Jacqueline Palfy (Host): Hi. I’m Jacqueline Palfy here with Sanford Health News. I’m sitting here with Jim Slack, the vice president of Sanford World Clinic. Welcome.
Jim Slack (Guest): Thank you. Glad to be here.
Host: Yeah. Thanks for coming out today.
Slack: You bet.
Host: We are here to talk a little bit about the World Clinic Initiative through Sanford Health. I think that a lot of folks probably don’t know what that is. Tell me how long has that been a program?
Slack: Well, we’ve been in existence now for 10 full years, as of actually this year. So, exactly a decade.
Host: That’s wonderful. What’s the philosophy behind World Clinic?
Slack: Well, we really have three main goals within our mission. The first is really to just engage in shared learnings. We really look for partners that are strategic, have great vision, and then we try to find different ways to collaborate with them and improve health care for them.
Host: And these are health care partners that we’re meeting with?
Slack: Health care partners. Right. Secondarily, we like to make impacts through these relationships. Obviously, through sustainable collaborations. Typically when we say sustainability, it includes clinical but as well as financial. And then thirdly really what we want to do is help build up the Sanford brand and reputation.
Host: So, you want to go somewhere where you can learn things. You want to make sure that it’s going to work —
Slack: You got it.
Host: — and then you want to help people know who we are. (Laughs)
Slack: You’re not guaranteed it’s going to work, but —
Slack: — you’re going to do your best.
Host: Absolutely. So, where is the first place that we established a World Clinic?
Slack: Duncan, Oklahoma was the first one, and that was actually the year I joined back in 2009. So, we opened that clinic, obviously a decade ago. Then, 2011, we opened our second clinic domestically in Oceanside, California, with Rady Children’s as our partner, and then probably what you’re really leading into internationally is we opened Ghana, Africa, as our first international stake, and that was in January of 2012. So, we’ve been there for about eight years, and proud to say that we’ve seen 1.25 million patients in that amount of time. So, making a lot of strides there
Host: That’s amazing. You know, I think people don’t always realize that Sanford World Clinic doesn’t just mean international. So, I’m glad we’re able to share that there is stateside clinics as well.
Slack: Right. And really the way we look at it is domestically, it’s a world clinic if it’s not in one of our servicing regions — kind of that outlyings when you get to Oklahoma and California. Not close here by the Midwest where our core is; they fall into the World Clinic bucket.
Host: So, the first international clinic is Ghana. Why Ghana?
Slack: Well, everything comes to us pretty much predictably through relationships, honestly. So, we’ve got a lot of physicians within our network, over 1,500 and counting, and so they know a lot of different people throughout the world. A lot of our physicians even come from foreign soil. So, they know partners and relationships over in their home countries. We’ve got a great executive management team that’s got broad exposure across not only the U.S., but even the globe, and so, a lot of our — really are relationship driven — how we’ve stumbled across them.
Ghana, in particular, was introduced to us by Dave Link, back in probably 2011. Actually, it was one of our asset management firms, and he knew of Kojo Benjamin Taylor, who is really our president over there right now and leads our initiative over there, and he was aware of him, and got us introduced, and one year later, we were able to partner with him and establish clinics there.
Host: Tell me what it looks like in Ghana. What is the Sanford World Clinic in Ghana? What’s that presence like in that mission?
Slack: Well, we have right now about 30 some clinics over there. Five are very large facilities that provide a bulk of the care. Ghana is just a totally different health care environment as you might imagine being it —
Host: How so?
Slack: Well, it’s obviously a developing, emerging health care system. It’s not like a developed country where you’ve got all these sophisticated policies, practices, standards. So, it’s all on that developing leading edge, and what we’re really trying to do is help them leapfrog. I always like to relate U.S. health care sitting at, I hope to say, around a nine, not a 10, or a nine-point-something out of 10, and when I look at Ghana, you know, I’d say we’re back in that two, three area. And so if we can make a two-three a four-five in our work together, we’ve really made a huge difference.
Host: And that’s as it relates to not only like organization and regulation, but outcomes and access as well. It’s sort of everything.
Slack: Absolutely. Absolutely.
Host: That must be really — that’s so many different things to think about at one time when you go somewhere.
Slack: It is.
It is. It’s very challenging. I mean when you think about what we’re accountable for now — we’ve grown from our one clinic and a decade later, now, we have about 120 locations literally across the globe — nine countries. So, that’s a lot of progress in a decade. So, as we sit in our offices and we work our day, we’ll be jumping from Germany to Ireland to Ghana. I mean your different time zones you’re having to work with. So, we’re a 24-hour shop, obviously in the care that we provide because patients are being seen literally around the clock in our environment —
Host: Around the clock and around the globe.
Slack: Exactly. Exactly.
Host: So, each time you come into these different countries or different communities, you are faced with a whole different set of challenges and opportunities to learn — based on culture, everything, right?
Host: It’s exciting.
Slack: It is exciting. It’s very rewarding but challenging.
Host: Yeah. Tell me a little bit about what you’ve learned in Ghana. Because it’s the longest standing one.
Slack: Right. It is, and we have a lot of learnings from Ghana. I relate first of all really to establishing an EMR literally within six months after opening our first clinic there. So, with that brings a lot of challenges. Electronic medical record — literally probably the first in country. But, you know, when you think about implanting that, it saved literally, for every patient that came through our clinic, one hour of time because the old methodology was you’d go and have to try to find any patient’s card, and if you can imagine bookshelves with just cards — literally hundreds and thousands of cards stacked on top of each other, and they had to go try to find that before they could even register them to see a physician. So, made huge strides literally within six months of opening that through the EMR implementation.
Host: And that’s — but with that you have to deal with, you know, the challenges of the technology, of teaching folks without internet access, all kinds of things, and then just a whole — inputting all the data and making sure it can all be put there.
Slack: Our employees did not even know what a mouse was, let alone a keyboard, and so, really the training of all this really started at that level of just introducing them to a computer, a keyboard, a mouse with a monitor. That was the first two days of lesson before you even move into, you know, what is an EMR, and how does this work for me?
Host: And now how long has that been going? The EMR?
Slack: We brought it up literally within six months.
Host: OK. That’s right.
Slack: So, eight — just about eight years.
Host: So, now, when you go to Ghana, and you talk to folks, can they imagine having to go back to the old way of doing it?
Slack: No, and I think it helps us draw, you know, the clientele that we do because we are more efficient than going to a lot of the public health facilities. When you can save an hour of your time, everybody loves that, no matter who you are. So, it’s been very impactful.
The other huge thing that we’ve done is just treat people like people, right?
Slack: We like to call them by name. So, because we’ve got the electronic medical record and access to the names and address, et cetera, we can greet them more personal, and it’s part of our protocols now so that – they’re not always treated that way when they go to the public system there. It can be kind of like a number there, and so we try to personalize that care, just similar as we do here in the U.S.
Slack: It’s made a big impact.
Host: The Sanford Family approach. It’s a real thing, you know. It’s a real thing for our patients to really have for us.
Slack: You really get it. You’re right there.
Host: So, our newest World Clinic is in Costa Rica.
Slack: Yeah. It’s exciting, exciting. We’ve got a great relationship there that we’re, you know, truly blessed to have honestly. The partner there is Hospital Metropolitano. They’re a very young but eager and growing organization. They’ve been in existence for about 10 years. They have a huge strategy and vision that we’re just completely bought into. They actually feel like a miniature Sanford growing up. They’ve got great leadership in place. They’ve got great employees. Great desires and aspirations, and they really look to us as trying to be like Big Brother. Help them eliminate mistakes and help them grow exponentially, quickly, and so we’re grasping that role. We’re just starting to dig in. They have huge potential in that I think we’re not only going to impact health care across Costa Rica, but they actually have goals and aspirations to get into other Latin American countries that we’re very eager and excited to be able to participate with.
Host: So, they have sort of their own World Clinic.
Slack: It’s exactly right. Exactly right. It’s just — it’s a perfect fit for us. So, we’re really looking forward. We just established an equity stake in July. So, it’s very fresh, but we’re really excited in what the future holds there.
Host: Well, it seems like things are definitely not going to slow down with World Clinic (laughs).
Slack: They’re not slowing down at all (laughs).
Host: Well, that’s wonderful. Thank you so much for coming on today to talk with us.
Slack: Alright, thanks Jackie.
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