Camille Baxter:
Hello, and welcome to Healthcare Insider, a sponsored content podcast series from Modern Healthcare Custom Media. I'm your host, Camille Baxter. And today we are speaking with Dr. John Di Capua, the CEO of North American Partners in Anesthesia, commonly known as NAPA and Jason Grant, senior vice president and chief information officer for NAPA. Dr. Di Capua is a trained anesthesiologist with fellowships in pain management and cardiothoracic anesthesia. Dr. Di Capua is passionate about infusing a performance based culture into healthcare and empowering clinicians to drive quality and operational improvements that support NAPA's patients first partners always philosophy. He is deeply involved in the issues of perioperative, operational management and clinical staffing models and lectures nationally on how anesthesia departments can provide quality and operational value to hospitals. Jason Grant is responsible for managing all of NAPA's IT activities and resources, including a major digital transformation at the organization. Jason has held multiple senior leadership positions in healthcare and consulting organizations.
He has more than 30 years of experience in leading business and technology initiatives and strategically transforming business with the appropriate use of technology. His experience ranges from startups to tech enabled healthcare companies to large organizations, including both healthcare payers and providers. Before we dive in, we'd like to thank the sponsor of this episode, North American Partners in Anesthesia. NAPA is the nation's largest single specialty anesthesia and perioperative management company. Clinician led since 1986. NAPA's more than 6,000 clinicians now serves nearly three million patients annually in nearly 500 facilities across 20 states. Today, we are talking to Dr. Di Capua and Jason Grant about NAPA's recent digital transformation and cultural integration, and why they describe this process as an intelligent transformation. We'll discuss their insights for healthcare leaders about aligning technology with business goals and how the right tools can improve employee engagement and drive change management, workplace cultures. Dr. Di Capua and Jason, thank you so much for being here today.
Dr. John Di Capua:
Camille, it's always a pleasure to be on these podcasts with you. Thank you very much for inviting us.
Jason Grant:
Thanks Camille. Nice to be here.
Camille Baxter:
Well, great. Let's dive in. NAPA is completing what you describe as an intelligent transformation, an organization-wide digital transformation that you started planning in late 2019. We all know that COVID-19 hit in March 2020 and then at the height of the pandemic in May 2020 NAPA acquired American Anesthesiology, a larger company. It must have been challenging to integrate the two companies during the pandemic on top of your original plans. Let's start with some background. What was the strategy for your technology heading into 2020 and what were you trying to achieve?
Dr. John Di Capua:
You're right. It was a challenging period of time and I'm very proud of the entire organization for doing all of that in the middle of a pandemic, which began with going virtual. Now you're right. We don't just call this information technology. We dub it, intelligent transformation. And I think it's because technology underlies everything that we do more and more so in healthcare. In fact, in all of our lives, it's the backbone of how we communicate. And our goal is eventually to be able to grow the organization in the field, but only minimally impact the amount of IT resources that we need in the back office. To give you a sense of how critical IT is in every one of our lives, I mean, our tools impact the experience of our clinicians. And a while back, you and I talked about the shortage, the labor supply shortage in our industry, and we have to keep our clinicians very efficient, connecting with patients as opposed to worrying about putting in data.
And they also don't like necessarily spending a lot of time apart from taking care of their patients. And so the tools that we use impact how our providers feel about their workplace and we want to make our workplace destination of choice in order to be able to attract and keep the greatest number of them. And these tools do color how our providers engage in their work day. Integrated systems also allow us to make better decisions, faster decisions, more efficient decisions, because as the data communicates between databases, it allows us to really mine that information to come up with pearls and value. It allows us to report that and communicate those decisions better to our people and also to our partners and customers. Enabling our clinicians to spend less time on paperwork and more time on patient care is a challenge in all of healthcare and not just anesthesias feeling this, but all providers in the world are demanding this.
We also allow ourselves to use technology to align with our NAPA goals. And so things like, what do we make as a mandatory field is directly tied to what are we trying to do in that given year? So if we collect quality data, for example, we specifically make it so that those piece of information that are really critical for our quality team, those things have to be filled out. And so being intelligent on how we use that mandatory function is also allowing us to meet our goals more successfully. We also want to make this data discreet. And so one of the goals was to take information and be able to put it into the database in a way that we can then use later. And if you put it in as discreet data, then the database experts can then allow you to report more efficiently on that information.
So I think everyone that's listening to this podcast will understand how important technology has become in our lives. And it's our jobs to be stewards of how we collect that data, what do we force our providers or each of us to do as we connect with data and then make the most use of it afterwards. That was really what we were trying to do all the way from 2019 and forever more.
Camille Baxter:
That transformation was occurring with so much going on, both in and around NAPA. So Jason, what was the impact of the pandemic? And then the acquisition?
Jason Grant:
Camille, it was interesting. When we started this transformation, we had a whole plan we laid out and actually started working on from late 2019 into early 2020. And we also had embarked on an initiative to replace our phone systems, our conference calling systems, all these kinds of things. And we had just selected and rolled out Zoom. And thank God we had because when the pandemic hit, that was really the lifeline of the company. That's how we ran the company, allowed us to immediately shift to a work remote posture. And those were some crazy days and weeks when all that was going on right there to begin with. But also when the pandemic hit the work we were doing, just like the rest of the world came to a screeching halt, as everybody was trying to figure out, what does this mean? And how do we survive?
How does every company survive? And we didn't lose sight of what we had wanted to do, but you had to hunker down and be ready. So when the acquisition came, you'd gone kind of from very full end, working on stuff to almost a complete stop to now back to a 100% start, let's go as fast as we can. We were now a $2 billion company and we didn't really have the technology infrastructure to support a $2 billion company. We needed to upgrade what we had. We also wanted to do these transformational things, because we knew they were the right things to do to really help the industry and help our patients and help our customers. We also, when we did this integration of the companies had time pressure to do it. We were trying to as quickly as possible, get everybody the one set of platforms to get off our transformation agreements that we had with the previous company and really try to scale up as quick as we can.
So to get there it involved replacing basically the entire application portfolio. So doing pieces of the portfolio is hard. Doing them all at the same time is really tricky and difficult and just requires a lot of balance. And then having to do that under time pressure is another factor, but we knew what we needed. We knew that we needed the information technology that was going to support the new business, the bigger business, the growing business. And we had at one time 42 different projects going on. We grew our IT staff pretty dramatically during this time. And we had lots of consultants to help us pull all these things together. So there was just this whole idea that we were doing this and then we were doing it remotely during a pandemic while everybody was trying to figure out their lives. It was yeah, a lot of fun in my world.
Camille Baxter:
Challenging to say the least.
Dr. John Di Capua:
But you did it great. To be honest with you as the person supervising from the top, I have to say that the company really did make this transition very, very seamlessly. I mean, none of our providers and none of our patients, none of our accounts were impacted by the fact that we went virtual. So that's a Testament to how professionally this was all done. Our people were learning how to provide care in a totally different way because we went from doing surgery to taking care of critically ill patients. So it was a very difficult time, but it's a Testament to the depth and the expertise of the team.
Camille Baxter:
Let's dig into that a little further. Besides having to do all this remotely during the pandemic, what were some of your challenges? And can you talk about how an organization embarks on this kind of transformation journey?
Jason Grant:
Yeah. Camille, that's a great question. I think the hard parts of this transformation aren't the technology parts, they're the business parts, right? So how do we make sure the organization as a whole knows what they do, how they want to change and that they're committed to the change. These types of things can fail, not because of technology, but because just the organizational will to do some things. When you're changing things, it's difficult for people, but we started with the basics. What are the things that we do and how do we get better and better might be more efficient, better might be more secure, better might be better customer services, could be a lot of different things. So we really started trying to look at that and what are our goals and how do we want to do things differently? And then we have to think who are the stakeholders, both internal and external.
So when we look at our clinicians, we have a lot of clinician stakeholders and what's unique about those guys. What are they doing in the day-to-day life and how do we make this technology serve them not them serve the technology and also for our customers, how do we make that work for them? So we had to look at our business processes, our stakeholders, and just really try to figure out what is it that we're doing and how do we make that look better? We also looked at, for example, our payers and our payer contracts, and what does this mean in that world? And how do we do that? We had to think about our patients, how can we make this experience better for them? So each of these different aspects of the business, how do we work on those things? And there were areas where we made changes that are really going to save us a lot of money and us saving a lot of money is really going to help our clients, not just us and it'll help our whole team.
We also believe that when we're done with all this, by taking this discrete data that Dr. Di Capua was talking about a few minutes ago, we'll have the largest anesthesia database in the world. We see a lot of patients, we'll have a lot of data and getting that data and getting it digitally, puts us in a really unique position. That enables us to do some things that others just really can't do right now. And I think the other part of this is the buy-in, right?
So it's buy-in from our own team and this, like I said, this willpower to get things done. We had to roll out a technology at 500 different locations with 5,000 clinical end users and it's difficult. And each one of those sites does things the way that our client does it. We have to adapt to that, but this is going to allow us to quickly grab that information, get it into our environment and use it to support all of our operations and do just a better job. So that really was a change in the company. If we didn't do that with the senior leadership on down, we're not going to be successful.
Camille Baxter:
Dr. Di Capua, I want to go back to something you talked about a little earlier about the transformation and how the process did not impact patients negatively. It sounds like this transformation was as much about change management as it was about technology. How did the digital transformation change the culture of the organization?
Dr. John Di Capua:
You're 100% right that the tools that we use impact our clinicians and how they engage with patients and you want to be very thoughtful first of all, about how much change you create. Anesthesia providers like surgeons, trauma surgeons, they're like fighter pilots. They practice high risk scenarios over and over and over again to improve their reaction times and develop very predictable, good outcomes. Whenever you change one aspect of what they do, pretty much it dominoes into everything that they experience and how their reaction times may change. And so you want to be very thoughtful about how much change you create in critical care environments. So the first thing we have to do is decide how much was necessary and what was not necessary. Well, when we were bringing in American Anesthesiology, those were 3,500 clinicians that came from a different organization. They had different tools.
So we knew that we had to create some change because we're an integrating company that believes that you get your best possible outcomes and your best possible value when you adhere to defining best practices and the best of breed tools and you use those uniformly across the platform. So we knew we had to create change for some people, but what was good is that we learned that the tools that we had in NAPA legacy may not necessarily have been the best of all tools. So we looked at both American anesthesia tools and we looked at ours and we tried to figure out what was the best of between the two of them. And then we tried to prioritize, what did we think were really necessary because you don't want to create too much change because otherwise the provider's normal reactions while taking care of patients might be impacted in a way that we don't want.
So it's a lot of thought that goes into this. And anyone thinking about changing tools that are used by critical environment, people in critical environments need to think about the ultimate impact is that it may change how they relate to patients, but we didn't do it quickly. I asked a lot of very hard questions and then prioritized very carefully. The other thing that you want to be very thoughtful about when it comes to changing the tools that you have and creating change is at the end of this journey, you want your providers to feel connected to the organization.
So we're very happy that the decisions we've made have actually increased engagement from our providers. People, for example, one measure of that is how often and how they connect to a AR HR platforms and internal communications like email and where before they may have been not exactly where we wanted to be. Now we have thousands of people engaging on a daily basis in the ways that we want them to. And that means that we're just communicating across our entire clinical and nonclinical platform more effectively. And that's good for everybody, including our customers. The word of caution is be thoughtful. It does have an impact on people and patients and prioritize very carefully, but you still have to do those things.
Camille Baxter:
Let's talk about customers a little bit more. Does this intelligent transformation within the organization have benefits for your client hospitals, health systems and ASCs and what are they?
Dr. John Di Capua:
I would say that if some kind of transformation, if it doesn't have benefits to patients, benefits to retention of your providers or benefits to your customers, then you really have to ask why you're doing it because change is hard for people. So when we think about the prioritization that I just talked about, it had to have some positive impact on one of those three main categories. And the answer is it has for us and we focus very much on what is the ultimate value. Better data, for example, makes for better reporting. And medicine has a lot of decisions that have to be made in order to improve quality outcomes, become more predictable and lower the cost to society. So decisions have to be made, but you need data that comes in reliably and then is managed, like I said, through discrete fields to be able to report on them well.
So we now feel much more confident about how we're collecting our quality data and how we're reporting it. And we're using that data now, not only to find best practices, but also communicate with insurance companies and our customers as to the value differentiation that we bring. Efficiency in reporting, the time it takes to get reports out so that people can make decisions is absolutely much better now and where it might have taken many, many people hours to get a single report out, a lot of things now are either automated or the end user can go in and dive into the master database using our BI tools. That wasn't possible before. It is possible now.
So it's very enabling to people and that includes things like economic reporting. A lot of our customers want to know why is it costing this much? What can we do to become more efficient? We now give hundreds and hundreds of reports to our customers that allow them to see the data that we're seeing so they can understand why we're advising them in some ways. Less distraction for our providers so they can focus on patients, we've talked about several times, that is an impact that's good for patients. And so if you can change your tools so that patients benefit, in my mind as a clinician, the highest, most important goal of why we would ever do this. We also, during this process became high trust certified. Jason led the team that allowed us to become high trust certified and high trust and Jason could talk a lot more about it, we're all being challenged by security in the IT world. There are people that are scamming dollars from us. They're holding our data ransom. They're holding hospitals literally, they're freezing their ability to take care of patients because they're freezing the electronic medical record.
You go back to the days where you had to run down to the laboratory to find what a patient's blood count is. This is a real threat to our society in general. But when you talk about these things happening in the healthcare space, patients could have very serious negative consequences and it could cost our customers a lot of money. And so what we committed to was to become high trust certified, which is the highest level of a company can offer to say, we take security very seriously. We've met all of these thresholds so that when we communicate with our customers, they develop a sense of confidence that we know that this data and being secure with the data is not just important to them, but it's important to us. And that has definitely given people a sigh of relief. So we're proud of that and becoming a destination of choice.
I mean, remember it has to impact our providers, our patients, to our customers and well, everything that we're doing has definitely created a work environment that's better to attract and retain our people. And that ultimately benefits our patients and also our customers because there's such a shortage of providers. If you don't do everything to attract and retain either surgery's going to get canceled or our customers are going to end up seeing loss of market share. And that is just not tolerable these days, because most hospitals are riding on slimmer margins these days. We have to do everything we can to keep them up and running.
Camille Baxter:
There are so many factors to be considered with this type of transformation. Jason, what would you advise for other healthcare organizations considering this kind of digital transformation?
Jason Grant:
Digital transformation is sort of a sexy term that everybody wants to put out there today. And they all say they're doing it. And we were doing it with a purpose, right, there has to be a purpose for it. I think Dr. Di Capua just outlines some things around patients and providers and so forth. The IT doesn't exist in a vacuum and it's not a magic bullet. It's something that you start thinking about how you want to change your business and you have to take all the stuff into consideration, because you can have a successful process redesign and successful technology and if the change management isn't handled right, it's going to fail, any one of those elements could fail. So just being thoughtful and having a full plan and doing that before you're trying to go get approval. Otherwise, you're not going to get approval. You're not going to get budget. You're not going to get a consensus.
Those are the things that really have to happen to make this be successful. I think the other part, the other side of it, so I think about my job all the time as how does IT support the business? I think the other side of that coin is how can we transform the business? How can we enable some new technology or some new techniques or just things that are going to make the business even better. So trying to understand the tools and the capabilities we have today and how those might help us change our business in a better way and just really try to elevate the company. So I think it's just being thoughtful about all those aspects and really begin with the end of mind, what are you trying to do to the company? And that's going to drive everything that needs to come after.
Camille Baxter:
Dr. Di Capua and Jason Grant, thank you for taking time out of your schedules to talk with us today about such an important topic.
Dr. John Di Capua:
Oh, it's a pleasure. I mean a lot of people underestimate how intertwined technology is in the delivery of healthcare. And so we're happy to be able to talk about it. We certainly hope that people get a sense of the thought that has to go into it because change management is not without its consequences and we're very happy in the organization, how we took many years to do this, but you finally, we're coming out of that tunnel in a much better, stronger platform. So thank you very much. Hope that was helpful to everybody.
Jason Grant:
Yeah. Thank you all. It's always fun to talk about this stuff.
Camille Baxter:
This has been a sponsored episode of Healthcare Insider created in collaboration with NAPA. For more information about NAPA, please visit Napaanesthesia.com. I'm your host, Camille Baxter. Look for more episodes of healthcare Insider at modernhealthcare.com/podcasts or Subscribe at Apple Podcasts or your preferred pod catcher. Thanks for listening.
