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Becker’s Healthcare Podcast
Transforming Cancer Care Delivery Through Strategy, Access, and Innovation with Nida Shekhani
00:15:10
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- [00:02]
A
The most important healthcare decisions don't happen in isolation. They happen when leaders come together. Becker's 16th annual meeting brings together more than 3,500 hospital and health system executives this April in Chicago. With 800 speakers from Ascension, Cleveland Clinic, Common Spirit, and more, the conversations get real. Leaders will share how their scenario planning for policy shifts brief, breaking through value based care barriers and building clinical teams that translate new ideas into real world care. Join top decision makers in the room April 13th through the 16th. For the agenda and event details, visit BeckersHospitalReview.com and click on the Events tab in the upper right.
- [00:45]
B
Welcome to the Beckers Healthcare Podcast. I'm Elizabeth Gregerson, a reporter here with Beckers Healthcare and I'm excited to be joined today by Nita Shakhani, Chief Strategy Officer and Deputy at Fred Hutch Cancer Center. Nita, thank you so much for being here today. I'm really looking forward to our conversation.
- [01:06]
C
Great, Elizabeth, it's my pleasure. As you mentioned, I'm Nidha Shikhani and I serve as a Chief Strategy Officer and Deputy COO at Fred Hutch Cancer Center. And I'd say my role really sits at the intersection of strategy growth and transformation. So the verticals I oversee include strategic planning, clinical business development, marketing, communications, government affairs, and then our commercialization and tech transfer office. Fred Hutch, for those that may not know, is an NCI designated comprehensive cancer center and one of the nation's leading cancer research and care institutions. And I'd say what makes us very unique is one our deep integration between breakthrough science and clinical care. We've pioneered bone marrow transplantation, we've been leaders in immunotherapy and cellular therapy. But also our work spans cancer prevention, infectious disease research and vaccine development. So when we think about cancer and strateg across cancer, we're truly thinking about the full continuum from prevention and discovery to treatment and survivorship and how we move innovation quickly from lab to patients.
- [02:10]
B
Perfect. Thank you for laying all that out. I'm always I love covering all the exciting news coming out of Fred Hutch. I'm excited to speak to you about it all. I'd love to know what you feel has been the most important initiative you've led or been a part of in maybe this past year. What did you do to kind of get it off the ground? What have the results been? Could you kind of give us a peek into that?
- [02:36]
C
Yeah. So Elizabeth, what what probably should have been, what I talked about is our three year strategic plan. So we are wrapping up our fiscal year 24 to 26 strategic plan and are actively working on our 27 to 29 strategic plan. And while that has been half of my time really thinking about how we shape future strategy across the organization, the other half of my time has been around leading enterprise wide transformation in a project that we're calling Project Redwood. Redwood is a fundamental redesign of how we deliver care. We're in growth mode, patient volumes continue to rise, complexity is increasing, margins are tightening, and our legacy operating model simply just wasn't built for the scale we've been in over the past couple years and the scale that we think we're entering. And so we realize that if we want to continue to lead cancer the way we have, our infrastructure has to evolve as aggressively as our science. We've named it Redwood intentionally, in case you're thinking about why. Redwoods, as you might know, are known for their strength and longevity. And that's exactly what this transformation is about. It's about building a more integrated, durable clinical model that can sustain growth and support our mission long term. So the key areas are access and scheduling, care team design, capacity management and revenue cycle performance. And truly the goal is simple but ambitious. It's around seamless access for every patient who needs it, while trying not to. And this is the hard part, put an additional burden on our care teams and create a more coordinated and sustainable experience for our care teams. We've had hundreds of people across the organization involved over the past, I'd say year, and our work up until now has very much focused on making some key decisions. We kicked off implementation last week, so it's very early to say what implementation is going to look like. And we're doing it in phases. So come back to me in a couple of weeks or a couple months and I'll tell you how things are going. But we are knee deep in implementation now. You know, ultimately Redwood positions us. The way we're looking at Redwood is it positions us to care for more patients and advance our clinical research mission. And it's about acting from a position of strength when we have the ability to do it now and not waiting for a lot of the external pressures that are here and maybe to come that then ultimately force that change.
- [05:13]
B
Absolutely. And I think, you know, even just calling it Redwood, right. Is such a visual example of kind of the foundation that you're building to last, right?
- [05:25]
C
I think I have a tree visual somewhere, Elizabeth.
- [05:27]
B
Yeah, I love that. I guess then you know that's kind of like the big picture initiative that you've just kicked off Are there any specific, maybe priorities or headwinds that you're focused on, you know, for 2026 as this begins to roll out?
- [05:43]
C
Yeah, so, you know, one is, I, I'd stay on that one, which is sustaining growth in a margin constrained environment. So, as I mentioned before, the demand for cancer care continues to rise. Our patients that are coming in are more complex, therapies are more advanced and costly, and our reimbursement pressures aren't going anywhere. So truly, what we are very much focused on is building our operational infrastructure in a way that allows us to expand access responsibly while also protecting our financial health to reinvest back into our system. So that's, I'd say on the clinical care side. Secondly, as I think many academic organizations are faced with right now, we're navigating the uncertainties in the research funding environment. So as you can imagine, the federal funding dynamics, the policy shifts, the broader economic pressures, they directly impact our ability to advance science. We've been very intentional about not making drastic changes or decisions around how we think about our science and the key areas that we invest until we have more certainty about the future. But as you can imagine, protecting our discovery engine is essential because truly, today's research breakthroughs are really what become standards of care. Right. And we're seeing that now as well. And so I'd say that's the other pretty significant area that becomes a topic of discussion as we're doing our strategic plan and as we're thinking about our budgets and our long range financial planning. And then the third for me is data and AI. We have so many initiatives across the organization around data and AI, but perhaps the most public one that folks might know about is our cancer AI alliance, which in the simplest terms, and this doesn't sound too simple, but truly in the simplest terms is a federated data model that enables us to analyze secure private and large amounts of data quickly. So we're spending a tremendous amount of time with industry and other peer cancer centers across the country with our cancer AI Alliance. We're also investing heavily in digital and analytic capabilities that allow us to move from more reactive to proactive care delivery. So I'd say the headwinds are real, Elizabeth. Funding uncertainties, capital constraints, regulatory complexity. But as you can hear, I also see enormous opportunity and we're actively working on some of those areas and those relevant, I guess, transformations to set up for continued success.
- [08:22]
B
Absolutely. And you know, when I listen to your answer, I'm just reminded of the other cancer leaders that I'VE spoken to just in reporting oncology and I've always gotten that sense that the headwinds you are facing, everyone's facing and even just hearing you talking about the AI alliance, how cancer leaders do have that mindset of like, we're going to figure this out together, like we're gonna like kind of move the, move our piece of the industry forward together. So I'm sure our listeners for sure will be able to relate to, to everything you said that you're facing. Speaking of facing things, it's a challenging question to ask, but it's always interesting to hear. Is there anything hard that you're anticipating you're going to have to do in your role in the coming year?
- [09:11]
C
Yeah. So now that we've moved to implementation last week, honestly I think the hardest thing will be driving meaningful change and doing it at scale and doing it quickly while we have the momentum. So we're in the middle of this major clinical transformation and as you can imagine, that requires asking high performing teams to work differently and often changing the way we practice in an area that isn't entirely broken but may just not be scalable for the future. Change is not unknown to healthcare, but change fatigue is real across healthcare. So the, you know, the first year of this, the hard part was making sure that we did the diagnostic appropriately and we were making the right key decisions. And now that we're in implementation, that almost seems like that was easier because transformation is exciting and it's hard and the decision making component is hard. But the hardest part about the actual transformation is disciplined implementation. And I think as we implement, it's also being very clear to so many people across the organization what we're solving for. And sometimes that means making tough decisions, making tough prioritization decisions, and also maintaining trust. I've spent a lot of time and the leadership of this transformation with me. We've spent a lot of time bringing people along with us being transparent about why we're changing. So it's not just growth for the sake of growing, it's growth for all the things I talked about to provide enhanced access to enable our clinical research engine to continue to be scalable in an environment that is volatile, but really being transparent about that and then showing people what success looks like and how it benefits both patients and our team. So really, I think as we continue down this path of implementation, I think that will be one of the harder things not just myself, but really hundreds of people within our organization are going to be working on over the next several months.
- [11:16]
B
Absolutely and you know, our podcast audience isn't just cancer leaders. They're across all specialties, you know, all offices within the executive suite. But I think what you said is something that's so relatable in the fact that change is hard. But really communicating that shared why and bringing people along with you, I think is just such a leadership kind of strategy that the healthcare industry seems to really be employing lately. As everything changes.
- [11:47]
C
It is absolutely critical. Right. To the success of projects like this.
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B
Absolutely. And on that same note, I'd love to hear kind of where are those best opportunities for whether it's change or just organizational growth, where are the places where you're seeing, you know, that momentum kind of takes shape.
- [12:07]
C
Yeah. So, you know, staying on the last piece of this around transformation, the first, I think truly is just expanding access and expanding it quickly, so getting patients in quicker and also being able to provide access to patients who don't have access to care. There are still too many patients who don't have timely access to subspecialized oncology care. So a big portion of our Redwood initiative is focused on access. But truly there are, we've been working on access for years. As again, to your earlier point of this isn't just cancer organizations across the country are working on ensuring that they are able to and we are able to get patients in as quickly and as timely as possible. I think the second and particularly as we're working on the strategic plan is integrating, is continuing to integrate our research and our clinical care enterprise even more tightly. So as a research driven institution, our ability to scale clinical trials is a huge differentiator. I think across the country we are seeing in many areas declining volumes of clinical trials for a variety of reasons. Some of it is what I talked about earlier, which is many of the things that were breakthroughs are now becoming standards of care and we're starting to see that shift a little bit. So growth in our clinical volumes strengthens that research engine and vice versa. So really being thoughtful about how that is done, I think is critical. And then the third, I will go back to AI because I do think it's such a big opportunity. You know, whether it's predictive analytics that optimize operations, to machine learning, that accelerates drug discoveries, to tools that support clinical decision making, we have to be willing to try, we have to be willing to be thoughtful, we have to be willing to fail. We are an excellent cancer center, we continue to be an excellent cancer center. But if we truly want to continue to and define the future of cancer care. We have to take risks in some of these areas and be ambitious but of course still be disciplined in how we're thinking about them and moving them forward. So a lot of the themes around the opportunities for organizational growth very much tied to what I talked about, but really with the idea of ensuring that we we continue to provide access to all patients that need it for cancer care, not just here in Seattle and the Pacific Northwest, but across the country.
- [14:37]
B
Perfect. Yeah, I loved, I think you said disciplined ambition. I think that's such a nice way to put it. Thank you again for joining me today. This has really been such an engaging and insightful discussion. So I just appreciate you taking the time to share your perspective with our listeners.
- [14:54]
C
It's been my pleasure.
- [14:56]
B
For those of you tuning in, you can find more episodes of the Becker's Healthcare Podcast at beckershospitalreview. Com. Thank you for listening. We'll see you on the next episode.