UHPS: Where We’ve Been and How Our Chief Physician Executive Plans to Build a New Vision of Success
October 05, 2022
UH Clinical Update | October 2022
By Cliff A. Megerian, MD, FACS, Chief Executive Officer; Jane and Henry Meyer Chief Executive Officer Distinguished Chair
When I took over as president of University Hospitals Physician Services in 2014, there were a couple of challenges. One was that we had not been able to grow our physician base for several years, and the other was that we had little communication between the UH Medical Group (UHMG) – our faculty physicians – and UH Medical Practice (UHMP), our community providers.
In addition, our primary care practitioners did not feel that they had connectivity to specialists at UHMG, and the UHMG physician leaders felt collaboration with the specialist physicians who were being hired within UHMP needed to be improved.
Also, we did not have a plan at the time that rewarded some of the things we hold dear to ideal patient care; for example, making sure that patients in need of care were promptly added to a physician’s schedule. And we did not have strategies that recognized physicians’ hard work, productivity or excellence.
Some departments used to have a 180-day wait for a first appointment with a physician. By creating Key Performance Indicators for clinical leaders, we dramatically lowered days to the first appointment and enhanced other quality metrics.
In addition we:
- Set up multiple routine ways to interact, such as Town Hall meetings, and leadership forums and training;
- Created awards for excellence, such as the Distinguished Physicians program;
- Offered financial rewards when physicians were promoted academically;
- Operationally merged UHMG and UHMP, so that the specialty physician chairmen had authority over the hiring of specialists within the community, allowing us to better achieve our goal of systemness;.
- Launched the UH Primary Care Institute (PCI), led first by Todd Zeiger, MD, and now George Topalsky, MD. Through the PCI, we have implemented population health metrics and improved our ability to ensure our patients receive optimal care within our continuum of care. In addition, based on the hard work of the PCI, our UH ACO, and Peter Pronovost, MD, PhD, Chief Quality and Clinical Transformation Officer, UH has attained one of the lowest costs in the nation for its Medicare member patients.
We also know that certified nurse practitioners (CNP), when practicing at the top of their license, are fully capable of being independent providers. As a result, we created the opportunity for CNPs to have their own case load of patients, just like physicians, which also improved patient access.
Our patients trust our CNPs, who are as vital to our caregiver team as any other provider. By elevating the role of our nurse practitioners, we also lightened the load of our primary care physicians. This in turn led to a significant increase in the amount of primary care physicians. In fact, our total employed physicians have grown from 1,300 in 2014 to more than 2,000 today. During our ‘pre-pandemic’ heyday, we were able to recruit between 100 and 200 new physicians a year because the caregiver experience with UH improved dramatically. And our provider engagement and alignment survey results increased from single level percentages to more than 60 percent.
As I listened to the needs of physicians, it also became abundantly clear that the largest source of their dissatisfaction at UH was our externally purchased electronic health record.
We engaged nearly 500 physicians in 2017-2018 and asked them to complete a diligent assessment or our own EHR. Their feedback caused us to switch to EPIC because that is what our clinicians and caregivers wanted.
By putting our caregivers first, we created better collaboration. So when COVID-19 hit in 2020, this cooperative culture buoyed the adaptability, agility and resilience of our response efforts.
When looking to hire a new Chief Physician Executive, we were most impressed by Scott Sasser, MD, because he recognized the collaborative culture we had in place but at the same time, recognized the value in elevating the importance of trust – among our physician community, between his team and our physicians, and most importantly, between our physicians and their patients. In doing so, we establish our providers as the most trusted in the region, so that employers and other health care providers, as well as the community at large, will turn to UH for the highest-value care.
I have asked Scott to share his initial impressions.
Scott Sasser, MD, FACEP, Chief Physician Executive and President, UH Medical Group and Physician Services.
"Since I arrived in early August, I have focused on dedicating much of my initial time on furthering my understanding of the UH system, and the UH team. I prefer getting out of my office and visiting the team at work, so I’ve been doing just that – meeting with system administrative, operational and clinical leaders and providers across UH.
“Going where people are, and not having them come to my office, helps me get to know not just them, but our structure and culture, our challenges and opportunities.
“I immediately saw that UH is just as it was described to me throughout the months-long interview process, and clearly matches its national reputation. It’s a great organization with great people, an inspiring mission and a remarkable history of care, education and research. So many of our caregivers have warmly and genuinely welcomed me to UH, whether through in-person meetings, Zoom calls, email or text – they have immediately made me feel like part of the team. It’s been an incredibly easy transition, and in the best way, I feel like I have been here longer than I have.
“Looking ahead, the national health care landscape is continuing to evolve, creating new opportunities and changing the way we care for patients, communities and populations. Additionally, all health care systems are facing challenges as we approach three years since the start of the pandemic. I believe that an integrated, engaged and highly-aligned physician and provider enterprise is essential to our success in this environment. This will enable us to thrive in caring for our community, ensuring exceptional quality of care, and fulfilling our mission in Northeast Ohio and beyond.
“As part of this journey, I want to ensure that all of our physicians, providers and clinicians know exactly where we are going, are aligned, engaged and involved in the development and execution of our strategy and operational plans - and that they know our voice and input is valued.
“It is an exciting time to be in health care, and I am grateful to be here and to be a part of this outstanding University Hospitals team as we serve our patients, their families, and our community and advance the science of health and the art of compassion.”
My Closing Thoughts
I look forward to learning from Scott and utilizing his expertise in working with physicians and clinical leaders to take us to the next level of optimizing our culture in a way that attracts, retains and develops our providers so we advance our goal of being the most trusted health care partner in Northeast Ohio.