Top Takeaways from Crain’s Hospital CEO Webinar “Health Care Beyond the Hospital”

On December 10, 2020, Crain’s Chicago Business held a virtual Hospital CEO Webinar entitled “Health Care Beyond the Hospital.” The event, which focused on the future of health care delivery in light of COVID-19, was moderated by Stephanie Goldberg, health care reporter for Crain’s Chicago Business, and featured a panel of three health care leaders in the Chicago area: Dr. Suzet McKinney, CEO & Executive Director of Illinois Medical District; Steve Nelson, CEO of the DuPage Medical Group; and Dr. Tom Shanley, President & CEO of Lurie Children’s Hospital. During the webinar, the panelists discussed a wide variety of topics, including the latest Supreme Court challenge to the Affordable Care Act, health equity, the rollout of the impending COVID-19 vaccine, managing the impact of the pandemic on the health care work force, supply chain challenges, health care transformation, and the discontinuation of low-margin services. What follows are the top takeaways from this very interesting and engaging event.

COVID-19

The panelists addressed the rollout of the impending COVID-19 vaccine as well as widespread mistrust surrounding the vaccine. The panel noted that mistrust of the health care system generally and vaccinations in particular is longstanding, dating back to the infamous Tuskegee Experiments in Alabama and Henrietta Lacks who unknowingly donated her cancer cells to medical research decades ago. Mr. Nelson noted that although some may lack trust in vaccines, patients generally place a high degree of confidence in their physicians, so physicians have a unique opportunity to leverage their relationships with patients and communicate the benefits of vaccination in a thoughtful and fair manner. Dr. McKinney said her organization has convened a “Vaccine Corps,” comprised of hospitals, community-based organizations, and nonprofits, whose goal is to train community members to serve as ambassadors for the vaccine in order to dispel some of the myths that surround vaccination and reduce the spread of COVID-19.

The panelist also discussed the preparations their organizations are taking to roll out the vaccine to their workers and the general population. They addressed the importance of working with the public health structure to ensure that distribution of the vaccine is broad, equitable, and low cost so that price isn’t a barrier to getting vaccinated. The panel also underscored the need for appropriate safety messaging around the vaccine.

In addition, the panelists talked about how the pandemic has impacted the health care work force, including how their respective organizations are managing safety concerns, physician burnout, working remotely, and other challenges faced by health care workers battling COVID-19. According to the panel, their organizations have implemented several measures to mitigate the transmission risk of COVID-19 in the work place, including screening, universal masking, social distancing, and more hand hygiene and washing stations. They’ve also allowed employees to work from home where possible and offered resources to the work force to strengthen their resiliency. According to Dr. McKinney, the Illinois Medical District surveyed its work force to identify their fears in returning from a virtual environment to a more in-person environment and found that they needed to continue remote work so employees could focus on caregiving and other challenges being faced by health care workers. Mr. Nelson mentioned that the increased amount of stress on health care workers stemming from COVID-19 has exacerbated mental health issues, which haven’t been appropriately addressed by the industry. The panel underlined the importance of supporting workers and giving them the confidence they need to do a hard job during a hard time. They committed to providing more resources to help manage anxiety, depression, fatigue, burnout, and overload by investing in mental health providers, systems, tools, and capabilities to not only support their work force but also the broader population.

The panelists also recognized the shortage of PPE and drugs the industry faced, particularly in the early stages of the pandemic, and described the supply changes they are making to prevent future issues. Mr. Nelson said his organization has made substantial investments in their supply chain relationships, including enhanced testing capabilities, PPE storage capacity, and cold storage facilities. Dr. Shanley highlighted the need to secure the health care supply chain domestically rather than outsourcing to other countries. Dr. McKinney advocated that the buying power of large health care institutions should be leveraged to improve and shore up domestic manufacturing systems and processes.

Health Equity

The panel discussed the inequities in the health care system, which COVID-19 has exacerbated. These inequities are apparent in the overutilization of emergency rooms and the excessive number of hospital admissions for chronic conditions that could be better managed on an outpatient basis.

The panel agreed that the promotion of diversity and inclusion is an important part of health equity. Mr. Nelson observed that having a diverse and inclusive organization—one in which employees bring a variety of backgrounds and perspectives to the table—is necessary to make progress on complex issues like health disparity and equity.

It was noted that most of the funds in health care are spent on more traditional health services like hospitalizations and doctor visits instead of the actual drivers of health status, such as mental health, food stability, housing, transportation, social isolation, and others. The panel noted their disappointment that often the biggest indicator of health status is a person’s credit score and zip code.

To make health care more equitable, Mr. Nelson advocated for better aligning education and payment models, and working with payors to ensure visits to primary care physicians take into account the actual drivers of health status instead of simply asking what a patient’s symptoms are that particular day. Dr. Shanley stressed the importance of collaboration in health care, which he defined as greater efficiency and communication. He said lowering barriers for data sharing is necessary to create better care and greater efficiencies because the system is currently extraordinarily inefficient and too focused on adults and later stages of life. Because children are the future, Dr. Shanley hopes to see policymakers pivot more toward optimizing the health of children. Dr. McKinney mentioned that the health care community has done a better job recently of engaging communities, incorporating health care advocacy, and talking to patients in a manner they understand so that they can be more active participants in health care, which lead to cost savings and a healthier community. Still, the panel acknowledged there is more work to be done to tackle disparities in the health care industry and ensure more fair and equitable access to health care for everyone regardless of socioeconomic status.