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Becker’s Healthcare Podcast
Vimal Ramjee, MD, FACHE, Physician Executive, CommonSpirit Health, Division Board President-Elect, American Heart Association
00:15:09
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- [00:00]
A
This is Scott Becker with the Becker's Healthcare Podcast. I'm thrilled today to be joined by a brilliant physician leader. We're joined today by Dr. Vimal Ramji. And Dr. Ramji has had so many interesting roles in his professional career. He currently serves at Common Spirit Health. He's got a brilliant career and Common Spirit's one of our favorite systems at a tremendous faith based system that both does fantastic care and safety net care in a ton of states throughout the country. Dr. Ramsey, can you take a moment and introduce yourself and tell us a little bit what you do at Common Spirit? Then we'll talk about so many of the roles you've had throughout your career and what you're most excited about currently.
- [00:47]
B
Thanks, Scott. It's great to be here and I appreciate the introduction. I I'm a cardiologist and physician executive with Common Spirit Health. Common Spirit Health is one of the largest nonprofit health systems in the country. The system is comprised of about 140 hospitals and over 2,200 care sites that spans coast to coast, about 24 states. And we're proud as a system to touch the lives of about 20 million patients on an annual basis. I've been with the system for about a decade now, including through the merger that brought together two large Catholic ministries at that time in 2019, Catholic Health Initiatives and Dignity Health. Having the opportunity to serve through the merger has given me quite a practical view of what it takes to deliver care at scale, not only operationally and clinically, but also from a cultural standpoint, which, as you know, makes an incredible difference in the value that we can produce across the enterprise. Over the past several years, I've had the opportunity to work both at the market, region and enterprise levels, being able to partner with clinical, operational and executive leaders on enterprise, clinical governance, care design, responsible innovation. I'll tell you, doing this work for the system and within our markets has been quite rewarding. We were able to bring high quality care to extremely heterogeneous markets that represent urban, rural as well as safety net communities. And so this has really shaped how we think about access, you know, workforce sustainability, delivering meaningful impact at scale. Some of the things that perhaps we'll talk about in moments ahead.
- [02:45]
A
Thank you. And you've got this incredible background between Emory, Johns Hopkins, University of Pennsylvania, serving as the president of the American Heart association in your area for a period of time or maybe nationally Also, you've done a number of entrepreneurial things. Take a moment and talk about some of the interesting parts of your career or your professional life that you've enjoyed greatly.
- [03:09]
B
Yes, I've been blessed to be able to contribute to a number of different initiatives, both on the academic front, but also, of course, at Common Spirit, really delivering care to communities that are largely rural and in high areas of need, which has been quite fulfilling. And then as you mentioned, working with external organizations in governance capacities who have highly aligned organizational mission, really to bring better care, higher quality care, higher reliability care, and more and more safety to these communities that are in great need. And so I think the thing I've really enjoyed about this work is that, and especially now is that we're better together. And really what I've learned is that we all are in different lanes historically, but there's so much to learn from each other that really elevates the mission and strategy and approach that we all take in our own respective domains. And so I've greatly enjoyed being a voice and being an advocate for really the same mission that we're all on, which is to provide the best quality, most effective care for as many people as possible. And so it's been a journey that I'm blessed to have and just grateful to be able to serve in these different ways.
- [04:40]
A
Let me ask you an off base question for a second, if that's okay.
- [04:44]
B
Sure.
- [04:45]
A
We have. My sister's son, Justin, is about to start at Emory Medical School this coming fall, I believe. Is it a lot easier to get into Emory today than it used to be?
- [04:58]
B
That's an interesting question. I'm not certain that I can say with eye confidence, as this is probably a good amount removed from where I am currently just being in leadership and less in the academic arena at this time. But I would say in my conversations with those who are closer to academic organizations and with the medical schools, it's actually considerably harder. It's a highly dynamic time. I think there's a great amount of uncertainty about really well, what direction do we take for these young graduates from high school who are entering college and trying to figure out what they should be when they grow up, or as you mentioned, for those who have done such a great job at the collegiate level and are moving towards medicine? There's a fair amount of uncertainty, but I don't think it's necessarily industry specific. I think this is fairly broad. And what I would say it doesn't change the fundamentals, which is follow your passion and follow what you, what you really enjoy doing, where you see that you can bring the greatest value to humanity. And so I, I think that to answer your question, as far as medical school, I believe it may be more competitive, but certainly not, don't quote me on that one. I think, I think best to ask.
- [06:31]
A
I joke, of course. He's a brilliant, brilliant young man. So I, I just, it, it's, it's not my kid, so I could say it. He's my sister and my brother in law's son, but a brilliant young man. So though he gets a shout out for his admission to med school and how just what a terrific young man he is. So let me ask you, what are you most focused on and excited about coming into 2026?
- [06:54]
B
Yeah, I think that there are many things, as I mentioned at Common Spirit, you know, we're really dialed into our core mission which is delivering effective evidence based care to the communities that we serve as science scale. And that's a big part of our organizational strategy and it really informs everything we do, including probably the greatest area of focus right now, which is modernizing our digital infrastructure to allow for a unified interoperable patient record. And this really is foundational so that we can affect better care, so that we can gain better insights in terms of forecasting and predictive analytics. It affects every function for the organization from supply chain to finances to clinical. And so this is a key area that we're pushing forward with as a system in terms of priorities. Another thing that's top of mind for me, I would say just because it happened quite honestly, and is that we have just opened a new 64 bed, State of the art smart hospital in an area of the country that's an extremely high area of need in North Georgia. Exceptional prevalence of cardiovascular disease and of other chronic medical conditions that otherwise did not have high quality reliable care. And so in this margin pressured environment, I would tell you that we're quite proud of that at Common Spirit. We're very proud of that in the south region here and we're very excited to bring quite honestly, gold standard cutting edge technology to communities who really need it right now.
- [08:37]
A
Fantastic. And talk a little bit about in cardiovascular care, what's new, what's interesting, what's working, where are we moving the needle positively on cardiovascular care and heart disease?
- [08:51]
B
A great question. And I think that there's so much tucked into that. As you know, sustained margin pressure is the defining challenge of this era. From what I've observed. This is not cyclical and it's here to stay, Scott. I mean, you know, we've got reimbursement tightening, the cost of care is going up, we've got ongoing capital costs, but why this is important is because it really underscores the need for clinically led efficiency. So what I mean by that and what we've seen is that if we designed care to deliver the right outcomes at the right time for our communities, then EBITDA follows as a result of doing the best thing for our patients. One example of that is us pioneering a single nurse led program that has allowed us to deploy evidence based surveillance protocols for a number of life threatening cardiovascular conditions, including coronary artery disease, aortic aneurysms and valvular disease, to help thousands of patients. And this is really something that we're proud of because it allows us to deliver better care with high leverage and with minimal to no additional capital costs. I think the other part that is really working in cardiovascular medicine, but also I'd say just from a clinical broader lens, is in responsible innovation. As you know, at its foundation, this is predicated on providing effective, efficient and reliable care in ways that are not as capital intensive. And so there's many discussions going on about artificial intelligence. I can tell you as a clinician who uses AI today that it's not always necessary and we have to be judicious and thoughtful about when and where we use these solutions. I think a big part of that is they are dominantly subscription based software as a service model and therefore can accrue quite a bit of cost on a volume, click, scan or time basis. And so they have a tremendous potential to drive up health system costs, specifically the operating expenses. And so I think when we think about AI enabled solutions, not only from a cardiovascular service line, but also broadly in terms of clinical care, engaging multidisciplinary teams to pursue high ROI initiatives that are in alignment with the broader organizational strategy is critical. One thing we've been able to do is build one of the largest AI enabled cardiovascular CT programs in the nation. We're quite proud of it. Not only have we been able to achieve a large scale within the system, but tremendous value by running the program with operational discipline and demonstrating sustainability with healthy operating margins. And so this deep learning technology that we use very carefully and benchmark very cautiously is able to detect coronary obstructions, what causes heart attacks before a heart attack, and allows us to intervene with appropriate gold standard care before a major adverse cardiovascular event, so quite literally is saving lives. And we're quite proud of that as well.
- [12:17]
A
It's amazing that the entire footprint and what the common spirit system does is so impressive and so fantastic. Talk for a moment, Dr. Ramsey. You've had this fantastic Leadership career and a very innovative career. Talk a bit about what advice would you give to emerging physicians, emerging leaders, about having impactful and terrific careers?
- [12:40]
B
I would say that, look, I mean there's no shortage of challenges where we've got quite a lot of headwinds in health care. But I think that this really underscores an amazing opportunity to lean in and to learn and to be creative. I think probably one of the most important skill sets, particularly from a clinician leadership standpoint that I've observed to be of great value is in developing cross functional fluency now more than ever. Working across departments, closely with finance, executive leadership, supply chain, informatics all together, working as a team, truly and closely really is what I've seen to deliver incredible value on large scale initiatives when we're talking about health systems and even honestly on a single hospital basis. The second part that evolving leaders need to be thoughtful about is understanding leverage. As I mentioned, margin pressure is a defining challenge at this time. And so being able to think creatively and using the resources that we currently have, like in our single nurse led program that's serving care to 7,000, 8,000 people in our region, is something that's going to be necessary as well as a key part of strategic impact and growth at an organizational level. So understanding leverage, being able to think out of the box about innovation being more than just technology, innovation being more than just AI. As much attention and value as there is in AI, there are incredible ways to innovate with the resources at hand. And so I think challenging ourselves to do that. And finally, there's no shortage of challenges as I started with, and so dig in. I think the willingness to roll up your sleeves and solve problems, solve the inefficiencies that we're facing today is extremely valuable and something that continues to teach me new things every day in the work that I am blessed to do with this system.
- [14:50]
A
Fantastic. Dr. Ramsey, what an amazing career. I can't tell you how thankful I am for all that common spirit does to support our country's healthcare needs. Really remarkable system. Thank you so much for taking the time to join us this afternoon. We really appreciate it.
- [15:04]
B
Hey, thanks so much, Scott. I look forward to seeing you at the meeting.