Issue link: https://beckershealthcare.uberflip.com/i/1074723
14 Thought Leadership Leadership in a competitive market: Cleveland Clinic's Dr. Michael Steinmetz on the trends in spine today + the qualities he looks for in tomorrow's leaders M ichael Steinmetz, MD, is chairman of the department of neurosur- gery at Cleveland Clinic. He has expertise in minimally invasive surgery, complex spine surgery, trauma and spinal cord injury. Here, Dr. Steinmetz discussed how leading a neurosurgery department has changed over the past few years and the big future oppor- tunities for Cleveland Clinic in spine. Question: How has your role as a spine department leader evolved over the past two to three years? How have your responsibilities changed? Dr. Michael Steinmetz: If you consider the past few years, it was easi- er to take your practice for granted. You could turn your lights on and patients would show up. ings were easier. Competition has grown substantially. Insurance contracting has narrowed the market, driving patients to one institution over another. Surgeons are doing more com- plex surgeries, and we are seeing much more regulation from the payer end. Even institutional changes with regards to implant use have made it harder to practice the way we did in the past. We're moving rapidly into an idea of outcomes-based clinical care as op- posed to outcomes-based research. We've had to evolve, and as a leader, I had to help lead that change. We have had to be much more creative in the marketing space, which is something that I wasn't involved in until recently. We are now focusing more on 'customer' service than we did a decade ago. Q: How do you differentiate yourself in a competitive mar- ket when consumers have so many options? MS: We look at cutting costs, but all systems have done that so we need to do something different to achieve an advantage. We meet regular- ly with our physician groups and look at opportunities for continuous improvement projects. An example is an operating room block utiliza- tion project. We looked three months into the future with the operating room and found where we had the opportunity to maximize utilization. at has been an effective way of making sure patients have access to the operating room without having to ask for more operating rooms. We don't really need more operating room time, but we do need to use it in a more efficient way. We have also been active in clinical outcomes research, and that is a shi from examining radiographic outcomes to patient outcomes. We are looking at basing our care on that research and using artificial in- telligence as well as predictive modeling to make sure we get the right patient to the right surgeon in the right facility as efficiently as possible, at the right cost. Q: When you are adding new surgeons and trainees to your team, what qualities have changed over the past five years in the applicants? What is most attractive now? MS: When we looked at recruits and trainees five years ago, we looked for people well-versed in basic science and clinical research. Now we look for people with backgrounds in data science and machine learning. Our research is now in big data. We have had a data registry since 2007, and we have to figure out what to do with all that data. We are using AI and machine-based learning to do data analysis of our outcomes and facilities to make that information more predictive. We consider which treatments will be best for each specific patient and whether there are factors that would affect the patient's outcome that we can mitigate. We can also see who the best surgeon would be to operate on each patient to achieve the best outcome. at's the direction we are trying to go, and I think that's the direction of spine surgery. We've gone from a concept to data science, and we can do that because we're a large academic medical center. e data gathering capabilities will be a limiting factor for small groups. Now we are look- ing at how we can export the data we have at Cleveland Clinic to other practices and facilities; there are many challenges out there. We are just getting our feet wet in the whole arena. Q: What changes are you seeing in the payer landscape? How are the financial challenges of the healthcare system affecting your practice and leadership role? MS: ere have been dramatic changes in payer regulation, and a big shi in what we can do. We focus our efforts on understanding the payer changes and being nimble so we stay proactive and document every- thing we need to document for payer approvals. I wouldn't have thought that would be a big part of my role five years ago, but now we spend time in administrative meetings making sure we stay on top of the care response, understand the payer's rules and make changes as necessary. Other institutional changes we've seen include the drive toward more standardization within the healthcare system. It's a challenge to convince a group of surgeons that it makes sense to use one single implant vendor. As a leader, we have to show how it benefits the healthcare system and us as physicians. We spend time convincing the surgeons that standardiza- tion is a good idea and we will see the rewards of that as a department. Surgeons are less likely to go into private practice today and more likely to work for health systems, so if the health system succeeds, we as sur- geons succeed. n