What I learned at the Community Hospital 100 Conference

November 11th, 2011 by Kenneth Cohn

I had a wonderful time delivering the closing keynote, “Moving from Me to We: A Practicing Surgeon’s Journey to Collaboration,” at the Community Hospital 100 Conference, October 23-25, 2011. For those who would like to learn more about the highlights of this conference by watching a four-minute video, please click here.

Leading the Health of Our Communities

The first session discussed the transition from fee-for-service to more value-based metrics. Lori Knitt, Chief Quality Officer at Aurora Sheboygan Medical Center, described her journey of giving physicians specific provider data, so that they could see how they were doing compared to peers in the same specialty.
Clinical champions encouraged laggards by constructing a mock jail cell in the physicians’ lounge and putting their photos behind bars with the caption “Most Wanted.” She feels that physician-driven innovations like these help her hospital become more nimble in dealing with disruptive innovation.

Joshua Potter of Steward Healthcare System relies on health information technology to monitor outmigration of consultations. The primary care physicians generally stay within network. Steward has facilitated conversations among specialists to foster increased accountability.

Mina Ubbing, CEO of Fairfield Medical Center, described baby steps a community hospital can take to move toward providing more collaborative (accountable) care, After her orthopedic surgeons asked for a heightened management role, she developed a co-management agreement that allowed them to improve processes and quality outcomes and to share risk with payers. She facilitated the process by serving beer on tap in her basement. The success of this process led to primary care physicians, nephrologists, cardiologists, cardiac and vascular surgeons, and interventional radiologists forming an institute to provide more collaborative care.

The Future of Independent Hospitals

John Dawes, CEO of Bothwell Regional Health Center, partners with the Federal Qualified Health Center in his area to hold health summits, improve communication, break down myths, and assist with recruiting physicians to the area.

Jill Fuller, CEO of Prarie Lakes Healthcare System, looks for disgruntled doctors who do not want to be part of large healthcare systems any longer because of loss of autonomy. She entices her physicians to participate in Monday evening conferences over dinner by offering timely discussions on focused topics of mutual interest like, “How are we going to get paid in the future?”

Dealing with Disruptive Innovation

Clayton Christensen, Professor at Harvard Business School, said that community hospitals represented three different business models within one structure:

Solution shop: where patients present with diagnostic problems that require treatment (eg. Emergency Department)
Start and finish business: eg. where patients come in for elective surgery
Facilitated networks: where people share information (eg. chronic disease registries like inflammatory bowel disease or breast cancer survivors’ groups)

Solution shops function on a fee-for-service basis, start and finish businesses can thrive on a pre-arranged fee structure (eg Diagnostic Related Groups), and facilitated networks are financed via a membership fee or monthly or yearly dues. For every doubling of pathways that hospitals provide to be a full-service enterprise, they can expect overhead to increase by 30% due to the attendant increase in complexity.

Conclusion

One of the most important investments that we can make is in our career development. I hope that those of you who work in community hospitals will consider participating in the next Community Hospital 100 Conference, October 14-16, 2012.

As always, I welcome your input to improve healthcare collaboration where you work.

Kenneth H. Cohn

Disclosure:

I have not received any compensation for writing this content. I have no material connection to the brands, topics and/or products that are mentioned herein.

Posted in Learning

Comments

Comment from Kare Anderson
Time: November 11, 2011, 7:36 pm

Ken what an exciting conference at which you spoke and how apt that you gave the closing keynote. Am honored that you titled it like my blog. Clayton’s incisive categories seem to complement your approach