ASHE PDC: CEO Panel Offers Comparative Discussion
Hospitals and healthcare systems across the country are struggling with what’s quickly becoming the new normal, a business environment tempered by waning reimbursements, consolidations, physician integration, and focus on quality and accountability.
And at the center of this transition is the need to define a new care delivery model.
Michele Flanagin, vice president of delivery system strategy, Kaiser Foundation Health Plan; and Patrick Muldoon, president and CEO, HealthAlliance Hospital, tackled the topic at the ASHE PDC Summit in San Francisco during “CEO Panel—A Comparative Discussion,” moderated by healthcare futurist Ian Morrison.
Spending $3 billion on facilities every year, Kaiser Permanente has to solve this problem for 37 hospitals and 620 medical offices across eight regions. Flanagin says the healthcare powerhouse faces complications planning in such different areas of the country, basing decisions on the amount of members using those facilities as well as member density in the locales.
However, what’s influencing Kaiser’s overall strategy is technology and its wholesale integration of electronic health records and online care offerings, which is the basis for a radical renovation for how the system delivers care.
“We do have an ambition of building fewer buildings in the future,” Flanagin said, adding that the system still isn’t quite sure how the shift will shake out in the end. While an innovation center is in operation, where new technologies are tested and refined, she says the care delivery model is what remains an unknown.
“Until then, we probably will build buildings according to that old paradigm,” she said.
At HealthAlliance, Muldoon says the adage of “the right care at the right time” should also include “in the right facility.”
The way he sees it, in a mature, reformed healthcare environment, the future of facilities must include the following:
- Efficient and effective application of technology
- Movement of care to the least expensive setting along the cost continuum
- Providers practicing at the top of their license
- Lean principles at every step of design
- Demonstrated value of efficiency and cost-effectiveness in facilities, rather than “super-sized” wasted space
- Minimum space allocated to maximize care, with a flexible design.
Focusing specifically on planning, Muldoon says facilities shouldn’t simply adhere to the wishes of physicians—for example, the desire for a bigger operating room. What if that OR wasn’t larger but instead more efficient and able to make a hospital, and the surgeon, more money? “Bigger is not better; throughput is better,” he said.
Flanagin agreed, stating that the difficult part moving forward is making that argument—people like new buildings and may not want to hear that, instead, a solution needs to be found to make the existing space better.
Figuring this all out will be critical, though, as Muldoon said the shift taking place in the healthcare industry is one rife with opportunity. “It’s like Southwest Airlines is about to happen in healthcare. What we do today, five years from now you won’t be able to recognize it,” he said.