American Healthcare Leader #10

The Determination of Laurie Hill

After being given a 5 percent chance to walk again, the scientist-turned-lawyer persevered to help lead a global biotech company, p. 38

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Facility Spotlight: Shriners Hospitals for Children

A typical patient room at Shriners Hospitals for Children’s Montreal location features dynamic colors and state-of-the-art equipment.

The pool at Shriners Hospitals for Children’s Montreal location is a useful amenity for patients who are unable to support their weight on the ground.

In the general waiting room at Shriners Hospitals for Children’s Pasadena, California, location, kids can play with an interactive wall projection that sends balloons flying across the screen when they’re touched.

This dinosaur-themed room at Shriners Hospitals for Children’s Montreal facility is used for patients who need physical therapy treatment.

Discover how executives at children’s hospitals around the country are bettering their facilities and health systems, improving patients’ lives in the process, p. 92

Shriners Hospitals for Childrens in Pasadena acquired an EOS X-ray machine, which delivers about three times less radiation than other leading machines and twenty times less radiation than a standard CT scanner.

Pulse Focus Life

The Lifeblood of Today’s Industry

Children’s Hospitals

Dive into the stories of these four executives who are passionate about improving processes—from building strategic partnerships to streamlining procurement—so that their organizations can best serve the young patients who walk through their doors

164

Population Health

A community’s healthcare needs vary from country to country, state to state, and even city to city. These professionals understand those nuances and work tirelessly to address the needs of their communities while giving residents the tools to take their well-being into their own hands.

19

For some, inspiration strikes in the shower. For Todd Simpson, it came while he was following along on a cabbage inspection for the FDA . Since then, he’s completely revitalized the agency’s technology infrastructure and made it one of the government’s technological leaders.

After working day and night at a corporate law firm for years, Leah Kendall has found the perfect work/life balance at Cardinal Health, where she combines her passion for business with her love of science

Most people can’t claim to be an accomplished lawyer and the founder of a popular food blog, but that description fits Jennifer Che perfectly. Throughout her career, she’s learned to master the art of taking risks while helping businesses.

62

Personal loss underscored the importance of the healthcare industry for Marc Fishman at an early age. Now, as head of US litigation for Novo Nordisk , he takes a compassionate approach to practicing law and leading his team.

32

For most of her life, Jennifer Rakolta has been involved with Advomas in one way or another. Now, as president of the company, she is helping to position Advomas for success in an uncertain healthcare landscape.

74

Jessica Harthcock turned one of the hardest moments of her life into an opportunity. After an injury that threatened her ability to walk, she is now helping others navigate the complexities of the healthcare industry.

Peter Emmett, Aaron Lewis, Jonathan Brain (Kendall), Bella Wang Photography LLC (Che)

Impact Prognosis

Making a Difference in the World

114

Bernie Knobbe knows that employees’ health isn’t just about getting exercise. That’s why he has pioneered wellness initiatives at AECOM, offering twenty-six different programs that tackle physical, social, emotional, and financial well-being.

The Cutting Edge of Care

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Lisa Graver has confidently steered Alvogen through a volatile healthcare market, helping the company thrive where others have failed while paving the way for future success

After being diagnosed with cancer in 2009, Hartford HealthCare’s CEO Elliot Joseph gained a new perspective on patient care. After his recovery, he took that experience with him as he transformed how care is administered at the organization.

Hari Krishna has made a career out of making business and IT work harmoniously together. His efforts have led to a complete transformation of Merial’s IT infrastructure.

198

Corrine Perritano knows from watching her father how damaging the effects of hearing loss can be. Now, as president of Beltone’s North American business, she’s committed to bringing state-ofthe-art hearing solutions to as many people as possible.

205

Revamping an organization’s enterprise architecture is no small feat. But Karen Xie broke down silos, created a detailed plan, and dramatically increased Blue Shield of California’s business operations in the process of doing just that.

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The Only Superpower that Matters

In the middle of my desk, located right behind my keyboard, Batman stares a dart through me. Well, an action figure of him does, at least. I love comic books—the heroes, the villains, and even the spandex costumes. But the Dark Knight has always been my favorite hero because he doesn’t have any supernatural abilities. That’s also why his quote is the only one I have in Post-it note form on my computer.

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This particular quote comes from the Justice League episode “Only a Dream.” Here’s the synopsis: Convict John Dee is the villain, who eventually assumes the alias of Dr. Destiny, and in A Nightmare on Elm Street-esque plan, he traps all the members of the Justice League in their dreams once they go to sleep— everyone except for Batman. Eventually, Batman tracks down this villain, and as Dr. Destiny is taunting Batman, he tells him, “You’re different. You don’t have any special powers.” And Batman responds, “Oh, I have one Johnny. I never give up.” Spoiler alert: Batman wins and saves the Justice League. It can sound silly, but that’s the quote I find myself repeating every time I think I’ve reached a limit. Life isn’t a comic book, and that’s why it’s hard. We don’t have any special powers to help us. There’s no Fortress of Solitude to fly to. And Captain America isn’t going to solve any diplomacy issues. Almost everything is determined by forces outside of our control. What is in our control, though, is recognizing how hard you’ve been hit and then still moving forward.

In each issue of American Healthcare Leader, we hear tremendous stories of determination and overcoming the odds. But it was this issue more than others that I found myself engulfed in this idea of resiliency and how anyone can rise to any occasion with a will to never give up. Take for instance Laurie Hill (P. 38), who overcame an injury where at one time she was only given a 5 percent chance of walking again. Or Jessica Harthcock (P. 74) who was paralyzed from the chest down, yet she not only walked again, but she also started her own company. And Marc Fishman (P. 62) lost both of his parents at a young age, inspiring him to make a difference in the healthcare field.

We all face obstacles in life that test our resiliency, and those in the C-suite are not immune from life’s kryptonite. It’s these same tales of resiliency that these executives bring to their corporations, how they help inspire their teams, never say quit, and that no matter what comes their way in this unpredictable cosmic universe, they know they’ve faced worst circumstances before.

It doesn’t take someone in a mask and spandex to never give up. As these executives prove, having the right mind-set, attitude, and a willingness to keep moving forward is enough to thwart off any literal or figurative enemy. Some call that being resilient. I just like to call it being Batman.

All the best,

Danny Ciamprone Senior Editor

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“Within my job, I’m adding to an organizational legacy that was started and created before I got here, and it will continue to be built and developed and grow after I’m gone.” p.16

Pulse

The Best of Both Worlds

Why Krista M. Curell of the University of Chicago Medical Center added clinical experience to her legal expertise

By David Levine

Law

or medicine. That was the career choice for Krista M. Curell. She was always interested in both paths, and as vice president, accountable care and chief compliance officer for the University of Chicago Medical Center (UCMC), she has successfully merged the two. But getting to that point actually started with a leap of faith.

Born in Vassar, Michigan, a small town in the eastern portion of the state, Curell attended Michigan State University and then Chicago’s DePaul University College of Law, where she specialized in health law. At the time, Curell thought she would focus on medical malpractice law. “Once I got to law school, though, I felt more drawn to the hospital setting, being on the front line with clinicians,” she says.

Curell researched in-hospital positions, such as risk management and patient safety roles, that would benefit from a legal background and thought that would be a good fit—except for one issue. “I didn’t feel I had the credibility necessary to be successful if I didn’t have a clinical background,” Curell says. So, she enrolled in Rush University’s College of Nursing.

“People thought it was so unusual to go to nursing school after law school,” she continues. “Occasionally, you see nurses go to law school, but you don’t often see lawyers going to nursing school. But nursing school was the perfect opportunity to learn about the clinical perspective and see firsthand how operations and systems affect patient safety and risk reduction. It was a focused approach to what I wanted to do, to speak the same language, and appreciate what patients and family members are going through.”

After graduating, she looked at many organizations and found UCMC. Curell recalls how it was UCMC’s unique approach to patient care that was especially important for her. “Through a multidisciplinary approach, clinicians and administrators partner to make decisions. Everyone has an equal voice at the table,” Curell says. Her own voice is also unique. In fact, Curell’s role is so rare, that you won’t find it at other organizations. “A diverse group of departments report to me,” she says. “You may not see how they connect, but we have so much synergy that it works very well.”

Curell handles risk management and patient safety, including all errors that occur during patient care, analyzing outcomes, and working with physicians to prevent errors. “When I came in, risk management was just starting,” she says. “We have expanded significantly.” She also helped the transition from written to web-based reporting systems and added to the scope of adverse events and alarms reported. “We started in 2001 with about one thousand events a year, and now we are at more than ten thousand a year,” she says. Most fall into the near-miss category and only require minor adjustments to fix. But these errors are important to identify and correct risks, she says. She also instituted a fully transparent disclosure program for when an error does occur to let the patient know exactly what happened and to look at the provider side of the story if the error results in litigation. “Most, if not all, hospitals are required to have disclosure programs now, and we were an early adopter of that philosophy,” Curell says. “If things don’t go as expected, we are completely transparent. We

Officer

Krista M. Curell

VP, Accountable Care and Chief Compliance

University of Chicago Medical Center

Jeremy Leonard, Darryl Edwards

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“Once I got to law school, I felt more drawn to the hospital setting, being on the front line with clinicians.”

walk through what we know to have happened with the patient and family. We are frank and honest when events occur. And it is also important that they hear from the clinicians themselves and not just administrators. We want to re-establish some type of trust that can be lost when things don’t go as expected.”

Curell is also responsible for the medical staff office, including credentialing and overseeing the physician assistance committee, which ensures physicians get the care they need as they age or face substance abuse issues. On the compliance side, she is responsible for meeting Joint Commission standards and is in charge of corporate compliance. She is also working with a group of about twelve nurses who in turn work with physicians to ensure that their medical records accurately reflect the complex nature of the patient population.

Currently on her to-do list is a major initiative to increase in-patient bed capacity. The focus is on case management, social services, and reducing length of stay for patients while also improving safety and capacity. “We are at full census almost every day, and we have no more space to grow,” she says. The hospital is also scheduled to open a Level I trauma center in 2018, which will add more patients who need complex care. “To meet those demands, we have to reduce current length of stay, so we are working to transition patients to ambulatory care or home healthcare as soon as possible,” Curell continues. Safety, of course, is paramount. Over the

past five years, the hospital has dramatically improved specific safety metrics, such as the number of blood stream infections. Curell says her department has a unique approach, in that everything it does involves partnering with a strong physician leader, including the hospital’s chief medical officer, Dr. Stephen Weber. “It helps to have that physician by your side,” Curell says. “It has contributed to my success and the success of the organization.”

Curell calls herself a vocal leader. She has high expectations for herself and her team, and she is the first to roll up her sleeves and jump in the weeds with directors. But she also gives them space to do their jobs. “I trust each of them as leaders,” Curell says. “You can’t grow and mentor leaders if you micromanage.”

And it’s all intended to meet the medical center’s primary mission: “We put patients first, ensuring we are not only meeting their needs clinically, but with a sense of integrity, honesty, and safety,” Curell says. “The pressure is on us as individuals and as a department to perform well. The goals are high. But I can’t think of a job more important than providing safety for our patients.” AHL

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Fighting the Silent Killer

Kirk Manz explains how American Addiction Centers offers help in combating the drug epidemic plaguing the United States

By Jeff Silver

Opioids

were involved in nearly thirty-four thousand deaths in 2015 alone, according to the Centers for Disease Control and Prevention (CDC). And in the spring of 2017, based on preliminary government data, The New York Times estimated that there were roughly sixty-four thousand opioid-related fatalities nationwide in 2016. This has made opioids the number one cause of preventable death in the United States.

It is against that backdrop that American Addiction Centers (AAC) is leading the charge to standardize the addiction treatment industry. According to Kirk Manz, chief financial officer of AAC, it has historically consisted of small-scale operations, frequently run by former addicts who got sober and are doing their best to help others.

“Mom-and-pop treatment providers are passionate and well-intentioned, but they frequently lack management experience, capital resources, or the underlying infrastructure to create a scalable and sustainable business,” Manz explains. “We believe the addiction treatment care model should be medically driven with on-site physicians, full nursing departments, comprehensive information systems, electronic medical records, quality physical environments, and treatment outcome studies, which are all standard in other healthcare specialties.”

In its quest to provide that high level of quality and consistency in nearly every region of the United States, AAC operates twelve residential treatment centers with about 1,400 beds (roughly four hundred more are planned for 2018) and eighteen outpatient facilities. In 2016, the company processed roughly twelve thousand residential admissions and fifty thousand outpatient visits, as well as achieved a 65 percent abstinence rate among clients who completed an initial two-month follow-up survey.

In spite of the ongoing opioid epidemic, Manz observes some positive signs, such as more addicts having health coverage and access to care than before. The stigma and

perception of drug addiction as a moral failing is also evolving, with more people now recognizing it as a disease. And state legislatures, such as in Pennsylvania and Massachusetts, are taking further action steps to allow physicians to write prescriptions for treatment in the face of a public health emergency.

“Drug epidemics in the past had their greatest impact on populations without the political clout that the middle class has,” Manz says. “However, today it is the middle class suffering the most from opioid addiction, and that is putting political and media pressure on our industry to do more by offering greater accessibility and higher quality care.”

Michael Cartwright, CEO and chairman of the board for AAC and a recovering addict himself, was an early industry advocate for co-occurring treatment—simultaneously

“When an addict enters our facility seeking treatment, we don’t call that an admit like in other areas of healthcare. We call that a rescue. We are in the rescue business.”

Kirk Manz CFO

American Addiction Centers

Perry Jenkins

diagnosing and treating underlying mental health issues that can contribute to addiction. He began his career by treating homeless addicts suffering from schizophrenia. Foundations Recovery Network, which Cartwright founded, was also one of the first treatment organizations to attract venture capital; the company was sold to Universal Health Services in 2015. Cartwright also founded the Moments of Change conference, one of the first efforts to unify what was still a fragmented industry and to provide a forum for sharing best practices and treatments trends. The conference continues to this day.

He brings that same entrepreneurial spirit to AAC, which strives to provide consistency of care in a client-centered environment. Manz says that being a public, for-profit company brings certain pressures, such as reporting requirements and educating public shareholders and debt holders on the business aspects of treating addiction. But there are benefits as well.

“As the only public company solely focused on addiction currently, we are transparent in our financial statements and in our protocols for how we do what we do,” Manz says. “This enables us to differentiate from other providers.”

AAC’s client focus is supported by a business model that centralizes most financial and administrative activities. Financial controllers, billing and collections, and payroll are maintained at its Nashville, Tennessee, headquarters rather than at individual facilities. This reduces the number of full-time employees and introduces possibilities for economies of scale and competitive advantages for M&A opportunities. A single call center also enables staff to direct potential clients to an appropriate facility.

“The more business functions we can centralize, the more on-site staff can focus their energy and attention on clients,” Manz says. “Our priorities are to be as efficient as possible in getting clients to where treatment is available, providing the best

possible care, and enabling each staff member to be exceptional in performing their part in the process.”

AAC is experiencing both clinical and business success in these efforts. Residential centers offer campus settings, medical wings and on-site physicians, and standardized detox protocols. Some sites also include additional treatment modalities such as equine therapy. In addition, the company has its own laboratory that is exclusively focused on the addiction industry and continually updates detection and identification of a changing list of synthetic opioids.

But even with extensive progress and positive changes in attitudes and in insurance reimbursement for care, the misconception of a one-month treatment solution persists. According to Manz, the “twentyeight-day model” grew out of expediency and was partly based on how long military personnel could be away from their assigned base before the model was eventually adopted by insurers.

“One month of treatment is a start, but the data shows that longer lengths of stay lead to more successful outcomes,” Manz explains. “Like diabetes, there is no cure, but if you manage your behavior, take your medication, stay engaged with a support network, and change the people you spend time with, then you can manage the disease of addiction.”

As AAC grows and reaches out to more patients in need, Manz and his team are focused on diversifying to more locations, expanding the company’s acuity levels— such as hospital and outpatient settings— and establishing working relationships with a broader range of insurers, including Medicare and Medicaid.

“We want to be the best provider of addiction treatment services with the broadest reach,” Manz says. “When an addict enters our facility seeking treatment, we don’t call that an admit like in other areas of healthcare. We call that a rescue. We are in the rescue business.” AHL

Strengthening a Legacy

How Russell Showers is preparing Tower Health’s team for the future of healthcare

By Galen Beebe

Showers grew up with a passion for healthcare. His aunt was a nurse, and Showers would regularly hear inspiring stories about her because of how many lives she touched in the community. Although he didn’t pursue a medical career, Showers still managed to follow in his aunt’s footsteps, becoming senior vice president, chief human resources officer at the nonprofit healthcare system Tower Health.

In 2017, Reading Health System became Tower Health upon its acquisition of five hospitals, expanding its reach throughout Northeast Pennsylvania and into Philadelphia, which also expanded its employee size to about eleven thousand. This year, the organization will also be celebrating its 150th anniversary. As the healthcare market continues to change and Tower Health continues to grow, Showers has sought ways to best prepare the healthcare system’s employees for the future.

When Showers joined Tower Health, he recognized a flaw in the orientation process for new leaders. He learned that after completing a standard employee orientation, leaders were mainly tasked with guiding themselves through the relevant processes. “It was not accomplishing what we wanted it to accomplish,” Showers recalls. “There was not an organized experience.”

As a result, Showers and his team developed a three-month onboarding program, which continues from the new employee

Russell Showers SVP, CHRO Tower Health

Robert J. Polett

orientation that managers, directors, and senior directors complete in cohorts.

Within the first forty-five days of the program, new leaders are trained on key systems and processes. They learn about the scheduling and managerial tools that support their work and meet with finance and HR leaders to review the processes and services that are available to them. They also meet with executive leaders to discuss the strategic plan, the organizational structure, and company culture.

“We spend some time covering what it means to be a leader here and what’s expected of them as a leader,” Showers says. “They get to learn where we’re at from a big picture, systemic perspective.”

To encourage professional networking, new leaders are invited to small-group lunches, where they meet colleagues from other sectors of the organization and members of the senior leadership team. “Our leaders love the program,” Showers says. “They’ve told us that it’s helped them be more productive. It’s helped them feel more comfortable about joining us. It’s helped them make some friends and professional connections. It’s helped them more easily learn how to navigate the organization.”

It was also in 2015 when human resources launched a leadership development series that offers leaders further skill development opportunities. Participants learn team management, performance management, communication skills, and are individually coached based on their strengths, weaknesses, and blind spots.

Showers and his team also partnered with an external firm to develop a similar program for physician leaders and physician high-potentials called Applied Physician Leadership Academy. This training covers leadership concepts and includes a section on healthcare economics and the healthcare market transformation. With the onboarding process, the leadership trainings offer an

“Within my job, I’m adding to an organizational legacy that was started and created before I got here, and it will continue to be built and developed and grow after I’m gone.”

opportunity to engage with enterprise-wide issues. As part of the program, physicians are placed in Action Learning Teams and are assigned an organizational challenge to solve. Their solutions are then implemented across the organization and offer physicians an opportunity to further impact the organization’s future.

“It’s helped improve the relationship between administrative leadership and the physicians,” Showers explains. “The high-potential and physician leaders loved it. They felt recognized, they felt involved, and they loved the learning.”

The leadership development series also focuses on skills necessary to adapt to the changing healthcare marketplace and the growing organization. “Focusing on how to lead change and how to cope with change was not a priority here five to seven years ago, and it didn’t really need to be,” Showers says. “Now, it is a priority that a leader knows how to work with their group, help them manage change, help them understand why certain things are changing—especially difficult changes—and give them tools on how to cope with change.”

Tower Health is well-positioned to adapt to the changing landscape. It has been a long-standing staple within the region and

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has received national recognition. “Our employees are committed to the patients they serve because they’re from this community,” Showers says. “With that, Tower has been very successful.”

Although significant, Tower Health’s accomplishments were not widely shared with employees or the community when Showers joined in 2014. Showers was an active participant in the development of the 101 Reasons campaign, a list format initiative that showcased the health system’s achievements, starting with the employees themselves. “Healthcare is a people business,” Showers says. “We really have some exceptional people here, and they really do a lot of great things during the day that go unnoticed.”

The 101 Reasons were communicated and displayed across the organization as well as in print, radio, TV, and billboard ads to the public. Employees have let the human resources team know that the 101 Reasons campaign made them more excited about working at Tower Health. And for tenured employees, it instilled a new sense of pride. “Over the years, you get to see the warts in a place, and it can begin to tarnish the reality,” Showers says. “We’ve received feedback that people have taken on, to some degree, a new sense of pride about working here. They’re more open about telling their friends and neighbors, ‘You should come here for care.’”

Through these initiatives, Showers is continuing both his family’s healthcare legacy and the legacy of Tower Health. “Within my job, I’m adding to an organizational legacy that was started and created before I got here, and it will continue to be built and developed and grow after I’m gone,” Showers says. “We’re trying to create great environments for people who are dealing with human life. It’s a serious business. It doesn’t get much more serious than that.” AHL

Willis Towers Watson congratulates Russell Showers on his distinguished career

The Inefficiency of Cabbage Inspections

In a little more than two years, Todd Simpson has made significant progress toward improving the Food and Drug Administration’s technology infrastructure. And to think, it all started with vegetables.

By Joseph Kay

Simpson was inspecting cabbage. Or rather, he was following along, shadowing an inspector at a cabbage facility as part of his orientation to the chief information officer position at the US Food and Drug Administration (FDA). “I followed these inspectors around to really understand what problems they were dealing with,” Simpson recalls.

It was a juggling act: inspectors were carrying pens and paper, cameras and GPS devices, stopping when water dripped from overhead onto their notebooks or when the chilly temperatures dried up their ballpoints. At the end, inspectors drove back to their offices to type the report, and on follow-up visits, those who were expecting a report asked why they hadn’t received a copy. Watching all of this, Simpson drew the conclusion of many disruptors, innovators, and pioneers: there has to be a better way.

“I had a thousand plans of action and milestones open. I had to start attacking these things the first week I was there.”

As a result, Simpson and his team launched a mobility program in 2015. This “choose-your-own-device” system provides an inventory of rugged, reliable tools to streamline the agency’s processes, enable mobility, and effect a virtual presence everywhere in the organization’s purview. Inspectors and other customers pick phones and tablets from a digital catalog. Afterward, the program provides support and billing services.

“Inspectors carry Dell laptops running Windows and one of a number of devices from our service catalogue,” he explains. “They select a device, but the real power is the coupling of our applications with the mobility.”

Simpson says those applications were redesigned to take advantage of device capabilities and empower the individual inspector. He explains that eFieldX and eNSpect are automated systems that interface with a mobile device. Since the first inspection at the cabbage facility in 2015 and the launch of the mobility program, the agency has completed 30,274 digital electronic inspections, all of which are secure and instantly retrievable. Through 2015, the FDA had limited cloud services. Now, there are six providers enabling an array of cloud services. But the federal government’s relationship with cloud systems has been cautious. Of the three ratings of data sensitivity (low, medium, and high), until 2016 only low-risk data was permissible in cloud storage. Now, the FDA can store a wide variety of data, a notable value-add.

From day one, challenges for Simpson were deeper and more numerous than just the inspection experience. Auditors from Congress’ Government Accountability Office (GAO) criticized the FDA’s digital security infrastructure in a 2015 report, and decisive, transformative action was necessary. “I had a thousand plans of action and milestones open,” Simpson says. “I had to start attacking these things the first week I was there.” By the end of that week, Simpson had reduced plans of action and milestones laid out by GAO by 70 percent and privileged user accounts by 40 percent. By the end of 2016, they had implemented 80 percent of GAO’s program recommendations and 76 percent of its technical recommendations.

In follow-up coordination efforts with the House Energy and Commerce (E&C) Committee personnel and GAO auditors, the agency was applauded for the organization’s speed and diligence. They declared that the FDA had accomplished in forty-five days a transformation that took other agencies eighteen months. The E&C went on record via a press release, stating that the FDA’s cybersecurity posture was much improved and that the collaborative efforts undertaken by all parties involved

DeJohn Davis

Todd Simpson CIO FDA

helped resolve the problem faster, more efficiently, and more effectively than traditional means.

Other accolades have since followed. The FDA administers about fifteen highvalue assets that are critical to the safety of the American people, and the organization’s revamped process to govern them was recognized as best practice by the Office of Management and Budget as well as the White House. Add to that a 2017 CSO50 award for the consolidated operations and security center, and the GAO remediation turnaround has been considered wildly successful.

One of the main keys to the agency’s success has been Simpson’s project management office. “When I arrived, there was no comprehensive portfolio of projects. We now have one, we have a standing project management review meeting every week, and we monitor every project in that portfolio,” he says. Through more diligent and engaged processes, the FDA continues to transform into a technological leader in the federal government. And while the progress has been impressive, the vision is far from realized.

“In terms of the maturity of the organization, we’re at a two out of five, and it took two and half years to get there. I’d really like to leave the FDA with a truly interoperable network with shared resources. I want to see tight collaboration. I want to see our data exploited,” he says. “My goal is to bring the FDA into the twenty-first century, exploit those technologies available to us, and to move the FDA forward.”

Two and a half years in, and Simpson looks to see this mission through. With those broad strategic endeavors underway, users can already tell that the organization is advancing: for the first time in memory, the FDA runs the latest versions of Microsoft Windows and Office, which is just the first sign of many improvements still to come. AHL

Aurotech is responsible for identifying innovative, cost effective tools, technologies and methodologies to advance the FDA’s Office of Innovation (OI), mission of promoting and protecting public health.

Aurotech supports the OI as the established Innovation Special Team (IST) vendor. Aurotech is tasked to quickly test, evaluate, prototype and demonstrate pilot solutions, which will eventually pave the way to the development of large-scale enterprise technical solutions. As the IST vendor, Aurotech leverages the HHS cloud computing infrastructure to identify the tools and techniques needed to understand, analyze and visualize the high-volume data available to FDA. Aurotech’s objective is to provide the necessary expertise to investigate technical solutions, convert architecturelevel designs to tactical level solutions, implement and evaluate prototypes, pilot systems and solutions and support the transition of OI-based work to production operations.

Some of our major innovation projects include:

Implementing Tableau for visualization and Data Analytics, and integrating mission critical systems

Integrating Drones with mobile device to download real time picture of facilities in support of inspections

Developing SharePoint Portal to define ideation portal to capture innovative ideas, challenges and technology requirements

Researching solutions for High Performance Computing, Enterprise Architecture and Master Data Management

Always on Guard

In the face of exponential expansion, Jason Barclay ensures that Athletico Physical Therapy is always one step ahead against risk

By Clint Worthington

Whenit comes to his role and responsibilities at Athletico Physical Therapy, Jason Barclay sees himself—and the company at large—similar to that of a soccer goalie. “As the lawyers for healthcare providers, we are there to play defense against risk,” Barclay says. As the goalie in this scenario, Barclay guards the company against outside threats from regulators, competitors, and the like. At the same time, he and his legal team work to facilitate victories and progress from their company to “put our forwards in the right position to score.” Detailed analogy aside, Barclay believes it is a succinct descriptor for the function he plays in Athletico’s continued success: “to create conditions to help clinicians provide high-quality care to our patients.”

For the past twenty-five years, Athletico Physical Therapy has rapidly grown from a single-clinic orthopedic rehabilitation organization to a healthcare titan, with more than 450 clinics located across eleven states. Barclay, general counsel and chief compliance officer of Athletico, has been vital to the company’s continued growth since he joined the company in 2016, the latest step in a fascinating career that has combined counseling in both the public and private sectors.

Starting out as a litigator at Barnes & Thornburg LLP, Barclay learned important lessons from the partners and staff at such a large outfit. “The most effective communicators were those who could take complex topics and communicate them in a simple way,” Barclay recalls as one of the most important lessons he learned.

Along with making partner at Barnes, Barclay’s legal career prior to Athletico involved him taking two sabbaticals to work in government. The first was to work as

Counsel, Chief Compliance Officer

Jason Barclay General

Athletico Physical Therapy

Ebony

Cotton

the general counsel and policy director of Mitch Daniels’s gubernatorial campaign in Indiana, then as general counsel for Illinois governor Bruce Rauner for two years. Afterward, he received the opportunity to become Athletico’s general counsel and chief compliance officer and hasn’t looked back.

Barclay’s own career trajectory and developmental growth have largely matched that of Athletico’s, with his own legal department being expected to grow just as Athletico grows year over year. He credits his team’s sheer dedication and work ethic for this success. “There’s an expression Mitch Daniels likes to use: ‘Opportunity is often missed because it’s dressed in overalls and looks like hard work,’” Barclay says. “There’s no magic bullet, no reliance on luck—just seizing opportunities and being willing to roll your sleeves up.” Using a team-first approach and taking care to hire only the best therapists in the market, Barclay and the Athletico team prefer to keep their heads down and power through the gradual progress needed to get ahead.

This team-first approach, Barclay believes, puts Athletico at a unique advantage, particularly in his work as general counsel. “I am not the smartest guy in the room, but I know I have the best team in this business working with me,” Barclay explains. “With the speed at which we have to make decisions, I rely upon that team to look at all possible downsides of a decision.”

In a healthcare industry that is constantly changing—with more government regulations to navigate as time passes— Barclay’s major challenge is to anticipate which way the wind will blow. “Government has its own language, and companies in this industry need a translator,” says Barclay, whose history in public government service gives him an advantage when it comes to anticipating policy changes. Among the major changes he has implemented include a ticketing system for both clinicians and their legal department, in which staff have a maximum of forty-eight hours to answer every single request.

This cuts down on lingering issues with patients, contracts, and billing, as well as

“As the lawyers for healthcare providers, we are there to play defense against risk.”

streamlines the process for everyone. This is the first of many innovations Barclay hopes to provide for Athletico. At all times, Barclay notes, he works to be in the position where “we don’t have to react to, but we can instead shape changes in healthcare.” This means being proactive and staying plugged into industry trends and advancements in medical technology. Barclay says he must continually ask himself: “How can our business be on the leading edge of using technology to provide high-quality care to patients?” By keeping in touch with the innovations and developments in the healthcare industry, Barclay can stay apprised of how Athletico can best serve its patients.

Barclay also believes that Athletico’s business model, which he calls, “community-based healthcare in a retail setting,” will help it continue to grow and remain a leader in the healthcare industry. Accessibility is paramount to Athletico’s mission, says Barclay. “If you have a hip replacement, you don’t want to navigate— figuratively and literally—a huge, convoluted hospital system,” he says. “You want to be able to communicate easily with your healthcare professional and pull up to the front door for each visit.”

Whether it’s through new technological advances, greater physical access to locations, or cutting through more government red tape, Barclay is more than confident that, as Athletico grows, so too will patients’ access to affordable, high-quality healthcare. AHL

Balanced, But Never Bland

As Cardinal Health continues expansion, including with the recent acquisition of Medtronic’s patient monitoring and recovery division, Leah Kendall explains how it’s never a dull—and always rewarding—moment

By Charlene Oldham

Leah

Kendall spent the first decade of her career at corporate law firms, where she was accustomed to working weekends and weeknights after putting her young daughter to bed. During the first few months of her tenure as vice president regulatory affairs and associate general counsel at Cardinal Health, she sat down to her computer each evening expecting to do the same.

“At first, I thought something was wrong with the email system, because I was so used to opening my laptop and working for 2–3 more hours every night,” Kendall recalls. “I continually wondered, ‘Why aren’t the emails pouring in?’ It was an adjustment for me.”

These days, Kendall fields more after-hour emails and calls now that Cardinal Health has broadened its product portfolio and expanded its global operations. But her job still affords the single mom and avid equestrian enough time to ride horses with her daughter three or four times each week. It also allows her to combine some of her professional passions.

Kendall, who holds a bachelor’s degree in chemistry from Butler University, originally planned to earn a doctorate and become a research scientist. A college internship convinced Kendall that life in a lab didn’t suit her, so the head of the chemistry department at Butler suggested law school. After she completed her law degree at Indiana University School of Law in Bloomington, the private practice

that gave Kendall her first job happened to need help in US Food and Drug Administration (FDA) law—a specialty she hadn’t considered before on her career path.

“It’s total serendipity, but it ended up being the perfect blend of science and business, combining both those things I really enjoy,” recalls Kendall, an Indiana native who was the first in her family to earn a college degree.

At Cardinal Health, Kendall and the two attorneys who report to her spend their days keeping abreast of FDA policy changes and guidance while also analyzing how the agency’s directives impact the company’s burgeoning business. The Dublin, Ohio-based corporation is a global, integrated healthcare services and products company, which provides customized solutions for hospitals, healthcare systems, pharmacies, ambulatory surgery centers, clinical laboratories, and physician offices around the world.

Although Cardinal Health now ranks among the Fortune 500’s top fifteen businesses, its legal team still takes a hands-on approach. Among other duties, Kendall and her team support both segments of Cardinal Health (medical and pharmaceutical) and cover a variety of issues from premarket regulatory strategy to manufacturing and postmarket compliance. Kendall also works closely with her colleagues on corporate acquisition diligence, execution, and integration. Her role has evolved since her early days at the company, taking on what was then a newly created position.

“My role when I first started was more of what I call blocking and tackling—dealing with putting out fires,” says Kendall, who joined the company in 2012. “Now, as Cardinal Health’s portfolio continues to expand and evolve, I have the opportunity to play a more strategic role, for example, by helping support quality and regulatory affairs as they build more mature systems and integrate various acquisitions.”

In recent years, Cardinal Health has grown rapidly through acquisitions,

Leah Kendall VP Regulatory Affairs, Associate General Counsel Cardinal Health

“It’s total serendipity, but it ended up being the perfect blend of science and business, combining both things I really enjoy.”

Navigant is honored to salute Leah Kendall, Vice President, Regulatory Affairs and Associate General Counsel at Cardinal Health for exemplary leadership in the healthcare industry.

Navigant is pleased to serve as a strategic advisor to Leah and Cardinal Health in regulatory compliance and acquisition strategy.

linkedin.com/company/navigant

twitter.com/navigant

“I’ve never been bored at Cardinal Health. It amazes me that, for a company this size, it’s ever-evolving, ever-changing, and so responsive to the patients’ and customers’ needs.”

including the $6.1 billion acquisition of Medtronic’s patient monitoring and recovery division, completed in July 2017, and the $1.9 billion acquisition of Cordis Corporation from Johnson & Johnson, completed in October 2015. These acquisitions, along with other transactions and product development areas, keep Kendall and her team busy familiarizing themselves with new products and adapting and expanding systems and procedures to maintain quality and regulatory compliance moving forward. Kendall says that the Medtronic deal dramatically expanded Cardinal Health’s medical/surgical portfolio and roughly doubled the number of Cardinal Health’s medical device manufacturing facilities.

“The acquisitions have helped build product platforms, bringing on an entire portfolio, whereas the internal development is often focused on rounding out those portfolios,” she says. At Cardinal Health, we manufacture and distribute an enormous range of products—implantable medical devices, over-the-counter and prescription pharmaceuticals, radiopharmaceuticals, positron emission tomography products, and lower-risk devices such as exam gloves and surgical drapes. It’s a huge and diverse portfolio that touches nearly all aspects of healthcare, and that’s what I find fascinating about the company.”

While she has more time for horses and hobbies than she did during her days in private practice, Kendall characterizes her life as balanced but definitely not bland.

“The law firm was so fast-paced that I was a bit worried I’d be bored in-house. I was concerned I’d be doing the same thing every day,” Kendall says. “But I’ve never been bored at Cardinal Health. It amazes me that, for a company this size, it’s ever-evolving, ever-changing, and so responsive to the patients’ and customers’ needs. I get to do something new and engaging every day.” AHL

How to Combat an Epidemic

The University of Pittsburgh Medical Center uses innovative methods to tackle opioid addiction in Pennsylvania

By David Baez

Inthe fall of 2017, President Donald Trump labeled the opioid crisis in the United States a public health emergency, reflecting the growing public consciousness of the epidemic and its impact on individuals throughout the country.

Heroin, a well-known opioid, is illegal. However, there are also many legal opioids, including painkillers such as morphine, methadone, hydrocodone, and oxycodone. These drugs can sometimes be overprescribed, but they are also sold illegally.

Pennsylvania has been hit especially hard by the problem. According to the Drug Enforcement Agency (DEA), a full 85 percent of the 4,652 drug overdoses in the state in 2016 involved an opioid.

At the University of Pittsburgh (UP) Medical Center, the Pittsburgh Poison Center is tackling the problem through innovative methods that involve a vast network of partnerships.

For instance, people who are struggling with opioid addiction or their family members can call a 1-800 number and benefit from the following services: medical screenings, information on how to obtain naloxone—a medication that helps with opioid withdrawals—contact information for detoxification and rehabilitation facilities, take-home resources on substance abuse, and help with payments for treatment. Poison center specialists will also follow up by phone to provide ongoing support.

In addition to these resources, one of the UP Medical Center’s most innovative projects is called OverdoseFreePA. In the program, the University of Pittsburgh’s Program Evaluation and Research Unit (PERU) works with death statistics to figure out where the problem is most concentrated among different parts of the state as well as other demographics.

In a recent interview with Fox News, Dr. Janice Pringle, PERU director, said that the initiative casts a wide net in order to assemble data that will help them be more targeted in addressing the problem.

“It’s represented by age, by gender, by ethnicity, by location,” Pringle explained during the interview. “That helps you understand that in certain parts of the state there may be patterns. We do have a couple of counties in Pennsylvania that are stabilizing with their overdose rates. We’re coming at this relentlessly from multiple directions.”

OverdoseFreePA is one of the first programs putting into action the Department of Health and Human Services’ emphasis on researching public health programs specifically targeting the opioid problem. Dr. Karl Williams, Allegheny County medical examiner explains that it’s an extraordinary program unlike anything else in the United States. “There’s nothing like it for information about what is going on for overdoses in each of the individual counties,” he said in an interview with Pittsburgh Tribune-Review

Allegheny is one of only sixty-seven counties in the state, and the program aims to store similar data from all of them. Information is available going several years back for some counties, while others only have data for the present year. Statistics are also constantly updated as new death reports come in.

The organization’s staff is hoping that as people nationwide see the success of the program, it will catch on in other states. And that’s important because the problem isn’t confined to Pennsylvania. According to statistics from the Centers for Disease Control and Prevention (CDC), more than ninety Americans overdose on opioids every day. In economic terms, when you

“We hope to arm the community and healthcare providers with additional information to combat the scourge of overdoses and addiction and the threat they pose to our public health.”

–Michael Lynch

take into account healthcare, treatment, legal problems, and lost productivity at work, that equates to a loss of roughly $78.5 billion a year.

Although opioids are readily available, addiction generally begins by a patient misusing a prescription. The CDC estimates that as much as 29 percent of patients misuse their prescriptions and that about 12 percent subsequently develop a disorder. In addition, 6 percent of those that misuse prescriptions eventually use heroin, and 80 percent of people who started with heroin abuse prescription opioids.

Among the health problems caused by opioid addiction are overdoses, neonatal abstinence syndrome (children born addicted), HIV, and hepatitis C through the use of syringes.

UP Medical Center is leading the way in finding solutions to the problem. In a medical center press release, Michael Lynch, medical director of the poison center, described the specific goals of the center’s initiative.

“This initiative represents a completely novel use of poison center knowledge, capabilities, and resources uniquely suited to addressing this epidemic,” he said. “We hope to arm the community and healthcare providers with additional information to combat the scourge of overdoses and addiction and the threat they pose to our public health.” AHL

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As a socio-economic predictive model, PARO™ uniquely enables hospitals to better understand, quantify, and budget their Community Benefit, and comply with IRS 501r.

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Never Go it Alone

UTHealth’s Daniel Reat merges his expertise with co-chief legal officer Melissa K. Pifko to manage a mind-boggling healthcare portfolio

By David Levine

When

Daniel Reat looks out his office window, he sees hospitals, medical clinics, research facilities, university buildings, and business offices comprising billions of dollars in real estate and an indispensable value in healthcare services. “It’s mind-boggling,” says Reat, vice president and chief legal officer (CLO), operations and business affairs for The University of Texas (UT) Health Science Center at Houston.

It’s also a major job for a CLO. Reat doesn’t have to do it alone, though. He shares the position with Melissa K. Pifko, who handles healthcare and clinical affairs while Reat focuses on operations and business affairs. It’s a tag team approach that lets each of them work to their strengths while collaborating to provide strategic direction for UTHealth, the most comprehensive academic health center in the UT System and the US Gulf Coast region.

UTHealth is home to schools of biomedical informatics, biomedical sciences, dentistry, nursing, public health, and the John P. and Kathrine G. McGovern Medical School. This is in addition to the UTHealth Harris County Psychiatric Center and a number of growing clinical practices operated by UT Physicians, the clinical arm of the medical school. UT Physicians has roughly one hundred clinics in Houston and the surrounding communities. UTHealth also has its own teaching hospitals: Memorial Hermann-Texas Medical Center, Children’s Memorial Hermann Hospital, and Harris Health Lyndon B. Johnson Hospital.

It’s a lot of responsibility, and that especially appeals to Reat. “To me, healthcare is an incredibly broad field,” he says. “It involves everything from insurance to research,

from patient care to real estate. There is a huge breadth to it, and I am still getting my arms around it all.”

Reat came to UTHealth with a wealth of legal experience in contract and corporate law and real estate, but he was relatively inexperienced in healthcare. Houston bornand-bred, he earned his JD from the University of Houston Law Center after getting his undergraduate degree from Rice University and working for IBM as an account administrator for three years to pay off student loans and take a break from school. “I had wanted to go to law school since high school, and after three years of working, I thought I better do it now,” he says.

“Having worked and having received a feel for real life was helpful for me. And I was always more attracted to words, to reading and writing and logic. To a certain extent, I like debating issues or, at least, discussing things.”

His favorite legal courses were contracts and real estate, and he worked in those fields for nearly twenty years at various companies. In 2009, he joined UTHealth as a senior legal officer, where he stayed until 2013. After a three-year period at the University of Texas MD Anderson Cancer Center, he returned to UTHealth in April 2016 as interim CLO and became co-CLO in December 2016. The co-CLO idea was borne out of the idea that a new joint leadership approach would leverage the expertise and versatility of

Daniel Reat VP and Chief Legal Officer, Operations and Business Affairs

The University of Texas Health Science Center at Houston

Dwight C. Andrews

two experienced legal practitioners as co-lead counsels and allow UTHealth to best respond to the rapidly evolving environment in academic healthcare. “This fit in well with my experience because I didn’t have any hardcore clinical, health experience,” Reat says. “It also worked out fine because there is so much work. There is not a day when I am not inundated with a wide variety of work.”

Reat and Pifko work collaboratively with academic and administrative leadership, faculty, and staff at UTHealth, as well as the Office of General Counsel at UT System, the State of Texas Office of the Attorney General, and others to provide appropriate legal advice and counsel, develop strategic plans, and negotiate agreements, among other duties. The work is split relatively evenly, Reat says, and there are some shared areas, such as research, risk management, compliance, ethics, communications, and public relations that are divided up depending on whether it is more related to clinical work or the business side of the institution.

As the CLO overseeing UTHealth’s business, operational, and infrastructure aspects, Reat is responsible for faculty affairs and employment, general contracts and procurement, intellectual property (IP) and technology commercialization, information technology and information security, institutional policies, facilities and construction, real estate, and environmental health and safety. On average, he says, about half his time is devoted to managing the work or attending meetings, while the other half is spent doing the work himself, though the balance can vary wildly.

“With real estate, there is always some activity going,” he says. The activity will ramp up again soon, as UTHealth undertakes a large development project to expand its psychiatric services. On the technology front, IP and IT security are taking up a significant portion of his time. The scope of work that he and Pifko handle demands strong collaboration to devise the most effective legal strategies for the organization and their department, which includes six other attorneys and four support staff. “We have some sort of meeting almost every day—not necessarily a planned one— to talk about budgets, personnel issues, long-term projects, policy, and procedures,” he says. “At least once a day, Pifko walks down to my office or I walk down to her office to discuss various issues.”

Pifko says their collaboration has worked well, especially given that she is new to UTHealth. “He is familiar with the requirements imposed on state institutions, so he has provided me with insights in my role that would be harder to learn if there were not two CLOs,” she says. “And because he was interim CLO for nearly a year before I arrived and he worked in the UTHealth office of legal affairs for several years before that, he is able to use his existing relationships with all of the players and his institutional knowledge effectively.”

Helping lead UTHealth through these challenging times is not easy, though. “Healthcare is changing and reimbursements are changing, which has effects on funding and budgeting, so there is a lot of change right now,” Reat says. “Who knows where the healthcare environment and our institution will be in two, three, or four years? But that’s fascinating, and it’s pretty cool to be part of it.” AHL

Our commitment to the healthcare industry

We are proud to partner with Daniel Reat, vice president and chief legal officer, The University of Texas Health Science Center at Houston.

Committed to outstanding healthcare. Dedicated to the highest level of corporate compliance and ethics. Focused on integrity, leadership and vision.

bakerlaw.com

Mission

Control

Jennifer Rakolta is helping to steer Advomas into the future while keeping its original vision intact

By David Baez

Jennifer Rakolta President Advomas

Marie Duprie Studios

than thirty years ago, Bruce Knight formulated a vision having observed the complexities surrounding the healthcare system in Michigan. With an unbridled entrepreneurial spirit, he founded Advomas, a mission-valued company focused on securing the highest payer source for hospitals and health plans in pursuit of healthier communities.

From its founding decades ago to its success to this day, little has changed from a mission perspective for the company. And, it’s Jennifer Rakolta, president of Advomas and Knight’s daughter, who is ensuring it stays that way. Today, Advomas is considered the region’s most respected healthcare compensation firms, a mix of healthcare policy experts and humanitarians. Part of the company’s mission today, as it was when founded, is to help its clients meet the needs of an ever-changing industry. Results are essential in this business, and Advomas is reimbursed only once the patient has secured coverage and the hospital has been paid by insurance.

But to understand the values that Rakolta and her family have brought to Advomas, you must travel back to before the future president of the company was considering a career path. By the time she was eleven, Rakolta was already spending summers and vacations working at her father’s business from the file room to reception to field operations, as well as data entry, marketing, and finance.

“I really grew up with Advomas, and the company was an extension of our family,” Rakolta recalls.

After graduating from the University of Michigan, Rakolta made her way back to Advomas where in about six years she climbed the ladder from director of sales and marketing to COO and now president. “Fate, opportunity, and timing led me back to Advomas,” she says. “For the last nine years, I’ve focused exclusively on building our brand, expanding our services, and leading our company.”

Rakolta says that, as president, everything is essentially her responsibility. Her overall goal is to ensure that the

leadership team is successfully executing the company’s mission, which she describes as securing the highest payer source for hospitals and promoting patient health. Having gone from an eleven-year-old helping out around the office to serving as Advomas’ president, Rakolta says that executing that same mission over time has required intense innovation and evaluation of internal processes to keep up with changes in the industry.

“I am constantly looking at new technology solutions, developing strategic partnerships, and recruiting diverse team members that challenge us to become a better company,” Rakolta says. “It’s my belief that a president cannot become one dimensional—focusing on only one area of the business. If that happens, I will know it’s time for me to move on. And if I’m doing my job correctly, I will have already developed future leaders capable of taking my place.”

A key component of continuing the company’s success and ability to serve its clients is partnerships, Rakolta explains. Many entities touch the life of an uninsured patient, and Advomas needs to collaborate with as many of them as possible if it is to be the most successful eligibility organization, she says.

One example of a key partnership is the one the company has with the Michigan Department of Health and Human Services. The two have partnered to rewrite state legislation to improve outcomes for uninsured patients.

“Our relationships have been cultivated over decades, and we are fortunate to have always had a fee model that rewards us based solely on results,” she says. “Our partnerships have also been nurtured through launching meaningful projects that have helped patients avoid bankruptcy, influenced preventative care steps, and enabled hospitals to increase net income.”

One partnership in particular stands out for Rakolta, and that is with McLaren Health Care. “Developing enduring, trusting relationships is crucial to achieving the

“I am constantly looking at new technology solutions, developing strategic partnerships, and recruiting diverse team members who challenge us to become a better company.”

goals of our mission,” she says. “To that end, people like Harry Crane at McLaren Health Care are pivotal. Quite simply, he is the most progressive man in healthcare—a true visionary. Like us, he understands that the relationship between a patient advocate and a healthcare provider is just that—a relationship, not just a series of transactions. And healthy, mutually beneficial relationships require trust. Harry’s trust inspires us just as it inspires his team.” Rakolta adds that over the past five years or so, technological partnerships have also become increasingly critical to leveraging expensive EMR systems, improving results, and fostering greater trust in the company’s working relationships.

It’s also the culture at Advomas that helps define its mission, which is one of compassion and diversity, Rakolta says. The team at Advomas embodies the company’s values of compassion, innovation, and effectiveness.

To create this team, the company focused intensely on the employee-selection process. Soft screening questions help identify if a candidate will be a good match with the Advomas culture.

At the next stage, they work diligently to make the recruiting process personal and create trust between the candidate and the company. Candidates are asked to speak about their passions, their goals, and their motivations, so

that when they walk away they’ll know that they were listened to.

Many of the company’s employees also work off-site at the client’s facility with the revenue cycle staff. That helps ensure a patient doesn’t slip through the cracks because of inefficient or slow communication. Rakolta says that from an HR perspective, off-site employees work because the client benefits, the employee benefits, and technology supports it.

“If we can offer flexibility, provide the tracking mechanisms, and communicate and manage the expectations of the employee working outside of our HQ, then why not create a more comfortable work environment with reduced travel time and expenses? When you have a culture of trust, you can prosper by being different,” Rakolta says.

And in the end, it all comes back to the mission. Rakolta’s philosophy is to first focus on the mission, and then figure out the money.

“This priority is fundamental to the way we at Advomas conduct business,” she says. “Our mission is to help patients get the coverage they need, which in turn helps hospitals maximize their revenue because revenue equals resources. And the more resources a hospital has, the better they can carry out their mission to deliver the best services to every patient that walks through their doors.” AHL

Life

“My work to support great minds and hearts and improving health outcomes is what drives me.” p.82

Never Tell Her

Laurie Hill shares why anything is possible and how it’s life’s unexpected events that can lead us on worthwhile paths that we never envisioned

By Danny Ciamprone | Photos by Gillian Fry

the Odds

This universe works in a never-ending, unpredictable equation—a series of intersections and incidents out of anyone’s control. In a different equation, perhaps Laurie Hill didn’t venture out that morning for a bike ride. Maybe that car wouldn’t have hit her. Her right leg wouldn’t have been shattered, and she wouldn’t have been confined to a wheelchair for eighteen months.

But life being what it is, Hill had a different equation. She was struck from behind by a car that morning on her Trek bike in Houston, hitting the windshield that caused a severe concussion, a broken leg, a helicopter lift to the hospital, and about five hours of surgery to reconstruct her leg, which forced her to forgo her active lifestyle and use a wheelchair for eighteen months. That’s where this story could’ve ended. In fact, it was highly probable. At twenty-nine years old, Hill was only given a 5 percent chance of walking again.

“For a long time, I think I had a lot of regret,” Hill says. “I wished I had stayed in bed that morning and that accident did not happen to me. But it is so entwined into the fabric of how I approach things and who I am that it’s a blessing in changing my perspective.”

There are a few traits of Hill’s that are paramount to not only understanding her recovery after that accident, but also to understanding her personal and professional success. During her hospital stay, Hill says she was “the patient from hell” because of her stubbornness to walk during recovery. In fact, in all aspects of her life, Hill is a passionate —even bullheaded—disruptor with more resilience than most can fathom.

Laurie Hill VP of IP, Deputy Chief Patent Officer Genentech & Roche

Before that accident, Hill was eleven months into her postdoctorate with a mission to practice immunology. She has loved science since she was as young as five years old, but after the collision, with the possibility that she would be permanently confined to a wheelchair, Hill ventured away from science and more toward law, particularly in the realm of intellectual property (IP).

“I could still do science but in a slightly different profession that would accommodate the fact that I might be disabled,” Hill explains. “I have to say that I think that the science part of myself is actually what makes a difference in how I approach everything as a lawyer. I self-identify first as a scientist.”

Before pursuing her professional career, however, Hill needed to overcome a major obstacle. The first question she asked her doctor post-surgery is when she could walk, and after hearing she had a 5 percent chance, the doctor said, “You’re a very lucky lady that you’re alive. You should be happy about that.”

“Here I am, I’m all hooked up on morphine drip and everything and I go, ‘That is not going to work for me. I have to walk.’ I’m sure he thought I was crazy,” Hill recalls with a laugh.

After eighteen months in a wheelchair, she was able to get up and begin rehab. It took Hill an additional six years to walk without a limp, and although she has residual nerve damage that leads her to struggle occasionally with walking, Hill is fully mobile.

“A lot of times, people will say, ‘That can never be done,’” Hill says. “It can be done if you just think about it a different way, approach it a different way, maybe measure the outcome a different way—the same way all those doctors told me I would never walk again and I said, ‘Yes I will. I must. Here we go.’”

At that time, though, it still left Hill with the lingering question of where to head professionally. There are two passions she loves more than anything: science, and being at a company where people are making a difference. That path first led her to MedImmune, where Hill was part of a dynamic company that was expanding its therapeutic pipeline. She then transitioned to Illumina in 2015, a leading developer and manufacturer of integrated systems that analyze genetic variations and biological functions.

“Illumina came on the horizon, and it looked like a very interesting opportunity to come in and do intellectual property in an area where the company itself was creating the ecosystem,” says Hill, who was the head of global IP. “That ecosystem had the potential to disrupt and totally revolutionize everything we know about health and medicine and all other things that are impacted by the life sciences.”

The values that Hill looks for in a company, though, are not the most typical of those in the legal realm. She seeks out innovation, disruptors, and a company-wide commitment to better mankind day in, day out. It’s these same qualities she has now discovered in Genentech and Roche, one of the leading biopharmaceutical companies in the world focused on medicines that help treat life-threatening medical conditions.

“A lot of times, people will say, ‘That can never be done.’ It can be done if you just think about it a different way, approach it a different way, maybe measure the outcome a different way.”

“I am very drawn to that big purpose, so Genentech fits into that whole model. Historically, they’re known as the best in the business,” she says. “They are known in the business for having a fantastic culture and also being passionate about diversity.”

Inspiring Others

And as a “recovering scientist,” Hill is never far from her original passion with Genentech. “I will frame the risk, frame the strategy in what we think the science is,” Hill says. “That has worked quite well. And it makes it more fun for me, too, because I’m never far from my first love so to speak.”

Today, she’s also never far from another one of her passions: biking. Hill is back on her titanium road bike, and since the accident she has completed seven, one hundred-mile bike rides. There are also a few lessons she has taken with her since that day in Houston. One is that the world is a constantly changing place. “If you can embrace it and find positives, then you’ll always get to a better place,” she says.

Laurie Hill’s story is filled with inspiration and determination, but it’s more than intangibles that she has been able to exemplify throughout her career as she continues to make a difference beyond a company’s bottom line.

During her tenure at MedImmune from 2009 to 2015, Hill was part of the executive leadership team, where she was also the executive sponsor of the company’s first employee networking group as part of a diversity and inclusion initiative. In addition, she was also the executive sponsor for the LGBT employee network group, and she also launched the Women’s Network Group.

Hill recalls how her team gathered an assortment of data and analysis from various companies that proved promoting diversity and inclusion not only strengthened an organization, but it also helped improve a company’s finances.

“We were able to show that this wasn’t a social exercise, but rather a commitment to retaining good people and recruiting good people,” Hill says. “I think for me, it is about sharing values on the importance of diversity, building great teams, great products, and a great corporate culture. That has been a consistent aspect of what I’m looking for, especially as it pertains to innovation.”

After she joined Illumina in 2015, Hill continued to make a difference when she joined the Women’s Leadership Network. The organization supports women at various levels of the company by having several guest speakers and events to encourage success through various business and networking initiatives. The Women’s Leadership Network also has several forums, where senior leaders come in to speak and host various round tables.

“No one knows of my injury, and I consider that such a victory that people go, ‘I had no idea that happened to you.’”

The other is to be a constant learner. Experience everything, and constantly challenge yourself. “Resilience allows you to still be proud of what you’ve accomplished, know that you did that really well, but still have belief in a different future doing things in a different way,” Hill says.

If Hill had never gone on that one bike ride, her equation may not be the complex series of trials and obstacles that have made her a symbol of resiliency for her friends, family, and colleagues today.

“I always use that as a reminder of the fact that I did get out of that wheelchair and I’ve been out of it a long time, and that first doctor told me I’d never get out and stay out of it,” Hill says. “No one knows of my injury, and I consider that such a victory that people go, ‘I had no idea that happened to you.’” AHL

Fish & Richardson salutes Laurie Hill on this well-deserved recognition of her inspiring leadership, creative legal mind, and dedicated mentorship of others on her team. We have seen the importance of her contributions to Illumina during the multiple matters that we’ve had the privilege of handling for them.

Perfect Fit

With a career that has spanned several decades and oversight of numerous major initiatives, including a hospital transformation today at The MetroHealth System, Michael Phillips reflects on how he saved one of his best decisions for last

By Clint Worthington

MMichael Phillips will be the first to tell you that he has no plans to retire any time soon. In fact, he will even elaborate and suggest that he can think of no better organization with which to spend the rest of his time in law. “This has been a great way to finish my career, given all the people we’ve been able to help,” Phillips says.

He’s referring to MetroHealth, a health system based in Ohio that is committed to providing healthcare to everyone in Cuyahoga County and improving the health of the community overall. But before joining MetroHealth, Phillips started his career in an age before specializations. “To be candid, being of the age I am, I predated special programs and classes in healthcare,” he says. After nearly forty years of working in private practice, Phillips made a transition and joined The MetroHealth System, where to this day he is the senior vice president and chief legal officer.

With so much on his plate, Phillips marvels at how far his career has come since its humble beginnings. Coming to Cleveland after graduation to become a corporate finance lawyer at Calfee, Halter & Griswold in 1977, Phillips spent the first decade of his practice becoming involved in partnership and transactional work in a variety of fields, including tax-oriented ventures and energy.

Phillips credits his early days at Calfee with the development of many of his skills at MetroHealth. “There were a lot of opportunities given to a young lawyer to work directly with clients,” he recalls. “The firm had a healthcare practice even

Michael Phillips SVP, Chief Legal Officer

The MetroHealth System

before a lot of corporate firms called themselves a health law practice group.” His first real exposure to health law was through his background as a tax lawyer, accomplishing work for 501(c)(3) tax-exempt hospitals. Then in 1988, his managing partner asked him whether he would be willing to help out in the healthcare practice area of Calfee. “Back then, there were a lot of healthcare lawyers who knew the internal workings of a hospital, but not many with a corporate law background,” Phillips recalls. From there, the rest is history. Phillips would go on to spend twenty-plus years focusing on healthcare law at Calfee, with much of that time being spent representing MetroHealth. During his time as external counsel, Phillips found himself working as special counsel to the board of trustees in early 1993, advising the board’s leadership during a critical transitional phase. This afforded him the opportunity to work extensively with MetroHealth’s general counsel at the time, becoming the primary outside counsel for much of the regulatory public law work that MetroHealth needed.

In addition to his strong relationship with the board today, Phillips finds the challenges of his work quite rewarding. “One bit of self-awareness I’ve realized over the years is that I like complex legal issues, structures, and clients,” Phillips says.

And Phillips received plenty of it while navigating the complexities of MetroHealth’s mission as a billion-dollar safety net hospital for Cuyahoga County. Even so, transitioning fully to MetroHealth was a decision that Phillips did not take lightly. “I enjoyed the variety of what I was doing,” says Phillips of his work, but adds that he still turned down the offer for a position at MetroHealth several times before joining.

In 2012, Phillips became interim chief legal officer at the behest of Metro’s then-CEO Mark Moran during a transition period for the role of general counsel. Five months later, the board hired current CEO Akram Boutros. On his third day, Boutros asked Phillips to come on permanently. After initially declining, Phillips says, “I concluded that the time and place was right. I haven’t regretted it since.”

Among his responsibilities as chief legal officer is his involvement in supervising all the legal services of the system and managing the group that handles all of MetroHealth’s legal work—from basic healthcare to corporate work—as well as risk management and professional liability issues. Phillips is also responsible to the CEO and board of trustees, acting as general counsel to the board as a continuation of his previous work as outside counsel. Phillips also manages a team of five attorneys, while they search for a sixth senior attorney to join their ranks. “It’s not a huge group, but we get an awful lot done,” Phillips says.

Phillips has spent the last several years working out a nearly $1.3 billion bond for a hospital transformation of MetroHealth’s facilities. Among the objectives of this work includes plans to replace the two towers at the hospital, which are more than forty years old and require expensive maintenance and repairs. Through Phillips’s work, the team of underwriters, and the help of outside counsel, they’ve managed to scale back the project significantly, working the amount of funds needed down to about $963 million. The hospital transformation will allow MetroHealth to update to more modern facilities that are easier to maintain: a new garage, new hospital, and updated outpatient facilities, as well as a new central utility plant. The goal is also to ensure that patients stay as close to family and friends as possible when they need short-stay hospital care.

Outside of this major project, Phillips has spent the majority of his time on other significant initiatives. For example, he has been working on organizational changes to adjust for potential alterations to the government’s allocation of Medicaid. Ohio is a Medicare expansion state, with a large population of Medicaid recipients. Perhaps his most significant value is combining his unique knowledge

Fast Facts: The MetroHealth System’s Transformation Project

In May 2017, The MetroHealth System issued $946 million in revenue bonds to pay for construction of a new twelve-story hospital and upgrade its main campus on West 25th Street

Construction is scheduled to begin in 2018 and completed in 2022

MetroHealth is set to receive a $32.4 million appropriation from the county—less than 4 percent of its annual operating revenue

Tucker Ellis is proud to work with MetroHealth on its campus transformation project.

tuckerellis.com

“I’ve been able to provide real value here, creating a better culture of service, and bringing on valuable new hires.”

of MetroHealth’s governing statute with his healthcare experience to find ways for the health system to adapt to the rapidly changing healthcare environment and pursue new business models not contemplated when the decadesold county hospital law was enacted.

Through these projects and more, Phillips says one of his major challenges is navigating MetroHealth’s status as a public hospital. In the hospital transformation initiative, Phillips says appeasing public interests was one of the obstacles they had to overcome. “The challenge was convincing a very complex set of constituencies that it could be done,” he says. Despite these challenges, he finds joy in putting together viable business models and initiatives that end up being well-received in the market.

Whether as outside counsel, interim chief legal officer, or full-time chief legal officer, Phillips is proud to have worked in such a highly competitive and challenging area of public health law. “I’ve been able to provide real value here, creating a better culture of service and bringing on valuable new hires,” Phillips says. “We all feel valued here.” AHL

Tucker Ellis congratulates Mike Phillips. His wealth of experience and leadership skills have been critical to the success of MetroHealth’s campus transformation financing. His steady guidance will continue to impact this project over the next several years as MetroHealth fundamentally transforms its campus and the surrounding neighborhood.

At Calfee , our client’s success is the highest priority of our firm. Founded in 1903, we are a proactive, strategic corporate law firm providing comprehensive counsel to healthcare systems and facilities, Fortune 500 companies, entrepreneurs and startups, financial institutions, management agencies, governmental entities, and individuals. We understand the industries and the communities in which our clients work, allowing us to provide innovative legal solutions that also make business sense. We have 150-plus lawyers working from our offices in Cleveland, Columbus, Cincinnati, and Washington, DC, offices. Visit us at calfee.com.

Calfee recognizes the leadership and accomplishments of Michael Phillips, Senior Vice President and Chief Legal Officer, The MetroHealth System. Congratulations on the well-deserved recognition by American Healthcare Leader.

Knowledgeable on changing health care laws and regulations, evolving reimbursement models and trends, and other business and regulatory developments, our Health Care practice group works together to provide clients with quality, comprehensive and practical solutions to the problems they face.

Calfee’s Health Care practice group is a cross-disciplinary team of attorneys that provides legal services to a variety of organizations, health care providers, facilities, and technology and wellness companies. To learn more, contact:

Thomas M. Welsh, Partner twelsh@calfee.com 216.622.8529

Michael G. VanBuren, Partner mvanburen@calfee.com 216.622.8343

All in Good Faith

Wendie Carlson followed her heart to spiritually oriented West Tennessee Healthcare

By David Baez

SSince childhood, Wendie Carlson’s spiritual and humanistic outlook has never dampened. And now as chief human resources officer for West Tennessee Healthcare, which provides medical services to about six hundred thousand patients in a largely rural part of the state, she has found a workplace with a spiritual culture that lets her feel right at home.

As is the case with many hospitals, West Tennessee Healthcare has chaplains on staff. But they also begin leadership meetings, as well as new employee orientation, with prayer. There is a spiritual garden on the hospital grounds, where patients or employees can follow a labyrinth intended to encourage spiritual reflection. When staff asks patients dealing with a difficult condition if they can pray for them, the question is almost always met with appreciation. Certainly, the culture of the Bible Belt has much to do with why all of this works.

“That’s one of the things I love about the South,” says Carlson, who grew up in Minneapolis before making Texas her home for many years. “Up North, people ask if you go to church. In the South, they ask where you go to church.”

At the beginning of her career, Carlson had no inkling that she would end up in healthcare—and certainly not in a rural area of the Bible Belt—but fate can be a strange thing, she says.

She began her career as a flight attendant. When deregulation of the industry led the airline she worked for to shut down operations, she got a job at Four Seasons Hotels. Her application was to be a concierge, but they offered her human resources. To her surprise, it was a perfect fit.

“I really just fell into HR,” she says. “It wasn’t a career I aspired to. But what I found early on in HR is that you establish meaningful relationships with people. You hire new employees, then you see them get married, have babies, and get promoted. I realized I had a calling to interact with people one person at a time.”

After ten years, Carlson decided to make a move into healthcare. It may seem that the two industries couldn’t be more different, but Carlson says she immediately saw the similarities.

“Hospitals have beds and food and beverage services just like hotels, so that was something I was already familiar with,” she says. “And I loved the idea of working for organizations with a commitment to improving the health and well-being of people and communities.”

At West Tennessee, which Carlson joined in 2012 after years of working for other healthcare employers, the

Wendie Carlson CHRO West Tennessee Healthcare

David Bard Adkins

spiritual culture seems to add an extra element to that commitment, which Carlson enjoys. As an HR executive, however, she is sensitive to the possibility that a potential employee could feel alienated or turned off by that, and she says that all staff have that same sensitivity. The lead chaplain, for example, makes sure prayer at meetings is always nondenominational, so as not to put anyone in an uncomfortable position.

As with any hospital, whether faith-based or not, staying fully staffed with good people is a challenge. Getting the right people is even more difficult for rural health systems such as West Tennessee, which sees many candidates in its area gravitate toward similar opportunities in nearby Memphis and Nashville. Still, Carlson says that her hiring philosophy goes well beyond the idea of simply filling a need as fast as possible.

“In day-to-day recruiting, it’s about filling the needs we have today,” she says. “But I’m more of a global strategic thinker. I believe the ability to develop a workforce is what allows an organization to excel. If we hire the right people with the right attitudes, and who are a good fit for the culture, then as the needs of the organization evolve and change, they can evolve and change in step.”

And Carlson is also trying to keep in step with new recruiting technology and techniques. Before beginning the search for a new head of talent acquisition, she attended a conference of healthcare recruiters. At the conference, she learned about modern recruiting techniques using social media, networked with people, and took note that some of the HR leaders she met there had come from industries other than healthcare. All of that played into finding the person she ultimately hired. She is also in the process of implementing a new applicant-tracking system that will be easier to navigate so that applicants won’t give up on the process out of simple frustration.

“To me, the faith-based part of our culture is less overt than prayer and service. It’s more about values like love, respect, and inclusiveness.”

Willis Towers Watson congratulates Wendie Carlson of West Tennessee Healthcare

We applaud her well-deserved recognition as an outstanding CHRO and leader.

We greatly value our successful relationship with West Tennessee Healthcare.

The spiritual culture and outlook at the organization permeates everything, including HR. But Carlson emphasizes that the value of that culture lies in the way it manifests every day as staff interact with each other and with patients.

“To me, the faith-based part of our culture is less overt than prayer and services,” she says. “It’s more about values like love, respect, and inclusiveness—the way we treat every person, every time.” AHL

willistowerswatson com

Pioneering a Path

Using the skills instilled by her legal career and her award-winning food blog, Jennifer Che is not slowing down as she continues her unique journey

By Jacob Winchester

IIt’s hard to believe that the former head of intellectual property (IP) and legal affairs for a pioneering biotechnology start-up such as Axcella would also have enough spare time to author an award-winning food and travel blog. A food blog so prominent, in fact, that it has been featured in SAVEUR, Bon Appétit, TIME, and The Boston Globe, as well as CNN, NPR, and many other notable media outlets.

As someone who spends her days drafting patents and her evenings crafting recipes while also reviewing Michelin-starred restaurants, it’s surprising to learn that Jennifer Che, who currently runs the blog Tiny Urban Kitchen, initially struggled with written English.

“I hated writing in school, and I never wanted to write,” Che recalls. “And law was the one career area I thought I’d never pursue. I told myself I’d maybe get a PhD, go to medical school, or get a PharmD because I loved science and math and aced those with no problems. But I didn’t really like English, I think, because I struggled with it as my second language.”

The daughter of first generation Taiwanese-Americans, Che grew up in northern Ohio, where she would marvel at her mother’s remarkable ability to conjure up quintessential Taiwanese cuisine from everyday American pantry staples. “As immigrants in Toledo, our family had much less access to Asian ingredients or authentic Chinese restaurants, so my mom would buy US ingredients and adapt them to make very authentic recipes,” Che explains. “I grew up with my mom always being entrepreneurial in the way she cooked, and that really influenced me.”

Eventually, Che’s STEM-centric interests lead her to study chemistry as an undergraduate at MIT. After entering the workforce as a scientist at Millennium

Pharmaceuticals (now Takeda Oncology), Che attended a lecture given by a patent attorney. The attorney invited chemists to consider a career in IP law, which was something Che had never considered.

“At the time, I was very much still trying to figure out what I wanted to do,” Che recalls. “I went to talk to this patent attorney, and it was really cool because he described his position in a way that sounded like I could be exposed to science even more. I would be able to touch multiple projects going on within a company, and I would be able to see a diverse range of programs.”

Transitioning to patent law would also allow her to play a major role in the cutting-edge successes of a company and work intimately with a wide variety of emergent technologies. “I’ve always been a big picture person and a strategy person. I also love the idea of innovation,” she says. “As a scientist, you’re often assigned to one program or one project with a very narrow focus for a long time. You don’t really get to see the big picture of the company’s programs. For me, it was really exciting to be able to know that I could talk to more scientists and learn about more technologies—specifically the ones that actually work because I’d be working to patent them.”

While attending law school, Che also worked a full-time job. But when her program ended, she found herself faced with a newfound amount of spare time and no shortage of energy. “I was in a hyperintense state of living because I was so used to packing my schedule. I would have to study every free moment I had outside of work and class,” Che explains. “When I graduated, l was still in that state. I had tons of energy and now tons of time, yet nowhere to channel it. I started to explore all sorts of hobbies with

my spare time like oil painting and Brazilian capoeira. I decided I was going to run a marathon. I joined an a cappella singing group, and I learned how to sew handbags from online tutorials.”

She also gave blogging a try, and it stuck. Che recalls how in college she would call her mom regularly for cooking recipes and instructions. “She would explain her adaptations and modifications, which were interesting—like how to cook something in an American oven that might be steamed in a Chinese kitchen,” Che says. “I think one of my main inspirations for eventually starting the food blog was to recreate my mom’s recipes and write them down so that I’d have a repository for them.”

Che has channeled an equal amount of passion into her legal career, and after working for several medium-sized companies as an attorney and legal consultant, Che joined Axcella—a pioneer biotech start-up company that harnesses amino acids for use in therapeutics and nutritional products. Naturally an extrovert, Che thrived in the company’s positive, encouraging environment and also learned valuable skills that she will now take with her in a move from Boston to Hong Kong with her husband.

Introducing a New Recipe for Success

While Jennifer Che worked by day at Axcella, her evenings were reserved for her food blog, Tiny Urban Kitchen. However, it was also during her time at Axcella when Che was given the opportunity to spearhead a company-sponsored initiative to create a multicultural, community cookbook featuring recipes from Axcella’s diverse base of employees.

It’s one of the several aspects of Axcella’s culture and mentality that inspired Che on a daily basis at the prominent start-up company.

Jennifer Che VP, IP and Legal Affairs Axcella

Penny S. Smith, Life Science Law is a team of experienced attorneys who have direct industry experience. Our attorneys understand the critical legal and regulatory issues facing FDA-regulated entities and are sensitive to the demands of time and budget constraints, and the need for streamlined legal services. We have assisted numerous clients in the clinical trial contracting and outsourcing process for global research projects. Our knowledgeable and efficient services have enabled our clients to meet study timelines and avoid research delays.

Tel: 404.421.1445 www.pslifesciencelaw.com

“Axcella’s culture is unusual, unique, and more fun than any culture I’ve ever seen,” she says. “Any start-up is going to be fun of course, but I think Axcella is at a different level. It’s partly due to the the fact that it’s an environment where people aren’t afraid to try new things and encourage others.” That atmosphere, according to Che, has also forged lasting relationships that make the company operate more effectively.

As the fast-paced start-up’s only attorney, Che learned to take creative risks while managing and overseeing legal affairs for the company. These included working to secure the company’s new technology with patent applications and strategies, developing rebranding trademark tactics, and tackling the general IP and contracting issues that typically arise in a business’ nascent stages.

“Working at a start-up, in a lot of ways, is trying to do something that’s never been done before. That’s what startups do. They’re pioneering a path,” Che says. “And working at a start-up has been really interesting for me because it’s taught me to really push boundaries and take more risks because you have limited resources, time, and money. You only have one shot sometimes, so you have to make your best judgement and be a bit more aggressive or creative in solving problems.”

As for the future, Che says there are many opportunities in Hong Kong. She says she is excited to bring her expertise from both midsized pharma companies and small innovative start-ups to her newest endeavor. Additionally, Hong Kong has some of the best restaurants in the world.

“It’s a really great hub for accessing many different places throughout the rest of Asia, and for that reason, it’s a great stepping point for expanding the scope and reach of the blog,” Che says. “I’m definitely going to keep on traveling and blogging the way I always have. I hope to continue building up the relationships I’ve made in the past while using skills I’ve learned over the years to expand my blog to the next level here.” AHL

Penny S. Smith, Life Science Law is a team of experienced industry attorneys representing FDA-regulated entities related to product research, development, and commercialization. Our services have been key to helping Axcella Health Inc. research study timelines. Visit us at pslifesciencelaw.com or call 404-4211445. Congratulations Jennifer for this awesome achievement!

A Passion for Employee Progress

John Beatty and his team work to ensure employees continually develop throughout their careers at BJC HealthCare

By Russ Gager

JJohn Beatty spent most of his career working in manufacturing and engineering. It was only eleven years ago, however, that he discovered his passion for working in the healthcare industry. His first job in healthcare was as vice president of human resources for Barnes-Jewish Hospital in St. Louis, which is part of BJC HealthCare.

"I was fascinated by the healthcare industry, but I wouldn't say I had a passion for it," he says. "But six months after I started at Barnes-Jewish Hospital, it became a passion. I look back and wonder why I didn't work in the industry for thirty years before I got this job. It's a great industry, and every employee—no matter the job— ultimately plays a role in helping to provide exceptional care to our patients and communities. "

Beatty, however, discovered his passion for human resources much earlier. After earning a bachelor's degree in English literature from Eastern Kentucky University, he started working as a teacher and football coach in Mason, Ohio, and then joined Cincinnati Milacron Inc. as a technical trainer, documentation specialist, and field service technician. Following some time at General Electric as a training manager in the robotics and vision systems division, Beatty joined Rockwell Automation and eventually became the director of human resources for Rockwell Software.

"I was tapped on the shoulder by a division general manager at Rockwell who said, 'With your skill set, I think you'd be really good at giving the human resources thing a try,'" Beatty recalls. "I said, 'I don't know anything about it.' And he said, 'It's OK. You have really good people beneath you.' He took a chance on me, and I took a chance on HR."

After six years at Barnes-Jewish Hospital, Beatty had the opportunity to move into the system level at BJC HealthCare as the vice president of human resource operations, and two years ago, he became the chief human resources officer. Progressing in these positions helped Beatty see firsthand where improvements were needed to centralize HR operations and increase efficiency at BJC HealthCare, which has about thirty thousand part- and full-time employees across fifteen hospitals and multiple community health locations that serve Missouri and portions of Illinois. Since becoming CHRO, Beatty and roughly 230 HR employees have worked to centralize the organization's employee service center and recruiting efforts. "I've always been a big believer—because of my manufacturing background—in making data-driven decisions by looking at

John Beatty SVP, CHRO BJC HealthCare

the analytics and seeing what the numbers are telling us," Beatty says. "We didn't have that in the human capital world. It didn't exist."

With analytics in mind, Beatty and his team set up systems that examine several hundred human capital data points by department. This allows managers to evaluate metrics such as retention, pay, recruitment performance, vacancy rates, operational vacancy rates, use of contract labor, trends in premium pay, and cost of turnover.

"It's very data-focused and appeals to the leaders in healthcare in a language they understand, which includes metrics and analytics," Beatty says. "It's not just human resources coming in with what they think is a good idea. We have evidence that shows what we should do and why. In most hospital systems, labor costs are 45–55 percent of revenue. So if you want to make an impact on your cost structure, it's usually good to look at the place where you're spending the most money."

In the future, Beatty plans to use information to evaluate leader performance, exit interview data, employee engagement results, patient safety, and quality data. “This will give us the ability to do a better job of targeting interventions to enhance our employee experience,” Beatty says.

“We really pride ourselves on the fact that we’re a learning organization. We want everybody to continue to grow.”

To enhance the employee experience, BJC offers many benefits such as a defined benefit pension plan, multiple voluntary retirement savings plans, and an employee discount plan. Employees also can obtain the skills and knowledge to progress in their careers at no charge in a 188,000-square-foot building largely devoted to the BJC Institute for Learning and Development (BILD). Thirty-two HR employees work full-time to provide this employee development. "We really pride ourselves on the fact that we're a learning organization," Beatty says. "We want everybody to continue to grow. If you want the next job, then you've got to prepare now."

In addition to the organization's internal employee education programs, BJC HealthCare partners with universities to provide employees with better educational options. "We have a very robust tuition assistance program," Beatty says. "People can get anything from a high school diploma to a master’s degree at a cost much lower than it would be anywhere else."

Beatty's own career development has included numerous leadership training programs, and he coaches BJC managers on leadership. His leadership philosophy is simple. "Get fantastic people around you—the best people you can find—and collaborate with them," he says. "Then, get out of their way as much as possible but stand ready to help them when they need it." AHL

PwC recognizes the leadership and insight that John Beatty has achieved in his role as chief human resources officer for BJC HealthCare. PwC has a long-term relationship with BJC and John, and we have successfully worked together along the transformation journey. John has led initiatives to make an impact not only on their people and culture but also in the community. His efforts will have a lasting effect on the organization and the healthcare it provides. PwC looks forward to continuing our relationship with BJC HealthCare and John to serve them in meeting the changing needs of healthcare in the future.

Culture of Caring

For Gwinnett Medical Center’s Cathie Brazell, the key to success as a hospital administrator is making emotional connections

By Jeff Silver

CCathie Brazell, Gwinnett Medical Center’s vice president of operations and a former bedside nurse, comes from three generations of caregivers: her aunt, her mother, and sister were nurses, and her niece recently graduated from nursing school. Between them, they have more than 105 years of nursing experience.

But Brazell herself knew what her career path would be when her grandfather died when she was fifteen years old.

“The nurses at the hospital acted as if he was their grandfather,” Brazell recalls. “I loved how they interacted with us, but it wasn’t about what they said. It was how they made us feel. I knew at that moment I wanted to be able to make people feel that way.”

Before joining Gwinnett Medical, Brazell was chief quality officer at Winnie Palmer Hospital for Women & Babies. It was a position in which she was able to support staff throughout the facility, which meant she could follow through on her goal to make people feel cared for.

No matter what position she’s in, Brazell is proactive when it comes to building relationships and putting herself in the middle of the action to gain firsthand experience with operations and procedures and where improvements are

needed. The strategy grew out of advice from her father at the start of her career: “Go where the work is being done.”

“My father told me that if you stay in your office, all you know is what people tell you,” Brazell says. “But, if you get out, you learn how things are really functioning. It’s also an opportunity to connect with people on a personal level and show them that you care about what’s important to them.”

To this day, she goes on rounds with various staff members at least once a week. In fact, she refers to those experiences as the best part of her day because they make her feel as though she’s going back to her roots. Brazell accompanies everyone from bike safety patrols and environmental service workers to neonatal ambulance teams.

“Healthcare is incredibly complicated and can become very siloed,” Brazell says. “An important part of my job is to show each person how they fit into the big picture. It takes a village to run a hospital.”

For example, if an environmental services employee says they just clean rooms, then Brazell explains how that activity is just as important as any other job because it helps keep the patient healthier, which gets them home sooner. She also gets directly involved in training and has used

Cathie Brazell VP of Operations Gwinnett Medical Center

“An important part of my job is to show each person how they fit into the big picture. It takes a village to run a hospital.”

David Naugle

“Whether you’re the CEO or emptying the trash, healthcare is about real people, emotional interactions, and treating everyone with respect. Once you make those kinds of connections, the business will take care of itself.”

her clinical background to help teach topics such as proper cleaning techniques and clarifying who has responsibility for maintaining different pieces of equipment.

But her approach does more than create clear expectations, eliminate misunderstandings, and improve working relationships among staff. For example, rates of clostridium difficile infections have gone down, and turnaround time for preparing patient rooms has been reduced.

“I used to get strange looks when I tried to explain why just cleaning a room was so important,” Brazell says. “But the entire staff now has a much better understanding of how they all contribute to clinical successes. In fact, after a recent training session, the leaders got a standing ovation.”

Because she enjoys change and new challenges, Brazell actually took a step down in title when she originally joined Gwinnett Medical as director of women and children’s services in 2010. The department was facing a period of successive changes in leadership, so she devoted herself to working with people to understand employees’ strengths and how to collectively leverage those to positively impact morale and performance.

She was able to simultaneously create a plan that placed the right people in the right positions, helped them develop relationships throughout the organization, and then got out of their way. To this day, staff turnover has been reduced by more than 30 percent, and job satisfaction has increased nearly 19 percent.

A portion of those results can be attributed to Brazell introducing the Spirit of Care-Giving, a learning process originally designed to address professional burnout among nurses. Gwinnett uses the two-day interactive experience to help staff at all levels reconnect with their passions, both in their personal lives and on the job.

Brazell also established the Women’s Advisory Council (WAC). The 165-member group was established five years ago to give local women opportunities to network, to mentor each other, and to identify and address community needs. One of its more prominent accomplishments was

recognizing the need for a twin-capable ambulance for the medical center’s neonatal unit, which treats infants from communities up to a two-hour drive away. WAC raised more than $250,000 for a state-of-the-art vehicle in less than a year. But there was one lesson Brazell had to learn when she made the transition from nurse to healthcare administrator: patience. “As a nurse, I got constant feedback from patients, staff, and physicians,” she recalls. “As an administrator, you’re successful if you are able to execute three to four projects annually. But when you do, it still feels just as impactful.”

Some new administrators that Brazell now mentors have no clinical experience. In those cases, she emphasizes the importance of direct contact and connections with patients, staff, and the processes and decision-making that go into working on the clinical front lines.

“If you only have administrative experience, it’s very common to view healthcare as a business that requires checking boxes and meeting goals for the bottom line,” Brazell says. “But whether you’re the CEO or emptying the trash, healthcare is about real people, emotional interactions, and treating everyone with respect. Once you make those kinds of connections, the business will take care of itself.” AHL

“Cathie Brazell has taken the success of our partnership with Gwinnett Medical Center to the next level. Her commitment to excellence in every aspect of patient care is inspirational and has elevated the performance of our entire team. On behalf of everyone at Clarus Linen Systems, we congratulate Cathie for this well deserved recognition.”

-John Giardino, CEO, Clarus Linen Systems

Pilgrim Mat Services congratulates Cathie Brazell on this well-deserved honor! We are proud to partner with Cathie and Gwinnett Medical Center as their premier entrance mat provider helping maintain a clean and safe environment for their patients and employees alike. We’re your helping hand. Visit pilgrimmats.com or call 1-800-939-2523.

A Prescription for Change

Why Novo Nordisk’s Marc Fishman was compelled to apply his litigation skills to the pharmaceuticals industry

By Chris Gigley | Photos by Lisa Weatherbee

MMarc Fishman didn’t grow up with a passion for pharmaceuticals. He simply loved to litigate, whether facing family, friends, or perfect strangers.

“I would take a position in an argument knowing and anticipating what the other side would be,” says Fishman, vice president, associate general counsel—head of US litigation at Novo Nordisk. “I always had somewhat of an analytical mind, and that led me to being a litigator.”

A pair of family health crises led him from his position as a successful trial lawyer at the firm McCarter & English LLP to an in-house position in the pharmaceuticals industry. In 2000, his father died suddenly of a heart attack at age sixty. A father of two small children at the time, Fishman says it was a major wake up call.

“It made me recognize my own mortality,” he says. “I saw how hard he worked and realized I was on a similar path to working myself to death as a litigator at a big law firm.”

Fishman took stock of his priorities and tried to maintain a better work/life balance. But in 2004, doctors diagnosed his mother with an aggressive form of brain cancer, and Fishman took on the role of managing her day-to-day care. In addition to often driving her to chemotherapy and radiation appointments, he administered her medicines and grew to appreciate how those treatments prolonged her life, even if only for about a year.

VP, Associate General Counsel—Head of US Litigation

Marc Fishman

Novo Nordisk

Having experienced the loss of both of his parents at a young age, Fishman felt a responsibility to work in healthcare. Even without a scientific or medical background, he knew that he could help businesses in the field mitigate risk and enable doctors and scientists to focus on producing medicines that improve patients’ lives. So, he targeted the pharmaceutical industry for his career change.

“It felt like a natural place for me because I’d learned firsthand the impact pharmaceuticals have on people’s lives,” Fishman says. “To see how some of those products gave my mother more time to share with her family shed new light on how meaningful a career in healthcare would be.”

Fortunately, he was well-positioned for such a move. As a litigator, he had the freedom to work for companies in virtually any industry. Many types of businesses, including pharmaceutical companies, get sued or need help bringing lawsuits. However, because most corporations utilize external counsel to manage litigation matters, in-house litigation positions can be difficult to secure. In 2006, Fishman got his chance when pharmaceutical and diagnostics company Hoffmann-La Roche Inc. hired him as a senior litigation counsel at its headquarters in Nutley, New Jersey.

Fishman knew that moving into the healthcare industry would be a challenge. And transitioning from a law firm to a corporate environment was no easy task.

“In a law firm, litigation is typically very reactive,” Fishman says. “You are called upon to manage a particular issue or crisis for a client, and when that is finished, you move onto another issue for another client. You don’t often get the opportunity to learn about that company’s business, its culture, its people, and what motivates them to want to work there.”

Fishman learned all of that and more about Hoffmann-La Roche. “For me, I didn’t have a very robust background in pharmaceuticals, so I also had to learn about the supply chain, which was eye opening,” he recalls.

Similar to many outside of the pharmaceuticals industry, Fishman was only familiar with getting a prescription from the doctor and getting it filled at the pharmacy. Behind the scenes, however, a complex healthcare system involves manufacturers, wholesalers, pharmacy benefit managers, hospitals, doctors, insurers, and many others who play important roles in the supply chain. Because one of his first tasks at Hoffmann-La Roche was managing pricing litiga-

“People in-house need to understand that if you want firms to go the extra mile, you need to treat them the same way you’d want to be treated.”

tion across the company’s entire portfolio of brands, he had to quickly become an expert in all aspects pharmaceutical.

During his time managing pricing litigation, Fishman learned how to interact with various corporate stakeholders, from scientists and physicians who educated him on the benefits and risks of medicines to sales and marketing professionals who instructed him on the commercialization strategy of the company’s products. Throughout the process, Fishman never lost sight of each player’s important role in bringing a medicine from the laboratory to the patient. The process involves close collaboration across many important functions, with each group interdependent upon the other. Fishman recognized the same teamwork is essential to the success of any organization, including a litigation department.

Fishman brought these lessons with him when he transitioned to his current role at Novo Nordisk in 2014. Here, one of his key responsibilities has been managing how the company engages with external legal counsel. The company works with firms around the world, and Fishman works on getting better performance through forming better relationships with those lawyers.

Fishman explains that in-house lawyers are often wrongly perceived as living in the corporate world, where they can shut down their computer at five, go home, and not worry about work until the next morning. Fishman calls this phenomenon the “Flinstonian Principle,” though he has no dinosaur to slide down or rock quarry to leave from. “In litigation, it doesn’t matter if you are the in-house lawyer, external partner, associate, or law clerk—we are all part of the same team with the same goal of achieving the best outcome for the business,” he says. This means sometimes working late nights and weekends to achieve success for the organization.

Although much of his current role includes strategic planning, stakeholder and talent management, budgeting, and other administrative tasks, Fishman still enjoys taking a hands-on approach to his cases. He vividly recalls managing a significant employment litigation that went to trial in Florida several years ago. Even as the client, he recalls sharing late nights with external counsel helping

McCarter & English salutes the leadership of Marc Fishman Vice President, Associate General Counsel – Head of U.S. Litigation, Novo Nordisk.

McCarter & English brings decades of experience in the pharmaceutical, medical device, biotechnology, and healthcare fields, to both established and emerging life sciences companies.

We have “a seat at the table” when these companies make far-reaching decisions ranging from raising venture capital and structuring clinical trials, to protecting valuable intellectual property rights and defending product liability suits.

“There is a variety of talent within this team, and I try to give everyone a voice to share that knowledge with our organization.”

prepare witnesses, review testimony, and assist in trial strategy. He even remembers offering to write the closing arguments for his counsel who unexpectedly needed the entire evening to prepare a key witness for trial the next morning. Happy to oblige, Fishman spent the early hours of the morning preparing a closing argument that would be delivered to a jury less than twenty-four hours later. That case ended in a unanimous defense verdict.

For Fishman, he was pleased at the outcome but even happier with the collaboration that got them there.

Not everyone, however, subscribes to Fishman’s philosophies. “People in-house need to understand that if you want firms to go the extra mile, you need to treat them same way you’d want to be treated,” Fishman explains. “I’ve been on the other side. If you appreciate that lawyers have personal lives and truly partner with them, then they will be more likely help you on short notice.”

Fishman takes a similar approach in leading his dynamic in-house team of lawyers, paralegals, risk managers, records coordinators, IT professionals, and administrative staff. He empowers them to contribute to the group effort and take the lead in areas where they have expertise. Although he technically leads the team, he sees every member as his colleague and peer. “I don’t own the company, so nobody works for me,” Fishman says. “They all work with me.”

“I think people need to be acknowledged and recognized for what they bring to the

table,” he continues. “There is a variety of talent within this team, and I try to give everyone a voice to share that knowledge with our organization.”

Fishman’s management style is certainly a draw for prospective employees, but he says that’s just part of the company’s overall culture of respect and inclusion. Another aspect of that culture is something Fishman himself has come to value in his career, particularly after his father’s death.

“Work/life balance is very important to me, and we do our best to respect people’s personal lives,” he says. “I’m proud to work for a company where both personal and professional respect for one another is embedded in the corporate culture. While patients are always at the center of everything we do, we value the contributions that each employee brings to the organization.”

To connect with his team on a personal level, Fishman holds one-on-one meetings with his team members to discover what is important to each of them. He encourages them all to take their vacation time, and he gives them the flexibility to work from home when they can.

“Sometimes, when it’s six, I will walk through the office and bang on doors to say, ‘Go home and be with your family; you don’t get paid by hour,’” he says with a laugh.

Fishman may say it in a lighthearted way, but everyone knows he’s serious. They also know there’s no use arguing. Fishman, after all, is a born litigator. AHL

Arnold & Porter

Kaye Scholer LLP is proud to honor

Marc

Fishman

Vice President Associate General Counsel and Head of US Litigation, Novo Nordisk

On his well-deserved recognition as an American Healthcare Leader.

SHOULDER TO SHOULDER .

When it comes to our clients and their business issues, we’re in the trenches with them. When they need practical solutions to complicated problems that extend around the world, we are there. We are a law firm that works alongside our clients wherever and whenever they need us.

DLA Piper is proud to support clients like Novo Nordisk’s Marc Fishman.

From Union Talks to Talking Recipes

Jane Maksoud, senior vice president of human resources and labor relations at Mount Sinai Health System, improves the lives of the organization’s employees through innovative programs and direct involvement

By Jonas Weir

WWith seven hospitals and twelve freestanding joint ventures, Mount Sinai Health System has a large footprint in the New York metropolitan area, where it strives to provide compassionate patient care and to advance medicine in the many diverse communities it serves. More than thirty-eight thousand people contribute to providing that care and creating the best experience possible for the millions of patient visits the organization sees each year. And a major part of advancing that mission is ensuring that those employees have the best experience possible, which is where Jane Maksoud, the organization’s senior vice president of human resources and labor relations, comes in.

Maksoud, who has been known to share some notable cooking recipes with employees, leads the organization’s people strategy, which is designed to attract, develop, and retain top clinical and administrative talent and is supported by an environment of mutual respect and collaboration for team members. To execute on that strategy, her role includes a wide variety of HR functions, including faculty and employee relations, talent acquisition, learning and development, compensation and benefits, executive and physician compensation, international personnel, recreation, and workforce analytics. Maksoud’s role at Mount Sinai, however, was not always in human resources. In fact, she has seen a broad spectrum of how Mount Sinai delivers care during her more than thirty years with the organization.

After earning a degree in nursing from the College of Mount Saint Vincent, she started at Mount Sinai as a certified clinical research coordinator in 1987. She

continued to work in a clinical capacity in a variety of roles, including as a nurse clinician in ambulatory care and cardiothoracic ICU staff nurse. She also held a role as the Maternal Child Health Bureau’s Region II coordinator before transitioning into human resources. After joining the HR team, Maksoud worked in a variety of roles before being promoted to her current position in 2013.

Upon taking the new position, Maksoud led a crossdepartmental team of HR, IT, and clinical to launch the Portal for the Education and Advancement of Knowledge (PEAK). The customized learning management system has expanded Mount Sinai’s capacity to deliver learning content and to monitor compliance. In addition to improving learning and development programs at Mount Sinai, Maksoud has markedly improved employee health and wellness with innovative initiatives and hands-on involvement.

One of the organization’s more pioneering programs is its partnership with Off the Scale, a behavioral health intervention program for payers and providers who are at financial risk from populations with lifestyle-driven chronic conditions. Off the Scale aims to ultimately slow, stop, and reverse the progression of chronic diseases by disrupting behavior choices, including nutrition education, exercise, and psychology. In February 2016, the organizations announced their partnership. “At Mount Sinai, we are creating a pathway for our employees to achieve their professional goals as well as their health and wellness objectives,” Maksoud said in a news release. “We understand that many of our employees have multiple

roles and face multiple stressors, but by offering wellness initiatives that focus on self-care, mindfulness, and resilience, our hope is that employees will experience a sense of pride and overall well-being, while recognizing their full potential.”

The partnership has been highly successful. In fact, Mount Sinai announced that it would be extending and expanding the program this past fall. And the team at Off the Scale couldn’t be more excited about the opportunity. “Jane has really been a huge help to us,” says Off the Scale CEO Peter Brechter. “We couldn’t have got to where we are without the help of Mount Sinai.”

Outside of her work with Off the Scale, Maksoud is involved with helping all employees at the organization make better lifestyle choices. She hosts healthy cooking classes and has even compiled a recipe book for Mount Sinai employees and patients alike. The book she wrote is dedicated to the inspiring Mount Sinai family who are taking positive steps to care for themselves and those they love. Mount Sinai Fit Cooks! includes five of Maksoud’s personal, easy-to-prepare recipes. Anyone can access the book for free through Mount Sinai’s website.

And Maksoud’s work to improve the employee experiences at Mount Sinai has not gone unnoticed either. HRO Today recognized her this past year as a finalist for CHRO of the Year for her contribution to transforming Mount Sinai’s Beth Israel hospital so that it had fewer inpatient beds but a much larger ambulatory platform. The project required Maksoud to work with major unions to craft agreements that guaranteed that all union employees at Mount Sinai Beth Israel would be offered other union opportunities within the Mount Sinai Health System at equal pay. It was a major undertaking but also a rewarding success.

It’s that type of leadership and dedication that has helped Maksoud thrive for more than three decades at Mount Sinai: the visionary skills to lead major initiatives paired with the commitment and humility to write up and share her recipe for ground turkey ragu and pasta. AHL

Mount Sinai By the Numbers

300 community locations

36 multidisciplinary research, educational, and clinical institutes

38,000+ employees

6,500+ physicians, including general practitioners and specialists

2,000+ residents and clinical fellows

145,000+ inpatient admissions

3.1 million+ outpatient visits to offices and clinics (nonemergency department)

480,000+ emergency department visits

16,000+ babies delivered a year

3,000+ beds

130+ operating rooms

Are you ready for a program that generates results?

Get in touch at hello@bluemesahealth.com to talk about how we can help your company with our CDC-recognized diabetes prevention program.

How to be Resilient in the Volatile Biotech Industry

Jeffrey Hessekiel is steadfast in using his legal prowess to support Exelixis in its mission to help cancer patients recover stronger and live longer

By Porcshe N. Moran

DDuring the fall of 2014, Jeffrey Hessekiel had an important decision to make. He had just joined biotechnology company Exelixis that February. By Labor Day, the oncology-focused business was making tough decisions because a pivotal clinical program for prostate cancer had failed. The company’s stock dropped to single digits, and Exelixis reduced its workforce by about 75 percent. Hessekiel was given the option to remain in his position as executive vice president, general counsel, and corporate secretary. Ultimately, the George Washington University Law School graduate stayed with the San Francisco-based firm through that period because he believed in its goal of developing and commercializing new medicines for difficult-to-treat cancers.

“Legal judgment, ethical values, and experience in risk management are essential when things aren’t so good,” Hessekiel says. “This is what I try to bring to the table, so I felt it was my duty to stick it out. Running to the exit would have been unprofessional and not in keeping with the kind of lawyer that I want to be.”

Strong leadership at Exelixis also factored into Hessekiel’s choice to stay with the twenty-four-year-old company. “Biotech is not a business that is made or broken on the basis of one person,” he says. “You need a great team to be successful, and the team at Exelixis is very strong. I have great respect for their values and leadership, and it meant a lot to me that we stuck together through the hard times.”

Hessekiel’s loyalty to the company paid off. In 2015, Exelixis received positive results from its clinical trial in patients with metastatic kidney cancer. Since then, the company has continued to thrive and grow. It recently signed a long-term lease for offices and labs in Alameda, California, which are newer, bigger, and less expensive. Hessekiel says it’s a place where Exelixis can develop a true campus. Moreover, the company also introduced new branding in September 2017, which included a redesigned logo and a revised tagline: Resilience. Results. Remission.

“Having rebounded, we now have a lot of new people on our team,” Hessekiel says. “We got rid of half a billion dollars of debt and have sustained profitability for the first time in our company’s history. We feel good about where we are now. The new branding shows potential employees, investors, physicians, and patients what we are about and underscores our commitment to bringing best-in-class oncology medicines to market.”

Although Exelixis is on the upswing, Hessekiel says the corporation is staying grounded. He is maintaining focus, fiscal discipline, and efficiency as he knows that his colleagues may see the company’s legal group as a bellwether.

“Having learned how to survive through lean times, you don’t want to blow the doors open and forget the good lessons you learned about how to make do,” Hessekiel says. “We are taking a slow and conservative approach as we pursue our mission.”

In his role, Hessekiel serves as the senior legal and compliance advisor to the company and its board of directors. He oversees a team of sixteen people, and he says he is grateful for the opportunity to manage a group of smart, focused professionals who perform top-notch legal work while helping their colleagues to evaluate and mitigate Exelixis’ operational risks.

“I like working through problems with a close-knit team,” Hessekiel says. “I enjoy the people with whom I have the pleasure and privilege to work with. I try to give them what they need to be successful, whether that is resources, support, or feedback. I want to facilitate the team coming together in a well-coordinated, collaborative fashion.”

Hessekiel’s management style has proven to be effective. The Recorder—a daily news publication about California’s legal, business, and technology trends—recognized Exelixis in its 2017 In-House Legal Departments of the Year awards. The legal team won in the specialty area of mergers and acquisitions for securing collaboration and licensing agreements with Ipsen Pharma, Takeda, BMS, and Genentech, and it also took home an award in the category of product counseling for helping to manage the approval and launch of Cabometyx, a therapy for patients with an advanced form of kidney cancer.

“This is a service role,” Hessekiel says. “The legal team serves its internal clients. However, at the end of the day, all of our accomplishments are on behalf of cancer patients and their families. They are our motivation. If we can continue to make progress on the company’s mission to provide new and better treatment options for people with cancer, then we have every reason to be confident that financial rewards and personal and professional growth will come, too.”

Prior to Exelixis, Hessekiel was senior counsel at Arnold & Porter (now Arnold & Porter Kaye Scholer), where he represented clients in the life sciences industry.

“Jeff knows how to handle virtually any situation,” says Daniel Kracov of Arnold & Porter Kaye Scholer LLP. “I have seen him navigate through very complex scenarios, and I know those experiences have greatly contributed to his success.”

Before joining Arnold & Porter, however, he worked at biopharmaceutical company Gilead Sciences from 2002 to 2012. He credits both

“Having learned how to survive through lean times, you don’t want to blow the doors open and forget the good lessons you learned about how to make do.”

Jeffrey Hessekiel EVP, General Counsel, Corporate Secretary Exelixis

WE ARE PROUD OF THE COMPANY

Leading the Way

of these jobs as essential to his development as a lawyer and a business person. Another critical point for Hessekiel was when he traveled abroad to do humanitarian work for refugees with the International Rescue Committee after college. There, he learned how to work through complex problems on behalf of others and to not be reactive.

WE KEEP honigman.com

Honigman congratulates JEFFREY HESSEKIEL, Executive Vice President & General Counsel of our client Exelixis, Inc. for his well-deserved recognition by American Healthcare Leader. We value our partnership and wish him years of continued success. HONIGMAN.COM

King & Spalding proudly joins in recognizing our friend and client, Jeff Hessekiel,

“My experiences lead me to believe that resourcefulness is an important quality for legal professionals,” Hessekiel says. “I had many opportunities to exercise resourcefulness when I was living abroad in Asia and when performing humanitarian aid work during the war in former Yugoslavia.”

Hessekiel’s global background gave him lessons in tolerance and understanding, too. He also took away a useful perspective for dealing with daily challenges at Exelixis.

“The risks that a business faces in the United States are, thankfully, of a different magnitude than the risks that people face in refugee camps and war zones,” Hessekiel says. “It is advantageous to understand that disappointments and problems in the office are on a wholly different level from the urgent, existential concerns that people in other environments face every single day.”

Because his father was a doctor, Hessekiel says he always knew he wanted to help people. Yet, he was more drawn to solving problems through a legal and business framework rather than through medical means. At Exelixis, he is thrilled to use his skills as a lawyer to make a difference in the healthcare industry.

“The legal team is further away from creating new cancer drugs than someone in the research or clinical development departments, but what we do is still important,” Hessekiel says. “By providing expert legal advice and counsel, we improve the safety, security, and professionalism of the environment for people who are developing or promoting the medicines. I enjoy the knowledge that somewhere down the line what we are doing will benefit cancer patients.” AHL

Turning Tragedy into Action

After a devastating injury at age seventeen, Jessica Harthcock went on to found Utilize Health and help others with neurological conditions navigate the complexities of healthcare

By Danny Ciamprone

TThe night was winding down as Jessica Harthcock took her position on the gym mat. The seventeen-year-old varsity springboard diver, who cross-trained in gymnastics, had already completed roughly twenty gymnastics maneuvers before setting up to attempt the front double tuck layout twist. “I had done several beforehand, and it was just the last one that went wrong,” Harthcock recalls.

That evening in June 2004 in Evansville, Indiana, perhaps changed the trajectory of Harthcock’s life forever. As Harthcock came down, she landed on the top of her forehead breaking her neck and multiple vertebra, leaving her paralyzed from the chest down. “I instantly lost feeling and movement,” she says. “I actually couldn’t speak for a second.”

Harthcock was rushed to the emergency room, where she was eventually transferred to another hospital for surgery. Afterward, she went to an inpatient rehabilitation facility, where she began an extensive road to recovery. Then, after completing inpatient rehabilitation, she continued outpatient therapy for six hours a day, often six days a week for several years. She moved around the country, living in hotels from Chicago to Louisville, Kentucky, to Louisiana and Indiana. The rehabilitation was a culmination of electrical stimulation, gait training, aquatic therapy, vestibular therapy, and strengthening.

Then, after working for a year and eight months at a grueling pace, Harthcock saw her first sign of recovery—a muscle twitch in her right thigh. “It was almost unnoticeable, but that tiniest of twitches gave me an incredible amount of hope,” Harthcock says.

It took another three years before Harthcock learned to take a step and another six years of rehabilitation before she could walk completely unassisted.

Jessica Harthcock Founder, CEO Utilize Health

Johnathan Jones/ThePhotoJones

“If you saw me walk today, you’d have no idea anything was wrong,” Harthcock says. “However, I don’t have feeling from my chest down and still face numerous challenges.” Harthcock has a boot on her foot from torn ligaments, and she cannot squat down to the ground. “But the good news is I’m really healthy, live a completely independent lifestyle, and I’m no longer the high-cost, frequent user of the healthcare system, which is great,” she says.

But Harthcock doesn’t attribute her recovery solely to a tireless work ethic. She credits her parents, who would wait on the phone with their insurance company for hours on end, took her to countless therapy sessions, and doctor’s appointments. She also looks toward her husband, Adam, who was one of her trainers who helped her to learn to walk again after her injury. He would also be instrumental in Harthcock’s new entrepreneurial path to help others, which she first envisioned during her own recovery.

In her years of rehabilitation and visiting multiple doctors, Harthcock identified areas in the healthcare system that could be improved upon. As Harthcock explains, when she was in inpatient rehabilitation and then in outpatient phases, she realized that the healthcare system, particularly for patients with complex medical conditions, was often extremely fragmented and confusing, which forced her to have to trust in the healthcare system to provide her with the best treatment. She believed there should be a better way, and in 2013, she and Adam cofounded Utilize Health.

“I had Adam’s full, unwavering support, not just financially, but also as a husband and a partner and as someone who has watched almost my entire recovery process,” says Harthcock, now founder and CEO of Utilize Health. “We work together every single day and have since 2014, when we completed our first round of funding.”

Entrepreneur in the Making

Today, Utilize Health is a complex care management solution, which is sold to health plans to help patients with neurological conditions navigate their care paths. Members in the program include individuals with stroke, brain injury, spinal cord injury/disorder, multiple sclerosis, muscular dystrophy, and cerebral palsy, as well as their neurological subcategories. Harthcock says patients in these categories represent up to 4.5 percent of a typical health plan’s population but account for up to 24 percent of overall medical spend. As a result, Harthcock and her team at Utilize Health focus on all aspects of a patient and include their social determinants of health.

By helping patients with health, social, and environmental resources, it allows the Utilize Health team to drastically lower care costs and improve the health outcomes of the members they serve. To achieve this, Utilize Health has combined a unique set of clinician concierge services, a specialized set of digital tools specifically designed for people with neurological conditions, and a programmatic approach to combining and tailoring these aspects to each patient.

Each patient in the program is paired with a Utilize Health Patient Advocate, who’s a dedicated clinician concierge. Patient Advocates are employees of Utilize Health with at least eight years of experience in neurological rehabilitation who have worked in a multitude of care settings. They address the whole person, taking into account how a member’s primary neurological diagnosis affects their life and approach to other health risks. This year, Utilize Health has gone a step further and deployed a community health worker model. “This puts boots on the ground for our team and allows us to reach the member in new ways,” Harthcock says.

Before Jessica Harthcock founded Utilize Health, she founded Good Life and Healthy Mind (GLAHM) at eighteen years old while she was a patient at Shriners Hospitals for Children Chicago. During her treatment there, Harthcock recalls what an inspiring organization it was and how the hospital sponsored several camps for children.

As a result, Harthcock cofounded GLAHM, a beauty and self-esteem building camp for women with neurological disabilities.

“We had incredible sponsors,” Harthcock says. “There's just a lot of things that we did that really boosted their self-esteem.”

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“Our patient advocates are the ones who are speaking to our patients, gaining their trust, and helping them day in, day out.”

Additionally, Utilize Health has multiple digital tools for members of their program. One of these tools, Utilize Health’s Facility Finder, works similarly to Hotels.com and allows patients fill out a questionnaire, which then matches them with a facility that best suits their medical needs. “We not only look at facilities, but we also look at equipment inside those facilities and the modalities they use to treat a patient,” Harthcock explains. “Then, we’re able to share that with the patient so their care team and the patient can make the best decision in regards to treatment.”

Because of this, Harthcock says Utilize Health puts a major focus on keeping patient data secure. There is also a major emphasis on data analysis for the benefit of members and clients so Utilize Health is “very cognizant of security and HIPAA,” Harthcock says.

Looking ahead, Harthcock says that as a young company, Utilize Health is focused on expanding its footprint and its program. Just as Harthcock understood during her recovery, she wants every patient that comes through Utilize Health to know there is someone in their corner. “How do we navigate a very messy system, how do we be the trusted resource for everyone, and then how do we give every patient the same opportunities to recovery is what we set out to do,” Harthcock says.

And part of that is ensuring the team is as strong as possible. Harthcock praises her phenomenal team, who she refers to as the heartbeat of Utilize Health. “Our patient advocates are the ones who are speaking to our patients, gaining their trust, and helping them day in, day out,” she says.

As they all row in the same direction, there seems to be no limitations to what Utilize Health can provide for patients and ensure they are maximizing the best healthcare available to them.

“How do we get each patient to maximize their potential of recovery? Because quite frankly, we don’t know what maximum is today,” she says. “If Utilize Health can help patients achieve that, then we really fulfilled a bigger mission there all while saving health plans a lot of money in the process.” AHL

Leading with Bold Talent

Soni Basi brings years of experience infusing organizational cultures with the right mix of talent to drive a company’s success

By Pamela Sornson

DDriving growth by improving the culture of a company is an industry-disrupting exercise—and Soni Basi, now vice president of global talent at Allergan, has a lot of experience doing just that. She has spent the bulk of her career defining the process of connecting culture to corporate success. Over the past seventeen years, she’s counseled dozens of corporate leaders on how to improve their bottom line by improving their employee engagement strategies. What she's learned along the way now makes her one of Allergan's most valuable assets.

While studying psychology at the University of Central Florida, Basi was intrigued by the emerging science of industrial psychology, that is, applying psychological principles to business practices. “How people interact is a significant part of how companies function,” Basi says. “On a macro level, I wanted to understand how the culture of an enterprise furthers its business goals and, following that, how talent contributes to that metric.” She eventually earned a PhD in social psychology with a focus on aligning people with organizational performance from Bowling Green State University.

Basi began her career as a consultant at International Survey Research in Chicago, which is now a part of Willis Towers Watson, and helped many companies—such as manufacturers, large and complex retail banks, and pharmaceutical companies—achieve higher performance through improving the links in their talent processes, culture, and strategy. When some corporations remained mired in old-style methods that failed to embrace the full value of their workforce, she saw an opportunity.

She recognized and witnessed the importance of cultural leadership to corporate success, especially in today’s hyper-competitive global marketplace.

"Leadership sets the tone of the culture, allowing workers to embrace and adopt it authentically,” she says. “Those that were aware of the macro-shifts in the workforce and were able to make even micro-shifts to their culture had notable success. Creating a culture that reflects the business strategy is critical. For example, if you want to compete on innovation, you have to create a culture of risk-taking. This starts with who you attract, how you develop them, how you reward your talent, and the decisions leaders make daily. When you get it right, the whole organization breathes in a way to support the strategy.”

After leaving International Survey Research, Basi spent three years as the director of global learning and development for Schering-Plough where, among other projects, she worked to create a corporate university, led cultural integration during two mergers, and was responsible for the behavioral competency model that linked the talent in a thirty-three thousand-employee workforce to the company's total rewards strategy.

She spent the next six years at The Estée Lauder Companies, most recently as vice president of global learning and talent development. During her tenure, she continued her work to standardize and globalize the talent management processes for the company's more than thirty brands and forty-four thousand employees. Working for a company that had a significant millennial population and was on the cutting edge of creativity, digital marketing, and the shifting omnichannel landscape gave Basi an opportunity to introduce programs that appealed to the next generation of the workforce, leading from a digital-first approach and mind-set.

As much as she loved what she was doing, the option to move to Allergan was too intriguing to pass up. The company's forward-leaning, entrepreneurial, and start-up attitude promised her yet another opportunity to knit her talentdevelopment skills into innovative corporate practices—this time, in the biopharmaceutical sector. And she appreciated the corporation’s mission to always do the right thing for customers and patients, which has been apparent in how CEO Brent Saunders and other leaders at the company have taken a stand on topics that others have shied away from, such as the social contract with patients. It was unique, she says, to find leaders who were bold and took on the tough issues.

Allergan is one of the world's largest biopharmaceutical companies with more than eighteen thousand employees across seven therapeutic areas. What attracted Basi, however, was its Bold for Life philosophy. Bold for Life empowers employees through four key elements: build bridges, power ideas, act fast, and drive results. Basi

Soni Basi

VP, Global Talent Allergan

Jeff Weiner

“Our leaders support talent across the board, giving teams the authority to make decisions without unnecessary bureaucratic burdens.”

was brought in to help the company execute its strategy through its focus on attracting, developing, and engaging its exceptional talent.

Since day one, she's been impressed with its culture and leadership. “Our leaders support our talent across the board, giving teams the authority to make decisions without unnecessary bureaucratic burdens,” she says. “The focus on doing the right thing is embodied in our social contract with patients and our CEO's willingness to speak out about important issues, such as the need for a diverse workforce and inappropriate use of medical aesthetic treatments in teenagers.”

And that tone set at the top has trickled through the company. “The talent that we seek at Allergan is equally bold, courageous, entrepreneurial, and committed to doing the right thing,” Basi says. “Additionally, the company is focused on tomorrow by supporting initiatives empowering young minds to turn to science and medicine, such as our commitment to women in STEM programs. Our talent processes—from hiring, developing, and engaging—are being updated to reflect our Bold for Life culture. This makes it an even more exciting time to work at Allergan, and personally, I think I have the best job at the company.”

More than anything, Basi enjoys hearing how her work influences the lives of her coworkers and the patients the company serves. “I love knowing that my work has made a difference in people's lives,” she says. “That it makes a difference is the truly rewarding part of doing great things at Allergan." AHL

Congratulations Soni Basi for the recognition! Fusion Consulting Group is honored to have worked with Soni since 2006 as her trusted strategic communications partner. Fusion prides itself on being a small, nimble team, deeply dedicated to our clients. Fusion’s success stems from our personal approach, asking thoughtful questions from all angles and delivering creative, memorable communications. sheila@fusionconsultinggroup.com

No matter how complex your business questions, we have the capabilities and experience to deliver the answers you need to move forward. As the world’s largest consulting firm, we can help you take decisive action and achieve sustainable results. Look again. See what’s possible with Deloitte.

Point of Impact

After thirty years in healthcare law, Jeanette Schreiber’s experiences serve her well in transforming healthcare at the University of Central Florida College of Medicine

By David Baez

JJeanette Schreiber is integral to the University of Central Florida (UCF) College of Medicine’s development and expansion. As associate vice president for medical affairs and chief legal officer, she plays multiple parts.

She has been responsible for legal and compliance, helping to create an infrastructure that supports all of the medical school functions. She has also built a self-insurance program. And she’s a leader in the medical affairs division, with responsibility for strategic and business initiatives, which includes launching the development of a new university hospital and community programs in population health sciences, health IT, and physician practice transformation. It’s a role that encompasses her passion for both law and social issues.

After thirty years exploring the legal side of healthcare, her current position may have been a long time coming, but the seeds were planted decades earlier, during her childhood. While growing up in Orlando, Florida, Schreiber’s father was a lawyer dedicated to helping those in the greatest need. Her mother was a fierce social advocate who worked with mothers who couldn’t afford day care, eventually starting a social service agency that became a model for communities across the country.

It was the late 1960s, and her home was often buzzing with conversation among the many community activists who gathered there. The house was like an energy center for people who wanted to transform the community, and Schreiber soaked it all up.

At Emory University, Schreiber studied psychology and then pursued a master’s in social work at Florida State. It was the beginning of a period of enlightenment that would eventually lead to her carving out exactly the career she wanted.

“I learned so much about the issues in our society at school,” she says. “I saw how much need and misery and injustice there was. I also learned about the impact of

policy, and given my interest in law, it was easy for me to see that if I could work with law and policy, then I could have a greater impact at a community level by combining law and social work.”

After working for a year at a law firm, she decided to go to law school. Once there, she realized the extent to which her father had passed on to her the skills of a lawyer.

“Growing up with my father, I learned to think like a lawyer,” she says. “I didn’t know I had it, but I found that there was a sense of analytical logic, an ability to use language creatively that was second nature for me.”

At Harvard Law, she began to focus on healthcare, which she says was just then becoming a legal specialty. She loved that it was an area that impacted every stratum of society and that law and policy were crucial in transforming it in a way that it could more positively affect people’s lives. So she decided to become a healthcare attorney.

Jeanette Schreiber Associate VP for Medical Affairs, Chief Legal Officer University of Central Florida College of Medicine

Out of law school, Schreiber joined a law firm in Connecticut, Wiggin and Dana, that had a health law practice. She became a partner and was there for more than twenty years, working with hospitals, health systems, home-care agencies, and state medical societies. During her time there, she was the primary outside health law counsel for the Yale New Haven Health System. She was able to look at issues surrounding medical ethics that were just coming to the fore, such as the right of a patient to refuse resuscitation. She also worked on regulatory and corporate matters, health legislation and policy, health information technology, and joint ventures and affiliations, and she handled care and payment issues.

“I realized that law is not a static thing,” she says. “It has to be interpreted and applied. You can help people by making law a tool rather than an impediment. We wrote law in many situations at a state level. Whenever there was a problem, one of the major state associations we worked with could develop legislation to address it. I loved it because I got to be impactful.”

After twenty-four years of law firm practice, she finally made the decision to go in-house when the opportunity at UCF came up. Not only was the role perfect for her, but it also brought her back to her native Florida.

“I realized that law is not a static thing. It has to be interpreted and applied. You can help people by making law a tool rather than an impediment.”

“The shift was not intended to be a career-path change as much as a life change,” she says. “My goal professionally at that point was to see how I could take all the experience I had in Connecticut and use that to add value to my home community in Central Florida.”

Before moving back, she took the Florida Bar and became board certified in health law. To better prepare, she interviewed people in health systems and law firms in the state. Right when she began her job, UCF was preparing to build its medical school, which has become the culmination of Schreiber’s lifelong desire to make an impact.

“By building a medical school and medical center, in an era when healthcare is changing so much, I have a chance to do innovative things and add value in healthcare to the community,” she says. “It might have looked like a crazy career change, but there was method to it. I felt very blessed.” AHL

As a new medical school, we embrace high-tech learning tools, an integrated curriculum and a pioneering spirit to better educate doctors and scientists in the 21st century.

The State of Mind

At CHI St. Vincent, Chris Stines partners with medical pioneers to explore and care for the human brain

By Jenny Draper

TTo some it might be a surprise, but more neuroscientists than ever before from around the world are heading to Little Rock, Arkansas, to learn. It’s also where they’ll find Chris Stines, who is guiding a medical renaissance that promises to transform Catholic Health Initiatives (CHI) St. Vincent into a national and international hub for neurosurgical research and care.

The 130-year-old regional health network has topped best hospital lists by US News & World Report and Becker’s Hospital Review year after year. Yet Stines, vice president of operations at CHI St. Vincent North hospital, is ushering CHI St. Vincent into the next phase of its evolution through the development of facilities and talent on a global scale.

Stines works with a team of five neurosurgeons—all first-generation Americans—from Lebanon, Pakistan, Iran, and Greece whom comprise the Arkansas Neuroscience Institute (ANI). They perform more than one thousand surgeries every year on some of the most complex patient cases.

The team is led by world-class neurosurgeon Ali Krisht, who ranks in the top 1 percent of all neurosurgeons in the United States by the physician ratings firm Castle Connolly. Dr. Krisht is also the chief editor of Contemporary Neurosurgery Journal. His groundbreaking treatments of rare tumors, venous malformations, and aneurysms have achieved survival rates that are three times the national average. In fact, ANI patients’ three-year survival rates for

glioblastomas, a type of brain cancer, is 34 percent compared to the national average of roughly 8 percent.

“We had a patient who came to ANI after seven surgeries elsewhere,” Stines recalls. “Previous surgeries couldn’t get all of the brain tumor, and she had lost eyesight in one of her eyes. Dr. Krisht was able to get the whole tumor out the first time, and the patient asked Dr. Krisht, ‘Why didn’t I know about you sooner?’”

To expand the reach of the Arkansas epicenter, Stines is spearheading a $13 million renovation of the sixty-nine-bed North Little Rock hospital to create a one-stop neuroscience destination. Set to be complete this fall, the facility will feature ten additional new ICU rooms, four updated operating rooms, a 3T MRI, 128-slice CT, and a biplane angio suite, as well as a new pharmacy, helipad, and presurgical testing area.

Adjacent to the hospital, CHI St. Vincent is also developing a cutting edge research and education center to expand relationships with new generations of neurosurgeons. Currently, ANI facilitates educational training with Taiwan, Japan, Russia, Brazil, Belgium, Finland, Mexico, Holland, Sweden, Nigeria, and Italy. The site is expected to be complete this fall and will house clinical and research space, as well as a 150-seat auditorium.

It’s also Stines’s collaborative approach that is not going unnoticed by his peers. “In working with Chris to establish intraoperative neruomonitoring for spinal procedures

at CHI, AMS has found a partner who is able to keep patient care at the forefront while delivering against mutual business goals,” says Brad Vinson, CEO of Advanced Monitoring Services Inc. “He is a great collaborator with the ability to view the big picture and yet not let any details fall through the cracks.”

To further understand Stines’s ability and dedication to propel CHI St. Vincent’s neuroscience institute to the world stage, look no further than his own career path.

At age eight, Stines already had a business mind-set. The son of a dentist and a Mary Kay saleswoman, he sold cologne in class, candy bars from his locker, and repackaged golf balls he found around the golf course in egg cartons. “But my dad was the first to teach me about serving the poor and vulnerable,” Stines says. “He had a sliding pay scale for his patients. My mother taught me the importance of working for a company that shares your values.”

Stines attended Indiana University (IU) to earn a bachelor’s degree in economics with a certificate in business and a master’s degree in healthcare administration. He stuck around the first year after graduation to work in the IU School of Medicine’s obstetrics and gynecology department. He was promoted the following year in 1995 to executive director of a large IU-affiliated neurosurgery physician group practice, where he spent the next twelve years working with department head Dr. Paul Nelson.

“Dr. Nelson taught me many things, but two things he always said were: ‘Always take the high road, and there’s a big difference between zero and one.’ That means there’s a big difference between nothing and something,” says Stines, who considers Dr. Nelson a mentor, friend, and father figure.

“My work to support great minds and hearts and improving health outcomes is what drives me.”

Chris Stines VP of Operations, SVN CHI St. Vincent

“Neuroscience has always intrigued me. The human brain is like the last frontier.”

As a result, Stines made the first step toward hospital administration with Purdue University’s acute care veterinary hospital in 2007. From there, he rejoined Dr. Nelson at IU to negotiate a significant merger as the executive director of neurosurgery and president of the researchbased nonprofit Foundation of Goodman Campbell Brain and Spine.

During this time, however, divorce upended his personal life. Stines describes the shock of coming home to an empty house as the catalyst prompting a figurative journey in his career—one that literally took him around the world, starting in Africa.

Stines joined a church mission trip to Kenya, where IU also happened to have a partnership with Moi University. He shadowed administrators at the Academic Model Providing Access to Healthcare (AMPATH), which was created to help stop the spread of HIV/AIDS. There, he met with Dr. Florentius Koech, the only neurosurgeon in the region, and learned about the area’s high incidence of neurological trauma from motor vehicle accidents. Their conversation led to the creation of an IU rotation of neurosurgeons in Kenya to provide additional care and a visiting lectureship for Dr. Koech at IUSOM Indianapolis.

“I toured the wards of the hospital in Eldoret, where there were often two grown men to a bed,” Stines recalls. “Clearly, not an ideal, sterile environment for patients, but that’s all they had. Africa was a juxtaposition. It had incredible beauty with blooming trees and flowers. But there was also an incredible ugliness from the lack of resources and poverty.”

Stines also visited Kibera, Kenya, where a million people live in one square mile. With not much running water and other dire living conditions, it’s one of the largest slums in the world. He describes residents as kind and caring people who are struggling to get by.

The following year, Stines went to South America. He traveled up the Amazon River on a medical expedition to help locals in need. They distributed eyeglasses, doctors and nurses delivered medicines, and dentists performed

extractions. Stines took photographs of the families in each village they visited and presented them framed copies. “I was like the ambassador of goodwill for the team,” he says. “Even though I’m not a physician or nurse, there are other nonclinical ways to contribute.”

His travels strengthened his resolve to pursue international medicine administration, and a role in the Persian Gulf caught his attention. His year in Kuwait kicked off in 2012, during which Stines represented Johns Hopkins Medicine to implement the university’s best practices overseas as its chief operations officer and project director. Through the partnership with the Kuwait Ministry of Health, his team boosted standards of care and facilitated doctors’ on-site learning exchanges between Kuwaiti hospitals and the Baltimore-based university. After work hours, his commitment to the poor and vulnerable was lived out through volunteering to procure and distribute food staples to poor immigrant workers of Kuwait.

An opportunity to return stateside in 2013 did not disrupt his focus on international medicine. He joined CHI St. Vincent as its executive director of neurosciences in Little Rock. The city offered the hot climate that Stines was accustomed to while CHI provided an opportunity to continue his commitment to serving the poor and vulnerable. Service to the poor and vulnerable is one of the nine metrics that are measured and communicated monthly at CHI.

His purview expanded shortly thereafter as the division’s market director in 2015 and again with his promotion to vice president of operations in 2016. All in all, Stines describes his nontraditional path to CHI St. Vincent as providential.

“Neuroscience has always intrigued me. The human brain is like the last frontier,” he says. “My work to support great minds and hearts and improving health outcomes is what drives me. And our mission at CHI, supported by education and research and grounded in the Gospel, urges us to emphasize human dignity and social justice as we create healthier communities everywhere. It’s exciting work, and it’s the why that is unique to CHI.” AHL

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Rising to Any Occasion

Kim Harrelson shares how the lessons learned over her career are now making a major impact in her new role at Lonza

By Danny Ciamprone

Kim Harrelson Consumer Health Integration Manager Lonza

Kim Busby Photography

SSomething about Kim Harrelson blurs the lines of perception. On one hand, there is little she hasn’t seen throughout her distinguished legal career, yet she will readily admit that she is not the smartest lawyer in the room. And even when it comes to beginning a role outside of her comfort zone—such as a daunting task in assuming a new role in business operations at a global healthcare company—she welcomes it with open arms.

There are a few traits, though, that have influenced Harrelson throughout her career, including her journey to Lonza—a leading supply company to pharmaceutical, biotech, and specialty ingredients markets. From a young age, Harrelson describes herself as always being a worker bee. But she was also identified early on as someone with impeccable leadership skills who is ready and willing to outwork everyone and who has the keen ability to bring people together.

“Even though I was identified for having good leadership skills, it came from not really having the authority or the position of being a leader, but rather by making an effort to make sure the right people are exchanging information, whether that’s peers within the legal department, or a lawyer with somebody I know on the business side who’s dealt with something similar,” Harrelson explains.

Perhaps then it was in high school when Harrelson was first recognized for her leadership skills. Being involved in the debate and dance teams, Harrelson was also encouraged to run for class office, where she went on to be elected vice president. Then as a business major in college, Harrelson was asked to participate in a business plan competition, which involved organizing a group to formulize a proposal, forecast financials, and outline the model.

“By the end, through practice, I had risen to the level of the team leader because I thought that I was the one that was making sure that the pieces made sense fitting together, and I could take a higher-level perspective,” she says.

These leadership qualities—collaboration, strong communication, and a tireless work ethic—are ingrained in Harrelson. It’s also a collection she brought with her to

“I had risen to the level of the team leader because I thought that I was the one that was making sure that the pieces made sense fitting together, and I could take a higher-level perspective.”

Arch Chemicals in 2007, where at the time, Harrelson says she was the lowest lawyer on the totem pole. But over time, she earned several promotions, and another intangible in Harrelson’s collection of leadership qualities emerged: the ability to keep calm under pressure.

“I’ve had some colleagues that I’ve worked with in the past ten years on a variety of different things reach out and say, ‘You were always a calming influence when things were difficult,’ and that they appreciated my steady support through things that people can otherwise get pretty excitable about,” Harrelson says.

In 2011, Lonza acquired Arch Chemicals, and in 2015, Harrelson became the company’s North American general counsel. Despite working predominately on the legal side of the company, Harrelson explains that the collaboration between legal and business was evident. Often times, many assume that going to the legal department with a question means receiving a no answer. But Harrelson made it a point—and also encouraged her team—to know Lonza’s customers, understand the strategic objective of the company, and to be a true business partner to solve any issue. “You become really more of a proactive problem-solver than just an advisor of legal advice,” she says.

Last year, Lonza finalized a major acquisition of Capsugel from KKR for about $5.5 billion. Recognizing her strong business mind-set, the company appointed Harrelson to the role of consumer health integration manager shortly after. Having thoroughly enjoyed her role in the legal department, Harrelson admits that, though she was excited to embark on this new role, she was skeptical about working mostly in the business realm of the global corporation. With such a large acquisition as well, there were several obstacles that needed to be sorted out when combining the two major organizations. Along with coordinating human resources, leaders also had to define and communicate strategy to the combined team and, in the end, position Lonza and Capsugel to come together seamlessly. It’s a tall order for any company to sustain business continuity during a business acquisition, particularly one of this magnitude.

To assist in the transition, Harrelson is actively participating in change management, bringing those same qualities that were instilled in her at a young age to the forefront of the company. She’s also using that tireless work ethic to go the extra mile, such as attending trade shows to learn more about the business and meeting with team members throughout the company to increase communication and collaboration. Harrelson says it has been a daunting new venuture, particularly because of all the moving pieces.

“Our primary goal is to maintain business continuity, first and foremost, and then to organize strongperforming, combined teams and build what will continue to be a growing business,” she says. “We refer to it as taking the best from both. Even though the days are hard and I sometimes feel like I’m running behind, at a minimum, I’m helping connect people to talk to each other to figure out the best way forward.”

Harrelson has all the qualities, though, to make this venture a success, which has received numerous accolades from her peers. “Lonza benefits from Kim’s collaborative and steady leadership style,” says Bob Shuftan, partner at Steptoe & Johnson LLP. “She empowers her talented colleagues to share responsibility for making important

Only as Strong as the Team Around Her

It’s fair to say that Kim Harrelson is a natural born leader, but she is also the first to acknowledge that when overcoming any challenge, a team is right by her side lending their valuable expertise. Now with the acquisition of Capsugel, that team is continuing to grow.

Harrelson says one of her proudest achievements in her role as North American general counsel was bringing on board new hires and continuing to bring together her existing team members. “Even those who have worked together for some time, I believe, have found new ways to develop individually and help develop each other and add value to the legal team, as well as the respective businesses and functions they support,” Harrelson says.

Now, Harrelson is helping other groups come together to solve difficult issues. Although Lonza has a long history of success, Harrelson says that doesn’t mean there aren’t challenges. During these times, it’s more important than ever to rely on their collective expertise and genuine camaraderie.

“What I think I bring to these situations is truly an open mind with a strong desire and pragmatic approach to solving problems and an ability to get people to engage as their best selves with their best ideas,” she says.

Grey Street Legal, LLC joins in honoring our friend and client

We proudly salute Kim C. Harrelson for her many accomplishments at Lonza,

for her creative vision and insightful leadership as Lonza’s Consumer Health Integration Manager. We wish her much continued success.

a law firm with global reach known for its preeminent litigation practice and experience handling sophisticated, high-profile corporate transactions.

“I think you really have to be sincere and believe in what the initiative or the objective is.”

strategic decisions while supporting them and balancing business needs. The result is a strong team approach to meeting and overcoming challenges.”

There are many different types of leaders, just as there are many qualities that help define the perception of Harrelson. It’s these traits, along with a genuine interest in a team she leads, that have propelled her career, whether it be transitioning from North American general counsel to consumer health integration manager at one of the largest corporations in the world or earning the trust of her high school classmates to be elected vice president.

“I think you really have to be sincere and believe in what the initiative or the objective is,” Harrelson says. “I think the first part of it is really getting your own beliefs and support. Then, people can see that authenticity and that you’re supporting what you believe in. When you have good relationships with people and they trust you, then that helps bring them together faster. I always told my legal team that I’m certainly not the smartest lawyer in the room, but I’m happy to be a sounding board for you to make you the best that you can be.” AHL

“It’s our privilege to work with Kim Harrelson and Lonza, one of the world’s leading and most-trusted suppliers to the pharmaceutical, biotech, and specialty ingredients markets. We value our relationship with Kim and the rest of the Lonza team and are committed to working with them to deliver the highest level of service.”

–Kevin Collins, Partner, Jenner & Block

Children’s

Children are the future. And through everything from back-office process improvements to major culture changes, these four executives are paving the way for the newest advancements in children’s health.

Hospitals

Bringing Big

Changes to the Smallest Patients

Dr. Sandy Melzer and Seattle Children's Hospital are dedicated to bringing value-based models to pediatric care in the Northwest

By David Levine

Just as the healthcare marketplace moves slowly but inevitably from fee-for-service toward value-based care and payment structures, providers and payers have been acquiring data and developing models to make population health work, both financially and in terms of quality of care. At least, that is the case for adult healthcare. Pediatrics, however, is a different animal.

Dr. Sandy Melzer, executive vice president for networks, population health at Seattle Children’s Hospital, is working hard to bring attention to the importance of pediatric population health as the healthcare environment continues to evolve.

“The total spend on children’s health is relatively small in proportion to adult health spending. It has not been prioritized,” he says. “With the ACA, there was a big focus on putting money and effort into finding new clinical and business models, especially for adults in Medicare. There really has been no parallel effort for children.”

Working on behalf of children’s health has been Melzer’s lifelong career, beginning as a pediatrician and later moving into management. Originally from New York City, Melzer graduated from the University of California, Berkeley, and Icahn School of Medicine at Mount Sinai. After a few years of clinical practice, he became intrigued by the business side of medicine. “As the healthcare environment changed, I got interested in how regional specialized hospitals respond and thrive in this very dynamic environment,” he says.

In 1994, Melzer joined Seattle Children’s, the pediatric and adolescent academic medical center for Washington, Alaska, Montana, and Idaho—the largest region of any children’s hospital in the country, now comprising forty-one network sites in those four states. His first major task, which took up much of the first decade or more of his tenure, was building that network.

“I really enjoyed that external role,” he says. “I spent a lot of time in Alaska and western Montana, flying around in small airplanes, having breakfast with doctors in local diners, and trying to build that network to bring Seattle Children’s specialized care to distant communities.” He discovered that his clinical background was a major benefit. “I find it critical to understand the clinical side and to be

able to have clinical conversations with our providers and partners,” he says. “My unique role is kind of the ‘doctorbusiness guy.’” Melzer augmented his business credentials by earning an MBA from the University of Washington in the early 2000s. “That solidified my skill set and gave me the vocabulary and knowledge of the nuanced financial aspects of healthcare delivery,” he says. “A physician/executive with an MBA and a well-developed clinical perspective has a tremendous advantage.”

The philosophy behind all of this network building, as with other large regional medical centers, was to create the hub-and-spoke system of tertiary care connected to community-based hospitals. “The goal is to provide pediatric care closer to home, in places where care is very limited,” Melzer says. A secondary goal is to collect and analyze care data to push best practices in the new world of population health as it relates to children.

The main difference between adults and kids, he says, is that many adult health problems are age and lifestyle related, such as diabetes, hypertension, and substance abuse. Children, on the other hand, are generally healthy, except when afflicted by acute conditions, congenital diseases, or complex conditions such as cancer. “In pediatrics,

Sandy Melzer EVP for Networks, Population Health

Seattle Children’s Hospital

What appealed to you about working at Seattle Children’s Hospital?

Children’s hospitals are very special places, as they are solidly grounded in a shared mission of taking care of kids. Seattle Children’s has a history that goes for over one hundred years of taking care of all children regardless of ability to pay in the region. In addition to being attracted to the mission, I also came to Seattle Children’s because of its great group of providers. As an adult learner and as a physician, you want to be able to work in an environment where there are great colleagues and smart people teaching you every day.

How do you network with other leaders in children’s health?

One of my main networking organizations is the Children’s Hospital Association. Within this group are the other free-standing children’s hospitals that we at Seattle Children’s see as our peers. And while we might compete for the same specialists and research grants, it’s overall a very collaborative environment largely driven by the fact that the missions are very similar. Among the free standing children’s hospitals, there is a general sense of camaraderie and collaboration, and that has been very helpful for shared learnings in patient safety, cost improvement, quality improvement, and for advocacy effort.

How do you recognize trends in children’s health?

As a physician, I try to stay up to date through medical meetings and reading medical literature. In addition, I learn the most from market scenarios. Hearing about what other children’s hospitals are experiencing in Denver, Cincinnati, Boston, or Philadelphia is very valuable. Many of the themes are the same but with a market specific twist, and this is always interesting.

we are challenged in managing complex, rare, and expensive conditions,” he says. “We don’t have the same standardized evidence that exists for many common adult diseases. There are hundreds of outcome measures for adults, but few standard measures for children. We would greatly improve quality of care by developing consistent metrics and standardizing care.”

Melzer also emphasizes the importance of keeping children front and center in health policy conversations and developing solutions specific to their needs. In health policy development, kids are often left behind and may be an afterthought in planning, Melzer says. “When it comes to clinical care, children are not little adults, and our population health interventions, policies, financial arrangements, and approach to families must reflect that fact. We are working hard to raise awareness of the differences between adult and children’s population health and hoping to improve care in that way,” he says.

To that end, Melzer has been spearheading the health system’s new clinically integrated network, called the Seattle Children’s Care Network, a quality improvement and contracting initiative that he says is relatively new to pediatrics. Made up of about two hundred independent, community-based primary care physicians and about seven hundred pediatric specialists employed by the network through faculty arrangements, its goal is to standardize care, reduce utilization through better data analysis, and collaborate with those community-based doctors in new payment products. “It is largely focused on employer-based and commercial value-based arrangements, and we have learned some very valuable lessons in the process, especially around quality improvement and data collection,” Melzer says.

Another major project on his to-do list is leading a fifteen-hospital collaborative effort on accountable care for the Children’s Hospital Association, a national trade association. Each hospital is looking for different solutions for accountable care and value-based contracting, Melzer says. “There is no single model, no well-defined path, and it is fascinating to see the different approaches hospitals are taking,” he says. Several organizations are “placing big bets” on full capitation for Medicaid populations, Melzer says. Others are looking to develop legal entities between community physicians and hospitals to improve quality and share data. “A third area is children’s hospitals attracting kids with special needs,” Melzer says. “Some are positioning themselves as population health managers for kids in foster care or disabled kids. They are looking at ways to work with a wide range of payers to treat some of these complex and expensive cases.” One of the most challenging aspects of his job, though, isn’t the work involved.

Fasten Your Seat Belts

Building a network across widespread, remote parts of the American Northwest provided Sandy Melzer with some interesting, and sometimes harrowing, experiences. For example, he once was asked by Senator Patty Murray to testify at a hearing in Central Washington. “I expected a state patrol car to pick me up,” Melzer says. “Instead, a man from Fish and Game met me with a well-worn two seater airplane and took me on a fantastic tour over the Cascade Mountains. He wanted to give me a personal tour of where he worked. It was a bumpy, windy, thrilling ride. And it was not what I had expected when I got up to go to work that morning.”

“It’s getting people’s attention in the market,” he says. Breaking down the silos and shifting the focus from transactional healthcare to a more longitudinal perspective takes up much of his time as he coaches, mentors, and energizes people to move in the direction of change. “We know the world is going this way and that the old fee-for-service world will be less of our business,” he says. “Here in Seattle, I don’t see us being 100 percent value-based, but enough of our business will move that way that we have to be effective in making that transaction.” AHL

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The Art

of Saving Dollars and Lives

Brian Rounsavill leverages Children’s Hospital of Philadelphia’s budget to ensure funds are always available for world-class patient care and research

By Joe Dyton

Walking into any hospital, people expect to find the standard equipment: ultrasound machines, syringes, hospital beds, and more.

And at Children’s Hospital of Philadelphia (CHOP), Brian Rounsavill is the reason it’s all there.

As the senior director of contracting and procurement, Rounsavill helps the organization purchase equipment, materials, and services, whether it’s adhesive bandages, MRI machines, cleaning services, or even buildings. Rounsavill is not just issuing orders on CHOP’s behalf. Rather, he is part of a team that strategically makes purchases so that CHOP can continue to lead the way with positive patient outcomes.

Rounsavill and his supply chain team look outside of the organization to ensure CHOP is a leading hospital, while also looking within the organization to partner with their end users to discover ways to add value to the hospital. These methods include cost savings, process efficiencies, value analysis, and obtaining the desired high-quality products and services.

“In short, my job is simply to get the best things for CHOP at the best possible price so our surgeons and researchers can continue to make breakthroughs every day,” Rounsavill explains.

Although he did not start his career in the healthcare sector, Rounsavill’s previous experiences have made him an ideal fit to manage CHOP’s spending. When he worked for a decade at an international engineering association, he traveled the globe to negotiate deals that facilitated Nobel Prize-winning electrochemical research. He also got an understanding of the company’s many different business climates and sourcing strategies. Rounsavill then spent more than twelve years at Princeton University, where he worked as director of purchasing side by side with faculty and students for one of the top educational institutions in the country.

These experiences inspired him to stay in the nonprofit sector, so when he moved over to healthcare, he took the same approach to business at CHOP as he did during his time at Princeton. The fact that his previous work had a major focus on research and teaching—similar to CHOP— made the transition easier for him.

“Our ability to add value in the form of cost savings or improved quality products has a direct impact on patient care outcomes and the overall patient-family experience.”

Brian Rounsavill Senior Director of Contracting, Procurement Children’s Hospital of Philadelphia

What appealed to you about working at CHOP?

Having the opportunity to work for a world-class organization that is focused on improving the lives of children was really a no-brainer. By improving our productivity, finding more efficient ways to do business, and reducing unnecessary costs, we enable ourselves to be leaders in pediatric innovation and contribute to improved patient care.

How do you network with other leaders in children’s health?

Attending the CHA conferences enables us to network and benchmark with our peers on a regular basis, in addition to developing connections that we can rely on throughout the year. However, I am extremely fortunate to work for one of the true leaders in the pediatric supply chain industry, Joni Rittler, our vice president of supply chain. She motivates and inspires me on a daily basis here at CHOP.

How do you recognize trends in children’s health?

In order to grow our mission and manage uncertainty in the healthcare industry, we have to be aware of the changing healthcare landscape and continue to find opportunities to utilize our resources in the most optimum ways possible. Doing so allows us to reinvest in the research, education, and clinical capacity initiatives that set us apart.

“Everyone learns a little something from each of their past experiences, and it helps shape who they are and how they function in their roles,” Rounsavill says. “These learning experiences, combined with the relationships that I have built, have all been stepping stones for me.”

Those stepping stones helped Rounsavill and his team as they achieve significant cost savings for CHOP. During the past three years, Rounsavill’s department has helped the organization save money by reorganizing the procurement and contracting team, rewriting its operating policies and procedures, redefining its success metrics, and re-engaging with their end users.

“In doing so, we developed strategies across all of the major supplies and services spend categories to identify cost savings and value-added opportunities,” he says.

Additionally, the department studied all of the supplier contracts that were up for renewal and also for opportunities where it could rebid that business or shift the source to another supplier that would save the institution money or provide additional value.

“We looked at it from multiple standpoints—such as standardization and reduction, leveraging spend, GPO optimization, or competitive bidding—to see what was the best approach for us in each area,” Rounsavill says.

Rounsavill’s team needed more than just negotiating and analytical skills to make its strategies work. The team also had to display the ability to work well with others and demonstrate the value that their strategies would bring to the organization. Both of those skill sets were particularly important when dealing with the end users. According to Rounsavill, most of the time the surgeons and researchers know the vendors and products or services they want—and they want them “yesterday.”

“The key is looking at where we can add value from a business perspective,” he says. “We have to gain credibility through a series of small successes, where we can prove that we’re partnering with them for the right reasons.”

One of the reasons Rounsavill is so passionate about seeing his department’s money-saving measures come to fruition is because they aren’t just about improving

CHOP’s bottom line. Every dollar his team saves the organization can go toward improved research, novel technologies, or creating new medicines. “It’s fun when you are able to save the organization time or money and see the direct result that comes from that,” Rounsavill says. “We are actually returning it back in the form of better care and improved outcomes for our patients.”

Although CHOP’s contracting and procurement team has had an abundance of success under Rounsavill’s watch, he knows he couldn’t have achieved it alone—and he is proud of that fact. As a youth sports coach and athlete himself, one of the most satisfying parts of his role is knowing that all of the good CHOP does for people is achieved through a team-oriented approach.

“Working for a world-class organization that provides top-notch patient care is both an honor and tremendously rewarding,” he says. “Our ability to add value in the form of cost savings or improved quality products has a direct impact on patient care outcomes and the overall patient-family experience.” AHL

Canon Business Process Services (Canon) congratulates Brian Rounsavill and his team for their successful procurement initiatives. Canon has worked with CHOP for more than ten years, improving processes related to materials distribution and inventory management in support of the hospital’s mission of delivering the finest quality healthcare for children.

Green Security would like to congratulate Brian Rounsavill for receiving this welldeserved honor. Brian has been a partner and leading advocate for the safety of the patients, families, and employees that enter Children’s Hospital of Philadelphia facilities every day. Green Security is proud to be included in that initiative.

Bank of America

Merrill Lynch commends Brian Rounsavill for his strategic initiatives at Children’s Hospital of Philadelphia.

Connecting industry expertise and customized solutions is how healthcare systems and patients grow stronger.

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Balancing

Two Worlds

Richard Paula uses his experiences as an emergency medicine physician to transform the administrative side of Shriners Hospitals for Children

By David Baez

Shriners Hospitals for Children

Ahospital tends to be divided into two spheres that overlap, yet at the same time remain disconnected at a fundamental level: there’s the physician/nurse side and then there’s the administrative side.

Obviously, a hospital wouldn’t be a hospital without its practitioners who treat patients. But at the same time, business decisions have to be made. And when you have administrators who haven’t been on the front lines, it can frustrate physicians who don’t feel their voices are being heard or their needs met.

At Shriners Hospitals for Children in Tampa, Florida, Richard Paula, who formerly worked as an emergency medicine physician and now serves as chief medical informatics officer, is bridging that gap.

Paula spent ten years in the hectic ER world as a physician at Tampa General Hospital before becoming a physician consultant, a medical director, and CMIO at Tampa General Hospital before taking the job as CMIO at Shriners, which accepts all patients regardless of their ability to pay. He says his experience treating patients has been invaluable in his current work.

“When I was a physician, I didn’t like hospital administrators,” he says. “I felt we had an adversarial relationship. I started to get frustrated, not about patient care, but the way the hospital was being run.”

From the vantage point he has now as an administrator, Paula says he clearly sees that physicians are good at one thing and administrators at another. This is one of the reasons they tend not to understand each other.

“Emergency medicine physicians are excellent primary order problem-solvers and poor secondary problemsolvers,” he says. “In a busy ER, physicians can solve anything. People come in with objects sticking out of their body, and they can solve that. But the secondary order is related to patient flow or efficiency, and that’s what administrators do.”

While still a doctor at Tampa General, Paula addressed his frustration by showing up at business meetings uninvited. But he soon discovered—to his surprise—that administration actually welcomed his presence there. He began attending more meetings, something none of his colleagues were doing. Soon, he became an assistant medical director and began his transition to the administrative side.

for

“When you look for a physician executive, you want people who enjoy their job as a physician and aren’t just trying to escape to a desk.”

When asked to take the lead on an EM-specific medical records system, he became fascinated with the idea that he could design it in a way that could actually help physicians, whose greater efficiency would trickle down to the patients themselves. Based on his success on that project, the hospital—which had more than one thousand beds—hired him into the newly created CMIO position. He says he has realized during his tenure that one problem with hospital administration is that the wrong people are in those jobs.

“When you look for a physician executive, you want people who enjoy their job as a physician and aren’t just trying to escape to a desk,” he says. “You want to hire the ones who enjoy taking care of patients. That was me.”

Richard Paula CMIO Shriners Hospitals

Children

What appealed to you about working at Shriners?

Shriners has some of the most talented and renowned pediatric surgeons in the country. The medical staff are so busy with patient care, performing research, and presenting at national-level meetings that they need to have utmost confidence knowing their interests as physicians are represented in leadership discussions at the system level.

How do you network with other leaders in children’s health?

At Shriners Hospital for Children, we are lucky to have prestigious academic affiliates across the country that work closely with us to provide the quality of care we expect. Our hospitals are located across the country, and regionally, we have been fortunate to develop ties to great medical systems. We have a long history of relationships with Mayo Clinic, Washington University, University of California, Davis; Massachusetts General, Temple, USC, Oregon Health & Science University, Providence Health Systems, University of Pittsburgh Medical Center, and more. All of these institutions inspire us.

How do you recognize trends in children’s health?

We are members of the Children’s Hospital Association and receive news from them regularly. It mainly focuses on larger national issues and big trends. I read a lot of industry trade magazines and subscribe to many blogs as well. I usually start my day with an hour or so or reading the news, much of it from medical and healthcare IT news sources. Some that I read regularly include: Modern Healthcare, Healthcare IT News, WSJ CIO Report, Harvard Business Review, HealthLeaders Media, and FierceHealthcare.

In 2014, a recruiter called him about the position at Shriners. He was happy as CMIO at Tampa General, but the chance to lead a national-level hospital system with such a well-known brand was an offer he couldn’t resist. He dedicated himself to becoming a full-fledged administrator, with the chaos of the ER–which he often looks back on fondly—behind him. As a former physician who has now seen both worlds, Paula is convinced that having physicians in administration is key to the overall quality of a hospital.

When he sits in boardroom meetings, Paula says he sees himself as the voice of the physician in the room. He considers his responsibilities to be twofold: be responsible to the organization and to the medical staff. When budget decisions are being made, he’s thinking about both areas and how to harmonize them.

“When I’m working with the chief medical officer, my role is to focus on the technology and assist him with that,” he says. “But I’m always thinking, ‘Is this going to improve patient care and make them healthier?’ It doesn’t have to be the newest or most expensive equipment. When I talk to medical staff, I explain to them why certain decisions were made and why we had to make compromises.”

Shriners is working on several initiatives now to improve patient care through technology. It is using a new outcome measure that looks at functional outcomes. The first goal is to do the surgery correctly, but the hospital is now tracking what happens after the surgery by giving the patients iPads and having them record progress. They ask questions such as, can they do what they did before the surgery? Can they play sports? Can they dance? Can they open a doorknob?

“That helps guide our care,” he says. “The social domain—school, friends, sports—is more abstract than thinking about infections healing, but it’s just as important.

With the surveys, we have a better handle on which surgeries are successful in the larger sense.”

The hospital is also trying to address physician burnout, which is common for various reasons—long hours, frustration with administration, not being able to help patients as much as they would like, and more. Paula’s team has found that streamlining the medical records system can take pressure and frustration away that could be the tipping point for a physician to burn out.

Paula hopes to see more physicians make the move to administration—physicians who deeply care for patients and have a humanistic view of the hospital’s mission. He studied literature in college and quotes everyone from Plato to Hemingway to poet William Carlos Williams, who was also a doctor. He feels that his liberal arts education was invaluable to his ability to care for patients in the ER, as well as to think about them working in administration.

“When I talk to friends who want to be doctors, I tell them my advice is to major in liberal arts,” he says. “A knowledge of the humanities is important. Your life should not just be about science. Science is quantitative, and literature and philosophy are underappreciated. We’re a rare breed, but I’m thankful for my background.”

Even though he’s settled into his position at Shriners, he says he’s had to come to terms with being in an office and sometimes looks back on his ER experience longingly.

“I don’t miss being in the ER on Saturday and not having dinner and wine with my wife. But I do miss patient care,” Paula says. “Still, I feel that my impact at this level is so much bigger than what I could do as an individual physician.” AHL

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The

Lean Journey

Greg Souza of Stanford Children’s Health is paving the way for the future of pediatric healthcare through a major organizational culture shift

By Jonas Weir

Stanford Children’s Health is entering one of the most exciting phases of its nearly one hundred-year history as an organization as it prepares to celebrate an impressive milestone. In December 2017, Stanford Children’s Health completed its first major expansion since opening the Lucile Packard Children’s Hospital in 1991. The new hospital campus is the culmination of a $1 billion, multiyear journey that aims to transform the patient and family experience and make Stanford Children’s Health a leader in children’s healthcare for years to come. For Greg Souza, the organization’s chief human resources officer, the expansion is about more than a new state-of-the-art facility. It signifies a major cultural shift within the organization.

“We have been shifting or changing from just a hospital to a children’s health system, creating an enterprise approach to deliver pediatric care across a broad geographic expanse,” Souza says.

About three years after Souza joined Stanford Children’s Health in 2007, the organization started looking at adopting a lean management system. The journey started by researching Seattle Children’s Hospital, which had already adopted a lean management approach to children’s healthcare. Stanford’s leadership team even visited the hospital to get a better sense of the process.

“We came back and felt that, yes, there were some intriguing aspects in terms of what this management system could do in creating greater efficiency within the hospital and improving our abilities to deliver care,” Souza says. “That was really the beginning of it.”

So in 2010, Stanford Children’s Health officially began introducing the Packard Quality Management System (PQMS), which was its own take on the lean management system. According to Souza, PQMS is not just about efficiency and cost reduction. Rather, it’s about continuous improvement in every respect.

Souza points to patient flow as one example of where the organization has improved. As patients need admission into the hospital, Stanford Children’s Health now has staff that works specifically on looking at the number of surgical cases planned for the day, the number of available beds, the amount of discharges, and if the hospital has the proper rotation to create the acceptable flow of patients in and out of the facility.

When the organization began to introduce the program, the human resources department was instrumental in unrolling it throughout the organization. This happened with two programs.

First, HR introduced PQMS to the organization with the Stanford Children Health’s Leadership Academy. In this program, leadership development staff from Souza’s team worked closely with some leaders in the process improvement office.

“The approach we were taking was to recognize that as a lean system is introduced into an organization, it’s not just about the tools, if you will, but it’s also very much about the mind-set,” Souza explains. “You have to marry these two things together or you can’t really make any progress. That partnership started many years ago and has continued.”

After the Leadership Academy unrolled the tools and mind-set of a lean management system to leaders throughout the organization, human resources then progressed the roll out of the lean management system with the Coaches Academy. Similarly, the Coaches Academy trained leaders in the company on lean tools and the mindset required to be a successful lean leader. The Coaches Academy, however, trains managers throughout the organization rather than only company leadership.

The three-day program was broken down into three focuses. The first day focuses on shifting the mentality to

Greg Souza CHRO Stanford Children’s Health

What did you see in Seattle Children’s Hospital that made you look at the lean management system?

At a macro level, it was obvious that Seattle Children’s continuous process improvement effort created a system that was focused on the patient first, and it addressed process issues in quality, service, and affordability simultaneously. It was also readily apparent that the focus on the people of Seattle Children’s was key to their success. This was a thought revolution in terms of how problems had been addressed previously and how they were approaching process improvement, using the tools of a lean management system. Underlying all of this was the clear message that the mind-set of all leaders, physicians, and staff was shifting to embrace the fact that staff and physicians are partners to be engaged—not customers to be served. Patients and families come first.

At an operational level, examples throughout all of the hospital’s departments demonstrated how process improvements were being used to improve overall patient safety and demonstrated improvement in overall employee engagement. It all presented a strong case for seriously considering implementing a lean management system at Lucile Packard Children’s Hospital.

How do you network with other leaders in children’s health?

The Children’s Hospital Association sponsors an annual meeting and biannual discipline-specific (i.e., for HR, CFOs, COOs, etc.) forums for children’s hospital executives across the country. Through those meetings, I make contacts that create a network I can use throughout the year. The association also sponsors a listserv that keeps people in touch on specific issues. I also meet other children’s hospital executives at a variety of conferences, sponsored by organizations like the Society for Human Resource Management, Advisory Board, and Oracle.

How do you recognize trends in children’s health?

As an academic medical center, we have a robust connection with other academic centers through our physician faculty and executive leaders, and they track many clinical and administrative trends through those connections. Journals and research studies also further our ability to track trends. Consulting services, industry publications, and our own strategic planning processes all also help us identify trends. Our government relations staff indemnify legislative trends. We also track leadership trends through our enterprise learning and development team and their learning connections both specific to the healthcare industry and outside of healthcare. For example, this has accelerated our use of virtual learning platforms.

align with PQMS. The second and third day focus on the more tactical aspects and help managers learn what it takes to actually coach staff and to be coached.

“At a practical level, what we were trying to do was shift managers’ behavior from being an authority figure and addressing immediate needs to exploring issues with an individual and facilitating their development process,” Souza says. “There was a whole process around identifying or examining some underlying assumptions about what works and what doesn’t and about why people don’t perform effectively.”

Following the Coaches Academy, Souza and his team provided managers with a ninety-day virtual learning program called Coach the Coach. The program alerts participants via text message when topics that may interest them are available.

At the end of the program, Souza and his team felt as though it was a success, and they eventually had the data to back that up. “We did a survey about people’s willingness to coach and willingness to be coached before the program, and then we did it again after the program and saw significant improvement in both areas,” he says. “They were much

more comfortable with the idea of acting as a coach, but most importantly, to being coached. That can affect either their relationship with their own leader or with each other as peers.”

The implementation of a lean system has not only affected leaders throughout the organization, but it’s also affected the way Souza leads the HR department, which is made up of about fifty people. Since adopting PQMS, HR has unrolled a daily management system to each subgroup within the department: compensation, talent, benefits, learning and development, and operations. In this system, each group has a daily huddle, and they also use a visual management system where they use a whiteboard to track major components of their work to track progress and ensure everything is aligned with the core values of the company. And they’ve used the visual management system to help solve issues as large as revamping the organization’s recruitment system to most recently unraveling some of the complexities of leaves of absence.

Now that Stanford Children’s Health is more than seven years into its lean journey, the organization is seeing major improvements and continual advancements across the board. It’s also spurring collaboration across departments and functions. One initiative in particular that’s a priority for the organization is the Optimal Human Experience.

This idea dates back to late 2013, when Stanford Children’s Health began working with Bridget Duffy who was, at the time, the CEO of ExperiaHealth and the former patient experience officer at Cleveland Clinic. The idea is that patient experience, employee experience, and physician engagement all feed into and affect one another.

“The dots started to really connect that you can’t really improve on one without the other,” Souza says. “It led us to this concept of looking at the optimal human experience and how could we actually achieve that.”

So Souza, along with the vice president of medical affairs and the chief operating officer, began looking at engagement and experience numbers from everyone throughout the organization. By working together, they believed they could create the Optimal Human Experience, a goal that they’re still working toward. And taking this theoretical concept to their teams, they found that there were many actionable items that could improve the experience for patients, staff, and physicians alike.

“We’re looking at how to take action within our work environment that will ultimately translate to the work we do caring for patients and families,” Souza says. “That includes looking at how we care for ourselves.”

Now, as the new hospital and Stanford Children’s Health continue to grow its footprint in the healthcare industry, Souza will continue to improve upon PQMS, focus the organization on the Optimal Human Experience, and positively affect employees through wellness programs, coaching, and positive cultural change. AHL

Willis Towers Watson is proud to congratulate Greg Souza on his outstanding work to help Stanford Children’s Health and its employees succeed.

Willis Towers Watson’s unique perspective allows us to see the critical intersections between talent, assets and ideas — the dynamic formula that drives business performance and success in hospitals and health care systems.

Impact

“We’ve been training our people to get ready to move, to adapt, and to be agile. This is not a place for the status quo.”

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Bernie Knobbe VP, Global Benefits Enterprise Human Resources, Total Rewards

AECOM Guerrero Howe

Healthy Improvements

AECOM’s year-round wellness opportunity program is changing how employees take a proactive role in their own health

By Jeff Silver

When Bernie Knobbe joined the premier, fully integrated global infrastructure firm AECOM three-and-a-half years ago, the company already had a health and wellness program, Wellness at AECOM. Since then, as vice president, global benefits enterprise human resources, total rewards, he has dramatically increased the program’s reach, employee participation levels, eligibility, and the number of diverse programs and services offered.

“There used to be a more traditional focus on health, fitness, and nutrition,” Knobbe says. “Now, we take a much more holistic perspective that truly encompasses the overall wellness and well-being of each employee and family.”

To cover the full spectrum of issues that impact employees’ well-being, Wellness at AECOM offers twenty-six different programs in four key health categories: physical, emotional, social, and financial. In addition to providing comprehensive advice, support, and activities, Knobbe has expanded the programs, which originally ran for only four months, to now being run year-round.

“We want to reinforce a culture of health and well-being every day,” Knobbe says. “That’s how you create healthy routines and good habits. Otherwise, it seems like it’s only important to pay attention for part of the year.”

Wellness at AECOM uses incentives to encourage employees to participate. They earn points for company-offered corporate social responsibility, health, and safety programs and services and for selfreported outside activities in the key health categories. For example, a required health assessment is worth twenty points. Other activities, such as actively managing your 401k, walking in a community charity event, or creating exercise and meal plans with family members are also eligible for points.

When employees reach one hundred points, they earn a discount on their health insurance contributions for the following year. At 150 points, they are designated Rock Star status, which makes them eligible for drawings for $250 gift cards. Two-hundred points makes them eligible for the Super Star status grand prize of a $1,000 gift card.

“We want to reinforce a culture of health and well-being every day. That’s how you create healthy routines and good habits.”

BERNIE, Thank you.

“Bernie’s fresh ideas in employee engagement have made wellness a daily priority at AECOM,” says Nancy Rodriguez of Anthem. “While Anthem plays a key role in treating members holistically, Bernie’s innovative approach to expanding AECOM’s wellness culture goes beyond traditional programs.”

In addition to the point system, coaches follow-up with participating employees to make sure they are aware of activities such as smoking cessation and stress management, as well as online and WebEx-accessible training programs. This enables them to choose activities aligned with their personal interests and values.

To address concerns about how personal health information from assessments and screenings will be used, Knobbe stresses that no individual results can be accessed. “The only details we can track are aggregated overall trends,” he says. “Our goal is simply to encourage more people to be aware and then engage by participating.”

As part of that objective, Knobbe is always innovating and improving Wellness at AECOM. One recent change is allowing spouses and domestic partners of employees to participate in the points program, which enables them to qualify for the health insurance discount and gift card drawings. In addition to sending wellness mailings to employees’ homes and an electronic benefits newsletter that employees can forward to spouses and partners, Knobbe helped create a wellness website that allows spouses and partners to sign up for their own individual accounts.

It’s been such a pleasure collaborating with you on benefits communications. Together we’ve merged two industry giants, executed three open enrollments, launched numerous wellness campaigns and pioneered benefits technology. Our efforts have received 13 awards for communications excellence, including Best Campaign in the World, Best Campaign in the U.S. two years in a row, three IABC Gold Quills, and many others.

We couldn’t have made such an impact without you. Your leadership, talent and creativity have made our communications innovative, engaging, and fun. We look forward to many more years of making amazing happen, together.

Willis Towers Watson congratulates

Bernie C. Knobbe

Vice President, Global Benefits AECOM

We applaud Bernie Knobbe for his leadership and dedication. Your friends at Willis Towers Watson.

Together, we unlock value and see potential from every angle.

“It’s a way to make wellness a family priority with support from everyone involved. Teamwork works in the workplace and at home.”

“By being able to reach more potential participants in each household directly, we can help facilitate shared accountability for setting up new healthy goals and routines,” he says. “It’s a way to make wellness a family priority with support from everyone involved. Teamwork works in the workplace and at home.”

Wellness at AECOM even has its own Instagram page. Thousands of employees have submitted pictures of their wellness activities along with brief descriptions of their goals and the satisfaction they get as a result of participating. Employees have submitted photos from team hikes with coworkers. One employee who lost 150 pounds shared photos of her transformation. She then wrote about how much better she feels and the excitement of hearing her physician tell her how she was more likely to see her children and grandchildren grow up.

Knobbe learned his approach to ongoing improvement and refinement when he worked on a benefits awareness campaign at Yahoo, where he was the senior director, global benefits and global mobility. The guideline was “always iterate” in order to constantly redesign and increase alignment of the message with the intended audience and outcome. When he decided that he wanted to expand AECOM’s wellness activities to twelve months, that approach served him well in being able to convince senior management that the idea was a wise investment for the future.

Healthy for the Long Haul

Bernie Knobbe was out of shape in high school. In fact, he didn’t start taking better care of himself until he was in college, when a friend who was a physical education major introduced him to her routine of daily running and exercise. He has stayed committed to remaining physically active and maintaining a healthy diet ever since.

The personal nature of health and well-being is emphasized for Knobbe through his parents, who are in their late eighties, and his senior dogs as well. “It’s a virtuous circle,” Knobbe says. “The chances of living longer are greater now than ever before. If you’re healthy, the more you can enjoy the journey.”

“Expanding programs year-round is part of ongoing incremental improvements,” he explains. “We were able to point to increasingly positive results, such as an 18 percent differential in healthcare costs between participants and nonparticipants. That shows a ‘return-on-individual’ for employee experience and engagement and a ‘return-oninvestment’ for financial cost management of our healthcare plans.”

And members of the leadership team at AECOM aren’t the only ones to notice the impact Knobbe has made on the company.

“Bernie has made a huge impact in only three-and-a-half years,” says Tom Rollins, a global client manager at HR consulting firm Mercer. “With an 18 percent healthcare cost savings for participants and a big improvement in AECOM’s culture, the program truly evolved from traditional to innovative.”

WE SALUTE OUR COLLEAGUE

Bernie Knobbe

FOR YEARS OF OUTSTANDING LEADERSHIP IN HEALTH CARE.

Over the years, Bernie has become one of the most prominent leaders in health care, providing fresh perspectives and innovative solutions to the toughest challenges facing our industry.

Anthem is honored to work with him and his entire team at AECOM Global Benefits.

Thank you, Bernie, for your vision, professionalism and partnership.

The range of outside, self-reported activities that qualify for wellness points has also been expanded. This came about after some employees involved in marathons and triathlons complained that they couldn’t receive points for their healthy lifestyles and competitive events. “The broader we can make the incentives and the easier we can make it to be involved, the better it is for everyone,” Knobbe says.

In the future, Knobbe plans to increase the number of shared initiatives with AECOM’s US Health and Safety Department, followed by its global locations, which will organically benefit AECOM’s overall culture of well-being. Knobbe expects that will also contribute to improved employee retention and productivity, morale, and further help reduce absenteeism.

“Our approach always focuses on the positives,” he says. “Instead of concentrating on only healthcare costs going up, we provide helpful, practical ways to do something about it and to make yourself feel better and to be well.” AHL

Cigna is a global health service company who, like Bernie Knobbe, is focused on customer experience and pushing boundaries in a positive way to promote health and well-being. Cigna values our partnership with AECOM, and we applaud Bernie for his innovative approach and dedication to the industry.

Blue Communications is proud to work side by side with Bernie Knobbe and AECOM on their HR and benefits strategy while innovating the world of employee communications. We congratulate Bernie on more than twenty years of unparalleled service to the industry.

INSPIRED LEADERSHIP

“ Bernie Knobbe is one of the most skilled global benefits leaders I’ve ever worked with. His ability to inspire his staff and manage complex global problems is unique. Bernie leads with pragmatism, compassion and humor. Even when workloads are enormous, Bernie always delivers, and never fails to treat all colleagues and consultants with the utmost respect. Congratulations, Bernie!”

– Thomas Rollins Partner, Global Business Solutions, Mercer

One Aspiration Is Not Enough

Lisa Graver’s deft decision-making is helping Alvogen succeed on multiple fronts

By Jeff Silver

Lisa Graver had worked as in-house legal counsel on pharmaceutical intellectual property (IP) matters for nearly a decade by 2010. She had developed tremendous expertise in the field, but she was driven to find an environment where she could assume a broader role, contribute more directly to developing strategy, and have more extensive ownership of overall business results.

Alvogen—the generic pharmaceutical developer, manufacturer, and distributor—provided her with the perfect opportunity. She joined the company as vice president, IP, and has risen to president with overall responsibility for its US business. She has worked with founder Robert Wessman to build the team, grow the company, and diversify its portfolio. What began as a team of one hundred, including manufacturing staff, has grown to about 2,800 worldwide, with 480 employees in the United States.

Alvogen’s growth has occurred in spite of extensive consolidation throughout the generic drug manufacturing sector and distribution channel. This consolidation has resulted in downward pricing and profitability pressures at the manufacturer level. The same dynamics have also impacted the wholesale level, even with roughly 90 percent of the wholesale channel being controlled by only three major players.

“Most companies did not foresee the full impact of the drug channel consolidation dynamics that came into play when we began,” Graver says. “But the majority of our growth has been organic and driven by first-to-market

opportunities. So, we’ve been relatively insulated from price deflation compared to others that have been extensively involved in M&A activity.”

Graver’s steadfast leadership in uncertain times has been noticed by her industry peers and business partners. “Lisa has a brilliant legal mind and has no equal when it comes to patent and regulatory analysis,” says Jim Veltrop, managing partner of Axinn, Veltrop & Harkrider LLP. “But what really sets her apart is her ability to cut through all that and to visualize, adopt, execute, and stand behind a business strategy that makes the most sense for her company.”

The company’s effective growth strategy was developed by inviting input from all functional areas within the company. These contributions help to build comprehensive models that test assumptions and justify either moving forward with or walking away from a given opportunity.

“We don’t consider ourselves smarter than anyone else, but we are disciplined and creative in our approach,” Graver says. “Even when the results look good on paper, we still develop a risk-weighted process that takes the management team’s collective experience into account. With so much input to draw from to challenge our intentions, we’ve been successful at developing relatively accurate models that tell the real story. That doesn’t mean we don’t take chances, but that the risks we take are very calculated.” That approach has resulted in several notable successes. Specifically, Alvogen recognized the opportunity for litigation that led to a precedent-setting decision in the Federal Circuit court, the highest level for IP cases.

By successfully challenging the IP protection of Tamiflu before its patent expired, the company was able to commercialize oseltamivir phosphate, the first Tamiflu generic equivalent. This enabled the company to have the only generic product in the leading prescription flu treatment market for most of the 2016/2017 flu season.

“We’re always looking for unique ways to identify products that will be profitable and sustainable,” Graver says. “With oseltamivir phosphate, we knew we had a unique strategy that would be breaking new ground.”

The search for new products and channels comes at a time when FDA processes and roles in the generic market are changing. Recent adjustments that are seen favorably by the industry were made to the Generic Drug User Fee Act (GDUFA), which was established in 2012 to make safe and effective generic drugs available to the public more quickly.

GDUFA was intended to make the timelines for reviewing generic drug applications more consistent and predictable. Previously, it was not uncommon for some applications to still be pending after more than five years of review. The time frame, in most cases, has now been reduced to a range of about 15–24 months, depending on the quality of the application and whether patent litigation may be involved.

As part of the changing regulatory environment, Graver is adapting how Alvogen presents applications for product approval.

“Beyond the data, we have to be sure we’re really educating regulators and telling the best possible story as to why our product should be approved,” she says. “Doing that successfully is a factor of both language and science, especially in areas where no other generics have yet to be approved.”

She believes this is particularly important in categories involving highly

Lisa Graver President

Alvogen

“My goal is always to be driving for the next thing that will contribute to making the Alvogen name grow.”

The Drug Price Challenge

A report by QuintilesIMS, an industry research firm, found that in 2016, after accounting for discounts and rebates paid by manufacturers, drug spending increased by nearly 5 percent. Generic drugs accounted for about 89 percent of prescriptions dispensed that year but were responsible for only about 26 percent of the costs.

The challenge for Alvogen, as with other generic companies, is how to continue to satisfy the demand for low-cost, critical medicines while maintaining a sustainable business model. Lisa Graver believes that the company’s tradition of creativity, discipline, and ability to manage uncertainty will position it well to seize the opportunity.

complex and unique molecules, such as biosimilars—generic versions of biologic medications.

This type of highly evolved science and business strategy is exactly what Graver envisioned when she joined Alvogen. She describes the company’s early days as an entrepreneurial adventure that involved a small but highly motivated, dedicated, and passionate seed team.

“We all shared the goal of wanting to start something from the ground up and to work with Robert, who had a track record of building successful pharmaceutical companies very quickly,” Graver says. “I thrive on uncertainty, so it was very exciting to be persevering together as a team while we waited for approvals and to have that first product in the market we could put our name on.”

As Graver continues to focus on diversification, Alvogen is one of the few pharmaceutical companies that continues to add staff to its workforce. That is largely due to her determination to bring in expertise that will help differentiate its lines of business and enable the company to leverage sectors that go beyond its traditional focus.

“My goal is always to be driving for the next thing that will contribute to making the Alvogen name grow,” she says. “After all, one aspiration is great, but it’s not enough.” AHL

Acquiring a Brighter Future

Bioclinica’s Jeannine R. Dwyer reflects on the lessons she learned after Cinven acquired the company

By Joe Dixon

Despite being a certified public accountant and having years of experience working in financial auditing and reporting, Jeannine R. Dwyer met one of her largest professional challenges at Bioclinica, a leading provider of clinical trial services for prescription drugs, where she serves as vice president of finance.

In August 2016, global private equity firm Cinven announced that it would be acquiring Bioclinica. Once involved, Dwyer immediately sprang into action to ensure that process went smoothly. Although she had been instrumental in taking other companies public, she had yet to experience what is was like to be on the selling side of a transaction. The process involved amassing vast amounts of documents and critical data that Cinven requested. At any given time, Dwyer and her team were also handling several hundred tasks that were essential steps in completing the acquisition.

Dwyer spoke with American Healthcare Leader about her experience with the acquisition, how she led her team through the immense challenge, and her thoughts on the company’s future under new leadership.

What was the initial reaction when the merger was announced?

There was a combination of excitement and relief. The management team and fellow colleagues who were working on the transaction were instant messaging each other and congratulating one another. We had heard very positive feedback about the new owners, so we knew we were going to be in good hands.

Jeannine R. Dwyer VP of Finance Bioclinica

Joseph Roberts

Everyone was excited and relieved because this enormous effort we had been undertaking was brought to fruition. We were eager to get back to running the business full-time, rather than trying to straddle both running the business and keeping the acquisition moving forward through constant data mining and reporting due diligence efforts, which was stressful and challenging for the staff and the company but was necessary to close the deal.

What were the most crucial components you needed to manage to ensure the acquisition’s success?

I think it was important to move very quickly. At Bioclinica, we have a strong financial planning and analysis (FP&A) function and a lot of A-players in finance in general. We chose a few critical leaders who would participate in the acquisition effort in order to be able to still provide the quantity and quality of data the potential purchasers were looking for—but with caution as to not overwhelm all teams throughout the organization.

Being strategic in who was handling this effort and staying in constant communication was crucial. We were talking every day with key leaders across different departments and making sure we had an active task list that was color coded like a traffic light so we knew the urgency of each of the requests.

How did you determine which individuals at the company to include in the acquisition process?

We had the initial skeleton crew of who was driving the data requests in the beginning. With something like the sale of a company, you’re very cautious about who you share that information with inside the company, given that the sale may not materialize and that it’s news that shouldn’t be publicly announced until appropriate. You want to keep it to as small of a group as possible, while still being able to function and provide the information quickly and accurately.

For about half of the effort, I was doing it alone from the FP&A team perspective. Then, at about the midway point, when the task list became so large, it became difficult to keep up with the requests. It was time to engage a few key players on my staff to help me, so I spoke to the CFO and said, “OK, I believe I am at my capacity. I would like to onboard another person from my team to keep the data requests moving forward.” It was clear who those people would be to assist me, and they were onboarded with the project quickly.

Get a finance and HR system that lets you focus on keeping patients happy.

How was being on the selling side of an acquisition different from your previous experiences?

At PricewaterhouseCoopers (PwC), I remember bringing someone public. It’s similar in nature, given the size of the initiative and the data collection effort involved. It’s very heavy in data mining and being able to report the data in a cohesive and concise fashion is key. The difference is that I had a much more active leadership role at this stage in my career.

How has the acquisition affected your workflow?

It’s been wonderful. Cinven has provided us with some funding so that we can automate our forecasting and budgeting process. This had typically been done completely manually using Excel. Now, we use an application specifically for forecasting and budgeting that facilitates a much more controlled environment. We are able to update changes to our data more quickly, and we now have one source of truth.

Additionally, I was evaluated as a senior leader in FP&A, and it was a very positive experience for me. The evaluation provided me a summary of what was viewed as my strongest attributes, and it also provided me some recommendations for growth. I considered the evaluation

an investment in me as a leader and appreciated the attention and guidance.

What are you looking forward to the most under Cinven’s new leadership?

I am really going to digest the feedback that I received from the evaluation and pursue a formal mentor relationship that is offered for senior leadership within the company. I believe mentoring is such a critical element of growth in corporate America. I think it goes without saying that, from first-year associates up to CFOs and CEOs, everyone benefits from it. There is always room for improvement and an opportunity to work with someone out there who has a skill set you can learn from.

Do you have any advice for other executives whose companies are being acquired?

Make sure someone is owning the process with a log of what’s due, to whom, and prioritizing which tasks are the most urgent to the potential buyer. If that can be put in place early and efficiently, then I think that takes a lot of the difficulties and inefficiencies out of the process. Keep an eye on your team’s morale, and keep a positive attitude regarding the transaction. AHL

Joseph Roberts

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Revitalizing Compliance

At EmblemHealth, Debra Lightner is building cross-departmental relationships to bring compliance to the next level

By Lori Fredrickson

When Debra Lightner was first contacted by a recruiter from EmblemHealth in 2016 about taking on a role as its senior vice president and chief compliance officer, she was immediately intrigued. Having spent the past two years as director of regulatory compliance for Horizon Blue Cross Blue Shield of New Jersey, after working for that organization for eleven years as in-house counsel, she was aware of how much her legal experience and business instincts could help revitalize a compliance department.

“Lawyers learn to multitask and prioritize,” Lightner says. “Compliance requires the same agility: you have to be able to pivot and compartmentalize.”

During her two years with Horizon’s compliance department, Lightner strengthened its regulatory compliance program and instituted a robust communication plan with business stakeholders, fostering relationships and open dialogue throughout the organization. When she met with the new CEO of EmblemHealth, Karen Ignagni, who was focused on modernizing the nonprofit health plan’s business model and saw how passionate Ignagni was about supporting a strong compliance program, Lightner was hooked. “I knew the success that our business model achieved at Horizon,” Lightner says. “Karen’s level of support for compliance confirmed for me that the process would be successful at EmblemHealth as well.”

Debra Lightner SVP, Chief Compliance Officer EmblemHealth

Quite similar to Horizon, EmblemHealth needed a fresh set of eyes to look at ways to build a new compliance strategy that aligned with the regulatory complexities of the industry and the company’s mission and goals. For Lightner, the two most important drivers of success are building relationships and fostering communication. She immediately set about doing both.

Her first step was to redesign the compliance department. Previously, all of Lightner’s team members had been trained to cover a broad range of compliance areas, rather than specialized fields. “What we needed were strong subject matter experts in compliance so that we could guide the business,” Lightner explains. She reorganized the department to create regulatory, corporate, privacy, and special investigations teams based on the strengths of each of her employees.

From there, she focused on building stakeholder relationships, sending teams out to partner with different areas of the business so that compliance could be involved in strategy development from the early stages. “When the

Michael Benabib

compliance department has the reputation of being the bad cop, people will avoid it,” Lightner says. By making it clear to all areas of the business that her team was there to help them and mitigate the compliance risk hidden in any strategies they were developing, she was able to ensure that those strategies would have a clear path from the start.

Lightner’s next step was to make the compliance department visible throughout the company. Within the first month, she recorded a video, which was then posted on EmblemHealth’s internal network and broadcast in elevator reception areas to introduce herself and to highlight her department’s plans for the year. In early 2017, her team developed internal marketing materials that explained the department’s mission as well as the way that all employees play a role in the compliance program. The information was then distributed to every employee in the company.

“When the compliance department has the reputation of being the bad cop, people will avoid it.”

One of the major victories in her first year was identifying new team members to help drive compliance, particularly in EmblemHealth’s product regulatory operations team. The team had previously reported to the sales and product development team. “They are regulatory subject matter experts with strong business stakeholder relationships. We need them driving regulatory compliance, monitoring performance, and contributing to strategy development,” Lightner says.

Within six months, the product regulatory operations team joined the regulatory compliance team, and the positive impact was immediate. “I can’t tell you how many business partners have come to me and said, ‘This is the greatest thing to ever happen in compliance at EmblemHealth. Now we have a centralized compliance function,’” Lightner says. Whereas business leaders had previously struggled to understand the uniqueness of the compliance department and the product regulatory operations team, her union of those resources now streamlined the relationship into a one-stop regulatory guidance shop.

Since then, Lightner has also seen other developments throughout the company as a result of her efforts, both in business partners reaching out cross-departmentally to engage with compliance and in increased collaboration. “Business teams and employees are coming to us to ask questions about how to be more compliant,” Lightner says, adding one of the main areas has been concerning privacy

Philip R. Sellinger, David Jay, and the entire GT family proudly congratulate Debra Lightner on her feature in American Healthcare Leader, and join in recognizing her dedication to EmblemHealth, and her longstanding contributions the healthcare industry and the community.

At Greenberg Traurig, we are Committed to Client Service GTLaw has more than 2,000 attorneys in 38 offices in the United States, Latin America, Europe, Asia and the Middle East and is celebrating its 50th anniversary.

Our Health Care & FDA and Litigation attorneys have the experience and scope of knowledge needed to steer the fi rm’s clients ahead in an ever-evolving, dynamic health care space.

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Co-Managing Shareholder, GT New Jersey

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issues. “Compliance is at the table now, and we are consulted proactively as subject matter experts, which we hadn’t been before.”

One of the most personally satisfying results of her work, Lightner says, is seeing how much her team enjoys the work. It’s no coincidence that Lightner is committed to building morale and employee engagement. Having moved out of big law firm life and into an in-house counsel role, in part to have a more predictable schedule while raising her two daughters, Lightner has long been a strong proponent of work/life balance, and she’s ensured her team that she’ll be as flexible as she can as long as they’re getting their work done. “When you feel like senior leadership understands that you are a person with a life outside the office, it makes you want to bring the best version of yourself to the office,” Lightner says. “I’ve been fortunate to have that for most of my career, and I want to pass that on to my team.”

Some of her goals moving forward with EmblemHealth include increasing the effectiveness of delegate oversight and making sure that outside business partners are maintaining designated standards of compliance. She’s also focused on embedding her strategy deeper within the organization and its subsidiaries.

Now in her fourth year of working in compliance, Lightner says she hasn’t looked back once at her legal career, where she’d originally started out as a commercial litigator. “Compliance is different every day,” Lightner says. “I love that I continue to learn new things because that makes me want to come to work.”

Most importantly, though, she’s able to see how the results of her work are supporting EmblemHealth’s mission to modernize the business and bring better results to its members. “We’ve been able to put together teams, where people are able to use their best skills every day and bring their best selves to work,” Lightner says. “That, to me, is very rewarding.” AHL

Duff & Phelps is the premier global valuation and corporate finance advisor with expertise in complex valuation, disputes and investigations, M&A, litigation, real estate, restructuring, and compliance and regulatory consulting. We are experts in the complex regulatory framework of US and global healthcare systems. Contact: elaine.wood@duffandphelps.com

Greenberg Traurig, LLP has more than two thousand attorneys in thirty-eight offices in the United States, Latin America, Europe, Asia, and the Middle East. GTLaw was named the second largest firm in the US by Law360 in 2016, and among the top twenty on the 2016 Am Law Global 100.

Pi votPo w re

Adriene McCoy urges Baptist Health South Florida’s employees to adapt to the dynamics of healthcare to stay ahead of the curve

By Russ Klettke

Everywhere you look—in healthcare technology, organization consolidations, and public policy and politics—the prevailing theme is transformative change. And although much of that change is good, it is disruptive and remains under a cloud of legislative uncertainty.

But healthcare leaders are still required to work and thrive in these circumstances. This means organizations need to constantly pivot to adapt to increasing needs from an aging population.

Baptist Health South Florida, a Miami-based nonprofit hospital and clinical care network that spans four counties in the southern portion of the state, is a prime example of an institution meeting these changes headon. It has the unique circumstance of an executive team with members who each have been in executive positions with the organization for several decades, including president and CEO Brian E. Keeley, who has been in his position for more than two decades. Adriene McCoy, corporate vice president and chief human resources officer for the organization, counts herself among those longtenured employees, having spent ten years at Baptist Health to date.

With nine hospitals, more than fifty outpatient facilities, urgent care centers, physician offices, and sixteen thousand employees, the organization has undergone significant strategic growth organically and through acquisition under stable leadership. McCoy’s management and HR strategies in particular have been instrumental to the success of Baptist Health during this uncertain time in healthcare. A critical component to her HR policies include “the pivot concept.”

Adriene McCoy Corporate VP, CHRO Baptist Health South Florida

task. “There’s a four-hour travel distance between our northern and southern facilities, which creates a challenge for leaders,” McCoy explains.

One strategy is to use Skype for certain meetings. Another is to keep the leadership of two hospitals in the Keys on one executive team. But above all, workplace and organizational culture always stays on McCoy’s radar. That includes acclimating newly acquired hospitals and facilities into the organization, and McCoy conversely also recently managed the voluntary separation of roughly 540 people from the organization while hiring more than seven hundred people for a newly built, research-based cancer institute. These initiatives were so successful that McCoy was named the 2017 Healthcare Human Resources Executive of the Year by HRO Today, a human resources industry publication.

“We’ve been training our people to get ready to move, to adapt, and to be agile. This is not a place for the status quo.”

“With so much transitioning going on, no one should be too comfortable in one job,” McCoy says. “We’ve been training our people to get ready to move, to adapt, and to be agile. This is not a place for the status quo.”

The geographic layout of Baptist Health’s various facilities also presents challenges for McCoy and her team. The system serves patients in Miami-Dade, Broward, Palm Beach, and Monroe counties, the latter of which encompasses the Florida Keys. Knitting together numerous facilities over a wide-spanning geography isn’t a simple

The new cancer facility, Miami Cancer Institute, is a world-class outpatient center that provides leading-edge clinical care, advanced clinical research, and state-of-the-art technology—including the first proton therapy center in South Florida, Latin America, and the Caribbean. Miami Cancer Institute is Florida’s only member of the Memorial Sloan Kettering Cancer Alliance, which brings together clinical trials, research, and cutting-edge discoveries to patients across South Florida.

McCoy says the January 2017 opening of Miami Cancer Institute, with more than one thousand physicians, technicians, nurses, and other support staff on duty from day one, wasn’t as difficult as it may sound. “We had been planning for three years that we’d have to staff up to meet the needs of this facility,” she says.

This modesty is consistent with McCoy’s pivot concept. It’s about responding to changing market needs and taking advantage of newer practices and technologies.

For example, Baptist Health has fully adopted EHRs. McCoy says that physicians and nurses are now required

to document more than they have in the past. She also speaks of disruptors—the newer technologies that currently put patients in the driver’s seat. “We are seeing wearables such as Fitbit, Google, and virtual care on demand,” she says. “Patients have a greater number of choices in healthcare, and as consumers, they are looking for quality, convenience, and great service.”

The Affordable Care Act (ACA) was another catalyst for transformative change that McCoy had to adapt to. The ACA initially insured more people, but a portion of them used the emergency room as a primary care starting point. McCoy says that with the economic imperatives to lower costs and point patients to the right site of care, Baptist Health has been successful in expanding its community-based primary care and urgent care facilities.

To get patients to the right site of care, education is paramount. This only comes about, however, through well-trained and coordinated hospital communications staff who, quite similar to clinical professionals, have more specialized jobs and tasks than before. They are expected to deliver best-in-class care while also watching the bottom line. It’s a challenge, but Baptist Health is well-positioned to remain strong through the rough waters of healthcare reform. For seven years running, Ethisphere Institute has named the organization one of the “World’s Most Ethical Companies.” The institute cites “shifts in societal expectations, changing laws, regulations, and geopolitical climates” as factors that Baptist Health and other healthcare companies on the list face every day and continue to thrive in.

In other words, this means staying true to the mission of healthcare in a rapidly changing environment. Or, as McCoy might put it, Baptist Health knows how to pivot. AHL

Strengthen knees, elbows and other joint efforts.

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Long-Term Teams in Long-Term Care

Jeanne Phillips’s role as Genesis HealthCare’s chief human resources officer means equipping staff members with the tools they need to rise to any occasion

By Russ Klettke

When it comes to understanding the 24/7 nature of long-term care organizations, think about news reports regarding nursing homes in a hurricane “zones of concern.” Evacuations are not simple matters, because the process of transporting patients can endanger vulnerable residents. But if residents shelter in a care facility during a Category 4 storm or higher and facility administrators are accused of negligence—as was the case with senior care facilities in the United States and Caribbean islands that were hit this past fall by Hurricanes Harvey, Irma, and Maria—it can cause trouble for organizations that are trying to help patients who require around-the-clock care.

Jeanne Phillips, the chief human resources officer for Genesis HealthCare, a post-acute care provider with more than 450 skilled nursing centers and assisted/senior living communities in thirty states, is familiar navigating this scenario. She lived through it in 2017 when fourteen of the company’s skilled nursing centers fell into storm-affected areas in Texas and Florida. “We had to move more than one hundred people out of our center in Beaumont, Texas,” says Phillips, a fourteen-year veteran with the company. “Our dedicated staff successfully accomplished that in the most challenging of times.”

Phillips joined Genesis in 2004 as vice president of risk management and employee development. Part of what the organization developed in subsequent years—notably, in the wake of Hurricane Katrina—was an emergency preparation plan for each center, which outlines for employees the decision-making process and how to execute evacuations as needed. Phillips’s focus is to staff the organization with capable people, empowered to deal with today’s challenges,

including natural disasters. It’s a major job, as about 65 percent of all company expenditures are invested in employee compensation and benefits, Phillips says.

“Genesis’ employees play a big role in the experience our patients and their families have with us,” Phillips says. This means one of her key objectives is to keep employees healthy, happy, and doing their best work.

“Our surveys show our employees choose this career because what they do matters,” Phillips says. “Our staff has no hesitation about leaving their own homes to take care of our patients. During Harvey, one of our facilities had to evacuate at the last minute. With no available local agency support resources, the on-site leadership assembled patient transport vans and buses to get the job done. We have rock stars out there to pull that off.”

Phillips says that same level of dedication to post-acute care exists in the corporate offices as well. But many of the challenges come from Medicaid reimbursements, a significant revenue source to the organization. Nationwide, about one-third of all Medicaid payments (31.5 percent of about $400 billion) goes to long-term care of the elderly and disabled. Because state and federal governments determine Medicaid payments, the annual increases are not directly tied to increased costs. In 2017, the rise in reimbursements was a scant 0.5 percent, while the inflation rate was about 1.9 percent and the cost of private-room nursing home beds

Jeanne Phillips CHRO Genesis HealthCare

rose 5.5 percent, according to a report from long-term care insurance provider Genworth Financial.

Balancing Medicaid shortfalls relies on Genesis’ development of a post-acute care therapy continuum that taps into other funding sources, such as Medicare and private insurance. With a focus on short-stay, intensive rehabilitation, and patients returning home, Genesis bridges the gaps in the current healthcare system.

On the corporate side, Phillips has also been heavily involved in the company’s recent acquisitions, which taps into both her strategic and tactical experiences.

The company has made two major acquisitions since 2012 (Sun Healthcare Group, Inc. and Skilled Healthcare Group, Inc.), making it one of the largest skilled nursing providers nationwide. In such transactions, Phillips’s involvement begins before a letter of intent is sent.

“We get the sale book, look at the data, and initiate an active dialogue across the table,” she says. “I look at the employee culture in our intended acquisitions. I learn how their leadership and accountability work. I ask, ‘How does their leadership perform? What is the communication between the C-suite and staff working with patients?’”

Where there are redundancies in a merger, the company provides opportunities for employees to take alternative jobs and supports all transitions in an orderly and organized plan after it’s completed.

“Our staff has no hesitation about leaving their own homes to take care of our patients.”

As the acquisition approaches the point of completion, she gathers like-minded professionals from both sides to establish a successful transition. “We find that not all interests are always aligned,” she says. “So we meet face-to-face to establish rules of the road to the close. The important thing is to recognize opportunities uniting the strengths of both organizations.” The objective is to create a company that is imbued with trust and transparency. “After all, we want to acquire an asset able to operate effectively.”

Throughout it all, Phillips has never lost sight of providing a supportive work environment for the staff. “Our highest cost in workers compensation was from patient transfer injuries,” Phillips says. “After investing in a program with lift-assist equipment and intensive patient handling training, our staff injuries were reduced by 25 percent, and cost of claims dropped by 45 percent. Employees told us they were happier and healthier, too.”

To get that equipment funded took breaking down silos and involving support from all departments across the organization, she says. An aligned workforce—in the corporation and in the centers—can help accomplish that. AHL

A Life of Service

Rick Grooms of AnMed Health explains how he found his way to human resources through a surprising source

By Kasey Cheydleur

Rather than a company or a hospital, it was the United States Air Force that sparked Rick Grooms’s passion for healthcare and human resources.

After attending The Citadel, a military college in South Carolina, Grooms worked as the squadron commander of a unit comprised of medical assistants, physicians, and nurses in Wichita Falls, Texas. He went on to build a foundation of human resources skills when he moved back to South Carolina to serve as an ROTC recruiter for Clemson University. It was an introspective time for Grooms as he was pondering many of the same questions he was asking recruits: What is your motivation? What do you enjoy? What are your long-term goals?

For Grooms, it became clear that building relationships and serving others was the answer.

“I learned very quickly in The Citadel—and even in the air force—that relationships drive results,” Grooms says. “You have to build rapport with people to meet them where they are. You need to recognize the gifts each person brings and that they may be different than yours or from other people’s gifts.”

Grooms continued to use those relationship skills in the military until the air force began downsizing in the early 1990s. Grooms decided it was time pursue his passion for healthcare and human resources in the private sector. His first position after he left the military was with a home health and hospice business. From there, he served as the director of human resources for two different hospitals in North Carolina: Roanoke-Chowan Hospital in Ahoskie and Randolph Hospital in Asheboro.

Those experiences set him on the path for his current job as chief human resources officer at AnMed Health, a health system located in Anderson, South Carolina, and northern Georgia that has more than four hundred physicians and nearly four thousand employees. AnMed is one of four hundred healthcare organizations out of six thousand nationally to be identified as part of the American Nurses Credentialing Center’s Magnet Recognition Program, which recognizes superior quality in nursing care.

The size of the organization means solid relationships and strong leadership are all the more critical. Grooms describes his leadership style as “tight, loose, tight,” which is an analogy of teaching someone to swim. At first, you

keep the person tethered close, so you can make sure they are steady and safe, but after they demonstrate they can swim and survive in the water, you let the rope out as far as they want. This is where they stay, unless they run into trouble, in which case the rope is still there to tow them back in and evaluate what went wrong. Ideally, he says, that initial “tight” period is short, and then employees have all the leeway they need in the “loose” period indefinitely. If he needs to reel someone in, he evaluates “if they will recover, need another seat on the bus, or need to find another garden to bloom in.”

With Grooms’s leadership, his team at AnMed was able to wrap up a comprehensive wage and benefit study that led AnMed to overhaul its compensation plan altogether and add new pay grades and pay ranges. This victory for HR meant that about three out of five employees received a market adjustment. The team also helped institute the company’s switch to an electronic employee performance management system. For a company that is more than one hundred years old, the switch from paper and the new focus on goal-oriented systems for individuals and departments signaled a significant cultural change.

That change is one of the reasons Grooms enjoys working in the healthcare industry. “Healthcare is changing rapidly, sometimes to the degree that we don’t know the next change coming,” he says. “For some folks, that can be very intimidating. But I think with change comes opportunity.

“We may not be able to cure every patient, but if we find out what’s important to them, then we can work with them to get their needs met.”

Rick Grooms CHRO AnMed Health

Hats off to Rick Grooms at AnMed from your friends at SHDR

Congratulations to Rick Grooms and AnMed on your well-deserved recognition. We are proud to be a trusted partner you rely on as you continue moving forward with distinction. Your example enriches our community and inspires us all.

Stanley, Hunt, Dupree & Rhine is a division of BB&T Insurance Services, Inc. Insurance products and services are offered through BB&T Insurance Services, Inc., a subsidiary of BB&T Insurance Holdings, Inc. BB&T and its representatives do not offer tax advice. Consult your tax or legal professional regarding your individual circumstances. © 2017, Branch Banking and Trust Company. All rights reserved.

Pinnacle seeks to maximize the performance of client organizations and teams by helping them to establish cultures of Organizational Health PINNACLE

Authenticity… in relating to clients

Adaptability… to the client context

Alignment… with client culture and business operations

So, I look for ways that my team and I can plug into the organization and be a source of support, create something new, innovate, or tweak what we have.”

The patient is at the center of every decision for AnMed. The organization’s CEO, William T. Manson III, is famous for changing the saying, “What’s the matter with you?” Instead, he asks, “What matters to you?” Grooms explains that the key to success is all about listening and understanding patients’ needs and goals.

“We may not be able to cure every patient, but if we find out what is important to them, then we can work with them to get their needs met,” he explains. “We may not be able to cure your cancer, but if your goal is to get to a health state where you can be at home or spend time with your grandchildren or walk your daughter down the aisle—or whatever the case may be—we can work to get you there.”

He says that approach doesn’t stop with patients. For employees, it means asking what motivates them to perform at their best and recognizing each person as unique with different needs and desires. In healthcare, employees have many different options for where they want to work, so for Grooms, getting to the heart of what inspires people to stay and produce their best work is at the center of his mission.

“When you are serving, you may think you know what you need to do,” he says, “but you won’t know until you ask.” AHL

Pinnacle Consulting congratulates Rick Grooms on his recognition by AHL! Rick is steadfast in seeing that his executive colleagues remain focused on living out—and leading others in the pursuit of—the cohesive behaviors of trust, healthy conflict, commitment, accountability and focus on team results, and in the development of directional clarity for AnMed!

Where Care Takes Flight

At American Airlines, health and wellness is a direct path to better business, thanks to Mary Anderson

By Jenny Draper

American Airlines employs about nine hundred thousand people worldwide, and Mary Anderson has spent the past few decades advancing their health and happiness from the company’s headquarters in Fort Worth, Texas. The average career span at the largest airline in the world is about twenty years, and Anderson knows firsthand that the company’s top-notch care programs play an integral role in that.

“There’s a lot of job fulfillment. There’s never a dull moment,” explains Anderson, who recently retired after thirty-seven years at the company. “My goal all along has been to create this culture of health and safety.”

Anderson believes it’s critical to have a sound corporate wellness program as a long-term employer. When employees don’t take care of themselves, she explains, companies will pay roughly five times as much when they’re older from time lost due to medical issues.

“Healthcare is a way of investing in people,” Anderson says. “It’s not only a way of showing employees you care about them and their families, but it also promotes better engagement with the employer.”

To the surprise of some, though, the former managing director of health and wellness originally studied accounting. Anderson earned a bachelor’s degree in business administration at the University of Nebraska, and after graduation, she joined a Big Eight accounting firm as an internal auditor. But at age twenty-four, intrigued by the travel industry, she joined the accounting department at American Airlines. She knew she was at the right place but soon realized she wanted to seek a different role. “One of the best things about American Airlines is that they let you go into different areas,” Anderson says.

She moved into a marketing role in revenue management and then, in the early 1990s, found her home in human

resources. “I used a lot of my financial background but for the people side of the business rather than strictly the numbers,” Anderson says. “I felt a sense of purpose there.” She delved into the fields of compensation, HRIS, and strategic business partnerships and was promoted to managing director of compensation in 2005. Five years later, she landed in the benefits and productivity group, which would eventually become a comprehensive health and wellness function under her leadership.

Her father, a personnel manager at Campbell’s, shaped her leadership outlook. “He told me early in my career, ‘Take care of your people, and they’ll take care of you,’’’ Anderson recalls. She spent time understanding the motivations of employees and ensuring they felt their work was meaningful and supported. “Our airline moves people, but that’s just the function,” she adds. “Really, we’re connecting people to their families, to their jobs, in times of happiness like weddings, and in less happy times. It’s important that people get to where they need to go.”

As a result, Anderson zeroed in on absence management—a crucial facet of productivity. Although her team tracked lost time and ensured compliance with labor laws, such as the Family and Medical Leave Act that was established in 1993, Anderson took it one step further by looking at the root causes behind the numbers—and patterns in the claims emerged. Her team also offered cash rewards to employees who opted for biometric screenings and health coaches. That’s when they discovered systemic issues within the workforce that her team needed to address directly.

The same medical conditions were affecting employees, and musculoskeletal pain topped the list. “Our employees do a lot of physically demanding jobs, whether they’re on the ramp carrying the bags, up and down ladders working on the aircraft, or the pilots and flight attendants sitting

“If employees don’t feel the support from the company, then they won’t give the support to our passengers and customers.”

in a cramped space for a long time,” she says. “It’s hard on the body. So we focused on ways to help our people learn to move correctly.”

Her team brought on-site resources to several American Airlines locations, helping employees learn to stretch, build, and condition their bodies to avoid injuries on the job.

“We have evolved from HR just being hire-and-pay to a group that really supports our people, because people are our profit,” Anderson says. “If employees don’t feel the support from the company, then they won’t give the support to our passengers and customers.”

Taking individual preventive actions is not only geared to improve occupational health, but also to improve productivity company-wide, according to Anderson. She describes the perspective shift as “employees engaging in their health as a way of engaging in their jobs.” From the onset, Anderson realized that access to care can be difficult for airline employees. For example, if an employee has a doctor’s appointment, they may lose an entire workday to travel time because of locations on the outskirts and the need to go back and forth through airport security. “We really wanted to give them more affordable access to care,” she says.

As a result, in 2015, Anderson’s team revamped and implemented eleven on-site health clinics through a partnership with Premise Health. Now, roughly 80 percent of American Airlines’ employees have access to immediate care and biometric screenings with low $20 copays and free preventive care services, such as flu shots. These clinics are safe and secure options.

“It’s really a place where employees can go and get the treatments they need to get back to work,” Anderson says. “Plus, it’s much more affordable for them. The cost of acute care is less than half of what it would be at a primary care physician or an urgent care center.”

Today, American Airlines prioritizes access to more holistic healthcare among its transient workforce. To do so, Anderson spearheaded the Doctor On Demand service. With this service, employees can call a doctor and get a prescription wherever they are. “They can use it for their kids in the middle of the night or for themselves during a layover,” she says. “It’s a really quick way to get care.”

Mental and emotional health services also serve employees on the front lines with the public. Support for depression and substance abuse has led to on-site employee assistance representatives and 24/7 hotlines.

In the past few years, Anderson’s team has created several wellness programs that target specific health needs of American Airlines employees. The Staywell RX program offers free generic medication for diabetes and high blood pressure for adherence to the medication and regular visits to a doctor. When American Airlines went entirely smokefree, it created the Knock Out Nicotine program to support employees. It provides free cessation medications and nicotine replacement therapies, as well as specialists on call for support.

Employees can also receive health coaching and talk to nutritionists directly through the ten-week online program Naturally Slim and WebMD portal. “We’ve had almost sixteen thousand people in the past two years enroll,” Anderson says. “The response has been phenomenal not only in participation, but also in results. We recently calculated that all the pounds employees have lost could fill up one of our AirBus aircraft.”

All of these initiatives are not going unnoticed by Anderson’s peers, who share her same enthusiasm for healthcare. “Finding ways to control healthcare costs while promoting healthy work environments and encouraging employees to live healthier lifestyles is the underpinning of what we do,” says Trent Riley, chief operating officer at Premise Health.

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“We want our employees to be a co-owner in their health, and we have to give them the tools to do that.”

“We are thrilled to be part of the delivery of this meaningful employee benefit, and are proud to see Mary and the team at American Airlines recognized for implementing on-site programs that deliver true value to employees.”

Anderson adds that her team also focuses on the local level because “health populations are vastly different in Oklahoma and Florida than in Texas.” Healthcare delivery systems also vary by state, and communicating a cohesive wellness strategy has been one of the major challenges, especially when 90 percent of employees are unionized. Her team produced an online wellness portal this past September and a mobile app to continue to unite all of the health services offered at American Airlines in one place. “We want our employees to be a co-owner in their health, and we have to give them the tools to do that,” she says.

In the future, Anderson envisions a more concierge-like service for corporate care. The future of her own career is also shifting since her retirement. In the years ahead, she aims to continue developing healthcare programs at nonprofits and small companies, as well as consulting directly with low-income individuals in need of affordable options. “There’s a pandemic of unhealth in this country,” she says. “I’ve always been fairly healthy, but now it’s a crusade.” AHL

Blue Cross and Blue Shield of Texas (BCBSTX) has served the healthcare needs of Texans for more than eighty years. We are proud of our long-standing relationship with American Airlines and thank Mary Anderson for recognizing the benefit of our dedicated programs.

MetLife is a global provider of life insurance, annuities, employee benefits, and asset management. Since 1989, MetLife has proudly provided employee benefits to American Airlines employees. MetLife has operations in nearly fifty countries and holds leading market positions in the United States, Japan, Latin America, Asia, Europe, and the Middle East. Visit www.metlife.com.

Backed by the brand you trust, WebMD Health Services is leading the way in well-being. We’re proud to support American Airlines and all of our clients who are dedicated to empowering people to live better lives. Learn more about our integration expertise and configurable solutions at webmdhealthservices.com.

Driven by Vision

The Lubrizol

Corporation’s

Deb Langer saw an opportunity for the Cleveland company

to enter new markets and innovate the way pharmaceutical and medical device companies bring their products to market

By Jonas Weir

Sometimes, revolutionizing a business and disrupting the status quo takes a single visionary to identify an opportunity hidden in plain sight. That’s exactly what happened when Deb Langer, vice president of personal, home and health care at The Lubrizol Corporation, noticed that the company had two product lines that existed in two separate business units, with something remarkable in common: their inherent ties to healthcare.

Lubrizol offered a line of personal care products that some customers were using in pharmaceutical grade applications, as well as a material that other customers were using for medical device applications in Lubrizol’s industrial business unit. Langer decided the company should merge these two lines into a single entity: Lubrizol LifeSciences. To make her vision for a new business a reality, Langer began her due diligence.

“I knew the idea would require some fairly intensive insight into the realities we’d be facing,” Langer says. “Creating LifeSciences was a conviction that grew over time as I got more information and learned more.”

Specifically, she looked at where the markets were going, where Lubrizol’s products were used, and the value of its products in those markets. As she delved further into this research, she became certain the company should pursue this effort.

“I thought this should be at the forefront of what we’re doing,” she says, “and we should be putting more into marketing efforts, getting our name out in these life science markets.”

This proposition was borne out of Langer’s deep experience with healthcare at Lubrizol and beyond. After graduating from Purdue University with a degree in chemical engineering, Langer took a job at the global pharmaceutical company Eli Lilly in Indianapolis. As a process design engineer, Langer worked on designing and scaling the processes for drugs such as Prozac, Vancomycin, and Humulin. However, with personal ties to Cleveland, she began to look for opportunities to further her career in Northeast Ohio. So Langer took a risk and quit her job.

Upon moving to Cleveland, Langer looked for another engineering job. With Lubrizol, she found the perfect match. Since joining the company, she has been awarded sixteen patents, authored or coauthored twelve papers on specialized low emission fuels and engine oil products, and won both the R&D 100 award and the NorTech Innovation award for novel commercialized products. However, her role in mergers and acquisitions at the company may be what prepared her most for her current role. After all, her original vision for Lubrizol LifeSciences stemmed from seeing an opportunity for growth.

“My idea was to have the company expand into a broader life sciences business by developing a long-term strategy that included acquisitions and additional partnerships,” Langer says. “That potential made me even more determined by suggesting that this is something we should be doing both now and in the future.”

Still, Langer had to convince leadership that this was a good idea. “Through perseverance, I was able to share

Deb Langer VP of Personal, Home and Health Care

The Lubrizol Corporation

“Through perseverance, I was able to share my vision and tell the story of how Lubrizol could morph into a life science business.”

my vision and tell the story of how Lubrizol could morph into a life sciences business,” Langer says. “Essentially, the research showed that we had already been in the business and been profitable without too much resourcing. I presented the current market trends and explained how we were well-positioned within this space. By allocating the proper resources and aligning our strategy, we could become a leader in this high-potential market. Realizing that we were already there, we just needed to visualize what we could do.”

Although she initially received pushback from some who thought the life sciences marketplace was too high risk, she eventually won support from company leadership, and in 2012, Lubrizol LifeSciences was formed.

Since then, Lubrizol LifeSciences has become a success story—adding millions of dollars in revenue and growing to become one of the most profitable business units within the company. To that end, it’s not only creating exciting products, but Langer’s M&A and pharmaceutical experience has also helped the business embark on even more exciting partnerships.

“We’ve been working with several pharmaceutical companies now and have developed some extremely unique products that can deliver a drug more effectively and efficiently to a human being with our technology,” she says.

One exciting product the business has developed is a device small enough to implant under a patient’s skin that releases a diabetes drug over the course of three, six, nine, or twelve months. The goal of the product is to eliminate the need for daily medications for some diabetic patients. And while the product was developed with a partner and is still in the final phases of clinical research, it’s a point of pride for Langer because it’s the synthesis of what she saw Lubrizol LifeSciences doing.

“It’s exciting for us because it represents what we envisioned, a drug delivered through a device that we were able to help develop together,” she says. “It shows that we know the market, and that we’re able to develop a product with unique value and significant patient benefits.”

Although Lubrizol LifeSciences might have been Langer’s brainchild, she credits her entire team with making the business a success and for pushing the entire industry forward.

“We have completely changed business models and the way we go to market, which is extremely innovative,” Langer explains. “We’re doing things within Lubrizol— even in some cases in the industry—that have never been done before.” AHL

Craig Yingling

A Patient-Centric Growth Model

How ATI Physical Therapy maintains its personalized feel through rapid growth

By Galen Beebe

Robert McKenzie spent much of his childhood in law firms. His parents operated a boutique tax controversy firm in Chicago, and he grew up working in the office. After graduating from the Illinois Institute of Technology’s Chicago-Kent College of Law, he followed in his parents’ footsteps, joining a boutique tax firm in Illinois.

McKenzie compares working as outside counsel with being in an ivory tower. “You’re never quite as far down in the weeds as the clients are. When you’re an in-house attorney, you’re shoulder to shoulder with the rest of the team,” McKenzie says. “It makes you become more of a strategist, as opposed to strictly a legal decision-maker.”

Now, McKenzie is the general counsel at ATI Physical Therapy, a company with an aggressive growth strategy. ATI opened its first clinic in 1996 and added a second location four years later. A third and fourth clinic soon followed. By the time McKenzie joined in 2012, the company operated 180 clinics and was doubling in size every eighteen months.

Historically, ATI’s expansion strategy has focused on acquisitions. Acquiring a company provides a foundation on which to build, but an established organization only comes with established norms. Transitioning staff to a new corporate philosophy and convincing clinicians to shift how they provide care can prove challenging for a healthcare company where the approach centers on providing exceptional

customer service. ATI aims to make a patient’s experience in a clinic the best part of their day.

“The ATI Way is an overwhelming commitment to patient care that is disruptive within our industry,” McKenzie says. Clinical and regional directors attend leadership trainings and are made accountable for motivating their team members to deliver patient-centric service. But accountability does not only come from the top. When a clinic performs well, every staff member from the front desk attendant to the clinical director is rewarded for their exceptional customer service. “There’s a reason why when you go into some businesses, everybody’s happy,” McKenzie says. “It’s because they create a more positive customeroriented atmosphere. That’s something that we embody here at ATI, full stop.”

In the past year, ATI has increased its emphasis on building new clinics. Opening new locations allows ATI to hire staff members who share the company’s vision, but finding qualified clinicians presents its own challenges. Physical and occupational therapy have traditionally been fractured industries, but as healthcare has become more highly regulated, smaller businesses have combined into larger groups. As the industry consolidates, competition for clinicians increases. “For the first time in the industry’s history, the bigger players are starting to regularly bump into each other due to staff members accepting positions with competitors,” McKenzie says. This can cause complications for hiring team members who are subject to noncompete agreements. For each new team member, the legal department must consider any noncompete agreements to determine whether the company can place the employee in the intended clinic.

ATI has a small legal department, and McKenzie works closely with outside counsel. For corporate matters, ATI hires larger law firms, but for more specialized issues, McKenzie returns to his roots in boutique law firms. He works with local advisors in each of the twenty-five states where ATI operates. This approach delivers state-specific guidance and decreases the legal department’s overall spending. “Over the years, we’ve increased our spend on boutiques overall while largely reducing our spend on big law to get us to that happy medium where we have the right tool deployed on the right job,” he says.

To ensure successful partnerships, McKenzie invests resources in developing long-term connections. He often spends weeks introducing outside counsel to ATI’s corporate structure, business mentality, risk tolerance, and

“The ATI Way is an overwhelming commitment to patient care that is disruptive within our industry.”

Robert McKenzie

General Counsel

ATI Physical Therapy

Meade, Roach & Annulis, LLP

Congratulates Robert McKenzie, General Counsel, ATI Physical Therapy, on his consistently outstanding work and exemplory leadership. Bob is the epitome of an e ective General Counsel. We are proud to have worked alongside Bob for years, and look forward to many more years of collaboration to come.

Knowledge, Experience & Guidance

We Can Help.

With hands-on solutions to complex compliance needs, Meade, Roach & Annulis, LLP is a leading health law and compliance firm dedicated to building, implementing, and enhancing world-class compliance programs.

customer service approach. “It takes a significant investment of time and effort to integrate new outside counsel and have them work with the company seamlessly,” he says. “We stick with those law firms that commit to understanding our business and honoring our customer service mentality.”

The laws governing patient care vary from state to state and from patient to patient, depending on their insurer. To guarantee that patients receive the proper care, the legal and compliance departments have established state- and patient-specific care guidelines, which they operationalize through a custom EMR system. “Within the industry, there was not a commercial product available that could pivot and grow as fast as we needed it to,” McKenzie says. “So, we built our own.”

The records system has an electronic health chart for each patient, with a series of data entry fields where clinicians record the details of a given visit. Through labels and color-coding, the program indicates the patient’s status to the clinician and the rules the patient is subject to. The system has built-in compliance and safety measures that flag potential data entry mistakes. If the clinician checked the wrong box for a given patient, the system will highlight the information. “It’s the clinician who’s the ultimate decision-maker as to how they document the care, but we prompt them and drive real-time error checking through our system,” McKenzie says.

These streamlined compliance measures lay the foundation for ATI’s continued growth. The company now operates more than 750 clinics, with new locations opening frequently. Looking ahead, McKenzie is developing holistic approaches to contract management and considering how to grow the legal department—all while maintaining his focus on patient-centered care and ethical growth. “There’s plenty of press out there about companies that don’t do it right,” McKenzie says. “Our goal is to never be that headline. We’re going to do it right.”

Cultivating a Healthy Culture

Patty Varona is drawing upon her seventeen years with Femwell Group Health to create a productive environment for its employees and the physicians they serve

By Randall Colburn

Not everyone becomes a physician to be a business person. Often, all the paperwork and books piling up on their desks only serve to distract them from what brought them to medical school in the first place: helping people.

That’s where Femwell Group Health Inc. comes in. Located in Miami, the company provides management solutions that help physicians run the business side of their practice so that they can focus on the health and well-being of their patients. But it’s not just managing the day-today business operations for its clients. Femwell keeps its doctors ahead of the curve by bringing meaning to acronyms, such as ACO, MACRA, and PCMH, and offering a suite of innovative services through its patient-facing brand, TopLine MD Health Alliance.

As vice president of corporate services, Patty Varona, MHSA, makes it her main priority to ensure Femwell’s physician clients and state-of-the-art imaging facilities remain at the forefront of healthcare technology and patient care. “There are so many different facets to the business side of medicine that would require a physician to spend hours on each week,” Varona says, “so we try to take that portion away from them so that they can just focus on practicing medicine with the best technology and resources available to them.”

But physicians aren’t the only ones she’s concerned with keeping happy. Because Femwell’s mission is to keep doctors working toward quality, not quantity, it only makes sense for that philosophy to also extend to its own staff, all of whom are given a great deal of flexibility when it comes to balancing work with their responsibilities at home.

“We especially have a sensitivity to working mothers,” Varona says, adding that Femwell is short for “female wellness” and that the company itself was started by a group of OB-GYNs in 1997. “It’s important to give our employees the same opportunities for advancement and leadership, while also being supportive of their responsibilities at home. We pride ourselves on having a culture where employees can take time off when needed while ensuring they are empowered with talented teams to take care of the needs of the business.”

Varona says Femwell is careful not to enforce stringent hours in the office, noting that many of their staff have the ability to work remotely. For employees that work out of the corporate office, Femwell ensures that there is a designated quiet room where employees are able to schedule a

VP of Corporate Services

“It’s important to give our employees the same opportunities for advancement and leadership, while also being supportive of their responsibilities at home.”

Lynn Parks

Patty Varona

Femwell Group Health, Inc.

thirty-minute massage or acupuncture treatment as a means to relieve stress from the busy work day. For Varona, these types of perks aren’t benefits so much as appropriate resources for anybody looking to maintain a healthy work/life balance.

Femwell also works to keep its employees motivated by clearly outlining the necessity of every individual’s contribution to the company. “I think them understanding the role they play in our success is extremely important,” she says.

Education is also key to that sense of support and inclusion. “We’re constantly offering training sessions and educational seminars in healthcare and leadership,” Varona says, listing a series of topics that run the gamut between coding and billing to programs centered around particular healthcare initiatives.

Through education and familiarizing herself with the entire spectrum of a practice, Varona was able to make the transition into leadership at Femwell. She’s been with the company for seventeen years after having climbed the ranks from an administrative assistant to a team leader to her current role as a vice president of corporate services. During that time, she’s worked as a billing collector, overseen the benefits process, hired staff, and helped open the company’s twelve ancillary centers, among countless other duties.

That variety of experience is part of what’s kept her there for all these years. “It’s constantly changing, so I’m always learning,” Varona says. “The healthcare market as a whole changes depending on the political climate, so the fact that it’s never going to be the same year after year has made it interesting.”

And just as the job changes with the times, so too does Femwell. That’s why education remains a focus for Varona, who says she’s “never been turned down” when it comes to introducing new educational programs. Other changes are on the way, too. Varona says the company’s TopLine MD initiative is the vehicle that will catapult Femwell and its physician clients into the future of healthcare. Simple conveniences such as paying bills online or scheduling virtual visits with your doctor are just some of the ways the company is keeping up with times.

“Healthcare is usually the last to implement these kinds of changes,” she says with a laugh, “but we’re making a real effort to stay ahead of the game.”

With Varona at the helm, it’s a safe bet that Femwell will stay that way. AHL

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The Ripple Effect

How the CEO of Hartford HealthCare experienced the patient’s point of view firsthand, and how it has further inspired him to help transform the healthcare system

By Charlene Oldham

Elliot Joseph had walked through the front doors of Hartford HealthCare’s flagship hospital and exited its fifth floor elevator more times than he could recall. But the sign marking Hartford Hospital’s Cancer Center looked much different to the organization’s CEO on the day he was entering as a patient in 2009.

“I read that sign and broke down,” recalls Joseph, who was walking with his wife by his side to be admitted for a thirty-day stay. “I started to cry, and all the emotions I had been holding in until that moment came out.”

During his admission, Joseph was successfully treated for leukemia, an experience that has further shaped his approach as a leading healthcare executive.

“For me, what that turned into—thanks to a lot of good fortune—was a deeper appreciation for the emotional journey of patients, families, and staff members,” Joseph says. “That is really the core of what we do. I thought I understood before I had that experience, but I really didn’t, and I think it’s informed how I have thought about things going forward.”

Being a patient also reinforced the idea that physical and emotional well-being is integrally connected for both those being treated and those administering the care. And although the transformation has been slower in the healthcare industry than for its leader, Hartford HealthCare is implementing a more integrated approach to treatment that addresses patients holistically.

“This is truly a transformative stage in healthcare in this country—a generational change,” he says. “To have that transformation, behaviors, processes, and structures have to change. But I’m a believer in the importance of language to facilitate change in behaviors and, ultimately, outcomes.”

At Hartford HealthCare, the modern metamorphosis has now involved changing the corporate culture, technology, and even the language clinicians and other staff members use. Rather than being “discharged” from acute care after a hospital stay, Hartford’s “customers”—a term Joseph says is a better fit considering healthcare’s rising out-of-pocket costs—transition to other settings. That journey may include physical therapy, home care, and other services.

“There’s really nothing good about the word ‘discharge’ in almost any of its meanings,” Joseph says. “And yet, as an industry, we’ve become very comfortable with the concept of discharging people.”

The term is an especially ill fit at Hartford, which in addition to operating hospitals, has become Connecticut’s largest provider of behavioral services and home care, as

well as offers an assortment of other services on both an inpatient and outpatient basis. Joseph’s mission is to have Hartford be viewed as a community provider that offers an integrated continuum of care well beyond hospital walls. But integration is a tall order for what has long been largely a cottage industry of individual providers. Joseph says that’s especially true for those in the community who are most ill, who often see as many as a dozen doctors to help them manage multiple health issues and prescriptions that could number in the forties or fifties.

“They are trying to traverse a system that wasn’t built to care for people with multiple chronic diseases, so they experience tremendous lack of coordination, repeated emergency room visits, and repeated hospital admissions, many of which would be unnecessary in a system built around them and their needs,” Joseph explains.

Elliot Joseph CEO Hartford HealthCare

Chris Rakoczy

“We want to create a meaningful difference for those served, where you feel a sense of our brand in our language and our behaviors in a way that makes you look at us as most trusted for personally coordinating your care.”

In fact, Joseph believes repairing the healthcare system to improve integration and transparency would boost affordability, access, and positive clinical outcomes for all users. Technology will be one of the cornerstones of the renovation at Hartford, which recently inked a seven-year partnership with GE Healthcare to implement a variety of initiatives to reduce patient wait times and improve communication and coordination between providers, among other benefits.

One example entails using GE’s expertise in predictive analytics to determine where to deploy specific medical equipment so that providers and patients receive it when they need it most—similar to how retailers stock up on rock salt before a snowstorm. Likewise, Joseph wants to take a cue from consumer companies that have built a strong brand identity that customers recognize and respect.

“We want to create a meaningful difference for those served, where you will feel a sense of our brand in our language and our behaviors in a way that makes you look at us as most trusted for personally coordinating your care,” Joseph says.

As part of that effort, Hartford recently introduced an online employee feedback and recognition system that its eighteen thousand staff members have access to every day. With this system in place, employees can provide information that executives can review weekly to address issues that may be contributing to burnout or other factors that could impact the health and happiness of Hartford staffers and those they serve. The healthcare system also brought

on a chief experience officer to help reinforce its culture and values. Such moves represent somewhat of a sea change for an industry, where the primary focus has never been on coordination, cost savings, or customer service, per se.

And there may be no better person to captain that ship than Joseph, who often found himself in turbulent waters during his school days for always asking “why?”

“For better or worse, I was born a rebel, a questioner of authority,” says the native New Yorker. “So I never saw myself as the leader of an organization, so to speak. But I feel blessed to be here and be here now in the midst of an evolution in the industry. I have had a really stimulating and exciting career up until now, and it’s been built primarily on asking ‘why?’”

Joseph’s unconventional executive ethos even extends to his taste in music. He points to the last verse of the Grateful Dead song “Ripple” as something that bolsters his resolve and sense of purpose as a leader. It reads:

You who choose to lead must follow

But if you fall, you fall alone

If you should stand, then who’s to guide you?

“It also reminds me that, if I lead, I have to follow. I have to create engagement and listen to others,” Joseph says. “At the end of the day, there are few management books I’ve read that are more insightful to me than those lines of that song. This philosophy has served me well, especially relevant during a period of major transformation.” AHL

Leadership is the capacity to translate vision into reality.

~ Warren Bennis

Hartford HealthCare honors Elliot Joseph, our chief executive officer, for a decade of innovative, transformative and service-oriented leadership that has helped us build and sustain one of the country’s leading integrated healthcare systems. Thank you for helping us create healthier communities.

At the Intersection of Healthcare and Law

As assistant general counsel, Mistee Arias Galicia uses her experience and skills to help medical students and physicians prepare for the future

By Jeff Silver

When Mistee Galicia began her legal career as a deputy county attorney in Arizona, she was sure she would ultimately become a judge. But that was before she went into private practice and started specializing in medical malpractice defense. As a result, she fell in love with working in medicine and with physicians. “I quickly learned that the best way to defend a case is to delve into the details and understand the medicine at issue,” Galicia recalls. “I ended up not only loving the science of it, but also the collaboration with physicians who put their legal well-being into my hands.”

At the time, one of her clients was the insurance carrier for the Nevada System of Higher Education Board of Regents, which oversees the University of Nevada, Reno (UNR) School of Medicine. That connection led her to join the university, where she currently serves as assistant general counsel. And because of her prior experience, Galicia has a strong appreciation for the many moving parts that are required to deliver optimal medical care to the community.

“Besides treating patients promptly, accurately, and safely, care has to be precisely documented, providers need to be compassionate, and a skilled, diverse staff is necessary to help put all patients at ease,” Galicia explains. “It’s a

Assistant General Counsel

University of Nevada, Reno School of Medicine

myopic view of excellence in the delivery of medical care if you focus only on what happens in the exam room during a patient visit.”

This view has served her well at UNR Med, where she quickly realized she would be focusing on a broad range of issues that go well beyond clinical care. On any given day, Galicia may focus on insurance matters, healthcare regulations, educational and training issues, and employment and shared governance, among others. She refers to her responsibilities as “a broad intersection of healthcare and the law.”

Her expertise enables her to be a proactive voice within the School of Medicine. Beyond clarifying the requirements of statutes such as Stark (protecting against fraud) and HIPAA (safeguarding confidential patient information), she knows how to effectively assess clinical details and guide care providers in making appropriate decisions regarding their legal obligations.

“We’re uniquely positioned to equip students and residents with the tools they need to fully understand medical ethics and the rigors of compliance,” Galicia explains. “I know how to ask the right questions and develop trusting relationships so my clients—and students and residents who are still training—know I’m willing to engage with them and walk them through whatever they are facing.”

In a highly litigious society, one of the concepts that Galicia emphasizes to students and physicians alike is that poor outcomes and malpractice actions can occur even when care and medical technique is well above the prevailing standards. In one instance, she represented a highly skilled physician who successfully treated a patient’s cancer but still faced a malpractice lawsuit brought about by that patient.

“My client was so blindsided and distraught by the lawsuit that he advised his daughter, who wanted to go medical school, to choose a different career because practicing medicine was too stressful,” Galicia says. “That broke my heart. It’s why I tell our resident physicians that even though litigation comes with the territory, you can’t let it define you.”

One of the unique and challenging aspects of her role has been her responsibilities resulting from the expansion of the state’s public medical education to include a separate school of medicine at the University of Nevada, Las Vegas (UNLV). For nearly fifty years, physicians who have trained at the UNR School of Medicine have done their residencies at either Reno or Las Vegas. The Las Vegas specialty clinics included OB-GYN, surgery, pediatrics, internal medicine, and family medicine, among others. As Galicia explains, resident physicians had additional training opportunities in Las Vegas through partnerships with University Medical Center. UNR faculty physicians have also been part of this cooperative arrangement.

However, in 2013, the state legislature mandated a separate medical education and training program at UNLV as part of an effort to address a shortage of physicians in the southern portion of Nevada as well as to enhance research opportunities for UNLV. This was because the new medical school, which opened in July 2017, will now fill many of the clinical roles in the Las Vegas community previously filled by UNR. Two years of complex negotiations were required to revise contracts and agreements related to medical insurance providers, control and maintenance of medical records, third-party vendors, and a myriad of other

Mistee Arias Galicia

“It’s a myopic view

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REPUTATION MAT TERS.

Social norms dictate that when health issues arise, we seek treatment at a hospital, doctor’s office, or urgent care clinic. But officials today in all realms of the healthcare industry aren’t just waiting to help individuals once they need treatment. Instead, the focus has shifted to promoting education in communities and focusing on population health to ensure everyone has the resources they need for improved healthcare. As these executives share, healthcare doesn’t start when the doors open. Instead, it’s about strengthening health in communities, which in turn improves people’s lives.

No Excuses, Just Excellent Care

Benefis Health System doesn’t let the challenges faced by many rural health systems get in the way of delivering high-quality service to patients

By Joe Dixon

Rural healthcare providers face a host of unique challenges that force physicians, nurses, and hospital administrators to think creatively in order to deliver the highest quality care possible to patients. Those challenges include a lower physician-to-patient ratio than in urban areas, a higher risk for injury-related deaths such as car accidents, and more difficult access to care because many residents have to travel extensive distances to reach a clinic or hospital.

Less populated areas also tend to have higher unemployment and uninsured rates, making it more difficult and expensive for residents in these areas to access the care they need to remain healthy, according to the National Rural Health Association (NRHA).

Care providers, such as Benefis Health System in Great Falls, Montana, handle these challenges on a day-to-day basis. However, Benefis Health System makes it its mission to not let the obstacles presented by its relatively rural location get in the way of its dedication to the betterment and long-lasting health of the patients it serves. In Cascade County, where Benefis Health System is located, many of the problems faced by rural health systems are relevant. The county has an above average poverty rate, for example.

More than 15 percent of Cascade County’s residents live under the federal poverty level, according to data compiled by Data USA. In contrast, the national poverty rate is roughly 12.7 percent, according to 2016 data from the United States Census Bureau.

The area also has a low physician-to-patient ratio, with only one primary care physician for every seventy-seven patients, Data USA reported. This disparity is even wider for certain areas of specialty care in the area, such as mental health services, where the physician-to-patient ratio is one physician for every 249 patients.

But instead of viewing these problems as unsolvable, Benefis Health System has concocted a wide variety of solutions focused on population health so that patients can do as much as possible to safeguard their own health if they aren’t able to make it to the hospital for regular visits with a doctor. “As a rural healthcare provider, Benefis faces technology challenges that community hospitals in more populated areas do not,” explains Bob Green, vice president of technology services at cloud-based solutions provider CloudWave. “CloudWave has been helping maintain Benefis’ on-premises data center while also working with Benefis CIO Mark Simon to meet these challenges and deliver high-quality care.”

“Telehealth services provide a great service to patients in rural areas who might struggle to access care otherwise.”

–Judy Hanover

For example, Benefis Health System has implemented a variety of technology-based solutions to make care more accessible for patients living in rural areas. Spearheaded by Simon, the organization has created the Realizing Education and Community Health (REACH) Network, which provides access to telehealth services related to oncology, mental health, cardiology, and many other areas of care. The initiative is seen as a pioneering technological success by many of Simon’s partners.

“Mark promotes technological utilization to streamline resources for efficient care, and Verizon is a proud partner in support of his objectives,” says Michael Sullivan, major account manager for Verizon Wireless.

The REACH Network spans a network of fourteen hospitals and clinics throughout northern and central Montana. Operating this vast network of hospitals requires Simon and the Benefis IT team to maintain a modern technology infrastructure, with the help of some key partners.

“Telehealth services provide a great service to patients in rural areas who might struggle to access care otherwise,” says Judy Hanover, product marketing manager at data storage solutions company Pure Storage. “Pure Storage is proud to partner with Benefis to help provide top-quality care to patients around Montana.”

The organization also offers a variety of classes on areas of care that address specific issues within the community. For example, the county has a relatively high percentage of residents who live with diabetes. In fact, about 9.1 percent of residents are diagnosed with the disease, according to Data USA.

A Snapshot of Rural and Urban Healthcare in the United States

Number of physicians per 10,000 people

Number of specialists per 100,000 people

Source: National Rural Health Association

Benefis

Health System: By the Numbers

230,000 residents served across a fifteencounty region that is larger than Connecticut, Massachusetts, New Hampshire, and Vermont combined

530 licensed beds

250 area physicians partnering with Benefis Health System

In order to help combat this, Benefis offers a class on diabetes management, where individuals can learn about various aspects of living with the illness, from tips on healthier eating and blood glucose monitoring to information on medications and support groups.

Benefis is also taking steps to address the most severe problem it sees in its emergency room: fall-related injuries. In addition to accounting for many of the most critically injured people to visit Benefis’ emergency department, the organization notes that falls are the leading cause of death for individuals sixty-five or older in Montana. The institution offers a Fall Prevention class, which focuses on tips to prevent falls in the home. The class also provides free screenings for individuals to see if they have any fractures or other injuries that they might not know about.

In addition to these seminars, Benefis offers a host of other classes related to first-time motherhood, mindfulness, and cancer support groups, among other topics to help people find ways to remain healthy without having to make multiple trips to the hospital.

The health system also makes additional efforts in the community to assist underserved populations.

125+ years Benefis Health System has served the Great Falls area of Montana

For instance, the organization has partnered with Meals on Wheels in the past through its Blue Jeans Fridays program. This initiative allows Benefis employees to pay $20, and in exchange, they don’t need to wear their uniform to work on Friday. Previous efforts from this program have resulted in donations of more than $2,500 to Meals on Wheels, which helps provide meals to homebound seniors in the Cascade County area.

Through these classes and initiatives such as Blue Jeans Fridays, Benefis Health System will continue to demonstrate how rural health systems make just as significant an impact as its urban counterparts. AHL

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Coming Full Circle

Henry Holguin came of age in an impoverished Mexican-American neighborhood in East Los Angeles. Now as general counsel of AltaMed—the nation’s largest independent, federally qualified community health center—he’s giving back to the community that helped shape him.

By Randall Colburn

Located near his junior high school, Henry Holguin used to take his grandmother to a free clinic, AltaMed. “I remember she would always comment that she felt welcome and well cared for by the staff,” he recalls.

Little did Holguin know that years later, after he’d graduated from the University of Southern California and built his own law firm, AltaMed Health Services would enter his life again. A chance meeting a decade ago between Holguin and AltaMed’s CEO Cástulo de la Rocha would result in Holguin becoming the organization’s general counsel years later. Upon joining AltaMed, Holguin would discover new opportunities to serve his community.

More than four decades ago, AltaMed started as a single clinic in East Los Angeles and has since grown to a network of forty-seven sites across Los Angeles and Orange counties. Each year, AltaMed serves more than three hundred thousand patients. Tremendous organizational growth has been welcomed, but it has come with a set of challenges as well.

One consistent obstacle for a nonprofit community health center clinic is being able to provide quality care to a growing patient base, including for many who cannot afford payments. “AltaMed provides quality healthcare services without exception,” Holguin says. “As a community safety net, we don’t turn anyone away. It’s our responsibility to help those who are in need.”

Holguin explains that many patients qualify for free healthcare services through Medicaid, while others who don’t qualify for financial assistance are charged on a sliding scale based on their income level.

But AltaMed is working on a plan that it hopes will result in a more secure revenue stream, remove the uncertainty of reduced federal funding, and provide greater access to its patients. “We are in the process of applying for a license from the State of California to establish and offer a health plan to our patient populations,” Holguin explains. As an alternative to insurance, offering a health plan to households that don’t qualify for financial assistance with a set fee each month will allow people to access a comprehensive list of healthcare services at AltaMed. “Offering a health plan means families can visit their healthcare provider without the worry of an unexpected expense,” Holguin adds. “This gives patients peace of mind and provides AltaMed with a consistent revenue stream to expand its footprint and offer more services.”

Another challenge for healthcare providers comes from Capitol Hill. With the future of healthcare legislation uncertain, community health clinics such as AltaMed have become that much more important. Their aim, Holguin says, is similar in some ways to that of the Affordable

With a population of roughly four million, Los Angeles is California’s most populous city and the secondmost populous city in the United States after New York City.

16.2% of population is living in poverty

21.8% of adults ages 18–64 are uninsured

19.8% of adults reported no regular source of healthcare

Source: Los Angeles Department of Public Health

Henry Holguin General Counsel AltaMed

We are proud to have partnered with Henry Holguin for over 20 years. Congratulations on your recognition and we look forward to many more years working together.

“My community helped shape who I am today. I feel fortunate to be able to give back and help take care of the community that helped take care of me and my family.”

800 West Sixth Street Suite 320

Los Angeles, CA 90017

(213) 689-0899

Care Act: to keep people out of the emergency room and hospitals. Providing the public with access to affordable healthcare coverage reduces the strain on hospitals and lowers costs for patients and taxpayers. Holguin notes that emergency care is quite expensive, and it does nothing to regulate or eliminate chronic health conditions, such as managed care programs.

Preventing unnecessary emergency room visits is a motivation behind another upcoming AltaMed initiative, which is to introduce a clinic in South Orange County.

“Orange County is typically thought of as an affluent area,” Holguin says. “However, it also has a large, underserved elderly population that lacks access to affordable and comprehensive healthcare programs and services.”

When discussing any of AltaMed’s initiatives with Holguin, he immediately refers to the dedicated leadership of its CEO and president and the commitment to AltaMed’s mission: to eliminate disparities in healthcare access and provide quality care without exception for undeserved Latino and multiethnic communities across Southern California.

It’s a mission Holguin has adopted and one he feels has brought him full circle in his own journey. “My community helped shape who I am today,” he says of his upbringing in East Los Angeles. “I feel fortunate to be able to give back and help take care of the community that helped take care of me and my family.” AHL

A Mind for Business

How Michele Calandro is using her expertise to help Blue Cross and Blue Shield of Louisiana break new ground

By Chris Gigley

ichele Calandro is more than a legal mind for Blue Cross and Blue Shield

(BCBS) of Louisiana. She is also a key strategist who is helping the business make all the right moves to grow and meet its ongoing mission.

Over the past two years, BCBS of Louisiana has expanded into new markets, an initiative rooted in the company’s mission to improve the health and lives of all Louisiana residents. But two years ago, that wasn’t necessarily the case.

“Historically, we had only been in the commercial space,” recalls Calandro, executive vice president, chief administrative officer, and general counsel at the organization. “But looking at the demographics of the state, we saw a large number of younger people moving away. The population here is aging.”

About 15 percent of Louisianans were on Medicare, a figure that is trending upward and is currently at roughly 17 percent. Meanwhile, the percentage of the state population at or below the federal poverty line receiving Medicaid was also about 15 percent. When Louisiana expanded Medicaid in July 2016, that percentage almost doubled. But BCBS services weren’t reaching any of these people.

Then, as Medicaid was expanding, BCBS of Louisiana introduced its Medicare Advantage plans under now-retired president and CEO Mike Reitz.

His replacement, Dr. I. Steven Udvarhelyi, quickly saw Medicaid as another opportunity to fulfill the company’s mission and diversify its portfolio of product offerings.

“It was a chance for us to not only provide coverage from cradle to grave, but also through people’s financial life cycle,” Calandro says.

“Sometimes your economic status changes. We thought, ‘Let’s look at how we can cover everyone at all times.’”

In December 2016, BCBS of Louisiana signed an agreement with Amerigroup Louisiana, a subsidiary of Anthem, to pursue a Medicaid-focused partnership. Amerigroup Louisiana is a managed care organization that provides services and benefits to about 229,000 members who are part

Michele Calandro EVP, Chief Administrative Officer, General Counsel

Blue Cross and Blue Shield of Louisiana

Jason Cohen

As Michele Calandro explains, the population in the state of Louisiana is aging. Central Louisiana, which is Region 6, recorded the highest population of residents sixty-five or older.

17.6% of population is sixty-five and older

4,681,666

Source: Louisiana Department of Health

of the state’s Medicaid, Medicaid Expansion, and LaCHIP programs under the state’s Healthy Louisiana Medicaid managed care program. In September 2017, Amerigroup

Louisiana rebranded its Louisiana Medicaid plan to Healthy Blue, leveraging the recognition of the Blue Cross and Blue Shield name. The partnership has given BCBS instant market share in Medicaid, a stake it plans to build on in the coming years in collaboration with its partner.

Calandro will figure prominently in those and other developments, particularly under Udvarhelyi’s leadership. He is the fifth CEO Calandro has worked with during her tenure at BCBS of Louisiana.

“He is definitely in the weeds with the rest of us,” Calandro says. “I jokingly call him my co-counsel. He’s been in a lot of areas in this industry and knows about a lot of things. You really have to be on your toes and make sure you’re giving him the right advice. He can definitely second-guess you.”

That has only made Calandro sharper as her role expands along with the business. Once she focused primarily on

support functions, such as administrative services and functions that are traditionally in the legal arena. But now, she is called upon to use her financial and business acumen to handle the company’s internal audit and enterprise risk management functions.

In that role, Calandro studies the business, political, and regulatory environments, as well as business opportunities and identifies possible risks. Ultimately, her job is to provide the board and management team with strategies to achieve objectives without opening BCBS to risks that are outside of the company’s tolerance. She recommends risk appetite and tolerance, and the board defines or sets those levels based on Calandro’s recommendations.

Her work in managing the legal and compliance areas has led to many positive developments at BCBS of Louisiana. One example is the organization’s paperless initiative, which aims to reduce expenses, communicate with customers in their preferred medium, and be more environmentally friendly. The organization couldn’t simply demand customers go online to pay their bills and view

“We have rural areas where the lack of primary care physicians and behavioral healthcare is a challenge, and telehealth may be a way to solve it. ”

important messages about their coverage, Calandro says, so she helped the company find alternative ways that fit within the current legal framework. Sometimes, as was the case with telehealth, Calandro works with the state legislature to reshape the legal framework to help BCBS better serve Louisianans.

“We have rural areas where the lack of primary care physicians and behavioral healthcare is a challenge, and telehealth may be a way to solve it,” Calandro explains. “We had an initiative in place, but our laws didn’t allow it to take effect to the extent that would make a real difference in access to these services.”

The main sticking point was the out-of-state locations of many telehealth providers. Louisiana didn’t allow health professionals not physically located in the state to give medical advice to citizens. So, Calandro used her tactical skills to convince legislators to loosen the laws.

“That took a couple of years,” she says. “The Louisiana State Medical Society wasn’t eager to change the laws. They were concerned about being able to ensure a true physician-patient relationship and the quality of services.”

Now, BCBS of Louisiana provides its members and all Louisiana citizens the easy access to healthcare they need. With its solid position in the Medicare and Medicaid markets, BCBS of Louisiana will likely need Calandro to do more work on the legislative front. Given the uncertain future of the Affordable Care Act, this work has become more difficult, she says.

“We work hard to stay in contact with our congressional delegation,” Calandro says. “We meet often with our state’s congressmen and senators. We are also able to leverage the Blue Cross Blue Shield Association’s resources to try to keep one step ahead of legislative and regulatory changes.”

Often, the feedback she gets from these meetings isn’t much to go on. But for Calandro, who brings her strategic, legal, and tactical thinking skills to bear every day, it’s enough to make smart recommendations. The future of BCBS of Louisiana depends on it. AHL

Herman Law Firm is proud to join in celebrating Michele Calandro's leadership and accomplishments, as recognized by American Healthcare Leader We applaud your achievements and dedication to the healthcare industry. Congratulations!

Escape from Recidivism

Michigan Primary Care Association’s Loretta Bush has followed her career from maternal health to infectious diseases. Now, she’s addressing the needs of those in the criminal justice system.

By Galen Beebe

or those who are released from prison, reentering their communities can be a struggle. Many may return with complex mental, physical, or dental health issues. “One of the things that can be very difficult to maneuver is the health system,” explains Loretta Bush, CEO of Michigan Primary Care Association (MPCA), a statewide health center advocacy organization that represents forty-four member agencies throughout the state of Michigan. “Unaddressed mental health issues, substance use issues, and physical health issues really drive up the rates of recidivism in the correctional system.”

As a result, the MPCA launched a pilot program in October 2017 to help those released from prison connect with care providers. When an inmate is released, Bush says, a Michigan Department of Corrections social worker contacts the MPCA, which then connects the person to a health center. This warm connection is the first step in creating a system that bridges the gap between the Michigan Department of Corrections and community health centers. Macomb County, where the program takes place, has a state prison with a reentry unit attached, which will help smooth the connection between the two systems.

Loretta Bush CEO Michigan Primary Care Association

Jena McShane

“We’re not talking about giving them a card with the health center’s name on it,” Bush says. “We’re talking about true care coordination and case management to really help them navigate the health system.”

The MPCA worked with Senator John Proos to secure a $75,000 appropriation in the state budget to implement the yearlong pilot program. The funding will cover the yearlong pilot program, but the MPCA’s goal is to expand the program throughout the state. Recidivism results in higher costs, but Bush and MPCA argue that creating the program offers more than just financial benefits. “There has to be that human perspective that people deserve this kind of care coordination and case management so that they can stay out of the correctional system,” she says.

Bush has been working in community health since the 1980s when she finished college and took a position at a women’s clinic. At the time, she sought a career in maternal and women’s health. But while she was working at the clinic, news began to spread of mysterious deaths of men in New York and California. Bush was working with women in Michigan—a different population and location than those that were affected—but her interest in community health drove her to research the new disease, which would come to be known as HIV/AIDS.

During the height of the AIDS crisis, Bush had the opportunity to see community health at its worst and at its best. “It gave me the opportunity to see what happens when people are empowered and when they advocate for themselves and for their friends and would not go away and die quietly,” she says.

Believing that researchers would soon find a cure for AIDS, Bush transitioned to Planned Parenthood to lead the organization’s education department, and having determined that she did not want to be a clinician, began graduate school in health administration. A cure for HIV/AIDS did not materialize, however, and the disease became a major focus in Bush’s career.

“I do feel that it was meant for me to do that work,” she says. “It was meant for me to give voice, many times to people who did not have a voice.”

For the next two decades, Bush continued working in women’s health and HIV/AIDS administration, moving back and forth between Planned Parenthood and city and state positions. While working at the Michigan State Department as the AIDS director in the early 2000s, she began shifting her focus toward minority health.

“It was an opportunity to start thinking about other chronic conditions and other issues than infectious diseases,” Bush recalls.

When she became Wayne County’s director of public health in 2007, her role widened further. She was now in charge of the infectious disease, maternal and child health, chronic disease departments, as well as managing

According to the Michigan Department of Corrections, the prison population in fiscal year 2016 was 43,338.

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environmental health issues such as restaurant and day care inspections. She also responded to public health emergencies such as the H1N1 pandemic that soon hit after she took the job. “Even though we had drilled for it, sometimes there’s nothing like the real thing,” Bush says. “It was an opportunity for me to see strong public health in action.”

Bush employs an asset-based approach to healthcare, which she first encountered in action during her two visits to Ethiopia with the National Association of State and Territorial AIDS Directors (NASTAD). An asset-based approach focuses on an individual’s, community’s, or organization’s strengths, rather than its deficiencies. In Ethiopia, she met AIDS patients who found the resources to pay for their children’s schooling while suffering from advanced stages of the disease.

“This is a community that has long been finding a way to survive and thrive in sometimes very difficult economic situations,” Bush says. “We needed to learn and listen and then adapt the skills that we were bringing to their assets.”

Bush approaches the MPCA’s member health centers the same way. The association’s 260 sites range from highly funded health centers to poorly funded centers in struggling areas. “Maybe they don’t all quite have their data keeping right, but what are their assets? Because day-today they’re seeing patients, and they’re making a difference,” she says.

Bush connects the work of all health centers to the legislators whose policies affect them—legislators such as Senator Proos. “The thing that excites me most right now is taking policymakers and elected officials to the health centers and watching them become true believers,” Bush says. “And of course, I take them into their own communities. They’re watching and hearing the stories from the people who elected them. It’s a great feeling.” AHL

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Prognosis

The Process of Improving Processes

Harry Crane brings his lifelong passion for fixing things to McLaren Health Care

By David Baez

Harry Crane likes to say that he can hold a flashlight steadier than anyone. Born into a family with not much money to replace anything broken or faulty, Crane was always trailing his father as he made repairs in the house, and his job was to hold that flashlight and shine a light on the work being done. That instilled in him a passion for fixing anything and everything that has not dwindled to this day.

“As a kid, I was always playing with LEGOs or building something in the garage,” Crane recalls. “I never was happy with the way it was, so I would tear it apart and build it again. I was always trying to tweak things.”

Because Crane understood at an early age that his parents wouldn’t have the finances to send him to college, he set his sights on becoming an auto mechanic. But his father, who worked as a vending machine repairman, was constantly urging his son to look for a career outside of manual labor that would give him a better life.

Still focused on auto work, a meeting with a college counselor in high school enlightened Crane to look into other opportunities. He knew that paying for college would be challenging, but a partial scholarship to play football at

Grand Valley State University made it less daunting. Still, Crane felt the weight of paying for college on his own. He would go to school, then football practice, and work later that night. During his summers, he laid brick and poured cement for about twelve hours a day and then worked out later to keep in shape for football.

Eventually, Crane earned his degree in economics and statistics, dreaming of working at the Federal Reserve and being the next Alan Greenspan. By the time he graduated, however, he was entering a tough market. He joined Electronic Data Systems as a systems engineer, mainframe developer, and programmer, working mostly on the General Motors account. Soon, he moved on to Arthur Andersen as a consultant, where he was exposed to a wide variety of industries.

He says that the diversity of experience showed him that his skills were applicable almost anywhere. “Everything I did was around process improvement,” he says. “It was all the same, just a different context. When we improve processes, the intent is not just to change the process, but also to make companies more efficient in speed and quality and help them become more financially successful.”

“When we improve processes, the intent is not just to change the process, but also to make companies more efficient in speed and quality and help them become more financially successful.”

Harry Crane Corporate VP of Revenue Cycle McLaren Health Care

Kristiana Rose

Centralizing Billing Operations

Because of Harry Crane’s proficiency when it comes to improving processes, hundreds of jobs came to Shelby Township as McLaren Health Care centralized its billing and collections into one location from thirteen separate offices. The move was intended to improve insurance billing effectiveness that could increase revenue by about $30 million annually.

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McLaren offered a little more than three hundred full-time patient accounting employees at twelve hospitals with the opportunity to move into the new 57,000-square-foot building. McLaren’s medical group billing department also made the move. Crane says the move was not made to cut costs but rather to have standard processes and operate one way across the health system. This has reduced denials, and billing has become more accurate thereby increasing revenue and reducing costs.

By the time he joined McLaren Health Care in 2014 as the corporate vice president of revenue cycle, Crane had held two other jobs in healthcare. He says he has found medicine attractive in part because of the stage it finds itself at, where process improvement is crucial if the industry is to catch up to others.

“Something that has helped me a lot in healthcare was working in the auto industry,” Crane says. “Twenty or thirty years ago, process improvement was the price of entry for the auto industry. Then, lean manufacturing came around. That’s now just getting into healthcare because we’re getting paid for quality and performance.”

At McLaren, Crane is responsible for everything from the time a patient arrives to when they are discharged and the final payment is made. He manages the entire process of revenue cycle. Everything from patient access—who the patient is, registering them, admitting them, and verifying their insurance—to health information management, coding, working with doctors to ensure they are documenting accurately for the safety of patients, patient accounting,

billing payers, and collecting from patients. He says his staff is present at every clinic, every office, and every hospital in the system.

During his time at McLaren, Crane has already made a major impact. All of the changes fall under the umbrella of the “One McLaren” initiative—the institution of a single revenue cycle for the company’s many locations. Crane says that technology is essential for this process.

“It’s become so complicated for a health system to get paid that you can’t do things manually anymore,” he says. “We process more than four hundred thousand claims per month, so manual is simply not possible. When I came in, we had eleven autonomous hospitals that were each doing their thing their own way. We had more than twenty-six different versions of clinical systems to work with. You can imagine that it’s immensely complicated to try to bring that all into one process and get a single revenue cycle.”

Despite these immense complexities, Crane not only has the ability to navigate this terrain, but also inspire others.

“Harry Crane is the most progressive man in healthcare and a revenue cycle visionary,” says Jennifer Rakolta, president of Advomas. “His commitment to exploring new ideas inspires everyone that works with him. You believe in Harry because he believes in you.”

In addition to those complexities, Crane says that many companies use technology as a crutch, believing it can be a magic bullet. But Crane believes a good process is the foundation and that the tech is only there to support it. “A simple process can go a long way,” Crane explains. “When you put tech on top of it, you gain efficiency.”

One example is the way the company routes claims throughout the system to ensure accuracy. In the past, documentation was scanned, emailed, couriered, and discussed over the phone, so there was no clean process to resolve claim issues caused by documentation. As a result, Crane began to ask how to create a process that would route claims to the right person at the right time so that issues can get resolved quickly and everyone would be notified at the same time. That approach is now being taught for all of the hospital’s processes.

As the “One McLaren” vision begins to become a reality, Crane says his process improvement antenna is still always on. Even when he walks into a place such as McDonald’s, which is universally lauded for its efficiency of processes, Crane says he still thinks about how it might become more efficient. It’s as if Crane never let go of that flashlight he held for his father as a kid, and he shines that light on everything he sees today. AHL

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New Lease on Life

CIO Mike Woodrow got an inside look at the healthcare profession as a patient, and it’s made all the difference in his work at Avamere Family of Companies

By Chris Gigley

ike Woodrow, CIO of Avamere Family of Companies, was working his way through another long day at the company’s Wilsonville, Oregon, headquarters in December 2016, when something happened that changed everything. He had a heart attack.

“You don’t go through something like that without it changing many aspects of your life—both your personal life and your professional life,” Woodrow says. “It changes you in ways you can’t anticipate.”

Woodrow had always been an intense worker. You don’t get to be CIO of a leading senior living, rehabilitation, and healthcare company without a tireless work ethic. But being in the emergency room and hearing doctors tell him that he may not have survived had he arrived 30–40 minutes later gave Woodrow serious pause.

“I realized that it’s great to have that focus and desire for success,” Woodrow says. “But maybe I didn’t have to work all those hours or skip the healthy eating and exercise routine because I had meetings to attend.”

While Woodrow was still in the intensive care unit, former Avamere CEO John Morgan came to see him. So did Avamere president and now current CEO Gary Wart, as well as Larry Lopardo, executive vice president and general counsel. They made sure Woodrow fully grasped the gravity of his situation.

“They told me that my health was more important than anything I needed to be doing at work,” Woodrow says.

“That’s a serious statement since the CIO is involved in everything. Me not being available affects a lot of people.”

The executives insisted they could help fill in, and while Woodrow recovered at home, he received minimal phone calls, emails, or text messages from work. “You don’t see that very often,” Woodrow says. “I can’t think of better people to be around and work with every day.”

When Woodrow returned to the office, he found himself thinking about his hospital experience often. It gave him an inside look at what the people on the front lines of the business—caretakers, physicians, and nurses—do to care for their patients. The staff who cared for him, he says,

were the most selfless and dedicated professionals he’d ever seen. “Before I got there, they had no idea who I was, but for next three days, they took care of me as if I was the most important person in the world,” Woodrow says. “It’s amazing to watch what caregivers do for long hours on their feet. It inspires you to go back to work and try to improve on everything so those folks can do what they do even better: care for their patients.”

Woodrow spent roughly one month recuperating, and when he returned to Avamere, he immediately began working on a major big data project. In February 2017, Avamere and IBM launched a six-month research study of data that is currently being gathered from sensors at Avamere’s senior living facilities.

“It’s amazing to watch what caregivers do for long hours on their feet. It inspires you to go back to work and improve everything so those folks can do what they do even better.”

Avamere is the first and only post-acute care senior living facility to work with IBM on this type of project.

The aim is to use IBM’s cognitive computing power to gain insights into physical and environmental conditions, as well as identify factors that affect thirty-day hospital readmission rates in patients. Woodrow is confident the project will yield results.

“When we first got together with IBM, I really got a sense of the amazing ability they have,” he says. “They’re tremendously intelligent, innovative people. When you can put that kind of talent with our amazing folks on the healthcare side, good things will happen.”

IBM has equipped twenty short-stay skilled nursing rooms with devices strategically placed in spots such as under beds and near doorways to measure everything from sleep quality to room temperature. Patients who have agreed to participate will also wear sensors to monitor physical conditions such as gait and heart rate. By the time all the data is collected, analysts may need 2–3 years to discover the results that can help Avamere caretakers be even better at their work. The future, however, is in Woodrow’s sights.

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“It’s about owning your position and doing the best you can to succeed every day without having to be told what to do.”

“I have to be looking six and twelve and eighteen months down the road to make sure our strategy lines up with our business,” Woodrow says. “To do that, I have to have a team that can function on its own and is responsive and accountable and professional.”

Woodrow says the IT team is the most important asset any business has when it comes to technology. IT personnel must be able to implement solutions quickly and efficiently, or it doesn’t matter how good the technology is.

“Mike works closely with the PCM team,” says David Case of PCM, which markets technology products, solutions, and services. “I can say that his innovative work has prioritized critical apps and ensured that patients enjoy a first-rate healthcare experience.”

As a result, when Woodrow scouts for new talent, he is always focused on leadership qualities.

“It’s about owning your position and doing the best you can to succeed every day without having to be told what to do,” Woodrow says. “When you have that kind of team, you can start doing things other companies aren’t and help the business differentiate itself.”

Woodrow, however, concedes that finding the right people for his IT department is a challenge.

“I want to know how they think and function,” he says. “I don’t need someone who is the best in whatever technology we hire them for. If they can’t function within the team, then it won’t work. It’s really about identifying people who understand that.”

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Teamwork is particularly important given the tools they use and the people they service. Networking, database management, and communication technologies evolve rapidly. So too do the needs of the healthcare community, which is in flux with uncertainty over the aftermath of the Affordable Care Act. Woodrow, on the other hand, has a way of making strategic decisions in the face of such uncertainty.

“You take your experience and knowledge and apply it to a strategy that lines up with the business and that you think makes sense at that time,” he says. “Then, you continue to adjust, understanding that just because you’re changing the strategy doesn’t mean it was wrong when you created it.”

Change is simply a part of business and a part of life. Few CIOs understand this better than Woodrow. It took a health crisis to make him see it, but his outlook at home and at work are much healthier now. Because of that, so is Avamere. AHL

Lenovo Health congratulates Mike Woodrow for being recognized in American Healthcare Leader. Lenovo Health is a proud strategic partner of the Avamere Family of Companies and empowers healthcare organizations with our technology and solutions to improve outcomes, deliver high-quality care, and actively engage patients throughout their care journey.

Give us a call at 503.968.8908, or visit www.sterling.net

Sterling is an Oregon-based Managed Services provider that specializes in leading-edge Cloud Services technology for growing businesses. Our twenty years of experience allows us to find solutions that help clients work smarter and more efficiently. Sterling is proud to partner with Avamere in streamlining their organization by taking full advantage of the latest advancements in VOIP, VDI, and SD-WAN Cloud services. Supporting a thought leader like Mike Woodrow is what we’re all about.

Privacy and Security by Design

Cyberattacks in healthcare have increased by 500 percent over the past several years. Jacki Monson of Sutter Health is leading the charge to stop them.

By Randall Colburn

When she was a child, Jacki Monson would wander the halls of the hospital where her mother worked in healthcare administration.

“I spent as much time there as anywhere else,” Monson recalls, noting that as a little one she was used as a “test baby” during pediatric initiatives.

This was long before cyberattacks became a demonstrable threat to hospitals. After all, it took the healthcare industry quite some time to begin storing records digitally. As recently as ten years ago, medical files were still kept in cabinets. And while having patients’ information go digital has been beneficial for hospitals, doctors, and patients, EMRs unfortunately weren’t created with security as a top priority.

“If you would’ve asked me five years ago if the technology was going to constantly suffer from cyberattacks, the answer is that it would’ve been very unlikely,” Monson says.

Now, as the chief privacy and information security officer at the nonprofit health network Sutter Health, Monson has seen firsthand the importance of security in the realm of healthcare. She notes that cyberattacks and security breaches have increased exponentially over the past several years, especially now that biomed devices are also becoming subject to attacks.

“Healthcare is pretty vulnerable because the technology was never designed with security in mind,” she says. “It’s always much harder to go backwards and try to redesign that password that’s already been implemented—the one everybody is already using.”

When it came time for college, Monson decided to pursue law instead of healthcare, but she soon found herself interning for the general counsel of her mother’s hospital. During her internship, she worked on HIPAA law in addition to general compliance, an experience that helped ignite her passion for healthcare and issues of privacy and security. Her career eventually led her to a role at the Mayo Clinic as the organization’s chief privacy officer, where she worked for two-and-a-half years before yearning for her next big challenge.

Her next undertaking came at Sutter, which offered her the opportunity to help build out the company’s privacy program at a corporate level. “Most people would probably be scared by that,” she says, “but I viewed it as a dream opportunity to actually—from start to finish—design a program instead of having to work with one that’s already been developed.”

Monson developed a model suited specifically to Sutter and, after two years, had built a sizable, fully functioning

privacy program. In fact, the program was so successful that senior management offered Monson the opportunity to extend her reach to the company’s information security as well. By fusing together the consistencies she found between both cyber and insider threats, Monson says she’s been able to provide a more holistic view of the risk landscape and possible incidents. Privacy informs information security and vice versa, she says.

Another key to Monson’s long-term success is her focus on being proactive instead reactive. Reactiveness, she says, tends to be the go-to mind-set for people in cybersecurity because of the constant threat of breaches and the need to resolve them as quickly as possible. Monson, however, believes that a reactive approach is ultimately going to be quite costly to the healthcare industry and that it could impact the safety of patients.

Jacki Monson Chief Privacy and Information Security Officer

Sutter Health

Scott Clark Photography

A proactive approach, though, centers around working to meet business needs while also ensuring that all privacy and information security requirements are met, a process she calls privacy and security by design. This means clearly articulating these requirements to those leading Sutter’s myriad initiatives. That can apply to the facility department’s remodeling efforts or to Sutter’s partnership with a company that uses smart glass technology to help chart information in patients’ medical records. By building a strong foundation at the beginning of a process, Sutter won’t need to backtrack in the future. Unlike the healthcare technology of the past, these new initiatives are being designed with security in mind.

What’s important, then, is the ability to be proactive and reactive simultaneously. “You have to be able to respond to cyberattacks or privacy breaches while, at the same time, seeing that light at the end of the tunnel of what proactive looks like,” Monson says. The benefits of a proactive approach in terms of strategy and technology can result in what Monson describes as a job that can ideally be 80 percent proactive and 20 percent reactive.

Monson credits her ability to balance the proactive and reactive elements of her job to the senior leaders at Sutter, who she says are forward-thinking and supportive of her team’s vision. “In that aspect,” she says, “we’re paving the path that other large organizations are following.”

Given that Monson and Sutter are exploring new territory for healthcare privacy and cybersecurity, Monson has found herself drawing inspiration from other industries. “The financial sector, for example, is much more sophisticated than healthcare in a lot of these spaces,” she says, “so we’re always seeing what we can glean and learn from them.”

Monson also emphasizes and celebrates the creative mind-set of her team, who she says work together to find the best ways to manage a new or trending issue that’s different from previous issues.

Building that strong foundation is important to her on both a professional and a personal level. Her mother has been with the same hospital for forty-three years, she says, and it’s clear that the same level of commitment runs in the family.

“I’m passionate about healthcare because I grew up in that space. I’m passionate about providing the best care possible to patients,” Monson says. “My work directly impacts the safety of the patients. If you’re not keeping your patients’ information secure, then you’re not taking good care of the patients.” AHL

IT Strategy Is Business Strategy

Hari Krishna knows that business success in the animal health industry relies on constant IT evolution

By Lori Fredrickson

Throughout his career in IT, Hari Krishna’s mantra has always been “agility and delivery focus.” And as the head of IT, transversal and analytics solution center, for leading global animal health company Merial Inc., Krishna has found that mantra to be particularly vital.

“The market is dynamic, and as prices change, the business might be focusing on different things or making a complete change to what it needs,” Krishna says. “We don’t want to wait to deliver solutions.”

Throughout his sixteen years with Merial Inc., Krishna has applied his instincts for speed and adaptation throughout a broad range of projects, ranging from modernizing legacy systems to building new platforms and products. And he’s completed these projects in a way that focuses on influencing company strategy to ensure that the business and tech sides aren’t operating in silos. “My approach has been to facilitate the conversations that fuel new partnerships, mind-sets, and governance models so that business and IT strategic planning can work toward the same objective,” he says.

Krishna has steadily worked his way up through Merial since starting to work with the company in January 2001, before joining in October 2002 as a staff employee.

From Nuzvid, India, Krishna moved to the United States in January 1999 after earning a degree in engineering from Andhra University and worked in a variety of IT roles in financial, logistics, and hedge fund organizations before developing an interest in animal pharmaceuticals, which was taking off as an industry at that time. When Merial offered him a chance to come on for a contract assignment as a developer, Krishna saw an opportunity to help them modernize, starting with a migration to Oracle ERP from a less advanced platform.

Within months, Merial offered Krishna a full-time position, and he has since moved from senior developer to solution architect to director of business intelligence to head of global business intelligence and analytics solution center before assuming his current role. Much of his work in doing this has been partnering with the business side directly to offer the right solutions. “It’s about knowing how the business can manage things better without IT involvement,” Krishna says.

In 2003, one of his first achievements for the company was to build a customized, automated Oracle advance-pricing engine using APIs for sales promotions during the sales order entry process—a new functionality for the Oracle advance pricing module.

Afterward, Krishna moved on to building MCASE, a custom TIBCO application error-logging system, in 2008. Previously, IT had monitored various jobs overnight, fixing errors where they occurred individually and then later reporting them to business leaders—a process that was often time-consuming. MCASE instead logged all errors that occurred overnight in a userfriendly platform.

“Now, when business leaders come in the morning, they know where there have been successes or failures,” Krishna says, adding

“It’s about knowing how the business can manage things better, without IT involvement.”

Hari Krishna Head of IT, Transversal and Analytics Solution Center Merial

“What we do is build a model of something and let the business start using it so that the business can see the delivery value.”

that this allows them to make immediate fixes to the systems.

One year later, he was instrumental, along with his peers, in improving Merial’s service-level agreement uptime for all of the business critical systems. He also worked to modernize legacy systems, making Merial an early adopter of cutting edge financial planning systems as well as Informatica software in 2014.

In 2011, Krishna also orchestrated the company’s migration to its Cognos business intelligence system, making Merial one of the first five major companies to begin using it. He was able to do this within three months by ensuring that the business was partnered with the project from the beginning. “When people deliver new systems or upgrades, they often do a lot of testing before anyone is able to use them,” Krishna explains. “What we do is build a model of something and let the business start using it so that the business can see the delivery value.”

In recent years, many of Krishna’s projects have focused on big data and cloud solutions, including for social media analytics and Tableau. Rather than building infrastructure to house that data, Krishna instead began to contact various thirdparty companies to select a range of plans

and options from developers. After monitoring their usage and value, he determined which to keep and which to drop. “Rather than spending six months to a year developing something, you’re able to use it within five days, and you don’t need support people,” Krishna says. His success in doing this has led IBM to select him as a keynote speaker on the subject at a conference in 2015.

Since then, Krishna has begun to focus on implementing new business intelligence strategies. Many of his projects focus on harnessing big data, which has been critical to the company’s current success. The new big data platforms have allowed business leaders to explore new ways to bring value to the company, Krishna says.

As a team leader, Krishna also focuses heavily on emotional intelligence to ensure that he has the trust and respect of his members and to make sure that they’re also able to do their best work for the company. He has four pillars of this that he applies to his job and organization: self-awareness, social awareness, self-management, and relationship management.

Working in a global role with various members across Asia, South America, North America, and Europe, Krishna also focuses on understanding different cultures, as well as different mind-sets of employees in various areas of technology. “I’m a constant learner, and I always operate on sharing knowledge and facts,” Krishna says. “When you do this, you’re able to take your team with you.” He also blocks out four hours for himself every Friday to either work on relationship building with other IT and business leaders to explore more opportunities to help, or to spend time researching and learning about changes in the market and at other companies.

As Merial has recently been acquired by Boehringer Ingelheim, Krishna is looking forward to continuing to build and deliver new solutions across the organization, and he’s looking forward to working with new business partners to do so. “The company is evolving constantly, which is an exciting challenge,” Krishna says. AHL

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How One Sound Can Save a Life

Beltone and Corrine Perritano are tackling hearing loss and changing lives with groundbreaking hearing aid technology

By Joe Dyton

Corrine Perritano is not in the business of selling hearing aids. She’s on a mission to help people hear better.

That vision is shared by her employer, Beltone, a Glenview, Ilinois-based company that has used the latest technology to develop award-winning hearing solutions for more than seventy-eight years. Perritano is president of Beltone’s North American division and works extensively with the marketing department to ensure that the company’s message reaches as many potential future users at it can.

Beltone’s team hopes to educate people about hearing health and how the company can help people not only when hearing loss develops, but also before the loss starts to occur. Perritano works with Beltone’s network practices to ensure they are getting all the support they need to be successful. “Ultimately, the number one mission is to help people hear better,” Perritano says. “That means getting the

message out about what we can do and then ensuring when someone does come to a Beltone office that they have the best possible technology, training, and services available to meet their individual needs.”

One reason Perritano is passionate about Beltone’s mission is that she watched her father cope with hearing loss. She was not in the hearing aid industry at the time, but now that she is, Perritano witnesses firsthand how Beltone’s technology can change someone’s life. She believes it would have made a major impact on her father, who did not address his hearing loss and ended up with dementia later in life—a condition that Perritano believes was brought on because he began to disengage from social activities because of his hearing loss.

“It’s not just hearing,” she says. “There are other impacts of hearing loss that we can actually fix. I love the fact that we are part of something so noble and something that can make a difference in so many lives.”

“The number one mission is to help people hear better. That means getting the message out about what we can do.”

Corrine Perritano President Beltone

“Patients who have been wearing hearing aids for years put this on, and they can’t get over the ability to hear in a crowd or detect sounds around them.”

Beltone Trust is the company’s latest difference-maker. The hearing aid’s groundbreaking, cross-directional functionality, enables people to hear in a truly natural way. When a Trust user hears a sound, they can determine the direction from which it’s coming, whether that’s from the left, right, front, or even behind the user.

Beltone Trust settings can be adjusted through a mobile application called HearMax, where users can fine-tune their settings remotely. If a user is having difficulty with their hearing aid, then they can go into the app, note that they are having trouble, and their practitioner can make the necessary adjustments from wherever they are. Trust users can have adjustments made proactively, too. If they are going to be somewhere noisy, such as a birthday party or concert, but won’t be able to make it to an office beforehand, their practitioner can make the necessary adjustments ahead of time.

The technology launched in May 2017, and customer feedback has been positive, according to Perritano. “Patients who have been wearing hearing aids for years put this on, and they can’t get over the ability to hear in a crowd or detect sounds around them,” she says. “It’s not just noise amplification. It’s true natural sound, where they feel safe and confident that they aren’t missing out on any part of the conversation. They don’t have to be looking at someone in order to hear them.”

Beltone’s new marketing campaign features Beltone heroes—everyday people who rely on the Trust technology in order to save lives. One ad focuses on a police officer whose hearing aids allow him to hear a woman being attacked in an alley and come to her rescue, while another focuses on a respiratory nurse who must be able to hear and answer her beeper at a moment’s notice. Another Beltone hero ran in the Boston Marathon. The Beltone technology

let her feel comfortable to train without worrying about approaching cars that she couldn’t see or being knocked over if someone came from behind her.

“We are using these heroes to spread the word, share their stories, and tell people that they shouldn’t be embarrassed to use a hearing device. They can take control and live the life they want,” Perritano explains.

Beltone products can make a significant difference even for patients with hearing loss that they’ve written off as a normal part of aging. “People have felt they could live with a little hearing loss, but right now there’s no reason to,” Perritano says. “I have always felt we should challenge ourselves to be all that we can. I feel proud to work with a team that for seventy-eight years has been out there doing that. Our brand helps others and supports that mission with a wealth of research and development to make sure we’re coupling that service with the best technology.”

As the company continues to develop more groundbreaking technology such as the Trust hearing aid, Beltone will continue helping patients live the lives they want for decades to come— and beyond. AHL

CaptionCall is a revolutionary phone for hearing loss. It provides powerful amplification and customizable audio settings while simultaneously displaying captions of what callers say on a large, easy-to-read screen. Best of all, there’s no cost for your qualified patients with hearing loss. Learn more at www.captioncallprovider.com / 1-877-557-2227.

Stericycle Communication Solutions proudly delivers a comprehensive healthcare communications platform, including expert telephone answering, appointment scheduling, automated outreach, and more. By combining a human touch with innovative technology, we create truly best-in-class experiences while supporting organizations’ unique acquisition, engagement, and retention initiatives.

A Transformation for a New Direction

Maricopa Integrated Health System’s CTO explains how, in a new healthcare environment, the rewards of replacing the entire IT infrastructure greatly outweigh the risks

By Peter Fabris

hen it comes to a transforming industry, the past can often be like a frozen parking brake holding back the organization from advancing. That’s the case when it comes to legacy IT architecture in healthcare, explains Steve L. Schiavone, chief architect and chief technology officer at Maricopa Integrated Health System (MIHS) in Phoenix.

Schiavone confronted this issue head-on when he joined the regional healthcare system in 2013. As he took stock of the organization’s IT infrastructure, he had two realizations. One was that in a few years, the equipment would be on the verge of obsolescence. And two, the current architecture was not flexible enough to support the organizational change that was coming. Similar to other healthcare systems, MIHS was planning to open a significant number of ambulatory facilities to serve patients closer to where they lived. The exact scope of this strategy was yet to be determined, but it would mean IT would have to change.

Schiavone conceived and designed a new IT infrastructure that would be flexible enough to support the unpredictable future. His goal was to provide maximum flexibility no matter what strategies the organization

adopted. As he explains, a gradual approach, where pieces of the infrastructure were upgraded over many years, wouldn’t work—a one-for-one technology swap out or replacement is not transformational.

“Many organizations make incremental changes to support the future,” Schiavone says. “Sometimes, it is better to simply build new systems for the future.” To that end, he proposed scrapping the existing IT infrastructure and building a new one from scratch. The overriding principle of the new architecture would be to abstract or virtualize all computing resources so that each MIHS site could easily plug into the organization’s core infrastructure with minimal underlying technology needed on-site. “All that we would need is an IT closet to connect to,” says Schiavone, adding that no major infrastructure would be necessary outside of the data center.

Steve L. Schiavone Chief Architect, CTO

Maricopa Integrated Health System

Each time that a new site opened, the IT investment would be minimal, and all system-wide services would be managed from a central location. Another major advantage would be the way IT security would be deployed. Instead of the existing scheme of placing security features in points along the network, security would be embedded into the DNA of everything, Schiavone says.

In addition, MIHS personnel would no longer operate the data center. Instead, that task would be right-sourced to a colocation site away from the main campus, saving space and making more efficient use of hardware. The existing data center occupied about 2,300 square feet, but the new data center footprint would be just four hundred square feet. The number of racks would be reduced from fifty to just sixteen, as Schiavone says MIHS has moved toward ultra-high density computing.

Schiavone’s four hundred-page technology road map, titled MIHS careNET, defined new architectural and engineering design principles, standards, and goals and provided a set of traceability matrices that translated the MIHS strategic objectives and IT strategic goals into IT technical objectives, technology domains, and capabilities, programs, and projects.

Schiavone was convinced that this sweeping change in IT design was essential to support MIHS’ future, but it was going to take a major investment. MIHS’ senior vice president and CIO Kelly Summers, an author of the MIHS IT strategic plan, made a persuasive case, emphasizing the essential need for IT to change drastically in order to support the organization’s new direction.

“A lot of the conversation is very technical,” Schiavone says, adding that it needed to be put in terms that board members and C-suite executives would understand. Summers emphasized the ability to open more remote sites faster, with stronger provisions to protect systems, data, and people. With a number of highly publicized data breaches in the news, the pitch had resonance.

In 2014, the board developed a proposal that involved the reinvention of care and a drastic reimagining of the organization. Taxpayers got on board, voting to spend roughly $934 million for improving acute care, ambulatory services, and behavioral health services. Within this award, about $23 million was allocated to the transforming the technical foundation of IT.

“Many organizations make incremental changes to support the future. Sometimes, it is better to simply build new systems for the future.”

As of July 2017, a new colocation data center with a new technical foundation opened, and MIHS was in the final stages of upgrading its new operational EMR software platform. At the time of press, the plan was to begin migrating legacy IT systems to the new data center in mid-2018. The new hyper-converged architecture offers a more robust, more secure infrastructure that will be able to support operations anywhere MIHS wants to go. “We have, in effect, created an entire virtual-technical ecosystem or private cloud,” Schiavone explains. And the speed and cost to set up a new remote site will be minimal, no matter what type of clinic is opened. That holds true for even a nonclinical office such as a call center, as well.

Moving to a new IT infrastructure required a massive retraining of in-house IT personnel, as staff needed to become familiar with the new technology and get certified to maintain it. That initiative included having MIHS staff members shadow the consultants hired to deploy the new technology. This way, the organization received the benefit of training along with the actual deployment. To ease the transfer of responsibility for IT from a consulting firm to MIHS IT staff, there will be a one-year overlap where both groups will work together on operating and maintaining the new system.

It’s been a major undertaking—short-term pain for longterm gain. “We have basically created a new IT organization over the last 6–9 months,” Schiavone says. The reinvention was an absolute necessity, he adds. The available technology has to be able to support the strategic direction, even if it means starting over with a clean slate.

“You can’t be a barrier for change,” he says. “Many people are afraid to throw away a legacy infrastructure, but it may be time to reinvent IT along with healthcare.” AHL

Thinking Big, Starting Small, Advancing Fast

From developing enterprise architecture to breaking down silos, Karen Xie is at the forefront of Blue Shield of California’s push to advance how it runs and grows its business

By John Sadler

Building a house is a multistep process. Defining needs and wants, planning how to best achieve the needs and wants, and executing the plan are all part of the construction. It’s much the same with enterprise architecture in a business, says Karen Xie, the vice president of enterprise architecture at Blue Shield of California.

Xie describes it in an analogy: In the first stage, the homeowners define what they need or want in a house. In the second stage, architects provide blueprints to the homeowners that detail the future appearance of their house and the construction sequence. In the third stage, the house is built.

“Enterprise architecture for an organization works in a similar manner—bridging stage one, business strategy development—and stage three, strategy execution,” she says. “In stage two—like the framing, plumbing, and wiring home construction blueprints—the enterprise blueprints provide the future-state business capabilities and their interrelationships, such as omnichannels, digital marketing, and customer experience.” Therefore, Xie says, enterprise architecture is the process of transforming business strategies into an effective execution plan for delivering businessaligned holistic systems. This transformation process entails designing an enterprise in its current and future states from people, process, and technology perspectives.

Xie’s work at Blue Shield of California is her second time defining a company’s enterprise architecture programs. She worked as the vice president of architecture and innovation at Trinity Health, a national nonprofit health system that runs ninety-three hospitals in twenty-two states, for more than sixteen years before joining Blue Shield.

Since joining the company in 2014, one of Xie’s top priorities has been tearing down business silos. “They do nothing but cause chaos and waste,” Xie says. For example, she ensures that business departments throughout Blue Shield are communicating so that no group is purchasing technology solutions when the company already has similar tools with the same capabilities. If various related projects

are pursued in a silo, then it can jeopardize the sequence and result in implementation failure.

Xie recognizes that operating in silos is an industry trend. She points to a study about the annual number of radiology tests conducted in hospitals around the country. “About 20 percent of those radiology tests alone are redundant due to patient data silos,” she says. “This 20 percent costs $20 billion per year.”

Under Xie’s leadership, the company has leveraged the architecture blueprinting process to create an multiyear enterprise road map that guides planning for both the annual strategic budget and human capital. And, under the rigorous enterprise architecture discipline, there are no unnecessary purchases of duplicate technology solutions by various functions of the business.

“Technology solutions at Blue Shield have been rationalized and simplified,” she says. “Therefore, it has reduced rework, waste, and cost caused by silos and improved business efficiency, effectiveness, and agility.”

Although enterprise architecture has become one of the dominant best practices for top-performing organizations, Xie says there isn’t a magic formula or universal method to apply. She cites research from Gartner Inc., which found that among two-thirds of companies with enterprise architecture programs in place, the programs are barely functional and failed within two years.

“There’s not a playbook to follow,” she says. “It requires applying the best practices and lessons learned with the customizations based on the business environment, people’s skill set in the organization, the maturity level of the program, etc.”

Karen Xie VP of Enterprise Architecture Blue Shield of California

In forming the enterprise architecture program for Blue Shield of California, Xie started by creating an operating model that consists of four key elements: governance to guide the architecture decisions; process to streamline the architecture deliverables; framework to provide the methodologies and tool set to help the architects; and operations to manage the service quality and deliver business value.

“In operationalizing the enterprise architecture operating model, I took the approach of thinking big, starting small, and advancing fast,” Xie says.

Now that it has been formed, Blue Shield’s enterprise architecture program consists of four different architecture domains: business architecture, which defines the enterprise business capabilities to help grow the business; information architecture, which defines enterprise data and data integration standards to support efficiency; application architecture, which defines and rationalizes application solutions to manage information across the company; and infrastructure architecture, which defines and rationalizes the infrastructure that supports application technologies.

Xie’s leadership with these architecture programs is only the beginning of her role in the company. Within a year of being hired, she was tasked with establishing a data services program, which reformed the company’s health innovation technology program and transformed quality assurance testing and automation functions. While working on the health innovation technology program, she has also helped create California’s largest health information exchange platform for patient longitudinal records.

“Technology solutions at Blue Shield have been rationalized and simplified. Therefore, it has reduced rework, waste, and cost caused by silos.”

Blue Shield of California is also pushing to become the best healthcare provider in California, and Xie is passionately committed to that goal. Under her leadership, Blue Shield of California’s enterprise architecture program has reached a 4.3 out of five on Gartner Inc.’s assessment of architecture maturity model. This is up from 2.3 in 2014 and significantly higher than our industry’s average maturity level, Xie says.

With her work in evolving enterprise architecture and breaking down silos, Xie will be essential to the company’s strategy to become the number one healthcare payer in the state of California. AHL

Congratulations to Karen Xie of Blue Shield of California

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We wanted to know:

What healthcare trend will most impact your work in 2018?

Kirk Manz CFO

American Addiction Centers

The demanding trend will be the spreading opioid epidemic that will drive increasing demand for greater access and higher quality care.

As an industry trend, it will be the increasing demands from payers and a tougher marketing environment that will put pressure on smaller mom-and-pop providers to compete, which will in turn present interesting consolidation opportunities.

Elliot Joseph CEO

Hartford HealthCare

It’s consumerism. Responding is difficult and complex. Increasingly, patients are in high-deductible health plans. They want quality and pricing information, especially for “shoppable” services. So, they’re customers, not just patients. For health systems, it’s cultural. We have to be comfortable sharing quality information internally so that we can offer it to our customers. We’re also moving more investments into ambulatory facilities in response to demand—sixteen urgent care centers in eighteen months, for example.

And we’re making early investments in both telehealth and digital health. Consumers are redefining healthcare. If we don’t respond, then there are plenty of nontraditional niche players who will.

Jessica Harthcock Founder, CEO Utilize Health

A big trend is a move to niche vendors throughout the healthcare continuum. Twenty years ago, there were a small number of general population health vendors that covered a broad spectrum of conditions, patient types, and diseases, but really only impacted a few of them effectively. This was primarily due to a limited amount of data, technology, and personalization platforms, and a preferred purchasing mind-set for consolidated vendor management. With the recent explosion in data collection along with advancements in technology, we’re at the point that vendors and health plans can manage on a more granular level. The result has seen specialty players impacting conditions, patients, and health plans’ bottom lines more effectively compared to general program providers.

Michael Phillips SVP, Chief Legal Officer

The

MetroHealth

System

MetroHealth’s critical challenge for 2018, and likely beyond, will be addressing and attempting to implement a variety of strategic initiatives designed to offset and/ or reduce the negative impact of governmental reimbursement reductions. In Ohio, Medicaid, both FFS and managed care, will be reduced for 2018 and beyond. This includes the Medicaid rates as well as HCAP and UPL adjustments. In addressing these reductions, we developed a number of initiatives and also will be pursuing an active government relations approach. The legal department will be significantly involved in these initiatives as we provide counsel on how to address our authority on certain types of projects given our status as a limited purpose government entity.

People & Companies

20%

The amount of radiology tests each year that are redundant due to patient data silos, which cost the healthcare industry about $20 billion each year. (Blue Shield of California, p. 205)

64,000

The number of opioid-related fatalities nationwide in 2016. (American Addiction Centers, p. 13)

1/3

Nationwide, this fraction of all Medicaid payments (31.5 percent of $400 billion) goes to long-term care for the elderly and disabled. (Genesis HealthCare, p. 138)

89%

In 2016, generic drugs accounted for a major percentage of prescriptions dispensed but were responsible for only 26 percent of the costs. (Alvogen, p. 124)

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