Ryan Levy, MD, chief of thoracic surgery at UPMC Passavant

Joy Gero, PsyD, is director of Population Health and Improvement and program manager of LGBTQIA+ Health at UPMC. She is dedicated to ensuring health equity and inclusion for all patients and staff.

What brought you to UPMC? Did you always envision yourself in the medical field?

I have wanted to be a psychologist since I was a kid. After finishing graduate school, I started out my career as a therapist. I wasn’t having the experience I wanted, and that’s when I heard about UPMC Western Psychiatric Hospital.

I fell in love with working at UPMC, and the pace of working at an academic medical center suited me. Now, I’m at the Wolff Center and have been at UPMC for 15 years. I can’t imagine working anywhere else.

What inspired you to be in the role you are today?

I started working with the Wolff Center because of my experience working in UPMC Children’s Hospital’s Patient Relations Department. My colleagues and I began noticing the need to focus on care for LGBTQIA+ patients.

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I then took on the program manager role since there was a need for expanding access to quality care for these patients and other underserved and marginalized communities that we serve.

That focus became stronger during the pandemic, when we saw that members of the queer community, Black and Brown communities, and the LBGTQIA+ community were more affected by COVID than other populations.

We started wondering – Why did they get sick? How sick were they? Who got vaccinated, and who didn’t? We knew we needed to be intentional to address health disparities in underserved communities.

What are your responsibilities as the program manager for LGBTQIA+ Health Initiatives of UPMC’s Health Services Division? How are you helping UPMC harness gender and sexual orientation equity?

I have many responsibilities and projects! Currently, I am working with our medical director, Kristen Eckstrand, UPMC Health Plan, the Wolff Center, and other external stakeholders on a plan to improve care and access for LGBTQIA+ folks by improving sexual orientation and gender identity data collection in our electronic health records.

We are doing this project to make our services more accessible to LGBTQIA+ patients across our regions, especially in rural Pennsylvania where gender affirming medical care is limited.

We are also looking to improve care and care access for LGBTQIA+ seniors and communities of color.

Projects pop up all the time, and we are always making intentional choices that center on health equity for our LGBTQIA+ patients. UPMC is a large health care system, so everything we do, we make sure it scales down to all our locations and the people we serve.

How is UPMC working to be inclusive of its employees and patients? What do you think could be done to better serve them?

We largely adapted into using telehealth because of the pandemic. Our five-year goals were met in a two-week period in March 2020.

It pushed us to think about how we develop accessible health care and specialty care in concentrated regions across UPMC’s footprint, especially for people with limited access to transportation or living in rural areas. COVID forced us to view telehealth as a key focus on how we deliver care.

Another way UPMC is working toward inclusiveness is a developing project with UPMC Health Plan. We are inviting physicians and advanced practice providers to become designated as a LGBTQIA+ affirming provider. This involves training and learning how to improve communication with LGBTQIA+ patients.

We are looking to build out a list of providers on our various Find-A-Doctor applications who received training in addition to listing these providers on our LGBTQIA+ patient and caregiver resource page.

LGBTQIA+ patients want more than providers simply opting in to saying, “I am accepting!” They want providers who are affirming (been given interpersonal training to better support these folks), knowledgeable (know how to provide specific care e.g. hormone therapy or PrEP), and sometimes they want their provider to be part of the LGBTQIA+ community.

What are other projects where UPMC is working toward being more inclusive of employees and patients?

Aside from gender equity, we’re improving language interpretation services for patients with limited English proficiency.

There are many barriers for patients whose English is good enough for day-to-day living but too limited to navigate their health care. We are working this year to create better communication about language interpretation services at our UPMC locations.

We are also focusing on employee experience for LGBTQIA+ people. We want to grow a group of people who are part of the community and allies interested in improving the employee experience because it’s important to have diverse voices.

We’re starting to formalize how to create relationships with people in Allegheny County, particularly LGBTQIA+ people of color.

This group has the most need for accessible health care, which is not being met in Pennsylvania. We ultimately want to focus on this group across UPMC’s footprint, and those in rural areas who need access to affirming care.

What is population health and why is it so important to UPMC? How is UPMC working to better connect and serve populations?

When we think about population health, it’s a way to think about the relative health of a group of people and the health outcomes within a group of people.

Population health differs from the individual health of each person we serve. Population health includes factors like gender identity and where a population lives.

To best serve populations, we need to build programs and processes. For example, the Black Equity Coalition is a group of researchers and physicians formed in the Allegheny region to ensure the Black community does not get left behind during the pandemic.

They used zip code mapping to identify areas of greatest need, and where we need to put more health care services.

One of the members of this group is Tracey Conti, MD, Chair of Family Medicine at the University of Pittsburgh and UPMC. She is also on the Vaccine Advisory Board for the underserved and under vaccinated.

Zip code mapping was used to develop our strategy, especially when the vaccine supply was limited. As a result, we got vaccine clinics set up in areas of greater need.

Right now, our population health strategy is using that kind of data to improve care for groups of people that are marginalized or underserved. We are also looking at groups that require greater help because of where they live.

What are your responsibilities as director of UPMC’s Population Health and Improvement? What does this division do?

We’re working to improve the standard for language interpretation services. Our goal is if you walk into any UPMC facility, you will have access to interpretation services.

We’re looking to accomplish that by improving access in our clinics and hospitals to video remote interpretation. We started doing video remote services at our vaccine clinics, and we are hoping to expand this practice over the next few months.

In my role, I look at data about health disparities among minority groups. There’s a discrepancy with access and use of primary care. That’s one of many reasons why we see discrepancies between Black and Brown health versus white health in the United States.

To address this issue, we’ve partnered with groups like Neighborhood Resilience Project, Sisters Pittsburgh, Grow Sto-Rox, and many other community partners during the pandemic.

For example, we partnered with the Urban Redevelopment Association and Neighborhood Resilience Project in Summer 2021 to set up a vaccine clinic in the Hill District.

The Hill District’s closest primary care center that functions a lot like a federally qualified health center is Matilda H. Theiss Health Center. The center is relocating from the South Side to Oakland in April 2022 to bring primary care closer to a population that needs it.

Of the many factors that contribute to the health disparities among Black and Brown populations, improving access to primary care and providing primary care that meets the community’s needs is what UPMC can do to help ease disparities.

Health disparities became stark in the pandemic. This helped us think about how we can better meet the needs of the communities that surround us in Pittsburgh.

In your roles, are you hopeful you’ll bring positive change to UPMC and the communities we serve?

Yes, I feel hopeful. I have seen a lot of amazing changes. Some of those changes we accomplished during the pandemic, like adding sexual orientation and gender identity information to EPIC in 2020.

I think it’s such a huge win we’ve continued to focus on marginalized and underserved communities during the pandemic.

We certainly have more work to do. I’m blessed to know and get time with our executive leaders. My position wouldn’t exist if our executive leaders didn’t realize there was a need to focus resources on these areas.

I think the collaboration with community partners is another reason why I’m very hopeful. We can have the best intentions in the world, but if we don’t hear the voices of the communities we’re hoping to serve, we’re going to get it wrong. We should always be building services that better connect to the communities we care for.

There is a lot of work to do. It’s not going to be done overnight.

We are building a strategy so that you can keep turning the ship in a certain way and moving the ship forward. During this process, we can hear a lot of critical feedback.

As a psychologist, that’s probably one of the ways that my training helps in this role because we learn to tolerate all kinds of feedback and not get reactive, especially when the feedback is difficult to hear.

About UPMC

Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 800 doctors’ offices and outpatient centers, with locations throughout Pennsylvania, Maryland, New York, West Virginia, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. We are dedicated to providing Life Changing Medicine to our communities.