← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Dennis Disch, MD, MMM, FACC Vice President, Hospital-Based Specialties, Advocate Health
00:11:54
Loading summary
Transcript11 lines
- [00:02]
A
This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. Looking forward to hosting you in Chicago.
- [00:33]
B
This is Grace Linkeller with the Becker's Healthcare Podcast and we are recording live at the 13th annual CEO and CFO Roundtable. I'm currently joined on the podcast this morning by Dr. Dennis Dish, who is the Vice President of Hospital Based Specialties at advocate health. So Dr. Dish, thanks for being here. I'm going to first have you start off by introducing yourself and telling us a little bit more about your background.
- [00:57]
A
Good morning. Thank you very much for the opportunity to be here. I've been looking forward to the discussion. So as you mentioned, I serve as the Vice President over the hospital based specialty service line for Advocate Health. A little bit about Advocate Health we're the third largest nonprofit health system in the country. There are three state based divisions to Advocate Health. There's the North Carolina, Georgia Combined Division, the Illinois Division and the Wisconsin division. So the way we think about hospital based specialties at Advocate Health, we actually combine five service lines within one large service line because we really think fostering collaboration among those service lines is important. So I oversee all five of those service lines for the Illinois and Wisconsin divisions and serve as the physician leader. So those specialties are anesthesia, radiology, hospital medicine, critical care medicine and emergency medicine. I love what I do. It's a really great role to be in right now because what it really allows me to do is focus on fostering collaboration among a very talented group of physician leaders who are experts in their specialty as well as their administrative diet partners. We really think that class collaboration fosters moving hospital based care forward in sort of a synergistic way. I also get to foster the collaboration of those leaders with our hospital based operational leaders across all 27 of our hospitals in our Illinois and Wisconsin division. So again, another full sort of synergy to move the process of really creating operational efficiency and financial success across all of our divisions. Prior to that, I actually spent two years with Advocate Health overseeing the cardiovascular service line. I'm actually trained as a cardiologist and spent a lot of my early earlier career with cardiovascular service lines and then prior to that I was with Coralwell Health in Michigan where I served as the service line leader for cardiovascular for the south region of Corwell Health, as well as the chief medical and chief operating officer for one of our hospitals.
- [02:49]
B
Wonderful. Well, thank you for taking the time to be here this morning. And first question for you as we start our conversation, can you elaborate on your growth strategy over the next year or two?
- [02:59]
A
Yeah, it's a really great question. You know, in hospital based specialties, we, we have to kind of think about growth in a little different manner than I'm used to as a cardiovascular service line leader. So you know, for the, our ambulatory specialties and our procedural and surgical based specialties, you know, growth really means growing market share, growing practices, providing additional procedures and advanced surgeries that really, that our patients and our communities can benefit from. With hospital based specialties, we're not really asked to go out and create organic growth in the community. So when, when we think about growth potential, what we really try focus on really is two things. Number one is creating inpatient capacity within our existing hospitals so that we can actually accommodate more of those acute care admissions that are necessary through the emergency department and those elective admissions for the advanced procedures and surgeries that our specialists in our communities really rely on. The way we do that is by really again, leveraging those leadership teams with each specialty and having them work closely with our hospital leadership teams to really drive operational efficiency so we can move patients through their hospital admissions with the highest degree of safety, which is important to patients, but also with the highest degree of efficiency, which is important to our financial bottom line and to making sure we have enough capacity. And then the second way in which we think of growth is that we're a very large health system and these are five very large service lines. So we really have to constantly be focused on recruiting and retaining top talent. Just to give you to put some numbers on that. Across our five specialties, for 27 hospitals, we employ 1800 providers, including physicians and apps. So we're constantly in recruitment mode. And so we really have to not only nail the recruitment side of things and we're fortunate that we have a lot of very talented recruiters with whom I get to work and also to retain those physicians. And so we really have to have robust wellness and well being policies as well.
- [04:59]
B
Absolutely. And tell us about the most exciting and impactive initiative or project that you're currently working on.
- [05:07]
A
Yeah, great question. So you know, in hospital based specialties, we're really trying to focus on identifying, identifying initiatives that really leverage the Collaboration among the five service lines, number one. So in other words, trying to synergistically think through how to solve the problems that our hospitals and their administrators are facing by getting these minds together across their specialties. But then we're also trying to look at initiatives that also leverage new technology that advocate is increasingly becoming known for. So, for example, we have some really robust virtual health programs and hospital at home programs, as well as some really robust AI programs. And so one of the ones I'm actually most excited about is what's called our. We just kicked this off is what's called our ED boarding project. So any hospital administrator will tell you that definitely in their top five list of difficulties that they're dealing with is trying to solve the ED boarding crisis. And that's especially relevant in some of our larger, especially teaching hospitals in big cities such as Chicago and Milwaukee. It's something that no patient wants to do. They don't want to sit in the emergency department for extended periods of time. And it certainly creates inefficiencies in our hospitals that we just can't afford to have. And so what we've asked our teams to do across critical care, emergency medicine, hospital medicine, and even radiology is really to start that collaboration process earlier, as soon as the patient walks in the door. Some of our triage activities, if the patient's not acutely ill or seriously ill, can actually be accomplished by our teletriage program, for example, so we can start figuring out not only what the patient's diagnosis, but what is their disposition much earlier in the process. And then instead of providing that diagnosis and disposition process sequentially. In other words, traditionally what happens is the emergency department physician sees the patient and then they decide if they're sick, and then they order tests, and then they decide if they need to see critical care or if they need to see hospital medicine. And those physicians say, I'm waiting on the test results. We're really asking these groups to. To communicate earlier. So perhaps we can move that patient out of the emergency department more quick and into an acute care bed in an appropriate setting, even if those test results aren't back. One thing we discovered in this process is that one contributor to the ED boarding issue is that there's a hesitancy to move the patient out of the emergency department to the floor, because as soon as they do that, they tend to go from the top of the imaging cue to the bottom of the imaging queue. So now they can't get their CT scan. So we're really trying to challenge that notion and ask our physician leaders to really move people through more expediently. That's going to accomplish at least four things. Number one, is it going to create a quicker diagnosis and disposition for the patient? It also allows the patient to be the recipient of multidisciplinary decision making earlier in the process of their ED admission. Of course they're going to spend less time boarding in the emergency department. And then lastly they could potentially avoid actually admission. We're actually going to tailor onto this are very hospice, very significant and very successful hospital at home program for advocate that started in the Charlotte region, Charlotte market, and is now being extended to several hospitals in our Illinois and our Wisconsin markets. So some of those patients who traditionally would sit in the emergency department waiting for an inpatient bed could be candidates to have to be admitted directly to the hospital at home program. So that's just another way in which we're really trying to decompress our emergency departments and really handle that challenge.
- [08:46]
B
And as we close out our conversation, what is the most important thing healthcare executives should do right now to make sure their organizations are successful in the future?
- [08:55]
A
Yeah, you know, there are a lot of challenges and we're in a financial environment of which everyone is aware that is really making providing high quality, efficient nonprofit healthcare increasingly challenging in our country. So there are lots of things to do. A couple come to mind in terms of things that I think need to be on the front of mind of healthcare executives. Number one, and I look at this through the hospital based specialties lens, is that we have to be willing to have earlier, more honest, ongoing conversations with our very valued independent physician groups. We have a lot of those who provide the services that I just mentioned in the Chicago area, lesser so in our Wisconsin division, but quite a few really valued independent partners and a lot of them provide these specialty services such as anesthesia, critical care, emergency medicine and even hospital medicine. The pressures that nonprofit health systems are feeling from a financial, in this financial environment with rising costs of providing care and declining reimbursement is something that is actually being felt perhaps even more acutely by our independent physician partners, especially in these specialties where they can't, you know, they can't offset their, their cost and grow their revenues with an ASC or by doing outpatient procedures and that sort of thing. So what we found is that the business model that worked for them two years ago may work today. So we want to have those conversations with them earlier and say, hey, listen, if this is still working for you and we're meeting our metrics together and and you can still make this work from a business standpoint, then great. We value as a partner, but if this is becoming increasingly difficult for you, we'd rather have that conversation about whether an employment type situation makes more sense for everybody earlier rather than later. We see this most acutely in anesthesia, where, you know, the sudden exit of an anesthesia group from our system dramat disrupts care and does not give us the ability to take care of our patients in the way that we want to. So we would rather be prospective and thoughtful about that ahead of time rather than have to react to a situation once it falls apart. And then the last thing I'll mention is that we really have to take good care of our app. In a physician workforce, that's something that Advocate Health is very intentional about. We started a program a couple years ago called Best Place to Care, and we've noticed a dramatic improvement in our engagement and alignment scores through that program. We're also active participants in the AMA's Joy in Medicine program, along with a number number of other large health systems. So I think through those two things, we're going to be able to increasingly demonstrate to our app and physician colleagues that Advocate really is a great place to work and that will then allow us to really maintain the type of services that our patients and our communities deserve.
- [11:42]
B
Wonderful. Well, Dr. Dish, thanks so much for joining me today on the Beckers Healthcare Podcast. Again, we are live at the 13th annual CEO and CFO roundtable.
- [11:51]
A
Thank you.