OSU Wexner’s Hal Paz, M.D.: Pandemic Drove Innovations That Are Here to Stay
Last week, Hal Paz, M.D., executive vice president and chancellor for health affairs at the Ohio State University and CEO of OSU’s Wexner Medical Center, was recognized by Modern Healthcare as one of this year’s 50 Most Influential Clinical Executives. In a recent interview with Healthcare Innovation, Paz discussed his efforts to transform OSU’s health system and how the COVID-19 pandemic has accelerated advancements in research, clinical care and education.
Paz, the former chief medical officer at CVS Health/Aetna, said the pandemic highlighted our health system’s ability to innovate in a number of ways. The fact that the vaccine development happened so rapidly was due the foundation built by years of research in the field of genetics, in particular understanding the role of messenger RNA (mRNA), which is a key component of taking the genetic code and translating that into protein production inside cells, he explained. “That fundamental research was the key to creating a vaccine. It underscores the importance of ongoing, fundamental research, but a second component is innovating quickly. The pandemic has shown us over and over again that we do have this ability to innovate quickly, to pivot in ways that maybe in the past would have been thought to be very difficult and time-consuming. In fact, when the need is there, we can move forward very quickly.”
Academic health centers have played a central role in this because they are really all about innovation, he said. “We have enormous research infrastructure here at Ohio State Wexner Medical Center. I estimate that when we close this year, we will have had over $300 million in research funding, and enormous numbers of different research projects just in the area of COVID-19 — well over 100 different clinical research projects ongoing, and, and that research and innovations can then be translated into innovative and improved patient care where we can discover treatments and cures for diseases that hadn't existed in the past.”
Paz says the Biden Administration’s goal of creating a DARPA-like research agency for healthcare is a great idea. “We’ve seen the discoveries that have occurred with DARPA and making similar investments in healthcare now is really important. For the United States to remain competitive, globally in scientific progress and in biomedical progress in particular, these additional investments are extraordinarily important.”
Innovation in clinical care
If the vaccine development represents a success story in innovation, so does the shift in clinical care that OSU Wexner undertook to care for patients during the pandemic, Paz said. “We were able to quickly pivot in terms of caring for exceptionally sick patients. We able to quickly organize care delivery across central and southeast Ohio,” he said. “There are 40 hospitals across this region. Many are community hospitals, particularly in rural areas. We partnered with the other health systems here in the greater Columbus area to create a response to the pandemic. Particularly early on, when we saw the surge, we were able to coordinate our efforts to take over the convention center to create another 1,100 beds if they were needed for a level 3 surge. We were able to work with the community hospitals in the rural areas to make sure that if they had critically ill patients, for example, they could be transferred to the Ohio State Wexner Medical Center to be cared for in our intensive care units or to provide ECMO treatments. Today tragically, we're now doing a lot of lung transplants for those patients who survived COVID but suffered irreversible lung disease as a result. So the role we play in the region was only amplified and accelerated as a result of the pandemic.”
Paz said the telehealth surge that OSU saw during the pandemic is expected to continue. “We were doing 50 telehealth visits a month before the pandemic. Now we do up to about 3,000 per day, and I really don't see that changing,” he said. “When I came here two years ago, part of my plan was to transform a health system into a health platform. And central to that was this notion of using telehealth and digital health to drive care into the home — and that gets to health equity.” He said social determinants, behavioral determinants and environmental determinants of health are significant drivers of outcomes. “Many studies have found they make up about 40 percent of one's likelihood of dying of premature death or having poor health.” With two adjoining ZIP codes in the Columbus area, he added, the difference in in life expectancy difference is nearly 20 years.
“We've expanded our telehealth platform dramatically and we have digital solutions as well,” Paz said. “We're really putting more emphasis on driving care in the home, and trying to do as much as we can to keep people healthy in their homes or address their healthcare needs in the home, because we recognize that if we can do that successfully, we can create a personalized health experience and ecosystem of solutions beginning in the home that really address those social and behavioral and environmental determinants of health, where we believe we have the greatest opportunity to impact overall outcomes and to do as many things as we possibly can to avoid premature death and poor health outcomes.”
OSU recently announced a partnership with DispatchHealth, a provider of in-home medical care, as well as a joint venture with Alternate Solutions Health Network (ASHN). The ASHN deal will become operational by August 2021 and will be jointly owned by OSU Holding Corp., an Ohio State-affiliated entity and ASHN. A multi-disciplinary team will treat patients for many types of illnesses, injuries and conditions. This includes patients recovering from surgery, patients with chronic or acute conditions including cancer, older adults, and patients who require nursing care or rehabilitation services.
The innovation in response to the pandemic extends to medical education, Paz said.
OSU Wexner is building a new interdisciplinary Health Science Center, which is expected to open next year. “This is the physical place to do what we're working on programmatically. Ohio State is unique. We have seven health science colleges. All told we have 10,000 students in the health sciences. One thing I've been struck by is the fact that historically we've been training these students in their schools more or less in silos, yet we expect these graduates to work together in a hospital or clinic or in the home in interdisciplinary teams.”
Paz wanted to create interdisciplinary health science education early in the curriculum. “This year, about 1,300 of our health science students are involved in a service learning project on race and disparities in health care. Last year, they did it on opioid addiction,” he added. “It’s an opportunity to bring together students in medicine, nursing, pharmacy, dentistry, public health, veterinary medicine, optometry, and teach them how to create a common language because oftentimes, the different professions have their own language, and to teach them common care paths while they're in school, so that when they graduate, they have effectively learned how to be teams that can work across the spectrum so that we don't have doctors and nurses who are working alongside each other, but working on different pathways.”
He said that creating more seamless operations can allow health systems to start working on eliminating some of the waste in the system and then “repurpose those dollars to reinvest in the communities we serve around those social and other determinants that I mentioned earlier.”
