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Making Rounds

Nicole Ortiz

Healthcare Brew delivers the latest news and trends in healthcare.

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Occasionally, we schedule our rounds with Healthcare Brew readers. Want to be featured in an upcoming edition?

Loneliness epidemic. Mental health crisis. These terms are often used to describe the state of mental health in the US, all while the country is also experiencing a behavioral health 

These mental health professionals provide counseling without going through the traditional state licensure process. One group, the 

 (LCA), is helping train groups like social workers, legal aid staff, and community health workers to become lay counselors.

Co-founder Alli Moreno brings her own expertise as a defense investigator and lay counselor to provide guidance for others interested in a “nonconventional pathway.”

After leaving the legal field when she started a family, she told us she was looking “for something that would be intervening or making a meaningful difference in people’s lives.” She joined up with co-founder Elizabeth Morrison in 2021 to see how Morrison’s psychology background and Moreno’s experience could help shape the field.

Healthcare Brew spoke with Moreno about her career and what people might not know about lay counseling.

This interview has been edited for length and clarity.

What do you think are some of the biggest misconceptions about lay counselors?

One that comes to mind is this misconception that mental health counseling is only being provided by licensed professionals. The reality is that, as we all know, the mental health crisis is acute, and the 

 is severe, so there’s that ongoing barrier to access.

There’s tons of different ways to approach this issue, but one of them is to acknowledge that mental health counseling is happening. Really pour in rigorous professional development like workshops, training, practice opportunities, adding weekly clinical supervision and support, all of that to make structural adjustments so that counseling that’s already happening is more effective and the people providing it are more confident in doing so.

[Another] misconception is the idea of a triage, or the idea [lay counseling] is a cheaper way to provide care. Our hope is that it is equivalent in terms of value.

What are the biggest challenges you’re trying to address through the LCA?

It’s really access to quality mental health support. The need is so severe, and it’s only increasing as more marginalized, vulnerable communities are targeted in government policies and 

. It’s already affecting young people and immigrants and LGBTQ+ community members; it’s already affecting people in 

There are so many competent, skillful people who are nowhere in this conventional licensure pipeline. But they have skill, and they have community connection, and they have the desire to be helpful. So, bridging that gap of helping folks, who are already in connection with people who need the help, to help them be able to do that even better and more competently and confidently and feel acknowledged is the biggest challenge.

What are the ways health equity plays into how you’re approaching this?

When you think about people who have lower resources, have lower social power, they’re less likely to be able to get care that they need. When we’re supporting people who are already in those communities—who already have relationships to meaningfully respond to those needs and to do so in a way that’s supported and there’s continual learning and growth—we’re responding to people who have the least access. That’s where we’re gravitating toward first.

What’s your biggest achievement in your career so far?

These [cohorts] are hearing these mental health struggles from people, which means that they’re doing something to indicate to the people that they’re safe. And that means that they have some sort of skill. And then not only is that person telling them, but they keep coming back.

I always feel so proud and happy to be able to elevate and amplify and acknowledge that skill in other people who come through our course and who are on our team, too.

A portrait of Alli Moreno, co-Creator of the Lay Counselor Academy & Counselor.

Lay Counselor Academy's Alli Moreno discusses lay counseling and reaching underserved patients

Through the Lay Counselor Academy, Moreno is addressing a provider shortage in behavioral health.

Alli Moreno discusses lay counseling and reaching underserved patients

Ever since he was a kid, Ryan Gibney, UCI Health’s associate medical director at its Orange, California, facility and an emergency medicine physician, knew he wanted to be a doctor.

But before that happened, he worked in the service industry for many years—and performed in a band—while he studied at med school. Once he took the plunge, he had a “meteoric rise” from residency to leadership, which includes serving as the incoming medical director of the health system’s new Irvine site, scheduled to open later this year.

Healthcare Brew spoke with Gibney about his career and what he’s hoping to accomplish in his new role.

This interview has been lightly edited for length and clarity.

How did you go from working in the hospitality industry to the hospital industry, and what did it teach you?

I moved out to California, where my mom had moved in the interim, and I ended up starting back in the service industry at a bar and restaurant in the area. It wasn’t until 2007 when I got married that I decided that looking longevity-wise and raising a family and that kind of career didn’t really kind of go hand in hand. And I did a very thorough self-inventory and said that I’m going to go back to college.

We actively look for people that have service experience. It teaches you a lot about people, a lot about anticipating needs, multitasking, and the behaviors that exist in emergency medicine. And I think if you want to be a reductionist about medicine in general, it is a service industry.

What was one of the most unexpected parts of transitioning into the medical field?

I found it to be so similar to working at a bar that it was almost off-putting.

I will say that this meteoric rise to admin and leadership is something I didn’t expect this fast. I’ve been in a full-fledged attending career—this is now my fifth year—and I’m already in charge of opening a new emergency room and hiring staff, and I’m involved in leadership strategy for the entire hospital. That’s a lot of very quick learning, but I think a lot of it comes from that route in the service industry and my life experience, being in my 40s and starting my career here instead of my 20s. I think that the ability to speak and interact with people and anticipate needs and see in a different way has lent itself to building this skill set quickly.

Can you tell me about your new role at the UCI Health – Irvine hospital and how it might change compared to what you’re currently working on?

From a clinical lens, the work is going to be similar. I mean, emergency room is emergency room.

You know, in the service industry you do the soft opening, the friends and family, and all the policy procedures. That’s what we’re doing right now. It’s really all about the strategy of prepping as best as we possibly can, so on day one, when we open, we are really representing what we can do here at UCI.

Within the larger hospital world, what do you think needs to change the most?

 and that have challenges to access have led to this critical national problem of patients carrying out all their care in the emergency department—even their inpatient care—and it forces our work further and further out of the physical spaces that are designated as emergency medicine to where you’re doing stuff in the waiting room. Nationally, this is a problem. Locally, this is a problem. There’s a lot of downward pressure to do all these things that are just almost not possible in the primary care space.

The medical director of UCI Health, Ryan Gibney, a man in a necktie and lab coat

From hospitality to hospitals, UCI Health's Ryan Gibney talks career moves and industry pain points

The emergency medicine physician will be UCI Health’s medical director at its new facility opening later this year.

From hospitality to hospitals, Ryan Gibney talks career moves and industry pain points

Occasionally, we schedule our rounds with Healthcare Brew readers. Want to be featured in an upcoming edition? 

 column, where we feature experts in the healthcare industry and highlight what they do, the challenges and misconceptions they face, and the parts of their jobs that bring them the most joy.

We spoke with Robert Andrews, CEO of the Health Transformation Alliance (HTA), a group of healthcare organizations working to provide better healthcare experiences for employees and their families. Before starting HTA, Andrews served as a member of the New Jersey House of Representatives for almost 25 years.

“Put simply, we’re all working together to do one thing: fix our broken healthcare system,” he told us about the company’s goals.

What’s the best change you’ve made at a place you’ve worked?

At the HTA, we have learned the immense value of saying a polite “no” when a potential partner’s services are not a good fit for our members. By embracing the practice of politely declining partnerships that do not align with our collective goals, we ensure that our valuable resources and efforts are focused on collaborations that have a higher probability of success and a positive impact. While it can be challenging to turn down opportunities, especially when a potential partner presents an appealing solution, we believe it is crucial to assess every opportunity for the greater good of the collective.

What’s the biggest misconception people might have about your job?

One of the most common misconceptions about our work at the HTA is that our sole focus is on saving money for employers. While it’s true that we do strive to achieve cost efficiencies, our primary mission is focused on the people we serve. We are passionately dedicated to driving meaningful change in the healthcare system by focusing on better health outcomes for millions of employees and their families.

What healthcare trend are you most optimistic about?

The growing emphasis on consumer-centric care signifies a pivotal step toward better healthcare outcomes. When healthcare services are tailored to meet the needs and preferences of the patients, it fosters a stronger sense of engagement and empowerment among individuals. This, in turn, can lead to higher levels of adherence to treatment plans, increased participation in preventive care, and, ultimately, better health outcomes.

As more and more consumers demand convenient healthcare delivery, it can also act as a catalyst for innovation in the industry. Healthcare providers and systems may respond to this demand by adopting and integrating technologies that enhance access to care, such as telemedicine, remote monitoring devices, and digital health platforms. These advancements can break down barriers to access, making healthcare more readily available to a broader population, including those in remote or underserved areas.

What healthcare trend are you least optimistic about?

While the intention behind making pricing information more transparent is noble, there are two key reasons why I am cautious about its impact.

Firstly, the process of obtaining and disseminating accurate and comprehensive price data is taking far too long. The implementation of price transparency initiatives has faced significant challenges, including data collection, standardization, and collaboration between various healthcare stakeholders. As a result, the information made available to consumers might not be as up-to-date or as comprehensive as needed to make fully informed decisions.

Secondly, the publication of price data in the absence of quality data raises concerns about potential unintended consequences. While knowing the price of healthcare services is essential, it is equally vital to consider the quality of care being offered. Relying solely on price data without accompanying information about the quality of services or outcomes may lead patients to make decisions based on cost alone, overlooking critical aspects like provider expertise, treatment effectiveness, and patient safety.

Health Transformation Alliance CEO Robert Andrews

Health Transformation Alliance CEO Robert Andrews on what led him to leave his government role and found the collective

The group of health organizations is trying to “fix our broken healthcare system,” CEO  Robert Andrews says.

Health Transformation Alliance CEO on what led him to leave his government role and found the collective

In this edition, we’re featuring dental artificial intelligence (AI) startup Overjet’s Chief Dental Officer Teresa Dolan, who oversees real-world applications of its AI platform.

How would you describe your specific job to someone who doesn’t work in healthcare?

I oversee a team of experienced dentists who collaborate closely with our engineers, machine learning scientists, and product teams. We guide how the AI is trained and evaluated so that it can accurately detect dental disease from X-rays and data from the patient’s record. I also bring in feedback from the field. I spend a lot of time speaking with dental practices, DSOs [dental service organizations], and insurers to understand what’s working, what’s broken, and where AI can genuinely help.

So while I’m responsible for ensuring clinical accuracy, I’m equally focused on usefulness. If a feature is technically impressive but doesn’t make a dentist’s life easier or improve care, we rethink it.

What’s the best change you’ve seen at a place you’ve worked?

The shift from building tools in isolation to developing solutions alongside clinicians. That’s been a major turning point, both for Overjet and the broader industry.

Early on, a lot of health tech companies focused heavily on what was possible with technology. They weren’t always solving real problems, or they built things that didn’t fit into clinical workflows. Now, there’s a much stronger feedback loop between the people developing the product and the people using it.

Preventive care, especially when it’s supported by personalized data. We’re getting better at identifying risk earlier, and that changes everything.

Historically, much of dentistry has been reactive. A patient comes in with a problem, and we fix it. But when we can identify risk factors early, through imaging, genomics, patient history, and now AI, we can intervene before disease progresses. That’s better for the patient and more efficient for the system.

AI plays a key role here. It can highlight subtle changes on an X-ray, flag missed diagnoses, and show patients exactly what’s happening in their mouths in a visual, understandable way. That transparency helps patients engage earlier and more actively in their care.

The average dental student now graduates with $350,000 in debt. That limits their choices. Many feel pressured to enter private practice immediately, often in high-income areas, just to manage their loans. That’s understandable, but it makes it harder to recruit dentists into underserved communities, academia, or public health, all areas where we need more investment.

It also impacts diversity. Students from lower-income backgrounds may not even consider dentistry because of the up-front cost. And without diverse perspectives in the profession, we risk missing important cultural, linguistic, and community-specific aspects of care.

If we want to reduce disparities and expand access to oral healthcare, we need to address the financial barriers that are shaping who enters the field and what roles they pursue.

Headshot of Overjet's Chief Dental Officer Teresa Dolan

This AI platform is working with clinicians to shift dentistry toward preventative care

Chief Dental Officer Teresa Dolan talks AI and how the dental industry is evolving.

Cassie McGrath

In 2017, Hurricane Maria devastated Puerto Rico.

The storm led to a collapse of the island’s healthcare system, a 

 reported, following power outages and a lack of disaster management plans that contributed to 3,000+ deaths. 

 in 2017 that Puerto Ricans living on the island already had low access to healthcare before the hurricane hit. Years after the storm, the region faced ongoing staffing shortages and issues with federal funding that restricted care, 

That’s why, in October 2017, Emmanuel Oquendo and Israel Figueroa founded BrainHi, a health tech company with an AI receptionist called Lara, which completes administrative tasks for providers. The tool can answer missed calls and schedule appointments, and is designed to reduce clinicians’ workloads. Some of the company’s clients include NeoMed Center, Ashford Hospital, Manatí Medical Center, and Mennonite Healthcare System, all based in Puerto Rico. 

Oquendo spoke with Healthcare Brew about his goals for the company going forward.

Do you solely serve Puerto Rico at the moment? Are you looking to expand?

When we launched, we were very focused on that critical moment in Puerto Rico [after Hurricane Maria], and how we can help our island and providers.

 face a unique challenge, just like Puerto Rico, where the staff is often overwhelmed by daily demand, and they’re not able to serve all the patients. So what we found is that Puerto Rico is not the only place in the US that may find these sorts of issues and may need automation. Puerto Rico remains to be the core of our company, but we work with health centers in Florida and in other places in other parts of the US.

You introduced AI for administrative tasks before its current rise in popularity. What have you learned from this experience?

We’ve been working nearly a decade on this.

We’re not only focused on the AI component but we offer a full digital front-door platform that serves as a host for all the communication that is happening, and it facilitates and streamlines a collaboration between AI and the human side. That’s what’s given us a great advantage as we expand now and accelerate growth because now that we are gaining a ton of traction and there’s 

, we’re ready for this. We’re ready—not only with the technology, but we deeply understand the workflows and the integrations that are required to really 

What separates AI receptionist Lara and BrainHi from your competitors?

In addition to the comprehensive platform, we stand out in a crowded place of 

 because we’re looking beyond transactional interactions. Our focus is on building a trusted, long-term relationship between the AI and patients because we believe that the next frontier for AI is to create human connection at scale.

Let’s say that Lara has a call with a patient. As soon as we get that first call, we start creating a profile on that patient that goes far beyond what is documented in the electronic health record.

What we found is that getting all these personal notes about the patient and understanding what they need allows us to personalize that relationship much more. We still believe that AI is not there yet in terms of being completely human, if you will. But by being very diligent on understanding the patient’s needs, understanding their preferences, actively listening to the patient, and taking notes on the conversation, we’ve seen that it greatly impacts engagement.

Emmanuel Oquendo, founder of AI administrative company BrainHi

Meet Emmanuel Oquendo, founder of AI administration company BrainHi 

This founder made an AI admin tool in response to Hurricane Maria’s impact on Puerto Rico. 

This edition, we’re featuring Craig Larsen, a breast surgeon with New York Health who works specifically with breast cancer patients.

He spoke with Healthcare Brew about some things people might not realize breast surgeons do—as well as what he finds most gratifying about his work.

“There’s nothing more rewarding than guiding patients through their breast cancer journey,” he said.

I’m a breast surgeon and I specialize in treating patients with breast cancer and benign breast diseases. My job involves performing surgeries to remove cancerous or noncancerous breast tissue such as lumpectomies (removing a portion of the breast to treat the cancer) and mastectomies (removing the entire breast). I work with a team of doctors to provide comprehensive care for patients, including plastic surgeons, medical oncologists, radiation oncologists, and palliative care physicians.

While many people are aware of breast cancer surgeries, there are still several misconceptions about the role of breast surgeons. One of the most common misconceptions is that breast surgeons perform cosmetic procedures like breast augmentations or reductions. In reality, these procedures are typically performed by plastic surgeons.

With breast cancer, there are often two types of surgeons involved, and both are present at the time of surgery. A general surgeon with specialized training in breast cancer (like me) performs the surgical removal of the breast tissue or the entire breast. Then a plastic surgeon will perform the breast reconstruction surgery.

Another misconception is that breast surgeons are solely involved in the surgical removal of breast tissue before passing the patient on to another specialty for follow-up. While surgery is a significant part of the treatment, breast surgeons play a crucial role in the overall care of patients. They work closely with medical oncologists to provide comprehensive care, from initial diagnosis to long-term follow-up.

Finally, there are still many who believe that breast cancer is incurable. While there are advanced cases, most breast cancers can be treated successfully. Breast cancer surgeons and medical oncologists work together to develop personalized treatment plans that aim to eradicate the cancer and improve patient outcomes.

What’s the most fulfilling aspect of your job?

There’s nothing more rewarding than guiding patients through their breast cancer journey. From explaining their diagnosis to supporting them through treatment and follow-up, it’s incredibly fulfilling to build lasting relationships with patients and their families.

What healthcare trend are you most optimistic about, and why?

I’m most optimistic about the trend toward prevention and de-escalation of treatment in healthcare, particularly in breast surgery. A good physician strives to prevent disease, rather than just treat it. Over the years, there have been significant advancements in breast cancer treatment, moving from aggressive, sometimes brutal surgeries to less invasive options and highly targeted therapies that are tailored to individual patients and their specific diagnosis. I hope that future treatments become so personalized and effective that we’ll look back on the more invasive approaches of the past as outdated.

Tell us about any medical advantage that’s made your life easier.

One of the most challenging aspects of breast surgery is the patient’s disappointment regarding the loss of sensation that often occurs. Because of the nature of the surgery and the way that sensory nerves traverse the breast tissue, there is usually some level of numbness after mastectomy. However, the collaborative relationships between breast and plastic surgeons, combined with advancements in nerve identification, preservation, and surgical nerve reconstruction have significantly improved our ability to maintain or restore some sensation in patients after mastectomy. This has made a positive impact on the quality of life for many patients.

Healthcare Brew Making Rounds series featuring Dr. Craig Larsen.

New York Health breast surgeon talks the most challenging—and rewarding—parts of the job

Craig Larsen says he’s optimistic about how healthcare is trending toward prevention and not just treatment.

Maia Anderson

While clinical trials have historically played a more behind-the-scenes role in healthcare, they’re starting to come center stage as the federal government and companies like 

Anthony Costello has spent his entire career working in the clinical trials space, starting in data management at Genentech and now working as CEO of Medidata, a company that develops technology created to address some of the industry’s most pressing challenges.

“We sit at the center of and make a big difference in so many products that are going to so many different disease areas,” Costello told Healthcare Brew. “At Medidata, our focus tends to be those cases where there’s an unmet medical need, and we specialize in places where…there is no solve for the medical problem.”

Costello sat down with Healthcare Brew to give insight into the work Medidata is doing to improve clinical trials.

One of our biggest aspirations has been to extend the way that we as an industry engage with patients. Patients are often recruited for a trial and then dropped at the end—they don’t know what happened, they don’t have any follow-up with the drug, they don’t even know if their research was successful.

We’re really trying to focus on changing that engagement profile with patients, making it more of a lifelong engagement.

We’re also focused on the pharma companies that are running the trials and the CROs [contract research organizations] that are managing those trials. We’ve created a bunch of technology interspersed with lots of artificial intelligence capabilities in order to help those people who are at the center of running the trials be more effective in their jobs.

What would you say are the biggest challenges facing the clinical trials industry?

The biggest one is cost and complexity. Pipelines of very interesting drugs are just dying under the weight of their own cost and complexity, and the result is bad news for all of us. These pipelines are quite simply not being explored to the extent that they could be and should be.

Medidata’s focus is trying to decentralize trials, trying to reduce burden, trying to make trials more cost effective, trying to hit higher diversity profiles throughout the industry.

These are lofty goals; these are all decades-old challenges for our industry, but solving them collectively will bring down the cost and complexity of running these studies.

You attended the White House Clinical Trials 

 earlier this year. Based on those discussions, where do you see the future of clinical trials headed?

The heads of government agencies and a bunch of very large academic institutions throughout the country that execute very large Phase 3 critical trials attended, and they’re all talking about the same problems: How do we bring down cost? How do we leverage AI [artificial intelligence] in a way that’s appropriate? How do we pull data from a patient’s life?

As an industry, we really come in and leverage this tiny little fraction of the available data for the 12- or 18-month period that a patient is on a trial. Everyone at the White House Forum—and definitely everyone at Medidata—is focused on really changing that paradigm, such that we, as a clinical research industry, are leveraging much more of that patient’s lifelong data to learn much more rapidly whether a drug is going to work for them, and then using that same data to build better AI models.