Jayme Ambrose: The Maslow Effect

Show Notes

Meg speaks with Jayme Ambrose, CEO of Adobe Care & Wellness, an innovative healthcare solution company that focuses on customizing programs for insurance groups, providers, hospitals, and families.

Meg and Jayme discuss Jayme’s background as a psychiatric nurse and workers compensation case manager; Adobe’s focus on social determinants and proactive care; the inverse relationship between quality of life and health costs; health access for the rural community; Adobe’s “human touch” mission; their app, Maslow; the “Nurse Mindset;” and much more. 

About Jayme Ambrose:

Jayme Ambrose is CEO of Adobe Care & Wellness, an innovative healthcare solution company that focuses on customizing programs for insurance groups, providers, hospitals, and families. Adobe Care & Wellness germinated from a class project for her doctorate, in which Jayme created a holistic and integrative healthcare model. In 2021, Jayme received Phoenix Business Journal’s Health Care Heroes Award for the Innovator category.

Prior to launching Adobe Care and Wellness, Jayme was the Vice President of Clinical Services at The Beech Group. She is a member of the Case Management Society of America and was previously a board member. Jayme is also an active member of the Arizona Nursing Association. Jayme holds a Bachelor of Science and Master’s of Science in Nursing from Arizona State University, and a Doctorate of Nursing Practice from Case Western Reserve University.

Further Reading: 

Adobe Care & Wellness

Maslow’s Hierarchy of Needs

HEI

Health Current, AZ

A Woman of No Importance

Episode Credits: 

The Game-Changing Women of Healthcare is a production of The Krinsky Company. 

Hosted by Meg Escobosa. 

Produced by Meg Escobosa, Calvin Marty, Chelsea Ho, and Wendy Nielsen.

Edited, engineered, and mixed by Calvin Marty. 

Theme music composed and performed by Calvin Marty. 

©2022 The Krinsky Company

Creators & Guests

Host

Meg Escobosa

Meg Escobosa has 15 years of innovation consulting experience, focusing on the unique challenges of healthcare since 2012. For The Krinsky Company, Meg leads client engagements overseeing advisory board design, creation and management. She also leads industry research, expert recruitment and trend analysis to support corporate innovation initiatives centered on the future of healthcare. Her background in innovation and strategy consulting began at IdeaScope Associates where she was involved all aspects of strategic innovation initiatives including understanding the voice of the customer, industry research and aligning the executive team to invest in promising strategic growth opportunities. Meg received her BA in Latin American Studies from Trinity College in Hartford and her MBA in sustainable management from the pioneering Master’s degree program, Presidio Graduate School. She is also on the board of a non-profit foundation focused on researching and developing technology to support a sustainable society. She lives in San Francisco with her husband and two teenage daughters.

Producer

Calvin Marty

A man of many hats, Calvin Marty is a Podcast Producer, Editor, Engineer, Voice Actor, Actor, Composer, Singer/Songwriter, Musician, and Tennis Enthusiast. Calvin produces, engineers, edits, mixes, and scores The Game-Changing Women of Healthcare. Calvin is also the creator of the 2020 podcast, irRegular People, among others. Find his music under the names Calvin Marty, Billy Dubbs, Nature Show, and The Sunken Ship. Over his long career as an actor, Calvin's has voiced many Radio and TV commercials for a wide-range of companies and products and has appeared in small on-camera roles on shows such as Chicago Fire and Empire.

What is The Game-Changing Women of Healthcare?

The Game-Changing Women of Healthcare is a podcast featuring exceptional women making an impact in healthcare today. We celebrate our guests’ accomplishments, setbacks, and the lessons they've learned throughout their careers. We dig into the many healthcare issues we face today and how these innovative leaders are working to solve them. Join host Meg Escobosa in conversation with some of the many brilliant, courageous women on the front lines of the future of health.

Jayme Ambrose: If we're able to get in that home within seven days. Make sure that their doctor's appointment make sure that their medications, but most importantly, do they have enough food? Are the utilities paid for? Are they safe in their home? That reduces that readmission rate. It goes down to 7%. If we help them with their quality of life, then those costs that you're paying to hospitals and skilled nursing facilities. Those costs go down. Because they're living better lives. Come on. Let's stop treating the disease and start caring for the people.

Meg Escobosa: Hello everyone, and welcome to The Game-Changing Women of Healthcare. I’m your host, Meg Escobosa. Today, I'm looking forward to talking with Jamie Ambrose, the CEO and founder of Adobe Care and Wellness in Phoenix, Arizona. Hello Jamie, welcome.

Jayme Ambrose: Hi Meg, thanks for having me.

Meg Escobosa: We are just thrilled. This is such a cool organization you've created. Would you mind sharing a little bit about yourself, your background, how you got into this field?

Jayme Ambrose: Absolutely. So I've been a nurse, actually, for 40 years. Prior to getting into Adobe, I had a very varied and interesting nursing background. So I'm not what you would call a typical nurse. In fact, my grandfather would always say to me, “when are you going to be a real nurse?” because I didn’t work in a hospital. I started out, actually, as a psychiatric nurse. I did psych nursing for 15 years, and then I moved to workers' compensation case management, because I had worked with a psychiatrist whose motto was, “We are all crazy. Just some of us have jobs”. So when I got my first work comp job, it was for the, at that time, the world's largest distributor of fresh meat.

So I worked with meat packers for another seven years. And in that time I was working with injured workers and identifying that one of the big barriers that they had in returning to work is they didn't have enough resources that we're allowing them to recover. So what I did was I created, at the time, I called it a Holistic Case Management Program and I would go into the home and I would make sure that they had food, that they had transportation to get to their doctor's appointments, and then we focused really on getting them back to work and light-duty positions as quickly as possible. So really focusing on that mental health component too. And so as that happened, then we were able to reduce workers' compensation costs for the company. And then I moved to Arizona so that was kind of the beginnings of where Adobe's concepts came into play was looking at each individual from a holistic perspective.
And then once I moved to Arizona, I went back to school and in my doctoral program, my partner and I, we put together a program that was the basis of Adobe and sold it in our business course. And in doing that, that was the beginning of what is now Adobe Care and Wellness.

Meg Escobosa: Wow, congratulations. I mean, to come up with something in school and then to be able to bring it to life, in reality. is amazing.

Jayme Ambrose: Absolutely. Yeah. It's awesome because so many people will say to you, “Well, what did your doctorate benefit you?” and so I have the ability to say, “This is what my doctorate benefited me. I was able to create a business from it.

Meg Escobosa: and, and benefit the community, right?

Jayme Ambrose: Absolutely. Yeah. Our mission at Adobe is to positively impact the lives we touch and that's what we focus on every single day.

Meg Escobosa: You know, it's so funny that you went right there and I appreciate you doing that because I was going to call that out specifically because it's a beautiful mission. You've also said that your company provides both technology and the human touch in order to proactively care for patients. So maybe, can you explain what you mean by that? And the importance of proactive care and how Adobe Care and Wellness operates. How do you strike a balance?

Jayme Ambrose: Yeah, absolutely. And it is a balance. So what we've been able to do, from a technology standpoint, is develop tools within our software development that allow us to do risk stratification. When Adobe started, it was about how do we reduce hospitalizations? And at that time, the main idea was, well, we just make sure that they get to their doctor's appointment and they get their medications filled. And from our standpoint, looking at the social determinants that they have food and that they, you know, their utilities are on and all of those kinds of things, but it was all done on the back-end, right, once the hospitalization occurred, but as we've moved deeper and deeper into the coordination of care, what we've identified is that we have to be able to stop that hospitalization from ever occurring.

So what we identified is that 80% of the reasons that people are hospitalized or that their chronic condition becomes acute is related to a social determinant gap. They can't afford their meds. They can't get to their doctor's appointments. They don't have money for food, all of those issues. So let's identify those at greatest risk, address those issues first. And that's where the technology comes in. We get the data from the insurance plans that we partner with. We run it through our risk stratification tool. We identify those top individuals and we start contacting them prior to anything happening and in doing so, we're able to identify that 9% of them don't have enough money for food. 9% of them have issues paying for their meds. 11% of them don't have transportation to get to their doctor's appointments.

So we resolve those issues and how we resolve those is we then use that human touch. We send someone into the home. We do a full assessment. We look at all of the barriers to them being healthy and we reduce those risks. And in combining those two, we're able to absolutely prove that if we improve the quality of life, we decrease overall health costs. And that's the brilliance of it. And it's so simple, right? It's so simple. It's like, let's not keep throwing all these dollars into other issues other than making peoples’ lives better. And that's really how those two, how that human touch in that technology piece combine.

Meg Escobosa: It is beautiful and sort of elegant what you described. The issue of finding those people to provide that human touch - I'm sure there's some challenge there. I know that there is a great shortage in nurses. Who are the case managers, how do you find great people? Is that something you've got some good insight about? And how to do that? (7:52) I mean, or are you like everyone, we’re all challenged with this issue.

Jayme Ambrose: Well, this has been obviously the first year that we've been as challenged.
So we have a team of nurses, we have social workers, we have what we call care navigators. They’re medical assistants. We use registered dieticians, and then we have nurse practitioners. So all of those individuals are part of that integrated care team that surround the patients as their needs arise, and depending on what their needs are. And this year has been our greatest struggle with actually hiring, not the RNs where we're not having as much trouble with the RNs as we are with LPNs and medical assistants. That's really our greatest shortage right now.

Meg Escobosa: Do you think technology can help in that area either to compliment or allow you to hire people with different skill sets that maybe aren't the traditional candidates?

Jayme Ambrose: Absolutely. So from a technology standpoint, that's really our human touch piece. There's really no way to take that one out to replace it. Yeah, we can't do that, but what we are doing is we're offering a program that if you're not a medical assistant, but you have good customer service, you come work for us and we'll pay for you to go to MA school, and we'll pay for you to get through MA school and we'll put you in a different role until you're done with that. And that will allow us then to continue to feed ourselves moving forward. So we are doing that.

We have obviously used a lot more telemedicine than we did prior to COVID, which has been a huge benefit, not just for us, but obviously for the patients as well. We've been super surprised because our population is generally the senior population. You know, they have smartphones and they are able to use them. And you know that even though they're not technology natives, that it's clicking and it's working very well. So that's been a huge bonus as well, especially because our niche is the rural communities. And here in Arizona it could be, they live an hour away from anything. So that's that's been very positive as well. So we have used technology in that way to fill some of those gaps.

Meg Escobosa: For those of us that are living in a city, it's just you, we forget just how significant it is to be able to deliver care in the home like that through the computer. Connect to professionals, help that person to not feel isolated. So that's great.

In terms of, you know, psychiatric nurse background and this work that you're doing, how much does mental health care play a part in what you guys provide? Do you address mental health issues? And what's interesting is to think about you being a psychiatric nurse well before we probably had a broad appreciation for the mental health challenge that everyone addresses. So can you just describe a little bit about the mental health needs of your population and how you guys are tackling that?

Jayme Ambrose: Sure. Absolutely. We have always addressed the mental health issue. One of the assessments that we do on everyone is doing a measurement for their level of depression. And so we're always looking at that. Obviously, during COVID, those rates of depression went up significantly. And you know, one of the biggest issues that the rural senior population deals with is isolation, loneliness, which leads to depression. And then there's a direct correlation to depression and hospitalizations and non-adherence to, you know, your care plan, all of those kinds of things play into that. So it's absolutely significant for what we do.

Our social work team works diligently to get them into mental health services, and then we have what we call a tele-well team that will call individuals on a daily basis or a weekly basis. However often, just to chat with to help decrease that isolation, you know, “How's your puppy doing that? Did your grandchildren come and see you?” and then also, “Hey, did you take your blood pressure today?” and, “Did you remember to take your meds and how much have you eaten today?” And all of those things all play into that. So it's crucial to what we're doing. And we also then have events where we work with the senior centers and other community organizations in those counties where we're doing health fairs and sending out invitations to everyone to get everybody to come in and it also then gets them to recognize, “Oh, that senior center is really not that far from me,” you know, that that barrier may not exist. So we're doing all of those things as well, but absolutely there, that connection is essential and we want to make sure that those issues are addressed at all times.

Meg Escobosa: Oh, that's great. You, I think, gave your IT team a challenge to develop a solution to help solve some of these issues. Can you describe how the new app, Maslow, was created and what it does?

Jayme Ambrose: Absolutely. It's an amazing thing. I work with a group of very talented millennials and we always banter back and forth. Cause I'm the boomer and they're the millennial. And, you know, we have that conversation, which is a lot of fun, but I asked them to create a resource tool in our EMR that would just basically, if the social worker was in the home and they said they needed resources, that they would find the closest ones. And what they absolutely did was they went far above that.

They created our app called Maslow. And what Maslow does is it asks 13 questions related to social determinants, and then geo locates the closest resource to that individual to help them resolve that issue. So here's the closest food bank, here's the closest opportunity to help get your utilities paid. So what we have done now is taken Maslow, it's on a QR code. It now sits in a lot of the rural primary care doctor’s office so that they can take it from there. If we're unable to contact someone who's on, you know, someone we need to get ahold of, we then text them that QR code because at least let us help you. If you don't want to talk to us, at least use Maslow if you're at risk. And so we're gathering all that data to see what outcomes we can come up with, but we're very, very excited about it. To our knowledge, there's nothing else out there like it. So we're super pumped to get it into as many communities as possible.

Meg Escobosa: Congrats. I can appreciate that. Having a tool like that for the user. Maybe there's some shame it in some of this experience of realizing like I don't have enough food, this is just, you know, I'm at this point in my life, how could this be? It's not a good experience and it's something you don't really want to talk about. So I can imagine that being able to use a tool like that to help myself provides some level of dignity to the experience. Is that what you think is an element of why it's being successful and being used?

Jayme Ambrose: I think that number one, you know, you're doing it on your smartphone or you can do it on a tablet when we are in dialysis centers, the social workers are right there with them, and they'll help them fill it out. I think the biggest issue too, especially with the senior population, to your point, is I'm ashamed that or I'm embarrassed that I'm at this place. But they also don't know that resources are available that could help them. And so there's that lack of knowledge, that barrier that exists. And once we're able to help them identify those and it changes their lives, improves their quality of life. It's a huge, huge impact for them.

Meg Escobosa: Can we back up just a bit to better understand your path into nursing. I know it sounds like you had a conversation with your dad. Can you tell us why, when and why you got inspired to pursue nursing? Was there something that sparked a passion or a personal experience?

Jayme Ambrose: Yeah, well, my aunt was a nurse, but she was a surgical nurse, so she was a real nurse compared to what I was. So, I really, interestingly, I really thought it was going to go to law school and in my senior year, I was caring for one of my brothers. They had scraped their knee or something and I was cleaning it off and putting a bandaid on it. And I thought, “Wow, this is really cool. I think I'll be a nurse instead.” So that was that, that was the path that I took and I have never, ever regretted it. I really am very passionate about being a nurse. It's kind of a joke between my spouse and me that I think like a nurse. So, you know, if there's something going on and that just becomes who you are, and I've had such a beautiful career because of being a nurse. I mean, so many fabulous opportunities to do so many different things. It has just been a wonderful path.

Meg Escobosa: I mean, tell me more about this mindset of a nurse, you know, what is it that, how do nurses think? And I imagine you guys have to be really prepared, anticipate things. What else?

Jayme Ambrose: Big thing, I'll give you the perfect example. So Pat was sick and I was taking notes on, you know, just on my phone, I was just writing “on this day, she was sick and there were the symptoms. And on this day she was sick and these were the symptoms.” And we went in to see her doctor and the doctor said, “Well, how are you feeling?” and she said, “great.” And I said, “no, no, no, no.. That's not true. These are the, these are the issues.” And she was very, very upset with me and her friend who was also a nurse said to her, “but that's how nurses think they're always looking for trends. They're always analyzing the data. So they're going to take the symptoms to see what happens next.”

And so that's how nurses think. It's always about problem solving, right? It's like this symptom might mean this, but maybe it means this. So I have to gather more data to be able to do it. And so that's how I think.

Meg Escobosa: It's a secret-weapon skill.

Jayme Ambrose: It is a secret weapon. So just know that if you're walking down the street and you have a little limp, a nurse might see you and she's going to watch you walk to then identify, “hm, what's causing that limp. Is it her hip, is it her knee? Is it her ankle? What's, you know, what's going on with that?” So just know you're always being watched, Meg, the nurses are always watching you,

Meg Escobosa: That's great. I'm reassured by that, honestly.

Jayme Ambrose: Absolutely.

Meg Escobosa: Before nursing, what was one of the hardest or weirdest jobs you've ever had that
taught you something valuable?

Jayme Ambrose: Well, interestingly enough, I never had any other jobs. I was a nurse's assistant when I graduated from high school, and I went from that job into nursing school. So the only other, I mean, it wasn't a job. It was how I grew up, I grew up on a farm. So, you know, we had cows and pigs and horses. And so it was kind of idyllic and that, so taking care of animals was part of my job.

So which could have absolutely led to, you know, the caring component. My niece is in vet school. Definitely growing up on a farm gives you an appreciation for life itself. Right. You see, we saw puppies born and baby pigs and all of that kind of stuff, and just the beauty of watching corn grow and listening to the corn fields talk at night and all of those kinds of things, you know? And I think that's the piece of it that adds to why we do what we do.

Meg Escobosa:What is a risk that you have taken that maybe didn't work out and what happened? What did you learn from that experience?

Jayme Ambrose: Well, I, obviously, when we first started, when I was working prior to purchasing Adobe, it was with another company and we had a contract and we, that contract went away. And when that contract went away, I had to lay off a bunch of people. And that was probably one of the most difficult times in what I've been doing.

What I learned from that was so much in relationship to most importantly, being sure that we're utilizing the data that we have to tell a good story, right? To be sure that our worth is always acknowledged because we're telling the story, not just from the, :Hey, we did this wonderful thing for this patient,” but also here's what the data is showing that we've done and, and the impact that we've made based on, you know, our touch points and all of that. So that's what has made me even more in love with data is being able to take that experience and then change how we do what we do.

Meg Escobosa: So would you say that is informing how you work today. I mean it sounds like that’s what guide you.

Jayme Ambrose: Absolutely. We have an awesome data analysis team and we meet on a weekly basis. And so if you think about this, we've been gathering data, in relationship to all the assessments that we do, in relationship to claims, and relationship to zip codes and gender.
And so all of those things, I mean, millions of data points. So. We're able to sit down and say, “okay, what happens if we do this to this population? What does that outcome look like?” and so we've just done a really deep dive into that whole readmission issue. And what is the number one thing that stops that patient from being readmitted. And what we found after looking at all the data is that if someone is in that home within seven days, if we're able to get in that home within seven days, make sure that their doctor's appointment ,make sure that their medications, but most importantly, do they have enough food? Are the utilities paid for? Are they safe in their home? All of those things are looked at, and that reduces that readmission rate by 7%. It goes down to 7%. If we're in there within 14 days, it goes up to 14%. So it doubles. So that's just one, one example of the data that we look at.

Meg Escobosa: Yeah. The experience you had, where the contract went away.
I'm sure that was just humbling and challenging as you described. How did you find the confidence to take on the challenge on your own and sort of build up this business on your own?

Jayme Ambrose: Because I always believed that it would work. I always believed in the theory of what we were doing, right. It was just give us this opportunity and start off with a small population and we will show you
what we can do. And that started out…our first contract was a very small contract. Our very first year we had 12 employees, one small contract. We're now at over 160 employees. And, you know, we have several contracts and it was just again, proving, proving the theory, right? This is what we say we can do. Let us prove it to you and continue on.

And as we've grown, The number of programs that we've created and how we do things [00:26:30] continues to shift, but that innovation and that drive on how we do it better just keeps happening. Right now, we've got two pilot programs going on to see how we can impact a diabetic population. And so it’s just always using that technology, but also that human touch and the skills of our staff to see what other differences we can make.

Meg Escobosa: Have you observed [00:27:00] anything in terms of, over the years, how clients, your customers, so the insurance companies, other people that you're doing business with, have you seen a change in how they're think in terms of what they expect and have you learned what to look for in a good customer?

Jayme Ambrose: Absolutely. One of the most interesting things that has happened is our largest insurance plan that we work with is, you know, in the rural areas. And what they've done is–from a benefit standpoint–is that they [00:27:30] now provide. They now provide utility support. So they help pay for utilities there. Their over-the-counter booklet now includes not just band-aids and aspirin, but other items that are essential.
And so we've seen them understand and begin to understand and really embrace that these social determinants are crucial to being addressed in order to [00:28:00] improve the outcomes. So that's been amazing. They're a fabulous partner. And whenever I meet with them, I always thank them for allowing us to, you know, bless lives with their money.
So it's a win-win for both.

Meg Escobosa: Yeah. Yeah. Nicely put. How has your leadership style evolved over your career?

Jayme Ambrose: Pretty dramatically, I would say I've always most often been in leadership roles. And, [00:28:30] when I got out of school I was called the Little general, you know, because I was very…

Meg Escobosa: That speaks for itself.

Jayme Ambrose: Yeah, I was, you know, I was very: “We're going to do this and that,”
and, one of my favorite quotes is Winston Churchill, who said, “If you're not a rebel at 20, you have no heart. And if you're not a conservative at 40, you have no brain.” So I've become far more conservative [00:29:00] in, or not conservative, but really just engaging with others. And I think too, the other piece of that is as you become older and you are in a leadership role, your role shifts to one of being a mentor and a guide, not so much as the person in charge, right?

So here's my idea. You guys figure out how to make it work. And obviously. They do a better job, you know, a vision that goes [00:29:30] beyond mine. And so I think that's, that's really the crucial, the crucial piece is creating that trust in others and ensuring that they share your vision and growing with them. And that's, that's really, that's the biggest piece and it's great. It really is. It's, it's an awesome, awesome way to live.

Meg Escobosa: It sounds also too, like the burden is not completely on your shoulders alone, that you, you share it with your team and your team [00:30:00] sounds like they readily take it and work with it and carry it forward.

Jayme Ambrose: Absolutely. Absolutely.

Meg Escobosa: What advice might you like to give your younger self? When you look back on the path you took, might you have tried anything different?

Jayme Ambrose: I have thought about that. And I think the biggest thing that I would want to tell myself is to always know that I was loved. Because that makes risk-taking less frightening. And it also [00:30:30] allows you to become who you really are. You know, if you as you can own that piece to know that you were loved before you were born, then you are, you're just more willing to engage with the world as a whole and to walk through any door because you're not afraid, right. Whatever, somebody's got my back and I'm going to do this.
And I think that that is probably, [00:31:00] what I would want my younger self to embrace far more than I did in my youth.

Meg Escobosa: Yeah. I can relate to that myself. What do you do to recharge just for fun, after running this business? What restores you?

Jayme Ambrose: We do a lot of things. I mean, we travel, obviously we're looking forward to being able to travel more, now that, COVID is…I don't know if it's going away, but it’s doing whatever it's doing. [00:31:30] And I read a lot. I go to the gym.

Meg Escobosa: What are you reading? Are you reading anything spectacular?

Jayme Ambrose: I read a lot of history. Um, and right now I'm reading a book called A Woman of No Importance, which is the story of an American who led–an American woman–who led the French resistance during World [00:32:00] War II. So it's a really interesting book.

And we have six grandchildren, so that keeps us super busy, watching them grow and being engaged. The older ones are in a rock band and the younger ones want to go to the zoo. So yeah. You know, it's yeah. Again, it's, it's a lot of fun.
We enjoy our family.

Meg Escobosa: Is everyone kind of nearby? Is everyone in the area or do you have to travel to see them?
Jayme Ambrose: [00:32:30] No. So all of our kids, all four of our children live in Arizona, so they're in and out of the house at all holidays and all of that.

Meg Escobosa: That's awesome. What innovation accomplishment or impact in healthcare are you most proud of?

Jayme Ambrose: Oh, absolutely, I would say this [Adobe Care & Wellness]. This has been the pinnacle of my career. Just the ability to grow something from very [00:33:00] small to substantial and to sustain it. That's the ongoing issue that we continue to focus on is the sustainability. But also to take every day and create something new. And that's the beauty of it is to say, “okay, this is how I want to do it today and see if this works.” And, and because it's, you know, mine, I can do that within, within reason.

Meg Escobosa: Of course. [00:33:30] You're not a general anymore, right?

Jayme Ambrose: There's not a ton of bureaucracy that's going to stop me from, or not me, but just anyone within the company from doing something and, and having that openness to be able to do that. That's what keeps it all going, that creativity.

Meg Escobosa: Can you talk a little bit more about the experience of bringing this idea to life? Just from a market acceptance perspective?

Jayme Ambrose: Yeah. That's an ongoing struggle. It really is. It's an ongoing [00:34:00] struggle. You know, one of our biggest goals is to be in another state so that we can show that this just isn't an Arizona model, but then it's another model.

So we've met with, uh, several states now, other plans in other states, and continue to talk with them. And it's just, “This is what we can do, give us the opportunity.” And it's a very slow, slow process because you're shifting how healthcare is [00:34:30] delivered. Right? You're saying, “Look, this is really what needs to happen.” And “Well, we're used to just paying the doctors and we're used to just paying skilled nursing facilities and hospitals, and that's what we're comfortable with.”

So it is that ongoing shift and what we're really hoping is through the ongoing utilization of Maslow we can gather even more data that substantiates, you know, not just what's told by [00:35:00] census bureau or nationally recognized that the seniors live in poverty.

I mean, you know, that's, that's a proven data point, but that if we help them with their quality of life and help improve their quality life, then those costs that you're paying–to hospitals and skilled nursing facilities–those costs go down because they're living better lives. So that's, that's really the push, that's the push of, of what we are focusing on.
That's the innovation piece to [00:35:30] create that revolution in healthcare, you know? Come on. Let's stop treating the disease and start caring for the people.

*Music*

Meg Escobosa: You know, I was thinking like we are paying–what?-- 20% of our GDP is devoted to healthcare costs. And of course, some of that is the innovation costs. I mean, that's just the innovation happening in the space, but it's really the trend of rising costs of care. We have to change. Hopefully this is the moment. And I think you're right: now that we've got this data, the role of social determinants–where we live, our economic status, how much disposable income we have–all of those things impact our wellbeing.

And so the idea that you are approaching it with a clear solution and resources to address it holds a lot of promise. It's very [00:36:30] exciting. And do you think it is replicable? Are there policies that are preventing wider adoption or are there other structural barriers that we should consider tearing down to make it easier for solutions like yours to be more readily used?

Jayme Ambrose: The main barriers are really a mindset. You know, I think that's the biggest barrier. I think that, you know, obviously the rural areas are those areas that are the greatest in need, [00:37:00] because not only do you have–as you talked about–where you live: well, if you live in a rural area, there's not going to be a specialist closely available to you.

There may not be those additional resources. So that's another huge barrier. You may not even have good internet. Right? You, you don't have access to that. That's another, another barrier.

And so the ability to create, as we've done, a solution that is [00:37:30] specifically focusing on those rural communities–is it replicable? Absolutely. Absolutely. It is. And the more that we innovate processes and the more that we're able to have data analyzed and all of those things that play into it then creates that level of clear focus of what is it exactly that we need to be targeting. You know, not that individuals are widgets. I'm not saying that. But that [00:38:00] you have that clear ability to say these are the things that we need to do.
And these are the top problems that we need to address. And that's what we're going to continue to work on and focus on.

Meg Escobosa: You know, people feel good helping others. You know, we get so much more out of giving to others than getting something new ourselves. You know, more money for me makes me feel better. But actually me giving away that money is known to [00:38:30] be more positively benefitin my mood, my feelings, my attitude, et cetera. So I would think that people being involved in this kind of organization, being able to participate and help their community, I would think that there's just a lot of high motivation to engage in that kind of work.

Jayme Ambrose: Absolutely. And once we get people hired–you know, the difficulty right now is getting them hired–once we get people hired those that work with the patients, their [00:39:00] longevity exists. Because they do have that whole feeling of, “I did make a difference in this patient's life.” Right? “I did make a difference.” And each one of our case management meetings starts out with “give us some positive stories,” you know, so that those are shared.

And we talk about those at all of our meetings is, you know, “give me, give me a story of, of what has happened and how I felt that [00:39:30] impact.” One of the things that we say, well, “if you leave, we know you're going to come back” and we've had people, we've had people do that. So, um, you know, it's not just urban legend and that it is a blessing. It absolutely is, you know, that you're able to make that impact in someone's life. And we talk about how, you know, it's a ripple effect. You're this pebble that started this process. So you improve someone's life, then they're able to look at their lives and then [00:40:00] they're able to look outside themselves.
So then they're able to do something else. So it does create that cycle.

Meg Escobosa: Yeah, it strengthens our whole social fabric. It strengthens our country…You know, I think about this a lot: young people that are growing up in poverty, they don't have access to all kinds of things. And if they aren't taking care of themselves and physically well, it sounds so simplistic, but it just makes me angry to think about young people who don't have what [00:40:30] they need to be strong and vibrant and engage in school and, and it just plays out. And so to think of older people isolated at home, disconnected…

Jayme Ambrose: Oh, absolutely. Absolutely. And that's really, if you look at it, that's the premise of Maslow's hierarchy, which very simplistically says, well, if you're not safe, and you don't have food and all of that then how do you, how do you [00:41:00] have a sense of belonging? You can't get to that point.

So that's the whole point of: Let's address those two barriers first, and then you increase that. And then they can feel a part of the community and they can feel like they're worth something to their family and all of those pieces all play into it. So if we are able to do that, even for a fraction of the population, it does create that shift. [00:41:30]

Meg Escobosa: Yeah. What gives you the most dread or hope–you can go either way–as you think about the next five to ten years in healthcare?

Jayme Ambrose: I try not to think about dread, right? I'm always looking at: What are the possibilities. And I think that I truly believe that healthcare is continuing to shift.

One of the positives that has come out of COVID is all the innovation of “how do we [00:42:00] touch people that we were never able to touch.” So the increasing Telemedicine and, and the increasing in different types of reach, reach out and all of those things that were happening and how do we continue to do that?

And think that that is happening. A perfect example is we with a group of specialists, um, nephrology group, and I said, well, “how often do you ask your [00:42:30] patients if they have enough money for food?” And then: “Well, I never thought of it, but I should.” Right? So those kinds of things I see happening.

And so I have a great deal of hope that how we deliver care is going to change dramatically and the innovation in technology and AI and all of those things are going to impact you know how we do business and in a very positive way, I feel very good about that.

And [00:43:00] the other piece of that too, is, as I said, I work with a young crowd.
I work with millennials and they’re embracing of how it should be different and their willingness to step up and create those innovations and to engage with that senior population is also awesome. Because, you know, somebody's got to take care of us, right? So we need to be sure that they're engaging and they want to do that.

And so [00:43:30] that's, that's also, you know, they, they have beautiful hearts and so their willingness to do that is also a great hope as well.

Meg Escobosa: I wanted to ask you just about healthcare data, how do you manage healthcare data? And what opportunities and/ or threats do you see as a result of the massive amounts of health data that continue to be generated everyday?

Jayme Ambrose: That's probably–the massive amounts–that really is the issue for us. I mean, big data is everywhere. And one of the [00:44:00] struggles is “Where do I start?” Right? So what we have done is we've started very simplistically and we've spent this whole quarter really just looking at retrospective readmission data.

And now what we will be doing next is starting to correlate that data. Right? So correlate it with–as we talked about–level of depression, correlate it with lack of food or, all the different data points [00:44:30] that we can pull out of our system to then identify what happens next.

The issue is we're a small company, so we can look at it from a very simplistic standpoint.
Doing that deep dive for others is I think very difficult because it's again, where do you start with it? The other issue that we deal with is that we do get reports, you know, from our contracted [00:45:00] entities and they're not a hundred percent accurate, right?

We just had this conversation. So, this person is pulling the report from this data point and this person's pulling the report from that data point and the two reports don't match. And so that's another issue. And then the other issue is we're part of the Arizona HIE. So we get data from them. But then there's that [00:45:30] variable of: but this hospital doesn't report it in a timely manner or this hospital only reports this information and not that information.

So again, you're not getting clean data. So we have a ways to go with how we manage data from a whole health system standpoint. And then just from our point as well, because clean data in means clean data out. But if you can't get the clean data in then… [00:46:00]

Meg Escobosa: It's useless.

Jayme Ambrose: It's useless. Exactly.

Meg Escobosa: What do you believe are essential ingredients to innovation?

Jayme Ambrose: I think number one, you have to be willing to take risks. You have to also always be thinking outside of the box or not believe that a box even exists.
It's really taking that idea and, and doing that. What is the wildest thing that you would love to see happen and then narrowing it down to a place where it's engagable? That someone could actually utilize it. If we could do what we would love to do, it would be so much [00:47:30] more, but it would not be sustainable or cost-effective, or, you know, all of those things that play into it. And never saying “That's not going to work,” or “We tried that before.”

Oh man, those are the worst words in the human language when it comes to innovation, right? It's like, yeah, well maybe we tried it before, but we didn't try it this way. Or we should have tried it with this twist or, or whatever. And so always being open to that and acknowledging [00:48:00] that creativity in places you wouldn't expect it to be. That's the other piece of it. That anybody can create, can produce that idea. That's going to change things, even if they don't have this title or that degree, or, or whatever.

Meg Escobosa: Wow, I feel like you should be a member of the team because, you know, I, my career has been in innovation and one of the very first things I was taught was: everyone is creative. There are [00:48:30] not creative people and non-creative people. It's like, we all have the capacity for creativity and innovation as the first belief, you know, the first…square one.

And then the other thing that you mentioned, which we really believe in too, is that you really have to envision the wildest dream.

So what is your wildest dream?

Jayme Ambrose: Oh, my wildest dream would absolutely be that this model of care becomes THE model of care for [00:49:00] healthcare in the United States. That instead of getting a prescription for a medication that may or may not work, I get a prescription for free fruits and vegetables. You know, that I get a prescription for a quality of life that allows me to live as healthy as possible. I mean, that, to me, is what we should be doing for everyone.

Meg Escobosa: It's been really wonderful to talk with you, Jamie. Thank you for making the time.

Jayme Ambrose: [00:49:30] Oh, absolutely. I appreciate the opportunity. It's been wonderful. Had a great time.

Meg Escobosa: Thanks for joining us for The Game-Changing Women of Healthcare, a production of the Krinsky company. Today's episode was produced by Calvin Marty, Chelsea Ho, Wendy Nielsen and me, Meg Escobosa. This podcast is engineered, edited, mixed, and scored by Calvin Marty. If you enjoy the show, please consider leaving a rating and review [00:50:00] wherever you get your podcasts.It really does make a difference. And share the show with your friends and colleagues. If you have any questions, comments, or guest suggestions, please email me at [e-mail]. And you can visit on the web at https://www.thekrinskyco.com.