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Time to go through my notes and pull some of the interesting ideas from the various health systems that might spark some thinking for you at your health system. Today, Children's Hospital of Philadelphia, CommonSpiriti and Bon Secours Mercy. Hope you enjoy.


Today in health, it GP Morgan. Second day, I'm going to dive into presentations. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in health. It. Instead of channels dedicated to keeping health staff current and engaged. We want to thank our show sponsors who are investing in developing the next generation of health leaders, Gordian dynamics, Quill health tau site nuance, Canon medical, and current health. Check them out at this week.

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All right. Last week we looked at themes. , yesterday, we took a look at some of the health systems. We took a look at its sension advocate and Intermountain. , today, we're going to go a little further and we're going to look at a couple of the other presentations. , well, let's start with, let's say let's start with common spirit.

, not a lot, really to talk about with common spirit, except, I mean, there are swallowing the elephant, right? So a common spirit was a growth through acquisition play for many years. And then they took on, , Chi. And, , grew massively and Chi had, , a fair amount of warts, , associated with it. So they had to digest that.

140 hospitals, 33.3 billion in revenue. , 2.1 million virtual visits, 5.1. Billion in, , charity care, , which is pretty impressive. Lloyd Dean is, , is retiring and moving on. , their financials were, , 214 days cash on hand, 2.9 billion in cashflow. It's an interesting. Statement that they're the only ones that reported the financials that way.

, you know, their, their ratings are going up again. They're just swallowing the elephant. Not much to talk about with regard to technology. Although I know they're doing a lot of really interesting things. , with technology and I love to, and I will. Explore trying to get, , someone from common spirit on to talk about some of the things they're doing.

With regard to technology. , children's hospital Philadelphia. , very impressive. , impressive presentation, great stories. , they always share great stories. Of what they're doing in terms of research and, , and really advanced care for children, , their revenues going up after a blip, obviously in 2020 revenues going up operating margin, going up.

, income going up. They are, they're doing some interesting things to do some interesting things with data. , and, , just a lot of devices and whatnot. So, , always good to keep an eye on what they're doing in the children's space. I think they're , one of the leaders in the children's space, , for sure.

, one of my favorite presentations and this might be all we end up talking about for today. Cause I have a lot of. , notes on this one. Bon Secours mercy health system, I think has one of the more interesting leaders in John. , Starcher. , and, , he, , presents what they are doing.

And so much of it resonated with me that I just have a ton of notes. , on this.

I want to go back to this theme that we've been talking about, which is this labor crisis. And, , John ended up addressing this in the presentation and he talked about how their health system faces workforce challenge headwinds. Remember I said, headwinds came up an awful lot in the presentations.

Obviously. A significant amount of turnover. We have the great resignation that's going on. It's impacting healthcare, probably, , one of the, one of the hardest hit areas, a little less than hospitality, but more so than other parts of the industry. , these were three points he had on a slide loyalty to employers.

He has been diminished during the pandemic loyalty to the profession of healthcare has been diminished. And physical and mental wellbeing has suffered. I saw a cartoon today. Not a cartoon funny, but a cartoon that sort of makes you think where, , there was two beds next to each other, separated by a curtain.

And the patient said a nurse and the person in the bed next to him said, yes. How can I help you? And I think that's what we're seeing. I mean, this Omicron has really impacted the healthcare community. , there's a lot of people that are sick. , with the virus because it is so transmissible. , and then we also have the great resignation going on.

And so a lot of organizations are addressing that. , by. Looking at their labor supply chain by opening up their hiring. , across more states, I talked to a CIO that now has a 48 state. Hiring strategy. Think about that 48 state hiring strategy. Can you run your it organization with people being hired across 48 states?

, we know that's the way people want to work. More people will apply to jobs if they were remote. So, , maybe it's time to put your plan together. To figure out how you're going to run your organization that is scattered to the four winds, , but supporting your organization. , they had , some numbers that, , they shared

, cash on hand. And again, impressive went from 183 days in 2018 to 330 in 2021. , operating cash went from 3.7. Billion to 9.2 billion. And, , admissions is up 6.2%. They're doing a lot of interesting things. 10.7 billion in revenue. , even a margin is 6.2%. Net income margin, 7% capital expenditure, $670 million.

I like the way he talked about innovation and this is the area where I'm probably going to camp out a little bit. , because they have reorganized around innovation and really growth through new models of care and , new ventures. If you will, you talked about outside innovation and bringing outside innovation into the organization. And for that they've partnered with companies like Avia.

, they have directed investments into companies as well. They have inside out innovation and then they have innovation funds that they've invested in. , things like saute ventures and seven wire. , ventures as well. And so those companies are out there investing in, , interesting startups, , in the case of seven wire in, in Lavango transparent and other players that we've talked to.

And they are participating. With that now, interestingly is their footprint. So they made a significant move into Ireland. And, , it's just very different and I'm sure that was ministry based. Somehow they got pulled into Ireland. And they have 1200 sites of care. , in the U S N Ireland combined.

, 50 hospitals. Across those locations. So they're in New York, Ohio, Maryland, Virginia, Kentucky, South Carolina, Florida. But some of that is long-term care. And they are moving out of that.

Okay. , here's what the future looks like to them. And again, I found this interesting, less oriented solely to acute care services. We hear that a lot. And we'll have to keep an eye on that to see how that plays out. , dedicated to growth, both organic and inorganic, more proactive than reactive and responding to opportunities and threats. And I think coming out of the pandemic, this is one of the things we have to be. We have to have four sites. We have to be forward looking forward, thinking.

And be proactive around the things that are heading our way instead of reactive. , less anchored to a geographic footprint. So this is the health system that figures this out and Mayo is probably. Getting there faster than anybody else. Because they have the brand and they can go into these other markets. You.

You don't have to establish your brand if you're Mayo going into any part of the United States or even abroad for that matter. , but you have someone like Bon Secours, mercy. Who is saying, look. We don't want to be anchored to a specific geography. We want to figure out how to participate in care across whatever geography clearly. I mean, they're in.

Ireland as well. A diversified revenue and EBITDA mix and committed to mission and vision. I probably read that in the wrong order. They would want me to read committed to mission and vision first. , So they restructured. And I found this interesting, and I found an interesting, for a couple of reasons. And for it listeners, they're going to find this interesting. The first is they hired a chief digital officer and it reports up to the chief digital officer as does analytics as those research innovation and digital strategy.

So all of that comes up to the chief digital officer. , and so you have that kind of dynamic, and they're not the only ones doing that. You're seeing all of the digital and technologies and analytics start to flow into one area , and have a single leader for that area. In some cases, the CEOs are stepping up to become that in other areas they're actually going externally.

And that's the case here. They did go externally and bring in. A new chief digital officer. They have a chief diversified growth officer. Okay. So they are looking at ambulatory ventures. They're looking at. , health system operating platforms. , they have, , just a bunch of other, , unique kind of, , of things. , things that are distinct to them that they are trying to grow out. And then they have a president and COO. Of the core operating entity and that is the operation. Of hospitals and clinics and healthcare. Let me give you a little details on the chief digital officer. It's Jason.

Suzuka S Z C U. K a. So Suzuka is how I pronounce it. I hope it's close. , chief digital officer. He used to service Cigna's chief digital officer he's entrepreneurial in nature started a digital tech startup. , that was acquired by Cigna. So, , again, going.

Not necessarily outside of the industry. I mean, Cigna's not outside the industry, but going to a payer and bringing that in for the skills that are more about , the digital DNA and about the entrepreneurial nature that they are looking to foster within the organization. , they go on to talk about how they are allocating their capital.

And. Pivoting the ministry, expanding the ministry and transforming the ministry. , is a significant area of where the capital is going to be going. , their strategic agenda strengthened the court. You heard this a lot strengthen the core. All right. So no one's abandoning their acute care hospitals and their clinics and those kinds of things. They're going to strengthen that they're going to make it, , better in terms of its service.

Its quality. , it's profitability. They're going to do those things, but when they talk about pivot the ministry, he's talking about the way they engage. The way they meet patients and consumers, where they are, the way they tap into digital technology. So this is going outside the four walls. We talk about going outside the four walls all the time and meeting the consumer where they're at. That's what they mean when they talk about pivoting the ministry.

Expand the ministry, and this is how they are going to leverage their scale. , the way they find new sources of revenue, the way they partner with other health systems and physicians. I want to talk about that. Find new sources of revenue that came up over and over again, it didn't matter.

Again, these are larger health systems that are presenting. They're all looking for new creative ways to find revenue. All right. So that is going to be recurring theme. They can either do that through investments, through being a VC through, , standing up new models of care. They could do this in a lot of different ways, but they're looking for new sources of revenue

, in hopes of diversifying their revenue and then transforming the ministry. And that's the way they innovate. , the way we adapt new care delivery models, the way we invest and adopt. Innovation. So again, that is a culture statement right there. That's saying, Hey, this is who we are. This is what we want to be about. And this is where

, we are headache. So they go on to talk about some of their investments and where they're going. , they share some of their financials, their gross revenue. , again, we shared a little earlier their operating margin. We shared a little earlier about 6% ish. , operating income bounce back after 2020.

And operating cashflow margin is a about 15%. And, , again, , I was fairly impressed. I think the things you want to take away from this presentation. Are the communication of vision was very clear. , this is going to be an innovative organization. They're jettisoning some of , , their previous investments.

And they're looking to really focus their capital on strengthening the core, pivot the ministry, expand the ministry, transform the ministry. And that's how Catholic health care talks about, , , their hospitals. They talk about their entire, , system. And they talk about it as a ministry. So anytime you hear the word ministry thinks system pivot the system, expand the system, transform the system.

, again, great presentation. I think the alignment is another thing I would take from this they're aligning around operations, right? Operating hospitals, digital. They're aligning around digital and they're putting all the technology assets under that and they're, , aligning around diversified growth. So again, interesting alignment.

, interesting way to look at innovation as well. They are investing in innovation. They're bringing innovation and they are, , looking to do transformative innovation and then they have invested directly into , , some key players. Again, I like this presentation. I think there's a lot to , take away from it.

And, , it really gives us a good idea of, , what a forward leaning health system is doing. And to be honest with you, this is probably three years in the making. But I thought about the first time I saw John present was at the JP Morgan conference. And he talked about the combination of Bon Secours mercy.

And the thing that was most impressive , , what's their approach to the merger. They didn't play around. He said we didn't form a committee and say, let's decide what EHR we're doing. We gave him 30 days and said luck. , we all know we're going to epic. So just tell us what it's going to take it. , it's almost disingenuous to put people in a room and say, Hey, figure it out. Well, they did that with all their core systems. What are we going to do for ERP? What are we going to do for imaging?

What are we going to do for. , fill in the blank and they went through all those things. They identified the core. , staff the core leadership within the first 30 days as well. And then one level below that as well, so that people weren't sitting around going, Hey, what's my future look like? So,

I think this is a very well-run organization. I'm going to keep an eye on these guys. And, , I don't know, maybe get some interviews out of them this year for some of our other shows that's all for today. If you know of someone that might benefit from our channels. Please forward them a note. They can subscribe on our website this week, or wherever you listen to podcasts, apple, Google, overcast, Spotify, Stitcher, you get the picture. We are everywhere.

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