Pittsburgh-based UPMC will transfer 6 million patient records from nine EHRs to Epic Systems by mid-2026, a move that will enable its clinicians with better data to improve health equity and quality, according to Johanna Vidal-Phelan, MD.
Dr. Vidal-Phelan is chief medical officer for quality and pediatrics within UPMC's insurance services division. She is also a clinical assistant professor of pediatrics at UPMC Children's Hospital in Pittsburgh. Becker's sat down with Dr. Vidal-Phelan to discuss how UPMC is turning conversations around health equity into action within the communities it serves.
Question: How do you personally define health equity within the context of your role at UPMC?
Dr. Johanna Vidal-Phelan: Health equity means we all have equal access and ability to achieve our wellness. It means that no matter where you are from, or your religion, race, ethnicity or sexual identity, there are no stumbling blocks for you to achieve your full potential in health and wellness.
Q: What's currently keeping you up at night?
JVP: The issue of interoperability is a big barrier. From a quality perspective, I believe in organizational efficiency and improving access to data at the right time so that we can serve our members at the right time. One of the things that I'm proud of UPMC for doing in this space is moving our entire system to Epic so that our providers in the outpatient world and the inpatient world can see each other and improve communication. It's also going to greatly benefit our members' and patients' experience. What keeps me awake at night is that interoperability has to not only be built from a provider and system perspective, but also from the perspective of a member and the community.
Q: Looking to 2024, what is the top challenge you're facing?
JVP: As a healthcare leader and pediatrician that comes from the Latino community, I'm worried that we are spending a lot of time talking about health equity, but now we need these discussions to go into action to truly impact our members and our patients.
I really appreciate that we're having these discussions now in healthcare at the national level. We can freely talk about structural racism — a phrase that wasn't common even 10 years ago. But I want to be sure that as we are discussing this, that we are now truly creating change and driving health equity in everything that we do. Quality also has to be embedded in everything we do because I see a parallel between equity and quality. You can't have quality without health equity.
Another area that I worry about a lot is immunizations because we're seeing declining immunization rates nationally and locally. We've seen some declining teenage immunizations, but the one that I see the most are in the first two years of life. This is a multi-prong issue from not only the impact of the pandemic, but also misinformation that is impacting a lot of new parents and families. We must overcome that lack of trust so children can receive the immunizations they need.
Q: How do you overcome what are often engrained opinions surrounding immunizations?
JVP: I practice with the foundation of respect for you and your concerns. That comes with having respect for me and my opinion. But we have to learn how to compromise. That may look like a family deciding not to receive all immunizations in one visit. It may not be ideal, but we will create flexibility to meet parents where they are. Building trust, especially in vulnerable communities that have seen health inequities, takes time, but it's something that we have to continue doing.
Q: What's a change you've made in your day-to-day workflow that's had an effect on members and patients?
JVP: We work in a matrix structure, which means that we have to work with many teams across the organization. When we think about member impact and driving better outcomes, it truly takes a village and having everyone actively engaged in driving that change. I work with a small but very important pediatric team, and one of the things that we have established this year is regular leadership meetings every week for an hour. We talk about where we are today: access barriers, ongoing challenges and how we can help each other.
Q: Final thought for the broader insurance industry about how to improve health equity?
JVP: I'm very fortunate that I work for an organization that not only understands the importance of health equity and enabled data, but is driving action to improve it. But I want that to be across the industry. If you truly want to serve your community, you can't do that from the office or with a spreadsheet. You have to choose to go out and be among those you serve.