Health Evolution | November 19, 2019
AdventHealth President and CEO Terry Shaw is on a seven-year change management journey toward whole-person care.
The $12 billion system, which rebranded from Adventist Health System in January, has a strong organization-wide focus on patient-centered care. AdventHealth was recently named the Number 1 hospital in Florida by U.S. News & World Report over the summer and a CHIME Most Wired hospital late last
Shaw has been at the helm of AdventHealth since 2016, after serving as senior vice president and CFO until 2010, at which point he assumed the COO role as well. During his 30-plus year career, Shaw has also held senior leadership positions at Florida Hospital (AdventHealth Central Florida
Health Evolution Editor-in-Chief Tom Sullivan spoke with Shaw about what AdventHealth has achieved in the first year-and-a-half of the transition to patient-centric care, the public promises it is working on for its patient population and three key questions caregivers ask every patient to improve the way providers engage consumers and vice
Health Evolution: You said at the Health Evolution Summit that you would like consumers to look to AdventHealth as a partner and that Advent is pivoting toward whole-person care. Where are you in that journey?
Shaw: We are one and a half years into a seven-year climb. We had to totally change how we implement strategies and communicate across the company. It takes a concerted effort to get an organization to pivot into a new direction and that includes the 3,000 leaders, down to manager and director levels.
Health Evolution: It’s interesting that you used the word ‘pivot’ because of AdventHealth’s size. How do you lead the cultural transformation of some 80,000 people?
Shaw: It’s not enough to have your CEO understand, you have to get into the organization and have congruence about mission, vision, values, strategy and how we’re going to interface differently than in the past to build momentum and move the flywheel of change. Every quarter our top 50 leaders come in for a strategy session. That work expands to 500 voices and, in turn, becomes 3,000 voices. Those 3,000 lead the 80,000 employees and it’s getting easier, because of so many key people speak with the right voice.
Health Evolution: You also said that “military and hospitals discharge people, we’re trying to let the military own that and take hospitals out of it.” Aside from being a great line, what is AdventHealth doing as part of the shift toward patient-centric care to improve the outpatient experience so it’s less like a military discharge?
Shaw: People are more than the sum of their diagnoses. They’re a sum of thoughts, feelings and beliefs. We see millions of people in outpatient settings on an annual basis, and we’ve added three questions to ask them as part of their intake and medical record: Do you have someone at home who loves you? Do you have a source of joy in your life? Do you have a sense of peace today?
About 80 to 120 people a day are being referred into spiritual care follow-up based on the results of these questions and we follow up from there based on what the person needs, whether that’s food, counseling, etc. We’re finding that providers are doing a lot more than medicine by knowing a little bit more about patients.
Health Evolution: Particular to those three questions, what exactly are you hoping to learn through the answers beyond the obvious? It sounds like a front door into a patient’s life …
Shaw: If someone says yes to all three, “I have grandchildren and here’s a picture, let me show you,” that’s one thing. But when someone starts crying the minute you ask the questions; you spend a little more time going deeper into their life — it is a front door.
Health Evolution: I know it’s still early but have you seen any tangible results from asking those questions?
Shaw: We are seeing physician offices make wholesale changes in the way they view people and take care of people. In addition our spiritual care advisors become their pastor, providing an outlet and opportunity to intervene and provide support for employees. So we’re seeing many tangible results but if you’re asking if we see net revenue, that I couldn’t tell you.
Health Evolution: Is that because the effort is not about net revenue?
Shaw: No. I’m not saying we are or we’re not earning net revenue. We’re a year into the transaction and we’re tracking the care and concern for people and how that rubs off and how they are sticky with us. The better we are, the more sticky they’ll be.
Health Evolution: And that translates to net revenue down the road? At least ideally?
Shaw: Absolutely. The truth is things are going quite well and our net revenue is strong. We see this as an investment in our transformation.
Health Evolution: Let’s get back to improving the outpatient environment because I believe there are some other initiatives AdventHealth is undertaking …
Shaw: The second thing we’re doing in the outpatient setting is providing people with someone to help them navigate the system. So, instead of a stack of discharge instructions, patients leave with a set of doctor’s appointment information so they know where they’re going and how to get there. If you’ve never been handed that discharge sheet with instructions to see three different doctors, then you don’t know how hard it can be to just get to those appointments. So, we’re offering full care navigation.
The third thing we’ve done is made online tools go from being horrible to being very consumer friendly for the average person who uses their phone for Delta or Amazon or anything else.
And we have a five-year road map to consumer promises that we’re rolling out. We’re making 20 consumer promises.
Health Evolution: What are the overarching themes of those consumer promises?
Shaw: When you use your credit card online, you get one statement. When you’re done with medical care you get a blizzard of bills. It’s ridiculous. We’re committed to giving consumers one bill — and you’re going to know how it all comes together in one place just like you do on your credit card statement.
We also want to deliver synchronous and asynchronous contact with providers 24/7. These consumer promises are very thoughtful and very deep. It’s about how we behave and how consumers experience AdventHealth.
Health Evolution: As you increasingly focus on the outpatient environment how do you strategically re-imagine what happens in hospital settings and do so in a financially sustainable manner?
Shaw: My job is to make sure people who need hospital care get the best hospital care they can get and make sure people are connected so they can navigate a complex outpatient system. When you need to be in the hospital, our hospital needs to be as efficient and effective as it possibly can be.
What I see happening inpatient vs. outpatient in next two years is the technology will continue to perfect itself and allow us to do great things in the home — but there will still be hospitals in 10 years.
Health Evolution: What’s next for AdventHealth?
Shaw: First, we started the care navigation process and at the end of three years I envision no care gaps. Second, is synchronous and asynchronous access for questions and care needs for consumers and family members.
Then there’s our price guarantee on the top 500 items you can take to the bank. Another is to meet care needs within a 15-minute radius of your home 95 percent of the time and offering a unified record for our employed and non-employed caregivers to have a full view into the consumer (patient) much like Amazon lets other people sell into their network. This takes us closer to complete consumer connectivity.