Risking revenue and relearning your job

This new monthly column is being kicked off by the executive who first conceived of it.

Dr. Marc Harrison, CEO of Salt Lake City-based Intermountain Healthcare, suggested to us that the industry’s push to innovate might be made easier if executives know they aren’t leaping into the unknown alone or even for the first time.

YOUR RISKIEST DECISION

Probably how we built out our telehealth services. Another difficult, not risky move was taking down our regional structures.

WHAT WAS RISKY ABOUT IT?

Telehealth done right lowers the total cost of care and should lower out-ofpocket costs for patients, but it also systematically lowers revenue for the enterprise. It requires a lot of discipline. With restructuring, it was really difficult because it required people to relearn their jobs. It also unmasked areas where we had unintentionally competing priorities.

THE OUTCOME

It’s been fantastic. We launched one of the largest digital hospitals in the U.S. We have all of the intensive-care unit beds in the entire system monitored by our Tele-Critical Care program. And in every hospital we serve in that fashion, the risk of mortality, cost per case, length of stay, and need for transfer all go down. It’s also making our smaller hospitals financially viable.

The restructuring has been really successful, too. One of our chief nursing officers who now works in quality recently said, “You know, I was pretty sure that my colleagues and I were doing things all the same way, but now I can see how divergent we were.” And, she said, “I’d never go back.”

THE RESPONSE FROM THOSE INVOLVED?

The proof is in the pudding, and one of our rural hospitals noticed that patients were choosing to die rather than to get chemotherapy at one of our major centers that was a twoto three-hour drive. That spurred the local leaders of that organization to set up a tele-oncology program. Patients now are not spending their lives driving back and forth and the cost is more reasonable. When you tell a story like that, people get it.

ADVICE TO EXECS IN SIMILAR POSITIONS

Patients are increasingly acting as consumers and are going to be unwilling to pay for services that they know could be delivered in a less-expensive environment. Executives need to admit that and then hurry up and take risks. And, I’d be surprised if their boards aren’t telling them to already. Take constructive criticism but filter it through a process that allows you to determine whether the folks who are your fans or your critics are giving you good advice and modulate accordingly.

DESCRIBE YOUR LEADERSHIP STYLE

I guess that I am clear-thinking, visionary, inclusive, that I’m able to inspire people to want to deliver against that vision, and that I’m supportive of my leaders, that I don’t micro-manage them, that I trust them, and that I give them an enormous amount of freedom to deliver against our shared goals.

HOW OTHERS WOULD DESCRIBE IT

Probably some of that, but also I would suspect that some people would find that I want to move really fast and that I can be impatient. ●

Take constructive criticism but filter it through a process that allows you to determine whether the folks who are your fans or your critics are giving you good advice and modulate accordingly.