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Profiles in Leadership: For Gail Donovan, the details matter

By | August 16 th,  2011 | business, profile, Top 25 Women, urban, executive, hospitals, interview, Modern Healthcare, New York, operational effectiveness, value-based purchasing, article, Blog, chief operating officer, electronic medical records, Gail Donovan, leadership, Continuum Health Partners, COO, quality | Add A Comment

One in a series of profiles of Modern Healthcare’s Top 25 Women in Healthcare (sponsored by Furst Group)

 

As the daughter of a surgeon and an operating room nurse and now as one of the leading healthcare executives in the nation, Gail Donovan has been around hospitals all her life. So when she says she’s a bit worried about healthcare reform, one tends to listen more intently.

 

“Hospitals are like running 40 different businesses,” says Donovan, Executive Vice President and Chief Operating Officer of Continuum Health Partners, Inc. “As a large provider system, our hospital emergency rooms care for 250,000 visits a year in our system and we have very large ambulatory services handling more than 3 million visits a year. I love being able to provide access and to make sure that, as much as possible, we’re able to meet the needs of the very large and diverse communities we serve.”

 

While she agrees that changes are necessary, Donovan says some of the details, like value-based purchasing, need to take into recognition the realities that urban hospitals and systems wrestle with every day.

 

“We know how to run financially distressed hospitals because we’ve had to learn how to do that, and move from operating in the red to operating in the black, all the while we’re trying to improve and demonstrate improvements in quality,” she says.

 

It’s the details that matter to Donovan in reform and in healthcare in general.

 

“The absolute top quality that an executive needs to have is operational effectiveness,” she says. “Essentially, you must be grounded in details and be able to be not just productive but effective in managing the details of your work and your job.

 

“It’s through this that you can then have strategic vision. I don’t think you can really have strategic vision unless you understand what you’re managing today.”

 

Donovan and her team long have been visionary about the need for electronic medical records, but she credits her board with having the courage to invest more than $100 million in EMRs even as the system was struggling to provide basic core services. With an eye to the future, Continuum is well-positioned for whatever reform may bring, but Donovan wonders where the funds to help urban hospitals with compliance will come from as value-based purchasing expands from six core measures to 30 or 40.

 

“For urban hospitals to potentially be penalized and have reimbursement taken away could take a very fragile healthcare structure and create significant problems and an inability to maintain services.”

 

Many urban hospitals, Donovan says, are capital-starved and have a high dependence on Medicare, Medicaid and the bad-debt charity care pools.

 

“If those dynamics are altered without having a proper definition of safety-net facilities, like a number of my institutions are, then that dynamic could completely upend our ability to meet the needs of the very large communities we serve.”

 

Despite that sober warning, Donovan clearly enjoys her chosen field. To varying degrees, she has been serving since she was 12 and first became a hospital volunteer. She interned in health administration before going to graduate school and did a residency as part of her graduate degree that was “pivotal,” she says.

 

“I still strongly advise graduate students to seek internships and residencies. They’re called different things now, but exposure early on to a number of different organizations and their components led to job opportunities for me.”

 

She also credits luck in finding professional mentors who championed her early in her career.

 

“I was usually the youngest in the room – and the only woman,” Donovan says. “I think that has changed in certain settings, but there continues to be a lack of women in the most senior of positions in hospitals and healthcare systems.

 

“I think we’re changing that, but it’s a little bit slower, perhaps because of some concerns about work-life balance. As a mother, I know that if I did not have a supportive husband who had greater flexibility, I wouldn’t have been able to put in the time and the commitment to do what I needed to do professionally as well as support my family.”

 

Her professional reach has extended far beyond her system. She was president of the Metropolitan Health Administrators Association before it became the New York chapter of ACHE. And, with Susan Waltman, Executive Vice President and General Counsel for the Greater New York Hospital Association, Donovan spearheaded emergency preparedness measures in the wake of 9/11 that the Joint Commission has adopted as standards for all U.S. hospitals. Such responses, applicable to natural disasters as well as terrorist attacks, go beyond medicine, she says.

 

“So much of emergency response ends up dealing with adequate communications structures and systems,” she says. “And even in a sophisticated environment like New York, that continues to be one of the top challenges. So one of the outgrowths of the post-9/11 work was ongoing emergency preparedness that includes all the municipal structures and systems with the provider community.

 

“It’s why my job is fun,” she adds. “I actually love my job. Always have.”

Profiles in Leadership: McNutt makes sure IT’s voice is heard in healthcare’s future

By | July 15 th,  2011 | CHIME, clinical informatics, Dallas, Healthcare, Top 25 Women, executive, HIMSS, information technology, IT, Modern Healthcare, Pamela McNutt, Blog, chief information officer, CIO, College of Healthcare Information Management Execu, electronic medical records, female leaders, Methodist Health System | Add A Comment

 

One in a series of profiles of Modern Healthcare’s Top 25 Women in Healthcare (sponsored by Furst Group)

 

Computerworld Magazine covers its industry to a T – make that IT. But amid major stories on automakers (“How IT is fueling Ford’s turnaround”) and competing systems (“Clash of the Clouds”), last Nov. 22’s cover features senior vice president and chief information officer Pamela McNutt of Methodist Health System in Dallas, who weighs in on “Healthcare IT: No Quick Cure.”

 

McNutt’s national stature also made her a wise choice to chair the policy steering committee for the College of Healthcare Information Management Executives, and she and her colleagues have spent time advising the CMS on what works and what doesn’t in the federal government’s new regulations.

 

“One reason I’ve been so active nationally is there’s a lot of concern about meaningful use,” she says. “Are the incentives achievable? Are we moving too fast on some things? Too slow on others?”

 

Besides CHIME, McNutt is active in HIMSS and AHA. She earned a Leadership Award from HIMSS in 2001 and was named CHIME’s CIO of the Year in 2002.

 

While she is very hopeful about the future of electronic medical records, she cautions that there is a long road ahead.

 

“There is a sense that healthcare has been behind other industries in adopting information technology,” she says, noting that healthcare traditionally spends 2.5 percent of its budget on IT while other businesses devote 5 to 10 percent on new technology.

 

But shedding ink-on-paper for computer records isn’t as easy as some people think, notes McNutt.

 

“We still have issues with normalizing the way data is collected,” she says. “Even being on the same vendor platform doesn’t mean you’re going to be able to exchange data seamlessly.”

Beyond that are the issues raised by HIPAA.

 

“ ‘Contradiction’ may be too strong of a word, but we face a real dilemma as healthcare providers in reconciling privacy and security of records. We want to provide quick and easy access to provide the best possible care, but at the same time providing privacy and security.

 

“The whole industry is struggling with this on a national basis,” she adds. “What rights does a patient have to control, restrict or direct where their data goes and, on the flipside, what right does the caregiver have to see a complete and accurate picture?”

 

That dilemma won’t be resolved any time soon. But the growing role of IT in healthcare means that there are opportunities for workers in that field. McNutt suggests it’s also a window for women to move into leadership.

 

In fact, one area where healthcare has shone, she says, is in the development of female leaders.

 

“Healthcare has always been ahead of other business sectors in having female leadership,” she notes. “When I started in IT years ago, it was a male-dominated field. When you go to meetings of our professional societies today, there are so many more women. I think healthcare was a field that was ripe.”

 

IT workers with nursing backgrounds are proving especially valuable, she says, but adds that there is plenty of room for more. “Clinical informatics is a very special skill set, and we’re 50,000 people short nationally,” she adds.

 

If Methodist has a head start, it’s because McNutt had the foresight to revamp its IT system in 2003.

 

“We made a conscious decision to start over in 2003,” she says. “Rather than continue to put puzzle pieces together, we decided to bring in a bulldozer. At the time, it was a bit of a radical approach, but it’s working very well.”

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