Transcript
Julie Kiefer: The University of Utah has announced three major projects that greatly increase the reach of health care that University of Utah Health provides. These are two new health centers on the west side of Salt Lake County and one in Utah County.
Today I'm pleased to have Dr. Michael Good as my guest to talk about the expansion of our health services. He's senior vice president of Health Sciences and CEO of University of Utah Health. Welcome to U Rising, Dr. Good!
Michael Good: Thank you. It's a pleasure to be here.
Julie Kiefer: The three health centers are the first major off-campus development in quite a while. There's the Huntsman Cancer Institute's New Comprehensive Cancer Center, the University of Utah Population Health Center in Rose Park and the U West Valley Health Center [Univerity of Utah West Valley Hospital and Health Center] That's a lot! What's driving these expansions?
Michael Good: Well, really two things. First of all, the population of our state is growing and continues to grow rapidly. So as more and more individuals become members of our great state, they bring their health care needs with them as well.
The second and perhaps most important is that University of Utah Health, we're striving to provide as much care as we can close to where people live, work and play. And although these three projects, as you said, are the first in a while, you know, if you look back over the last decade or so, we've opened the large health centers in South Jordan, in Farmington and more recently in Sugar House. And in addition to those large, three multispecialty centers, we have nine other primarily primary care centers already located throughout the valley. This is kind of just our next phase in that push to be in the community and to be able to provide really world-class health care in people's neighborhoods.
Dr. Michael Good is the senior vice president of Health Sciences and CEO of University of Utah Health.
It's also great for our teams. As you know, the area here around the university where we have the university hospital and many of our clinics is a congested area. And so, another benefit of having health centers in the community is there's less travel for individuals and less traffic congestion around the university. You know, when we studied West Valley and made plans to have the health center there, we estimate that individuals who live on the west side of the valley drive 12 million miles a year back and forth, they and their families, to the university, so that reducing travel and congestion for everyone involved — that's part of it as well.
Julie Kiefer: Yeah, that's interesting, all the thought that goes into it. When you think about these three centers, they're all meeting a certain need and part of that is an expansion of population health services and, in fact, the Rose Park Center has that term in its name. What is population health and why do we need more of it?
Michael Good: First of all, population health means many things to different people so it's not a precise term. But in general, of course, we always start with the care of the individual patient that's before us and taking care of their specific care needs. But population health expands that to say not only how do we provide great care to this specific patient, but how do we provide overall best care to this population of patients. That population may be a community, it may be a zip code, it may be a population of patients with a specific health concern or concerns.
So, it moves from, again, always starting with care of the individual patient, but looking at also the care needs of a population. And when you do that, you often find commonalities. You often find things that are often referred to as the ‘social determinants of health.’
You know, we oversimplify a little bit, but in general, overall health is about 20 percent are genetics. Thank you. mom and dad! It's about 20 percent access to great health care. But really about 60 percent of our health revolves around these things, things like where we live, how we live, our education, our social economic status, the opportunities that we have, our nutrition, our diet, our exercise.
And so as we begin to look at a population, we start to focus on, particularly when we can identify that it's affecting a large number of members in that population, some of these social determinants of health. Another word that's used is kind of ‘whole person approach.’
Julie Kiefer: So, let's talk about each one of these centers and start with the Huntsman Cancer Institute's new Comprehensive Cancer Center in Utah County, in the city of Vineyard. Can you give us an overview why in Vineyard and what type of services will they offer?
Michael Good: Well, this is such an exciting project and particularly for the people of Utah and especially those afflicted with cancer. When, particularly a complex cancer as many of them are, you want to get care in, when we say comprehensive cancer center, one that's been thoroughly reviewed and designated by the National Cancer Institute, which is the largest of the National Institutes of Health here in the United States. It's a very high bar and there's only about 60 cancer centers designated by the National Cancer Institute and only a subset of those are comprehensive.
So there really is world-class care being delivered by the physicians and clinicians and staff members in the Huntsman Cancer Institute. And, of course, the institute not only provides that care, but it is driven by the latest research and research findings. For example, one of the exciting areas I'm following is this so-called precision medicine, where, say historically, if you had a certain type of cancer, everybody that had that type of cancer kind of got the same treatment.
Nowadays we look at the genetics of the person, the patient, and we look at the genetics of the tumor and the treatment is personalized or becomes precise for that particular genetics of the patient, genetics of the tumor, and that's leading to better outcomes.
So, a wonderful resource for the citizens of Utah. But right now, if you live in Salt Lake County, that's great, but if you're in Utah County, often cancer treatment involves repeated infusions of chemotherapy agents or often radiation therapy, which requires every day or every other day treatment for weeks. Many people view this, in a way, it's an access barrier. And so again, following the overall University of Utah Health strategy to deliver world-class care closer to home, our Huntsman Cancer Institute is planning its next facility to be in Utah County. Great care, less travel, a focus on a variety of patients including those in many rural parts of the state. This will be a closer access point for those patients.
I really do want to give a shout out to the Huntsman Foundation for their gift of $75 million that gets us started on this journey and we’re in a campaign now with many other generous partners also contributing to this effort. We need to get the fund raising done, but many of us are optimistic that we'll be able to break ground on this facility in Utah County for the Huntsman Cancer Institute later this year.
Julie Kiefer: Yeah, that'll be fantastic to have that resource out there for the community. This project includes a unique new partnership with Utah Valley University, the HCI-UVU Health Collaborative. What is that partnership? What's the goal?
Michael Good: You know, partnerships are so important. I often cite the little simple mathematical, you know, one plus one is three, or sometimes one plus one can be four or five partnerships. Synergistic partnerships make each partner better and so excited about the partnership with Utah Valley University. It provides many things for both parties. UVU students can become immersed in cancer research and cancer care. It'll be right there on their campus. And so additional opportunities for UVU students.
We and the health professions, we need so much. We need team members and this gives us an opportunity to train a whole variety of professions in our workforce — medical assistants, nursing assistants, technicians of a variety of different professions. So, we look to this community to be a place where we can train and hire additional members of our team. Part of this being in the communities is to recruit, train, employ, retain and develop careers locally. So that's another advantage for us.
I mentioned the research, but then there's also a number of educational opportunities. All of these are still being developed and discussed and prioritized, but we think there may be as many as 50 health and science-based learning opportunities every year that will be accelerated and increase the number of students participating in each as we move forward together — Huntsman Cancer Institute, the University of Utah and Utah Valley University.
Julie Kiefer: So, you talked about these student training opportunities. How will that work?
Michael Good: Well, first of all, some of these are already underway, but again, people having to drive back and forth and we're excited when they can be more facilitated closer to home. But the students really contribute to the world-class cancer research, working in the laboratories, the clinics, the hospitals, other departments like communications and public affairs. A big component of health care involves communication. If patients don't know about the opportunities that are available to them when they have a certain condition or symptom, we need to do a better job communicating.
So, there's again, a lot of opportunity across many of the disciplines and it's experiential learning, right? It's not in a classroom on a whiteboard, but it's working with an oncologist or a nurse practitioner or a pharmacist who specializes in oncology. They get to work side-by-side and in the teams that are providing care at HCI. The modern-day cancer treatments are delivered by interdisciplinary teams so it really is a unique experience for the student to be able to become immersed and a part of that team and actually participate in either the care or the research, depending on the nature of the particular team.
Julie Kiefer: That sounds like a really great opportunity.
Michael Good: Hopefully, I don't know how we convey excitement on a podcast, but hopefully . . .
Julie Kiefer: I'm excited!
Michael Good: . . . our audience can hear the excitement in our voices! I think this is just going to be, it truly is a win-win win, and particularly for individuals that are being challenged, their health is being challenged by cancer.
Julie Kiefer: Now, one of these three new health centers has already opened. In October, the U opened the University of Utah Population Health Center in Rose Park, which involves a partnership with the state of Utah. So, tell us about this one.
Michael Good: Yes, as we mentioned earlier, using population health approaches, this clinic and, more importantly, the people, our people that work there, focus on meeting unmet needs, improving health and reducing overall cost of care and, in doing so, using again a whole person approach with a particular focus on the social determinants of health. Many of our members, our patients, there are Medicaid members and they have complex health, mental and medical conditions. Others are underinsured or even uninsured, and it's an integrated clinic.
So, there are, within our own organization, four or five partners have come together to make this clinic really unique. Actually, our dental school was one of the first to make this a focus of their work. They are the principal provider of dental and oral health care to members of our state who are on Medicaid. Now, we have the Spencer Fox Eccles School of Medicine student-led clinics. The student-led clinics are where not only do our faculty, these are all faculty supervised and staffed clinics, but not only do we teach the students, the medical students, about caring for patients, learning how to take histories and physicals and prescribe medication, but in what I think is a unique aspect of our medical school in the country, we challenge the students in leadership teams to actually run these clinics, to learn what it means to run a medical practice. Who answers the phone, how many medical assistants do I need? How do we get the insurance claim correctly filed?
And the students are so energized and so enterprising, they will identify something that can be done better in the clinic. For example, they were not totally satisfied with the medication management that was always taking place. So, they went out and partnered with their colleagues in the College of Pharmacy and now pharmacy students are part of these interdisciplinary teams. Other teams would notice that while the primary care was great, the specialty care connections were not perfect. So again, really thoughtful students connected with dermatology and ophthalmology so that patients can be connected with specialty services when they need them.
And then I told you we challenged them to run the clinic and so what did they do? They went over to the David Eccles School of Business and we now have business students part of the teams studying and improving the care processes. So again, a synergistic win-win win. The students are learning how to provide great care in interdisciplinary teams. The patients really are the true winners because many of them would not have access to this level of care and the university and the community when, as I've always said, the University of Utah Health, we're here to serve our community.
And I forgot to mention another very important activity that happens at the population health center is where New Americans, particularly refugees and immigrants, undergo their initial health screens and are connected with the health system in our community as they resettle here. So it's really unique and, again, beneficial for everyone and particularly for the patients.
I want to make sure I mention our partners because we could not, the population health center in Rose Park would not be a reality without many, many partners. First and foremost, the Utah Department of Health and Human Services, Health Clinics of Utah, the Behavioral Health Innovation and Dissemination Center, special shout out to University Neighborhood Partners who have been instrumental in helping us bring all this together. I mentioned the importance of nutrition and the Utah Food Bank is one of our partners. And then across the university we have the medical school, the dental school, the pharmacy school, the business school, the intensive outpatient clinic. And I probably have to call out there and check today, there's probably a new partner that I'm not aware of, but just a really coming together of people who want to make our world a better place in a real and tangible way.
Julie Kiefer: You had mentioned the clinic for refugees, which is called the Newcomer Health Clinic, and I was really intrigued by that. I hadn't heard of something like that before. What are some of the specific needs of that population that will be addressed by this clinic?
Michael Good: I'm really proud of our state and the way we welcome refugees and immigrants and work to help them find stable ground, in a broad sense, in our community. And part of that effort is the state's resettlement agencies. I've already mentioned the Department of Health and Human Services and these New American clinic, it's many, it's refugees, asylum seekers, special visa immigrants and so on.
And as they come into a new community, we do a health assessment. So, a full-time medical provider who is dedicated to this newcomer health, newcomer clinic, provides these health screenings. You know, many patients they screen and they don't have any ongoing issues or health challenges that need attention. But when they do, about a certain portion of the time, there may be ongoing challenge in treatment or our screens may identify some new health challenge that the individual did not realize they have. And so because of this integrated approach, whole person approach, the Newcomer New American Clinic is then able to work to connect people with the services so that they're particularly ongoing health treatments don't slip or, if you will, fall through the cracks because of the relocation and Rose Park is the exact right place for it because, say for example, what if the challenge is oral health? What if it's a tooth abscess or an evolving oral cancer? Those individuals can get connected right away and get those problems corrected before they get out of hand.
Julie Kiefer: So, the third big project is the U West Valley, a new health center. So why West Valley and what's the scope of this particular facility?
Michael Good: As we look at our community , where people live and the health needs they have and the health services available to them, it's a pretty sophisticated analysis. But it was that analysis which showed that West Valley City, in particular, the second largest and one of the fastest growing areas in our state, quite frankly in our nation, and many and specific health needs of that rapidly growing population and very few health care services available in the area. So, it became quite obvious that we needed to be in West Valley City and we needed to be providing the health care services that individuals of this community need. And we also partnered with many people and many organizations in West Valley. One of the most important things in community engagement is to listen. Certainly, often in academic medicine we like to talk before we listen. University neighborhood partners have been a big part of this journey.
And really, I want to thank President Randall, who as he leads our university, keeps us focused on this goal of becoming a top research intensive university with unsurpassed societal impact. And I can think of no greater societal impact than bringing not only world-class health care, but also the full force of the university — our education programs, our economic development. And so, this is a deep partnership, it’s multidimensional and it's, over the last couple of years, has really began to deepen and to focus on how each of us, University of Utah and the people of West Valley, how we can make each other stronger. And obviously I'm focused on the health part of that, but many other team members here at the university are also focused on the education programs, the economic development, housing, all kinds of different aspects that we have expertise and we have people of passion in the university who want to be a part of this effort.
Focusing on health, you asked about kind of why West Valley, what drives us? One of the statistics that really bothers me is there is about a 10-year difference in life expectancy, whether you live on the east or the west side of I-15.
Julie Kiefer: Wow.
Michael Good: And so that's an example of that disparity that exists in our valley here. If you dig a little deeper into the data, you see that the physician shortage is five times worse in the West Valley communities than, for comparison, the Wasatch front communities. If you look at physician per a hundred thousand citizens, a fivefold difference in physicians available close to where people live east versus west, and there's large differences in household median income between some of the highest income and lowest income areas of our valley. I mentioned earlier, while bringing health care services to West Valley is the leading goal, I guess I would say, but we also want to educate, train, hire, employ and develop careers for members of the West Valley community and hopefully changing that income differential that I just mentioned.
Currently, we're planning both an ambulatory care facility. That's where you see your doctor and your other health professionals on an outpatient basis, oftentime called a clinic. We'll have both primary care and also a number of specialties there. We will have Huntsman Cancer Institute, will be a part of the West Valley Health Center. We will have an emergency room, we will have a surgery center including areas for GI, the colonoscopies and the endoscopies now that are such an important part of cancer screening. And we do plan to have a hospital there, inpatient beds with delivery center, a variety of imaging care modalities. So it's going to be a hospital and an ambulatory health center altogether. We still are working on the phasing. Some days, I think we'll be able to do it all at once and some days I think we may have to phase the ambulatory and the emergency room first and the hospital beds later, but those details are all being worked out and again, we're going to do our best to get a shovel in the ground in West Valley City here in 2024.
Julie Kiefer: That's great. And beyond the health care that this will be providing, you had alluded a little bit to the strong connection to community that this center has and the commitment to student education. Can you tell us a little bit more about that?
Michael Good: Yeah, you know, if you look back over the past two years, if we're counting right we've had something like almost 140 community meetings, meetings with the residents, with the other partners. The team tells me they're coming close to 20,000 hours of planning, designing iteratively, interacting with the West Valley community. One of my goals is this hospital, this health center, becomes something that the people of West Valley feel is theirs. It's not the university, it's their hospital, their health center. It's where they see their doctors, the people that take care of them and maintain their health. Again, this is going to provide great access. Hopefully, we can eliminate that 12-million miles of driving back and forth. We want to build a health system that's culturally responsive. We want to make sure that there's great language access, that just because someone doesn't speak English, we need to be able to interpret and translate so they, too, receive world-class care.
And, as part of all this, I mentioned the increased access to training, education and family-sustaining jobs. This notion of working on full-time student, part-time work or full-time work, part-time student, even if you’re a full-time worker, can we work education into your job so that while you're on the payroll, while you're doing your job, there are also periods of time where as part of your job you're learning, getting the next credential, the next class, whatever you need next to continue your career.
We're estimating over 1,700 new jobs. We're working on the pathways that bring people into this workforce, innovative ways of on-the-job training, not just traditional learning opportunities. And we also want many of these West Valley individuals, for those that want to pursue careers in the health sciences and the health professions, I mean, wouldn't it be great to being cared for in the West Valley Health Center by a doctor and a nurse who grew up in the neighborhood? So that's a long way off, but that's where we aspire to be and are working hard to get there.
Julie Kiefer: Yeah, that's a great, great place to head for definitely. You know, we started this conversation talking about population health and what that means and how this expansion meets the evolving needs of population health. I'm wondering what the future of population health looks like in Utah and how we're preparing the next generation to deliver it.
Michael Good: We have a unique program in the Spencer Fox Eccles School of Medicine, again, created in partnership with Intermountain Health, called our Population Health Scholars Program. It's truly innovative, nationally. Through an endowment gift from Intermountain Health, we are able to offer scholarships to a select number of students in our medical school, about 10% of the class. And in addition to receiving the scholarship, they receive a focused track in the medical school around population health. So, they learn the science and the practices and best-case examples as part of both their coursework and their work in the clinic. And we refer to them as our population health scholars.
I really, again, want to shout out to Intermountain Health because many of the physicians that practice across their broad health system serve as one-on-one mentors for the population health scholars. And so, they get not only classroom work on population health, but they get one-on-one mentorship and partnership with a physician, often practicing in some of Intermountain's population health clinics.
And so that's just one example of where we're trying to train the next generation to be ready to more broadly deploy the concept of population health more broadly across our state and across our nation. Then another program we're working at in the medical school, we have a Department of Population Health Sciences, and so our faculty and staff in many departments, but particularly those in population health sciences, the Department of Population Health Sciences, are actually studying and doing the research to create the best approaches for this notion of how you take care of a group of patients, not just an individual patient.
Julie Kiefer: Yeah, it's really great to hear how the U is adapting to the needs of our times. Dr. Good, we would love to have you back at some point and hear more about these different projects and health centers. And thank you very much for being my guest here on U Rising.
Michael Good: You're welcome. Glad to come back anytime you'll have me.
Julie Kiefer: Listeners, that's it for today's episode of U Rising. Our executive producer is Brooke Adams and our technical producer is Robert Nelson.
I'm Julie Kiefer. Thank you for listening.