Q&A with Beth Lindsay-Wood, Part 1: “Cancer Care Has to Continue.”

There are different approaches that can be taken as an interim leader, but for the most part, the objective remains the same: maximize the impact while minimizing the damage. For Beth Lindsay-Wood, however, the tactic she took at Moffitt Cancer Center was the same has adopted with every role, interim or not. To her, it’s an opportunity to provide an outsider’s perspective on how to do things more effectively, while becoming “part of the organization.”

Recently, Lindsay-Wood spoke with healthsystemCIO about her journey so far at Moffitt, and how the team is leveraging analytics to provide personalized cancer care. She also provided her thoughts on what it means to be a true digital organization, how the organization has pivoted during the pandemic, and what excites her most about the direction of the industry.

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Key Takeaways

• Moffitt, a 30-year old organization built on the campus on University of South Florida, is “very balanced in terms of clinical services and research,” which distinguishes it from other cancer centers.
• Along with its physical expansion (construction of a new facility is being planned), Moffitt is growing its artificial intelligence capabilities to “take unstructured text and make it actionable” at the point of care.
• The ability to offer different options such as virtual visits has required “a big push from IT” in providing desktop, clinical, and research support.
• The three main pillars of Impact 2028, Moffitt’s Digital Transformation strategy, are: precision/personalized medicine, organizational growth, and the digital care and discovery accelerator.

Q&A with Beth Lindsay-Wood

Gamble:  Let’s start with a high-level overview of Moffitt. Obviously you’re a cancer center, but if you could give us some information about the organization.

Lindsay-Wood:  Moffitt is only about 30 years old. It all started with H. Lee Moffitt; while he was a member of the House of Representatives, he pushed hard to build a cancer center in Florida, and it happened. To his surprise, it was actually named after him. He’s still actively engaged today.

It’s located on primary on the campus of the University of South Florida, but it has grown dramatically. We are the only designated cancer center in Florida. We have a smaller hospital because most of our business is ambulatory with treatments, but we are building an expansion hospital on another campus that will be primarily surgical. That’s coming up in the next couple of years.

The exciting thing about Moffitt is that we are very balanced in terms of our clinical services with our research — I think that’s what makes Moffitt unique. In general, and particularly in Florida, there are some top 10 organizations that have a heavy research program along with the cancer services. We have a large research team that does a lot of clinical trials, a lot of drug discovery and different types of things. We have just started an artificial intelligence group with a new Chief Artificial Intelligence officer, and we have a new machine learning group in the research area. And so, from a tech perspective, a lot of very exciting things we’re doing here that you don’t typically see in a large IDN or a hospital based system, which is my background. So for me, this is pretty exciting stuff.

Our growth year over year is dramatic and continues to be. As an IT organization and as a health system, we continue to evolve. We have a large physician footprint, very high-end oncology footprint, and researchers working collaboratively with the doctors on applying the research to phase 3 clinical trials.

 

Gamble:  It seems like you’re getting the best of both worlds in having the clinical aspect and research.

Lindsay-Wood:  Right, and I think that’s the difference, because we have those high-end oncologists, and that’s what we do — that’s all we do — is focus on that. We really have an advantage in that we have real-world evidence through our patients to look at how different therapies and treatments work, and do the research on that — along with evidence outside of our own patients — and apply that through our clinical trials and care pathways on the patients. And so patients get the best treatment that they can.

 

Gamble:  With COVID, one of the big things for a lot of organizations was cancelling elective procedures. It seems that with cancer care there’s not much that’s elective. But how was your strategy affected?

Lindsay-Wood:  That’s a great question. And you’re right, there’s a lot of cancer care that has to continue — you can’t stop it. But in some cases where there is an opportunity for elective surgery that could be deferred short term, we did look at that.

One area where we got a lot of press was in our ability to rapidly deploy virtual visits. We were doing them before, but again, because this is cancer care, it was limited. Within a matter of days, we did a 5,000 percent increase in visits. We moved routine visits to be virtual wherever possible. Sometimes it was virtual in that the patient was at the facility getting treatment, but the provider was virtual, depending on his or her location.

There were all types of scenarios, like virtual dieticians, that we offered to try to minimize exposure of our patients and yet make sure that they were getting the treatment that they needed for cancer care. And so we did — and we still do — virtual consults and visits with patients, second opinions, anything we can. We continue to use and leverage that unfortunate pandemic to look at new and innovative ways to treat our patients virtually. That was a big deal for us to do that and we saw significant patient satisfaction.

All the scores were indicative of the fact that patients were very appreciative of us being careful about exposure for them and yet making sure that we continued treatment. So it was a very positive experience. Like everyone, we did see some reduction in visits, but we needed to continue to care for our patients, so it wasn’t the same as with places with a lot of primary care or elective surgeries that could be deferred.

 

Gamble:  When you’re dealing with a vulnerable patient population, I can imagine there are measures that had to be taken with clinicians, but did it affect your team? Was IT pretty much remote?

Lindsay-Wood:  No, I definitely have teams that are onsite. We provide all the support to clinicians. So as we were transitioning them largely to virtual, we had a lot of our team there rounding with the doctors. Through all of Covid, we’ve had a presence on campus — not just desktop support, but also clinical support and research support, because a lot of the research requires individuals to be in labs with specimens. That type of work can’t be done from home, so we had to continue to support the organization.

We did really change the model a little bit. Like everybody else, there was a big lift to get people home temporarily. That was a big push for IT to get that going and to get everybody comfortable with Zoom. We already had it, but we didn’t have as many people using it; now more than 50 percent of the organization is working remotely. So that was a big deal. Zoom has become a way of life for us.

 

Gamble:  And in terms of some of the key objectives, you talked about AI and machine learning. What does the organization hope to achieve?

Lindsay-Wood:  Shortly after I arrived as an interim, the chief artificial intelligence officer came onboard. He’s working with deep learning against things like radiology images, and using NLP to look at how to take PDFs and clinical documents and pull out information we can use. It’s taking unstructured text and trying to get structured data out of it so that we can make it actionable. With lab results for tissue and histology and things where normally there isn’t real discrete data, it’s usually in a report — it’s trying to look through those to find information we can use.

For us, it’s all about clinical trials. We want to make sure we can identify whether a new patient is eligible for a clinical trial. You have to sort through all these papers to figure out what their results are and whether they would be eligible; this way you could extract that and it would be readily available. Within minutes you know whether a patient is eligible or that this trial might help their cancer.

He’s doing work in that realm using BERT, which is a deep learning tool. A lot is required to support high-end technical systems, and so we’ve purchased a number of those. They’re little in size, but have big power to crunch all that data.

One thing he’s doing that’s really fascinating is he’s looking at radiation oncology, different types of radiation, and different types of cancer, and looking at how we can minimize exposure, because it can be toxic if you’re not careful. And so he’s running a bunch of algorithms to see how that can be minimized. Most of this work is focused on advancing cancer care, looking at ways to utilize technology to speed up cures, get access to access to cures, and prevent cancer altogether. They’re using high-end technology to try to look at different ways to do that.

 

Gamble:  Let’s talk about digital transformation. What is Moffitt doing or what do you plan to do to move forward with some of these digital tools?

Lindsay-Wood:  We have a strategic plan called Impact 2028. It was a 10-year plan developed in 2018. It has three major pillars; the first is around precision medicine and personalizing medicine to make sure that you’re targeting the uniqueness of each patient — what type of cancer they have and what would be the best treatment. And not just a cookie-cutter treatment, but the best target treatment for each patient. It’s about delivering personalized medicine and delivering a great experience.

The next piece is around growth. We’re expanding our reach across Florida in different ways through partnerships or different development of our pathways and different things we can offer to other partners. So there’s a lot of work on the growth side.

The third piece is what we call the digital care and discovery accelerator, which is really the digital component. It’s twofold; one is looking at digital in terms of our digital front door and how we interact with consumers and patients. It’s also how we look at digitizing our business through things like robotic process automation and business automation workflows to leverage technology to be efficient and effective, and in supporting our providers and our researchers. We’re finding different ways to use digital tools to help. We have our main big systems like everybody does, but how do you link it all together in a way that makes it official and effective?

The other side of that is the discovery accelerator, which is similar to what we’ve talked about with AI and ML. We have a strategy that we’re implementing as we speak around high-end analytics in the cloud and moving our data in a way that gives us a lot of capability and flexibility with tools and some of these cloud vendor offerings to accelerate the discovery of cures and look at clinical trial matching in a virtual way.

And so there’s a lot of work happening on the discovery accelerator side. With cancer care, it’s all about speed; we want to get to something as quickly as we can. And so we’re creating environments that are going to help accelerate the discovery side. It crosses over; it supports the other pillars in terms of growth and precision medicine, but it, in and of itself, is a strategy around digital, internally and externally, and what virtual cancer care could look like in the future.

Part 2