September 2020, Volume XXXIV, Number 6

interview

Teaming up to serve patients

Bevan Yueh, MD, MPH

University of Minnesota Physicians

What can you tell us about your ongoing rebranding initiatives?

In 2019, the University of Minnesota, Fairview Health Services, and University of Minnesota Physicians began a new partnership known as M Health Fairview. This brand encompasses all the facilities and services in our joint clinical enterprise, including those acquired by Fairview when they purchased HealthEast in 2017.

M Health Fairview is the brand we use to help the public understand who we are. It represents the powerful combination of academic medicine at the Medical School and University of Minnesota Physicians and the operational strength and reach of Fairview Health Services.

The Medical School and M Physicians are the “M Health” in M Health Fairview. We bring research capabilities, innovative care models, and multi-specialty expertise, and we train the next generation of medical professionals.

Please share some of the new learning that has come from the pandemic.

The pandemic clearly demonstrated the power of academic medicine. Our physicians were in communication with colleagues around the world in late 2019. We knew what was coming and we knew we’d have to prepare—pivoting research and clinical care resources to address the disease and the community impact. Our commitment to saving lives sends us in to overdrive during times like these. I have seen collaboration across specialties and disciplines like never before, a willingness to do things differently for the sake of our patients and the communities we serve. I am hearing a strong desire to continue this momentum to help conquer other challenges in health care today, including health disparities and access to care.

What can you share about new learning from operational changes?

We have learned that virtual care is a real option for many kinds of visits. It opens up access—not only for patients far from our metro area, but also for those who are closer. The emergency orders in place during the first months of the pandemic paved the way for us to provide care to patients in some other states. Now we face licensing barriers to provide broader virtual care across state lines. We are consulting with other health care providers to address these issues and share best practices at an operational level.

It is critical for us to form new kinds of partnerships.

Please tell us about converting Bethesda Hospital into a COVID-19 facility.

We decided early on that we could provide the best care by creating “cohorts” of COVID patients. This meant keeping patients on dedicated units to improve efficiencies and to improve care. My colleague at Fairview, Mark Welton, MD, floated the idea: What if we make all of Bethesda a COVID hospital? In just over two weeks, our physicians stood up Bethesda to care for COVID patients—the first in the state and one of the first in the nation.

We have since demonstrated great outcomes, with higher survival rates than in other metropolitan centers, and an extremely low rate of infections among health care workers. Brad Benson, MD, FACP, FAAP, chief academic officer, Tim Schacker, MD, vice dean for research, and their teams have led a number of clinical trials that demonstrate how our academic physicians are advancing the standard of care.

Please tell us about your partnerships with Minnesota health care industry leaders.

One recent example stemmed from the concern that we would run out of ventilators during the COVID-19 crisis. Anesthesiologist Stephen Richardson, in partnership with the University’s Earl E. Bakken Medical Devices Center, worked with Boston Scientific, Medtronic, and UnitedHealth Group to develop the Coventor, a low-cost, simple-to-produce ventilator. These companies used their expertise to refine the ventilator and help get rapid FDA approval.

How are you addressing health disparities in our communities?

Many of our clinicians are involved daily in addressing health disparities. For example, research funded by the Medical School is helping physicians and learners in our family medicine clinics tackle access barriers faced by our Somali, Hmong, and Karen communities.

Our Broadway Family Medicine Clinic has been serving the North Minneapolis community for more than 40 years. Tanner Nissly, DO, Kacey Justesen, MD, and their team partner in unique ways to improve both health and health care. Dr. Renée Crichlow’s Ladder Program helps kids from underrepresented populations pursue health care careers. They have also partnered with Second Harvest Heartland to address food insecurity and a lack of education regarding nutrition. They are currently relocating the clinic to a larger site and, with the help of a University grant, are partnering with the College of Design to create an innovative, community-focused clinical space.

How are you dealing with institutional racism within your own organization?

Through our partnership with Fairview, we recently launched the Healing, Opportunity, People, and Equity (HOPE) Commission. Our physicians, Taj Mustapha, MD, and Christopher Warlick, MD, PhD, are part of this commission and focused on dismantling the structural racism that impacts health outcomes and health care.

Our leadership will soon include a vice president of diversity, equity, and inclusion to ensure comprehensive focus on any issues of racism or bias in our organization. This new leader will partner with Ana Núñez, MD, FACP, who recently joined the Medical School as its inaugural vice dean for diversity, equity, and inclusion.

To respond to the needs of our employees, we have established internal working groups comprised of physicians and staff to address themes from listening sessions we held earlier this summer. I have also asked each of our Board committees to add a goal to their charter statement that relates to diversity, equity, and inclusion.

You have a special interest in improving hearing loss. What are some of the most exciting new advances in this field?

Hearing loss profoundly impacts health and quality of life across the lifespan. Hearing is important for learning and forging social connections, and for maintaining brain health as we age. Prevention of hearing loss is an important public health goal, and we also need better treatment options to restore hearing for the millions of individuals who have already suffered loss.

The University of Minnesota is on the forefront of hearing technology development. We have a leading-edge, high-volume cochlear implant program. A team of scientists, engineers, and surgeons, led by Hubert Lim, PhD, Meredith Adams, MD, MS, and Andrew Oxenham, PhD, is conducting a multi-national project funded by the National Institutes of Health to develop the world’s first auditory nerve implant, which will bypass the diseased inner ear to send electrical signals directly to the hearing nerve and on to the brain.

Our researchers are also developing novel hearing aid technologies, such as an ultra-hearing device that transmits low-level ultrasound signals non-invasively but directly to the cochlea, so the brain that does not need to compete with distorted sounds coming through damaged middle and inner ear structures. We are also developing technology to treat tinnitus with multimodal neuromodulation.

What are the most pressing issues facing University of Minnesota Physicians?

The crisis of health care affordability is a national conversation and we feel the effects acutely in Minnesota. Health care systems are feeling the cost pressures of providing high quality care and an excellent patient experience, even as reimbursements fail to rise at the same rate. Addressing access issues and health disparities in our communities requires long-term investments that do not see an immediate return.

The University of Minnesota Medical School has been a center for solutions in the past, and we are in the best position to find solutions now. Our faculty members are doing some truly amazing things that will change the standard of care. Through science and better health system organization, we will find answers.

Bevan Yueh, MD, MPH, interim CEO at University of Minnesota Physicians, also holds leadership positions in the Medical School as vice dean for clinical affairs and as the department head for the Department of Otolaryngology/Head & Neck Surgery. 

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interview

Bevan Yueh, MD, MPH, interim CEO at University of Minnesota Physicians, also holds leadership positions in the Medical School as vice dean for clinical affairs and as the department head for the Department of Otolaryngology/Head & Neck Surgery.