HealthLeaders Strategy editor, Melanie Blackman, is joined by Anne Klibanski, MD, president and CEO of Mass General Brigham, an integrated healthcare system in Boston, Massachusetts. Dr. Klibanski...
The survey of 1,000 commercially insured consumers finds that they used telehealth because it's more convenient than a trip to the doctor's office, but frequency is still an issue.
Convenience is still the top reason that consumers enrolled in commercial insurance plans use telehealth, and most would like Congress to make sure it stays that way.
Almost 70 percent of respondents to a survey commissioned by America's Health Insurance Plans (AHIP) in October said they've used telehealth during the past year because it's more convenient that a trip to the doctor's office, clinic, or hospital. And almost 80% say telehealth makes it easier for them to access care when they need it.
“Patients and providers accept – and often prefer – digital technologies as an essential part of health care delivery,” Jeanette Thornton, AHIP's executive vice president of policy and strategy, said in a press release announcing the survey of 1,000 consumers, which was conducted by NORC and the University of Chicago. “Telehealth can be just as effective as in-person care for many conditions and allows patients to receive more services ‘where they are.’ That’s why health insurance providers are committed to strengthening and improving both access and use for the millions of Americans who use telehealth for their healthcare needs.”
The news isn't earth-shattering, as many surveys have highlighted consumer preference for telehealth, particularly in the wake of the pandemic. But it does add to the library of evidence that consumers will seek out a healthcare provider or health plan that features telehealth, and it reinforces the need for hybrid care strategies that allow for a choice between virtual and in-person care when available and appropriate.
That's especially true of women, who were almost four times more likely than men to say they used telehealth because they lacked childcare or eldercare services.
Overall, 46 percent of those surveyed said they used telehealth because they weren't able to schedule an in-person appointment, while 24% said they wanted to save money and 23% used telehealth because their doctor's office was closed (a nod to the value of telehealth for after-hours and weekend care).
Among other data points, 85% of those surveyed said there are an adequate number of care providers available to them via telehealth for the needs they have, an indication that virtual care is helping to alleviate the provider shortage and improving access.
And telehealth use among the low-to-middle income brackets is about the same or slightly higher than use in the higher income ($100,000+) bracket. That might mean telehealth is helping to address gaps in care experienced by lower income consumers, or it may conversely highlight the fact that lower-income consumers aren't able or willing to take advantage of telehealth.
The latter would seem more likely. According to the survey, 36% of respondents used telehealth just once over the past year, while 53% used it between two and five times, 4% used it between five and 10 times and 5% used it more than 10 times. This means telehealth adoption is still on the low end, even after the pandemic.
Telehealth use had surged during the pandemic, as healthcare organizations sought to push as many services as possible onto virtual care platforms to reduce traffic at hospitals and insulate both patients and providers from COVID-19. Providers were helped in this fashion by state and federal legislation, as well as waivers from the Centers for Medicare & Medicaid Services (CMS) aimed at boosting access to and reimbursement for telehealth during the public health emergency (PHE). Many of those orders and waivers will expire when the PHE ends sometime next year, which could greatly affect telehealth use as health systems cut back their services.
Telehealth advocates are pressing Congress to make those waivers permanent, and consumers are behind that effort. According to the survey, 73% said Congress should act to make sure those waivers stay in place.
The Pentagon is planning to hire 2,000 healthcare professionals to address a wide range of health concerns, from suicide and dangerous behaviors to social determinants of health.
The Pentagon is getting serious about workplace wellness, with plans to create a "first of its kind" mental health program.
Deputy Secretary of Defense Kathleen Hicks said the Department of Defense is looking to create a department of some 2,000 healthcare staff to handle a wide range of issues, from suicide to social determinants of health.
“That could be on financial stability; it could be on food security; it could be on relationship issues," she said during a recent Washington Post online event. "All the factors that go into causing stress and harm behaviors, including suicide.”
"We are quite confident that's a very science-based approach that we're using," she added. "It's the largest effort like ... this that has ever existed at an unprecedented scale …. This prevention workforce will be a first-of-its-kind, and we're going to do it right here in the United States military because that's what we owe our people and their families."
While a report issued in October by the DoD indicated suicides in the military have dropped 15% from 2020 to 2021, the military isn't immune to the mental health crisis affecting the country, seen in rising rates of substance abuse, family stress and other harmful behaviors. Programs like REACH (Resources Exist, Asking Can Help) and CALM (Counseling Access to Lethal Means education) aim to help service members and healthcare professionals address these issues, but the DoD now wants to establish a dedicated workforce.
Some resources feature digital health and telehealth technology, designed to give service members and their families on-demand access to resources, include healthcare professionals, through mHealth apps and virtual visits. Those access points are designed to tackle the stigma of "being seen" as needing help.
"We have a number of initiatives underway now to make sure we remove that stigma, not just that it's not ... bad to seek help, if you will, for your behaviors, for your mental health, but really that it's a sign of strength," Hicks said.
That includes addressing thoughts of suicide and lethal force.
"We know, and it's well documented, that if we can create a little time and space between that ideation, that idea of having concerns about ... potentially committing suicide and those lethal means — obviously, firearms being foremost, but also medications — if we can create that time and space, create some safety, then that reduces the likelihood of suicide," she added.
A new survey from the Center for Connected Medicine and KLAS Research finds that patient access is still top of mind for most health system leaders, with telehealth, AI and scheduling tools the most popular tools in the toolkit.
Health system leaders are focused on using digital health technology during the coming year to improve patient access, according to a new survey from the Center for Connected Medicine (CCM) and KLAS Research. And they're most interested in using telehealth and AI to improve engagement and help patients find what they need.
While "patient access" is a broad term, it highlights the emphasis being placed by health systems on patient-centered care, and creating new and better connections between patients and their care teams, particularly at a time when the competition is fierce for healthcare services.
The Top of Mind for Top Health Systems 2023 report, released this week by CCM, the innovation arm of UPMC, and KLAS Research, represents the thoughts of 61 leaders from 59 healthcare organizations, and marks the second year in a row that patient access is at the top of the to-do list. Some 28% of those surveyed for this year's report rated it as the problem that has the greatest potential to be improved via digital health--and one that has been greatly impacted by the pandemic.
“It’s no secret that health systems have been facing significant challenges since the start of the COVID-19 pandemic and must address consumer demands for greater convenience and accessibility from their healthcare providers," Joon Lee, MD, executive vice president of UPMC and president of UPMC Physician Services, said in a press release. "This report reflects the priority that we and others are placing on patient access, including more options for virtual care, greater self-scheduling functionality, and higher engagement with patient portals.”
The biggest challenge to improving patient access, meanwhile, isn't technology, but the people behind the technology. That might be the patient who's not overly concerned about healthcare or healthcare providers and staff who aren't too thrilled with changing the status quo.
"Respondents specifically cited the difficulty of getting patients to be engaged in their own healthcare," the survey reported. "Many also talked about organizational change management--in other words, guiding the people in healthcare organizations to buy into and make changes. This is particularly important for implementing patient access tools."
With that in mind, according to the survey, the highest priority for improving patient access is process change.
"One CEO explained why this focus on process is so vital: 'The process varies from practice to practice and hospital to hospital,'" the survey noted. "'Trying to standardize these processes is maddening. Our organization used to be one hospital, but now we have more than 15 hospitals. We have just not been able to get all those people on the same processes so we can actually realize efficiencies of scale.' Healthcare organizations are often turning to vendors to help guide effective processes around new or existing technology."
As for what technologies are considered important to improving patient access, telehealth tops the list, with 56% of survey respondents placing high value on virtual care. Close behind are the patient portal (55%), patient appointment reminders (55%), online bill paying (52%), online registration (49%), an online provider directory (47%), and patient scheduling reminders (46%).
Those top technologies also have their drawbacks. Patient portals are considered the baseline technology for interacting with patients, but patient adoption has been low. Patient self-scheduling technology is considered vital to meeting the needs of today's consumers, yet health systems are reporting problems with achieving provider buy-in and finding the right technology that can handle such a complex task. And while telehealth technology is considered effective and improving patient access, there are problems ensuring that access, ranging from broadband issues to a lack of resources for underserved communities.
The survey also found that:
65% of health system executives see price transparency and cost estimation as important facets of patient access, but almost all say they’re compelled to do so by federal regulations, rather than a desire to improve the patient experience. And most of those surveyed say the biggest challenge to delivering price transparency is the complexity of determining a patient's bill.
A little more than half of health executives are using AI for patient access, and close to 70& believe it will be important in the future in improving access.
Telehealth use has decreased since the pandemic, with most organizations reporting using it for less than 20% of appointments. Patient convenience is the most cited benefit of telehealth, and many want to use it more often, but the uncertain reimbursement landscape is the biggest obstacle to growth.
Most health system leaders surveyed say telehealth is adequately addressing physician workflow and care delivery needs, though roughly one-third say the technology isn't effective, mainly because it doesn't integrate with the EHR or there are too many solutions on the market. Most of those surveyed do feel that telehealth is adequately expressing patient experience needs.
Westchester Medical Center Health Network's CMO says staff members ''understand the forces behind decisions if they are a part of the process.''
Renee Garrick, MD, executive vice president and chief medical officer of Westchester Medical Center Health Network (WMCHealth), says managing the health system's quaternary care hospital and balancing resources are her top challenges.
Garrick is the clinical leader for the Valhalla, New York–based health system, which features 1,700 inpatient beds at nine hospitals in the Hudson Valley. She recently talked with HealthLeaders about a range of topics, including leadership, physician burnout, clinical challenges now that the crisis phase of the coronavirus pandemic has passed, and workforce shortages. The following transcript of that conversation has been edited for clarity and brevity.
HealthLeaders: What are the main challenges of serving as CMO of WMCHealth?
Renee Garrick: There are two major issues in being the CMO of our network.
First, we are the only quaternary care hospital for this region, which spans several thousand square miles. As the major quaternary care hospital, it means we accept patients at the main hub who need high-end care that cannot be offered at the other facilities in the Hudson Valley. We are a referral hospital not just for our patients but also all hospitals in the region.
From the CMO perspective, that means there is a lot of juggling in terms of having our staff at the ready to accept patients and to be able to juggle inpatients and transfers 24/7. We must be able to do that while taking great care of the patients in our hospitals and the patients who transfer to our medical center. I spend a fair amount of my time making sure we have the best possible staff on the medical side, the nursing side, housekeeping, social work, and dietary to be able to care for a broad range of patients. I also need to make sure that the staff has the time to take care of themselves as well as patients, so their lives are balanced, and they can give the best care possible.
The other challenge is we have a lot of busy practitioners, and they have valid and important resource needs. It takes a lot to balance those needs and know that people understand that you are doing everything you can for everyone to the extent possible. That means there is some sharing that must go on. So, if surgery needs A and B, and neurosurgery needs C and D, and medicine needs E and F, they all must understand everyone's needs as a group. I expend a lot of energy making sure that people understand we are balancing resources and making sure that everyone has access to the best that is available. There's nobody who gets more than another. In the end, it all balances out.
Sometimes, people want to have an enormous amount of add-on resources, and you cannot do that if it is going to hurt a smaller department with equal need. I spend a lot of time speaking to the physicians, the medical staff, and the graduate medical staff so they can all understand how it works. Transferring patients and allocating care—and recruiting and retaining the medical staff—is a big part of what I do. It can be a challenge getting everyone to understand the greater good and the goals of the organization. It takes a lot of listening to make sure you do that well.
HL: How do you persuade colleagues to share resources?
Garrick: I try to be transparent about it. People understand the forces behind decisions if they are a part of the process. You must be aware of the staff you are working with—the medical staff, the nursing staff, and the administrative staff. You must explain your position and how you came to a decision—that is an effective way of building a coalition and having people come to an understanding of why things are being decided the way they are.
I graduated medical school in 1978. My experience has been as long as people are treated respectfully and you are honest about what can and cannot be done, the process resonates with people. A problem is created when facts are not shared, then people make up their own facts. They fill the vacuum with what they might think is the truth. It's hard to rescue the process under those circumstances.
Renee Garrick, MD, executive vice president and chief medical officer of Westchester Medical Center Health Network. Photo courtesy of Westchester Medical Center Health Network.
HL: What is the status of physician burnout at WMCHealth?
Garrick: Over the past year, we have recruited hundreds of providers. In the past three months, we have recruited 100 new nurses. So, we are a resilient organization. Part of that is we are the tertiary care referral center, and we are proud of that.
We are still dealing with COVID. But we have also been dealing with monkeypox—we have given 1,800 monkeypox vaccinations. We are thinking about polio because we are in the Northeast, where polio has had a resurgence. We also are dealing with RSV. So, our staff takes enormous pride in being at the ready and being resilient. We get so much joy out of helping patients on the nursing side and the physician side that our burnout has been less than other organizations.
A big key to physician burnout is the happiness and unanimity of purpose that we share with our nursing colleagues. Our nursing staff just ratified a new five-year contract, with overwhelming support. The core of the contract is to make it clear to our nursing staff that we have an enormous amount of respect for their skill and expertise, and we want to be able to recruit, retain, and reward the best nurses in the country. For doctors to be at their best, they work best when they have nurses who are happy by the bedside. A big part of our resiliency is we partner with an extraordinary nursing staff. That helps with how physicians cope with burnout—having a great nursing staff.
HL: What are your primary clinical challenges now that the crisis phase of the pandemic has passed?
Garrick: For us, the clinical challenges are always being ready for the next stress for the organization. Our staff had to be resilient because in the middle of COVID we had monkeypox, and we were asked by the state to be a referral center for monkeypox. We are also dealing with RSV. So, the clinical challenges are keeping the engine humming while gearing up for the next level because as a quaternary care hospital you must be able to provide basic care and get to the next level.
Right now, we are looking at high-end new radiation oncology equipment and thinking about how to move that part of our service for the region forward. That means recruitment, that means building, and that means growth and development. We are looking at building a new critical care area for the medical center to be able to serve the Hudson Valley with the highest level of care.
The clinical initiatives and clinical challenges are looking ahead to the next things we need to do to always be on the cutting edge. We are asking our people to have their feet in two worlds—the current and the future, where we are thinking about artificial intelligence and outfitting the ICU with bedside ultrasound. It's a big clinical challenge to do the day-to-day care while also planning simultaneously for the next several years to come.
HL: What are the primary efforts you have in place to address workforce shortages?
Garrick: On the medical side, we can attract some of the best physicians in the country because we provide a range of care including quaternary care. We have a good organ transplant program—we do heart, kidney, and liver. We have amazing neurosurgery and pediatric care. We have high-end care, but we are also a large network. So, at our institution, we are lucky because physicians can come to the medical center and ply their trade in complicated cases, then they can go to another hospital and be satisfied taking care of community-level conditions.
One of the advantages that we have in terms of addressing workforce shortages is there is a lot of variation in the kinds of patients that we treat, and physicians like to have the opportunity to see more than one type of patient and tackle more than one type of challenge. Over the past two years, we have credentialled more than 1,000 practitioners in our network, and the wide spectrum of the kind of patients that we see is attractive to young physicians.
We also have a lot of mentoring. When you finish your training, you still want to have somebody near your elbow as a mentor; so, if you have a question or have a complicated case, you have someone to help you. We are proud of the fact that we have a staff here that is stable—the medical staff has little turnover, and we have a lot of opportunities for mentorship. This is important for young physicians, especially the ones who trained during COVID. Our ability to provide mentors makes this network an attractive place to work.
Being an academic medical center also helps us recruit and retain physicians. Having a medical school at our main campus and being able to engage in research is a big part of recruitment and retention. The residents and fellows participate in the research as do the medical students. We love the fact that medical students stay here as residents, and some of them stay on as attending physicians.
Southern California Kidney Consultants is collaborating with Strive Health to improve outcomes and chronic care management for Medicare patients living with kidney disease.
Higher quality, cost-effective kidney care is the goal of a joint entity formed between the largest nephrology group in Orange County, California, and a Denver-based technology company.
The joint venture between Southern California Kidney Consultants (SCKC) and Strive Health is targeted at Medicare beneficiaries in Southern California, whereby each partner shares in the financial benefits, management, and governance of risk contracts with Medicare and Medicare Advantage plans and Independent Physician Associations (IPAs), aimed at improving outcomes and reducing costs.
The partnership includes 21 providers, based mostly in Orange County, who serve 5,000 patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD). Leveraging Strive's platform, SCKC aims to prevent the progression of kidney disease.
Centers for Disease Control and Prevention (CDC) estimates show that kidney disease impacts 37 million adults, or 15% of the US adult population, including more than 38% of those over 65 years old. Kidney disease is responsible for $410 billion of unmanaged annual medical spend, demonstrating the need for payment models that are based on outcomes.
"We know that our dedication to value-based models will make our practice a leader in the community," says nephrologist Nirav Gandhi MD, one of SCKC's partner/owners. "We evaluated several partners to help us on our journey and are confident that Strive offers the strongest vision, capabilities and team in value-based kidney care.”
The new SCKC/Strive entity contracts with Medicare, Medicare Advantage plans, and IPAs to take risk on the outcomes and costs of their kidney patient populations. Strive will supply SCKC with access to data and technology resources, administrative support, management expertise, and an interdisciplinary clinical care team including nurse practitioners, dietitians, pharmacists, care coordinators, and licensed clinical social workers. These team members act as an extension of the nephrologist’s office and help manage comorbidities, such as diabetes, that can impact a patient’s overall health.
"For so long, the investments in this space have been really focused on treating people with kidney failure once their kidneys fail," says Ben Kuhn, senior vice president of partnerships and growth at Strive Health. "A big focus of Strive and this partnership is on getting upstream, intervening with patients who have chronic kidney disease, helping to prevent and delay the progression of their kidney disease to avoid kidney failure. That's obviously in the interest of the patients, the providers, and also in the interest of the payers."
For SCKC, the partnership is intended to break a vicious cycle of patients failing to follow-up with their care providers or keep in touch in a timely fashion, which can lead to adverse health outcomes and even death.
"We get referrals of patients who have anywhere from mild to moderate to severe kidney disease that are sent to us in the office," Gandhi says. "What happens is sometimes these patients, whether it's insurance-related or they get lost to follow-up, or they just have a hard time for socioeconomic reasons, or various other reasons, they are not able to follow up or necessarily adhere to the treatments and everything that's necessary to try to delay progression of their kidney disease. They may end up suddenly crashing into the hospital ER, where they present and they're in advanced kidney failure."
In deliberating whether to partner with Strive, SCKC's partner/owners did due diligence, Gandhi says.
"Anytime you have a bunch of doctors who have a little bit of intelligence and ego, we're all going to have some opinions," he says. "We've been working on something like this for over 18 months and Strive is not the only company we spoke to. We had presentations with other companies. We even spoke to some of the large dialysis organizations, to figure out who we think would partner best with us to do what we wanted to do."
Competitive approaches varied from technology companies trying to do healthcare to healthcare companies trying to do analytics.
"We thought Strive was kind of both," Gandhi says.
SCKC will use Strive’s technology platform, which gathers data from hundreds of sources, to gain a holistic view of the patient’s experience. That information can help paint a picture about the risk of hospitalization or progression of disease, helping nephrologists better tailor care to a patient's specific needs.
"We’re giving leading nephrology groups the ability to intervene earlier based on data, which enhances the patient experience and makes expensive treatments less necessary," Kuhn says. "SCKC has leaned into these innovations, and the group and their patients are well-positioned to succeed in the future of kidney care."
The SCKC/Strive partnership also fits in with the Comprehensive Kidney Care Contracting Program launched in 2021 by the Centers for Medicare & Medicare Services' (CMS) Innovation Center, whereby nephrologists can take on value-based care incentives for Medicare patients they are already seeing.
"We were not going to join somebody where we're not heavily involved in decision-making, because we still think we know what we're doing better than anybody else when it comes to taking care of these patients," Gandhi says.
Strive manages more than 56,000 patients with CKD and ESKD through partnerships with nephrologists and other care arrangements with payers and providers. Earlier in 2022, the company signed a nephrologist-led partnership with the nation’s largest nephrology group, Nephrology Associates of Northern Illinois and Indiana (NANI).
HealthLeaders Innovation and Technology Editor Eric Wicklund chats with Joanna White, chief nursing executive for Infor, about using technology to engage and improve a health system's workforce culture, reduce stress and burnout, and adapt to new concepts like digital health.
A survey of CHIME executives by digital health company symplr, unveiled during the HLTH conference, indicates executives have adopted new technology at a fast pace, but those new tools and software solutions aren't always compatible.
Health system leaders say they're being swamped by technology solutions that don't integrate with other solutions, and it's costing them a lot of money and stress.
This, in turn, puts more pressure on the enterprise, increasing clinician burnout, complicating patient care, and slowing the pace of healthcare innovation.
Those takeaways can be found in a survey of 132 members of the College of Healthcare Information Management Executives (CHIME), conducted by Michigan-based digital health company symplr and unveiled during the recent HLTH conference in Las Vegas. It paints a picture of an industry that has been embracing new technology at a rapid pace, but hasn't been making sure those new tools and software solutions play well together.
According to the 2022 symplr Compass Survey, about 60% of respondents are using between 50 and 500 point solutions to manage healthcare operations, including roughly a quarter who are using at least 151 point solutions. Meanwhile, 88% say that working with all these IT systems and applications complicates their job.
And that's causing a lot of problems, including lost revenues, workforce stress and burnout and an inability to truly take advantage of innovative technologies to advance clinical care and improve workloads.
The problem has been compounded by the pandemic, which saw healthcare organizations adopt new technologies—particularly digital health and telehealth—at a dizzying pace. Many of these new point solutions were not integrated, leading to siloed platforms and, according to the symplr report "resulting in a decrease in management's confidence in the integrity of their operational infrastructure."
According to the survey, technology integration and interoperability could address a number of pain points for a health system. Almost 41% of those surveyed cited financial pressure as their biggest concern, while another 31% cited staffing challenges and clinician burnout and 22% listed patient privacy and cybersecurity.
Aside from finding cost savings in reduced IT expenses through better integration, executives say a more fluid and integrated technology platform would reduce stress on clinicians, including nurses, who often have to jump from one station or solution to another. Almost a quarter of executives surveyed say enabling their clinician workforce is their top priority when it comes to managing operations, and 84% say a streamlined IT infrastructure is an extremely or moderately important factor in their ability to keep clinicians.
“There’s a lot of concern about the danger of alarm and alert fatigue for nurses, and health systems are under increasing pressure to streamline and simplify clinical communications and processes,” Donna Summers, MSN, RN-BC, the Henry Ford Health System's chief nursing informatics officer, said in the report.
“Clinical collaboration among multidisciplinary teams is essential to improving care quality and creating efficient care delivery with very tight resources, and it is achievable by using the right technologies,” added Michele Strickland, MBA, BSN, RN, Asante's director of informatics and applications.
The symplr survey cited the 2022 Bain & Company KLAS Research report on the state of healthcare IT spending, which noted that healthcare organizations are rethinking their IT strategies and looking to streamline their IT stacks. According to that report, about a quarter of providers say their existing IT infrastructures are keeping them too busy to stay current on new offerings in the market, while a lack of cross-solution interoperability and poor EHR integration are hindering growth.
"Almost 80% of providers say labor shortages, inflation concerns, or specific organizational situations (like M&A or leadership changes) are top catalysts sparking new investments, and 95% of provider organizations expect to make new software investments in the next year despite economic uncertainty," the Bain/KLAS report noted.
All of this boils down to a four-pronged strategy for improving IT operations. According to the symplr report, healthcare organizations should use technology that unifies siloed systems and streamlines administrative tasks, offering efficiencies in:
Financial health, through enterprise tools that identify cost-containment strategies and value and savings opportunities;
Clinical communications, with automated provider processes and improved collaboration tools that enable staff to focus on patient care;
Technology consolidation, through standardized, scalable enterprise solutions that enable health systems to avoid data risks and regulatory penalties while curbing costs; and
Patient-centric care, with new digital health and telehealth platforms that cater to patient preferences and improve the patient-provider dynamic.
“To reduce costs without compromising service, we analyzed spending at the cost center level, discovering that we were inefficient across the system and uncovering huge savings opportunities," Kevin Smith, Luminis Health's chief financial officer, said in the report. "By adopting new operating measures, the health system has saved millions of dollars.”
A newly launched venture collaborative in Chicago aims to bring together health systems, corporate partners, innovative startups, and community resources to tackle health inequity.
A lot of the conversation in healthcare innovation these days centers around new partnerships to address health equity. In Chicago, a unique venture collaborative is forging those partnerships between health systems and community organizations, while closing gaps in care that contribute to wasteful healthcare spending.
Chicago ARC (Accelerate, Redesign, Collaborate) was launched in June 2022 on a model designed by Israel's Sheba Medical Center, a global leader in transforming healthcare delivery through innovation. Chicago ARC's goal is to create programs that bring together health systems and the communities they serve and take on barriers to accessing healthcare.
"These challenges have always been going on," says Kate Merton, PhD, Chicago ARC's executive director. "There's no one I know who doesn't want to solve that. It's getting down to the devil in the details … that takes time and effort."
Chicago ARC's healthcare partners are the University of Chicago Medical Center (UChicago Medicine) and the Sinai Chicago health system. The two health systems signed memorandums of understanding in June with the new organization, agreeing to support innovation that addresses such issues as maternal and child health, chronic disease management, rural and urban healthcare disparities, senior services, home-based healthcare, and behavioral health.
Kate Merton, PhD, executive director of Chicago ARC. Photo courtesy Chicago ARC.
"The south side of Chicago has experienced shrinking healthcare resources for many years," Kenneth Polonsky, MD, UChicago Medicine's executive vice president for medical affairs and dean of the biological sciences division, said in a press release announcing the collaboration. "Partnering with the Chicago ARC creates the dual benefit of identifying and integrating global technologies that meet the needs of our patients and healthcare professionals while enabling the University of Chicago to bring its research and innovation expertise to a local and global community seeking to address health inequities."
Armed with a $100 million investment fund, Chicago ARC will connect those health systems with local community organizations, venture capital funding, corporate partners, and startups to design programs that might include affordable housing, food resources, childcare, social services, transportation, and schools.
"Our job is to understand what keeps [healthcare executives] awake at night," says Merton, referencing the surge of attention being paid to social determinants of health and barriers to care that keep people and communities from accessing the care they need.
Much of that attention was brought on by the pandemic, which highlighted the plight of underserved populations and communities and turned the spotlight on digital health and telehealth as a means of addressing those inequities.
"COVID has incentivized innovation," Merton says. "People are more willing to take that leap now and try new things."
Chicago ARC may be an ideal example of healthcare innovation strategies discussed at the recent HLTH 2022 conference in Las Vegas, which included companies, startups, and ideas not usually associated with healthcare delivery. The conference helped to spotlight the benefits and challenges of partnerships, and the growing idea that innovation needs to expand its sights and adopt some unconventional concepts to tackle the biggest pain points in healthcare today.
These ideas also point out that healthcare—especially primary care—is getting crowded. New players like Amazon and Google are entering the market, alongside telehealth companies, payers, and retail giants like Walgreens, CVS and Walmart. All are offering unique access points to healthcare and their own banks of providers that compete with the local health system, clinic, or private practice.
Merton says collaborations like Chicago ARC give health systems an opportunity to get in front of those competitors.
"Industries outside healthcare will certainly have an impact on healthcare," she says. "But it's very easy to get distracted by the shiny ball."
The key to innovation, she says, is financial sustainability. A new program may look good and address a pain point in care access or delivery, but it won’t go anywhere if it can't support itself and find the right path to continued use. That's where payers, corporate partners, and even financial institutions play a role. They can highlight the processes needed to maintain sustainability.
Merton notes that payers are influencing healthcare innovation and have some pretty good ideas themselves—especially in health plans that support health and wellness—but they have their own business models.
A more important partner, she says, might be the Centers for Medicare & Medicaid Services (CMS), which covers a significant percentage of the population that would benefit from the programs and partnerships that Chicago ARC would be developing. CMS is conservative in embracing innovation, often calling for a good deal of research and data to support new technologies like telehealth and digital health for considering reimbursement, but the CMS Center for Medicare & Medicaid Innovation has been showing interest in new programs that address health inequity.
Merton says the goal now is to develop "a shopping list" of innovative ideas, then match the resources with programs aimed at addressing those ideas. With more people and organizations at the table, more opportunities will result.
"Imaginative thinking can truly make a difference when it's executed properly," she says.
Renee Garrick, MD, executive vice president and chief medical officer of Westchester Medical Center Health Network. Photo courtesy of Westchester Medical Center Health Network.
