Tom Sullivan | July 8, 2020
The world is halfway through one of the most tumultuous years on record — but the battles against COVID-19 and racial inequality dominating the national discourse against the backdrop of an already divisive political election season are only part of 2020’s narrative. Other critical aspects include insights about leadership, innovation, resiliency, and striving for the greater good.
Health Evolution reflected back to the year’s beginning and leveraged analytics to determine the most important articles based on how readers engaged with them. Taken together, these pieces tell a story of the nation facing a pandemic, and doing so with a broken health care system, while considering the possibility and indeed working to emerge with a stronger, more equitable system.
Here are the 10 most-read Health Evolution articles of 2020 thus far.
Founder and Executive Chairman Glen Tullman said the company has seen payers, PBMs and large employers come to Livongo asking how to keep populations of people with chronic conditions out of the hospital and how to manage costs. “This is an opportunity to rapidly evolve the health care system. They have no choice,” Tullman said. “There’s no reason for anyone to go back to the old way of doing things.”
Prior to the ongoing pandemic, Health Evolution interviewed more than a dozen CEOs to delve into their most pressing agenda items for 2020 and beyond. Snapshot: Change quickly or risk failing. “If I don’t move 180 degrees, I’m going to be part of a dying breed,” said Steve Klasko, MD, CEO of Thomas Jefferson University and Thomas Jefferson Health. Marshfield Clinic CEO Susan Turney echoed that sentiment: “We know if we don’t do things differently, our competitors will — and they’re not just our competitors of the past.”
The Hospital for Special Surgery’s CEO Shapiro pointed to four principles that guide the enterprise amid the pandemic. Protect staff, protect patients and protect the organization and contribute to solving the problem. “There’s a micro and macro view. What we’re seeing is organization over individual, society over organization,” Shapiro explained. “That’s promoting a level of teamwork that is unlike everything I’ve seen within the organization, across organizations and across populations.”
This one began with words of wisdom that became prescient to the recipient: Write a plan for what to do when you get fired. “I worked for a Governor at the time and you could get fired for a headline. Often, that made people hesitant to make decisions. So the point the Governor made was ‘okay, now that you have a plan to take action in the event that you get fired, go do your job.’” Another pearl: “The best advice was that ‘when people tell you that you can’t do something what they really mean is they can’t do it,’” said Rushika Fernandopulle, MD, CEO of Iora Health. “You need to decide for yourself if you can do it or not.”
Describing COVID-19 as “a once-in-a-century fight for the health and wellbeing of our citizens and our nation,” Health Evolution Founder and Executive Chairman David Brailer, MD, wrote in his Leadership Matters column that when the crisis is behind us, the U.S. will ask what we learned and what we should do differently next time. “A future investigation will not show that federal agencies failed to follow rules, but rather that the rules themselves were obsolete and not adequate for today’s challenges,” Brailer noted. “It is a systematic institutional failing that demonstrates the huge downside of having the government too much in control of health care.”
The report laid out a phased approach that begins with slowing the spread, then transitions into state-by-state reopening, followed by establishing immune protection and reducing physical distancing and, ultimately, includes preparing for the next pandemic. “Properly implemented, the steps described here provide the foundation for containing the damage that future pathogens may cause,” the authors contend.
How substantive is the burnout problem and what should CEOs understand about it? Burnout costs an estimated $4.6 billion annually because it impacts nearly half of physicians. What’s more, evidence suggests that the ROI to addressing this problem can be immediate. “As a CEO, you’re already investing considerable financial resources every year on physician burnout. You’re already investing $10 million per year on burnout. You’re just investing it at the sharp end of the stick, on replacing physicians who leave because of burnout rather than on prevention,” said Christine Sinsky, MD, Vice President of Professional Satisfaction for the American Medical Association.
Information interoperability. It’s not just the IT department’s problem anymore. “Sharing information about patients reduces duplication, wasteful treatments, improper care and errors,” Brailer wrote. “A startling $1 trillion dollars a year could potentially be saved by making health care more efficient and higher in quality.” To that extent, Brailer called on CEOs to embrace the (presently delayed) interoperability and patient access final rules from Health and Human Services. “Those who lead our industry and care deeply about improving health cannot let this opportunity be lost.”
When Health Evolution Senior Manager of Digital Content Gabriel Perna interviewed ProMedica CEO Randy Oostra and ProMedica International President Kathleen Krueger, the WHO had just declared the coronavirus outbreak a global health emergency and the overarching question among provider CEOs was whether or not China was to be considered an important business opportunity as Cleveland Clinic, UPMC and others expanded into the country. “We are focused on helping them establish organizations around healthy senior aging and post-acute services,” Krueger said. Asked about COVID-19’s impact on that work, Oostra answered: “This doesn’t deter us from China. It shows us the importance of working together.”
The Commons Project is working to establish an open-source, non-profit public infrastructure for the digital era with longevity in mind. Think: 100 years, or the lifecycle of at least a generation of human beings. CEO Paul Meyer modeled the Commons Project on the Port Authority of NY&NJ because if the Port Authority operated on venture financing it would have had to sell the bridges within five years to appease investors. “Some services ought to be operated as public services and as a society we haven’t found a model to create and operate digital services for public good,” Meyer said. “You need a different operational structure for services intended first and foremost for the public good — a traditional model just doesn’t work.”