Emily Reiser of Texas Medical Center: “Healthcare urgently needs to be more representative of our communities”

Preventative care is still challenging to do well in our current system because it’s hard to measure outcomes and the timelines involved require significant patience and investment. In addition, we are only beginning to understand and incorporate the science of behavior change into healthy living. The sooner we can measure, track, and drive improvement in […]

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Preventative care is still challenging to do well in our current system because it’s hard to measure outcomes and the timelines involved require significant patience and investment. In addition, we are only beginning to understand and incorporate the science of behavior change into healthy living. The sooner we can measure, track, and drive improvement in patient’s engagements in healthy lifestyles, the better.

The COVID-19 Pandemic taught all of us many things. One of the sectors that the pandemic put a spotlight on was the healthcare industry. The pandemic showed the resilience of the US healthcare system, but it also pointed out some important areas in need of improvement.

In our interview series called “In Light Of The Pandemic, Here Are The 5 Things We Need To Do To Improve The US Healthcare System”, we are interviewing doctors, hospital administrators, nursing home administrators, and healthcare leaders who can share lessons they learned from the pandemic about how we need to improve the US Healthcare System.

As a part of this series, I had the pleasure to interview Emily Reiser.

Emily Reiser is the Senior Manager of Innovation Community Engagement at the Texas Medical Center (TMC). Emily builds connectivity between entrepreneurs, investors, clinicians, healthcare executives, and advisors in order to identify strategic pathways for true progress in healthcare innovation. Her career in medical innovation began in research, including completing a PhD in Bioengineering at Rice University.

Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a bit about your backstory and a bit about what brought you to this specific career path?

My gateway to medical innovation was research — I developed vaccines for cancer during my PhD at Rice University. During that experience, I became frustrated by how far away my work was from impacting patients, so I started working with healthcare startups that were closer to improving patient outcomes. Most of those startups were a part of the TMC Innovation community; I joined the team in 2019 to work with the Accelerator companies in order to build collaborations between the startups and the hospitals that are part of the Texas Medical Center. I now work across all of our programs and network, so I play a role in a lot of the exciting things happening in the Texas Medical Center, including helping innovators collaborate with champions in the world’s largest medical center!

Can you share the most interesting story that happened to you since you began your career?

Just last month (June 2021), a company that I supported in the Healthcare Accelerator began a clinical study with one of our TMC member institutions. This company is on a mission to save lives, and is doing the trial to demonstrate that now. This evidence-generating study is happening because of the hard work of the team driving this company and why I do what I do. When the relationships I help to foster result in opportunities to improve patient lives, there is no better feeling for me.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

Nearly a year into working, I was at a networking event where I saw someone who looked vaguely familiar but who I couldn’t place. I didn’t speak with her right away, but eventually she approached me and asked me how I was! I panicked trying to remember where I knew her from, but never figured out who it was when we were speaking. A few minutes later, it hit me that it was a senior executive at our company! I’ve enjoyed the opportunity to work with her more since then, and wish I would have approached her for a get to know you conversation earlier in my arrival at the company. I’m now trying to learn more about my team members, including the ones who I don’t work with on a daily basis.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

It’s about the journey, not the destination. Although measuring outcomes and milestones is vital in my work, there’s always another goal waiting on the other side of each success. Focusing on the journey keeps me grounded for the highs and lows along the way, because the satisfaction of reaching the destination is fleeting, but embracing the journey keeps me motivated and grateful.

Are you working on any exciting new projects now? How do you think that will help people?

We are working on a new program to enable more women to start companies in healthcare. Women shoulder most of the responsibility for healthcare, are the primary healthcare workforce, make most healthcare decisions, and have identified problems worth solving. By empowering them to get a strong foundation to start new healthcare technology companies, we believe they will bring transformational solutions to patients.

How would you define an “excellent healthcare provider”?

An excellent healthcare provider puts patients at the center of care and truly follows through on that ethos. The patient as the center of their care is emerging more and more prominently than ever before, yet there are clear differences in how this mindset is being implemented into policies and procedures at different health systems. I think the patient-centric systems are going to provide the most excellent care.

Ok, thank you for that. Let’s now jump to the main focus of our interview. The COVID-19 pandemic has put intense pressure on the American healthcare system. Some healthcare systems were at a complete loss as to how to handle this crisis. Can you share with our readers a few examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these specific issues moving forward?

The key area where health systems struggle is viewing healthcare as what patients need when they are sick, and neglecting the community, social determinants, and preventative components of health and healthcare. These areas have historically been neglected because the incentives were not aligned for them to take on these longer term and comprehensive views of health. The COVID-19 pandemic is illustrating what happens when these community and preventative factors of health are neglected. This pandemic affects us all, but is particularly hard on our most vulnerable who have had challenges accessing healthcare, fewer resources, and employment that is dependent on in-person interaction. We can begin to address these issues by seeking to understand the entire patient’s experience with their healthcare journey and how all of the aspects of their life — shelter, food, transportation, and community — intersect with their health.

Of course the story was not entirely negative. Healthcare professionals were true heroes on the front lines of the crisis. The COVID vaccines are saving millions of lives. Can you share a few ways that our healthcare system really did well? If you can, please share a story or example.

Healthcare systems are fantastic at the operations of health distribution at scale, at least regionally. I think one of the underappreciated areas of this was the vaccine rollout. Health systems did an excellent job, in particular compared to pharmacy and emerging retail entrants, in running an efficient vaccine rollout with little waste. I had the privilege to volunteer at a mega site with one of our health systems in March and April and it was incredible how safe, efficient, and caring the entire staff and operation was. As a scientist who knows how decades of basic research go into those early discoveries, and as someone who is aware of how much pre-clinical validation, manufacturing, clinical study, and regulatory components need to come together to get a vaccine to the community, I was already impressed by how the entire scientific, industry, and government entities had come together to make this happen. But being part of that last mile delivery of the vaccines to people, many of whom expressed overwhelming gratitude from behind their masks in their vehicles, added another layer of awe and humility that all of this came together for the community.

Here is the primary question of our discussion. As a healthcare leader can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

Healthcare urgently needs to be more representative of our communities. This message needs to galvanize healthcare across research, data, clinicians, and clinical leadership. Clinical trials traditionally have low representation from minority communities, and thus our data about new and existing pharmaceuticals is incomplete. We believe that companies like DrugViu are taking a meaningful approach to educate and add value to diverse patients so that they are empowered to consider in enrolling in clinical trials. Medical schools and health systems must spend more time recruiting, retaining, and promoting Black physicians. When communities see physicians and clinical leaders that reflect them, the health outcomes will improve.

Access to healthcare needs to be improved and constantly addressed. Technology can support in this area and also brings new opportunities for disparities in healthcare delivery. We’ve seen companies bring valuable solutions in access points in healthcare including appointment scheduling (WELL), transportation (Roundtrip), and care coordination (Luma Health). Other areas with significant need are in pharmacy, including managing pharmacy fillings and deliveries as well as accessing food to take with medication. Telemedicine has made appointments more accessible for some, including the disabled. But access is still limited for people with unreliable internet access. Therefore, technology can simultaneously expand access and create new disparities that we must be mindful of and intentional about addressing.

Many health systems are talking about the shift toward more patient-centric health. Viewing the patient as more than a 15-minute conversation but as a person who brings emotions to their appointment, may have social determinants impacting their health, and may have experienced discrimination by other healthcare professionals is slowly gaining not just momentum but some real change. Medical education is adapting to incorporate more emotional intelligence into the bedside conversations, but more work must be done to truly see the patient as a person before, during, and after their appointment. Both DrugViu and Luma Health mentioned above support health systems in a more patient-centric approach to care and clinical research. We’re also excited about how b.well is enabling patients to be more empowered in their healthcare journeys and expect this area to grow significantly in the coming years.

Preventative care is still challenging to do well in our current system because it’s hard to measure outcomes and the timelines involved require significant patience and investment. In addition, we are only beginning to understand and incorporate the science of behavior change into healthy living. The sooner we can measure, track, and drive improvement in patient’s engagements in healthy lifestyles, the better.

Mental health access for all is a key area where healthcare can meaningfully improve health and wellbeing. Poor mental health access leads to significant declines in productivity, increases in emergency department visits and incarceration, and more. Enabling broader access to mental health services would be transformative.

Let’s zoom in on this a bit deeper. How do you think we can address the problem of physician shortages?

One key area is to focus on retention of diverse physicians throughout their training and continuing as they grow as physicians and clinical leaders. These changes will require structural overhauls and addressing systemic biases in existing clinical leadership that will take considerable time and intention, but are critical to address physician shortage and also improve health outcomes across minority communities.

How do you think we can address the issue of physician diversity?

We must address the adversity that diverse medical students, residents, and other trainees face during their training. For example, when Black trainees and physicians hesitate to encourage Black pre-meds from pursuing medicine because they think the environment that they experienced will continue to be harmful to others, then we will continue to struggle to recruit great candidates into medicine. The problem extends far beyond this window, but we can start by focusing on students and trainees and providing them with sufficient support, mentorship, and opportunities as well as continuing to seek to remove discrimination from their experience in clinical medicine.

How do you think we can address the issue of physician burnout?

Physicians can be penalized for requesting mental health services, which is an area that should be revisited by health systems. Another way systems can support clinicians is by implementing some policies, so that physicians don’t even have to ask for anything. For example, cancelling surgery cases following an unexpected loss is one structure that some systems implement to recognize that a surgeon needs time to process their experience without them needing to ask for help. More structures like these should be considered, especially as the stigma and penalty for clinicians seeking mental health care remains high.

What concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

I think the biggest thing that we can do is continue to challenge the existing stigmas that asking for help with mental health is equated to weakness or an inability to do a job, including in healthcare.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

Mental healthcare that is truly accessible to all would be transformative and everyone could benefit. We’ve seen several companies leverage technology and community to scale evidence-based mental health care, including Marigold Health and Meru Health. I’m eager to see companies like these grow and expand availability to more people to try to address the access hurdles people face to evidence-based mental healthcare.

How can our readers further follow your work online?

You can find the latest at tmc.edu/innovation and on my LinkedIn profile

This was very meaningful, thank you so much. We wish you only continued success in your mission.

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