Hospital boards grapple with an uncertain future—what to do now?

WP_20140513_14_05_24_ProOver the years, I have had many invitations to speak at hospital board retreats. This week, I spent Tuesday evening and part of Wednesday as the keynote dinner speaker for a health system retreat held in Port Ludlow, Washington. Accepting the invitation to speak was made easier due to the close proximity to my home and the tranquility of the venue. The view from my hotel room alone made the trip worthwhile.

The name of the hospital isn’t important. Like many other institutions around the country, this one is trying to figure out how to survive in a changing and very uncertain future. They must navigate healthcare payment reforms, accountable care, and an entire system that is shifting from a fee-for-service world to one centered on quality, value, and population health. They understand that the hospital is no longer at the center of care. If anything, they must plan for a future that drives as much care as possible out of the hospital and into other, lower cost settings.

WP_20140513_15_06_35_ProAnticipating these changes, one strategy that is playing out across the nation is hospital system consolidation through partnerships and acquisitions. At the board retreat I attended, a partnership between the hospital and a larger hospital system was squarely on the table. One of the benefits to the hospital for entering into a strategic partnership with the larger system would be getting their assistance on the purchase and implementation of a new hospital information system. As I pointed out to board, while a new hospital information system is needed, don’t expect your business to improve just because you have one. Yes, health information needs to be digital, but the real value comes not from digitization itself, but rather how you then use the data you capture to improve care quality, drive greater efficiencies, and deliver care in entirely new ways.

Aligning payment systems to reward value over volume is essential if we hope to reign in the spiraling costs of healthcare. Doing so will make it possible for providers to apply the most appropriate care in the most appropriate manner, time and place--be that in a hospital, ambulatory setting, or in the patient’s own home. That is the promise of the digital health revolution.

Hospitals and health systems that successfully navigate these choppy waters will not only survive, many will thrive. But for that to happen, I offered up a few other suggestions based on what I experienced not only at this retreat, but many of the others I’ve attended lately.

  1. Get some younger blood on the board—identify the next generation of clinical and administrative leaders. You are planning for a digital future that many of you simply cannot fully comprehend. Find the digital natives on your staff and get them involved now. After all it is really their future, not yours, that you are planning.
  2. Add some diversity to the board—all too often not only is age diversity absent, but also diversity in socio-economic status, culture, and gender. Your board should look more like the patient populations you serve.
  3. Build on a solid foundation. If you are jumping on the digital health revolution, make sure your institution and staff are ready for this change. Don’t even try to install new technology on platforms and devices that are well past their prime. (The computer being used at the board retreat was running Windows XP. I fear the rest of the hospital is still on it too). And by all means recognize that fixing your technology is the easy part. Using it to best advantage is harder. Allow plenty of time and budget to appropriately train your staff.

These are challenging times for our hospitals and healthcare systems. But with those challenges come great opportunities. Carpe diem!

Bill Crounse, MD Senior Director, Worldwide Health Microsoft

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