Issue link: https://viewer.e-digitaledition.com/i/619635
the nature of this care," says Rob Schreiner, MD, FACP, FCCP, Managing Director of Population Health at Huron Healthcare, a healthcare performance improvement organization that is part of Huron Consulting Group. "We worry that our individual infl uence over those processes will decline once we become part of a larger system." Clinicians also worry that if the process of care in a new organization runs less than smoothly, years of rapport and goodwill they have built with patients will erode, according to Dr. Schreiner. "Physicians trade on their credibility with patients, families, colleagues and the institution with which they're aligned," he says. "They also know that patients judge them not necessarily based on [making the] right diagnosis and [prescribing the most appropriate] treatment, but on the e• ectiveness and e¬ ciency of the health system within which they practice. If it's hard to make an appointment, reach the physician, and get in and out within [a reasonable amount of time], all of these service dimensions refl ect badly on the physician." COLL ABORATING, NOT COMMANDING It is incumbent upon healthcare administrators to foster an atmosphere of transparency, receptiveness and partnership with clinicians when a merger or integration is proposed. Those who dictate plans or expectations from the C-suite, or seek physician buy-in only when a reorganization is a fait accompli, face rocky relations with physicians, according to Malloy. "If [a merger or integration] is presented as a top-down strategy ... without giving physicians a voice in the process, the move is likely to fail," he says. "Hospitals need to establish two-way communication channels between the drivers of the strategic initiatives for the system and the physicians them- selves. The process has to be physician-centric. Administrators must acknowledge that traditional communication techniques aren't e• ective. Stand-up meetings, newsletters — these legacy strategies for communicating aren't e• ective in this integrated world. Communication needs to be participatory, mobile and have active mechanisms for feedback. [Using] digital technolo- gies is the only logical way to do this." How communication occurs is important, as is who is doing the communicating. Ma lloy and Dr. Schreiner agree that physicians are more responsive to peer-to-peer communication than administrator-to-physician messaging. "Use the physician leadership architecture that already exists in the institution to have a fact-based, thoughtful approach to soliciting advice [about a proposed merger or integration], and call it 'advice' rather than 'input,'" Dr. Schreiner says. "In an academic medical center, the chairs of the largest departments can hold town hall meetings for their departments to seek and obtain physicians' thoughts and concerns and then share these with leadership. In a community hospital, the medical executive committee is the best centralized source of physician leadership, and its members have ways of soliciting thoughtful advice from peers and colleagues in operational areas and then bringing them back to hospital leadership." By including physicians as partners directing the course of change, hospital administrators can set their facilities up for success during times of organizational transformation. ■ Speak Softly and Carry Big Data PRE SENTING CLINICIA NS, PA RTICUL A RLY those who practice independently, with evidence of the potential of clinical integration to simplify tracking of patients' interactions with the healthcare system can assuage concerns about the effect of integration on care. This is the conclusion of David Beto, Chief Growth and Business Development Offi cer at Healthcare Insights, LLC, a company that develops fi nancial manage- ment solutions for hospitals and healthcare systems. Beto wrote about the topic of physician alignment with clinical integration in a recent post for the Healthcare Insights blog. "One of the biggest benefi ts of clinical integration is the ability to track, via interoperable EMRs, claims analysis and other means, the progression of patient care through the system," Beto writes. "A¨provider can better follow the results of his or her practice and observe the course of patient care. [When they receive aggregate data presented] as an objective, easily accessible report, many physicians who would otherwise be resistant to integration will begin to see the benefi ts of closer collaboration. This is especially true if those reports show individual physicians' or practices' performance, relative to peers." M D N E W S . C O M /// M D N E W S C EN T R A L N E W YO R K ■ 2 016 1 7