Podcasts about partners healthcare system

"There's good news, we're actually seeing signs of a virtuous cycle, we're seeing [workforce] pride in organizations and that leads to people working together better, making the care better, which means the patients are more grateful, which makes people feel even more pride". — Dr. Thomas H. Lee, Professor of Medicine at Harvard Medical School and Chief Medical Officer at Press Ganey.In this episode, Dr. Thomas H. Lee discusses his professional growth, career development, and the core competencies of healthcare leaders. He distinguishes between leadership and management while highlighting their vital roles within complex health organizations. Dr Lee explores clinicians' important contributions to value creation, and the need to hone in on the "value chain". He further develops the idea that people should have choices when it comes to healthcare and we (healthcare providers) should be working hard to be chosen. Dr. Lee underscored the importance of trust-building with patients and staff alike.Follow Dr Thomas H. Lee: Twitter/X, LinkedIn.About the guest: Dr. Thomas Lee is the Chief Medical Officer for Press Ganey and an internist/cardiologist who practices at Brigham and Women's Hospital in Boston, Massachusetts.  He is on the faculty at Harvard Medical School and Harvard School of Public Health and is Editor-in-Chief of NEJM Catalyst and a member of the Editorial Board of The New England Journal of Medicine. He is a member of the Board of Directors of Geisinger Health System and chairs the Board of Geisinger Health Plan. Before joining Press Ganey in 2013, he was Network President for Partners Healthcare System.Additional resources mentioned in the podcast:Book - Healthcare's Path Forward: How Ongoing Crises Are Creating New Standards for ExcellenceBook - HBR's 10 Must Reads On Leadership for HealthcareTurning Doctors into Leaders - Harvard Business ReviewMusic attribution: AudioCoffee from Pixabay.Contact information: If you'd like to get in touch, reach out at jono@clinicalchangemakers.com This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.clinicalchangemakers.com

Peg McGetrick is currently a non-executive Director and former interim CEO for Boston asset manager Grantham, Mayo, Van Otterloo & Co (GMO). She is a member of the Board of Trustees of Save the Children International, and Chair of the Audit and Risk Committee; and Save the Children U.S., where she is the Chair of the Finance Committee. She was a founding partner of Liberty Square Asset Management, a majority woman-owned hedge fund with over $5 billion AUM (1998-2015) and before that a Partner of Grantham, Mayo, Van Otterloo & Co where she led the International Equity division (1985-1996). Ms. McGetrick began her investment career in non-US equities as an analyst for The Commonfund for International Investments. She has also served on the Investment Committee for Partners Healthcare System (2010-2019). She was previously on the Board and Investment committees of several educational institutions including Providence College, The Wheeler School, Friends Academy and Our Sister School. Ms. McGetrick graduated from Providence College with a BS in Psychology and Business Management, and holds a MS in Finance from Fairfield University. Ms. McGetrick resides in New York City and South Dartmouth, MA. --- Support this podcast: https://anchor.fm/toby-usnik/support

Presentation: This presentation, given on August 18th, 2016, was part of the Akron Roundtable's 40th Anniversary series, in which several key speakers from over the decades were invited to return to the Roundtable podium. Speaker: Dr. Austen, born and raised in Akron, Ohio, received his BS degree in mechanical engineering from the Massachusetts Institute of Technology and his MD degree from Harvard Medical School. He was appointed Chief of the Surgical Services at the MGH in 1969 at the age of 39 and he held that position for almost 29 years. Dr. Austen was active in numerous roles throughout his life including serving as a Founding Trustee of Partners HealthCare System, the Founding President and CEO of the Massachusetts General Physicians Organization (MGPO), a member of the National Academy of Medicine, a Fellow of the American Academy of Arts and Sciences, a Life Member Emeritus of the MIT Corporation (Board of Trustees) and Chairman Emeritus of the Board of Trustees of the John S. and James L. Knight Foundation. Dr. W. Gerald Austen passed away in September of 2022. For full speaker bio and event details visit: https://bit.ly/3ewDKh5  

In this episode, we go into the remarkable career journey of Dr. Gary Gottlieb, who went from his practice as a Geriatric Psychiatrist to become a national healthcare leader as the former CEO of the Partners Healthcare System, the former President of Brigham and Women's Hospital, the former CEO of Partners in Health, and now an Executive Partner at Flare Capital serving on the boards of prominent healthcare startups. Join for an inspiring story of a journey through healthcare leadership, leading change in psychiatric care, a discussion on where academic health systems should watch out for disruption from the startup sector, and key lessons for trainees reflecting on a storied career in leadership. --- Send in a voice message: https://anchor.fm/tdio/message

When it comes to aging in America, there are many issues that seniors face. These include brain health/ dementia, to a broad spectrum of issues to affordable housing with services. You should also know what type of retirement community best suits your needs based on location and budget, from aging at home or Independent Living to Memory Care.Seniors face numerous obstacles as they age, including the possibility of becoming disabled or losing a spouse. They must also consider how society will care for them in the future.Seniors and their families will need to consider the following at some point: How are assisted living and long-term care different? What does long-term care entail? What services are provided by long-term care? How do you plan for the possibility of long-term care? What characteristics define a quality long-term care community?Join me in conversation is Lou Woolf, President, and Chief Executive Officer, Hebrew SeniorLife.--------------------Bio:Louis J. Woolf is the president and CEO of Hebrew SeniorLife, one of the nation's leading not-for-profit providers of senior services and is affiliated with Harvard University.He has more than 30 years of experience in health care administration, including positions as executive vice president and chief operating officer at Partners Healthcare System's North Shore Medical Center and leading the Care Group Healthcare System.Find Louis J. Woolf on LinkedIn: https://www.linkedin.com/in/lou-woolf-2808a828/

Transcription:Ken Paulus 0:03Caregivers will be put back in a position to drive these big complicated specialty treatments instead of throwing these patients over the wall to us. And I think pharma will move from a sales model to a knowledge model where their job is to put information in the hands of caregivers, health plans, and members to make the right decisions at the right time in the right placeGary Bisbee 0:28That was Ken Paulus, President and CEO Prime Therapeutics, discussing the fragmented nature of today's healthcare system. I'm Gary Bisbee and this is fireside chat. Ken has been a health plan and large IDN CEO and now leads a pharmacy benefit manager with 30 million lives. He's in a unique position to comment on integration between pharma health plans and providers. Let's listen to Ken express the need for an air traffic controller to manage care for the patientKen Paulus 0:57I'm most concerned about fact that today, for any given American, there's really no captain of the ship. There's really no clear advocate or some person, entity-relationship that is air traffic control for a patient in need.Gary Bisbee 1:17Our conversation includes Ken describing the role of the PBM. And its value equation, barriers to quality and outcomes confronting caregivers, the need for physicians to be in charge complicated care paradigms, how Prime Therapeutics work with the federal government to ensure specialized drugs remain available during the COVID crisis, and the importance of developing a long term relationship with the patient. Let's listenKen Paulus 1:42COVID has shown us that we need somebody to focus on that long term relationship and it's just not happening today. Again, with great challenges come great opportunities now that's a big one. And if I was running a health plan business or an IDN right now I’d be running like heck, to solve that problem and fill that void. Our nation needs it now.Gary Bisbee 2:05I'm delighted to welcome Ken Paulus to the microphone. Well, good afternoon, Ken, and welcome.Ken Paulus 2:16Gary, Thanks for the invite. And I really look forward to talking to you today.Gary Bisbee 2:20I've interviewed you in person a couple of times with live audiences. So we're delighted to have you at the microphone. Let's get right into your background if we could. I know you grew up in the Chicago area. What was it like growing up? You had five siblings, six of you in the family? What was it like growing up with that group?Ken Paulus 2:38It was a very special upbringing, in a way. I'm from a middle-class family. My dad was a grocery store manager. My mom ultimately was a homemaker became a teacher, but neither one of them finished college. Kind of a classic Catholic family where they started having a family early both of them had to quit and basically raised the family. It was kind of a values-based upbringing. In even though we didn't have a lot, it was rich and full and positive and supportive and ended up being what gave me a lot of my resilience and in a lot of ways, feeling supported regardless of the circumstances. It's all good. I mean, I say I had a very good upbringing and nothing I look back on in a negative sense, other than maybe I was a little bit of a rebel and got myself into a little bit of trouble as a teenager.Gary Bisbee 3:25Well, there's learning there as well.Ken Paulus 3:28Yes, there is. I have some scar tissue from those days. But I was blessed in so many ways.Gary Bisbee 3:32Right. We were talking before and you indicated you basically worked your way right from the very early days right through school, that that turned out to be a good experience, any lessons learned there?Ken Paulus 3:43It was interesting. My parents didn't finish college. So it was very clear with them that we were all going to college and there is an expectation you go to college and you go to grad school or medical school or law school, so you're not stopping at a four-year degree and I'm thinking, well, who's paying for that? And the answer was you are. And the only way to pay for it was to work basically every free moment. So I had a paper route until I was 13 or 14 and then I became a busboy at an Italian restaurant and believe it or not, was owned by the mafia, and worked there for two or three years. And then when I was old enough to get a real job, I became various jobs within the grocery business because my dad had friends that could give me jobs. And I did everything. I was literally a night crew worker. I was an apprentice meat cutter a couple of summers, I did it all. And I learned a ton the learnings from how and when you saw good management was fairly readily observed if you were willing to observe us and I have to say I learned a lot about management from all of those crazy jobs. It's a good experience.Gary Bisbee 4:52Six siblings in the family. You're all in healthcare. How did that work out?Ken Paulus 4:57Well, it was interesting. My mom in particular had three things that she expected of us and I'll never forget it. And it really rang true for all of us. One was going to college, as I mentioned, the second one was critical. And she said, and both of them actually did this. They said, You really have to do something where you're making a difference. And then the third one was just an oddball thing. They're both smokers. They both quit in their middle-age years. And the third thing was don't smoke, please. And if you don't smoke by the time you hit 21, you get $100. So, I'm like wow, okay, well, that's worth it. And I never got my hundred dollars, but I never smoked so that was good. So this making a difference. Standard and expectation are what I think led us all into the helping profession of healthcare and it's been exceedingly rewarding and I'm so happy I'm in this business. I really love it.Gary Bisbee 5:46Well, after college at Augustana in Illinois, off to the University of Minnesota, the MHA program was the leading MHA program at that time, what got you to the Minnesota MHA program?Ken Paulus 6:01Gary, it was mostly that it was that they were the best in the nation at the time. I think they're still probably top five or so. And I was a science major. I was a human physiology major. But I have an entrepreneurial business streak in me. And I was literally trying to find an industry that married science with business. And healthcare is really the perfect combination away for me. Once I figured out that that's what I wanted to do, and I wanted to work in the nonprofit side of things. Then I just went on the search for the best program and this program in Minnesota was the best program and I have to say, it was an eye-opener and a critical event in my life to open my eyes to a much bigger opportunity set. It really was very possible.Gary Bisbee 6:47What was your first job then out of the MHA program?Ken Paulus 6:50So this 21 or 22-year-old kid, having never stepped foot in a hospital before this point in time has only worked in grocery stores and restaurants. I literally stepped foot into this hospital as a fellow post-graduate school and became an assistant vice president of a hospital that's part of Catholic healthcare West in Los Angeles. And it was quite the experience. I literally remember the first day on the job, the CEO said, Well, Ken all of your direct reports are waiting for you up in the conference room on the seventh floor. Introduce yourself. I said, Okay. I walked into the meeting. There were 10 folks around the table all roughly in the 40s and 50s. mostly women, as it turns out, running departments like occupational therapy and PT and nursing leaders. And I sat down at the head table and they looked at me and the first woman said, well, who are you? And I said, Well, I think I might be in charge of all these departments and they laughed out loud. No, like They laughed and they said, Are you kidding me? They all had 20 years on me. But I will say, Gary, I made one critical move that was probably saved my career. I just said, Hey, listen, I don't know anything about management and leadership. I've really never done it before. So if you all are willing to teach me, I'm willing to learn and I will try not to annoy. And they became just stunningly good leadership group. And they taught me management and leadership, these middle-aged men and women, mostly women and healthcare, taught me how to lead and forever I will be thankful and in gratitude for that experience, it was really special.Gary Bisbee 8:40What took you from that start to Partners Community Healthcare in Boston.Ken Paulus 8:44I had worked in California for the better part of probably a decade or more. And actually, my boss, the CEO, was pinged by a recruiter to come out to Partners Healthcare System, which is a brand new system that was just been formed. And they wanted him to lead the creating the risk-bearing entity partners called Partners Community Healthcare, Inc. and he declined. And he's a California guy, he's not leaving the state. And in an incredible show of support of me, he said, Ken, I hate to even bring this up to you because you are like, my number two, go-to guy. But I actually think this might be a really great job for you. And I don't want you to go I don't want you to take this wrong. I just want you to know that I'm a mentor, and I'm your friend. I think you should at least have a conversation if you can work for the mass general of Brigham in Harvard Medical School and have that on your CV it's probably gonna change your life. I said, Really? You're telling me you think it's a good idea? He said I don't want you to leave. But I think I owe it to you to take a look at it. So I did and next thing you know, I was In my car driving cross country and working at Partners. As probably the fourth or fifth employee hired post-merger, the Brigham in general.Gary Bisbee 10:07Wow, that was a terrific opportunity. What did you learn about managing risk there?Ken Paulus 10:12Oh, gosh, scary. I have so much scar tissue from those days. We built this risk network, this group of physicians and acquired a number of primary care practices, married them in our network to all the specialists of the Brigham and the general and then took full risk, full capitation risk, but with Blue Cross of Massachusetts. And we proceeded to get our hats handed to us. We just got crushed. We lost so much money so fast that we literally had to go to Blue Cross, we said that we just have to tear up this contract. We can't, we can't do it. And we did. They agreed, thankfully, to tear up the contract and start over. And what I learned was we were ill-equipped to take full risk. We've had no data. I had no systems to manage risk. No way to track patients and patient care. The incentives are completely wrong. Our teaching hospitals nationally Brigham wanted to bring everybody into a tertiary center. And that's just doesn't work with a risk insurance business. So we were just upside down in terms of our ability to take on risk and we lost a lot of money. It was quite a learning experience. I never want to repeat it. But again, that scar tissue is invaluable. And there's so much to be learned from the process.Gary Bisbee 11:28Great foundation, though, ultimately, you made your way to become the CEO at Allina in Minneapolis, what caused you to want to tackle a leading health system?Ken Paulus 11:38It had been on my mind Gary for a while that I was looking for a place where the physicians, the hospitals, and all the ancillary services of pharmacy and lab and home care and hospice and all that could all reside under the same roof. And if I had a chance to run a company that had all those pieces in one place, could I do something different and special to really put a dent in what I think are many intractable problems in healthcare. So that's what attracted me. And I think secondly, I'm from the Midwest, I had always wanted to come back to the Midwest at some point. But it was mostly this engaging opportunity of having all the pieces in one place. And it was quite a good ride. It was there for just under a decade, and I really, really liked it. It was good fun. And I think we made a ton of progress.Gary Bisbee 12:26If you could identify one main lesson that you learn to lead a large health system, what would it be Ken?Ken Paulus 12:32It was plus-minus Gary, On the plus side. I think having the physicians as part of the health system was crucial. I can't imagine a day where we'd ever go back or the caregivers, not just doctors, but doctors and nurse practitioners and all the people that take care of patients every day, day in and day out. Having them on the team was critical and crucial. And I think that allowed us to do some things that we wouldn't have been able to do otherwise, I think the negative or the downside of at least our idea was we were still so acute care centric, that limited our ability to innovate. And we were hooked on the drug of fee for service medicine. And because of that, all of our profits came from our hospitals. And the more acute, the more complex, the more of a specialty nature of treatment. The more we did, the more we made. And we could not get off that treadmill. And I gotta tell you, I'm a fairly transformative thinker. And I like to find ways to disrupt healthcare. I put my shoulder to that wheel, and I made some progress, but not a lot. And it's just part of how healthcare is delivered that acute care was the center of the universe. That's where all the money was. And it was hard to ever leave that and we didn't really make much progress against that. Unfortunately, you know, for that I'll forever have some regrets.Gary Bisbee 13:59You've got an interesting background and just regionally, Los Angeles, Boston, Minneapolis Midwest, and you had some unrest there in Minneapolis. How do you kind of think about the balance between management outcomes, maybe unions, how would you factor all that in with what happened there in Minneapolis?Ken Paulus 14:20Well, it's interesting in all of the markets have worked in, they've all been very high concentrations of union activity. And I'm very neutral on unions. I think they play an important role in some ways. And I'm not anti-union. I'm not pro-union. I think it's part of the system and it can work. It has worked, and most of the places I've worked, it's been a really good outcome. What's really stunning to me in terms of what's happened here with the racial unrest in Minnesota, and particularly this behavioral issue with the police, is that we're finding as we dig deeper into it, that much of the problem lies with management's inability to To act and to deal with poor performance, and the union's ability, or at least creation of a structure that would keep management from moving out poor performers. And unfortunately, the lead actor in this most recent event was a poor performer with multiple examples of performance issues, and he could not be removed. And I think what it tells me is there has to be a new day with how management and labor work together. And we have to have more of a collaborative partnership model. And both parties need to be held accountable for performance. And we're lacking that today. It's more of an advocacy model today. And I think we have to move to a performance model and it's a real opportunity. And it's also one of the root causes of probably ended up where we are, at least in Minnesota, and how policing takes place here. And it's unfortunate but from every bad circumstance comes an opportunity. progress. I think that's what this is going to prove to be.Gary Bisbee 16:02Well, on a happier note, let's talk about Prime Therapeutics. You recently celebrated your one year anniversary with Prime. Will you describe Prime Therapeutics for us?Ken Paulus 16:13It's a very interesting industry and company, we're in the pharmacy benefit management space. And I've always been in the IDN side of things. I spent some time in the health plan business at Harvard Pilgrim Health Care when I was running the physician side of the staff model. So I know the health plan side, I know a lot about risk and capitation. Having done that, in many places across the country, we sit squarely in the middle between pharma, providers, caregivers, IDNs, if you will, and health plans and we are a construct of a broken system in some ways. The fact that the interest of pharma the interests of providers and caregivers and the interests of health plans are not aligned. And as such, the PBM industry came before and we're in the middle trying to get pharma care to reduce prices, through rebates and other management formularies, passing those savings on to health plans and then working with providers to manage utilization. And it is purely a construct of a system that doesn't work. And in the ideal world, if the United States healthcare system really was efficient, there's no need for us. Unfortunately, we aren't efficient, we're not aligned, the incentives don't really work, and we actually are critical right now to make sure that the cost of medicines does not spiral out of control. So we're a reflection of a broken system that's still compartmentalized and still has incentives that don't deliver the outcomes that our nation needs, which is a stunning thing for me to say as a CEO of a PBM. But that's quite frankly where we are.Gary Bisbee 17:48So why the transition to pharmacy benefits manager to Prime, why did you do that Ken?Ken Paulus 17:54Gary, I had run my course of working in the IDN side of things. And I have mostly worked with physicians and caregivers throughout my whole life. And I've loved it. I've absolutely loved it. But I really needed to see a different side of healthcare, I needed to get out from under the IDN space, and see how others view it. And mostly I'm seeing health care from the payer, and PBM pharmacy management space now. And I'll have to say some of the things I'm seeing I wish I would have known as an IDN leader. The fact of the matter is, we're missing some very important issues on the provider side that you don't see when you're in the middle of it. And now that I'm not in it, it's like, wow, it's very apparent that there's an opportunity. So I absolutely love it. I never thought I would. But it's a great learning experience. I've learned a ton about how this system works. And it's very interesting to see how insurance organizations and health plans view the health care world. It's quite different and quite important.Gary Bisbee 18:56So how does Prime work with the patient? How do you work with blue plans?Ken Paulus 19:02The plans really come to us to work with pharma to stand between them and pharma to make sure that they're getting a reasonable deal. That's basically in a nutshell what we do. So they at Prime we represent 30 million Americans across 23 states 23 blues plans, and our job is to make sure we represent with pharma with pharmaceutical industry, that block of business and we buy and procure and source all of the medications and treatments that pharma represents. we acquire those treatments on behalf of our health plan partners and try to do so to create efficiencies, and it's very effective. I have to say, I know there's a lot of unusual perceptions around the PBM space because it is so opaque. The fact of the matter is in at least in our case, we're transparent PBM we pass through everything to our health plans, which you see is what you get. We don't have a lot of these arcane structures to move money around within the system. And we do play a critical role I can tell you, there are billions of dollars of savings that come through to health plans, and then to employers and then ultimately to patients and members. That wouldn't be there, at least in today's healthcare industry, if we weren't doing our jobs. So very interesting. And it's a critical role that said here, I have to say there's some aspects of this business that are incredibly inappropriate and broken, that create undue friction, and actually, harm quality in some ways. Those are some of the things that I'm very excited about working on.Gary Bisbee 20:37How do you work with the IDNs then?Ken Paulus 20:40That's where I do think that we're creating barriers to the very best quality for patient care. And there are two ways I can see with the IDNs that we should be integrated and working with them. One is what I call the friction model. Our model today is built on creating, you know, I hate to say this but barriers and gates for providers and caregivers to get through to make sure that they follow a formulary so that we can then use that formulary to lever pharma to get a better price. And it's a crazy way to do business. But it's the only way we have right now. So we have a very high friction model that we use with caregivers and patients to put them through these barriers and gates if you will hurdles. And that forces the system to drive to an outcome that again, we can use then to save money. That's one big problem. I'm not a fan of using friction for caregivers and patients. And having worked on that side for 30 plus years, the friction is untenable. We are putting caregivers through so many hoops and barriers that they can barely get their jobs done now. So that's one major problem. I think the other major problem or maybe opportunity, is that what's happening and pharma is the science is stunningly good. I mean, if there's one industry in this world that we actually lead-in, it's this bioscience, this creation of new solutions to pithy, complicated healthcare problems through incredible advances in science. And I think we're gonna look back and say this is the golden era of development. It's like when antibiotics were created back 50 years ago, this whole business of using the genome to unlock opportunities to treat patients in very different ways. It's really stunningly good. What's remarkable about that is that while we're breaking through on a daily basis with science and finding these new solutions, they're very complicated. They're very expensive, and there's no integration between pharma what we do and what caregivers do. I think the second big opportunity is for the health plan and the PBM leaders organizations to work very closely with pharma and the provider side to create partnerships in ways that we don't have today. We're basically buying cooperatives now that's interesting. It's a short term solution to a big puffy, complicated, expensive problem. But I just don't think it's going to deliver us to Nirvana, I think we're going to need a very close relationship with providers. And once we have that, and we bring pharma into the equation, I think two really important things will happen. One is caregivers will be put back in a position to drive these big complicated specialty treatments instead of throwing these patients over the wall to us. And I think pharma will move from a sales model to a knowledge model where their job is to put information in the hands of caregivers, health plans, members, to make the right decisions at the right time in the right place. And boy, if those two things happen, we will advance quality lower costs substantially in our healthcare system. So that's what I'm really excited about those two things, taking unnecessary friction out of the system, and bringing in a partnership level perspective for pharma and providers and what we represent so that we can create a breakthrough. And that's what's exciting about this job.Gary Bisbee 24:20Very exciting. What's your guess, I mean, we talking three years, five years, 10 years for this change to unfold?Ken Paulus 24:26Unfortunately, Gary, I'm 61. And I can't do this forever. I am in a hurry. We have got to show improvement and progress on this in the next three, four years, we have got to put a down payment on this. So for lots of different reasons. One is it's what the healthcare system needs. Two, it will save substantial money. Three, it will vastly improve quality. And I think probably most important, if we don't do it, I just can't imagine how this fragmented healthcare system will survive. I just I'm not seeing it. I just don't think it's working today and we have so much to improve. This is probably my last chance to run a big healthcare organization that could make a difference. I have got to go out in good form, I have got to be able to look back and say I was part of the solution not part of the problem?Gary Bisbee 25:16Well, we're looking forward to that. We have some confidence you will make a difference can let's move on to the COVID crisis. What observations from your current vantage point? What observations have you made about trends that might have already been in occurrence but that the COVID crisis accelerated?Ken Paulus 25:34There really is one big one that has me quite concerned. And you can worry about our inability to track infectious disease and our lack of preparedness and all those things. They're all things that we need to improve. But I have to say I'm most concerned about the fact that there's today for any given American there's really no captain of the ship, there's really no clear advocate or some person, entity-relationship that is air traffic control for a patient in need. And this crisis brought that to bear. I mean, if you are sick during this COVID crisis, you couldn't reach a primary care doctor's office, it wasn't clear who you'd go to for advice on well, do I do this test or not? Do I go into urgent care now or not? It is a fragmented combination of solutions and you had to do the best you could. Do I call telehealth? Do I go drive into my office? Do I go to the ER, it just wasn't clear. And we are in this position where COVID put a light on this incredibly broken system of no coordination. And there's really nobody in charge. So the patient's left to his or her own devices. And man that is just not a way to run a healthcare system. And that's what we've got today. And I think What you're seeing across the nation is any number of approaches to how to manage this crazy thing. And we're, of course, we're not getting much leadership from the government, not that that would have made much difference, but there certainly isn't much leadership from healthcare either. The industry hasn't done a great job and we are very fragmented and we're paying the price the fragmentation right now.Gary Bisbee 27:20Did COVID affect Prime's business model at all or Prime's economics at all?Ken Paulus 27:26Not really, because I think we acted relatively quickly. One of our first worries was the run on the bank for medications and there was one early on. And people were so nervous about getting their medications, chronically ill patients that needed their medications that they were stockpiling. And we had to immediately lay in rules that would manage the supply so that they were 30-day supplies or shorter supplies so that we didn't have patients with years of supply and not having other patients that needed medications and they couldn't get them. So we immediately worked with the government to put in rules and structures to manage the stockpile run on the bank kind of circumstance, and we avoided that, thankfully. So we didn't really run into shortages. It was close. There were some shortages around the hydroxychloroquine run that took place after the President made his comments. But they were short-lived. And I think we've managed through them pretty well. So I think, for the most part, we got through it, and we avoided any really significant problems. Thank God.Gary Bisbee 28:26It's evident that public health is now part of national security. We just never thought about it that way. How do you think about that, Ken?Ken Paulus 28:34I think public health has never gotten it's appropriate do in our system? It harkens back to our earlier comments, scary when you ask question around well, how IDNs work, you know, whatever. Public Health just isn't rewarded. Our nation doesn't really prioritize it. Now, I think we're realizing a pandemic. It's critical. And countries around this globe that are really good at public health has have done a great job of managing and pandemic in an incredibly difficult circumstance. We have no public health assets really, in terms of the scale or the integration or the coordination of public health in this country, we don't have it. So we ended up with our fragmented system which we already know isn't really well-coordinated doesn't communicate, put through the wringer. We have no public health system really to rely on and we ended up with the mess we've got and you get what you pay for. We got what we paid for. We've never prioritized public health. So I think we're gonna have to find a balance in the future between acute care, public healthcare, centricity of a patient, where is the place where cares delivered, acute care can be the center of the universe any longer. It's not even urgent care. It's not even home or maybe I think it might actually be virtual that there's a virtual system and public health has to be tied into that virtual system. So we're all coordinating and gosh, it's going to be so hard for us. Our political parties and our constant bickering back and forth, somehow we're gonna have to break down these barriers. And I'm not sure exactly how that's gonna play out.Gary Bisbee 30:08It is hard to see. But I totally agree with you. We need to get there. Well, let's turn to leadership, you've ideally positioned in the sense that you've led a variety of different kinds of companies. All in healthcare, of course, but when you first became aware of the COVID crisis, what was your first thought?Ken Paulus 30:28I really think my first thought was two concerns, one, protect my employees, and to make sure patients get their medication so we don't cause havoc. And I think those two things I thought oh my gosh, we have got to make sure that those two things are intact. And it's a scary time and critical time.Gary Bisbee 30:51So moving from that to what are the most important characteristics of a leader during a crisis, Ken?Ken Paulus 30:57There's much to be written about this. But for me, the first thing was calm in a storm. I mean, we're in a frightening circumstance, we still are, we don't understand it. And I think leaders must stay calm. We can't panic. I think the second thing for me was very regular, transparent, and high levels of communication. At a time of uncertainty. People need to know what's going on. Even if you don't have the answers. It's okay to say that you don't. I think third, it requires action. I mean, you really have to have a propensity to act. Assuming you're calm. Assuming you're highly communicative. I think you have to have some courage to make some tough calls and move. And I think that's critical. So I think for me, those three things really are like the three legs of a stool to get through a crisis. There's that great line from Rahm Emanuel during the financial crisis that I ascribed to and they were going Through with Obama and Rahm Emanuel going through this process of the Great Recession, and he said, You never want to, I'm paraphrasing, but you never want to let a good crisis go to waste. It's your opportunity to do great things. And that's really what we have here is an opportunity to great things. And the question is, do we have the courage to do it? That's really what's gonna come down to and I hope our leadership does and I hope I do. That's really what we need to accomplish today.Gary Bisbee 32:28Well, it's all about leaders at a time like this. No question about that. Has the COVID experience change you as a leader in any way or as a family member?Ken Paulus 32:37For sure it points to the importance of relationships and in health care, we're in the relationship business. It's critical. You can't optimize health for somebody that that's one of your charges, somebody you're responsible for without a really good trusting relationship. And I think we all now are looking at our relationships differently and realizing how important they are to us. I think that's probably the key takeaway for me, Gary is social distancing has put a spotlight on either the ability to maintain or the importance of those relationships and also the some of the challenges of not having a social connection that is a critical part of the human beings needs. So I do think it's all about relationships and social connection. And if I had to say on health care, the patient relationship or not even before they become patients and individual relationships, that trusting relationship is up for grabs. It will be very interesting to see who owns that for a lifetime. Will it be IDNs? Will it be primary care doctors? Will it be some health care, air traffic controller? Will it be a health plan? I don't know. But somebody is going to play that role. And I'll tell you, there's a lot of disruption in healthcare because nobody has stepped in to fill that void. COVID has shown us that we need somebody to focus on that long term relationship and it's just not happening today. Again, with great challenges come great opportunities. Now that's a big one. And if I was running a healthcare business or an IDN right now, I'd be thinking, we have got to be running like heck, to solve that problem and fill that void. Our nation needs it now.Gary Bisbee 34:23That's a terrific finding. This has been an excellent interview. Ken, thanks so much. I have one last question. If I could. You're a board member. Of course, you sit on the board of Teladoc, but you've been experienced boards throughout your career. What are the key questions a board members should be asking in a crisis like this?Ken Paulus 34:41I think it's really a couple things. One is definitely getting through the acute phase of crisis. We're in that now. And it takes all of those leadership skills that we talked about. I think those are really important and staying steady at the helm, communicating the heck out of it and acting and moving, and having the courage to make some really critical, tough decisions. I think that's really important. actually think the bigger opportunity is envisioning what your organization will look like when this thing's all said and done. And this is one of those unique opportunities to take a completely fresh look. blank sheet of paper, we're going to come out of a crisis, a very changed nation in a lot of ways. And could you do something substantially different, that would really advance your organization, your service, your connection to consumers, whatever. I think this is one of those rare moments in all of our careers where you can basically be bold, and go for it. The second thing I suggest to all leaders of the boards I sit on is to get through the crisis phase. But while you're doing that, put equal time in the recovery phase. And in that recovery phase, it's a chance for just incredible transformation. Take advantage of it, run with it. That's where the action is going to be with this.Gary Bisbee 36:00Well said, thanks, Ken, terrific interview much appreciated Good luck to you and Prime as we move forward.Ken Paulus 36:07Thank you so much, Gary. It's been a pleasure talking to you.Gary Bisbee 36:09This episode of Fireside Chat is produced by Strafire. Please subscribe to Fireside Chat on Apple Podcasts or wherever you're listening right now. Be sure to rate and review fireside chat so we can continue to explore key issues with innovative and dynamic healthcare leaders. In addition to subscribing and rating, we have found that podcasts are known through word of mouth. We appreciate your spreading the word to friends or those who might be interested. Fireside Chat is brought to you from our nation's capital in Washington DC, where we explore the intersection of healthcare politics, financing, and delivery. For additional perspectives on health policy and leadership. Read my weekly blog Bisbee's Brief. For questions and suggestions about Fireside Chat, contact me through our website, firesidechatpodcast.com, or gary@hmacademy.com. Thanks for listening.

In this episode we talk to Dennis Orthman. Orthman is the Senior Director with the Strategic Marketplace Initiative, supporting SMI executive teams in the development of innovative solutions to industry challenges. Orthman has over 30 years of healthcare supply chain experience, beginning his career as a hospital buyer and progressing through respected management, consulting, and executive positions. Orthman worked at Boston City Hospital, the Caritas Christi Health System in Boston, and served as Director of Contracting for Partners Healthcare System. Dennis has also worked as a Senior Consultant with Concepts in Healthcare and with BD Healthcare Consulting & Services, assisting IDN clients in creating hospital-vendor partnerships and delivering innovative supply chain programs. An MBA graduate from Suffolk University in Massachusetts, Orthman is also a graduate of the Georgetown University Healthcare Leadership Institute. Orthman is an active member of AHRMM, serves on the GS1 Healthcare US Leadership Team, has been published in numerous industry trade journals, and has presented on progressive supply chain topics at both the national and local conferences.

Dr. Thomas Lee, network president of Partners HealthCare System and professor of medicine at Harvard Medical School.

As healthcare moves toward evidence-based medicine, a physician's success will increasingly be dependent on how well advanced clinical decision support is applied to the practice of medicine. What measures are providers taking to deliver meaningful decision support that improves both the quality of care for patients and the quality of life for clinicians? Listen now to explore the challenges of establishing methods to manage this influx of new knowledge while transforming data into meaningful decision support in Healthcare Tech and the World: “Knowledge Management in the 21st Century." Host: Dr. Kevin Fickenscher Executive VP of Healthcare Transformation Perot Systems Corporation Guest: Dr. Tonya Hongsermeier, Director of Clinical Knowledge Management Partners Healthcare System www.partners.org

Through its federal charter, the American Health Information Community was formed to provide input and recommendations on how to best address the key concerns that would impede the widespread adoption of an electronic health record for all Americans: standards, privacy, system certification and a national health information network. Dr. John Glaser, CIO of Partners Healthcare System and AHIC member, discusses the group’s mission and its progress on helping make health records "digital and interoperable, while assuring that the privacy and security of those records are protected, in a smooth, market-led way." Host: Dr. Kevin Fickenscher Executive VP of Healthcare Transformation Perot Systems Corporation Guest: Dr. John Glaser, CIO Partners Healthcare System www.partners.org Length: 23:25 minutes File Size: 9.38 MB