Harrison Healthcare: The Practice You Imagined │ Cherry Live!

Harrison Healthcare is the next generation of comprehensive personal and family healthcare service created by Don Copeman, the founder of the Copeman Healthcare Centres.

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About the Event

Join us for a conversation with Don Copeman - Founder of Harrison Healthcare, Chris Nedelmann - CEO of Harrison Healthcare and Dr. Beth Donaldson - Family Physician & Medical Director at Harrison Healthcare.  Learn about how Harrison Healthcare is creating a compassionate, people first culture and practice.

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Objectives and Discussions

• Why Harrison Healthcare was created
• Day in the life of a Harrison Healthcare employee
• Problems Harrison Healthcare is solving
• How does collaboration enhance solo practitioner practices
• Mental health epidemic
• Technology (AI) and its impacts
• The future of Harrison Healthcare
• Culture and job opportunities

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More Resources:

LinkedIn: https://cherryhealth.co/linkedin

Facebook: https://www.facebook.com/cherryhealthinc/

Instagram: @cherry.health

Twitter: @cherryhealthinc

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Have questions? We want to hear them!

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Transcript

Speaker Identification:

[Host]: Alitta Tait

[Speakers]: Don Copeman, Chris Nedelman and Dr. Beth Donaldson

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Alitta: Thank you for joining us for today's episode of Cherry Live. Cherry Live is our podcast series where we meet with innovators and leaders in the healthcare space to discuss topics that matter to healthcare professionals. Cherry Live is brought to you by Cherry Health, Canada's medical network. I am very excited about our conversation today where we will be joined by members of Harrison Healthcare to discuss their vision and purpose. If you're interested in learning more about Harrison Healthcare, you can check them out on Cherry Health or on their website. So today we are joined by Don Copeman, Chris Nedelman and Dr. Beth Donaldson. Don Copeman is the founder of Harrison Healthcare. Don is an experienced healthcare and information technology executive with over 40 years of parallel experience in each field. In 2005, he created Copeman Healthcare, the first private family healthcare organization in Canada. It grew to become the largest in the country with four major clinics in Western Canada and began earning recognition by Deloitte Canada as a best managed company in 2013. In 2011, Don designed and directed the Engineering of Care Book, one of the world's first universal personal health records for patient self management and interprofessional collaboration. This became a cornerstone in Copeman Healthcare's vision to bring important health data and technology to patients to assist them with therapeutic lifestyle change. Chris Nedelman is the CEO of Harrison Healthcare. Chris is an entrepreneurial and execution driven healthcare executive with over 25 years of healthcare experience. He empowers leaders and creates collaborative, people-first cultures that drive accountability and strong results. Chris joined Copeman Healthcare in 2007 as the general manager of its Calgary operation and was promoted to the role of chief executive officer in 2012. He shepherded the company to recognition by Deloitte Canada as regional best managed company in 2013 and 2014 before achieving the prestigious national ranks of Canada's best managed companies in 2015. Under his leadership,Copeman Healthcare was named one of Canada's most admired corporate cultures by Waterstone Human Capital in 2018. Chris has focused on bringing this outstanding culture to Harrison Healthcare. Dr. Beth Donaldson is a family physician and a medical director at Harrison Healthcare. Beth is passionate about personalized preventative healthcare while empowering clients to attain their health goals. She believes wholeheartedly in collaboration with internal and external clinical providers. To ensure the most efficient care possible for her clients, Beth brings over 16 years of clinical and management experience working in a collaborative care practice, having been a founding physician at Copeman Healthcare and a former medical director with TELUS Health in Vancouver. Dr. Donaldson earned her medical degree from the University of Calgary with her family practice training at St. Paul's Hospital in Vancouver and a fellowship in women's health through the University of British Columbia. She is also certified with the North American menopause society. Alrighty, so let's dig in. So Dawn, first, why don't you tell us a little bit about why you started Harrison Healthcare and how it came to be?

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Don: Love to thank you Alita. First thing I want to do though, is I want to add to my CV, because it's actually, it's actually the most relevant part of the question. And that is that I'm a, uh, a brother, uh, a father, a friend. And these are the things that actually, uh, were the biggest part of the motivation to starting Copeman Healthcare back in, in 2005. At that time I was in the surgical services industry and I hadn't really paid too much attention to primary health care in Canada. I guess just because of my age, but at that time I started, I was starting my own family. I had aging brothers and sisters, aging parents and I really started to see the problems that were happening in primary health care at the time. So, because I was so exposed to specialists in the surgical services industry you know, I started to really take a serious look at this problem because it was becoming a big problem, it was becoming a big problem for my personal family. And I can tell you without getting into detail, there was a lot of heartache and a lot of stress around that time in terms of primary health care. So I like to see myself as a problem solver. So I started talking to specialists about what were the core issues involved? And the answers were, you know, really consistent. And that is family doctors. At that time runner, incredible pressure and still are, the situation hasn't gotten any better. And they simply lacked the time and the resources to practice the way that they were taught. And it was resulting in career dissatisfaction, burnout, and bloated waiting lists for specialists because this was kind of a quick option for them, right? And so I saw patients were suffering, doctors were suffering, and even the financial sustainability of public healthcare itself was starting to be questioned because the most expensive aspects of our health system, which is specialist care, you know, emergency room visits, hospital stays, this is what this is, this was, they were under even greater strain. So when I, when I think about what my motivation was at that time, you know, I have to just hone in on a word that's become kind of our core value at Harrison, which is just compassion, because I'm seeing kind of the, all of this suffering, I'll call it around me, at three different levels. And, you know, it's the center of our value system, and it, but it also means a little bit more, it means we have a compassion, not only for patients, but we have compassion for our coworkers, and compassion for the community. So these were the three problems that I was seeing. And I felt at that time, compassion was going to be the thing that drives us forward because guess what, the magical thing about compassion is that it drives naturally innovation and it drives excellence in the things that you do. So obviously it also creates an environment that's truly kind of rewarding and inspiring for everybody that's involved. And I guess to top it all off, now studies show that compassion in healthcare actually improves patient outcomes. There's clinical data on this. So there was a big problem. Our motivation was right. We wanted to really do things on a number of levels for a number of the stakeholders involved. And all we need now is a solution.

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Allita: And what was the solution? Tell us more. Dig into that a little bit.

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Don: Well, it took a lot of thought and it took a lot of input from really valuable people that I began to associate and talk to about the formation of this company called Copeman Healthcare in 2005, including Dr. Donaldson, who's on the call. And we came up with a kind of an interesting model that has four pillars to it, and they're very interdependent on one another. But the first one, and probably the most important one overall is that we needed to create an organization that was truly focused on prevention. And I'll go back into some of my research time around 2005 and Tommy Douglas himself, who was, you know, was largely considered the father of Medicare in the country, right? He said way back when the legislation was just being passed and the Health Act and related legislation, he said that the system would not, this public Medicare system would not be financially sustainable if we didn't change to a culture of prevention. And I agreed and so did my professional colleagues agree at the time, this has got to be the center of our clinical philosophy. So that's pillar number one, is a real focus on prevention, not just primary prevention, but also secondary prevention, the better management of chronic diseases, which as you probably know has become a big problem. So pillar number one, pillar number two, simply more time with patients. We needed to figure out how do we get more face time with patients? How do we get longer appointment times? How do we relieve this burden of these used rosters on physicians? Thirdly, true interprofessional resource availability that are practicing in a real collaborative fashion with the physicians. So I'm talking about people that are really relevant to therapeutic lifestyle change in particular, which of course is really important for not only primary prevention, but secondary prevention. We're talking about registered dietitians, exercise physiologists, mental health navigators, nurse practitioners, nurses, and even administrative staff for that matter who can take a huge amount of burden, administrative burden off the practice of professionals. So a true interprofessional environment would be pillar number three. Number four, which is becoming increasingly important for us, is technology.

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Don: So we had started building technology before we even opened our doors in 2005 at Copeman Healthcare. And we really believe it's the key to the future because patients need to increasingly take more control of their health and we need to give them some of the information back that we get through our interaction with them and that exists in their medical record. And we do that some really clever ways. We have a product now called HealthChart. That's a personal health management system. And so it's the technology parts, that glue everything together. I'm sure we'll touch on it a little bit further, but there it is in a nutshell. Probably took up a little bit too much time, but that's the motivation for starting the company. That's the, that's the, the core model is these four pillars that are really, really connected to one another. They really support each other. And I might as well actually add that this is people are going to be wondering, oh, so what's, what's the model? How do you, how do you pay for all this? Um, uh, the, the model is very simple.

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Don: A large component of our service are interprofessional, non-insured services. These are the services of some of those professionals I mentioned, there are some services, physician services that are not insured in various jurisdictions. So we charge our clients a services fee for that package of services. And that allows us to create a different kind of organization, more innovative kind of organization. Doctors, you know, we actually retain the doctors to help us with consulting, develop back to the technology to help us build systems, processes, technologies that so that we can increasingly leverage their expertise to bring more and more services to Canadians. So basically the model works by charging a fee for non-insured services and that's how we make it all work.

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Alitta: That's how it all clicks. No, that makes sense. Thank you for sharing that. And so that's how Harrison Healthcare came to be. And then Beth, why don't you tell us a little bit about what motivated you to work with Dawn and build your practice in this setting.

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Beth: Yeah, well, honestly, listening to that when I was, you know, right out of graduation, maybe a year and a half out doing a fellowship, doing some locums, and hearing about the four pillars, you know, why wouldn't I? It just seems sort of like a dream come true for a new GP who had some idea of the problems the system was in, but hadn't truly experienced it for very long. But my thinking was, you know, you're gonna give me more time. I get to focus on prevention. I have a smaller panel. I'm gonna make, you know, fairly good money for a GP in an unaffordable city. I don't have to think about any of the business side of thing in terms of hiring, you know, leasing a building, how much equipment costs, you know, who's gonna get the... the bed, my examination bed, you know, all that stuff. Somebody else was looking after all of that. And then throw in the collaboration with like-minded individuals. And whether that be someone in administration or your front desk staff or your nurse, your nurse practitioner, you know, everybody is there for the patient and to make the lives of the patient better. And that, you know, from that Don mentioned right off the bat is that compassion. And, you know, I know it sounds sort of like all huggy and you know airy-fairy but it's so true and if you're able to have the time to give compassion to your patients it's like it just feels so good at the end of the day and so it's that career satisfaction that I think a number of GPs are just not getting because they get burnt out by all the other stuff so it's all that other stuff that when I go into practice it's not weighing so heavy on me and I can really just focus in on the patient so compassion for the patient, compassion for our colleagues. If someone's having a busy day or a rough day or needs some support, we're there for each other. And compassion for ourselves. You've got to look after yourself as well. So why wouldn't I join at that stage of my career? And now that I've been in it so long, I would never go back. It's... to have the time and be able to talk to a patient, not just about the one thing they come in for, but know everything about them and be able to really look at the whole patient as opposed to just sort of superficially looking at them. Because I can't imagine if someone comes in, say, for like a mold check on their hand and you know that their sugars are overdue. They don't have, they haven't had a blood pressure check forever, like where are they at with their cardiologists, those sorts of things, but all you have is six minutes to really look at the hand. I just, I would feel kind of slightly empty after that visit to know that I wanted to do all of this stuff, but I wasn't able to. And that's a huge burden on physicians to carry, right? When they know what they should be doing, but they're not able to. Whereas here, we know what we should be doing. We have the technology to record what we're doing and to communicate with our interprofessional team in Harrison Healthcare as well as outside of Harrison Healthcare. And you put a lot of trust in your team that everybody is working towards the same common goal, which is the health of that patient. So yeah, I mean, it really, why would I practice anywhere else is what I keep coming back to.

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Alitta: No, I think we've heard and the research shows as well from surveys that have been done by the CMA and other organizations that physicians are burnt out from dealing with poor technology or not having the business supports that they need and coming out and graduating and also having to get an MBA while they practice medicine and figuring out how to run a business. That makes a lot of sense. Thank you for sharing that. So Beth, tell us about a day in the life. What is it like to work at Harrison? What is it like for you?

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Beth: Yeah, so a typical day, often I've got kids at home, so I'm sort of like multitasking always when I leave the house, but I often will get a couple of phone calls to patients in as I'm driving in, which people appreciate. They understand that I'm, you know, a busy working mom and so they love if I'm able to fit them in, they're just sort of happy to have that time. And then I will, you know, get in and visit with some while we're all making coffees in the morning, getting started with our day, do a little bit of collaboration in the lunchroom. And then we usually have a couple of preventative health assessments from my patient panel that have been organized ahead of time. And when these people come in, they will have already done their blood work. They'll have a visit with myself with kinesiology, as well as a nutritionist at some point in the day and then go through diagnostic testing as well, including ECG, eye pressures, audiograms, et cetera. So I'll have a couple of those visits. Those are about an hour each. And within that, you update the chart, you do a history, you do a physical exam, and then we come up with a report at the end of it that goes into Health Chart that the patient will then be able to access in the future to review their health goals. I'd probably have a mixture of say 60% in-person visits, maybe 40% virtual or phone throughout the day, probably maxing out at about 15 actual scheduled appointments but then throughout the day after you're reviewing labs and results and consults from physicians, you're probably touching a good 80-ish patients a day. We do a lot through email as well and direct messaging from the EMR just to keep patients in touch with normal lab values, abnormal lab values, plans for the future, etc. Somewhere in there would be a bit of a lunch break, lots of collaboration in the hallway or with various folks from the team. We also have a referrals coordinator. So there's lots of back and forth with the referrals coordinator who's helping us have the best time appointment that we can for them with the right practitioner. I would also be collaborating with my MOA or my care coordinator, and of course with the rest of the team. We also do care planning meetings where we actually do a bit of a chart review. It's kind of like rounds in the hospital that we all did when we were training. So I come to a meeting with my care coordinator, my nurse. And then various kinesiologists or dieticians also hop into those meetings. And we have already a list of patients that we know ahead of time that we wanna talk about. And we really just get into it. We make a plan so that by the time you leave that meeting, everybody knows what needs to be done with that patient. And we use technology to help us plan for that. So it happens efficiently and in a timely manner in the future. And then huge communicative. component of that, of course, with the patient as well. What else do I do? Most visits would be, say, 15 minutes for phone call to half hour in-person visit to an hour for a physical. And then, one thing I do wanna mention is, yes, we have more time with patients and we're able to look at the whole patient, but as you give... more time as people take more time. So if they know they only have five minutes and they expect five minutes but when they know they have an hour they have a long list you know of things to review. Yeah and of course being a GP there's you're always gonna have paperwork you know it doesn't matter how fabulous or technology is it there's just there's we work through lunch you know you're hopefully someone might bring you a coffee in the afternoon so it's not country club medicine um that's for sure you're still really busy during the day, but at least you feel like you're leaving your day completely satisfied because you feel like you've done a good job and you haven't just skimmed the surface. So yeah, like eight to five or so and that would be about a day in the life.

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Don: If can I jump in and just on something that Beth said, because it kind of gave me goosebumps because it was the very, very original vision. I've always said this to people over the years that the real idea was, because Beth mentioned how many people she probably touched in a day. I think she mentioned 80. It was a, it's a kind of a magic number because of course we wouldn't let anyone have the impression that she actually is literally, you know, communicating with 80 people in a day. But the whole vision of the company was that everyone has a health plan and everyone has targets and everyone is managed with the support of the interprofessional team. So the picture I always liked to paint was that in the morning, you know, perhaps the physician's nurse walks into the office with a list and let's call it 80 people on it, but they've got little dots beside them, green dots and red dots and yellow dots. And we know we can do risk stratification and we know who needs intervention and who doesn't, who is well managed at this point, who isn't. So a physician like Beth can effectively manage 80 people with the help of her team but maybe out of that list that she had of the red dots there's 10 people there. So she has 10 appointments arranged and this is how you drive quality into the system. We can effectively increase capacity, we know that now. But we can do it in a very thoughtful way that really, at the end of the day, results in just much more personal, attentive and compassionate care.

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Alitta: Yeah, and those higher patient outcomes when you have that collaborative approach to the care as well, having multiple professionals being able to give their insights because, hey, not everyone knows everything all the time. So it's lovely to have those different perspectives looking at it as well. Chris, I think we've gotten a really nice look at why it came to be and why Beth loves working there. But what are some of the problems? And I know we've touched on this a little bit as well, but what are some of the problems that you're seeing?

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Chris: Yeah, thanks. You know, I think we've touched on a lot of these things already. We spend a lot of time with physicians out in the community. We hear a lot about burnout. We hear a lot about the frustrations of working in a system where the focus is on quantity, not quality, of care. We hear a lot about the heavy administrative burden. And you know, the lack of work-life balance, you know, having to bring charts home every day or sit at the computer every single night and, you know, wearing pajamas, you know, write referral letters and things like that. And, you know, at the end of it, it's all about, I don't have time to be the physician that I wanna be, to be the parent and, you know, partner that I wanna be. And so, you know, what we're fundamentally trying to do at Harrison Healthcare is just to make the job better. Right. And so, you know, we do that by allowing physicians to spend more time with patients, to have time in their schedule, to collaborate with the team, both informally and formally. The smaller roster, again, is focused on quality, not quantity. And to be able to come into work and just focus on your patients. working with your team to continually deliver great care and great service, by the way, to those patients and let Harrison Healthcare do the administration. I mean, Beth doesn't have to worry about where the exam table comes from or what it costs and do we have supplies, do we have travel vaccinations in the vaccine fridge. That's all handled by the team that works very closely. with her. And, you know, at the end of the day, people want to have fun too. And so, you know, coming into the office, working with people that they love working with and want to spend time with just creates a fun, light atmosphere. And, you know, I operate on this, you know, perhaps over simplistic idea, but, you know, if our people are happy, our clients are going to be happy.

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Don: Can I jump in on something you've said again, Chris? Sorry, sorry guys, but I can't help myself. Cause Chris just brought up just an amazing point in what he was just saying. And that is just about how just improving kind of the quality of the work and the job satisfaction. We have a crisis in Canada of a physician shortage, right? It's a crisis. Name an industry in the world, any job type anywhere, where if you've got a job shortage, what do you do? How do you solve that problem? You make the job better. You make it more attractive. You attract people into the profession. You get people who maybe have retired back, actively again, because you're making the job more rewarding again. So the real answer, I believe the real answer, the partial answer to the physician shortage in the country is let's just make the job just more satisfying.

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Alitta: Yeah, and I think that makes a lot of sense. I mean, one of the biggest complaints from physicians isn't that they've lost the love of practicing medicine. It's that they've really lost the love for practicing in the way that they're being kind of pigeonholed into practicing in a lot of the settings that exist. And there's tons of different solutions, and I love that Harrison Healthcare is coming at it from a very people-centric, collaboration, compassion-centric way. And having fun in the workplace does matter. And it can be done in medicine. I think there's often to this perspective that, oh, but we've just got this critical issue, we need to solve, solve around the medicine and practicing for patients. And that is true, but I think what we're seeing here is that you can also do it and change the culture in the workplace to make it better as well. And so those two things can happen at the same time, which I think is really, really inspiring and really fantastic. Beth, as a, and doubling down on this, we hear from solo docs all the time that it's really difficult to practice in that fashion. And we've already talked about collaboration a little bit, but really let's dig into a little bit how that collaboration at Harrison Healthcare helps you enhance your practice and the care that the patients are receiving.

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Beth: Yeah, so for example, if I've got someone who's got high cholesterol, if I'm a solo practitioner, I am advising that patient on everything. I'm educating what's going on with the LDL, with their liver, how exercise brings one down, raises up the other one, getting into the nitty-gritty. What do you have to eat? What do you have to avoid? This is the medication. This is how the medication works. This is the dosing of the medication. So when I have that, I can say, well, I see you have an appointment with your dietician right after me. She's going to let you know about what high cholesterol means, what you can do to bring it down. We're going to talk after and decide if we need a medication right now. I might do a few more blood tests and have the nurse chat with you about your family history. Um, we're going to bring a little bit of technology. We've got a new genetic screening, um, test for those at high risk for coronary artery disease. Once we have all these pieces in place, we're going to decide the best plan. So, and that can all happen honestly in an hour, you know, as the patient is here, as opposed to when I'm practicing solo, it's like, okay, well, this dietician lives in your neighborhood, oh, she's on MAT-Leave, like, oh, you can see her in four months, and then maybe she'll send me a letter four weeks later, and then, you know, it just doesn't happen. So, the speed and efficiency of what you can. do for patients is unbelievable. And it just makes your practice so much easier. Like I don't have to think about immunizations, which is unbelievable. The immunizations, they change every three weeks. There's something different going on. Yes, I kind of have an overview, but our nurses are pros at that. I don't need to worry myself with that. I can sort of think at the higher level, more complicated chronic disease management and keep an eye on a lot of those preventative. factors that we're trying to be on the cutting edge for, what can apply to my patients. For example, pharmacogenetics that we use right now, I don't think there's many offices, solo practitioners out there using pharmacogenetics, but it can really change how you prescribe and how those patients respond to medication or feel on medication. So that's just sort of right into the collaboration, but also within collaboration that I didn't touch on before, which was a huge reason why I entered, especially as a young. practitioner was the mentoring that I had. I joined with a couple of other physicians who were into practice longer than I had been. If I didn't have them as mentors, it really would have been difficult. And we are really big at Harrison Healthcare into mentoring each other. It doesn't matter what direction, which clinician is mentoring who, we are all there to help each other be better. And to have that support is just amazing. Right? Because you can't have strengths in everything. We have to rely on each other and you have to be able to learn from people. And so it is really it's a collaborative mentoring approach. I mean, Don mentors me and he's not a clinician. You know, I help mentor the front desk and their administration. So it's sort of everywhere. It's it's just really lovely.

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Don: And if I can add to that again, Alitta, like the, we have a program on the table. We've been extremely busy, of course, getting our clinics up and running over the last couple of years, but we have a program that we're really serious about, and we're really proud of the concept, which is what we call the TEAM program, which really stands for Transition Education Acclamation and Mentoring, which is aprogram that we're designing for new graduating residents. I don't know if there may be some of those, you know, on this podcast, but I think we can make a real difference in people's, in professional lives, as Beth has just mentioned what happened to her for new graduate people, you know, coming into the profession, practicing for the first time by themselves. We can give them that, the kind of hand holding and guidance that they really need, whether they stay with us long-term or not, we're happy to bring them inunder our fold and show them the ins and outs of what a true collaborative practice really looks like and help them through all of the administrative things.

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Alitta: I love that. And we do hear often as well that physicians feel a little bit, and across the healthcare professions, feel a little bit as a professional development outside of the clinical practicing can be slightly limited. And we also know from the research that is really important for people. We humans love to learn and we like to progress and feel as though we're constantly progressing. And so having those types of professional development opportunities baked into the core of the business is really, really important. So thank you for sharing that. And Dawn, let's dig into that a little bit more. Tell us about the evolution of the business and how you've seen things change in the last 15 to 20 years.

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Don: Um, well, where do I start? But I mean, fundamentally, you know, the service that we offer hasn't changed that much because it's just once you, as it, once you have a practice that is focused on compassion and where your patients really feel that you care for them, the results are astounding. So the core, you know, element of the model hasn't changed that much. But one thing that stands out in my mind, well, there's two things really, one is technology, which, you know, we should touch the landscape in the next few years. So we should touch on that a little bit. The other thing I'll bring up though is mental health. So mental health back in 2005 was really important. In fact, it was one of our grand realizations when we first got started is that we wanted to be world experts in preventive healthcare, but oops, we missed the mental health professionals. So most people, challenges in therapeutic lifestyle change that something to do with their mental health. And it took us not too long to figure that one out and build a mental health team back in the day. Today, you know, it seems like an epidemic, you know, particularly with the young people, you know, we have a really very cool teen and young adult program, pediatric program that really focused on mental health. Cause we believe that's where prevention really needs to start, right? So it needs to start in those years. So very much in keeping with our entire philosophy. But we've developed some very cool technology for mental health assessment. We decided this time around, we wouldn't pretend that we could develop the best therapeutic relationships for people that needed mental health kind of therapy, that we wouldn't try to pretend we could internally provide the best therapeutic relationships. So we switched up our model, really focus on assessment. So we, and be very, very good at assessment. And so we are, and we developed a technology around it that's just really, I think, world-changing, if I may say so, that we're just rolling out internally now. And then we've put in place what we call mental health navigators instead. So once you've done a really thorough assessment and we know exactly what, if they need medication, then that may be an option in the therapeutic plan, but if they need adjunct therapy, then our job is... let's go find the best therapeutic relationship for them. Let's go find a relationship that's gonna work and a therapy that's gonna work for this particular person. So again, it comes back to this personalization aspect, really, really important in mental health. It just seems to me, correct me if I'm wrong, Beth, but it just seems like a bigger burden on the system than it ever was before. And we're on top of that one. We're really doing, I think, an incredible job with mental health right now.

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Alitta: Yeah, it seems like it was always a growing issue and then COVID helped to light a fire under that one and bring it forward even further. Now I do want to get into where we see Harrison Healthcare going in the future but let's talk a little bit first about some of this technology as well. So this is one in terms of mental health support and the programs that you use there, but tell us about technology at Harrison Healthcare and how this is making an impact overall as well.

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Don: Well, as I mentioned earlier, when we started Copeman Healthcare in 2005, we were starting to build technology before we were building clinical protocols. And because even then we really believed philosophically and this is again, was conversations with people like Beth at the time and Dr. Hose, who was our first medical director, now retired, you know, and many other specialists and other people that we were talking to, we realized we had to get people's medical information in their own hands to help support their efforts and reward their efforts, if you will, visually and through other means, through technology to give them a, we had one of the first personal health record technologies, I think, in the world, you know, back in 2005. It really did, it was really missed by people in later years when it disappeared under different circumstances, under different company ownership. But the, this tool, self-management tool, is extremely, extremely important. And we are bringing it to the next level at Harrison Healthcare with a product called HealthChart, which is just part of the service that clients get when they come to Harrison. And, for example, which is the mental health assessment technology I was referring to earlier, is launched from the HealthChart application, as will other applications, increasing number of applications, be launched from that platform to help people. you know, with their own self-management, if you will. So the next thing that's coming down the pipe, as we all know, is artificial intelligence. And we're just deeply committed to artificial intelligence as a way of further supporting our, not only our physicians, but our entire professional team and administrative team. Because this isn't science fiction anymore. This is actually here, this technology, you know, where you can have if you will, scribes that are really taking notes for you, they're automatically creating soap notes for you through a patient interview that can like look at disparate care plans from multi, an interprofessional team and find glitches or, you know, contradictions maybe even, you know, natural language processing and those kinds of technologies, they have, there's so much promise there. For further reducing the administrative burden, of our professionals. I mean, you know, I hate to say it, but even today, you know, you walk down a hallway and you see a lot of people at their computers documenting things. We want that to go away as quickly as possible. And we think that technology is virtually here to do that. We're already piloting some of these programs. And again, it's all about more FaceTime with patients and trying to increase capacity in any way we can. So you're going to see artificial intelligence and other kinds of AI-based technologies becoming a really big, big part of what we do. I think we're already doing it in some of our screening techniques that we're using. Like we do mole mapping exercise, and I think it's the AI engine behind the IT, for example, where it can take a really good look at images and do a superior job than the eyeball can, the human eyeball can, in looking at images of lesions.

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Chris: Just to add to that, there's the whole provider satisfaction angle to embracing technology. I used to be in the electronic medical record business, and at the time that I started, most people were using paper charts. Well, today, most people are using electronic charts. But the level of frustration at the amount of time that's still spent doing clinical documentation is as bad as ever, if not worse. Than when it was using paper charts. And a lot of that information is as siloed in an electronic world as it was in a paper chart that sat in the chart room somewhere. So it's just a very exciting time to start leveraging technology to, again, make the job better, but give us more patient-facing time with our patients or clients, as we usually call them.

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Alitta: And to empower the individual to take some control and have that information in their pocket about themselves as well, which I think is such an interesting dynamic that's happened over time is that many of us don't even know the results of our own labs, how to put it together into a story that we could tell to a physician if we had to go and see them and that kind of thing. So I think for a lot of people, having this in their pocket is critically important, too. Now, because I think you started to talk about this a little bit and we've talked about the technology side and stuff, but, you know, where do you see Harrison Healthcare going next? What's coming for Harrison? Both as a, you know, obviously from a technology perspective and such, but also just as an organization and the culture and the people and the growth of Harrison.

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Chris: Mm-hmm. Yeah. Thanks very much. You know, I spend most of my day making sure that our team, which is now, you know, about 100 people, is aligned with our strategy and that they have the tools they need to do their jobs and do their jobs well and that they feel empowered to improve their jobs and, you know, how we're delivering care each and every day. And then I just get out of the way and let them do their things, right? But at the core, you know, I'm a growth junkie. And so, you know, that's an exciting question. You know, a number of years ago, there was an important research project that looked at the Copeman Healthcare model back there. And the conclusion in the national survey was that more than 20% of Canadians were very interested in adopting this comprehensive primary care model. And many were prepared to pay the fee at that time, which was several thousand dollars. So, you know, we see our mandate is to, you know, leverage our expertise and our knowledge in this model of care to address the primary care crisis. But over time, you know, not everyone can afford a four or $5,000 annual program. And, you know, that's what it costs us to deliver this highly personalized service. So, you know, the other side of our mandate is, you know, how do we address, you know, this almost 8 million people in Canada who want this kind of a service? And so we need to democratize our services over time. So in the years ahead, for sure, you can, you know, we've been operating now a year and three quarters. We've grown to 100 people from, you know, just Don and me. And we have two clinics in November will have a third clinic that will be also in downtown Vancouver. So there'll be a geographical expansion focused on Western Canada and then moving eastward. But there'll be a number of new services that are really aimed at making our programming more accessible to more Canadians. And that of course is gonna require that we embrace technology and we've talked a lot about technology, but you know that's the way to bring the price down to make it more effective and to give you know hundreds of thousands of Canadians if not more access to those core elements of our highly personalized service in a way that's really meaningful and powerful and allows them to manage their health better. So yeah a lot more use of technology is coming down the pipe for sure. And it's just a very, very exciting time to be in the primary healthcare space. I mean, it's gonna be absolutely transformative over the next couple of decades.

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Alitta: Now, being mindful of time, one thing, there's two things I'd like to kind of make sure we tap on now. One, I would love to hear from each of you how you would describe the culture at HarrisonHealthcare in Cole's Notes version, quick versions. And then I wanna just close this well with if anyone's watching and hearing the podcast who's considering, who's in healthcare profession, I want them to know what you guys are hiring for with this growth and expansion. So let's start first. with the how you would describe Harrison Healthcare culture and Beth, let's start with you.

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Beth: Thanks, yeah. I mean, I could probably go on forever about this, but I would say it's a very supportive culture all around. We tend to hire a certain personality who wants, number one, to practice what they know and do what they know well. And we obviously have the environment to do that. So we are a supportive community that is there for each other. full of compassion for each other. We're a collaborative culture, and we firmly believe in doing your best at work, but also being there for your family at home and being your best self when you get home at the end of the day. And having those hobbies that make you a whole person. So I came into this when I was unmarried, no children, and I've... gone through all of those things and have felt 100% supported along the way through this organization to support not only my career and my continuing medical education, but also the needs of my family. And that's just been so tremendous. There's a lot of trust in each other that you trust that your colleagues are going to do their best if you give them the space to do so. And in general, people do their best when you... allow that. So that's how I see the culture and how I try and explain that to new hires for sure.

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Alitta: Thank you, Beth. Dawn, actually, Chris, let's go to you on this one. How would you describe Harrison Healthcare culture?

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Chris: Well, we've talked a ton about caring and compassion. I mean, that's really what we hire people for to start. I'll tell you what it's not. It's not hierarchical, right? It is open and transparent. Dawn and I and Beth, we're very, very accessible to absolutely everyone. And it's people first. And again, I wanna bring back the fun element. You know, there's a well-known hedge fund manager who says, you know, hire people you want to live with, right? And, you know, that hopefully that doesn't sound creepy to anyone. But the truth is you spend as much time or more with the people you work with than the people at home, whether that's good or not, you know, that's just the reality of life today. So, you know, make sure you hire people you want to hang out with and have some fun.

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Don: Perfect segue to me, Chris, because the first word that came into my head when you were asking the question was, it feels like it's family to me. And we often talk at the management level about what is the secret sauce that we seem to have in hiring just amazing people that love working together. And it is a little bit of pixie dust. I'll call it because, but there's just something in all of us when we're hiring people, we just know that they'll fit in and we'll enjoy working with them. And, and, and we will treat them like family. And, and, and then that's what I'm most proud of whenever I'm in the clinic, is I just, I have that feeling that it's, it's a, it's a company with family values, if you will. And, and it feels like I'm amongst family. We have a lot of huggers at Harris.

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Alitta: That's great. Thanks, Dawn. And for anyone listening who's curious, what are you hiring for? What kind of rules are open now and where do you see this expansion and what kind of opportunities are there?

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Chris:
Well, we're hiring in every single role. You know, where we're really putting a lot of extra emphasis is on recruiting physicians, recruiting nurse practitioners. You know, we're looking at some really innovative nurse practitioner led programming that I think is gonna make this an absolutely astounding professional opportunity for nurse practitioners. But honestly, we're hiring in every single role. So again, on the clinician side, you know, doctors, nurse practitioners, mental health professionals who work as navigators, dieticians, exercise physiologists, nurses for sure, the whole administrative support team, you know, we've had a lot of success in our client services function recruiting people with hospitality background. You know, if there are people out there who've worked in hotels. That's a huge part of the client experience. You step off the elevator, you're greeted by someone who works as if they've worked in a five-star hotel. It makes a huge, huge difference. So honestly, across the board, and of course the care coordinators who support our clinical teams day in and day out and are really the central focal point for our clients.

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Alitta: We'll make sure that in the show notes, there's the links to be able to see all of these open jobs and connect directly with the folks at Harrison Healthcare for anyone listening. I just want to say thank you for sharing, you know, about Harrison Healthcare and what it's like to work there as a physician and also in the leadership capacity of building and growing it and having the vision of what's next. It sounds like a lovely atmosphere. Maybe I'll take a look myself. But it sounds like a lovely atmosphere with lots of people and I think, you know, in this time feeling as though you have family at work and support and that collaborative approach is something that many, many people are looking for today. So thank you for coming on to CHERRY LIVE and for joining us today. And we look forward to connecting with you again soon.

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Don: Thank you Alitta.

Beth: Thank you so much.

Chris:Thanks Alita, lovely chatting with you today.

Alitta: Thank you.