Why is healthcare still observing banker’s hours when even bankers are available 24/7?

Key Takeaway: Changing the cost trendlines will require a different approach to how health systems operate. Integrating clinical systems are seen as a key to a successful transition.

Jonathan Bush, athenahealth; Amir Dan Rubin, One Medical; Andrea Walsh, Health Partners and Terry Shaw, Advent Health

The pressure to change how care is delivered is being felt throughout the US healthcare system, but nowhere is it being felt more keenly than in the executive suite.

“We’re having to fundamentally rethink a lot of the care delivery process. You’re not going to change it on a dime,” said Terry Shaw, President & CEO, AdventHealth, at the April 2018 Health Evolution Summit. “This is a five-year journey and not a ‘flip of the switch’ journey.”

In the Health Evolution Summit 2018 panel discussion “Provider Connect,”  Shaw said that changes in the patient-provider relationship are well underway but they’re far from complete.

“We’ve spent the last 100 years figuring out how to make you find me the way I want you to find me,” Shaw said. But it’s a mindset that needs to change.

“We have too many front doors in healthcare,” said Andrea Walsh, President & CEO of HealthPartners, Bloomington, Minn., adding that the system has a tendency to create even more doors. Instead, Shaw said “we need to make it easier so there’s no wrong door.” HealthPartners is both a provider and an insurer, caring for 1.2 million patients and providing coverage for 1.8 million in six states.

When patients first engage with a health system, too often, the journey is pre-defined and can have limitations depending on whether they started with an ER visit, a referral, or a walk-in clinic. Walsh said the system shouldn’t allow its own complications to interfere with the patients’ journey.

Shaw is addressing this with a commitment to better communication within AdventHealth’s clinical delivery network, which is integrating services from employed and affiliated physicians. AdventHealth, formerly Adventist Health System, includes more than 80,000 caregivers, nearly 50 hospital campuses, and hundreds of care sites including physician practices, hospitals, outpatient clinics, skilled nursing facilities, home health agencies and hospice centers.

“I’m a little agnostic about whether I own the doc or whether the doc’s in the market,”  Shaw said. “What I am not agnostic about is them being a part of the clinically integrated process.” He is stressing the importance of sharing information and coordinating schedules so care can be managed better.

Walsh said one of the challenges for traditional primary care clinics is “we’re [following] bankers’ hours, and bankers are 24/7 now but health care is not.”  HealthPartners is an integrated system with more than 1,800 physicians, eight hospitals and 55 primary care clinics, and also offers a health plan in six states.

Amir Dan Rubin, CEO of One Medical, a primary care provider, said that change will require strategy and a commitment to execution.

“Do you really want to do it or not?” he said. “Do you want to build an economic model around it or not? And are you going to build all the processes and tech around it or not?”

One Medical, a primary care practice with offices in more than 60 cities, is stressing an orientation around the patient as consumer. It has received equity investments from Benchmark Capital, Google Ventures, Maverick, JP Morgan and the Carlyle Group.

Rubin said that change at One Medical involves commitment on the financial and technology side. Physicians are paid only through salary. There is no ancillary revenue outside primary care. And One Medical also has a strong commitment to technology.

“We built our entire tech deck. We ship code every three days,” he said. Rubin believes that the commitment to building an EHR that meets One Medica’s needs is justified by the improved care that One Medical members receive.

The conversation took place at Health Evolution Summit in April 2018 during the session “Provider Connect: Where Provider Executives and Innovative CEOs Connect.” – Gus Venditto