In Lessons Blog

Since its origins in 1875, Indiana-based Franciscan Health, has long been a leader in healthcare and the provision of hospital services. The organization was one of the earliest pioneer ACOs – providing coordinated and comprehensive care across hospitals, physician practices and other healthcare providers – and it remains a recognized leader in cardiovascular diagnosis and treatment.

I recently had the privilege to meet Dr. James Callaghan, president and CEO of Franciscan Health in Central Indiana, along with his outstanding physicians and administrative team, before delivering a keynote address at the 10th Annual Franciscan Health Cardiovascular Symposium.

On the program with me were clinical experts in the cardiovascular consequences of cancer chemotherapy and those on the forefront of recent advances in technology that improve surgical safety. I would like to thank Dawn Ritchie-Wilks, RN, MA, and the entire Planning Committee, for organizing such an important symposium, designed to “improve patient care for those with cardiovascular disease by providing clinicians a dynamic and interactive educational experience.”

With more than 300 physicians, nurses, technicians and staff in the audience, I took the opportunity to focus on the shortcomings of our nation’s medical care and address areas for improvement.

Franciscan Health remains ahead of the curve in many key areas. Its hospitals have already begun to move from the fragmented, fee-for-service (FFS) model to an integrated, capitated and technology-driven system.

I encouraged everyone to do more and, during the Q&A period, they indicated a strong desire to do so, while lamenting the insurance companies that remain unwilling to change the model. Despite all the evidence that prepayment leads to higher quality outcomes, many health plans are still wedded to the dangerous FFS system. They’re reluctant to reimburse the cost of population health or pay for more efficient and effective approaches to patient care, including the use of video technology and other forms of health IT.

Audience members pointed out that Indiana has some of the nation’s highest rates of smoking, obesity and diabetes – and they believe these problems will only get worse in the future. Further, they worried that with the redundancy of heart centers throughout the state, many hospitals lack adequate patient volume maximize the expertise/experience of its cardiovascular specialists and operative teams.

Although I assured them the challenges they face are typical throughout the country, I also pointed out that the pressure to improve could increase soon in their city.

With Indianapolis a finalist for Amazon’s second headquarter location – and with the retail giant making huge news with its new healthcare venture – the winning city should expect healthcare competition to increase significantly. Without a doubt, Amazon will demand higher quality healthcare at lower costs for all of its employees.

I expressed my opinion that the health systems that move from the past to the future fastest and most seamlessly will be the long-term winners, even if the transition is problematic for them in the short-run.

The “first-mover advantage” is as real in medicine as in technology. Given Franciscan Health’s rich history, mission-driven spirit, and commitment to putting the patient first, I left feeling optimistic that this organization just might be the one to blaze the trail for all others to follow.

Dr. Robert Pearl is the former CEO of The Permanente Medical Group, the nation’s largest physician group. He’s the bestselling author of “Mistreated: Why We Think We’re Getting Good Health Care–And Why We’re Usually Wrong” and a Stanford University professor. Follow him on Twitter @RobertPearlMD.

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