A New Beginning for Academic Medicine

AAMC Report Cover - Advancing the Academic Health System for the FutureIntroduction by Lisa Fields and Colin Hung

This week #HCLDR welcomes Joanne Conroy, MD Chief Health Care Officer at the Association of American Medical Colleges (AAMC) and a frequent contributor to the Wing of Zock blog, as our guest.

We are honored that Conroy and the AAMC have chosen our tweetchat to debut their new report on the future of academic medicine. The AAMC believes in the educational value of social media – especially in healthcare. @WingofZock is a member of the #HCLDR community and has seen first-hand how rich and valuable the weekly tweetchats are for healthcare leaders. In recognition of the community and as a “tip-of-the-hat” the AAMC has graciously made their new report available to the HCLDR community free of charge. Normally there is a $150 cost for non-members. You can find a link to the report in the blog post below.

Special shout out to Jennifer Salopek for helping to make this week’s AAMC participation possible. We appreciate all your hard work and openness.

Join us for #HCLDR tweetchat on Tuesday March 18, 2014 at 8:30pm Eastern (GMT-5)

Conroy (1) - Web PhotoBlog post by Joanne Conroy, MD

Last week, the AAMC, in partnership with Manatt Health Solutions, released a seminal new report: “Advancing the Academic Health System of the Future.” In it, we reported on the activities of the Advisory Panel on Health Care for the past year: 13 academic medical centers (AMCs), selected for their reputation as thought leaders, were interviewed and studied in depth. These interviews revealed several shared characteristics—perhaps secrets to their success?—and the concrete steps they are taking to ensure continued financial sustainability and support of their education and research missions.

The interviews revealed eight common themes among these 13 institutions that are taking proactive steps toward the future:

  • The AMC of the future will be system-based.
  • These academic health systems require strong and aligned governance, organization, and management systems.
  • University relationships will be challenged to change as academic health systems grow and develop.
  • Growth and complexity of an academic health system requires enhanced profiles for department chairs, new roles for physician leaders, and evolution of practice structures.
  • Transparency in quality, performance, and financial information at all levels of the organizations is central to high achievement.
  • Competitive viability and long-term mission sustainability will require a radically restructured operating model for cost and quality performance.
  • It is time for AMC leadership on population health.
  • A candid assessment of strengths and weaknesses is essential to achieve positive change.

The 13 academic medical centers studied are growing into true health systems, offering a continuum of services. The emergence of larger systems is no doubt driven by alternative payment initiatives, which require us to think more broadly than the delivery of complex acute care. The role that each academic medical center plays in larger systems of care will vary depending on its market and resources. Some AMCs will take the lead in forming a health system responsible for substantial geographies and numerous covered lives. Others may merge or partner with non-academic providers to achieve this market power. Those that fail to act could become isolated and marginalized in their markets.

  • T1. AAMC’s research shows academic med centers growing bigger. As they grow do you believe they stray from their founding visions?

The foundation for the academic health system of the future will be a strong team structure made up of sophisticated and capable executives supported by excellent management systems. Personal leadership skills and the ability to work across boundaries with colleagues will be the defining characteristics for successful AMC executives. Principles that these leaders and teams will need to uphold include:

Trust. The basis for success requires that the leaders and teams believe that they are dealing with forthright partners.

Unified Direction. The task of establishing a successful academic health system will require that leaders prioritize collective needs over individual gains.

Transparency. Collective visibility into the team’s progress against agreed-upon strategies and objectives, and a clear understanding of operating, clinical, and financial performance are needed for a team to function at its highest potential.

Accountability. Leaders must be accountable to each other for executing and achieving results.

Communication. Leaders must ensure that information permeates the organization; they cannot achieve results if they are isolated and the directions in which they are leading the organization are not understood.

  • T2. Is there an effective way that teams can make decisions in a large organization – esp with competing priorities & personalities?

Leaders of AMCs must boldly and forcefully restructure their operating models or risk becoming marginalized as providers in their regions, increasingly relegated to government payers or to a subset of the highest acuity patients. Restructuring the operating model entails, among other things, a commitment to operating practices such as LEAN that inculcate training throughout every level of the institution and reinforce continuous improvement as an operating discipline.

  • T3. Continuous improvement (CI) is key. How, as leaders, can we encourage, empower and maintain momentum for CI initiatives? 

In the Report, we further urge leaders toward the vigorous reaffirmation of a patient-centric, “customer first” culture in all operating divisions and processes; and alignment and orientation of clinical services in a patient-centric organizational model.

Those AMCs that have implemented population health are a stark contrast to those AMCs that focus almost exclusively on the highest acuity patients. This focus will remain a necessary but insufficient condition for success in the long term. A particular challenge is developing a comprehensive network of primary care clinicians and a community-focused system of care, which will be necessary for providing comprehensive, longitudinal care to the chronic and elderly patients of coming decades. AMCs have always been a locus for complex and specialized care, but managing the health of individuals and populations across the entire continuum will be a new skill for many. A population health approach involves identifying opportunities for health improvement and identifying community strengths and resources, including public health, and connecting them with primary care and sub-specialty care to a larger base of primary and secondary care.

  • T4: How can/should academic med centers engage in population health? How can they improve relationships with patients?

I am looking forward to discussing the Report findings and the state of evolution in academic medicine during the #HCLDR chat on Tuesday, March 18, 2014, at 8:30 pm EDT.

Joanne Conroy, MD, is chief health care officer at the Association of American Medical Colleges. She can be reached at jconroy@aamc.org. Follow her on Twitter @joanneconroymd.

One comment

  1. […] Conroy MD (@JoanneConroyMD) – A New Beginning for Academic Medicine – Mar […]

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