Issue link: https://beckershealthcare.uberflip.com/i/301968
27 Dr. Mossallam: Fourteen months ago we created an internal physician ad- visory service here to perform secondary physician reviews for appropriate patient status [to better ensure that the patient is either an inpatient or out- patient (observation)]. We're significantly ahead of the pack on this. We've also refocused on resource utilization, which has been helpful. When we had to start rethinking readmission resources, there were a few problems when we directed resources not to where the problem was and had to redirect our efforts. It really is about engaging the right people to do the right work, the people who have the skill set you need. Dr. Orr: All CMOs should take stock of the information they have available. They should make a list of all the data sources they have, clinical data, claims data, health risk assessments, etc., and start getting feeds from them either manually or automatically. Then the information can be used to make deci- sions. Sometimes it's also a matter of getting the right people from different silos come in and meet once per week and make sure everyone is on the same foot. Then, once CMOs have the information they need to go out and com- municate and make sure the organization is all on the same page. Dr. Shabot: The best decision we made was to set a goal of becoming a high reliability health system and to consolidate many different hospital-based quality, safety and infection control departments into a single systemwide department with a single management structure. When we have initiatives for new measures we do them as a system and we develop the processes as a system. If there's new technology or something new for the EHR, we imple- ment it across the whole system. Dr. Slonim: The best decision we made was to make sure that we were engaging clinicians in the conversation about healthcare reform. By allowing the clinical voices to be heard, we are better able to identify alternative solution sets that advanced our redesign efforts. I think that the worst decision had more to do with the timing than the decision. I think we should have moved faster on some initiatives to achieve the full benefit of the intervention. Healthcare is moving very quickly; when you're thinking about doing something, keep your priori- ties in mind and be aware of when it needs to be executed. Q: what advice do you have for other CMOs for 2014 and be- yond? Dr. Arredondo: As leaders, we often underestimate the importance of com- munication and transparency when we face challenging issues. Important and difficult issues will have to be explained many times. Those whom we lead do not expect us to be perfect, and they understand that leaders are fal- lible because they are human beings. Don't be afraid to admit errors or mis- judgments, the trust and respect that you will earn for this painful admission will serve you in the long run. Dr. Mossallam: I think you have to really look at utilization practices. With regulatory issues like the readmission reductions and the two-midnight rule, ensuring the best and most timely utilization practices would be key for any administrator. Engaging the physicians is also key. Moving to a team based approach is necessary to stay ahead of the curve. Dr. Orr: You need a uniformed approach. It's sometimes tempting to say OK to making a contract for 50,000 lives in an ACO and then deciding to throw quality programs in, add some of the top doctors and see what happens. That's a mistake, because it does nothing to prepare the rest of the organiza- tion and confuses the doctors. It comes down to treating all patients fairly and consistently, regardless of payer status. You need that consistency across the whole organization. Dr. Shabot: Our healthcare system would be markedly improved if patient safety was the core value of all healthcare decisions. Memorial Hermann's board has set safety as the organization's core value. If we're starting a new program, then doing it safely and at the right hospitals is what we do. If we can't do it safely, we don't do it. Memorial Hermann has won many nation- al and state awards for quality and safety and has grown hand over foot all while complications and their associated costs have gone down. If we focus on quality and safety, the finances and growth will follow. Dr. Slonim: I think being a physician leader requires education, skills and experiences that are not taught in medical school. You have to be prepared for the job. My advice is to make sure you're prepared and get in the game. Make sure your interests and the interests of the patients you represent are being heard at the table as healthcare is being redesigned. n Get your free analytics eBook. Visit optum.com/gamechange to download the new eBook, Moneyball Analytics, and begin changing your game. Get in the analytics game. We understand health care analytics can be intimidating. But with the right data and processes, analytics have the potential to change the game for health care providers. From reducing costs to improving health outcomes, a smarter game plan founded on the right data and analytics can create a winning combination for providers and patients across the care continuum. "The best decision we made was to set a goal of becoming a high reliability health system." — Dr. M. Michael Shabot, CMO, Memorial Hermann Health System Optum is a leading information and technology-enabled health services business dedicated to helping make the health system work better for everyone. With more than 50,000 people worldwide, Optum delivers intelligent, integrated solutions that help to modernize the health system and improve overall population health.