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Lab directors—how do you make sure your concerns actually reach ownership?
Vendors—how are you being vetted by the groups you serve?
This week on Inside Reproductive Health, Amy Jones, Chief Quality Officer of Ivy Fertility, talks about how one of the country’s leading networks evaluates quality, chooses partners, and plans for growth.
Amy shares:
– The specific criteria Ivy uses to vet vendors for cryostorage and digital witnessing
– How they’re implementing an AI solution to compare data across EMRs
– The patient concierge platform guiding patients through the IVF journey
– Where current patient education tools fall short
– The tradeoffs of proactive expansion
– And why fertility professionals get into trouble when they stay “too stuck in their own lane”
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Amy Jones (00:00)
once they can afford IVF, getting them through the process, we've just found that there's much room for improvement in terms of patient experience and efficiency There are many places where a patient can get dropped or lost or not have appropriate expectations set. Once they approach us, have to be able to get them through from the new patient appointment to whatever procedure, you know, they're designated for.
Griffin Jones (00:35)
Lab directors and clinicians, how do you get your concerns represented to ownership or corporate? You who sell things to fertility centers and networks, how are you being vetted? Amy Jones was a lab director, now she helps assess and implement quality measures on the lab, clinic, and business side as the chief quality officer of IVY Fertility.
Amy share specific criteria for how IVY Fertility chose their cryo storage and digital witnessing partners and AI solution that they are implementing to compare data across EMRs, a patient concierge platform they're using to move patients through the journey, the limits to the current patient education platforms that are out there, the trade offs of proactively planning for expansion when doctors and embryologists are too stuck in their own darn lane.
I share a bit about a firm called Kaleidoscope Anesthesia Associates because some of you have written to me about how awesome Kaleidoscope are.
And some of you have talked about how much of a pain anesthesia staffing is. What a match. Amy's criteria for vetting partners is something that you and I can both systematize, and I hope to do so for all our benefit. Enjoy this conversation with Amy Jones, Chief Quality Officer of IVY Fertility.
Griffin Jones (02:47)
Ms. Jones, Amy, welcome to the Inside Reproductive Health podcast.
Amy Jones (02:51)
Thank you, pleased to be here.
Griffin Jones (02:53)
What is a chief quality officer brought in to solve for?
Amy Jones (02:58)
Well, as you can imagine, I wear many hats. But my role is primarily to lead the quality strategy for the organization. So that includes monitoring outcomes, ensuring that outcomes are appropriately reported, risk mitigation, efficiency, patient efficiency, getting them through.
evaluating how we can improve the patient experience.
Griffin Jones (03:25)
Were the issues that you saw issues that they already knew about and they're bringing you in to address them or were you identifying issues?
Amy Jones (03:25)
compliance.
Well, I think every organization needs someone looking at quality right in this field. And there are just a plethora of quality issues to monitor and solve. And so probably if every organization could afford to have 10 of me, they would have that.
But I wasn't there before I was hired, so I'm not exactly sure if they were looking to solve or being proactive.
Griffin Jones (04:03)
Talk about one role being responsible for, it's not that one role is responsible for quality, but often people would just say, well, each department is responsible for their own quality, right? Like the medical directors are responsible for the quality of their protocols. The lab directors are responsible for the quality of their individual labs. What does having a one role that helps to oversee quality do?
Amy Jones (04:28)
Yeah, so I mean, we're definitely focusing on outcomes and risk mitigation. So those are two huge areas in this field, as I'm sure you're aware. And a huge area of risk is cryo storage. And so our goal is to not require standardized protocol
protocols across the board. It's not our approach at all. But creating alignment on key issues is important. And so ⁓ we try to make decisions if it's involving the lab, with the lab directors participating in those decisions.
So it's a collaborative approach.
Griffin Jones (05:09)
What is she you mentioned cryo storage? What other issues did you see as being among the biggest that that you have to tackle? Yeah
Amy Jones (05:18)
in addition, in terms of risk.
Well, you know, everything in the IVF lab involves risk and witnessing is a huge area. So, you know, any sort of mismatches can be extremely problematic. And so we've created alignment on that as well.
Griffin Jones (05:34)
Can you talk to us about some of the measures that you took either in cryo storage or witnessing? The measures that you took, of the steps that you took or just things you decided to do?
Amy Jones (05:40)
Some of the what? Yeah,
so we have implemented a system called Vareus systems for monitoring cryo storage. The monitoring is duplicative in all the labs. So if one system fails, we have another. But Vareus is a great system.
You receive notification of a tank failure in time and plenty of time to make adjustments. We also require that all the labs have ready backup storage tank as large as their largest tank in case, you know, to account for any failure. We're implementing witnessing systems in all of the labs and ensuring that they're used appropriately.
Griffin Jones (06:25)
Was that a cell? Did you have to convince the lab directors of this?
Amy Jones (06:28)
No, that was not
a sell at all. They want it. Because right now, manual witnessing, it takes a lot of time.
Griffin Jones (06:34)
Do you find that your job then is sometimes to fight for the things that people already want? Cause I hear from lab directors all the time that they want witnessing, but it's still not like implemented across places because some business person doesn't want to pay for it. So is your job advocate for them and be fighting for what it is that they'd like to have implemented.
Amy Jones (06:42)
Absolutely, yeah.
Absolutely, but I wouldn't even describe it as a fight. It's just more an education approaching the stakeholders with information. I information is power. And also, you know, there's so many components. Financial is a component. And so we incorporate that as well. So when we're making a decision to go with a particular device, obviously the
The best one is what we'll gravitate towards, but we have to into account costs. So it's a balance. But I have to say, with this approach, when you get the support of the lab directors and then you approach the physicians and leadership with the information that they need to make a decision and they can see that it's been researched, it's not just, hey, we want this new.
Gadget? They're generally supportive.
Griffin Jones (07:45)
I imagine it's a question of prioritization as well, that you have so many competing priorities, how do you rank them?
Amy Jones (07:52)
cryo storage and witnessing is like a very obvious at the top that was easy for us to decide to do. Also, outcome reporting is very important. And I've been in this field a long time. outcome reporting has not changed very much over the years. So we have EMRs. We enter information into EMRs. It's very hard to get information out of EMRs.
And so we have these homegrown spreadsheets that labs use. So one of the first things I did was implement a standardized spreadsheet. What was the idea that we would move away from this? Because clearly an Excel spreadsheet is not the most efficient method of tracking data, and it's duplicative. ⁓
Griffin Jones (08:36)
Yeah, it sounds like homegrown
spreadsheet is the the arch enemy of a chief quality officer.
Amy Jones (08:43)
Yeah, yeah. So we aligned on that, and now we're moving towards using AI. We're piloting an AI company and their technology for exporting and ingesting the data from the EMR. And I think that will save us a lot of time, but it's a big lift. It's a heavy lift because it's not just the IVF.
who's involved, it's everyone who uses the EMR.
Griffin Jones (09:07)
Is that circle the is that the AI company you all are piloting? Tell tell me more about technology and how you see it being able to improve safety and quality.
Amy Jones (09:16)
So right
now, when we report data, the process of even though we have aligned on the standardized spreadsheet, the data still has to be cleaned, right? And that takes time. And it has to be crunched and put in a presentable form. So I find that we spend a lot of time doing that as opposed to thinking about the data.
Right, and so I think that when the shift comes where we just push a button and the AI generates the data that we need.
it's going to be life changing for us.
Griffin Jones (09:53)
Talk more about the data that we need. What data do we need specifically to make smarter decisions around quality?
Amy Jones (10:00)
So, I mean, as you can imagine, there's so much that influences the success of an IVF cycle, including the patient experience, because as we know, stress causes estradiol rise, which can impact how someone responds to stimulation. But stimulation itself, we rarely can connect the
the specifics of IVF stem to what happens in the outcomes in the IVF lab. So that's one of the items, stimulation, how long did they stem, what drugs did they use, when did they trigger.
What was the maturity rate in the eggs? What were the patient characteristics? What were the sperm characteristics? What specifically is going to impact blastocyst if it impacts blastocyst development and you get a blastocyst, are your rates equivalent to that of someone who produces many blastocysts? mean, there's so many questions that can be answered.
And I think that, you know, within a center and between centers, there are so many different protocols used, right, for IVF simulation. And then you get into the IVF lab and there are different media, different timings that people decide to strip the eggs, hyaluronidase the eggs or inject the eggs when they decide to do embryo biopsy.
how far along the embryo is when they do embryo biopsy, that makes a difference. That makes a really big difference. The embryo is not as expanded, doesn't have as many cells. You're taking a larger percentage of the embryo at that point. And so looking at all those features in detail and with the appropriate quantity of data points is going to be hugely impactful, I think.
Griffin Jones (11:52)
Do you have criteria for different types of solutions or is there an overarching criteria for any solution you might implement? Does it completely depend on we're gonna vet cryo storage totally different than we might vet a witnessing system or is there a certain set of criteria that you use to apply rigor to any solution you might be considering?
Amy Jones (12:17)
Yeah, I mean, that's a great question. ⁓ I think it is probably at this point more specific to what the technology is that you're looking at. certainly with cryo storage is a great example. With cryo storage, we ⁓ formed a committee and sent out questionnaires to the vendors that we're interested in using so that we could compare how each of the vendors are executing.
certain functions in terms of cryo storage safety. And we did come up with criteria and if they didn't have a particular feature, they had the opportunity to create that feature or adjust. It's not like we're saying, well, you don't have this, so we're not gonna use you. This is what we need. And for instance,
Safe shipping using medical couriers as opposed to using FedEx. It's a good example. That's an easy adjustment. Monitoring the tanks while they're in shipment. It's an easy adjustment.
Griffin Jones (13:21)
I'm gonna stay on this thread a little bit because I want free consulting from you. I think it'll be mutually beneficial. Part of what we're building as a trade media company is the crunch base of the fertility sector.
Last year we started the IVF Heroes universe. We just made a list of all the companies that sell to IVF labs and fertility clinics about 500 categorized them in about 15 different primary categories and my
long term goal. is so that people like you can go and do like the first parts, the first phases of the RFP process that you're currently doing. And so I want to aggregate as much of this sort of, know, like what you're getting in questionnaires, I want to get from as many different types of companies so that it's easier for people to be able to compare
different types of companies. You gave a couple of those criteria for that questionnaire in cryo storage, that they monitoring in transit, they have safe couriers. What are some other criteria that you frequently see that would be useful to have ⁓ side-by-side comparison? Who their tech partners are, like what their tech stack is?
Amy Jones (14:32)
Technology, technology.
Just that they
have technology for tracking what they have in, if we're talking about cryo storage, they have technology to track what they have in storage and the technology facilitates an efficient process of shipping back and forth. I mean, it is a very huge time burden on the embryology team, shipping specimens back and forth. And so,
Griffin Jones (14:43)
Yeah.
Amy Jones (15:03)
If an efficient process is already in place, that's a big win for that vendor.
Griffin Jones (15:11)
How about other categories that you might be considering? Are there any commonalities between the questionnaires? that's the questionnaire that cryo storage folks get. There may be a completely different one for EMRs, et cetera, but is there some commonalities?
Amy Jones (15:22)
Well, dude.
Data security,
that's huge. So they have to be compliant with it. IT is not my area of expertise, but there are measures in place so that we ensure that they have certain certificates in terms of compliance for data security.
Griffin Jones (15:43)
And so some different kinds of certificates, different kind of partners, those are among the things that you're looking for.
Amy Jones (15:51)
Yeah, and I mean, so cryo storage, if we were looking at PGT labs, for instance, what accreditation do they have? That's important.
Griffin Jones (16:01)
When you're looking for quality in partners, you want to look for people that have had success elsewhere in the space and that have solved some big problems for clinics. The anesthesia shortage, anesthesiology shortage is a growing challenge for fertility practices across the country. Coverage can be difficult to secure and when it's available.
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They can build out the entire anesthesia component of your fertility practice, making it turnkey, scalable, and far less of a burden on your team. Visit kaleidoscopeanesthesia.com to request a staffing quote. When you're vetting people, Amy, how long does it typically take? It might completely depend on the category, but.
Do you have a sort of passive process where you're always vetting people or is it, okay, now we're focused on improving this problem and we're gonna vet just companies in this priority area that we're trying to solve for.
Amy Jones (17:30)
Yeah, I think that we can't tackle everything at once, but once we sort of wrap up one implementation as we're nearing the end, we'll take on the next and start that vetting process. We've done, I think, a couple simultaneously, but it takes a lot of time and it takes organizing multiple people and their schedules.
regular meetings.
Griffin Jones (17:51)
Do you build a task force for each one? Is it the same people if it's in the lab, for example? Are you gonna have the same people that cryo storage as you are witnessing, or can it be different people even if it's the same vertical area?
Amy Jones (18:08)
Yeah, we try to involve different people because we want everyone to be engaged and invested in our decision making process. So we have different people, for instance, involved in the Circle AI project, different primary people involved. But ultimately, all of the lab directors will be involved and the practice directors and the physicians. I it's a huge undertaking.
be incredibly impactful.
Griffin Jones (18:36)
when do you decide if a solution just needs a sort of criteria that different clinics could pick from different partners or implement different solutions versus when every clinic or every lab should have this solution?
Amy Jones (18:52)
Yeah, that's another good question. So with PGT, for instance, right now we're using a myriad of companies. And we are not dictating at all who they need to use, but we do have recommended criteria. So we have here are some.
And it's not a policy, it's a guideline. So we have policies, we have guidelines, and this is a guideline. So we have a list of recommendations just so they know what the criteria should be and they can ask those questions themselves.
Griffin Jones (19:26)
How do you see the field? What do you think are the most important things for being able to expand access without sacrificing quality?
Amy Jones (19:34)
That's tough. Obviously, coverage.
you know, financial is the main barrier to access. But getting people through the door once they are aware or they can afford IVF, getting them through the door and then through the process, that's we've just found that there's much room for improvement in terms of
patient experience and efficiency in that particular realm. There are many places where a patient can get dropped or lost or not have appropriate expectations set. It's daunting the amount of information that patients are given and expected to sort of ingest and understand and apply.
And so I think that that is an area we can expand access, but we also have to, know, once they approach us, have to be able to get them through from the new patient appointment to whatever procedure, you know, they're designated for.
Griffin Jones (20:32)
Tell me about that. Tell me more about how you're seeing challenges in the patient journey and how you're approaching that.
Amy Jones (20:37)
Yeah, so the patient journey, you it starts really just with the patient being aware that that or the person being aware that they should maybe consider speaking to a reproductive endocrinologist. And so sort of top of funnel type of information. So I think we're you know, we're focusing on patient education and the different geographies once we get them in the door.
Setting the expectations from the start, we're really working hard on that so that they understand how long the process takes. Once they decide on IVF, setting the expectation of...
If you make it to baseline, you've paid for the cycle and signed the consents and you've crossed off all or checked off all those boxes, then just because you stem doesn't mean you'll make it to retrieval. And so setting that expectation just because you make it to retrieval doesn't mean you'll have mature eggs or fertilization or blastocyst development.
or a successful embryo transfer or normal embryos if you have PGT. And so just incorporating the education process into the patient journey and repeating, repeating, repeating is hugely important. Improving the journey itself, think patients require many touch points. think that technology will help with that. I don't think it can be the only.
⁓ measure we take, think we still need the human touch, whether it's the human touch by
nurses and personnel in the center or the use of auxiliary services like frame. We've we've engaged with a company called frame
to facilitate that patient journey.
Griffin Jones (22:18)
Talk to us about...
frame and what do they offer versus some other people that you looked at.
Amy Jones (22:23)
Frame is a very light touch. do not go into the realm of medical advice or they're simply a support. So they facilitate the patient getting to the appointment.
Right? Knowing what to expect at the appointment and if they have questions, how to get their questions answered. So Fram is answering the questions. They're telling the patient, here is how you can get answers to your questions. Because so many times patients don't realize, we'll just use our EMR portal. Or you need to call this particular number if you need answers to your questions. So they.
they facilitate the process. we have just preliminary information, but thus far it's been very helpful.
Griffin Jones (23:05)
Do you think that you'll need other technologies for other parts of the journey?
Amy Jones (23:10)
It's hard to say. mean, think that frame right now is working well for us. But the part of the journey after the patients have decided to do IVF and then they need to have financial consult and then tell their physician they're ready to go forward, that's where they drop off. So the...
The financial console, and this is, know, I'm sort of wandering into an area where I'm not an expert at all, but that piece is so important and it's a very emotional piece for patients, as you can imagine, because you're hitting a patient in two very sensitive spots, fertility and their bank account, right? And so I think...
If there is technology to, or companies that can assist with that piece, that could be helpful.
Griffin Jones (24:02)
Whether it's patient journey, whether it's lab side, whether it's clinical side or business side or anywhere else, have there been a couple needs that you just haven't found the best solution for yet? Maybe you find some solutions that they can do a lot of it or some of it, but I really wish for this problem there was a more comprehensive solution. Can you talk about that at all?
Amy Jones (24:26)
Patient education. So right now, Engaged MD is a great solution. They have the modules which are helpful, but different people learn differently. Some people are auditory learners, some people are visual learners. It does not completely check that box for.
educating patients and we know this because you know we will have assigned these modules and and then they come to us with questions and you know they clearly don't understand whatever process it is that they've signed up for which could be heartbreaking at times and so I think that
We have to do a better job of educating patients. And how that is an efficient manner, it's difficult to know because as mandated states and impact is great.
You know, when you're transitioning from self-pay to insurance pay, right? You have to become more how you get patients into the door and through the process. And so a risk of sacrificing the patient experience and the patient education because of efficiency. And so I think that we're.
We're going to have to pay attention to that and figure out the best way to set expectations and educate patients before they come into the center and while they're in the center and when they leave.
Griffin Jones (25:51)
I would have thought that engaged MD would have had that unlock. it just the case that there's more education that needs to be done than beyond informed consent, that there's just a bottomless pit of how many questions a patient could ask?
Amy Jones (26:06)
They don't even know what questions to ask sometimes. Right? So they'll kind go through and watch the videos, but it doesn't mean they understand. They're really comprehending that they're asking the right questions in their mind. So for instance, you know, any patient who is coming through to have their embryos tested, they need to ask themselves what
How are we going, what will we do next if all of our embryos are abnormal? one tends to put oneself in the head in sand. Like this won't happen to us. It's not going to happen to us. But you have to have that conversation and sort of make a determination before it happens. So that's something that I would recommend to any patient coming through.
Griffin Jones (26:50)
Do you there's a way for technology to solve that beyond an AI agent that can just answer as many questions as need to be answered and take as much time to proactively educate the patient and engage on a personal level as possible? Is there gonna be any way to do this without having an AI Russell Fulk that talks to patients before actually meeting with the real...
Russell Falk.
Amy Jones (27:16)
You know, I don't know if that's possible, but that would be, you it would be great if you could have an interactive AI agent to ask questions to and to, you know, generate information that leads to more questions. I don't, I'm not sure that that exists now, unfortunately.
Griffin Jones (27:35)
I have seen some AI agents that are starting to at least be able to answer a lot of the top of the funnel questions. There's certainly a limit to what they can answer, but the text versions are pretty good. And I think there might be not now, but in the not too distant future, ones that are able to do a lot of that as like, ⁓
audio or even having a video avatar. Have you seen any solutions that are anywhere close to that?
Amy Jones (28:06)
I haven't. But I think AI would be incredibly helpful. Have the patient answer some questions. How many, how large of a family do you want? How old are you? What's your AMH? Here are the things that you need to consider. If you're 35 and you have an embryo transfer and you get pregnant and you don't have another embryo in storage or the other embryo doesn't lead to a live birth.
then you're gonna be 37, 38, 39, next time you come through. Patients don't necessarily consider that. mean, some are more sophisticated than others, but these are all questions that they need to ask and they need to have in-depth discussions with their partners if that's relevant.
Griffin Jones (28:54)
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Amy Jones (30:06)
patients falling through the cracks, I mean, before they even get to IVF. But once they get to IVF, generally labs will limit the number of retrievals that can fall in any week simply because you have limited incubator space, limited set number of embryologists who can do the work. I don't see the risk necessarily in the IVF lab because lab directors will generally put parameters around what
they can accept in their IVF lab. But I think it's patients having to wait for treatment. I think that's going to be an issue unless we proactively plan for expansion. as you know, it's hard to do unless you know for sure that it's going to impact the number of patients who walk through the door.
You know, I worked in Europe for several years and they have coverage generally for infertility treatment, which is fantastic.
But if you look at the rates, and these are published rates, they're lower than ours are in the United States. So I think we should be really careful about sacrificing quality for quantity.
Griffin Jones (31:17)
proactively planning for expansion is often sometimes things that venture capital back groups do too much and then it bites them in the butt. And consequently, it's something that many private equity back groups don't do enough of because they have an incentive to improve the bottom line.
How do you proactively plan for expansion?
Amy Jones (31:41)
It's a balancing act between needing to grow. We know that physicians create growth, needing and wanting to grow, and also keeping an eye on the bottom line, which includes expenses in every area of the practice, but the IVF lab as well.
And mean, I think that's something that we are getting better at. As lab directors, we're learning how to function in this space, not only as lab directors, but also on the business side. mean, I think it's fair for lab directors to have a seat at the table. But to do that, you need to have an idea of how your purchasing is impacting the bottom line and whether you're doing it wisely.
So it's a, I think it's a real balancing act, but generally I think that we can look at heat maps of where your patients are coming from, where there's growth, where there's an interest in infertility treatment and move towards those areas, develop in those areas.
Griffin Jones (32:42)
Maybe you alluded to it a little bit with embryologists thinking about how their purchase patterns shape what's realistic and not. The question I have for you is, as you're implementing these solutions to scale and ensure quality, what do you run into frequently that you just want doctors and embryologists to think more about? That
if they were thinking about the issue in this way that things would be easier and and they'd be able to see more benefits from it.
Amy Jones (33:18)
and communication regarding...
how the patient workflow, how the patient journey, the start to finish from when they walk in the door when they leave the IVF lab. think that we have a great system in a few of our clinics where we sort of have a triad of the nurse manager, executive director, and lab director working as a team. And I think that benefits
not only the company in the bottom line, but also the patient. Because these three important components are communicating with each other and are aware of. ⁓
of risks and how one risk affects the other department.
Griffin Jones (34:01)
Am I inferring too much by picking up that they're too siloed that very often it's we're worried about what is immediately in front of us and not how it relates to everything else.
Amy Jones (34:14)
Absolutely.
Griffin Jones (34:14)
How have you in the past gotten them to see how what happens in another area of the practice or the company is relevant to them and vice versa?
Amy Jones (34:27)
I mean, I think being present and overly communicating. So go to the meetings, participate in the agenda, communicate, overly communicate, and be open to...
to questions and criticism. You just have to be. if...
Griffin Jones (34:43)
Is it more that
part? Because I feel like I feel like over communicating wouldn't be a problem for them. Aren't people just dying to tell you what they need, what they want more of? See more of the problem being them seeing what the rest of the organization needs.
Amy Jones (34:54)
You know embryologists, right?
Embryologists are perfectionists. so, you know, we, before we talk about anything or communicate anything, we want it to be perfectly laid out. And if it's not, we're just kind of, you know, tend to hold back. So getting the embryologists, getting the love directors to come out of their shell.
a little bit and also be open to feedback.
from other departments.
Griffin Jones (35:25)
I'll be getting feedback from you, Amy, as I build out our database, I'll be coming to you saying, is this important? What else should other information that we should we be getting and staying in touch? And I appreciate you laying out the framework for us today. Amy Jones, thank you very much for coming on the Inside Reproductive Health podcast.
Amy Jones (35:48)
Thank you so much for having me, Griffin.
Amy Jones
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