The Affordable Care Act has hastened the evolution to quality-based payments. My role on the payer side of health care has changed tremendously over the last five years. My current focus is developing partnerships with providers to truly affect quality and accessibility of care. I have had to learn how to more effectively drive change and strive for innovation. Over the past 1½ years at Florida Blue, we have implemented seven accountable care arrangements and introduced the third-largest patient-centered medical home program in the country.
Jonathan Gavras, MD, FCCP, is senior vice president of delivery system and chief medical officer, Florida Blue, Jacksonville, Fla., and serves on HFMA’s Board of Directors.
We managers, clinicians, and researchers are often overly confident about our ability to identify gaps and find solutions. I am reminded regularly that the healthcare system looks very different to patients than it does to us as insiders, even though we often have experiences as patients. The coordination problems of our healthcare “system” will take time to fix. Healthcare professionals who are adept at including patient and family perspectives in identifying gaps and designing solutions can make meaningful progress toward improving coordination issues.
Janice D. Walker, RN, is project director of OpenNotes, Beth Israel Deaconess Medical Center, Boston.
In the world of informatics, the changing landscape is leading to new technical capabilities. As healthcare leaders understand the art of the possible, the demand for new innovations grows. I have worked on topics I had never previously imagined, such as laboratory utilization. Each involves clinical workflow and data collection through modeling, alerts, reminders, and clinical performance validation. I’ve also had to improve my ability to translate informatics for others. It’s not enough anymore to find great solutions; you also have to justify and crisply explain the value proposition.
Jonathan C. Silverstein, MD, MS, FACS, FACMI, is vice president and head of the Center for Biomedical Research Informatics, NorthShore University HealthSystem, Evanston, Ill.
The characteristics of leadership don’t change even though times and circumstances change. I’ve had many diverse experiences, including leadership roles in planning, consulting, finance, and operations. While I’ve routinely had to reinvent my specific duties, my focus has always been on managing change, which is a key leadership skill. Harvard Business School’s John Kotter said that change is analogous to changing the layout of furniture that is connected with a rope. Moving one piece of furniture has implications for all of the other pieces. In other words, carefully consider the intended and the unintended consequences of change before execution.
Michael B. Green is president and CEO, Concord Hospital, Concord, N.H.
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