Creating a New Healthcare

Dear Friends & Colleagues, Today’s episode shares unique insights into one of the most powerful examples of transformation occurring in the American healthcare market. The leadership at CVS Health has been intentionally curating an expansive and comprehensive approach to healthcare delivery – specifically in the arena of chronic disease management, which makes up the vast majority of encounters and dollars spent in healthcare. By way of quick background, CVS Health – previously the CVS Corporation – was renamed in 2014, following a landmark strategic decision to remove cigarettes and other tobacco products from its shelves. Its assets now include: One of the largest payers in the country (Aetna), and its accompanying state-of-the-art consumer analytic and population health analytic capabilities; CVS Minute Clinic, a provider arm which has now been greatly expanded with HealthHubs; CVS Pharmacy, one of the largest retail pharmacy chains, including its Specialty pharmacy; CVS Caremark, one of the largest pharmacy benefits managers in the US. Our guest this week is Dr. Alan Lotvin, who, at the time of this interview was Executive Vice President and Chief Transformation Officer for CVS Health. On Feb 12, 2020, one day prior to the posting of this episode, Dr. Lotvin was appointed President of CVS Caremark, the largest division of CVS Health. This represents a significant opportunity and is a measure of the trust the organization places in him. He will also have oversight of CVS Specialty and CVS Kidney Care. Dr. Lotvin has extensive experience in the pharmaceutical benefit management and specialty pharmacy industries. He began his career as a practicing cardiologist in New Jersey. He holds a master’s degree in Medical Informatics from Columbia University and also holds a US Patent for Circulatory Valve Repair. In this interview, you’ll hear: How CVS Health is constructing a consumer-centric healthcare system – making it easier, affordable and more convenient to stay healthy. The broad swath of chronic diseases that CVS Health plans to manage. CVS Health’s differentiating value proposition and its new positioning in the larger delivery ecosystem. How the vertical assets of CVS Health are enabling it to create and optimize value-based health services. How CVS Health is using its multiple sources of data and it’s powerhouse consumer analytics to improve patient engagement and health outcomes. CVS Health represents one of the most remarkable stories in the annals of American healthcare.  As described in my book on Reframing Healthcare, I consider CVS Health to be one of the poster childs for what a consumer-oriented, value-based healthcare approach should be. What you will hear woven throughout this interview is a story of a purposeful leadership team committed to creating care that is safe, effective, convenient, easy to use and navigate, all while being affordable. It is also a story of leadership that has been forward thinking enough to invest heavily in the most cutting edge analytics to identify patients in need and proactively assist them in accessing the care they need to stay healthy. There is another facet of this story that also needs to be underscored. The CVS Health approach is a collaborative one. Dr. Lotvin refers to “collaborative partnership agreements” and “open platform models” of care. He points out that while healthcare is highly competitive, there is also the opportunity to cooperate – the notion of ‘coopetition’. This understanding also points toward the direction I believe American healthcare should be heading – toward a more open ecosystem of care rather than the closed legacy system models and platforms of the past. The ‘ecosystem economy’ is upon us, and we, in healthcare, have the unique opportunity to actually contribute to creating a more connected, agile and responsive system of healthcare.  I’ll leave you with a quote from Dr. Lotvin which captures this overarching sentiment. “There is so much opportunity for us to do the right thing for patients and consumers, and really improve healthcare… We need to be tenacious and get through all the problems because the opportunity is really there to do important work that will benefit people, benefit society and benefit the people who are able to do it well. It’s the proverbial win for everyone.”  Until Next Time, Be Well. Zeev Neuwirth MD  

Dear Friends & Colleagues, Our guest this week is Samuel Shem.  Many of you will immediately recognize the pseudonym for the author of the classic piece of medical fiction – The House of God.  I grew up in healthcare reading his book over and over again. For those of you who are unfamiliar with that piece of fiction, I would urge you to read it. It is a brutally honest, true-to-life, incredibly humorous depiction of the unjust abuses of medical training in one of the most prestigious and prototypical internship/residency programs in our country. It is also one of the most empathetic gifts anyone has ever offered up to those of us who endured medical training. Now, nearly four decades after the publication of that classic novel, Dr. Shem has published another book, Man’s 4th Best Hospital.  Whereas the House of God chronicled the trauma inflicted on doctors (and nurses) in training, this book provides some unique perspective on the dehumanizing aspects of healthcare delivery for patients and providers. Shem is currently Professor of Medicine in Medical Humanities at the NYU School of Medicine.  He is a novelist, playwright, and, for three decades, a member of the Harvard Medical School faculty. His novels include The House of God, Mount Misery, and Fine. He and his wife, Janet Surrey, co-authored the award-winning Off-Broadway play Bill W. and Dr. Bob, the story of the founding of Alcoholics Anonymous.  Dr. Shem is a graduate of Harvard College and Harvard Medical School; and earned a PhD as a Rhodes Scholar at Oxford. In this interview, you’ll hear: Shem’s understanding of writing as a way to empathetically resist the dehumanization of healthcare delivery. The unique way in which Shem distills and articulates the fundamental problems facing doctors and patients in healthcare today. The “big resist” and the solutions Shem shares to counter the root cause problems facing healthcare delivery today. Some of Shem’s opinions will, no doubt, be controversial, and some may consider his solutions extreme. I found Dr. Shem’s analysis to be thought provoking and disarming in its honesty and simplicity.  And while many of his observations are not earth shattering, he finds a way to say them in new and insightful ways. Whether you agree with him or not, what’s clear is that Shem is coming from a place of tremendous respect and empathy for patients and providers. Shem’s novel and his commentary are incredibly topical and timely.  Many, if not most, would agree that our healthcare delivery system is inadequate, poorly aligned to the healthcare needs of our populations, financially unsustainable, and in need of significant disruption. What I found most compelling about his book and this interview is Dr. Shem’s unrelenting hopefulness. He deeply believes that as long as we are connected with one another in just pursuits; as long as we can all have a voice in honest, open dialogue; as long as we are able to speak truth to power; as long as we can be critical thinkers and creators, and as long as we maintain a mutual empathy and a respectful sense of humor, we can change the world for the better. What his recent critics have misunderstood about Shem is that he is a human rights activist as much as he is an artist. He is not, in my opinion, writing for the purpose of winning awards or critical acclaim, although that may occur. He is here to actively resist the dehumanizing forces in healthcare, to catalyze positive change, and to make the world different and better. We recently honored the memory of Martin Luther King Jr who said, “Our lives begin to end the day we become silent about things that matter.”  Sam Shem, in the tradition of MLK, refuses to be silent. He is calling us to resist silence and become active participants in the creative effort to humanize healthcare for all. Until Next Time, Be Well. Zeev Neuwirth MD

Dear Friends & Colleagues, A common characteristic of the guests I invite on this podcast is their courage in and commitment to creating unprecedented positive change in healthcare. They don’t just do things right, they do the right things. And, while the content in these interviews centers on transforming healthcare, there are also lessons on humanistic leadership woven throughout. That’s not a coincidence because the act of reframing – of creative disruption – requires that type of leadership.  Our guest this week, Secretary David Shulkin, exemplifies courageous, transformational, principled-based leadership. Dr. Shulkin served as a member of President Trumps’ cabinet, as the 9th Secretary of the US Department of Veterans Affairs. Previous to that he served under President Obama as Under-Secretary for Health. In both positions, he was confirmed by a unanimous Senate vote – an unusual testament to his competence and integrity. Prior to entering the government, Secretary Shulkin had a long distinguished career in the private sector. He served as CEO at Beth Israel Hospital in NYC and Morristown Medical Center in Northern NJ; and also held senior leadership positions at distinguished institutions such as the University of Pennsylvania Health System and the Hospital of the University of Pennsylvania. He has been named as one of the Top 100 Physician Leaders by Becker’s Hospital Review and one of the “50 Most Influential Physician Executives in the Country” by Modern Healthcare and Modern Physician. He has also been named by Modern Healthcare as one of the “One Hundred Most Influential People in American Healthcare”. Secretary Shulkin recently published a book entitled, ‘It Shouldn’t Be This Hard To Serve Your Country’, a memoir of his experience serving under two US Presidents.  In this interview, you’ll hear: The important and unique role the VA system serves for military veterans, as well as its contributions to our larger healthcare system. The bold leadership maneuvers that Dr. Shulkin deployed to solve for immediate national VA healthcare crises and to navigate the entrenched culture of a slow moving and highly political bureaucracy. The lessons that Dr. Shulkin believes the US healthcare system can adapt from the VA. How Dr. Shulkin initiated the modernization of the VA system through the single largest electronic medical record (EMR) deployment in history. One of the major reframes that Dr. Shulkin introduced into the VA system, which was a shift from being a “pure provider of care” to becoming the “network coordinator of care”. The remarkable characteristics of Dr. Shulkin’s leadership approach are apparent in this episode. First – he focused on solving specific, patient-facing healthcare problems such as improving access to care and eliminating hepatitis C. Second – he fearlessly made decisions based on principles and evidence, followed with swift action. I say “fearless”because he was acting in a pathologically political environment, and many of the decisions he made were followed by highly publicized personal attacks on his character and integrity. Third – he focused on delivering measurable and meaningful outcomes, with a relentless push to transparency.   For me, the main story here is about a high-integrity, humanistic leadership approach coupled with a results-oriented, outcomes-based management style – singularly focused on creating unprecedented and differentiating value for patients and healthcare consumers. It seems ironic that we find one of the most brilliant examples of ‘consumer-obsessed’ leadership in the government-run VA system. Yet, there it is.  I’d like to conclude these notes with a very personal message of gratitude.  I would like to sincerely and publicly thank our Veterans for their service and their sacrifice. I had the opportunity to spend the first seven years of my medical career providing care to Veterans at the Bronx VA Hospital in NYC. It was an experience that shaped my perspective and professional trajectory, leaving me with an indelible sense of humanistic mission and purpose. Until Next Time, Be Well. Zeev Neuwirth MD

Friends & Colleagues, As we did last year, we’re going to do something a bit different in this final podcast episode of the year.  Instead of the regular interview format, I’m going to respond to a few questions that I frequently receive from listeners.  I’ll be asking and answering these questions (which I discovered is a lot harder than it sounds). This format is also a bit different in that my responses aren’t scripted.  So, this episode is a bit more informal and unfiltered.  And my responses are, by no means, comprehensive. What we’ll cover will include: The forces and factors that have shaped American healthcare in 2019, and will continue to be the predominant market forces in the next year and in the coming decade. Some of my healthcare disappointments of 2019, and hopes for the coming year. A few highlights from our recent podcast episodes this year. The ‘must-listen-to’ podcasts.  (Spoiler alert: They’re ALL ‘must-listen-to’ podcast episodes. Otherwise, I wouldn’t post them). A brief comment on why I’m producing this podcast series and why I wrote and published a book this year, Reframing Healthcare – a Roadmap for Creating Disruptive Change. A couple of ‘best-advice’ comments I’ve heard this year – year-end thoughts… We will kick-off the 2020 podcast season on Jan 16th. Our first interview is with Secretary David Shulkin MD.  Dr. Shulkin served as the Undersecretary of Health within the Obama Administration and then as the 9th Secretary of Veterans Affairs in the Trump cabinet. He recently published an enlightening and engaging book on his experience. Reads a bit like a novel. He’s a tremendous healthcare leader and will share his unique insights with us all.  Finally – I want to express my gratitude to you all – for your support & encouragement.  Truly appreciate your feedback.  Please keep emailing and messaging on LinkedIn and Twitter.  And, also, please continue to share the podcast and the book, Reframing Healthcare, with your colleagues. Wishing you and yours – Happy Holidays and a Happy & Healthy New Year! Until Next Year, Be Well! Zeev

Dear Colleagues & Friends, Have you ever thought of transportation as an integral part of healthcare? Have you heard the term “transportation desert” used to describe our inner-city, suburban & rural communities? Are you aware that the literature demonstrates a direct link between the availability of non-emergency medical transportation (NEMT) and outcomes such as missed appointments, medication adherence, patient safety and healthcare savings? During the interview with Megan, I was surprised by my own lack of understanding of how important NEMT is as a major contributor to the health outcomes and well-being of our patients and the populations we serve. Megan herself admits that, prior to joining Lyft, she did not appreciate the profound impact and importance of NEMT, despite having more than 20 years of experience in the healthcare industry. Now, it is her entire focus. Megan Callahan is the VP of Healthcare at Lyft. Prior to her current role at Lyft, Megan served as the Chief Strategy Officer at Change Healthcare. Before that, she served as SVP of corporate strategy and business development for McKesson Technology Solutions, where she oversaw enterprise strategy, business development and M&A for their $3B healthcare IT business. She holds a Masters in Public Health from UCLA. In this interview you’ll hear: Why Lyft is in the business of healthcare, and why healthcare is a growing business within Lyft. How Lyft delivers transportation to patients through health plans & hospital systems – which differs from the commercial approach we’re used to as individual customers. The negative impact of inadequate transportation on healthcare and health; and the important role Lyft plays in the NEMT ecosystem – in terms of lowering costs, improving safety and providing more personalized care. The rapidly expanding role of Lyft in state Medicaid programs, commercial Medicare Advantage programs, and in leading integrated healthcare systems across the country. Here are some key points I came away with from this enlightening conversation with Megan: First – transportation is one of the cornerstones of the ‘social determinants of health’ which are the major non-clinical drivers of health outcomes, accounting for over 60% of health outcomes in our country. As Megan emphasizes, the lack of transportation in healthcare has negative, even devastating, consequences for patients as well as for healthcare delivery systems. Second – although transport to medical appointments is the major reason healthcare systems & health plans utilize Lyft’s services, studies have demonstrated that the vast majority of demand and usage by elderly patients are for trips to the pharmacy, grocery store and to community and family social events. This should come as no surprise given that food insecurity and social isolation are two social determinants that are epidemic in our country and across the globe. Third – in addition to the concrete value proposition Lyft is offering – the transport of people to medical appointments – there is another set of deeper emotional and existential issues that Lyft is solving for. Toward the end of the interview, Megan shares a story of a woman with breast cancer who was immunocompromised due to the chemotherapy she was receiving. This woman was using a traditional shuttle transport to get her to the doctor’s appointments. Because of the ride-sharing, it was taking her two hours each way to get to an appointment!  And, because she was being transported with other patients in the shuttle, she was at high risk for infection because of her immunocompromised status. When she was able to obtain a Lyft transport through her health plan, her travel time decreased to just 20 minutes and she was able to secure an individual ride. Megan’s telling of this story is heart-warming and illustrates not only the clinical but also the human and emotional impact that high quality, reliable and customer-oriented NEMT can have on patients and patient care. I leave you with a bit of a reframe on the work that Lyft is doing. It’s as much about the human touch – about human dignity, decency and empathy, about human connections and relationships – as it is about the new technologies and business models that Lyft is bringing into healthcare. Having spent some time getting to know Megan Callahan I believe she would fully agree with me on that. Until Next Time, Be Well. Zeev

Dear Colleagues & Friends, I recently heard Adina Friedman, the CEO of NASDAQ, give a talk on what it means to be a free, open and efficient marketplace.  Her main message was that a free and open marketplace has two requirements: ‘certainty of product’ and ‘certainty of price’. What struck me about her talk was how healthcare delivery, for the most part, meets neither of those requirements. Healthcare leaders and economists have repeatedly described how the healthcare delivery system in our country seems ‘perfectly designed’ to be ridden with inefficiencies, frustrations and opacity. Our guest this week, Dr. David Berman, is keenly aware of these realities. He has practiced medicine for over 30 years.  Over the past couple of years he has been putting together a start-up company, ‘Slingshot Health’, whose purpose is to reduce the opacity and friction in the healthcare system. As he puts it, the goal is to “create an open, two-sided marketplace in healthcare – where you put the patients and the providers back in control of what they both want.”  It’s an ambitious goal, but Dr. Berman brings a very practical solution to the lack of price transparency, affordability and accessibility in healthcare. Dr. Berman is a gastroenterologist and hepatologist who trained at the University of Pittsburgh Medical Center. He is a highly accomplished physician & has published and spoken extensively on his subspecialized area within hepatology.  He is also a savvy and successful entrepreneur – having built a thriving, multi-specialty practice in Manhattan. What you’ll hear in this interview includes: The solution Slingshot Health is deploying. How Slingshot Health adds more provider supply and capacity to healthcare without any increase in cost to the market. How Slingshot Health solves a major challenge for providers, which is the significant percentage of unfilled appointments that go to waste each day. Slingshot Health’s rapid and expansive growth. There are a number of things I deeply appreciate about Dr. Berman, and the approach he and his colleagues are taking. First, he has been in the private practice environment for decades and intimately understands the day-to-day challenges and frustrations of providers and patients. Second, his approach is not a complicated bureaucratic schema; but instead a simple solution to the complex issues of convenient access, cost and price transparency. Third, I love the fact that it’s a win:win for both patients and providers. Patients win because they are able to obtain timely access to medical care, at a reduced cost. The average selected wait-time to appointments for patients who use Slingshot Health is 4 days, compared to the national statistic that it can take, on average, 3 to 4 weeks to obtain a medical appointment. Providers win because they get to fill their unused appointment slots each day. Somewhere between 10 to 20% of provider appointments go unfilled each day, which harms both patients as well as providers. Slingshot Health is inserting choice and self-determinism back into the healthcare marketplace. It is fulfilling the efficient marketplace requirement of ‘certainty of price’ that I referred to above. Dr. Berman is clearly a mission-driven physician and entrepreneur. But, he’s also a very down-to-earth business person. From my perspective, his company is a wonderful mix of both mission and margin. It is a manifestation of what an open, transparent and efficient market can offer to patients, providers and our healthcare delivery system. Now, nothing is perfect and I’m not suggesting that Dr. Berman’s start-up is the answer to the larger access, cost and transparency dilemmas plaguing our healthcare delivery system. And I’m not suggesting that it will address the larger issues of disparity and inequity, or the social determinants of health. But, it does solve some very real and specific problems. And it does it in a consumer-oriented, value-enhancing way. I’ll leave you with a quote from this interview which captures the pragmatic American idealism that Dr. Berman and his colleagues are attempting to manifest in their efforts. “Slingshot Health is democratizing healthcare – giving the individual back their voice and their vote in their healthcare destiny. No longer do you have to beg for what you need, but now you have direct, no risk access to what you want – at no extra cost.” Until next time, be well. Zeev Neuwirth, MD

Colleagues & Friends, This is, by far, the best discussion I’ve ever had about the value of social media in transforming healthcare. In a time in which we are constantly being reminded in the news about the downsides of social media, this episode highlights the humanizing and democratizing aspects of social media, with platforms such as Twitter and LinkedIn. Our guest today is Colin Hung. Colin is a healthcare IT professional turned healthcare marketing executive, turned social media guru. His career has been dedicated to using digital technologies, social media platforms and community organizing to improve healthcare. Over the last decade, he has helped numerous companies build and market solutions that improve patient safety, patient-provider communications and the patient experience. Colin has also co-founded one of the most popular healthcare Twitter communities – #hcldr – which brings together patients, clinicians, healthcare administrators and leaders as well as policy & governmental influencers. He has been selected as a HIMSS (Health Information & Management Systems Society) Social Media Ambassador three times and is internationally recognized as one of the top HealthIT Social Media Influencers. His work has been published in medical journals and he writes regularly for Healthcare IT Today and HITMC (Healthcare IT & Marketing Community). In this interview we’ll discuss: Colin’s discoveries regarding the benefits of social media – from being a source of expert information, to a platform for sharing diverse perspectives, to a powerful form of community building. Colin’s views on social media as a vehicle for humanizing & democratizing healthcare – for both patients and providers. The connecting and community organizing phenomena of Twitter chats, particularly the #hcldr twitter chat that Colin and his colleagues hold weekly. How organizations such as the Mayo Clinic and the Cleveland Clinic are using social media to create clinically-informed, patient-led, open forum communities. Colin’s understanding of healthcare social media is profound. Although he is an expert in information technology, healthcare marketing and social media, his focus is on the importance and value of connecting – connecting people, connecting ideas, connecting streams of work – and creating synergies through those connections. His work aims to empower and enable the professional development of those attempting to improve, innovate and transform healthcare. His desire is to create empathy. And although these connections and communities lead to concrete progress in the realm of product design and business development, he also sees the inherent value of human connectivity as being a primary goal, in and of itself. Colin is a remarkable ‘servant leader’ – a guide and mentor who is focused on helping others advance in their personal and professional journeys. The one trait that he emphasizes as being critical to participation in social media is “being open to being changed by the conversations and communities you connect with online”.  It’s a lesson in humility, diversity and acceptance. The world of social media allows us to go beyond the confines of our limited, and limiting, social and professional circles. It empowers us with information, expertise and divergent perspectives that we would otherwise not be exposed to. It releases us from the isolation and insularity that we can experience in our day-to-day lives. My call to action is for you to engage on a social media platform, if you haven’t already. Try just one Tweet or one LinkedIn message this week!  Or, if you’re more adventurous, please join a tweet chat like the #hcldr that Colin introduces us to in this interview. It’s at 8:30 PM EST every Tuesday night. Hope to see you there! Until next time, be well. Zeev Neuwirth, MD

Colleagues & Friends, Chronic disease management has become the predominant healthcare issue of our time. The vast majority of medical encounters and healthcare dollars are spent on the diagnosis, treatment, and management of chronic disease.  Despite the staggering negative impact, we continue to treat chronic disease within an episodic, reactive, generic and largely ineffectual care model. It’s a reflection of a healthcare delivery approach that is simply out-dated and poorly aligned with the societal and healthcare consumer needs at hand. Our guest this week, Dr. Jennifer Schneider, and her colleagues at Livongo, are ushering in a “new era” in healthcare delivery. Livongo is a healthcare start-up with cutting-edge digital and machine-learning technology whose mission is to “empower people with chronic conditions to live better and healthier lives.”  Dr. Jennifer Schneider is the President of Livongo and previously served as the company’s Chief Medical Officer. Prior to Livongo, she held several key leadership roles at Castlight Health, including as its Chief Medical Officer. Dr. Schneider is also the author of the recently published book, Decoding Health Signals: Silicon Valley’s Consumer-First Approach to a New Era of Health, which explores how companies are using big data analytics and artificial intelligence to reinvent care delivery for people with chronic conditions.  Dr. Schneider has a Doctor of Medicine degree from Johns Hopkins School of Medicine and a Master of Science degree in Health Services Research from Stanford University. In this interview, you’ll hear about: Applied Health Signals – the new category of chronic condition management Livongo has pioneered – which uses data-driven, machine-learning algorithms to deliver continuous, real-time, actionable, and personalized clinical insights. Dr. Schneider’s perspective on this new era of “human-first experience”  and “whole person” care in which the locus of chronic condition management is shifting from the provider’s exam room to the healthcare consumer’s life. How Livongo is reducing the “noise” in healthcare delivery – that is, reducing the frustration, friction and complexity of the patient care experience. Some of the clinical efficacy outcomes that Livongo has demonstrated in peer-reviewed publications. What I especially appreciate about Jennifer’s perspective and Livongo’s human-centered, consumer-oriented philosophy is the understanding that the primary goal of clinical care is not in deploying technical wizardry, but in solving the ‘pain points’ for individuals with chronic disease. Livongo’s focus is on understanding people’s unique needs, preferences and goals, as well as continuously ‘machine-learning’ how to customize communication in order to optimize engagement and motivate healthful behaviors. Once you hear about Livongo’ s model, I suspect it will become clear that this approach to chronic condition management is far superior to anything offered in our current medical models. The simple fact that Livongo’s technology stack is collecting multiple points of health-related data throughout the day, aggregating and interpreting that information, and then using it to communicate in real-time and in a personalized way, is so far ahead of where we are today in clinical practice. Livongo is creating and deploying a major reframe of healthcare delivery – humanizing healthcare, by unleashing the profound value of the patient as the most pivotal member of the healthcare team.  From a provider’s perspective, I firmly believe that this is a welcome enhancement of the role that physicians and other providers play in the chronic disease management ecosystem. As Dr. Schneider, who has managed her own Type I diabetes for the past 30 years, puts it, “The idea that the doctor or any other healthcare provider is in charge is really erroneous. It’s really the individual person living with that chronic condition, and great doctors understand that! Until Next Time, Be Well! Zeev Neuwirth, MD

Colleagues & Friends, You may not have heard of Renown Health – a moderate-sized healthcare system in northern Nevada – but once you hear how they are reframing healthcare – literally redefining and reorganizing healthcare delivery, I suspect that you’ll not forget them. Our guest this week is Dr. Anthony Slonim, President and Chief Executive Officer of Renown Health in Reno, NV.  Over the last four years, he and his colleagues have created one of the most innovative and progressive health services organizations in the country. Dr. Slonim is a nationally recognized thought leader. Modern Healthcare has named him one of the “50 Most Influential Clinical Executives” of 2019. He has also been named a “Physician Leader to Know” every year, since 2014, on the Becker’s Hospital Review. A board-certified pediatric intensive care doctor by training, Dr. Slonim has authored more than 15 textbooks and published more than 60 academic journal articles. Before joining Renown Health, Dr. Slonim served in executive leadership roles at Barnabas Health in NJ, Carilion Clinic in VA and Children’s National Medical Center in DC. Dr. Slonim currently chairs the American Hospital Association’s Systems Council, representing more than 300 integrated health systems nationwide. In this episode you’ll hear about: How Dr. Slonim caught the healthcare industry’s attention by launching the Healthy Nevada Project®, the first population health initiative that combines genetic, environmental, social and clinical data to address individual and community health needs. The reorganization of the Renown Health system into two major divisions – a ‘health’ division addressing preventive, population-based, public health needs; and a ‘healthcare’ division comprised of acute care facilities and chronic disease management providers and services. Why Dr. Slonim believes that the doctor’s prescription pad is a metaphor for the constraints of our system and what a better “prescription” for care looks like..  How Dr. Slonim’s background in public health, combined with his own long-term experience as a patient, shaped his perspective and his approach to healthcare delivery. There are a number of things that stand out about this interview. First, Dr. Slonim brings a great depth of clinical AND public health expertise to the perspective of a healthcare CEO, which is a rarity. Second, his thinking and approach are scientifically based, consumer-oriented, brilliantly logical, and elegantly simple. Third, he is laser focused on the needs of his patients, consumers and community. Dr. Slonim and his leadership team recognize that there are two fundamental, vastly different, value propositions that are required to care for communities. So they set about to restructure their system and redeploy the appropriate resources to deliver on those two value propositions. Their goal is to improve health through proactive community-based prevention, while creating the best healthcare system for those with acute and chronic disease. Once I heard Renown’s strategy and approach, I was left wondering why other hospital systems in the country aren’t immediately following suit. From my perspective, Dr. Slonim and his colleagues are brilliantly executing the steps of the Reframe Roadmap – reorienting their approach; redefining the problems from the primary perspective of patients and community; rebranding their value proposition to meet those needs; redesigning their healthcare delivery for results that matter to people; reorganizing their healthcare system to optimally deliver on those results; and importantly, redirecting their strategies, tactics and resources to make it all happen. What resonates the most, however, from this interview is the profound sense of empathy Dr. Slonim has for the people he serves. He shares that the biggest lesson he learned from his own cancer diagnosis and treatment was about the inequities and disparities of healthcare in our country. The lesson he learned wasn’t about himself, but about others. That speaks volumes about how his mind and heart work.  His goal and the goal of Renown Health is clearly to humanize healthcare. To make it less complex and less reactive. To make it more convenient, customized and accessible. To make one of its prime purposes the prevention of illness and trauma. To make it what people want and need in order to stay healthy and return to health. Again, why aren’t more healthcare leadership teams learning from and emulating this approach? Until Next Time, Be Well. Zeev Neuwirth, MD

For decades, Geisinger Health has been one of the most innovative healthcare systems in the world. It’s efforts are not only admired but also emulated and replicated throughout healthcare systems across the country. It is a literal mecca for healthcare leaders to come visit and learn. I’ve had the good fortune of visiting Geisinger at least four or five times over the past few years, and I will tell you that the initiatives, accomplishments and outcomes become more fascinating with each visit. In this interview, we have the great fortune of learning from Dr. Karen Murphy, Executive Vice President and Chief Innovation Officer at Geisinger. Karen brings a tremendous business, policy and innovation background to this role. Before joining Geisinger, she served as Pennsylvania’s Secretary of Health addressing the most significant health issues facing the state, including the opioid epidemic. Dr. Murphy previously served as Director of the ‘State Innovation Models Initiative’ at the Centers for Medicare and Medicaid Services leading a $990 million CMS investment designed to accelerate health care innovation across the United States. Dr. Murphy earned her MBA from Marywood University; her doctorate in business administration from Temple University Fox School of Business; and she also holds a diploma in nursing from the Scranton State Hospital School of Nursing. In this interview you’ll hear Karen’s take on: How Geisinger has defined ‘innovation’, and the significant resources they’ve put into their innovation efforts. The “4 pillars of Innovation” at Geisinger Health, and the specific initiatives within these pillars – including the virtual “Chronic Disease Management Command Center” and their highly successful “Hospital at Home” program. How Geisinger is using artificial intelligence, machine learning and predictive analytics to proactively prevent disease. Why and how Geisginer is making heavy investments in Behavioral Economics and Behavior Change technologies. What Karen believes to be two of the most significant challenges to innovation in healthcare. There are few healthcare organizations across the country that have the long, broad and brilliant track record of healthcare delivery innovation synonymous with Geisinger.  It’s a legacy that is a direct function of the visionary, patient-centered leadership they’ve had – beginning with Dr. Glenn Steele, then Dr. David Feinberg and now Dr. Jaewon Ryu. In this interview Karen Murphy gives us a vivid and comprehensive picture of the innovation landscape at Geisinger. She’s keen to point out that innovation is embedded in the DNA of the organization and exists well beyond the boundaries of the Steele Institute that she leads.   There are numerous lessons to be gleaned from this highly informative dialogue. Karen outlines a highly strategic and practical approach to large-system innovation. In the last few minutes of the interview Karen makes a strong case for why “accelerated innovation” is critical to healthcare these days. She reminds us, first, of the unsustainable costs of our current healthcare system. But she then also points out that while payment reform is critically important, without the advanced clinical models that can deliver value-based care, payment reform and other policy changes will not create the positive outcomes we’re all looking for – from the provider perspective, the payer perspective, and most importantly the patient perspective.   Until Next Time, Be Well. Zeev