‘We needed to think of ourselves a little bit differently’
“We know the nature of medical care is changing from being predominantly inpatient to far more outpatient, and so we’re allocating more of our resources to ambulatory care.”
In Chicago’s uber-competitive healthcare landscape, academic medical centers have been forging new alliances at a staggering rate, especially as they eye growth in the surrounding suburbs. In March, Rush University Medical Center, situated in Chicago’s predominately low-income near West Side, and suburban Rush-Copley Medical Center formalized a 30-year affiliation by joining together under a new banner: Rush. Michael Dandorph, president of Rush University Medical Center, will take the helm as president of the newly formed system. He recently spoke with Modern Healthcare reporter Maria Castellucci about Rush’s expansion plans, efforts to improve care coordination and its role in addressing population health issues. The following is an edited transcript.
Modern Healthcare: What was the strategy behind developing this fully integrated system and how is it different from what you were doing?
Michael Dandorph: One of our goals is to be the leading academic health system in Chicago. To do that, we’re going to have to think about more than just what Rush looks like on the campus with our flagship hospital. We started to think about how we governed the organization and how we make strategic investments and resource allocation and plan our growth regionally. We needed to think of ourselves a little bit differently.
Through the creation of the parent board, we wanted to position ourselves to think not only about this as an integration with Copley, but with regard to how we grow a system if we decided to integrate with other providers or physician groups or alternative care providers or insurance companies for that matter.
As we think about it from a strategic perspective, it allows us to do planning in a different way. We’re thinking about capacity optimization and how we provide better access to patients.
MH: It sounds like you have expansion plans and that’s where this came from.
Dandorph: We think about that in a couple ways. There’s organic growth and how you increase market share, how you grow as a system. We’re making investments in ambulatory sites in other markets off of our campus. A lot of it is about how we invest in ambulatory-care capabilities because we know the nature of medical care is changing from being predominantly inpatient to far more outpatient, and so we’re allocating more of our resources to ambulatory care.
We’re also thinking about partnerships in a very different way, which is why we constructed that parent board the way that we did. We want to become nimbler in the way that we’re viewed by potential partners to make sure that we’re thinking about their success as well as what the partnership does for our overall ability to manage populations and to create greater value.
MH: How is this strategic idea different from your counterparts in the Chicagoland area or even other academic medical centers?
Dandorph: Probably the biggest differentiation is having an integrated academic medical center that has a dedicated health science university. That’s a major strategic opportunity for us. Our curriculum can bring various aspects of healthcare together—a medical school, an integrated nursing program, allied health programs, a business health administration program—to develop the future skills that a healthcare workforce is going to need to succeed.
We’re really thinking about how we improve care coordination in a way that allows us to move the expertise closer to the community setting, closer to people where they live.
There are a few examples where we’ve begun to integrate with our care processes. One is an app called SeamlessMD, which allows surgical patients to
better manage their own care before and after surgery.
MH: What are you doing in the population health realm?
Dandorph: We are looking at how we use community health workers to keep people out of the hospital and avoid readmissions or prevent admissions that don’t need to come to the ED. One of the more interesting partnerships that we struck is with an innovation group called Avia.
Through them, we developed a partnership with a company called Proteus Digital Health. They have a smart pill with a biodegradable chip that’s the size of a grain of sand that gets embedded into a pill. We’re focused right now on hypertension. If someone is taking medication prescribed by a physician, that chip, through an app, will provide information back to the physician letting them know if the patient is taking the drug at the right time, if there are metabolic issues around absorption of the drug and what’s going on with their heart rhythm in a meaningful way. We’re in the process of launching it.
MH: What are some challenges you face today as an academic medical center? How do you balance the research mission with a lot of patients coming to Rush for intense specialty care?
Dandorph: Obviously, changes being debated with repeal and replace of the Affordable Care Act and different evolutions of what healthcare reform is going to look like and the expansion of Medicaid are big. Being on the West Side of Chicago, we have a lot of issues around disparities in care, an underserved population.
We’ve launched two major initiatives. One: We should be the largest employer on the West Side of Chicago. We have a mission to be an anchor in the community in a way that brings people together in a different way to improve the health of the community. Working with other providers in the Illinois Medical District we are bringing government, church leaders, the business community together in a way to create opportunities for employment, education and career development.
We’re also calling for an approach to a total health collaborative in which we’re not only thinking about healthcare and what Rush can do, but how can we be a catalyst on the West Side to bring partners together in a different way to deal with those underlying issues.
MH: What does that look like in terms of partners?
Dandorph: We’re working closely with one of the city colleges, Malcolm X College on the West Side, that’s been very focused on developing pipeline programs for healthcare and collaborating with them. We’ve developed a program where we can train community health workers because we know that drives some of those population health issues.