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Is Louisiana a healthy state? How does geography affect health care? Why are community health programs important? How is health care affected by socioeconomic status?
Yvens Laborde, M.D., Regional Medical Director and Medical Director of Global Health Education at Ochsner Health, joins us for a new episode of AMA's “What Keeps Me Up” series. There, he talks to healthcare leaders about the one thing that keeps them going. And what are they doing about it? Hosted by AMA Chief Experience Officer Todd Unger.
speaker
- Yvens Laborde, MD, Regional Medical Director, Medical Director, Global Health Education, Ochsner Health
Unger: Hello. Welcome to AMA Update videos and podcasts. We're back with another episode of our new “What Keeps Me Up” series. We'll talk about what healthcare leaders are thinking now and what they're doing about it.
Today's guest is Dr. Yvens Laborde, chief regional medical officer for Ochsner Health in New Orleans. I'm Todd Unger, his AMA Chief Experience Officer in Chicago. Dr. Laborde, thank you very much for joining us today.
Dr. Laborde: thank you. It's an honor to be with you.
Unger: Dr. Laborde, Regional Medical Director, is a new position at Ochsner, and you are the first person to fill this role late last year. Since then, what has kept you going and why?
Dr. Laborde: That's a simple question. Unfortunately, the fact that Louisiana ranks 50th in America's health rankings is what has caused me to have so many sleepless nights lately.
Unger: This is not a great statistic. This clearly means that you and the people at Ochsner have your hands full and there is no shortage of work that needs to be done to address these types of issues. How do you take on such a challenge? What are your top priorities this year?
Dr. Laborde: This is a tremendous challenge, and what we've tried to do is prioritize interventions based on the key structural factors that are actually causing our poor health. As we know, 80% of our health outcomes are actually determined by non-medical and social determinants of health. Therefore, our key focus at this time in the Healthy Nation Initiative is to focus on how these social determinants can be addressed to improve the nation's health outcomes.
Unger: Tell us a little more about your specific goals and how you try to prioritize your efforts, especially when it comes to data to drive decision-making.
Dr. Laborde: Well, one of the things that we actually used was that we used not only data from the American Health Rankings, but also data from the Regional Health Needs Assessments. And one of the specific pieces of information is the fact that the early death rate is significantly higher. That's one of the things that's actually driving up our poor health rankings.
And it's also caused by an incredible number of chronic diseases, cancer, obesity, smoking. So we're trying to use a data-driven approach by specifically understanding what those factors are and implementing interventions. Effective interventions to corner them.
Unger: By following such a data-driven approach, have you discovered any surprises that you might not have discovered otherwise?
Dr. Laborde: Well, I guess so. I think one of our main focuses is understanding how geography impacts data. We found that there was a clear correlation between the environment and geography in which patients actually lived and the nature of their outcomes. So, understanding that, we use that data to really focus on areas of intervention.
So we're all about the idea of actually delivering the right intervention to the right community, in the right context, at the right time.
Unger: All four of these need to work together. We want to hear more about your health equity efforts because they are critical to achieving our goals. Are there any programs at Ochsner that you are particularly excited about right now?
Dr. Laborde: Yes, that's exactly right. As you know, I am very involved in academia. So one of the things that we've really implemented is the AAMC competency-based approach to teaching health equity, and we want to implement this across the learning continuum. Therefore, we want medical students, residents, and learners to understand how incredibly important it is to master the science of health equity.
So that we can actually use that to address disparities, because disparities are unfortunately one of the main factors contributing to our poor health. And one specific example of how we apply this competency-based approach is that race is often said to be a social construct rather than a biological construct, and is often used as a proxy. will be done.
One of the things we do is we don't use race and ethnicity as a first line in a patient's clinical presentation. Apply it for further use in medical and social history, but avoid using it as the first symptom. A statement we make when we clinically introduce patients on rounds.
Unger: Now, one of the things we're hearing from a lot of health care leaders, especially those involved in health equity efforts, is how important it is to collaborate with community partners. Because this is a huge task, and the health system cannot do it alone. Please tell us a little about how you work with community organizations to achieve your goals. And give us an example of a successful community partnership.
Dr. Laborde: Yes, that's a good point. I mean, given the fact that 80% of the factors that actually impact health outcomes are not medically related, so this really requires a whole-of-community approach, so we're really looking at institutions. , schools and universities. We partner a lot in the community. Specifically, as I said in school, we usually partner with faith-based communities.
We believe that it is very important that a lot of health-related things take place outside of the hospital, so what takes place outside the clinic takes place outside the clinic. So once we understand that, it's really important to identify and partner with community-based agencies that we can really work with to address some of the social determinants of health.
And one of the specific examples that I can share with you is that we have established partnerships with a number of faith-based institutions within our service area to provide services and provide access. The fact is that they are often affiliated with. A very simple example, as I mentioned earlier, is cancer or chronic disease or other issues that are important to us.
So we identify specific areas that actually have high indicators and go to those specific areas and use the church itself to provide care. So when it comes to screening, we did the Cologuard test, we provided the Cologuard kit at the time of testing, and we even did the PSA prostate cancer test on site after the sermon.
Unger: oh. That's a lot of value to be gained from that particular Sunday morning.
Dr. Laborde: They also usually have clinics within these service areas, so you can set them up for ongoing treatment with your clinic.
Unger: What a great example! Mr. Ochsner, in addition to the kind of community work you do, he works closely with the AMA on a whole range of issues. Please tell us how AMA has supported you in your new role.
Dr. Laborde: Oh, the AMA has been a great resource for me, not only professionally, but for Ochsner in general. So this is a resource that I use often. You know, there's the Center for Health Equity, which is part of the AMA, and then there's my colleague Aretha, his Dr. Maybank, who I really refer to and rely on. Guidance is needed on how to implement some of the interventions that center health equity.
Therefore, the AMA and our partnership are very important to me and I have been able to work hard to achieve the goals that this important role has set before me.
Unger: Now, let's talk…
Dr. Laborde: thank you.
Unger: you're welcome. And it's great to work with you. Dr. Laborde, when you think about your role within the organization that you mentioned a little bit earlier, it's new, and when you think about how important it is to collaborate with the community, I hope other health systems follow Ochsner's lead. , do you think you are going to build a new position? What will you be like in the next few years?
Dr. Laborde: Yes, absolutely. Because given the trends in value-based care, equity-focused care, and community-centered, data-driven care, we need to ensure that we address the social determinants of health first and foremost. Because it is really necessary to have such a position. But more importantly, do it from a perspective of fairness.
Because ultimately, we want to ensure that everyone, regardless of their zip code or genetic code, has the opportunity to achieve their optimal peak health. And this role in their similar roles will be very important in achieving that goal in the future.
Unger: Dr. Laborde, thank you very much for joining us today. I wish you all the best in your new roles, and I would like to thank everyone at Ochsner for their continued commitment and important issues. To support the AMA's health equity work and all the work it does for physicians and patients, we encourage him to become an AMA member at ama-assn.org/join.
That's it for today's episode. We'll have another AMA update of hers soon. Be sure to subscribe for new episodes and find all videos and podcasts at ama-assn.org/podcasts. Thank you for joining us today. Please be careful.
Disclaimer: The views expressed in this video are those of the participants and do not necessarily reflect the views or policies of the AMA.
