Issue link: https://beckershealthcare.uberflip.com/i/170070
Service Line Leaders' Roundtable 26 Deb Hood Dereesa Purtell Reid Akram Boutros, MD resides, such as laboratories, imaging centers and physician offices. Without good data, you can't begin to have discussions about how to reduce costs or improve outcomes. We have spent many hours carefully detailing the exact description of an item we want to measure and exactly where the most valid data resides. Since most of oncology work is in the outpatient arena, this data, along with good comparative benchmarks, can be difficult to obtain. mendous amount of work that's preparing us for the future. We need their clinical leadership and expertise embedded in everything we do. Q: What are some of the challenges currently facing the orthopedic service line? Orthopedics A close second is physician alignment. Catholic Health Initiatives has very few employed oncologists, so working with independent practices in each individual market has been a challenge with various quality initiatives we'd like to implement. This work is much easier to do if you're a Kaiser or another institution where everyone is employed and willingly sharing data or on the same software system. Dereesa Purtell Reid, COO, Hoag Orthopedic Institute (Irvine, Calif.): More than ever, hospitals and physicians must look for ways to align their goals around achieving the highest quality while driving down the cost of care. With an aging U.S. population and an increase incidence in obesity, the demand for orthopedic care will continue to grow. Optimizing the health of patients before surgery is essential whether it is weight loss or addressing other co-morbidities. Ms. Reid: Two key challenges come to mind for any service line, whether it is orthopedics, neuroscience, heart or cancer. The first is that vocational commitment by physicians and the hospital is essential. Building a service line is a multiyear, perhaps multidecade commitment with many financial and organizational challenges. The most successful service lines were built by a core group of individuals that were internally motivated by a "calling" or vocational commitment to build a service line or institute that surpasses what any one individual or hospital can do alone. The second is that with limited resources and the need to produce top quality, not all programs and service lines may be feasible. The other challenge is figuring out the role of oncology in the various new models of care, such as ACOs, patient medical home, etc., that are developing. We're looking at the specialty neighbor model for oncology and have a lot of work ahead for us in this development. Q: How would you recommend overcoming some of the challenges facing the oncology service line? Ms. Hood: In the past, I didn't feel that your oncologists all needed to be employed. Today, however, I feel that we need something to link the oncologists and cancer centers in this new era of population health. Maybe that's employment, but it could also be professional or management service agreements. Physicians are lining up with various partners across the country, but some independent groups still want to wait and see what direction everything is headed. I'm not sure we can afford to wait for them. We have a lot of preparatory work that needs to be done now, and we need strong physician partners. For the work ahead, we also need to be physicianled. Our service line is organized in clinical dyads. My partner, Dax Kurbegov, MD, is the physician vice president, and I am the administrative vice president. Dr. Kurbegov and other physician leaders throughout our system are doing a tre- Q: What are some of the biggest developments or opportunities for growth in the orthopedic service line in the coming year? Q: What are some of the newest technologies or applications that are being used in the orthopedic service line? Ms. Reid: While orthopedic and spine implants continue to improve, we are focused on evaluating surgical products that improve patient care and also reduce costs. Innovative orthopedic surgical techniques, such as the direct anterior approach for elective, primary hip replacement, are less invasive and decrease recovery time. For example, Hoag Orthopedic Institute reviewed several patient-warming methods in the operating room. Keeping patients warm throughout surgery has been proven to reduce the risk of infection. Q: How would you recommend overcoming some of the challenges facing the orthopedic service line? Ms. Reid: Healthcare reform wills thoughtful consideration as to which service lines a specific hospital or health system can provide at the highest quality and reasonable costs. Value-based purchasing is creating quality transparency among hospitals and service lines. With limited resources and declining reimbursement, the portfolio of service lines offered by hospitals is likely to narrow. Q: What advice do you have for service line leaders for the coming year? In the world of neurosciences, the technology continues to advance — deep brain stimulators, neurological drugs and new approaches to neurological rehabilitation. Ms. Reid: Become best friends with nursing! Nurses provide care at the intersection of patient satisfaction and quality. They are the heart of the healthcare organization — serving patients and physicians. Akram Boutros, MD, Founder and President of Business First Healthcare Solutions, former COO and CMO at South Nassau Communities Hospital (Oceanside, N.Y.): The introduction of robotics. The RIO™ is a robotic platform designed to improve implant alignment and reduce surgeon error by passively restraining surgeon movement to ensure precision. Dr. Boutros: I would advise service line leaders to focus on service line transformation. While in the short-term, the focus on profitable growth is critical, in a highly competitive market, expansion of care beyond the operating room is important for long-term success. A full menu of options and packages from diagnosis to recovery should be aligned for effective delivery of highvalue, personalized outcomes. n