Q&A with Chief Innovation Officer Tracy Elmer, Part 1: “It has to be as authentic as possible.”

By nature, Tracy Elmer has always been an inquisitive person. “I’m always in discovery mode,” she said during an interview with Kate Gamble, Managing Editor at healthsystemCIO.com. In fact, when she’s looking to recruit team members, those who ask a lot of questions are most likely to catch her eye, for one simple reason: “When they’re leaning in, you know they’re probably willing to go the extra mile.”

To Elmer, communication is essential to an organization’s success. However, as remote and hybrid work models become the norm, it’s becoming increasingly challenging to facilitate meaningful conversations among teams and promote collaboration.

During the interview, she spoke about the importance of listening and empathizing; why flexibility is such a critical part of her team’s framework; and how TrueCare has been shaped by its “humble beginnings.” Elmer also talked about how the organization is improving access to care; what she learned during her time at Rady Children’s; and why she believes she has “the coolest job in the world.”

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Key Takeaways

• TrueCare’s “humble roots” started 50 years ago when RVs traveled to provide care for migrant workers with the philosophy that “a healthy community is one in which everyone is taken care of.”
• Incorporating social determinants of health and partnering with community organizations “has always been a core principle” for TrueCare, according to Elmer. “We’re stronger together.”
• Although it’s technically called a strategic plan, Elmer’s team thinks of it more as a framework “because we recognize the need to continually have the ability to pivot based on circumstances.”
• One of the biggest challenges in a remote or hybrid work environment? Not seeing facial expressions or body language, which makes it harder to know “when to dig in more.”
• It’s not enough just to create opportunities for individual conversations; leaders need to “listen and allow that moment.”

Q&A with TrueCare’s Tracy Elmer, Part 1

Gamble:  Let’s start with a high-level overview of TrueCare — where you’re located, the type of care you provide, things like that.

Elmer:  TrueCare is an incredible organization to be part of. We’re all about the provision of compassionate, high-quality care to everyone and anyone. We’re focused on access for all and promoting health equity to the fullest degree that we can.

We’re proud to offer comprehensive whole person care for our patients in 11 health centers, the majority of which are located in North San Diego County. We’ve also started to expand into Riverside County.

For us, whole person care starts with primary care. We have adult medicine as well as pediatrics care. We also offer integrated behavioral health, as well as women’s health services and dental, all of which promote the health and well-being of our patients.

“Humble roots”

We have humble roots that started 50-plus years ago as part of a goal to assure the healthiness of our community, which is diverse and multicultural in its population. They literally started providing care in an RV to migrant workers, with the understanding that a healthier community is one in which everybody is taken care of and we’re promoting health and prevention of illness.

Last year we introduced mobile services, which was so exciting to see. It’s an RV — a little nicer than the ones from 50 years ago. It can go anywhere and provide both dental and medical care, in addition to things like Covid testing or vaccines. It’s fun to see the innovation and the growth, while also staying true to our humble beginnings and the reasons we got into this space.

 

Gamble:  That’s really interesting about how TrueCare started. It seems like although there’s been an evolution and growth, there’s still so much focus on being a community organization.

Elmer:  There is. I will say, partnerships are vital to our ability to achieve our aims and our goals. We have a whole domain dedicated to outreach and community partnerships. There’s a lot of emphasis being applied now to social determinants of health; I like to say that with community health, that’s always been a core principle. Health status matters based on all of those other factors. I’m so proud to see the partnerships we’ve developed with Feeding America and other groups like Uber and Lyft to provide transportation to appointments. I love seeing folks come together for the greater good, and for those community collaboratives that recognize the important role they play in serving the health needs of patients.

We know that in healthcare, we’re stronger together. We’re better together. We can’t go it alone. And so, dedicating a whole team that focuses on community outreach as well as partnership cultivation is strategically important in enabling us to not just maintain what we have, but even expand further.

 

Gamble:  What do you consider to be your core objectives?

Elmer:  It certainly has been an interesting time. We actually just finished developing our next three-year strategy. It is a strategic plan, but we call it more of a framework, because we recognize the need for us to continually have the ability to pivot based on the circumstances of our world. The pandemic, obviously, being a core example. I love my role because even though I have my core responsibilities and strategic areas of oversight, I get to help power our plan in all domains.

“All about patient experience”

Transformation is a really big emphasis for us. It’s all about patient experience and transforming how we’re delivering patient-centered care. My purview includes clinical informatics and analytics as well as IT and project management. We’re drivers for change, but also partners for transformation. It’s fun to become more strategically oriented as a team as opposed to more tactical, which was the pathway of doing things, and be able to help in that regard.

Our focus now is expanding access and providing more of a digital connection. A really important element of that is education for our patients. We’ve introduced new tools in the last year which are wonderful, but if you don’t really know how to navigate, access, or use them, they’re not valuable at all. And so, another aspect of transforming the experience is enhancing digital health literacy and ensuring it doesn’t become a reason for a bigger divide with health equity. That’s a very cool, creative area to be connected with.

Cultural enhancement

Another focus for me as CIO and a member of our executive team is cultural enhancement. In addition to care, it’s incredibly important to care for their well-being; there’s a lot we’re doing to enhance that by looking at how we work and finding ways to work differently, but just as efficiently. There’s a lot technology can do to enable that. It’s also promoting how we can partner together for change; how we can support folks and teach them project management skills.

We have a program that our PMO director put together that helps all leaders understand the principles for change. That’s a really exciting area to be investing our time and resources. It’s so critically important right now.

 

Gamble:  Right. As you know, there’s been a huge increase in remote work and hybrid models. But because things happened so fast, there wasn’t much attention paid to how this would affect people. How are you approaching this?

Elmer:  I really appreciate you highlighting that. This is something my own team, first and foremost, has talked about a lot. It’s challenging folks who have always worked in the space where we had a lot of time together. I’m the type of leader who has led people both onsite and offsite. In this new era, we need to figure out what works best for employees and find ways we can continue to collaborate and connect when we don’t pass each other in the hallway and have those friendly, ‘how was your weekend’ conversations.

We do a lot with Zoom — that’s our mode for connection. We always start with ‘water cooler talk,’ which we do both in our small group or team meetings, as well as larger meetings, so people can chat.

Water cooler conversations

I know that sounds funny, but that’s where relationship development is best served. Just a simple, ‘What did you do last weekend’ can help understand folks’ interests and enable you to ask more questions. Providing a structure and agenda for water cooler talk may seem awkward, but it really does help folks share openly with each other. They can put things in the chat, and you can comment. There are different ways to assure you’re still connecting.

Beyond that, I think we’ve identified the criticality of those interactions. Some things are taken for granted like, for example, standing one-on-one meetings. Now, we have to approach it in a different way. Whether we’re in-person, or the phone, or in a Zoom meeting, it has to be as authentic as possible. We need to find ways to promote that and help others feel comfortable with it.

 

Gamble:  I like how you’ve created a structure for water cooler talk. It’s so important to have those discussions and get people going.

Elmer:  Absolutely. The one-on-ones — and my team and I have promoted this organizationally — are dedicated times during which you can learn about what’s happening in an individual’s world and assess how they’re doing. It’s different when they’re not with you in person; you can’t see their facial expressions or body language. You have to hone in and listen. It’s another discipline to try to pick up on the nuances and voice inflection so you can understand where to dig in more, and where to just check in.

That goes back to well-being and wellness. It’s been a long road. We left 2021 excited about our new strategy, and then when the new year started, we had to manage staff being out and patients needing more care services or information. It meant having to pivot, but we’ve been intentional about some of those changes, and I think that has helped us maintain support and continuity with our team. I’m glad that we initiated those last year and not today.

 

Gamble:  Has there been a deliberate effort with managers and directors to look for signs of exhaustion and make sure they’re in tune with their teams, even if they don’t see them in person.

Elmer:  Absolutely. It’s a fine balance of how many meetings you want to have to check in with folks. We’ve done some town halls around topics like California’s booster mandate, which happened right before Christmas. And so, we had to hit the ground running on Jan. 1 with, ‘what’s the status of our team?’ It’s difficult to do that when you’re coming back from a holiday. We had to dive in, but we were really cautious about our approach. The executive team took time with their teams. We did large town halls where we could, but we also had office hours to check in on folks. Individual outreach is so vital during times like this, because not everyone feels comfortable speaking up in larger forums. It’s about offering as many different type of connection opportunities as possible while also focusing on small group check-ins or one-on-ones.

It’s done by intention, and there’s a structure and a discipline to it. You need to ask a lot of questions and allow folks to share. Sometimes they just want to say, ‘this stinks,’ and you need to say, ‘I know,’ You need to listen and allow that moment.

I’m a very optimistic person by nature, which I think is a good thing for a chief innovation officer. But I know sometimes I have to listen and say, “I know it’s tough. It stinks.’ And give a moment not to focus on ‘it will get better,’ but to hold on to it a bit.

Part 2