Fortune

The Future of Healthcare

/ lesliesnavely / Leave a comment

I had the privilege of attending Fortune Brainstorm Health last week, an innovation conference working to bring together the best minds in Healthcare, Technology and Business to make a difference in healthcare.  The theme of this years conference was “Accelerating the Health Revolution.”  The topics were broad and thought provoking.  I found myself at the event wondering how I could do more on a day to day business to help.  Since the conference the question has only gotten louder in my mind.   In reflection, I think that the starting point is to write down my top observations after review of my notes.  Maybe this exercise will lead my somewhere…

  • There are amazing people who work in healthcare:  scientists, physicians, innovators and investors.  I met people brave enough to tackle life or death situations with a gusto every day that most of us don’t muster at our best moments.  People with an insatiable quest for learning.  These people provide me a great deal of hope for the future despite the rhetoric of politics.  
  • This conference reinforced my belief that healthcare is a fundamental human right.  You can often get lost in the public debate over healthcare finance, which is what most of the political conversations center around.  The media doesn’t help, covering the politics of healthcare, and grabbing on to often non-core issues.  This conference allowed me time to simplify it for myself.  All people deserve access to care.  In order to afford this as a country, investment must shift from treatment to prevention.  This will ultimately bend the cost curve.  That said, the reason to have health care for all isn’t economic, it is ethical.  
  • Despite what I said above, costs are a major problem.  As a nation, we over invest in late stage healthcare and under invest in prevention.  Dr. Sandro Galea, physician and currently Professor and Dean, School of Public Health at Boston University, made a compelling case for the investment in creating health versus treatment illness as our priority.  When ranked versus 17 peer countries, the US mortality rates are ranked #15 – 17 for all age groups under age 60 and we quickly rise to the lowest mortality rates in the world for over age 80.  We invest a large portion of our healthcare dollars into this treatment and it is what is incentivized by our healthcare payment system.  The alarming thing is that it doesn’t increase longevity.  
  • Healthcare is about so much more than clinical care.  We were joined at the conference by Mark Bertolini, CEO of Aetna.  He shared that  “Only 10% of life expectancy is driven by clinical care – 30% by genetic code, 20% by the social determinants of health, and 40% by lifestyle choices.”  Dr. Galea, who I mentioned above, spoke of this as well.  In follow up to his talk, I read a great piece he wrote last fall.  Within this article, you can also find the chart to support the mortality rate information I shared above.  Improving the health of our nation is as much about investments in our social infrastructure (e.g. education, clean water, public transportation, a living wage) as it is investment in medical advancements.  I feel incredibly lucky for the good fortune that my family has had.  
  • One of the best comments from the audience at the event was about hospitals and their role at the center of healthcare improvement. The quote was something like…”Isn’t it ironic that our healthcare system is hospital-centric? Particularly given that a trip to the hospital is the failure of care.” Prevention, prevention, prevention. Our role must be to influence behavior so that people do not reach the point of needing the hospital.  
  • Corporations have a critical role in improving healthcare.  It is the right thing to do to focus on employee health and wellness.  If moral responsibility doesn’t convince you, employees that are well – getting enough sleep, eating well, exercising regularly – are more productive. The power of top-down leadership to drive a culture of wellbeing for our employees will be the pressure our healthcare system needs to evolve. On a side note, I crossed paths again with a former leader of mine, Chip Bergh, who is now the CEO of Levi Strauss. I remember his dedication to well being 20 years ago, and it was amazing to see his continued commitment to wellness as a driver of employee engagement and productivity. 
  • Fertility issues are a health crisis. The awareness of the breadth of fertility issues is low, and there is still a stigma to discussing these challenges.  A world-renowned fertility physician, Dr. John Zhang spoke about a controversial procedure (the three-parent baby) that he led last year.  It was a fascinating discussion, which prompted me to talk with him on a break.  We had a great conversation about this awareness issue.  His point…there is a Breast Cancer Awareness month, an MS walk, a Lymphoma/Leukemia organization all of which are doing great work to raise awareness of their disease, and funds to help reach a cure.  Yet, fertility issues are still taboo, unfunded, and impact over 6 million women in the US alone.  Fertility issues are reported to be as stressful as dealing with cancer for a family. Solutions are expensive, and the path to the solution is complex. Long-term this is decreasing wellbeing, and increasing costs within our healthcare system.  
  • Our company (CHG Healthcare) has a critical role in helping physicians to perform at their best.  With all of the challenges in healthcare, physicians are working harder, showing signs of stress and burnout and more focused on administrative tasks than ever (less time on patient care).  I sat next to a surgeon who said that given all of the electronic charting that she has to do, she sees about 40% less patients per day now than she used to.  Helping physicians to be successful and delivering to their maximum contributions well help save lives. 
  • Technology and data will be a propelling force for change.  Amazing people are investing in amazing things.  We got two live demonstrations that were particularly impressive.  The first, a matchstick size device that slides under the skin currently in development from Intarcia.  This device, combined with chemical innovation that allows medicine to stay good at 104 degrees for up to three years, enables medicine to be dispensed into the body automatically for up to a year post implementation.  Imagine chronic disease treatment improvements via increased drug compliance if this could be installed once a year in a less than a one minute procedure.  The second was a partnership between Tricog Health and GE Healthcare to provide EKG support to rural Indian clinics via a connection to the cloud for immediate diagnosis.  Both of these were amazing innovations, but just the tip of the iceberg in terms of what could be.  
  • Genomics.  All I can say is wow.  This field is moving through years of progress in weeks and months.  To envision its role in the future is for people smarter than me.  Refer to the first point above. 
  • Finally, there are people in this world who are way braver than me. Two physicians, Dr. Nahid Bhadelia and Dr. Raj Panjabi discussed the Ebola breakout in 2014. They were both on the front lines of the disease in Africa.  Dr. Bhadelia spoke of the impact of global security decisions on their work on the ground. As a country, we were began acting with an “abundance of caution” and airlines stopping flying into this part of the world.  Although well intentioned, this created immediate supply issues for healthcare workers on the ground. At one point, she and her team were out of personal protective equipment and had to make the decision to either use tarps to cover themselves and go back to work, or to let more people die.  They went in with tarps.  The bravery that this requires is something that I cannot fathom. I leave this week with an even further appreciation of the difference healthcare providers make for patients every day.  

An amazing, thought-provoking event to say the least.  What do I do with it?  I don’t know.  What I do know is that we all have a role in the Future of Healthcare.  Whether as a consumer of care, the owner of our own personal health or as an activist for a cause, we are all leaders in this challenge.  That said, senior corporate executives have a unique role given their influence.  I will paraphrase (and adjust) a quote from Mark Bertolini:

“The role of a CEO (substitute any senior executive leader in my point of view) is the power to convene, and the power to set the agenda.”   – Mark Bertolini, Aetna

Becoming a Great Place to Work

/ lesliesnavely / Leave a comment

What does it take to become a great place to work?  Over my career, I have worked at some amazing companies.  Each place taught me something about what makes a company great (or not so great).  But, where I have learned the most about being a great place to work is at my current company, CHG Healthcare Services.  This week is one of my favorites every year.  We celebrated our sixth consecutive year on Fortune Magazine’s “100 Best Companies to Work For” list, ringing it in at #16 for the second year in a row with the last four years in the top twenty.  Although this award isn’t why we focus on building a great place to work, it is certainly an accolade we are proud of achieving. So, what have I learned in my close to five years at CHG about creating a great place to work?

image

1.  Trust is at the core of cultural success.  In fact, Fortune’s evaluation to achieve a spot on their Best Companies list requires that you have a culture of trust (as measured by an employee survey) that measures “management credibility, the respect with which employees feel like they are treated, and the extent to which employees expect to be treated fairly.”  Take aside the theory on this…my personal experience aligns with this.  An environment that is steeped in trust accelerates the degree to which people want the organization to succeed and thus drives their contributions.  Plus, it is just a better place to spend your days.

2.  Transparency and vulnerability builds trust.  In order to achieve this level of trust, employees and leaders must be transparent with each other as to both the current reality of the business as well as our individual engagement in the organization’s cause.  Some of my most powerful moments as a leader have been moments when I share the real person I am with my team, or when I share explicitly that I don’t know the answer to the problem or issue at hand.  Through these moments, my team realizes that it is both okay to be who they are, as well as to admit when they don’t know the answer.  By doing this, we resolve the challenges faster and to come up with better solutions than any of us could ever do on our own.

3.  Accountability builds trust.  As with all businesses, at CHG, we are aiming to grow our company’s bottom line results.  Sometimes, I read about companies building a great culture through adding high-end benefits, sabbatical programs, super cool workout facilities, etc.  Although all of these are great, and do with certainty make a work environment better, they aren’t by any means the only thing that makes a great culture.  Delivering on the results we set out to achieve, through personal and team accountability, creates wins for the organization and for individuals.  If we are accountable and deliver what we say we will deliver, we build a culture of trust.

4.  We need to have fun, and be proud of what we do.  Work is work, but the more my team members and others around me at CHG can enjoy what they do, the people that we do it with, and be proud of the work that we do, the better our culture becomes.  In order to be proud of what you do, it may take something different for every single person within the company.  As individuals, we need to find our way to be proud and make it happen.

5.  Building a great place to work never stops.  I think that one of the biggest mistakes that people make when working to build a great culture is that they see it as a project or an initiative as versus a sustainable organizational commitment.  There is no big bang, no silver bullet to building a great culture.  Instead, it is a series of steps, both small and large, that get harder the better you get.