Q&A: Breaking Down the Complexities of Healthcare with Anne Klibanski

Mass General Brigham's CEO looks ahead to what is needed for a successful patient-centric healthcare system of the future.

Editor's note: This conversation is a transcript from an episode of the HealthLeaders Podcast. Audio of the full interview can be found here and below.

Mass General Brigham, an integrated health system based in Boston is a world-recognized leader in research that serves 1.5 million patients annually.

Anne Klibanski, MD, serves as president and CEO of the health system, a role she took in 2019 following a seven-year tenure as the system's chief academic officer. Prior to joining the system's executive team, she served as chief of the neuroendocrine unit at Massachusetts General Hospital.

During a recent HealthLeaders podcast interview, Klibanski talks about the health system's successful 2022 initiatives and looks ahead to the future, discussing what care models are needed for a successful patient-centric healthcare system.

This transcript has been edited for clarity and brevity.

HealthLeaders: Can you talk about your personal and professional background and what drew you to work in neuroendocrinology and healthcare?

Anne Klibanski: I grew up in a family that valued resiliency; there are so many things that are out of one's control, and understanding how to best deal with that is an important attribute. The second important characteristic is compassion and what impact you have on other people.

When I started college, I brought two important interests with me: One was literature, specifically poetry, and the other was chemistry. They came together in interesting ways.

I've always loved poetry; it requires incredible discipline to take many complex things and put them together in a simple way that requires interpretation for many perspectives. That was something that appealed to me enormously. With chemistry, it was the simplicity of the organization of multiple elements and what that looked like.

I went through college with this combined interest that drew me to complex systems. Solving problems, and [having an] impact and [changing] lives for the better, those also drew me to medicine.

I was immediately interested in a subspecialized area of neuroendocrinology. I liked it because it is a very complex field. It brings together hormone regulation, multiple feedback systems, the brain, behavior, so many different things that are so delicately orchestrated in a way that is profoundly important in human health.

One of the things about neuroendocrinology as a discipline is sometimes very small things can cause so much havoc with the human system and can have such a profound impact on health. The ability and the discipline required to tease all of this apart for a patient so that one can determine what went wrong, these things can have such lifesaving effects on patients, and all of that became so important to me.

HL: During your tenure as president and CEO of Mass General Brigham, your vision has been to build the integrated academic healthcare system of the future with patients at the center. What strategies and initiatives have you led to make this a reality?

Klibanski: If I look across the system, it has two renowned academic medical centers: Brigham and Women's Hospital [and] Mass General Hospital. There are three specialty hospitals that are renowned: McLean Hospital for psychiatry, Spaulding Rehabilitation Hospital, and Mass Eye and Ear. [There are also] Community hospitals, outpatient clinics, [and] urgent care [sites]. Looking at all the parts of the system and thinking about how to take the best of all the parts and have the best impact.

Building the integrated academic healthcare system of the future—that requires a very different mindset.The first thing is to look at the strategic priorities we are focused on … and there are several guiding principles that we've looked at:

1. Understanding the care continuum and providing access to it.
2. Value-based care.
3. Innovation.
4. Health equity.
5. Providing high-intensity complex care fueled by research and innovation.
6. Clinical integration.
7. Technology-enabled care, home-based care, and shifting more care closer to home.
8. Patient-centered research and innovation.

HL: Looking into the future in 2023, what will be your top areas of focus in the new year?

Klibanski: Lack of access to quality healthcare is a crisis across the country and globally. Access is also an equity issue. The capacity levels that we're seeing are incredibly high [and] are grave.

We have labor shortages that make it very difficult to provide needed care. Filling the void with short-term labor is very costly. We're also seeing, across the country, many employees who are leaving healthcare, and the pipeline for many of these positions is inadequate.

We have the cost of drugs, supplies, equipment, supply chain shortages, and the highest level of inflation in 40 years.

Working on access is a high priority item.

One of the ways in which we're dealing with this is [by] taking all of the parts of the system and bringing them together. It's efficiency, it's integrated care delivery, it's services being enterprise-wide services: radiology, pathology, emergency medicine, and anesthesiology. It's also setting up service lines. We've launched a service line in cardiovascular medicine, which is cardiac surgery and cardiology.

These are important in terms of access, because it will provide a single entry point for patients who need any of this care. It also gets into how do we move care to the right place. So much care can be provided in community hospitals, so much care can be provided in ambulatory, so these [are] strategic priorities in terms of access, and having a single operations team across the entire system, having the hospitals that are community hospitals put together as a community division, all of these things are part of a plan to deal with the crisis in healthcare.

How we capture patients to be in the right place to get the right care at the right time, how we reach out to patients ahead so that we can actually deal with so many of these issues before patients come to the emergency departments.

Embracing digital care delivery. As we head into 2023 and beyond, we need to embrace the fact that care models have fundamentally changed. We need to reach out to patients, [and] patients need to reach us not only in terms of where they come in to be seen. We are redefining the patient experience and contact with patients.

Patients need to have a journey throughout their health; they need to be seen in many different ways. So much of this is not new technology, it's employing the technology that has been there a long time. The ability for telehealth that's not new, hasn't been really employed the way it needs to. And so that is the kind of work that we're doing. And during the pandemic, we saw what that looked like. We saw a few thousand telehealth visits go to over 2 million in a fairly short period of time. And it was life changing for many patients.

Using telehealth is the way to reach people, but we have so many barriers in all of this. It's the use, it's the regulations around it, it's the credentialing out of state. All of these things need to be worked on. These are very strong focuses for this coming year. We've already started to work on that.

Benefit from intentional partnerships. We see so many for-profit companies, technology companies, and pharmaceutical companies, coming into this space. How do we partner with those companies that provide things that will be beneficial to the nonprofit healthcare world? How do we think about partnerships in a different way?

We often hear about competition between for-profit companies, startups, and the nonprofit healthcare system like ours. [We] need to put revenue generated back into the system and support the mission. As many have said, and I'm always happy to join [in] saying this, we do not have shareholders, our shareholders are our patients. We have to invest in our patients. So how do we have those intentional partnerships that enable us to do that.

Supporting research. That knowledge and innovation will help define the future of healthcare. It's innovation in all of those areas and innovation in healthcare delivery. Both need to be done in parallel; both are essential for the future of healthcare.

HL: What do health systems and hospital executives need to prioritize in 2023 to be successful?

Klibanski: We need to work on new ways to think about what's best for patients, no matter where you are in the healthcare world, no matter what you're doing. We need to all focus on the bigger goals.

Healthcare needs to focus on what the models of healthcare delivery [will be] in the future. How do we best work with the state, with for-profit companies, the government to think about what are the best models? There are so many small community hospitals throughout the country that are in danger of closing. How do we provide care in many different settings in different ways?

The second thing is the basic financial models that fund healthcare. How do we achieve lowering the total cost of care, providing equitable care and access, and at the same time surviving as healthcare systems? We need to all be very much focused on that.

I'm optimistic about the future, but it will take a very different mindset to always put patients at the center of everything that we do. That is going to be a real shift for many healthcare systems and how we think about things in general.

HL: In 2019 you became the first woman leader to serve as president and CEO of Mass General Brigham, which was Partners HealthCare at the time. How does your background as a physician and a woman leader help define your current leadership style?

Klibanski: A lot of my story, and I think the stories of many, is building on what you've done. Seeing so many different things that you do in your career as all part of the same thing. Sometimes people think of the different things they've done as not being very related to what they're doing at the moment, and I think that's a major mistake.

I've spent the vast majority of my career seeing patients. Prioritizing, listening, getting people excited about a shared vision, and viewing things with multiple perspectives has been important.

When it comes to women in leadership, when I was first named to this position, I said I'm looking forward to the day when nobody says, 'How do you feel about being the first woman CEO in this job?' And I stand by that. I do think mentoring and thinking through what people's careers are are important.

HL: What advice do you have for women and others who aspire to be leaders in healthcare?

Klibanski: My advice to anybody is this: Do what you're passionate about. If you're doing what you're passionate about, if you and people around you share a vision, progress will be made. I feel that very strongly.

There are so many people whose lives have been profoundly changed by having a chance. So, giving people a chance, making sure they're doing what they're passionate about, that's absolutely critical.