Becker's Hospital Review

38 THOUGHT LEADERSHIP How Novant Health CEO Carl Armato's Type 1 diabetes changed the lives of more than 6,000 patients By Emily Rappleye N ovant Health System President and CEO Carl Armato was diagnosed with Type 1 diabetes at 18 months old. Aer living with the disease for more than 50 years, he credits diabetes for shaping him as a person and informing his strategy for preventive healthcare. Mr. Armato leads Winston-Salem, N.C.- based Novant Health, an integrated health- care network that spans four states. At Novant Health, Mr. Armato successfully im- plemented a program to find and treat undiagnosed diabetic patients — uncovering 6,000 people who were unknowingly living with the disease. He also published a book, A Future with Hope, about his personal journey with diabetes. Becker's caught up with Mr. Armato to talk about how he turned a dia- betes diagnosis into a motivator for change as a healthcare administrator. Note: Responses have been edited lightly for length and clarity. Question: What is your philosophy behind your management of diabetes? Carl Armato: First, you must have knowledge about the disease. My big- gest thing, even from a very young age, was fully understanding the disease itself. I consider myself somewhat lucky. Growing up without all the dia- betes management technology and support that exist today, I was forced to really learn how my body reacts to food and activities, and how that's changed over the years. I'm constantly focusing on what's going on in the environment, how that might impact my blood sugar, and I plan a lot and proactively prepare. For example, we have something called "No-meeting Wednesdays" where I'm rounding, and I'm out and about for hours. While I'm rounding, I stop to check blood sugar levels and watch how many stairs I'm going up and down. It's a constant monitoring, but over the years, I am confident I've figured out how to manage it effectively. Q: Was there ever a point when you worried diabetes would hold you back? CA: Even with my strong support system, I encountered challenges in my early adolescence. I told one of my coaches I was diabetic. He didn't fully understand it, and he just quit playing me. I think it was more out of fear — he was worried as I was running up and down the court that I could pass out or have a problem. What was unfortunate is that coach ended up mov- ing on, and I didn't tell the next coach about my diabetes. I began to start again, play and "be normal," as you would consider it. A lot of those events occurred, which made me not want to talk about the fact that I had Type 1 diabetes. I was worried how people would react and what that would mean for me later in life. For example, I had a girlfriend who I opened up to about the disease and the monitoring I had to do. Even the girlfriend said she didn't know if that was something she wanted to deal with. It was experiences like those, though, that only made me stronger and made me really want to show that if you have Type 1 diabetes you can thrive and realize your dreams. It forced me to be very cautious about who was in the inner circle and who I share the details with about my chronic disease. Q: When you started as CEO at Novant, you didn't share your diag- nosis right away. What made you change your mind and share that information with staff? CA: As I looked at what was going on in the healthcare industry, increas- ingly I saw a demand, and even an expectation, for transparency. It was a great approach for me to help create a culture of transparency. Sharing the fact that I am a Type 1 diabetic created more open dialogue, and our team members saw the human side of me. It helped the entire organiza- tion appreciate that openness, and it allowed us to really build on what I believe is authentic transparency. at's where I started the conversation internally. But it was really as I started to talk to more juvenile diabetics at local events that I realized many were really looking for hope, which led me to the book. Q: In the book, you say diabetes has made you the person you are today. How do you think living with diabetes has changed you for the better? CA: Very early in life, my parents — particularly my father — spent a lot of time helping me see that yes, I had a chronic disease, but that other people were also dealing with a lot of different complex issues in life. In healthcare, it's really helped me to walk into meetings or round in a Novant Health hospital or clinic and see things with a pretty unique perspective. It's beyond numbers on a spreadsheet or discussions in a boardroom. It's really about being able to look at a decision and see the impact it's going to have through a patient lens. As someone who has a chronic disease, I can maybe see something and uncover a gap or opportunity to improve care for many other people who may otherwise be missed. Just imagine that every meeting I walk into, every decision I make and have made since I've been in healthcare, has been through the eyes of someone with chronic disease. It helps me be a better healthcare leader; it allows me to truly keep the patient experience and the impact on patients at the forefront of each and every decision. Q: How do you decide who to surround yourself with at work? CA: What's wonderful is I'm surrounded by amazing people. Of course, when you look at my executive team — all my direct reports from phy- sicians to administrative folks — they all not only know about my Type 1 diabetes, but I've also taught them things to look for. It took me a long time to do that — to just be comfortable sharing that I'm a Type 1 diabetic and educate people about how they can help. Q: Is there anything else you'd like to share with our readers? CA: e other thing I would like to share is the impact at Novant Health. As a healthcare leader, you are always pushing yourself to ask what else can you do to help people. At Novant Health, we conducted a search and rescue. It was a three-year program to find people who had diabetes but weren't yet diagnosed. We tested every hospital admission. e amazing thing is we uncovered more than 6,000 undiagnosed cases of diabetes. Now many of those patients choose to get their diabetes treated at Novant Health. I think they are healthier today because we went aer that search and rescue. We serve more than 90,000 people with diabetes. When I look in our EHR at the records for those 90,000 diabetics, 68 percent are in the normal rang- es for hemoglobin A1C, their blood pressure control and their cholesterol control. What I'm excited about is we lead the industry — but that's not enough — because I want all of them in normal ranges. n

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