you know, we're really committed to being there
for our staff and helping make sure that patients overall get
the best integrated care. And so, it's been great to partner
with Vijay on this journey and appreciate your time today.
Dr. Vijay Shah: I will just add, it's all about our people. It's
all about our Mayo Clinic people. And that's how we're
going to help our patients. And that's how we're going to make
Mayo Clinic move forward.
Dr. Halena Gazelka: I love that. You said a little bit earlier
Vijay, about the people and how important of an asset they are
to us. And I have to agree that when people ask me, what's that
special sauce at Mayo Clinic, I say it's the people who work
here that just make this an amazing place to be not only a
colleague, but also to be a patient. So, thank you both for
being here today.
Dr. Vijay Shah: Thank you so much.
Dr. Halena Gazelka: Our thanks to Dr. Vijay Shah and Natalie
Caine for being here today to talk about the transformation
that's occurring in the Department of Medicine here at
Mayo Clinic. I hope that you learned something. I know that I
did. And we wish each of you a wonderful day.
Narrator: Mayo Clinic Q&A is a production of the Mayo Clinic
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