Issue link: https://beckershealthcare.uberflip.com/i/335303
20 Question: What is it like being head of a hospital in the healthiest county in your state? Judy Coffey, RN, Senior Vice President and Area Manager for Marin-So- noma of Kaiser Permanente (Oakland, Calif.): It's an honor, and with that honor comes tremendous responsibility. Being the "healthiest" county in California does not tell the whole story. At Kaiser Permanente, we believe good health is a fundamental right of all people. We recognize that promo- tion of good health extends far beyond the doctor's office and the hospital, which is why we have developed an extensive community benefit program to support the people, programs and services most in need. Donald Gintzig, MBA, President and CEO of WakeMed Health & Hospitals (Raleigh, N.C.): It's an honor, and I'm humbled by our 53-year history in Wake County and beyond. Wake County has held the top spot for five years straight as the healthiest county in North Carolina, and number 11 on the list of healthiest capital counties in the U.S. We want to continue that trend and move up the national list, so we're all looking to raise the bar, focus on population health and continue to improve health here in Wake County with the right services in the right places. Our elected officials also adopted a new goal for Wake County this year: to become the healthiest capital county in the U.S. And I think we can achieve it. Amy Pollard, BSN, RN, MPS, President and CEO of Noyes Health (Dan- ville, N.Y.): In most ways, being CEO at Noyes Health is not different than at any other hospital. However, to be in the healthiest county in New York state, there is a stronger commitment to working with community partners across the continuum of care. Together we identify barriers to care or patient com- pliance and define strategies to improve outcomes. The CEO has to lead the hospital to change from thinking about the care that is given while the patient is within our walls to thinking about the care of the patient outside our walls. Q: How has the increased national focus on population health changed the way your hospital cares for patients or does business? Ms. Coffey: At Kaiser Permanente, we have always had a focus on wellness and health advocacy. Prevention is in our DNA. Long before the Affordable Care Act made the word "prevention" a health care norm, our members were receiving regular preventive screenings and encouraged by their physicians to make healthy, active lifestyle choices and stay away from harmful habits like smoking. Another way we continue to evolve care is through the use of our electronic medical record system called KP HealthConnect. Our clinical experts can use KPHC to research trends in our most complex, chronically ill patients, identify successes and spread best practices in managing the continuum of their care. Lastly, our commitment to providing high-quality, affordable healthcare at the right place and at the right time continues to change the way we do busi- ness. Personalized, convenient care requires us to expand our services into less traditional settings, including emails to your doctor, home visits, tele- phone, online and video visits, prescriptions by mail and preventive apps for mobile devices. Mr. Gintzig: We are pleased to see the nationwide shift toward a system of health, not just healthcare. For patients, we are already leading the shift to a new model of care by forming an ACO. WakeMed Key Community Care is a physician-led effort in partnership with the hospital to provide integrated, patient-centered care. We think patients will find more resources available to them now as well as more people helping them get the care they need. This means coordination of care, more involvement in prevention and a more ac- tive role in helping people manage their overall health outside of the health- care setting. From a business standpoint, we've invested significantly in evolving our orga- nization to provide effective, accessible healthcare long into the future. Prob- ably the best example of this is our implementation of the Epic electronic patient record system, which marks WakeMed's largest single information technology investment to date. In our view, electronic records are a vital part of patient-centered care and crucial to managing population health. Ms. Pollard: We no longer see ourselves as a standalone organization, but rather as part of the region's broader healthcare ecosystem. So, we work close- ly with area physicians, other hospitals, nursing homes and rehab programs to help patients maintain their health. As a result, we have more conversa- tions with care partners to ensure consistent quality, a seamless transition and, of course, to keep the patient at home or at the most appropriate level of care possible. In terms of our business, we continue to see the transition from inpatient to outpatient revenue. Currently, 75 percent of our revenue comes from outpatient services, and I expect that to grow. Q: Describe the process surrounding population health planning at the hospital, if there is one. What are the most important focus areas? Ms. Coffey: Just as our focus on total health — integration, prevention and empowerment — drives internal planning for our members, it also drives planning for improving the health of our community. For example, every three years we conduct an extensive community health needs assessments to better understand the changing demographics, challenges and needs within our community. The CHNA process informs our community investments and helps us develop strategies aimed at making long-term, sustainable changes. The process also allows us to deepen our relationships with com- munity partners, including educational and governmental entities, other nonprofit organizations and safety-net clinics. Mr. Gintzig: Planning and decisions are made at all levels, from finance to quality to patient care and physician leadership. We're aligning our efforts to transform healthcare through partnerships and by helping patients take charge of their health. We are focused on the areas that are also challenging the healthcare industry as a whole: Increasing quality, safety and services, de- creasing costs and shifting to a culture in which we try to keep people healthy and out of the hospital. Through coordinated care, innovative programs, ro- bust acute and rehabilitative services and community physician partnerships, we have a unique opportunity to help our neighbors get and stay healthy. Ms. Pollard: Population health management can only occur with planning and cooperation within the region. Noyes is a collaborating institution of the University of Rochester and is a participant in the Accountable Health Part- ners network established by University of Rochester Medicine. AHP brings together academic and community providers who work together to improve quality, access and cost efficiency. Areas of focus for population health are the obvious ones of chronic disease management and preventive health services. Livingston County is a rural county with the primary industry being agricul- ture, so it is critical to have services in multiple sites and to have strong public health and home health programs. Q: How does your hospital integrate your employed and affiliat- ed physicians in the planning and execution of population health initiatives? Ms. Coffey: Through Kaiser Permanente's uniquely integrated model — hos- pital, health plan and medical group — we are able to bring together repre- sentatives from all aspects of the healthcare delivery system when planning "You can't achieve population health without bringing everyone to the table. It's this collaboration that will continue to lead us toward a system of health, not just healthcare." — Donald Gintzig, President and CEO of WakeMed Health & Hospitals