Becker's Hospital Review

53 THOUGHT LEADERSHIP 7 Questions With MetroHealth CEO Dr. Akram Boutros By Kelly Gooch A kram Boutros, MD, has served as president and CEO of e MetroHealth System in Cleveland since June 2013. Dr. Boutros, who has more than two decades of leadership expe- rience in large community hospitals, specialty hospitals and academic medical centers, most recently was president of New York-based consultancy BusinessFirst Healthcare Solutions. His previous roles also include executive vice president and chief ad- ministrative officer of St. Francis Hospital – e Heart Center in Ros- lyn, N.Y., and executive vice president, CMO and COO of South Nas- sau Hospital in Oceanside, N.Y. Dr. Boutros, an internist, earned his medical degree from the State University of New York Health Sciences Center at Brooklyn and also graduated from Boston-based Harvard Business School's Advanced Management Program. Dr. Boutros recently spoke with Becker's Hospital Review about the big- gest challenge he's facing as CEO, his goals for MetroHealth and more. Note: Responses have been lightly edited for length and clarity. Question: What's the biggest challenge you're facing as CEO? Dr. Akram Boutros: e military has a term they developed aer World War II called VUCA, and it's an acronym for volatility, uncer- tainty, complexity and ambiguity. Nothing could describe the health- care industry today better than that term. So the biggest challenge to- day is operating within the new environment, and the level of comfort that people have to develop with ambiguity, making decisions with incomplete and sometimes less than optimal information and data. It's also trying to reduce the complexity that keeps getting piled on to the healthcare delivery system. So that's really the biggest challenge, and the way we try to cut through that is we focus on our mission and values, both of which offer clarity about decision-making and offer the support for us to be courageous. Q: How do you approach the CEO role? AB: I believe the CEO role has evolved, at least for me, to be one of support. Help identify excellent talent, help develop a great team structure so it's a very high-functioning team, give people the sup- port to make decisions and even help them understand failure is OK if we fail effectively, if we fail small, if we fail fast and if we fail forward. It is also important to give them the leeway, the breadth, the decision-making ability to do what they do best. It is no lon- ger acceptable in our knowledge environment to have commanding control structures. Q: What was the last memorable thing you read? AB: e Story of Ferdinand. I just have it here in my office, and I was trying to explain to someone the difference between kindness and weakness. As an executive, some folks believe they can't show kindness because it will be misinterpreted as weakness. I believe you should al- ways be kind. Q: What is one of your daily routines? AB: You make a lot of decisions in an organization that affect a lot of people. I look for an opportunity each day to touch someone's life. Yesterday, it was about giving one of our senior executives a hug be- cause it was a really rough day for them and they needed that hug. Today, this morning, it was about holding an employee's hand as they told me about their mom's illness and how it's impacting their family. And when I don't find an opportunity to do that at work, I will drive by an area where there is a gentleman who is hungry, and I will always purchase dinner for him before I go home. It's about knowing that you made a difference to someone today in a small way. Q: What are your goals for MetroHealth? AB: It's actually pretty simple. It's leading the way to a healthier you and a healthier community. We're accepting responsibility for the en- tire community's health, and we want to improve everyone's access to healthcare, everyone's healthcare outcomes. And we want to be able to take the disenfranchised, the folks who do not have opportunities, and provide them a pathway to do that. Q: What is one phrase you think we should use less in healthcare? AB: "It's the patient's fault." We have been blaming the patient for gen- erations. We either preach at them, we call them noncompliant, we do a lot of things that are judgmental. To improve healthcare, we have to accept people for who they are. You must accept them with all their blemishes and look to help them in their current situation. We have pa- tients here, even though they have insurance, who are so busy figuring out where their children are going to sleep tonight or whether they're going to have food on the table, that their diabetes medication is not in the top 10 of their priorities on a daily basis. Q: What are some areas where the healthcare industry can improve? AB: Today, even with the ACA, we don't have enough collaborative effort between the consumers, providers and payers. And those un- aligned incentives are a significant obstacle to investments for long- term healthcare. We also have this unorganized and uninformed care system, so we're doing a lot of acute things that are not creating long-term outcomes. Hospitals have frequently become expensive buffer stops for lack of social progress. But MetroHealth, for exam- ple, put together a program in 2013 that began dealing with these things. We had a Medicaid 1115 waiver we developed called Metro- Health Care Plus, [which offers free medical care for people with low incomes who do not qualify for Medicaid and are uninsured]. The program can help you get the services and medications you need to stay healthy. We provided care for more than 28,000 new patients and by focusing on all of those things, we were able to reduce the total cost of care for these patients by nearly 29 percent compared to what CMS allotted to us. at was approximately $1,500 per patient per year. We also improved blood pressure outcomes by 8 percent in a one-year period. For me, these are the kinds of programs that need to be replicated. I think MetroHealth has figured out a formula for taking care of the highest-risk socioeconomic patients, and I think we have the oppor- tunity to create models that engage the consumers, the providers and the payers. n

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