13 health systems that are innovating to move medicine forward

Throughout this trying third year of the COVID-19 pandemic—which has piled inflation, staff shortages and the “tripledemic” to health care’s growing list of challenges—the AMA has recognized the outstanding efforts of AMA Health System Program members. The program provides enterprise solutions to equip health system leadership, physicians and care teams with resources to help drive the future of medicine.

Below are just a few highlights of health system excellence that helped remove obstacles to care, confront major health crises, and drive the future of medicine, as captured in news articles published on the AMA website. Recognition is one benefit of the being an AMA Health System Program member.

1. Amid doctor shortage, NPs and PAs seemed like a fix. Data’s in: Nope.

   1. Hattiesburg Clinic’s value-based care journey illustrates the power of data analysis—and the vital importance of physician-led team-based care. An examination of cost data for the South Mississippi system’s accountable care organization revealed that care provided by nonphysician providers working on their own patient panels was more expensive than care delivered by doctors.
   2. Patients deserve care led by physicians—the most highly educated, trained and skilled health care professionals. Learn how the AMA is fighting scope creep that threatens patient safety as part of the AMA Recovery Plan for America’s Physicians.

2. Why telehealth will be part of post-pandemic health care ecosystem

   1. While the telehealth surge that COVID-19 generated has tapered off, Baptist Health Kentucky recognizes that—in light of patient enthusiasm for using the technology—it must continue to refine its offerings and ensure that the connecting tools patients use to communicate with their physicians reduce rather than worsen health inequities.
   2. “This is not going away,” said Brett Oliver, MD, chief medical information officer for Baptist Health, Kentucky. “Patients have had a taste of this and whether you’re in a small practice or an organization, it would be really easy to go, ‘Boy, glad that's over,’ and move on,” he added. “That would be a mistake.”
   3. Telehealth is critical to the future of health care, which is why the AMA leads the charge to aggressively expand telehealth policy, research and resources to ensure physician practice sustainability and fair payment.

3. Could the end be near for prior-authorization faxes?

   1. Insurance company prior-authorization processes delay care while amplifying patient anxiety and physician frustration. But one leading health system has worked to automate its process for ordering and scheduling imaging tests and has dramatically sped up and improved the experience.
   2. Radiology prior-authorization processing times, costs and denials have been reduced at the Atlantic Health System in Morristown, New Jersey. But the effort it took do so was far more than just “automating” the process. Also, learn how Atlantic Health is uses augmented intelligence (AI) to spot potential abnormalities in diagnostic imaging studies and then move those images to the top of the list for a radiologist to review.
   3. Also, find out how the AMA is tackling prior authorization.

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4. Delivering lifesaving heart-attack care no matter where patients live

   1. Saving the lives of heart-attack patients across 45 Pennsylvania counties takes comprehensive planning and a dedicated team that extends beyond 10 hospital campuses.
   2. The ability to assemble such a network has earned the physician-led Geisinger health system the distinction of having the first three hospitals to be recognized with Comprehensive Heart Attack Center  certification, granted by The Joint Commission and the American Heart Association.

5. To draw physician talent, Sanford Health helps doctors excel as leaders

   1. Sanford Health is an integrated health system headquartered in Sioux Falls, South Dakota, and—like many health care organizations outside the nation’s largest metro areas—struggles to recruit physicians and other health professionals.
   2. But once doctors and others are “exposed to our culture, to our health care system, to our communities—people stay,” according to Luis Garcia, MD, president of Sanford Health. “And people stay for the right reasons, which is to provide excellent patient care in communities that are safe and that are welcoming, and in practices that are fully supported by a great organization.”

6. How patient simulations revive the art of bedside manner

   1. For internist Nayan K. Kothari, MD, a good bedside manner involves three crucial steps: taking a patient’s history, performing a proper physical examination, and arriving at a proper diagnosis. “Studies have shown that if you do that, you will get 85% to 90% of your diagnosis on almost anyone,” said Dr. Kothari, chief academic officer and directs the internal medicine residency program at Saint Peter’s Healthcare System, which is based in New Brunswick, New Jersey.
   2. Dr. Kothari inspired the creation of the Saint Peter’s Simulation Center for Interprofessional Learning, which houses the Institute for Bedside Medicine. Learn more about the role of simulation in training doctors on effective bedside manner—and why it’s important to use the right language to deliver unsettling news to patients.  

7. Focus on social needs helps heart patients avoid readmissions

   1. As health systems move beyond their traditional roles and boundaries to improve their patients’ outcomes by addressing social determinants of health (SDOH), physician-led care teams will be asked to do more—but experience is showing that success is more likely if they don’t try to do it all.
   2. That’s been the story at Bayhealth, a Delaware-based organization with 400 physicians on staff. A pilot program centered on Bayhealth’s cardiovascular service line and testing a SDOH-focused approach for patients with heart failure helped lower readmission rates for these patients by a whopping 67%.

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8. These away rotations boost future Black doctors, 4 weeks at a time

   1. A new partnership between Morehouse School of Medicine and Virginia Mason Franciscan Health (VMFH) creates opportunity and enhances representation. Over the long term, it will create major benefits for patients and their future doctors.
   2. Learn how the partnership enables medical students from Morehouse to do four-week away rotations at VMFH, headquartered in the Puget Sound. VMFH is one of seven sites in the nation selected by CommonSpirit Health and Morehouse School of Medicine to address two of the nation’s most pressing health care needs: a lack of physician diversity and the need for more equitable health care.

9. Providing inclusive hair care products at the bedside

   1. A Black woman’s simple, yet powerful plea on a patient-satisfaction survey helped kickstart a local effort to create a more inclusive environment that could become a model for hospitals and health systems around the country.
   2. “I wish I had a comb for my hair” was the response given by the patient, who had been at the mental health crisis stabilization unit at the University of Iowa Hospitals & Clinics (UI Hospitals & Clinics) and whose needs were unmet by the hair care products available in the patient rooms, which included narrow-toothed combs and shampoo with sulfates, which are designed for fine, straight hair more common among white people.
   3. Learn about the innovative, health equity-minded response from physician leaders at UI Hospitals & Clinics, as well as its nationally recognized LGBTQ+ clinic.
   4. Also, find out how health systems are learning together to advance health equity as part of the AMA Advancing Equity through Quality and Safety Peer Network.

10. How data drives value-based care and population health

    1. Philip M. Oravetz, MD, MPH, chief population health officer at Ochsner Health has some crucial advice for other health systems mulling value-based contracts. Before signing, get a commitment from your payers to provide claims data.
    2. This has been a sticking point for the move to value-based care for many years, said Dr. Oravetz, who provides physician leadership to Ochsner’s systems portfolio of value-based contracts. These include commercial shared savings and full-risk capitation within Medicare Advantage.
    3. Payers often have a critical view of what’s going on with patients compared with physicians and health care organizations, “because the claims data holds knowledge that is critical at the practice level,” he said. Learn more about Ochsner’s path to success with value-based initiatives.

11.  Group affiliation allows this pediatrician to practice independently

    1. For many physicians, operating a private practice, means delivering personalized care to their patients in the way they choose. While some may also enjoy the do-it-yourself aspect of managing the business side of the practice, there are alternatives for those who would rather leave those duties to someone else.
    2. For Sonal G. Patel, MD, an AMA member who leads the Magnificent Minds Neurology Center in Bethesda, Maryland, partnering with Privia Health provided her with support she needed in structuring her business, connecting an IT system and ensuring compliance in relevant legal matters—allowing her to concentrate on patient care. Also read this column by pediatrician Elizabeth Flynn, MD, about her experience with Privia Pediatrics.

12. Henry Ford paramedics visit homes to help patients avoid the ED

    1. Here’s what innovation looks like: Instead of having paramedics rush people to the hospital in an ambulance, Henry Ford Health has paramedics in SUVs go to people’s homes—mostly at pre-scheduled times—and work to keep them well enough to avoid the hospital.
    2. Community “paramedicine” programs use paramedics to check on patients in their homes and provide varying levels of care. Often, the activities are limited to assessing the patients and reporting back to their physicians—or transporting patients to the hospital if they are in poor condition. Henry Ford Health considers its “mobile integrated health” program a community paramedic approach on another level.

13. For Oregon doctors, climate change’s health impact is self-evident

    1. In 2020, wildfires intensified by warm, dry weather burned more than 1 million acres of land across Oregon. The next year, temperatures reached 116 degrees in Portland and about 800 people in Oregon, Washington and British Columbia died from record-breaking heat.
    2. The cause of these catastrophes is climate change, according to Colin Cave, MD, medical director of external affairs, government relations and community health for Northwest Permanente, which is the medical group for Kaiser Permanente Northwest in Portland, Oregon. And from Dr. Cave’s perspective, climate change should be talked about and treated as a public health crisis. Also, learn why the AMA says the U.S. health sector should decarbonize.

Find out more about the other medical groups moving medicine to support patient health and the medical profession.

The AMA Health System Program offers partners unique resources that improve outcomes, elevate recognition and drive value. The AMA Insight Network helps AMA Health System Program members gain early access to innovative ideas, get feedback from their peers, network, and learn about pilot opportunities. Learn more.