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Top 25 Minority Executives in Healthcare: Sumit Nagpal's technological innovations at LumiraDx take aim at overhauling care for people with chronic conditions

By | October 19 th,  2016 | Steve Jobs, Top 25 Minority Executives in Healthcare, Alere, LumiraDx, Modern Healthcare, NeXT, Richard Branson, software, Blog, CEO, EHR, interoperability, leadership, National Health service, Sumit Nagpal | Add A Comment


Classic content: One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.


The challenges facing patient care go far beyond issues of EHR interoperability. Patients eat, drink, exercise, do home testing, take prescriptions and talk with friends and family in a plethora of ways that have nothing to do with doctors – so can all those everyday moments that don’t happen in a clinical setting be collated to keep chronic conditions in check?


Sumit Nagpal and his co-founders have been thinking and working on those questions for, oh, about 25 years now. Thus, LumiraDx, the latest iteration of their ideas, could be thought of as an overnight success that’s been two decades in the making, as customers are rapidly coalescing in their recognition of the transformation of patients’ lives that is possible with this new firm.


“We think of ourselves as an outcomes company,” Nagpal says. “Our approach is to coexist and make use of all of the existing infrastructure that’s already in place, including EHRs, and amplify it to find out more about individuals at risk, always safely, and always with their consent – identify them, risk-stratify them, and then help them achieve better outcomes through very targeted programs.”


Nagpal, Chief Architect of U.K.-based LumiraDx Holdings, and CEO of its U.S. unit located in suburban Boston, says to think of their offering as an “overlay” on top of existing systems that address needs inside the four walls of hospitals and physician practices, but currently in a siloed way. LumiraDx uses data from these systems, and joins it up with information from point of care and home-based diagnostic devices, social care systems, personal-activity trackers including wearables, and even social media to personalize and customize care solutions.


Are patients adhering to their medication schedules? Are they getting depressed and unable to do the things that will improve their well-being? Do they feel positive about their health? “All of that can provide context and inform us as we then work to help these individuals slow and perhaps turn back the progression of disease,” Nagpal says.


The successes are adding up quickly. Richard Branson’s Virgin Care rewarded LumiraDx with a national contract in England to help the company manage and improve outcomes across the high-risk populations it serves. That’s on top of LumiraDx’s contract with the National Health Service, the national payer for England, to join up health and social care data for the entire population of greater Manchester, affecting 2.9 million lives. Another contract with a major corporation will soon bring LumiraDx into 12 more countries in Western Europe and Scandinavia. And other agreements are in the works, including in the U.S. market.


“We’re a grown-up startup,” Nagpal asserts. “I hope we never stop thinking of ourselves as a startup in many ways, because that mindset gives us the agility, speed, innovation and creativity that I value so much. But our software platform is now in its fifth generation and it’s been proven and tried in the market with real customers pushing its boundaries to the point where its flexibility, usability, and scalability are market-defining. And our credentials around precision diagnostics are second to none.”


So who exactly is LumiraDx’s market? Nagpal outlines three categories of buyers for their population-health offering:


• Providers that have figured out that a focus on improving outcomes is the only path to surviving and thriving in the new emergent models of care.


• Payers, both private and public, that have taken on an active role helping their members create those kinds of outcomes.


• Employers who might be self-insured, acting as payers with a vested interest in helping their employees live healthier lifestyles and achieve better productivity and outcomes because of that.


LumiraDx, Nagpal says, aims to go beyond, say, a simple glucose test at home.


“We are taking point-of-care and home testing to levels that have not been seen in the industry yet. We’re able to measure more advanced and actionable indicators of chronic disease. We’re able to reach deeper into a patient’s health status and therefore provide more targeted interventions, proactively, before higher acuity arises.”


And clinicians are deeply involved in every aspect. “We’re doing this with patient consent, under the supervision of their physicians, collaborating with them so that there’s a joined-up care plan,” Nagpal says. “We’re breaking the silos down, rather than creating yet another one.”


The importance of physicians and caregivers in Nagpal’s world comes from his father, who is an MD. “If I go back in time, my interest in healthcare really did arise from being fascinated with what my dad does,” he says. “He evolved from being a doctor to managing hospitals to being involved with the public health status of large populations. I grew up in these organizations.


“I’ve seen a similar evolution in my career along the way. If I weren’t doing what I’m doing today, I actually would love being a doctor.”


As an entrepreneur, Nagpal bears the influence of another leader, Steve Jobs, for whom he consulted when Jobs was creating NeXT in between his stints at Apple. Nagpal is perhaps more low-key than Jobs but earnestly wants his products to become nothing less than an omnipresent strand in the fabric of healthcare.


Nagpal says the value he brings to LumiraDx is a vision for giving patients and their caregivers “a seamless user experience” that isn’t tethered to the boundaries of a health system and simply lets them go about their daily lives as LumiraDx works unobtrusively in the background. “I’m helping create products that just blend into the woodwork of daily life, into routine clinical practice, even though there’s tremendous change that these things are causing, and massive complexity that we are masking.”


The path from a driven, college-age CEO to his current role has been a journey in leadership, Nagpal says.


“Leadership is both about leading and but also massively about enabling people you work with to also lead,” he says. “It’s not a cult of personality; it’s a team sport. If I had to make a choice between trying to do it all myself or doing it with people who have an incredible pool of knowledge, experience, talent and leadership, it’s a very simple choice.


“We are able to go much further as a team of leaders than I could ever have possibly imagined doing myself.”



Revisiting the Top 25: Leon Clark helps guide the transformation of Mayo Clinic

By | September 28 th,  2016 | Top 25 Minority Executives in Healthcare, chief administrative officer, integrated medical group, Mayo Clinic, Modern Healthcare, transformation, Blog, leadership, mentor, Leon Clark | Add A Comment


Classic content: One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.


For many years, Mayo Clinic has been arguably the leading brand in patient care. But as it has evolved over the past two decades, Leon Clark has had a hand in the transformation process.


He’s now chairman of the research administration department, where he’s in charge of a $675 million operating budget. When he joined in 1997 after stints at Ameritech and American Express, he was a unit manager in accounting. Clark has had a steady rise at Mayo, and he remembers the smart evolution of a respected American institution.


“At that time, Mayo started to realize that, if it were sustain its full tripartite mission – practice, education and research – that it would need to diversify its activities and generate income from sources other than just practice,” he says.


Among Mayo’s purchases back then were a continuing care retirement community that included retirement homes and skilled nursing facilities, and a medical transport company. Clark joined Mayo to help the controller align and assess the diverse businesses.


That led to opportunities to become the operations director of Mayo’s health plan and third-party administration operation and the chance to run the OB-GYN clinical department at Mayo. Over the last decade, working in research at Mayo, he is helping to engineer another round of reinvention.


“We’ve started to reposition research at Mayo to be more aligned with a traditional R & D operation,” Clark says. “One of the challenges for academic medical centers is, how do we reposition research assets to drive transformational change in patient care? So what we have are scientists who, in many cases, work in university environments where the incentives are misaligned with the goals of the clinical practice.


“They’re rewarded based on grants and publications, and not necessarily on improvements in patient care or creating products and services that advance patient care and differentiate the operation.”


So what Clark and his team are doing is looking at Mayo Clinic through a completely different lens.


“My physician partner and I approach it from the perspective that Mayo Clinic is an integrated medical group practice first,” he says. “Our research and educational activities essentially underpin the practice and we are creating new capabilities that will contribute to the advancement of patient care and ultimately differentiate Mayo in the marketplace.”


That’s an important distinction in the post-Affordable Care Act era.


“As healthcare payment reform takes shape, there’s a greater likelihood that many patients who would benefit from care at Mayo would be locked out due to a narrowing of their network or for other reasons,” Clark says. “So what we have to do is create compelling and differentiating capabilities that will inspire people to come out of their network and seek care here because, in my view, they’re going to be better off in the long run.”


Clark is glad he himself came to Mayo himself almost 20 years ago. He credits former chief administrative officers Jeffrey Korsmo, now the CEO at Via Christi Health in Wichita, Kan., and recently retired Shirley Weis for being invaluable mentors in his leadership journey.


“Early on in my career, Jeff took an interest in me personally and wanted to make sure I had a successful career at Mayo,” he says. “But the other thing he did for me was to run interference for me when I needed it and to point out landmines when he knew I was on a path that would probably lead to me stepping on one. I found out after the fact that he had conversations with other leaders about me as well.”


That was crucial, he says, because diverse executives don’t always get second chances after they’ve made a mistake.


“All of us make mistakes in our careers,” he says. “In fact, I worry about people who don’t make mistakes because that means they’re not stretching enough to make a difference. Our industry needs folks who are innovative and who think transformationally. That might lead to making mistakes and the question is, how do we recover? If you’re a member of a minority group, historically, it’s been more difficult.”


Mayo is a big company ($8 billion) but a small community. It’s governed primarily by committee, and some of that work allows executives to expand their exposure to the entire organization and to get involved in things that aren’t necessarily part of their day-to-day purview. In that setting, relationship management is important, and Clark says that is one reason he has flourished there.


“People know me, and they know I’m well-intentioned,” he says. “So even if I step on a landmine, I tend to get a little bit of grace.”
He’s committed to passing that on.


“I think it’s an obligation of every leader to identify, coach and mentor the next generation of leaders, so I’ve been very intentional and active around that,” Clark says. “The demographics are changing – Mayo wants to serve every patient who benefits from our care, and those people are increasingly diverse. We want to give them the full Mayo experience. So how can we do that? We need to diversify our employees so we can better understand our patients and serve them better.”



Medical care is only part of the solution to health disparities

By | August 24 th,  2016 | Healthcare, public policy, Top 25 Minority Executives in Healthcare, Modern Healthcare, safety net, Atlanta, Blog, CEO, diversity, Duke University, Harbor-UCLA Medical Center, health disparities, leadership, public housing, safety, Alameda Health System, quality | Add A Comment


Delvecchio Finley doesn’t shrink back from a challenge.


That’s one of the reasons his last two jobs have been leading California public health organizations with different but significant issues. But as he surveys the changes needed not only within his own health system but throughout the nation as a whole, he is adamant that healthcare is only part of the solution for what ails the U.S.


“Even though access to care and the quality of care is important, access to stable housing, food sources, education and jobs play a greater influence collectively on our overall health,” says Finley, CEO of the Alameda Health System. “I think the evolving research in the field is making it a lot more evident to all of us that those issues are significant social determinants of health.”


The interconnectedness of all those factors makes health disparities harder to eradicate, Finley says, but one way to begin is to address the lack of diversity in healthcare leadership and the healthcare workforce as a whole.


“Making sure that our workforce is representative of the community we serve – that people who are coming to us for care aren’t just the recipients of that care but can also play a major role in providing or facilitating that care – is what starts to provide access to good jobs and stable housing, and in turn begins to build a good economic engine for the community.


“Thus, you’re reinvesting in the community, and that’s how we start to get at the root of this and not just through the delivery of the services.”


Finley has some life experience along those lines. He grew up in public housing in Atlanta, where access to healthcare was poor even though the actual care was excellent when he and his family received it. In his neighborhood, he says, the three fields of employment that offered paths to upward mobility were healthcare, education and law enforcement. He was a strong student, and enjoyed helping people, so he was eyeing a future as a physician during his undergraduate years at Emory University, where he earned his degree in chemistry.


“Upon finishing my degree, I realized that I loved science but wasn’t necessarily as strong in it as I needed to be to become a doctor,” he says. “But I still loved healthcare and wanted that to be something I pursued.”


He explored other avenues and ended up earning his master’s in public policy at Duke University. Finley was the first member of his family to graduate from college and to get a graduate degree as well, but not the last, he is quick to point out.


“The thing that I’m most proud of is that, while I was the first to graduate from college, that achievement has set a path for my cousins, nieces and nephews, who have continued to shatter that ceiling for our family.”


He says it was also within his family – and within public housing – where he first began learning leadership skills that would result in him becoming one of the youngest hospital CEOs in the country.


“I spent a fair amount of my childhood being raised by my aunt, and she was a force of nature,” Finley says with a laugh. “She served as president of the tenant association and she used that position to strongly advocate for reasonable services and humane treatment for people who were in a very challenging circumstance. I learned from her that we have a responsibility to use our gifts – and to use our voice and our station in life – to help people.”


That was certainly the impetus for taking the helm at both Alameda and his previous post as CEO of Harbor-UCLA Medical Center.


“Both of them are safety-net organizations that serve a disproportionately underserved community,” Finley says. “That resonates with me from both a personal and professional standpoint. They have both provided a chance to work with a team to get our hands around some of these issues because of the very important work and role that these organizations play in their communities.”


At Harbor, the bigger challenges were regulatory, not having good, documentable evidence of the quality and safety of the care that was being provided, “which we were able to fortunately surmount and proceed from there,” he says.


The difficulties that Finley and his team at Alameda have had to address are different, he says. “A lot of it was short-term economic hardship combined with the growing pains of going from a historical health system that had grown exponentially through recent acquisitions of two community hospitals. We’re just beginning to stabilize and right-size the ship.”


The elements for achieving lasting change, both for the health system and the community, are within reach, he says. Alameda’s skilled nursing facilities recently outperformed a lot of private organizations in earning a 5-star rating from CMS, something Finley hopes can be replicated systemwide with a new strategic plan that promotes greater “systemness” and a focus on access, quality, patient experience, and innovative approaches to care delivery.


Alameda Health System is also a benefactor of the a state Medicaid Waiver called Medi-2020, which is a partnership between CMS and the State of California that aims to promote continued transformation of the safety-net delivery system for Medi-Cal recipients. And, internally, Finley plans to bring more Lean management processes to Alameda in the next fiscal year.


He had begun to explore Lean several years ago when he was at Harbor-UCLA. He and leaders from a number of systems – including Alameda – took trips to watch Lean in operation at ThedaCare in Wisconsin, Virginia Mason in Washington, and Denver Health in Colorado.


“I appreciated that Lean wasn’t just a performance improvement methodology and the flavor of the day, but it was an operating system,” he says. “I think my other takeaway from the trip was that Lean is very hard to do. You’re going to have fits and starts, but if you commit to it, it can lead to some very transformative outcomes for your organization and for the community you serve.”


Transformative outcomes? Finley personally knows a thing or two about that.



Debra Canales strives to put people first in the mission of healthcare

By | August 17 th,  2016 | Debra Canales, Top 25 Minority Executives in Healthcare, Catholic healthcare, chief administrative officer, executive vice president, integrated talent, Modern Healthcare, Providence Health & Services, taking risks, women leaders, Blog, chief people and experience officer, diversity, human resources, leadership, medical assistance, mission, Trinity Health | 1 Comments


One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.


Shortly before making the move into faith-based healthcare, Debra Canales remembers giving her former boss the business book “Jesus, CEO” by Laurie Beth Jones. He was grateful for the gift – but hid it in a brown paper bag.


“He didn’t feel safe,” Canales remembers now. “It was a pretty revealing moment.”


Years later, Canales is earning bouquets of accolades for her bold, holistic leadership at Providence Health & Services in Seattle, where the spiritual aspect of healthcare and work is welcomed as a natural byproduct of being human.


“What continues to draw me to healthcare is being able to bring my whole self to work as I center myself and think about a bigger purpose,” she says. “Leadership is not just from the neck up.”


Canales’ heartfelt worldview is expressed in very tangible ways at Providence, where in just two years as executive vice president and chief people and experience officer she helped achieve a 50 percent increase in women in senior leadership roles. She also led efforts to provide monetary assistance for employees coping with the high cost of healthcare premiums.


“I came to Providence because, when I talked with Rod Hochman (Providence’s CEO), he put people as the number one pillar of his strategic plan,” she says. “That was significant. It was a deeply rooted commitment, and part of that was shaping our talent strategy to be reflective of our communities.”


The medical assistance program offers free or reduced premiums tied to household income and the federal poverty level. Caregivers (which is what Providence calls all of its employees) who are at less than 250 percent of the federal poverty level pay no premiums or deductibles and are given seed money to cover out-of-pocket costs. Employees at 250 to 400 percent of the federal level get a 50 percent break on coverage.


“When we think about extending and revealing God’s love to the poor and the vulnerable, we need to take care of our own and extend that compassionate service to them as well. There has been an outpouring of gratitude and support, especially from a lot of single mothers and fathers,” Canales says.


On the practical side, she’s seeing reduced turnover levels as staff members choose to stay, as well as the highest level of employee engagement and satisfaction in a number of years.


“It goes back to our integrated talent strategy – we want to lift up our people as one of the most important elements in how we extend our mission,” she says, “We want to continue to build those enduring relationships with our caregivers and take care of what’s important to them so that they can, in turn, extend that experience to all who come through our doors.”


The mission of Providence is key to Canales’ passion.


“Mission is the number one factor for us,” she says. “In our engagement surveys, people say that is what brought them here and what keeps them here. It’s that yearning for something more in terms of spirituality and connectivity – the charisms of mind, body and spirit. That is certainly what differentiates us from a Fortune 50 company.”


Before she became a respected leader in healthcare, Canales had plenty of experience among such corporate heavyweights. She rose through the ranks as a human-resources executive in retail (R.H. Macy’s Inc.), food service (Yum Brands/PepsiCo), and high-tech (Hewlett Packard/Compaq). She moved into healthcare with Centura Health, then spent more than 10 years at Trinity Health, where she rose to chief administrative officer.


She’s become known for leading the charge to make human resources valued as a strategic partner for CEOs, for positioning corporate cultures for change management, and for facilitating resiliency. Yet while taking risks has paid off for her, it was not easy, she allows.


“A lot of my movement in my career has been to volunteer for the opportunities no one wanted to take,” she says. “I’ve worked for some very strong, driven bosses. I was always trying to work toward a shared understanding – that’s been my whole approach throughout my career.”


It’s an approach some would call courageous. In that, she says, she was influenced by her Aunt Trini, the sister of her grandfather, who was the provincial of a convent – a religious woman who had a lot in common with the Sisters of Providence, who began the health system where Canales now works.


“I keep her picture near me as an inspiration,” she says. “When things are hard, I look at her photo and it gives me that confidence to do what’s right. One of my hallmark traits is standing on principle. That’s not always been popular. But for me, that conviction and integrity gives me confidence and self-assurance.”


Canales says the woman she was in her 20s climbing the corporate ladder is far removed from the peace she now experiences, influenced not only by Catholic faith but also by the teachings of Buddhist nun and author Pema Chodron.


“Back then, I couldn’t take as many risks,” she says. “I could not be as vulnerable as I wanted to be. I followed the success pattern to get promoted and, for me, that was what was more important at that time. It was not always authentic. That’s not who I am now.


“In the long run, my wholeness is what I value. It’s a freeing sensation to be able to live life in this way, and to help set others free as well gives me such joy.”



A sense of mission drives Ketul Patel at CHI Franciscan Health

By | August 10 th,  2016 | CHI Franciscan Health, chief executive officer, Top 25 Minority Executives in Healthcare, Hackensack University Medical Center, health system, Kenya, Modern Healthcare, SafetyFirst Initiative, Blog, Catholic faith, Catholic Health Initiatives, clinician, collaborative, leadership, mission, safety, Ketul Patel, patient experience, quality | Add A Comment


One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.


Every month or two, CEO Ketul J. Patel journeys to the convent where the Sisters of St. Francis live and spends some time with the religious women who provide the missional context of the organization Patel leads, CHI Franciscan Health in Tacoma, Wash., part of the Catholic Health Initiatives system.


“I leave energized every single time I go there because of the amount of passion they have for this organization,” he says. “I have always felt that faith-based organizations have an extra touch of focus and mission than others. I couldn’t have asked for a better set of sisters to work with.”


Patel was raised in the Hindu faith but went to Catholic grade schools and high school growing up in Johnstown, Penn., 60 miles east of Pittsburgh. In an earlier role, he also worked for several years at a Catholic hospital in Chicago run by another group called the Sisters of St. Francis, this one based in Indiana.


“The Catholic faith has made a pretty substantial imprint into not only my career, but my life,” he says. “It’s given an extra allure to this type of organization for me.”


It’s also given a sense of urgency to the strides Patel hopes to make in reshaping CHI Franciscan and the other CHI hospitals he oversees as senior vice president of divisional operations for the Pacific Northwest Region. His goal, he says, is to have a top-performing organization with a mission-based focus on quality, safety and patient experience.


“We want to have a system of the most talented providers and innovative services in the Pacific Northwest,” Patel says. “Because of that, we just went through a significant structural reorganization to focus on those areas.”


Chief among the changes is the SafetyFirst Initiative, what Patel calls “a system-wide effort aimed at eliminating all preventable safety events.”


“We’ve branded it throughout the entire CHI system, and we’re seeing declines in serious safety events at all of our hospitals that have implemented SafetyFirst. It’s something our clinical staff is very proud of.”


The sense of service that Patel believes is a necessity for healthcare leaders comes from his parents, he says. Patel was born in Kenya, as were both his parents. His father is a retired physician. His mother, who passed away last year, was a nurse.


“When my father was practicing in Kenya, he would take my mom, brother and me to some remote areas of East Africa and provide care,” Patel remembers. “A lot of it was done under the umbrella of what was then the Lions Club.


“I have some very vivid memories – people who were missing hands, people with significant diseases with no access to care. The impact of that was substantial and that’s what prompted and inspired me to get into this type of role.”


His family moved to the U.S. in 1979 when Patel was eight. His brother went into medicine – he now heads cardiac surgery at the University of Michigan – and Patel started pre-med courses to head down the same path at Johns Hopkins. He also took a job as a research assistant to Nobel laureate Christian Anfinsen and, while it was a wonderful experience, he says, he couldn’t summon the same enthusiasm for it that he had for a couple health administration classes he took. He was reluctant to tell his parents he didn’t want to be a clinician.


“I thought it was going to be one of the toughest conversations I ever had with my father,” Patel says now, chuckling. “Instead, my father said, ‘We’ve been waiting for you to say this. All these years, we didn’t think you wanted to be a doctor.’ ”


The move to the administrative side has been a good fit. Patel got his first VP role at 26 and hasn’t looked back. He came to CHI Franciscan from Hackensack University Health Network and Hackensack University Medical Center in New Jersey, where he served as executive vice president and chief strategy and operations officer.


Patel says his leadership style has evolved in his 20 years in administration. “You have to be a born leader, to some extent, but I think your leadership style and your abilities change as you are exposed to different areas and experienced with varying challenges.”


But one absolute imperative, he says, is to be a collaborative leader.


“People support what they help to create,” he says. “If a staff member feels they’re part of a decision-making process that is helping to move the organization in a certain direction, they’re going to unite behind that.”


He says he especially loves the ideas that come from clinicians. “They’re the ones who are at the bedside.”


Besides, he says, his parents always loved to tease him about the importance of the front-line staff.


“I’d be on the phone with them and my dad would say, ‘By the way, just remember that the only reason you have a job is because doctors bring patients to your doorstep.’ Then my mom would get on the phone and say, ‘Don’t listen to your dad. The only people who know what’s going on with the patients are the nurses.’


“I give them a lot of credit for that.”



Gene Woods' influential leadership poised to enhance Carolinas HealthCare System

By | July 27 th,  2016 | American Hospital Association, Top 25 Minority Executives in Healthcare, ACHE, governance, healthcare disparities, Modern Healthcare, Blog, Carolinas HealthCare System, CEO, Christus Health, diversity, Equity of Care Committee, Ernie Sadau, Eugene Woods, Gene Woods, leadership, National Call to Action, safety, quality | 1 Comments


One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.


It’s the little things that tell you a lot about people.


After CHRISTUS Health nominated Eugene “Gene” Woods, its chief operating officer, for Modern Healthcare’s Top 25 Minority Executives in Healthcare awards, the respected executive took a position as president and CEO of Carolinas HealthCare System. But when Woods was presented the award at a Chicago banquet six months later, two tables of CHRISTUS people, including President and CEO Ernie W. Sadau, flew in to show their appreciation to Woods. It was a classy move that revealed volumes about the character of both CHRISTUS and Woods.


“CHRISTUS Health was honored to support Gene’s acceptance of this award for the same reason we nominated him—because we firmly believe that his time at CHRISTUS had a positive impact on our ministry,” Sadau says. “Our relationship was truly a symbiotic one, and we wanted to honor that and cheer Gene on to his future endeavors.”


Woods helped lead CHRISTUS’ international expansion, expanding in Mexico, and establishing flagships in Chile and Colombia, where he was able to use his Spanish fluency (his mother is from Spain) to communicate with the teams there.


“I really enjoyed working with Ernie, the sisters and the whole CHRISTUS team,” Woods says. “We were able to diversify the organization and reposition CHRISTUS internationally. But I’ve always had the goal of serving as the CEO for a large nationally recognized organization committed to being a model for redefining healthcare in the next decade. And that is why I am so excited to be leading Carolinas HealthCare System. It has the depth and breadth of capabilities to chart a new course.”


Carolinas is not a turnaround situation. It’s a historically successful healthcare provider and the second largest public healthcare system in the nation, serving patients through nearly 12 million encounters each year. But, during his interview, Woods says board chair Ed Brown quoted the famous adage that, “What got us here won’t necessarily get us there.”


Woods says his opportunity is to inspire his Carolinas team “to set a bold agenda for change that outpaces the industry and brings true value to individuals and communities.” In so doing, he says, he’ll be following in a tradition of innovation at the system.


“What I appreciate about Carolinas is that there have been a number of pivotal crossroads in our history where leaders could have tried to hold onto the past. Instead, they took the risk of reinventing the organization, and that’s really the reason it’s been so successful.”


Success in leadership has been a staple of Woods’ storied career, from serving as president of the ACHE club at Penn State University, where he earned both bachelor’s and master’s degrees, to his positions with the American Hospital Association, where his term as chair begins in 2017 and where he also serves as chair of the Equity of Care Committee.


But his interest in healthcare actually stems from two childhood incidents that showed him both the promise and the challenge of the healthcare industry.


When he was 10 years old, he was with his mother, sister, aunt and uncle in a car that slammed into a brick wall at a high rate of speed.


“Miraculously, we all survived,” he says. “I don’t remember the impact. I just remember that, as soon as the accident happened, it seemed like everybody was instantly there to care for us. It was just an amazing moment.”


A later encounter with medical care ended tragically.


“One of my aunts died in a hospital of a medication error. She had three young children,” Woods remembers. “It was something that could have and should have been avoided. To this day, I think about what life could have been like for her kids if that didn’t happen to my Aunt Carmen.”


Thus, patient safety has been a key priority for Woods throughout his career—in fact, his first management job in a hospital was as a director of quality. He recognizes the industry still has a long way to go on that front but says the latest AHA statistics show the trends moving in the right direction. Between 2010 and 2014, the AHA says hospital-acquired conditions decreased by 17 percent, saving 87,000 lives and $20 billion in healthcare costs.


“The goal is to reach zero harm, and I believe the field is on the right track in that regard,” he says.


While he also believes much progress is being made in diversifying senior leadership in healthcare, he’s very firm on how that needs to become a bigger priority at the board level.


“Our boards do not reflect the communities we serve,” he says flatly. “One of the biggest levers in diversifying an organization is when the board declares that it’s a priority. That was done at CHRISTUS and again here at Carolinas. I think it is an obligation of governance.”


What gives him optimism is the work of the AHA Equity of Care Committee, where it’s been demonstrated how diversity leads to improving healthcare disparities. In fact, more than 1,000 health systems recently signed the AHA’s National Call to Action pledge to eliminate disparities. Woods says the goal this year is to have 2,000 systems sign the pledge.


“That pledge includes improving collection of race, ethnicity and language preference data so, as we’re studying disparities in care, we have the right data set to use for that,” he says. “The pledge also includes increasing cultural competency training and increasing diversity in governance and leadership. You can’t solve for population health issues without solving for the disparities in care that exist and, in some cases, very dramatic disparities.”


After many years as a leading voice in healthcare, Woods remains bullish on where the industry is headed. In a recent talk to students at his alma mater, he told them the opportunities are brighter than at any time in recent memory.


“It’s an exciting time to be in healthcare because, in some respects, we’re all learning together,” he says. “Young people have an opportunity to bring an innovative spirit to their careers. But we can never forget that it’s about patients and communities. If you’re in it for those reasons, you’ll be successful.”



Patricia Maryland: Taking risks helps leaders grow

By | July 8 th,  2016 | Affordable Care Act, Patricia Maryland, St. John Providence Health system, Top 25 Minority Executives in Healthcare, C-suite, Modern Healthcare, risks, Ascension, Ascension Health, Blog, CEO, chief operating officer, diversity, leadership, Sinai-Grace | Add A Comment


One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.


Patricia Maryland is talking about her role as chief operating officer for the Ascension Health system, but her message seemingly echoes the philosophy of her entire career: to grow, you must take risks.


“A major part of my role is leading through change,” she says. “The healthcare industry is going through tremendous transformation which requires leaders to challenge the way we deliver care.”


While Maryland has been honored with a number of awards during the four years she has served as COO and president of healthcare operations, she says the arduous role that preceded her promotion stretched her in ways that made her current success possible.


In 2007, Ascension asked her to leave St. Vincent Health in Indiana and move to Detroit to become the CEO of St. John Providence Health System and Ministry Market Leader for Michigan. The recession was just getting started; General Motors and Chrysler were restructuring their debt through bankruptcy. The economic pain that Detroit became famous for was just taking shape. As a result, St. John was hurting too.


“That was the most difficult time,” she says. “A number of our patients who were formerly employed ended up losing their insurance. We had to close hospitals. We had to consolidate programs and centralize services, and that was very risky. I had to lead through the change of reconfiguring the health system to create long-term sustainability given the external factors impacting the region.”


It was a difficult professional time. But on the personal side, Maryland says she was taking a risk there as well. “My daughter was going into senior year of high school; my son was going into eighth grade. My husband was transitioning his career as well. I knew I had to make sure my family was settled and comfortable back in Michigan after having been away for 4-1/2 years.”


Looking back, Maryland says the sizable risk proved to be more than worth it.


“When I took on the role in Michigan, it was larger and more complex than my previous role, and I was further challenged because it was during the worse of economic times. But I felt like I grew so much from a professional perspective. That role really provided me with the experience I needed to prepare for my current role as chief operating officer. If I didn’t have that kind of experience in leading through change, I don’t think I would be as effective in my role today.”


With success comes confidence, and Maryland is utilizing her voice as one of the most powerful healthcare executives in the country to take aim at healthcare disparities. Through a series of op-eds she’s written, she is candidly and forcefully encouraging healthcare organizations and patients to build on the momentum created by the Affordable Care Act and work toward equity of care.


“Part of what spurred this outreach is that the African-American community has really embraced the ACA,” she says. “I think we’ve made some great progress to expand healthcare access for many minority populations, but we know that coverage alone is not enough to eliminate healthcare disparities.”
To truly be effective, Maryland says, healthcare organizations need to help patients navigate health systems that can be difficult to utilize.


“We must mobilize the newly insured to connect them to preventive care,” she says. “It’s really important that we get them into the appropriate setting right from the beginning. If you can get into a system early enough, see a primary care physician on a routine basis, and comply with your medication requirements, you can have a better outcome.”


Maryland is seeing this prescription for good health lived out in her own family. As the oldest of eight children, she was the primary caregiver for her mother, who passed away from diabetes complications at an early age. Three of her siblings are genetically predisposed to diabetes as well, and they and Maryland are determined that their outcomes will be different.


“They’re working hard to stave off diabetes,” she says. “They’re exercising, following and complying with their medication regimen, and keeping their weight under control. They’re taking personal responsibility to do what they need to do to stay healthy.”


Not every family, of course, has an executive like Maryland to be its advocate. That’s one reason why Maryland also has long been a champion of diversity in the C-suite.


“We definitely need to address the pipeline issues of finding more individuals who represent the type of patient we are treating within our organization,” she says. “But it’s also making sure that those who are in leadership roles have the cultural competency to be able to manage populations to which they are providing care.”


Such leaders, though, need to have the attributes of servant leadership, Maryland adds.


“The nature of our work requires humility,” she says. “The fact that we are taking care of people at their most vulnerable state, when they are entrusting their lives to us, requires a different kind of leader.”


Maryland says her mentors Tony Tersigni (President and CEO of Ascension) and Bob Henkel (President and CEO of Ascension Health) have been her role models for servant leadership. In fact, it was Tersigni who identified her as a potential CEO leader within Ascension after observing her leadership style at DMC Sinai-Grace Hospital. Sinai-Grace also was where she’d unknowingly caught the attention of authors James Kouzes and Barry Posner, who ultimately featured her in their book “The Leadership Challenge” because of the work she did in transforming Sinai-Grace by challenging the process of how care is delivered. During this time, she was able to effectively garner the support from the Jewish community to assist in the transformation.


“You never know who’s paying attention to you,” Maryland says. “So always do your best – and do it with grace.”



Strategic excellence is Tauana McDonald's calling card

By | July 1 st,  2016 | change management, Top 25 Minority Executives in Healthcare, bundled payments, C-suite, Catholic healthcare, electronic health records, IBM, ICD-10, Modern Healthcare, Rometty, Tauana McDonald, Blog, leadership, Trinity Health | Add A Comment


One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.


She paved the way for the ICD-10 project at Trinity Health in Michigan. She led the move to electronic health records. She mastered meaningful use. Now, she’s wrapping up bundled payments.


If you need a major project orchestrated correctly at Trinity Health, you inevitably turn to Tauana McDonald, senior vice president of clinical business operations for the Catholic health system.


“I know that I am not a clinician,” she says. “I identify the strategy needs and develop the plans. I lead the work from the corporate office so our clinicians don’t have to focus on operational issues and they can do the work they do best, which is taking care of patients.”


From the standpoint of organizational mission and personal satisfaction, it’s a role that McDonald says is a good fit for her.


“I think some of the projects I lead are making very positive change,” she adds. “That’s how I get to impact both the patients and the caregivers.”


McDonald came close to becoming a physician herself. Both of her mother’s sisters were nurses – one in the operating room and one in pediatrics. She remembers them both as being very nurturing people.


“People in the community looked to them during their most vulnerable times and there was something about that quality that really appealed to me,” she says.



So she completed four years of college as a pre-med, but the doubts about whether it was a good fit for her intensified as she sat down to apply to medical school.


“I called my parents and said, ‘I don’t think I want to be a doctor.’ And they said, ‘That’s fine. You just need to do something that is going to make you happy and contributes to society.’ ”


Giving back is a crucial part of McDonald’s ethics, a trait that she says was instilled by her parents. “In our household, we were always taught to serve because we were blessed and we should use our gifts and talent to help other people,” she says. “I thought healthcare was a great way to do that.”


After deciding to pursue a different future than medicine, she enrolled in the University of Michigan graduate school, where she earned a master’s in health administration. “From the first day in the first class, I knew I had landed in the right spot for me. That’s what got me started on my healthcare journey.”


Her path had several key stops along the way – IBM, where she was hired by future CEO Ginny Rometty; Deloitte, where she spent seven years doing strategy and operations consulting with healthcare organizations around the country; and motherhood – she stayed home for several years after her children were born.


The traveling that came with the Deloitte job was more than she wanted as she balanced family responsibilities, but her former employer Deloitte helped her find a good match at Trinity Health, where she gravitated to the system’s mission that echoed her mother’s advice that “to whom much is given, much is required.”


“A few days after I joined Trinity Health, I was in a meeting and we had to make a tough decision,” McDonald remembers. “The CEO leading the meeting said, ‘Can we bow our heads in prayer? Lord, let us put the patient first and ourselves last. Let us do the best thing for our patients.’ At that moment, I understood what it meant to be part of a faith-based organization. It really resonated with me. It still does.”


She says she also appreciates the diversity of the ministries that Trinity Health offers.


“If there is any kind of work you want to do in healthcare, you should be able to do it at Trinity Health,” she says. “Because we’re so big, there are so many different experiences. If you want to work in a large urban environment or an academic setting, you can work with our Loyola system. If you want to work in a small space, you can do that too. If you are interested in advocacy, we have a huge advocacy team.”


The diversity of the staff is of utmost importance to McDonald as well.


“Developing diverse leaders is really my passion, and I am intentional about it every day, looking at people in our organization who have a lot of talent that other people may not see right away,” she says.


“I believe that having a diverse workforce as well as a diverse leadership team helps us serve our patients better, because we’re bringing those same perspectives. We look like the patients we serve.”
As healthcare continues to evolve, the need for new ideas is critical, and a diversity of experiences can catalyze that, McDonald says.


“I take every opportunity that I can to help people with different perspectives share their voice and get a place at the table that allows them to do that.”


As the leader of so many key initiatives at a major American health system, McDonald is highly sought after as a mentor. Yet she says many of her key takeaways in leadership come not from another healthcare executive but from Florence Ferguson, her 102-year-old grandmother.


One key lesson Ferguson taught her repeatedly was, “You need to begin with the end in mind.”
“She said that a lot,” McDonald recalls. “She said that you need to think about where you want to end up because, as you’re going down that path, you need to be very thoughtful in order to get the results you want.”


Ferguson’s other key concept echoed the best leadership experts in her own less-fancy words.


“We always hear people talk about the shadow of the leader,” she says. “In her words, my grandmother would say, ‘Tauana, your actions are speaking so loudly that I cannot hear your words.’ If you speak things and your actions go in a different way, I don’t think you’re credible as a leader. So I try to have my actions support what I say – and I learned that from my grandmother.”



BCBSA's Trent Haywood: Clinical executives essential in move to value-based care

By | June 24 th,  2016 | Blue Cross Blue Shield Association, chief medical officer, Community Health Management, population health, Top 25 Minority Executives in Healthcare, Trent Haywood, Modern Healthcare, Blog, Centers for Medicare and Medicaid Services, health disparities, healthcare costs, leadership, physician executive, Lawton, VHA | Add A Comment


One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.


Trent Haywood has multiple titles after his name – an MD as well as a JD. But to find respect and cohesion among his leadership-team peers as he moved into a role as a physician executive, he says his biggest lesson was to check his degrees at the door.


“Someone gave me advice early on that, if you’re going to transition away from the bedside, you have to become comfortable no longer being called ‘Dr. Haywood’ but just ‘Trent,’ ” says the chief medical officer of the Blue Cross Blue Shield Association. “Being viewed as ‘the doctor’ has great social capital, but it prevents other executives from really getting to know you and sharing with you as a peer.”


But make no mistake – Haywood says he believes that more clinician executives are needed precisely because of their unique qualifications to bring the value to value-based care and to balance patients’ needs and concerns with healthcare finances.


“The business is evolving,” he says. “The model used to be ‘the suits and the scrubs.’ The suits did their thing, and the rest of us in scrubs did our thing. It was very siloed, and as long as you stayed on your side of the fence, it worked well.


“The model is changing. You have a new generation of clinicians who are going back and getting additional degrees. I think it’s going to continue to be the norm where you’re going to have many more clinicians in leadership roles.”



Haywood says his experience was easier than a lot of physician executives because he was able to wear both hats on a weekly basis for a seven-year period while he worked at the Centers for Medicare and Medicaid Services.


“On the weekends, all I was doing was focusing on individual patients as they came through the door of the ER. Then, during the week, I would be back at CMS flying all around the country trying to make a difference on a national level. My situation was unique; I was fortunate.”


Haywood’s own influences in leadership included his parents. His father Stanley, who recently passed away, had the longest tenure on the Lawton, Okla., city council in history. His mother Charlotte led the young people’s program for many years at the church the family attended.


“I learned early on from my mother that if you want maximum output, you have to take the time to invest in people,” he says. “You also have to delineate which people you are going to invest your time in.”


Haywood’s father coached him in athletics and impressed upon him the importance of teamwork over individual accolades. “If everyone showed up for practice, they were going to get into the ballgame, regardless of ability,” he remembers. “He put the onus on the team to think beyond ourselves and how we were going to approach the game in a team-based manner.”


In the same way, Haywood notes, payers and providers are going to need to work together as a team to help renovate the U.S. healthcare system. As someone who has worked as the deputy chief medical officer for the government (CMS), and chief medical officer for a major provider association (VHA) before coming to BCBSA, he thinks the convergence can’t happen soon enough.


“You’re going to see more and more collaboration across the board within a population-based framework,” Haywood says. “If I want to manage a population, then I need to understand more acutely where that population is going in terms of specialists and which ones are performing better for my population.”


But the talk between payers and providers needs to evolve beyond healthcare delivery, he says. Affordability is critical when many families live paycheck to paycheck with little savings, and that is reflected in BCBSA’s push for transparency in healthcare costs, Haywood adds.


“We don’t want families paying for waste in the system, and so that’s led to the issue of transparency. And the purpose is affordability – how can we make healthcare affordable for a family?”
Haywood has been using BCBSA’s new Community Health Management hub tool to take a deep dive into the data that affects healthcare consumers at the ZIP code level. For example, he recently dug into the statistics to show how something that many people take for granted – access to a car – affects population health, with many people in struggling neighborhoods unable to maintain nutritional health because they lack transportation.


“We need to get into the communities and do a better job of population health at the community level,” he says. “We need to find answers to questions like: What are the characteristics of a population? What are the environments in which we find those populations? And what are the behavior patterns of those communities?”


Like his father, the city councilman, Haywood hopes to make a difference on the local level – by guiding BCBSA policy on a national scale.


“Most healthcare decisions happen outside the four walls of a clinical setting,” Haywood says. “I’m excited that we’re going to transition to more of a preventive healthcare model instead of a disease-based model.”



After a complex merger, Ruth Brinkley works diligently to build a new culture at KentuckyOne Health

By | June 3 rd,  2016 | merger, Top 25 Minority Executives in Healthcare, Modern Healthcare, Ruth Brinkley, Blog, Catholic Health Initiatives, CEO, CHI, diversity, leadership, Louisville | Add A Comment


One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.


Mergers and acquisitions are complicated equations when just two organizations are involved. But three? That’s a daunting challenge for anyone. Small wonder that Catholic Health Initiatives turned to a veteran CEO like Ruth Brinkley to choreograph the complicated venture and lead the new KentuckyOne Health system.


Brinkley, who revamped the sprawling organization to survive and thrive under reform, says the bumps in the road are beginning to get fewer and farther between. “I’m a big believer in culture and the impact of culture on strategy and on building excellence,” she says. “One of the things we have consciously worked on since the very beginning was to shape a desired culture. I would say we’re 60 to 70 percent of the way there.”


KentuckyOne Health is comprised of the former Saint Joseph Health System, the former Jewish Hospital & St. Mary’s HealthCare, and the University of Louisville Hospital and James Graham Brown Cancer Center. It is a complicated arrangement. Catholic Health Initiatives is a majority owner of KentuckyOne. The other owner is Louisville-based Jewish Heritage Fund for Excellence. But the individual hospitals that were Jewish hospitals are still Jewish; the Catholic ones are still Catholic; and the university hospital remains secular. The partnership with the university was held up by former Kentucky Gov. Steve Beshear, who initially challenged a full three-way merger over concern that the public university hospital would be required to follow the Ethical and Religious Directives of the U.S. Conference of Catholic Bishops. And that, in turn, slowed down the process and the culture work by about a year.


Daunting? Absolutely. But Brinkley’s eyes were wide open from the beginning.


“I did expect this to be a big job, a big bite, so to speak,” says Brinkley, who left Carondelet Health in Tucson, Ariz., to return to Louisville and CHI. “I believe in the merger, in the vision of what we set out to do. When the days or the issues get tough, I go back to the belief in that vision.”


Brinkley had already achieved much in her career as a CEO and a lauded leader in Catholic healthcare for many years. Her resume was full. But the prospect of the merger energized her, moved her geographically closer to her children and grandchildren, and brought her back to her what she calls her extended family at CHI.



“The real draw was the excitement of the vision for this merger and what it was to accomplish. And it felt familiar. It felt good coming back to CHI. It’s always been a wonderful place to work. You see the mission come alive, and you see the values in people’s hearts.”


While the work of the merger more than filled her days, and many of her evenings, it was a temporary diversion from a personal tragedy.


“I had experienced a big loss in my life; my husband passed away when I was in Arizona,” she says. “Time is a great healer and work is a great healer, if you use it correctly. But I will also tell you that we all eventually have to pay the debt of grief. I like to say that grief can be delayed, but it won’t be denied. The work gave me something to focus on, but we each have to go back and deal with the issues we need to deal with, and I did that as well.”


Brinkley’s career has taken her from rural Georgia, where her grandparents raised her, to urban Chicago as a student and a nursing leader, to a number of other settings. So she is well-versed in the many types of populations that KentuckyOne serves, from Appalachia to Louisville. “The needs are very different across the state,” Brinkley says. “We try our very best to represent and reflect the communities we serve.


“We know that healthcare does not begin and end inside the walls of a hospital, so we’ve developed outreach programs to decrease the use of the emergency room for routine care, and to decrease readmissions. We’re starting to focus more on the social determinants of health.”


Brinkley says she learned many key lessons on leadership from her grandmother, who encouraged her to become a nurse, as she was growing up in Georgia – in fact, in 2009, she wrote a children’s book called “Grandma Said” to honor the woman who shaped her early life. But in Georgia, Brinkley also saw the sad results of those aforementioned social determinants, as family and friends dealt with suffering brought on by health disparities. Thus, she makes it a key priority to move her organizations upstream into the communities whenever possible.


“We know that a hospital only impacts 20 or 25 percent of health status,” she says. “The rest are social determinants. So, for example, at our St. Mary’s facility in west Louisville, we are starting a community garden. It’s a somewhat challenged area with a lot of immigrants. The city is leasing us 4 or 5 acres of land. We are going to engage the community and staff and hopefully be able to help people grow their own vegetables, because we had found through our community health assessment that this was a real need.”


Another need that Brinkley has been talking about for a number of years is the push to increase diverse leadership at the highest levels of healthcare organizations. Patients, she says, benefit greatly from diversity.


“It’s where our greatest opportunity is to serve the community,” she says. “It’s so important for our patients to have people in leadership who look like them and can relate to them. We have a lot more work to do, but we’ve made a good start at KentuckyOne.


“You have to let people know through word and deed that you understand their experience.”
With a wealth of experiences to draw from, Brinkley is trying to do just that.