The Health Pulse

APRYL: Right now, there's a lot of uncertainty. And I think if we look back in our history, every time there's uncertainty, that yields tremendous opportunity.

ALEX: Apryl Childs-Potter joins us, president of the Nashville Health Care Council from Healthcare City, USA, one of the largest conveners of healthcare heroes out there. She invites us behind closed doors to hear the ways members are reshaping every corner of our healthcare system.

[MUSIC PLAYING]

Apryl, you have one of the most meaningful views in all of American healthcare as a community builder and convener in literally Healthcare City, USA, as it's called. As a consumer of healthcare, and then as a leader building this ecosystem, is there some tension in that relationship, do you view health as broken now in the way that you experience it? Or are we further ahead than some may say?

APRYL: Well, first, Alex, thanks for having me. And I appreciate the compliment. One, I certainly didn't build this incredible ecosystem. I just get the privilege of helping maintain it, nurture it, and make sure it continues to expand.

As the leader of the Nashville Health Council, I wake up every day thinking about how can we better connect the ecosystem of leaders not just in Nashville, but across the industry, to make sure that we have the best health system in the country. I think what's always interesting, when you sit in a seat like mine where you see, in some cases, how the sausage is made, you have a renewed understanding of how healthcare is really complex, but you have a really renewed understanding of just how complex things really are. And so I think being in this seat has been really eye-opening for me. And it's created a lot of empathy, in my view, because I see what I see every day is leaders who may have different incentives who all want the same outcomes.

But we have a system that doesn't always make it easy for everyone to achieve those outcomes, given their incentive alignment. So I think I'm very positive overall on the system because at the end of the day, a system is about the people that operate it. And I get to see the quality of leadership that continues to be cultivated, not just in our network, but really across the system.

Like a lot of things, our healthcare system is not perfect. But one of the things that I think makes it unique is that there's always opportunity for it to continue to evolve. I tell the story as a mom. When my daughter started elementary school-- I only have one child. I've never done this before.

And so I thought-- that the school spends the summer really thinking about every single child, like in healthcare, you think they're really thinking about every individual patient, and really curating a path that's going to be the best for her to succeed. And in reality, that's not how the education system works. It's not exactly how the healthcare system works either.

But where the discrepancy happens is that, in public education, there are fewer resources, even by the day. In healthcare, there is both private and public investment that makes it possible for more innovation to happen. And so from my seat, what I see is that there are so many smart people working constantly to think about how we can deliver care more seamlessly, how we can get to a place where care can be more individualized. And I think that's pretty inspiring.

ALEX: That's a great analogy. And two industries that sometimes are compared to each other, both on the cost basis too-- we've seen costs go up over the years. The ecosystem that you've created, you talked about the leadership.

And it certainly spans the broadest parts of the industry. You have health tech, legacy hospitals and insurers. You have value-based care, startups, medical device.

Let us behind the closed-door sessions that you facilitate a little bit. Are these people working together? Are they competing? Do you see the mergers happening? What happens behind these closed doors?

APRYL: Well, it's funny because I think all of that happens. One of the things that's really unique about our ecosystem, and the sort of culture that the Nashville Health Care Council upholds, is this idea of everyone having a seat at the table. Nashville's healthcare industry was really birthed from the hospital system model and how that expanded across the country, and in some cases, the globe. But what we have today is such a more diverse ecosystem.

We publish what we call the Nashville Health Care Council family tree every year. And it represents all the companies that have spun out from our members, from companies that started in Nashville, but have grown and grown. And we joke every year that we have to kill a lot of trees to actually print the full family tree because it's so expansive.

And I think what's really incredible about it now is that we are working now to create a sister publication of that that's an ecosystem map, to really illustrate there's not just health systems or behavioral health systems. There's health tech. There's increasingly more medical device and technology-- wearables. There's the investment piece. We also have the education piece represented in our network.

So there's a really full spectrum of the healthcare industry all woven together. And we really work at the council to try to what we call "seat the table" with diverse perspectives. So in our programming, you'll frequently see certainly big, what we call "ballroom events," where we bring a lot of people together and they're listening to a panel discussion or they're getting to hear someone talk.

But what we do increasingly, and I think exceptionally well, is the curated table-setting. We have several programs like our Nashville Health Care Council Fellows program, intended to put together cohorts of individuals that are intentionally representing different sub-sectors of health care, to have meaningful conversation and dialogue about some of these big issues that are either opportunities or real challenges in the industry. And we really work to curate tables where people can have a common understanding.

What I find a misnomer is that folks that maybe even work in the health care industry often think that leaders that are from different sub-sectors don't want the same things. Yes, sometimes their incentives are aligned differently. But what we find is, when we put leaders from the payer side and the provider side or the education side in a room together, they often have very common goals.

The lens that they're looking through is just very different. And so we try to work really intentionally around creating dialogues and spaces for dialogues so that people can find that common ground. And we think that really benefits the whole ecosystem.

ALEX: You mentioned the fellowship program, some smaller curated events, big events. What does the Nashville Health Care Council calendar look like? What are the ways that the audience here can get involved?

APRYL: Yeah, so the Nashville Health Care Council releases its engagement calendar typically in September of the previous year. So somehow, we're already coming up on that fast and furiously. I think it's 96 days away from one of our biggest events, which happens at the end of September.

And so the way our calendar is created, it's really based on what we call our "leaders at every level" strategy. And that means that there are engagement points for leaders at every level of health organizations, starting from those first-time people leaders and managers, all the way up to the CEO. And we produce a calendar every year with over 180 opportunities to engage at different levels with the appropriate audience.

And so our biggest convening of the year is open not just to our members, but to the public. And that's Nashville Healthcare Sessions. It's a convening of about 1,200 executives, happens in Nashville in the fall. And it was designed by the healthcare industry leaders, CEOs of health companies, to really be an industry-led place where folks that are doing business in healthcare can come together and really talk with decision-makers, and executives about the big challenges and the opportunities and the model of business in healthcare, and how we continue to move that forward.

That conference happens September 29 and 30. But there are activities all across Nashville that entire week that people can engage in, even if they don't come to the conference. And so tickets to that are available to the public in a limited number starting July 7. It sells out every year the past two years, so we anticipate, again, a sell-out crowd this year. That's a place where even individuals who aren't part of the council network can engage with what we do, because there are public tickets to that event.

The council itself is a membership-based organization and membership is at the company level. So companies invest in the council, and then their leaders at every level have access to our incredible programming. So there are lots of ways to get involved at the company level.

There's also another individual entry point with our Leadership Healthcare program. That program is designed to offer a suite of engagement opportunities to first-time up to mid-career leaders in health. And it's really aimed at trying to shorten the length of time it takes for people to enter the industry, and to become really knowledgeable about how it works and how the ecosystem works together. We find that the earlier in someone's career in healthcare, we can help them understand the full scope of the ecosystem-- not just the lens that they see through, like we talked about earlier, the better they can be prepared to lead and manage the complicated industry that is healthcare.

So there are lots of opportunities for people to get engaged with the council. We are Nashville-based, but our companies are, in many cases, very large and operate across the country. About 30% of our member companies don't actually have an operation in Nashville, but they find our work and our convenings powerful enough to make time to come to Nashville to participate throughout the year.

Lastly, we do have some online engagement opportunities. This year-- actually, just next month, we are launching an executive forum series that is a roundtable group that will be partially virtual, that will allow small groups to gather around topics at different points throughout the year. And we also have some other programming that's virtual as well.

ALEX: I love the more than 180 convenings now, and you're launching new ones. So there's not enough reasons to get out to Nashville, sounds like.

APRYL: Well, we want to continue to add value to our members. And we think that our team wakes up every day thinking about, what do we need to help move the industry forward? And we're very member-led. And so we've heard from our members, they value the networking opportunities, but they also really value those touch points where they can connect in smaller groups. And so we're really working to ensure we're offering that breadth and depth in our calendar.

ALEX: I'm really worried about listeners and viewers the rest of this session. As you said, the Nashville sessions sells out. And so I think we're losing people rapidly that are running over to the website to sign up.

APRYL: Well, nashvillehealthcaresessions.com Get your tickets while you can.

ALEX: You've made it to the speed round. So we've got some fast-paced questions for you. The first one is going to be, you're the tour guide in Nashville and we come to visit you. Where is the one place you take people?

APRYL: Oh gosh, so that's really tough because Nashville has an incredible food scene, and I love to eat. And so I would typically say a restaurant. However, I think Nashville has such a unique cultural component.

I think Nashville might be the only city in the country where people come to visit and get costumes to do so. So if you're walking down Broadway, you're going to see people in cowboy hats and boots. And so if you want the real Nashville experience, I think you have to go to Broadway.

My recommendation is a little off Broadway. It's Category 10, which is the home of the former Wild Horse Saloon. They do free line dancing classes out on the dance floor that are very accessible and super-fun. And it's really a great way to experience that core Nashville tourism culture that's fun, and I think a little bit tongue in cheek, but exciting way to get to experience the city.

ALEX: Sounds like we'll be seeing our favorite health leaders out on the floor at Category 10. That's exciting. What's their favorite app or most used app on your phone?

APRYL: Oh gosh, this is embarrassing. So I'm a bit of an efficiency nerd. And so I have an app on my phone that our team uses called Align.

It's designed to help us keep our priorities in check, and so I'm on it a lot, just looking to see how things are moving along in the organization, making sure that I'm doing the things on my checklist. I love to check the box that I did the thing I said I was going to do today. So it's Align.

I think the other one that I use a lot, that's maybe a little more fun is the New York Times Games app. I'm a big fan-- I know everybody loves Wordle, but I love Spelling Bee and the Connections game. I like to do those daily to just keep my brain working in a little bit of a different way.

ALEX: Super fun. Night or morning person?

APRYL: I'm 100% a morning person. I like to be in the 5:00 AM club, getting up early, doing my New York Times Games and thinking about my day. If it's past 8:30, particularly on a weeknight, I'm probably already asleep. So not very fun on the weeknights really at all.

[CHUCKLES]

ALEX: The Broadway trips are fewer and far between.

APRYL: I go to Broadway at 11:00 AM on a Saturday or Sunday.

ALEX: I heard that's the real social scene, so I think you're doing it right.

APRYL: That's where all the fun happens.

ALEX: Mountain or beach?

APRYL: Oh, mountains. My family spends time in North Carolina in a little town called Montreat outside of Asheville every year. And so I joke that when my daughter graduates, we're going to be remote from the North Carolina mountains, for sure.

ALEX: You said 30% of the Nashville Health Care Council is outside of Nashville. The actual Nashville Health Care Council might be outside of Nashville, sounds like. Go-to workout.

APRYL: Oh, gosh. So right now, I'm really into something called Pvolve, which if you remember Jennifer Aniston from Friends, she invested in this fitness company that is aimed at low-impact fitness. And they're quick 20, 30 minute workouts that you can do with or without equipment. And I find them to be really energizing.

ALEX: This question pairs well with your favorite workout-- your favorite ice cream flavor.

APRYL: Oh my goodness. My favorite ice cream flavor is vanilla. I think it's underrated. I will try other things. But I always I think vanilla, one scoop and a regular cone on a hot day, is just perfection.

ALEX: Is there a certain brand? There's vanilla snobs out there. It's got to be a certain vanilla.

APRYL: No, I'm not I'm not that picky. I don't eat ice cream that often, so I'm not that picky. Now, honestly, I'd prefer an ice cream sandwich, like an old-school ice cream sandwich to an ice cream cone. So that's my preference.

ALEX: It's an excellent call, until I've seen the pictures making the rounds on social media of how ice cream sandwiches don't melt.

[LAUGHTER]

APRYL: I haven't seen those. I might need to check that out.

ALEX: Yeah, it's concerning.

[CHUCKLES]

Last question in the speed round-- your dream vacation. Or where's next on your bucket list?

APRYL: Oh my gosh. So we just got a direct flight to Iceland in Nashville. And so that's my next vacation bucket list item. Last year, my husband and I took our daughter to see Taylor Swift in Liverpool because we couldn't get tickets for the concert in the US. And we spent some time in the UK, but also spent time in Ireland.

And it was my first trip there, and I would go back to Ireland in a second. Lots of just beautiful terrain. Other than driving on the wrong side of the road, it's a pretty perfect place to visit.

ALEX: How fun. And yes, I heard the concert tickets are as hard to get to as the Nashville Sessions tickets.

APRYL: Exactly, very similar to a Taylor Swift Eras concert tour ticket. That's how hot they are.

ALEX: All right, we're going to shift. So talking about global travels and global trends, obviously, AI is everywhere on the main stages at conferences, probably in the back room conversations as well. How do your members prepare for this AI-enabled world, or are some of them starting to prepare for an AI-taken-over world?

Or do you have any dissenting voices? Are there people that are like, that's not for us or not right now? Is this a wave that everyone's getting on?

APRYL: I think it's a wave everyone's certainly getting on. I don't think there are any dissenting voices. Here's the reality, Alex.

I think the biggest challenge I hear consistently-- certainly, there are geopolitical things now that are maybe a little bit more pressing. But other than that, workforce is one of the biggest challenges our industry faces. And we don't see that changing anytime soon.

So I think a reality is that, whether we like it or not, this technology solution, what AI gives the industry, is a solution and a path forward to be able to take care of patients in a way that is going to be scalable. So I see, really, all of our members, if they haven't already embraced AI and begun to make those investments, they're talking about it for sure. You'll hear me consistently say that I think Wall Street has underestimated estimated how much the healthcare industry is focusing on technology investment. I certainly see it across the board with our members.

There is a real effort to figure out, one, how we can take burden off the clinician, so that we can remove that administrative burden so that they can focus on actual care delivery. And then you're also starting to see a little bit more opportunity to actually have AI pair with some clinical diagnosis or clinical suggestions that we don't think is going to scale. It's not going to replace the human, but it certainly can assist. And I think you're going to see some of those technologies continue to scale.

One of the things that we see, particularly across our hospital and healthcare system members, is that there are hospitals or facilities earmarked to focus on innovation. And so there are already models in place-- there are already parts of our systems that are scaling these technologies, figuring out how they can be used and applied without that additional burden to the clinician. And we're seeing a lot of success in that.

So I don't think that AI is going to completely take over. But I do think we're going to see perhaps unprecedented speed at which it's going to be adopted. And I we're going to wake up one day and feel like it happened overnight. The reality is that this has been happening for years, and we're just seeing the acceleration of it now.

ALEX: Workforce is certainly something that comes up a lot in healthcare conversations, both from a clinician and physician care team standpoint and from a population standpoint. We're getting older while living longer and while sicker, and so certainly a trend we see globally. You talked about how your member organizations are planning for this, how they're using technology.

How about at the Nashville Health Care Council? How are you building your teams using technology? What's the leadership philosophy there?

APRYL: Sure. Well, my general leadership philosophy in this role and has always been that I think there is so much potential in people and systems. And so I focus on trying to get the very best out of the people that we bring into the organization. Technology is a supplement to that.

And so I mentioned the Align app, for example, earlier. We use a lot of different technologies to try to make ourselves more efficient. What are the administrative components of our jobs that we can take out so that we can spend more time actually talking to our members and understanding the challenges they're facing, the opportunities, who are the connections they need to be able to move their businesses and organizations forward? And so we think a lot about incorporating technology from the efficiency side to ease burden on our staff in the same way that you would in a healthcare organization. It's a little bit different purpose, but the same concept.

And then we also think about technology from the perspective of how we leverage it to make our member experience better. And so we've made quite a few investments in our tech stack in the last couple of years to just find ways to make the registration process, the enrollment process, the connection process much more seamless for our members. So you'll see the Nashville Health Care Council continue to leverage technology.

And then I think, as the halo of that in our region with Nashville, Oracle made a big investment and announced the relocation of its headquarters to Nashville last year. And that was really because they wanted to be proximate to this healthcare industry ecosystem that's so strong here. And I think the next step of that is, Nashville's technology base is going to continue to grow, because we're going to continue to see that domino effect of more and more technology companies coming here. So as more technologies are proximate to us and those companies are here, we're going to have more resources, we're going to have more access, we're going to be exposed to more things. And so I think we'll continue to see both the council and our members engage with technologies across their companies.

ALEX: I love the core belief in the potential of people. I think that's such a great starting point. And then the layering on of technology, and the things that you have around you to improve your life and make it easier on the leadership team, I think, is an awesome story. You said you didn't, but I am going to tell people that you created Nashville Healthcare City and that you brought it together.

Another trend that I'm going to say that you started is health districts. You have experience there. The future of cities-- you talked about big anchor institutions coming or starting and how that takes shape.

The Healthcare City-- how do you see that being replicated across cities, potentially? And from an economic development standpoint, health outcomes, just thriving life, you've had your hand in this for a little while. I'd love to hear your thoughts on how cities shape around these health organizations.

APRYL: Yeah, well, I'll just give you a little bit of background. So my healthcare background is I started in the medical device marketing world. But my real passion has been around economic development.

I've always been interested in how cities operate, how they grow. And one of the things that I've learned in that work is that you have your big stalwart US cities that have had strong economies, our entire lifetime, mostly. But you have these smaller cities.

Like Nashville, if you look at Nashville 25 years ago, is a very different economy. And the economies like Nashville's that have grown really successfully in the last 20, 30 years have really done so through this really clustered approach to economic development. And so in Nashville, it was the healthcare industry.

Certainly, we're known for tourism and we're known for the music industry. It's called the Music City. But it's this power of health care and the companies and the volume of operations that are located here that's really helped accelerate the economy. And if you pair that sort of approach, which is why the council was founded, to think about how we continue to grow that ecosystem, that cluster of health care companies in this region, if you expand that out to health itself, you've got a really interesting concept. And so what you're seeing more in Nashville now is, not only do we have these healthcare companies that are businesses that operate to deliver care to people.

You also have incredible universities that are training the next generation of clinicians and healthcare executives, and you're seeing more of those two sort of sub-sectors working together. So you have industry here really informing what is being taught in the classroom. And you have industry sharing what clinicians need.

You're seeing a lot more of that connectivity. 20 years ago, someone who went and got a medical degree really didn't get any line of sight into how the business of health is operated. Now you're seeing more of that education walk alongside, so that a doctor can understand how the economics of their industry works. There's a lot of power in that.

And then if you layer on top of that, there are organizations here in Nashville-- ours is called Nashville Health, that are working to try to improve the health of the population that lives here in Nashville. So you have a lot of companies that operate in Nashville, but they may not actually deliver care in Metro Nashville. But they have expertise about how the system works.

You're marrying that now with the local population. And you're seeing organizations like Nashville Health leverage the healthcare knowledge here to do ZIP code-specific interventions to see can we reduce hypertension in this particular ZIP code. And it's that sort of mentality of, when you have a really strong industry cluster, finding ways to create connectivity. That really accelerates a region.

And so when we think about what we can learn from what's happened in Nashville, I think cities-- Raleigh, obviously, is one. There are many across the country that have strong populations of both healthcare workers, but also healthcare companies and healthcare education. And when you start to marry those things together and create opportunities for leaders in each of those subsets to work together, I think it creates a snowball effect.

You start to improve the health of individuals. You start to train physicians in a way that they understand how the industry works in a more dimensional lens. And then you also have insight coming into the business side of things about what it looks like at the bedside, what it looks like in the community from an actual health perspective. I think there's a lot of value in that approach.

ALEX: We all just received a master class in city planning and city growth. And I love how you tied together the healthcare aspect, the health aspect, the education aspect, and how it all is interconnected and works together. It's really important, really exciting. I think all of us want to attract you to our city so that you can build from there.

But it sounds like we will get some of your members and membership through you to be able to help build us where we are. I think I can answer this question a little bit, or I can predict your answer based on the optimism that you've shown throughout this. But what makes you optimistic for a healthier future?

APRYL: Oh, gosh. Well, I mean, I think that's probably what you'd predict I'd say. But I think I'm inspired daily by the kinds of people and the level of conversation that we get exposed to, and that I get exposed to from my seat. I very rarely walk away from a conversation deflated because I hear so much opportunity in the vision that individual leaders and leaders of companies have and what's possible in the healthcare system.

And I think right now, there's a lot of uncertainty. And I think if we look back in our history, every time there's uncertainty, that yields tremendous opportunity. So I think right now, I'm incredibly optimistic that, as we ride the waves of uncertainty right now, the other side of this is going to be some really incredible innovation, and I think some acceleration of moving things forward that we've tried to do for a long time.

I think there's value-based payments. There are all kinds of sites of care, lots of things that we've been working on-- not we the Nashville Health Care Council, but we as an industry, have been working about working on and thinking about. And some of the disruption that's happening now is going to accelerate the adoption of those things, and things that we don't even know about now. And so I'm really optimistic about what's ahead.

ALEX: So exciting, and so excited that we're all joining you for Nashville Healthcare Sessions. And right after on a Saturday morning, we're joining you for a scoop of vanilla ice cream at Category 10 and some line dancing. We can't wait.

APRYL: Fantastic. Bring your cowboy boots and your hat.

ALEX: Apryl. This was so much fun. We learned so much. So appreciative of your time and talent and energy and expertise.

APRYL: All right. Thank you so much, Alex.

ALEX: Thank you so much for joining us. We can't wait to grab a vanilla cone with you. If you'd like to join us as a guest, or if you want to leave us a comment, please email us The Health Pulse podcast at sas.com. See you next time.

[THEME MUSIC]

[BEEP]

Just a high-efficiency operation over here.

[BEEP]

There's got to be at least a blooper. Do you want a blooper?