Most leaders would like to think their organization is well-positioned for the future. But when your health system had the foresight to bring in futurists more than a decade ago to design a campus around the concept of patient-centric care, there’s no doubt about it. In this interview, Bill Lewkowski discusses the vision his team has and how they’re working to make it a reality, from building a clinical integrated network to viewing analytics as a core strategy. He also talks about the challenge of keeping the team focused during a pending acquisition (which eventually fell through), his plans bold plans with Epic, the cutting-edge work they’ve done with virtualization, and why it all comes down to having the right people.
- Competing against big players: to consolidate or not
- Operating during a pending acquisition — “It’s a challenge.”
- Upgrading Epic to “continue to optimize and evolve.”
- Forming a clinically integrated network
- Hosting site — “We’re very proud of our continued innovation.”
- Cutting-edge work with desktop virtualization
- Silicon Valley mentality
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[Editor’s Note: After this interview was held, it was announced that the planned affiliated with Metro Health and Community Health System was terminated. The proposed deal, which had been in the planning phase for two years, had involved the sale of an 80 percent interest in Metro Health. In an announcement, Doyle Hayes, chairman of Metro Health’s board of directors, stated that the two organizations were not able to agree on “important details.”]
We knew being independent would be very difficult in the long term, especially as you need to improve your value and your cost equation, you need more scale and scope, and being one hospital, it is very difficult to achieve that.
Our culture is very strong. We’re a small organization, we’re very tightly knitted together, we’re very team-based, and we don’t see that changing, and I think that helps keep the focus on the patients and on our future.
Epic just keeps on getting better and they’re expanding their business intelligence and analytics capabilities, their population health capabilities, their interoperability capabilities, and we just want to take advantage of all those things.
You authenticate, and within six to seven seconds, you have your desktop — your desktop, your files, your applications — live and running just like you left them two minutes ago or a half hour ago. And you can get that from anywhere.
Gamble: I know that in Michigan you have really large organizations — is that something that’s been a challenge in staying somewhat independent?
Lewkowski: Well, that’s been the reason for our pending acquisition or, I should say, we are getting acquired, but this is a proactive strategic move on Metro’s part. Metro made a decision back a couple of years ago that we knew being independent would be very difficult in the long term, especially as you need to improve your value and your cost equation, you need more scale and scope, and being one hospital, it is very difficult to achieve that. And also, to move into population management, you need an expanded base of a population to compete against some of the other players that are growing and growing. There’s a lot of consolidation going on.
So the board made the decision. Metro is a very, very strong organization. We’re financially strong, we are independent, we are technically at the top of the game and our care and our quality is tops, so we’re a very strong organization and we decided to proactively seek an equity partner who would want to invest in us and our strategy and the ability to take advantage of other opportunities to expand and grow in this region. We wanted to pick an organization that, if we can come together on that strategy, would help fund and finance that to continue to grow and expand, and that’s indeed what we’ve decided to do.
Gamble: And then what’s the status of it right now — it’s pending?
Lewkowski: Yeah, it’s taken much longer than we expected. The organization is Community Health Systems, they’re a for-profit out of Nashville. They’re the largest by the number of hospitals — they have about 200 hospitals around the country. It’s been challenging in that because there’s a lot of detail to these transactions. With every single one of our contracts, there’s just a lot of complexity to make this deal happen. It’s in its last stages and we expect that this thing will close within the next few weeks, but it’s taken longer than any of us expected, so I really can’t guarantee when that’s going to be.
Gamble: Sure. I imagine that does create some challenges kind of being in that holding pattern, but have you pretty much been able to just keep operating as you have?
Lewkowski: We have. In fact, it’s kind of interesting. We have upgraded our Epic to the latest version during this time period, so we’ve done some very, very large projects here. We’re also building an ambulatory hospital on the east side of the city — it’s basically an ambulatory site that’s going to have an ED and a lot of other services. And so that project, along with several others, have just continued along.
Gamble: And I’m sure that that’s helpful too from a leadership perspective because you always worry about what the staff knows and what they hear, and to have kind of things running as usual, I think, would be kind of comforting from that perspective.
Lewkowski: It is a challenge, I think, for the employees and the workforce here. When you’re looking at a change — a major change — that impacts them on a lot of different fronts, it’s kind of hard to stay focused.
Now, because we are an organization that’s been doing extremely well, we’re trying to stay focused on operations, but you still have that distraction of change that is pending. We do know that regardless of if the deal ultimately happens or not, we will always be Metro and we will be strong. Our culture is very strong. We’re a small organization, we’re very tightly knitted together, we’re very team-based, and we don’t see that changing, and I think that helps keep the focus on the patients and on our future.
Gamble: Okay. So now, what are some of the other projects that are big on your list or things that you’re really focused on in the near future?
Lewkowski: Well, obviously, this transition to another organization is probably taking the majority of my time and some of my staff’s, because there is a lot of transition work that has to happen. So I’ll just put that on the side and say that is probably our number one thing going on right now.
Beyond that, although we upgraded Epic to their latest version, we’re already looking to go to the next version, which isn’t even released yet. The reason we want to do that is Epic just keeps on getting better and they’re expanding their business intelligence and analytics capabilities, their population health capabilities, their interoperability capabilities, and we just want to take advantage of all those things. And so we are in the process of planning that project right now.
We are also putting in a business intelligence and analytics data warehouse platform, and so we’re in the middle of that project. That’s going to take several months; it’s with a third party. It’s not Epic — we do use all of what Epic has, but this will work with Epic, so we’re in the process of implementing that right now. There are a number of smaller operational projects. Probably the biggest strategic project beyond the acquisition is the expansion and the more formalization of our clinically integrated network organization.
Gamble: Right. Are you working with other organizations at all on that?
Lewkowski: No, Metro is the core of the CIN, along with our PHO or other affiliated providers, so that will continue to be the case. I do see that CIN potentially growing and partnering with a couple of other big providers in this region right now. I’ll keep their name out right now, but we see that happening in the future.
Gamble: As far as the pending acquisition, that’s something where obviously you’re in good standing with the fact that you are on the latest version of Epic, and you don’t think there would be any changes on that front?
Lewkowski: Yeah, one of the challenges that we had and that CHFs has had is that they are not an Epic organization. In fact, they’re in the process of implementing and rolling out Cerner across their other facilities. And so we are a bit of an aberration to them, but part of our deal and it’s written into the deal is that we will keep Epic. We’ve not only invested in this, but we are so integrated in it and all of our providers have come to really do extremely well with Epic and its functionality that neither of us — CHS or Metro — wants to disrupt that or change that.
So that is one thing that we see continue to grow and to expand and to be a center of what we’ve done. We’ve already done the investing. We’ve been on Epic since we started our ambulatory back in 2005, so we’ve been on it a long time, and we just want to continue to optimize and evolve.
Gamble: Yeah. I would think that would be a really huge challenge if you knew you were going to have to step away from that, especially if you think you’re already looking at the newest version, which isn’t even available yet.
Gamble: Have you ever had visitors for Epic or done anything like that being an early customer?
Lewkowski: Actually, we have. We’re a bit of a shill site for Epic, and they have brought potential customers to our facility to see Epic in use. And so, we do that a lot with Epic, but we do with some other technology organizations, too. We are a very innovative technology site. So we have partnered with a few key technology vendors out of Silicon Valley and have been on the cutting edge of things like desktop virtualization, and so we bring people and some of their potential customers to Metro to see our technologies.
The other thing is the Metro campus and our new hospital has won many awards for design and for environmental types of things, so we have visitors — even internationally — coming to Metro to see what we’ve done. So we’re very proud of our continued innovation, technologies and the operations here, and we have visitors come in and actually see those.
Gamble: Yeah, I would think that that would be affirming to the staff too; to see that other people are taking a trip to come in and see what you’re doing, it has to be kind of validating.
Gamble: Could you talk a little bit about the virtualization, the work you’ve done there?
Lewkowski: Yeah, I think the number one technology that we really have leveraged is desktop virtualization. I don’t want to name vendors here, but even before our campus, we created a virtualization technology that allows any workforce member — not only physician or nurse or clinician, but also any business worker or any other workforce member that has access to our systems — to walk up to any endpoint, and we utilize not only PCs, but we use these thin clients and even a variety of platforms for our endpoints.
Basically what you do is, you authenticate, and within six to seven seconds, you have your desktop — your desktop, your files, your applications — live and running just like you left them two minutes ago or a half hour ago. And you can get that from anywhere; they can be on our campus or any of our other campuses, it could be from across town or across the country if you’re traveling. That desktop virtualization is different than some of the technologies that folks are using to extend their EHR or to extend a shared workstation. We’ve worked with vendors in Silicon Valley to really bring the healthcare perspective and needs, and we actually invented a few things ourselves when we started this back in the 2006 or 2007, so we’re on about our fourth generation of virtualization.