Healthcare Horizons: Innovating for Impact

[00:00:00] Joy Rios: Hello there, and welcome to the HIT Like a Girl podcast.

[00:00:12] Britteny Matero: I'm so excited to be with you today.

[00:00:14] Joy Rios: Yes, I'm so excited that you're here. My name is Joy Rios. This is a show where we get to talk about the 30,000 piece puzzle of healthcare and health IT. It is a complicated world we live in, and each one of our guests brings their expertise on the piece of the puzzle to our audience.

So thank you for being here, Britteny. If you would take a moment to introduce yourself and let our audience know about your piece of the health IT puzzle.

[00:00:36] Britteny Matero: Yes. Again, thank you for having me. I'm Britteny Matero. I am a vice president with Innsena. We're a woman owned consultancy in the healthcare space, health technology.

And I'm here today to talk about maternal health, which is my personal passion.

[00:00:50] Joy Rios: Tell me more about what it is. First of all, you guys are a badass women owned organization. I just if people do not know about you, they should because you guys are making waves in so many ways. And I'm always floored and impressed by the impact that you all have.

[00:01:06] Britteny Matero: We are, I feel really privileged to be part of a team that is just, everyone is so passionate about this space and they really bring that into all the work that they do. And we really have the privilege of working with clients in a unique way where we become a little bit part of their team and we choose clients that are just as passionate about the space as we are.

So we work with health technology companies, health information exchanges, we're advising state agencies, we are in conversations with our federal partners, really looking at how do we move the dial on patient outcomes and support for the overall ecosystem of healthcare.  

[00:01:41] Joy Rios: You all are doing so much. So what are the things that you're most proud of? And I know you're here to talk about maternal mortality and that initiative, but I just want to give you a minute to talk about all of the ways in which you guys have been impactful.

[00:01:55] Britteny Matero: Thank you. I think that we're doing really cool things. So It was recently announced that we donated 100,000 to the Cancer Moonshot Initiative, which is an HHS and White House initiative, which is exciting looking at how do we reduce cancer deaths by 50 percent over the next, I think, 20 years.

That is exciting, right? How do we think about innovation in this space? How do we really move the dial for cancer patients to have better outcomes? So important work, right? So many of us are impacted. We've known somebody that's gone through cancer. We have gone through cancer, and we want to make a difference.

We want to do something that actually changes lives for the better. So we are doing that work. We're involved in some pretty exciting work right now with the ONC and SAMHSA around behavioral health information technology and an initiative that they have going on to really better the exchange of patient care and patient information, the collection of reporting.

And we are doing like some really cool stuff just around health data utility, health information exchanges. How are we supporting communities? How are we supporting women, minority populations, those that are disadvantaged? We love the Medicaid space, the public health space. So involved in lots of projects, lots of initiatives there.

[00:03:11] Joy Rios: Okay. Now for the one that you're here to talk to about today, tell me more.

[00:03:14] Britteny Matero: Yes. So we just announced. HHS had a racial equity and postpartum care challenge. We won the first phase back in 2020, and we were just awarded the phase two for it. So it's really looking at reducing maternal mortality and morbidity in black African American, American Indian and Alaska Native women.

And how do you think about innovation in this space and what can be replicated in other communities to have really great impacts in reducing maternal mortality? As we know, maternal mortality is on the rise, which is terrible and should not be happening. It was already in a terrible, it was already in a terrible space.

And then we, it just keeps getting worse. And in fact, today, the number one cause of maternal mortality in the United States is actually mental health. And we know that about 80 percent of outcomes related to maternal mortality are actually preventable. And we need to be stepping up and doing something.

[00:04:12] Joy Rios: Can we be specific about that? When we say mental health, what exactly do we mean?

[00:04:16] Britteny Matero: Yes. So we're talking about suicide. We are talking about drug overdose. So all the ways that women are trying to cope with postpartum depression, the changes in their body, the things that are around them and impacting their lives.

And they say that about one in five women have mental health challenges in the postpartum phase, which I think is probably very underrepresented, especially when you think about my personal journey in my maternity. And after I was sad. I was struggling with a new baby and the emotions and I would go and I would go in and they would say are you having suicidal thoughts?

No, I'm so excited about being a mom. No, I'm not like depressed and wanting to take my own life, but I am sad. Everything's on fire and you're, it's okay, it's fine. Everything's fine. And they were asking me questions that I don't think I ever really answered appropriately or maybe they weren't asked in a way that made me feel comfortable and safe enough to say yes, this is really hard for me.

[00:05:24] Joy Rios: And that is mental health, right? Oh, think about transitions. Any transition changes hard in like literally the transition of being pregnant to then not being pregnant. And you're, okay, and now I'm a mother. And you're just supposed to adjust. And now instead of taking care of yourself, you have a whole other being, and probably others, to take care of that can't be easy.

And the expectation that we expect women to just fit right in, and just be, okay, I know you just, I read that the equivalent of creating a baby in your body is like running 46 marathons. And then 24 hours later, you just did that and now you're expected to be of service.

[00:06:03] Britteny Matero: And get up. Are you ready to make dinner? You look great. Sure. You can do all the things that you normally do. And yes, like running a marathon. But then think about how many women today are now getting C sections, right? Because C sections are on the rise. A major surgery, that's a major surgery and you're not supposed to lift a car seat and yet women are scheduled to go in for follow up exams and they have to think about great, okay, I have to, how am I going to get there?

My husband's back at work. I don't have anybody to help me. I guess I will carry this car seat. And what if I don't have transportation? Now I have to figure out a bus. And a car seat there's just so many things. 

[00:06:40] Joy Rios: Be gentle through the whole thing. Just be gentle to yourself. And, can you imagine?

I'm just, I'm holding it together. Just sounds like the challenge of a lifetime

[00:06:50] Britteny Matero: And women are doing it and we should be supporting them, right? They always say it takes a village, right? And yet we more and more expect women to do it on their own. And they're trying to figure out how to be a mom, how to be a wife, how to have a career, how to do all of these things.

And and some of us are privileged in that we have great health insurance. We are able to pick a midwife that we want to walk through our journey with us, but then think about all of those that don't. And the project that we won the award for is in Nebraska and 35 percent of the births in Alaska, the women are on Medicaid.

There are so many things already impacting their lives. And we're expecting them to just pick it all up and keep going. And they're trying to figure it out. And about 40 percent now of women don't go to their first follow up appointment after having a baby. But think about that. At six weeks, you have your first follow up visit. Or are supposed to have your first follow up visit.

How many of us go back to work before six weeks, right? Many. And we can't just put our jobs on hold to go to an appointment. So all of these women are falling through the cracks. And then we wonder why are rates rising when it comes to mortality?

Or negative outcomes associated because there aren't the supports in place to make sure that a woman's journey is healthy, that she is supported, that she is connected into care and we're not meeting them where they need to be met either.

[00:08:24] Joy Rios: One of the things that crosses my mind is okay, you mentioned coping mechanisms and how many we all need to do better. But the coping mechanisms that we have, how important they are, but you're coping from a system that's been broken.

Instead, why don't we fix the system?

[00:08:39] Britteny Matero: Exactly. Why don't we fix the system? And why don't we think about there are many ways that are great for care. It doesn't have to just be one way, right? We don't have to only see an OBGYN. We can have a midwife. We can have doulas involved. There are so many paths to it being the right way and the right thing that is needed to support.

[00:09:01] Joy Rios: And there's so many things that are needed. So tell me what happens with phase two. What do you get to do? What solutions do you get to bring to the table?  

[00:09:08] Britteny Matero: The phase two award actually happened because so we started local. We started in Omaha back in 2022 with a couple of FQHCs with a hospital.

And what we did was we started making event notifications available to the clinics to be able to see when women who had high risk conditions, so hypertension, diabetes, SUD, substance use disorder, mental health challenges, when they had an emergency department visit. Because so often women go in to these emergency departments, have these visits.

Maybe they couldn't get in to see their primary care. Maybe they went back to the job, right? And they have all these things that impact, and now the emergency department is their primary care. And the primary care physicians don't know when that is happening. And we wanted to make it transparent so they could do all the wraparound care.

Oh, I see that you have needs. Let me help you and support this. And the case managers loved it at the FQHCs. They were, we've never had transparency into the data when women went somewhere else or had health needs. And so they were very excited and they started talking to their peers about it.

And so we were able to take it statewide as part of phase two. And so it now is in place across the state of Nebraska in the hospitals that sync health, which is the health information exchange in Nebraska. That is the State Dedicated Health Information Exchange, and they have it in the hospitals, they have it in the FQHCs, they are in other clinic areas, being able to bring this tool to them.

And then hopefully we'll start expanding it even further into thinking about how do we use it hook midwives into this? How can we maybe make this available for doulas and others that are part of the care team? How do we start to think about the social determinants of health side, right? It's not just about the clinic visit for a mom, right? It's about all these other things do they need help with transportation?

Do they need diapers delivered to their house to support them? I don't know. Do they have food insecurity? How can we help them there? And so expanding it even further to begin really supporting women in ways that they need to be supported.

[00:11:12] Joy Rios: I feel like you guys also have a really great understanding of the Medicaid, of Medicaid in general, and where it is lacking, where it needs to be built up. Can we talk about your expertise in that area? And can you help teach my audience and me on all of that? I would appreciate that. Thank you very much.

[00:11:28] Britteny Matero: So I mentioned that about 35 percent of women in Nebraska are on Medicaid, right? And these are women who are facing barriers with lower levels of income.

Not even to mention when we think about race and ethnicity and the challenges that are happening there. And so we're really trying to get upstream in Medicaid and start to think about the overall system of how do we think about whole person care and what does that look like and what do we need to do here?

And Medicaid is one of those spaces where there is so much opportunity to engage and start to think about health equity, start to think about, again,  those social determinants of health related social needs, all of the different pieces that really come together to impact and create better outcomes in the Medicaid space.

[00:12:20] Joy Rios: But I feel like if Medicaid in one state, Medicaid in one state.

[00:12:24] Britteny Matero: Yes, it is so different. Every state is different in the way they think about Medicaid, they roll it out. I'm sure many who are listening to this have seen the news about postpartum care has traditionally been covered under Medicaid only for several months.

And almost every state now has moved to actually cover it for the full 12 months postpartum, which is just fantastic. Yes, we should be doing this.

[00:12:49] Joy Rios: When yousay almost, who are the, who are we missing? We gotta shame them.

[00:12:54] Britteny Matero: I know we should shame them. And I cannot remember what that list looks like. So we will figure that out. We will shame them in the future.

But yes, there are still states out there that have not taken that step to do that. And so every state is different. Every state is different in how they decide that they're going to spend their money, what they're going to invest in. And so it's really working for each state within each state to recognize what are the opportunities? What are the barriers? How do we like move the dial?

[00:13:20] Joy Rios: And you guys have spent a lot of time in Nebraska, correct? Alaska as well?

[00:13:25] Britteny Matero: Yes. There's actually numerous states. So I come from the Oregon Health Authority. So Medicaid in Oregon and was involved in a lot of different work that was happening there around interoperability and public private partnerships.

And how do we do things in Oregon? But we're working in in Iowa. We have clients that are really all over the map now. Partnerships with CRISP and in Maryland and Connecticut and Vermont, all sorts of places where.

[00:13:55] Joy Rios: So think about the impact you guys have. That's incredible.

[00:13:58] Britteny Matero: It's really exciting. And it's a lot of work, right? And there are so many people, I feel like their intentions, they have such good intentions and they want to do things. We still need to see funding. We still need to see policy changes, right? And the way that states are told, yes, you can do work in this area.

I love some of the recent state Medicaid director letters that have come out around individuals that are, have been incarcerated and are being released. And some of the state Medicaid director letters around social determinants of health and how can you really think about leveraging Medicaid funding to really transform the space?

[00:14:37] Joy Rios: I'd love for you, if you don't mind, talking about, because you guys are women led and a team of powerhouses, it's just y'all are passionate and hard working and I don't know how you don't burn out. And speaking of coping mechanisms, how do you manage going full force on all of the things and also maintaining that momentum?

[00:14:58] Britteny Matero: I definitely think passion is part of it.

We truly believe we only hire individuals who are really passionate about this space, want to be in this space, want to make a difference. And I think that is something that we are very blessed to be able to do the other thing that we don't talk a lot about. But I think contributes to this is we work to give all of our staff 10 percent of their time to devote to a passion project of theirs.

So we encourage if you want to go and be part of different or it's our committees or you want to volunteer your time or you want to just research the area that you are passionate about, get involved in that. And we will support that. And that comes out of the time that you actually spend on the clock for our business.

Because we recognize that when you are tapped into your passion and the things that you truly care about, you will go harder, faster. You will be more willing to work harder on other things because you're getting to do what you love. And so we really encourage that in all of our staff.

[00:16:02] Joy Rios: But do you have any sort of limitations on what that could be?

You're, what if my passion is knitting? It has to be connected to healthcare.

[00:16:09] Britteny Matero: No, question. It definitely has to be connected to healthcare and we talk about it. And then we are able to bring that back internally as well. And so Melissa Danina, who is on our team, she's past passionate about incarcerated individuals.

And I know if I ever need to know anything, she knows everything that there is to know, and I can go and she shares what she's learning. And so there's a lot of really strengthening all of our subject matter expertise because we are sharing lessons learned with each other as well.

[00:16:38] Joy Rios: Is that formalized, the really cool model? Because it's one thing to be passionate and to have the opportunity to go follow that, but is it an expectation that you're going to share?

[00:16:48] Britteny Matero: It is. Yes. So we actually have OKR’s within our team about having a passion project and…

[00:16:56] Joy Rios: Those who don't know what OKR is. What is that?

[00:16:57] Britteny Matero: It's your initiatives. Your indicators, what you're tracking your performance by. So it's performance indicators.

[00:17:04] Joy Rios: It'd be interesting if “Oh, today's presentation on our passions” and everybody does a talent show of sorts.

[00:17:11] Britteny Matero: Yeah, we do. So we talk about it at our team meetings.

We have town halls. We have, we use Slack to communicate. It's our way to look around the cubicle since we all are remote. So we are constantly slacking on what we're learning, what we're passionate about, what we're working on. 

[00:17:30] Joy Rios: That's fantastic. So if some of them are interested in prison reform or that population, what are some of the other passions that people care about?

[00:17:38] Britteny Matero: We have an individual who is really passionate about reproductive health rights. We have someone who's really passionate about the SUD substance use disorder space. We mentioned I'm really passionate about maternal health. Our fearless leader, Kat, she is passionate about the opioid space. So lots of different passions.

[00:17:59] Joy Rios: I love what you guys are doing. I really do. I want to just say like congratulations on how far you have come and all that you have accomplished and I can just tell that the ripple is gonna just get bigger and bigger. And I love that for you guys.

[00:18:12] Britteny Matero: Thank you. We love it. And we also love the fact that we truly are about networking, lifting each other up raising all boats.

How do we work together? It takes all of us, right? To actually truly make a difference to see true change. It takes all of us. And we're so appreciative for your show and for what you're doing and for highlighting and championing women in this space who are doing incredible things. We need that voice.

[00:18:37] Joy Rios: I think more than anything, we have to challenge the status quo. We cannot do more of the same that will, we are going to be in trouble if we keep doing more of the same. We already are.

[00:18:47] Britteny Matero: Yes. And we need to be brave. And we need to it doesn't even have to be a big idea. Sometimes the small things make the biggest impact, right?

[00:18:54] Joy Rios: I love being able to share with people what you do matters. If you think it doesn't matter just start collecting evidence. And even if it's just right out your front door with your next door neighbor, that counts. You're making a difference. And it doesn't matter. People carry that with them and there is that ripple effect.

[00:19:09] Britteny Matero: I tell my husband all the time, I'm the biggest impact I could possibly make is actually with our kids. And if I can create two boys who are, love others and are passionate, then I've done my job.

[00:19:19] Joy Rios: And you're creating a good example for them too. So if people want to work with you, be inspired by you, connect with you, how would you direct them?

[00:19:29] Britteny Matero: Please get onto LinkedIn. Check out Innsena. You can check out my page, which is Britteny Matero. We have Kat McDavitt, Melissa DeNino. There's just so many of us in the organization. Come connect with us through LinkedIn. We'll return your messages. We will email you back. We'll get on the phone with you.

[00:19:47] Joy Rios: That's great. Thank you for everything that you do. I really mean it. You guys are amazing.

[00:19:56] Britteny Matero: Thank you. And thank you again for having me here today.

[00:19:47] Joy Rios: Thanks for listening. You can learn more about us or this guest by going to our website or visiting us on any of the socials with the handle HIT Like a Girl pod. Thanks again. See you soon.

Again, thank you so much for listening to the HIT Like a Girl podcast. I am truly grateful for you, and I'm wondering if you could do me a quick favor. Would you be willing to follow or subscribe to this podcast or maybe leave us a rating or review? Or if you're feeling extra generous, would you share this episode on your Instagram stories or with a friend?

All those things help us podcasters out so much. I'm the show's host, Joy Rios, and I'll see you next time.