Tuesday, January 15, 2019

Joel Hornberger, Chief Strategy Officer, Cherokee Health Systems

Today’s guest is Joel Hornberger, the Chief Strategy Officer and National Training Director at Cherokee Health Systems, headquartered in Knoxville, Tennessee. I had the good fortune to hear Joel speak last fall at an event sponsored by the New Hampshire-Vermont Chapter of HFMA and invited him to be on the podcast, and I’m really pleased that he did. Cherokee Health Systems is a combined Federally Qualified Health Center and Community Mental Health Center, which is kind of unique. Cherokee provides care for more than 70,000 patients through it’s 23 brick and mortar locations and 23 additional telemedicine sites.

Cherokee has been an innovator in the area of integrating behavioral health and primary care, which is the focus of my conversation with Joel today. In the interview we talk about how Cherokee uses embedded behavioral health consultants (BHCs) to collaborate with primary care providers as well as the Clinic developed a unique rating system called the BPSA to quantify the needs of individual patients, among other things. I really enjoyed talking with Joel because his passion for integrated care and the FQHC mission is so apparent. I hope you enjoy this conversation as much as I did.

During the podcast I make reference to a presentation that includes a floor plan used for integrating primary care and behavioral health, as well as the BPSA. You can find that presentation here.

Links to Podcast:

Soundcloud: https://soundcloud.com/healthleaderforge/joel-hornberger-chief-strategy-officer-cherokee-health-systems/

Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge

Podcast Outline

Time     Topic
0:01:58 education, VISTA volunteer
0:04:38 transition to healthcare administration
0:05:35 lessons from working in managed care in the 80's
0:08:05 Cherokee Health Systems - history
0:10:18 "going where the grass is brownest"
0:11:55 CMHC and FQHC - explaining what they are
0:16:21 growing from behavioral health to an integrated system
0:18:15 growing the system from 4 to 23 clinics
0:19:26 integrating behavioral health and primary care - treating the whole person
0:24:39 moving from co-location to integration
0:27:33 integrating beahvioral health consultants (BHCs)
0:29:38 an example of BHC treatment
0:32:26 the role of the BHC and behavioral treatment
0:33:56 training for BHC role
0:36:08 staffing ratios for BHCs vs primary providers
0:36:29 Services offered - Dental services
0:38:25 Services offered - addiction services
0:40:33 Grants and other funding for FQHCs
0:43:45 telemedicine to support school-based clinics
0:48:32 telemedicine in support of psychiatry
0:49:23 telemedicine - the aesthetics
0:50:22 telemedicine and licensing
0:51:49 Value-based contracts and the Bio-psycho-social Assessment (BPSA)
0:56:56 zip-code trumps genetic code
0:57:56 working with claims data
0:59:19 using the BPSA score to manage patients
0:59:59 using BPSA to guide preventive care, community health coordinator role
1:03:39 role as chief operating officer and now, chief strategy officer
1:08:03 what makes a good leader?
1:10:18 what do you look for when hiring a leader? Importance of fit
1:12:21 a difficult leadership lesson you learned the hard way? Making promises you can keep
1:17:28 why should early careerists look to FQHCs?

Links to topics discussed:

Cherokee Health Systems

What is Integrated Behavioral Health? AHRQ

Lebanon Valley College

Monday, January 14, 2019

We're back!

Greetings, friends! After an 8 month hiatus, the Health Leader Forge is back with new interviews. Tomorrow, January 15th we will release the first podcast of the new year. It is an exciting interview with Joel Hornberger, the Chief Strategy Officer and National Training Director for Cherokee Health Systems, headquartered in Knoxville, Tennessee. Cherokee Health Systems is a large, combined FQHC and CMHC, and they are leaders in integrated behavioral health, which is the focus of the interview.

Future podcasts already in the queue include an interview with the Heather Lavoie, President of Geneia, a healthcare analytics company located in Manchester, New Hampshire, and Brian Martin, President and CEO of Loring Community Hospital, a critical access hospital in Sac City, Iowa.

We're excited to bring you more interviews about the careers of healthcare leaders and their organizations - please subscribe and give us reviews on your favorite podcast app!

YouTube: https://www.youtube.com/channel/UCkUYyqD0z6a5jRSZL7wNB3g  

Monday, June 4, 2018

Podcast on Hiatus

Dear Friends,

It's been an amazing couple of years sharing the career stories and leadership advice of senior healthcare leaders, however, I will be putting the podcast on hiatus for the near future. The interviews already completed will continue to be available.

Hopefully we'll be back some time in the future.



Sunday, April 15, 2018

Jeffrey Hughes, Chief Strategy Officer, Wentworth-Douglass Hospital

Today's guest is Jeff Hughes, the Chief Strategy Officer for Wentworth-Douglass Hospital (WDH) in Dover, New Hampshire. In this podcast, Jeff talks about his career in planning and strategy in a wide variety of healthcare organizations from community hospitals to teaching hospitals to health systems and even a medical school. Wentworth-Douglass has recently gone through the process of becoming an affiliate of Massachusetts General Hospital, and Jeff talks about the lengthy process WDH went through to decide on this strategy. The podcast is a fascinating insight into the reasoning behind the industry-wide trend in consolidation. 

Links to the Podcast


Full length interview:  https://soundcloud.com/healthleaderforge/jeffrey-hughes-chief-strategy-officer-wentworth-douglass-hospital/

Abridged interview: https://soundcloud.com/healthleaderforge/jeffrey-hughes-chief-strategy-officer-wdh-abridged/ 
(The abridged interview starts with Jeff's position at WDH, the full length interview includes his work history leading up to WDH.)

Podcast Outline Time       Topic
0:01:03 education - finding direction
0:03:14 Yale program in health services administration and epidemiology
0:05:33 Healthcare Administration Residency
0:08:35 first role as planning coordinator for Newport Hospital
0:09:22 moving to Danbury Hospital, becoming director of operations
0:10:34 becoming a manager
0:12:11 meshing together strategy and operations
0:12:26 Price Waterhouse Coopers consulting
0:16:19 what do consultants do?
0:18:12 returning to direct care, starting own consulting practice
0:28:41 recruited by WDH
0:29:44 starting at VP of Planning at WDH
0:31:03 redesigning the strategic planning process at WDH
0:34:21 creating strategic questions
0:36:36 moving from process measures to outcomes measures
0:37:39 about WDH
0:38:41 what were the strengths and skills he developed leading up to WDH
0:40:54 Affiliating with Massachusetts General Hospital/Partners Health Care
0:45:04 strategic affiliation analysis
0:46:22 examining options: NH-based system vs. Mass Gen
0:48:47 negotiating from a position of strength
0:50:25 the NH option - horizontal vs. vertical merger
0:53:21 clinical affiliations - what are the benefits?
0:56:25 the future of telehealth
0:59:00 what are the strategic challenges in healthcare now?

Links of Interest:

Thursday, March 15, 2018

Dr. Teresa Leverett, DO, Freedom Family Practice

Today's guest is Dr. Teresa Leverett, the founder of Freedom Family Practice in Portsmouth, New Hampshire. Freedom Family Practice is a family practice clinic that runs under a model called Direct Primary Care (DPC). In this podcast, we talk about what DPC is, and how it is allowing physicians and patients alike to have a different health care delivery experience. Recent UNH graduate Sameer Panasar returns to guest host this episode.

Links to the Podcast

Podcast Outline 
Time       Topic
0:03:38 schooling
0:07:06 deciding to pursue family medicine
0:09:05 Residency at Eastern Maine Medical Center
0:10:55 when did she know she was a physician
0:11:53 clinical career before Freedom Family Practice
0:18:08 breaking with practicing in a large physician group, looking for something else
0:21:44 Founding Freedom Family practice - what is direct primary care?
0:24:18 panel size, what patients want from direct primary care
0:26:52 small businesses as customers of DPC
0:34:06 growing the practice
0:37:11 running a lean business
0:39:21 challenges of starting a practice
0:41:46 policy challenges of DPC - regulatory status
0:46:41 Specialists who are starting DPC-like businesses
0:49:04 DPC - "Back to the Future" model of healthcare
0:53:50 At year 3 of her practice - goals?
0:55:05 would like to teach medical students about how to grow a practice
0:56:12 thoughts on the primary care crisis
1:01:38 DPC helps her feel like a doctor

Links of Interest:

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Thursday, February 15, 2018

Colonel Jean M. Barido, Commander, Public Health Command - Central

Today’s guest is COL Jean Barido, the Commander of the US Army Public Health Command – Central. The Command provides public health leadership and evidence-based preventive medicine programs and veterinary services to optimize the health of military units, installation personnel, and animals within 20 states, the Caribbean, and Central America.

In this podcast we talk about COL Barido’s career as an Army Nurse Corps officer, starting in the reserves and then transitioning to active duty. We discuss her many roles in the military including deployments to Kosovo and Afghanistan, and then discuss her role as the Commander of a dispersed unit with many diverse missions. We conclude with a discussion of leadership.

Podcast Outline 
Time       Topic

0:01:24 introduction, education
0:02:40 working as an RN, joining the reserves
0:03:41 about the Army Reserves
0:06:17 balancing the Reserve duty with civilian full time job
0:07:43 deploying to Kosovo with reserve combat hospital
0:09:38 caring for local nationals in austere conditions
0:11:14 transition to active duty as an Army nurse
0:12:54 first jobs on active duty
0:13:29 deploying to Afghanistan
0:14:25 PROFIS units - how the Army staffs field units
0:16:54 the Afghan mission
0:21:06 return from deployment, becoming a nurse practitioner
0:22:26 Uniform Services University of the Health Sciences
0:24:21 work as a family nurse practitioner
0:26:24 moving to the Pentagon - working in Manpower and Reserve Affairs
0:28:38 Chief Nursing Officer, Moncrief Army Health Clinic, Ft. Jackson
0:29:28 Commander, Public Health Command - Central
0:32:25 defining public health - "one health" - people, animals, and the environment
0:34:24 composition of the command - units within the command
0:38:12 role of the Commander
0:45:06 role of Veterinary Corps
0:46:50 learning to lead in a distributed and diverse organization
0:47:57 the Army process for selecting commanders
0:48:54 what prepared her for this command
0:51:09 most pressing issues facing MHS from Public Health perspective
0:53:46 leadership philosophy - her 5 core values
0:55:11 characteristics of a good leader
0:55:58 her leadership role model - her father
0:56:39 what she is looking for in a leader
0:57:10 leadership lesson learned the hard way
0:59:30 organizational culture
1:01:48 her career mentors
1:02:46 what does a good mentor do
1:03:14 her role as a mentor
1:04:36 careers: why public health? Why nursing?
1:06:31 advice to future healthcare leaders

Topics Discussed:

Public Health Command - Central

399th Combat Support Hospital

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Monday, January 15, 2018

Mary Lowry, Administrative Director, Center for Telehealth, DHMC

Today’s guest is Mary Lowry, the administrative director of Dartmouth-Hitchcock health system’s Center for Telehealth. The Center for Telehealth is Dartmouth-Hitchcock’s consolidated telemedicine program, and in this podcast we talk about the variety of services and support that Mary’s team provides across New Hampshire and Vermont. It’s a fascinating look at the future of medicine, even though as Mary notes, telemedicine isn’t new, I think it is just now coming of age, and as we continue to transition away from a fee for service model in healthcare and towards the provision of value based care, we are only going to see greater levels of telemedicine utilization.

Links to the Podcast
Soundcloud: https://soundcloud.com/healthleaderforge/mary-lowry-administrative-director-center-for-telehealth/
Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge
iTunes: https://itunes.apple.com/us/podcast/healthleaderforge/id981989377 
YouTube: https://youtu.be/w4K5nXEUwqQ
Transcript is available here: http://healthleaderforge.blogspot.com/p/mary-lowry-transcript.html

Podcast Outline 
Time       Topic
0:01:15 introduction - about Dartmouth-Hitchcock
0:03:12 Mary's background, role of the administrative director
0:04:56 Connected Care Center
0:05:42 Telemedicine and Transfer Management
0:06:38 history of the program
0:07:38 Services - Telestroke & Teleneurology
0:10:11 which hospitals contract for telemedicine services and why
0:11:24 critical access hospitals, night coverage at PPS hospitals
0:18:35 partnership with Specialists on Call
0:19:47 reimbursement
0:21:40 the business case for telemedicine - keeping patients
0:23:25 protocol for treatment with telehealth
0:24:08 other inpatient telehealth services
0:25:26 tele-emergency medicine
0:28:50 challneges of quantifying the business case
0:30:18 tele-intensive care (tele-ICU)
0:31:48 "wired bed"
0:36:11 tele-ICU - complement, not substitute
0:37:51 the tele-ICU stations team
0:38:56 revenue stream for tele-ICU, ROI
0:40:50 tele-pharmacy
0:42:36 tele-psychiatry
0:45:40 why not ambulatory tele-psychiatry
0:47:50 ambulatory services
0:50:35 billing for home telehealth visits
0:51:45 pediatric specialty services - efficiency
0:52:45 strategy implications of telemedicine
0:56:30 synergies between services
0:57:20 identifying gaps in care and bringing resources to patients
0:58:05 building the business, seeking profitability
0:59:46 role of telemedecine and value based care
1:01:26 what are the limits on growth for telemedicine
1:04:06 future visions for telemedicine
1:05:35 business to business vs. business to consumer
1:09:25 closing thoughts

Topics Discussed:

Connected Care Center

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