Dr. Michael Johns

I applaud President Coleman’s recommendation and the Board of Regents’ approval of Dr. Michael Johns as interim executive vice president for Medical Affairs beginning June 2.

Dr. Johns’ impressive career, vast accomplishments and deep love for the University of Michigan make him an excellent choice for this role. I am looking forward to working with him to ensure a smooth and successful transition.

My Role as EVPMA

As my five-year appointment as the University of Michigan’s executive vice president for Medical Affairs nears conclusion, I have been thinking about my future – both professionally and personally. Being EVPMA at the University of Michigan and CEO of the University of Michigan Health System has been an enormous privilege. I have relished my time here and will forever be grateful for the growth, experiences and relationships made possible by this opportunity. UMHS is a community of extraordinary people who do extraordinary work. I have been honored to lead this organization, which is what made this decision very difficult for me. I have decided to not serve a second five-year appointment. My last day as EVPMA will be June 1, 2014.

Over the last five years, UMHS has grown and changed tremendously – not just in size, but in strength. I know that I will be leaving the health system well positioned for the future. We should all be incredibly proud of the work we have done together, including creating a strategic plan to guide us now and into the future, and dramatically changing the way we do business –“here” no longer means only Ann Arbor. We have and will continue to expand our reach and demonstrate our core commitment to the health of individuals and families throughout the state via new and enhanced relationships with other hospitals, health systems and physician groups.

Additional points of great pride that make us the envy of others include:

  • Our continuous efforts to create the ideal patient care experience, which have resulted in our highest-ever patient satisfaction scores.
  • We are financially sound and have been excellent fiscal stewards of our resources. We must continue to be vigilant to use our resources carefully, but, with over $3 billion in cash, we are able to invest strategically in all components of the tripartite mission of clinical care, education and research.
  • We lead the state and the nation in population management, as well as physician and hospital collaborations to improve quality and safety. These efforts have had major cost savings for us and governmental and third-party payers.
  • We are home to a medical school that remains in the top tier of academic medical centers for a remarkable student population, outstanding research productivity, excellent primary care and specialty programs, and the desirability of its graduates for selection by residency program directors.
  • We have built an infrastructure to enable us to envision and launch the Victors for Michigan campaign – and raise 45 percent of our $1 billion goal to date and before public launch.
  • We are leveraging the vast promise of the NCRC to exceed expectations, facilitate interdisciplinary collaboration, support entrepreneurship and enable unprecedented opportunities for scientific discovery, and investigator recruitment and retention.
  • We have made diversity, health equity and inclusion high-level priorities for our organization.

Because of the foundation we have laid, we have great momentum moving forward. UMHS will build upon its successes and continue to be one of the leading Academic Medical Centers in the country; of this I am confident.

Thank you for making this past five years a time that I will always cherish. I look forward to your continued excellence in creating the future of health care.

Ora

In Pursuit of Health Equity & Inclusion

Imagine the fear of experiencing a medical emergency in a hospital where nobody looks like you, speaks your language or knows your culture.

Imagine the frustration of having to choose between going to the doctor and buying groceries.

Imagine the distress of being a parent who isn’t permitted to make care decisions for your child because your state doesn’t recognize your marriage and your partner is the legal parent via biology or adoption.

When we incorporated diversity and cultural competency into our Health System strategic goals and launched the UMHS Office for Health Equity and Inclusion, we did so with the hope that one day these scenarios and the many others that plague underserved and underrepresented populations will no longer exist. The future of health care that we strive to create is one in which all patients have access to appropriate and timely care in a respectful and compassionate environment.

Real change comes from first understanding the problem and the underlying causes and then acting on that knowledge to alter behaviors and practices to improve individual and community outcomes. This is the “sweet spot” of an academic learning health system; this is where the intersection of our tripartite mission of education, research and clinical care can do the most good for the most people. While there is a lot of work to do in pursuit of our desired future state, we have made impactful progress toward this goal at UMHS.

For example, we have several outreach clinics throughout Michigan that focus on the needs of underrepresented and underserved patient populations, including the U-M Migrant Farm Worker Outreach Clinic in Lenawee County, Ypsilanti’s Corner Health Center for people ages 12-21, the Delonis Clinic for homeless individuals and families in Washtenaw County and the Student Run Free Clinic in Pinckney.

Since 1994, the Japanese Family Health Program run out of Family Medicine at Domino’s Farms has been implementing innovative programs that transcend cultural barriers and impact all components of our tripartite mission. Popular patient and family-centered features of the program include monthly birth center tours with a Japanese-speaking guide, prenatal group classes for mothers and fathers and an extensive library of Japanese and bilingual health education materials. Program faculty have posted medical education materials on Open.Michigan, an open source community created by the University to enable global sharing of  educational resources and research, and in 2010, the program was awarded a $1.4 million grant from the Japanese government to establish a residency training program and help Japanese doctors improve in-country family medicine practices.

Then there is the work of 31 active patient and family advisory councils throughout the Health System. These are groups of patients, family members, faculty and staff who are working together to identify and implement ways to make our practices, policies and environment more inclusive. In the future, we want to engage more individuals from vulnerable populations in the councils to better understand their unique challenges related to access, services, resources, transportation and more. Additionally, we want to expand these efforts into the ambulatory care setting and work with volunteer advisors to find ways to improve representation of diverse individuals in clinical trials. To address the latter, we are providing advisors with opportunities to participate in Patient Centered Outcomes Research by collaborating with UM investigators on the development and design of research proposals. At the same time, we are partnering with Nursing, Public Health and other disciplines which conduct community behavior research.

This is just a snapshot of initiatives under way at UMHS to address access, inclusion and equity. Certainly, there is much more to do if we are going to affect real and lasting change in our health care system.

Next month, each of you will have the opportunity to participate in a campaign led by the Office for Health Equity & Inclusion. OHEI was established to advance our health system’s equity and inclusion goals. With Dr. Carmen R. Green as the inaugural Associate Vice President and Associate Dean for Health Equity and Inclusion, I know that we will make impressive and substantial progress. Our voice as a Health System must reflect the diverse voices of the patients we serve, the health professionals we train and the people who work here. The Talk Health Care Equity campaign will be your chance to add your voice to this important conversation, and I hope that each of you will take advantage of this opportunity.

No matter who a person loves, where s/he lives, what s/he believes, how young or old s/he is or what s/he looks like, all citizens deserve access to the right care in the right place at the right time in an environment that is inclusive and welcoming. In a country as wealthy and democratic as the United States, exceptional health care should not be a luxury. It should be a right. Let’s work together to change the status quo.

Tweet For Tix

MTS header FINAL

This week, I am inviting you to share your experience as a member of the UMHS community to help generate our collective UMHStory. But, there is a twist – you have to do it in 130 characters or less on Twitter.

Beginning today and continuing through Friday, February 21, each day I will tweet a question from @OraPescovitz. All you have to do to be entered to win tickets is tweet your answer and include the hashtag #UMHStory in your response. Then, early next week, 10 eligible* individuals who responded will be randomly selected to receive a pair of tickets to a UM men’s Hockey or men’s basketball game, including match-ups against Michigan State and Indiana.

I look forward to hearing your responses!

*You must be UMHS faculty, staff, or student to be eligible.

Succeeding in Health Care’s “New Normal”

With a tripartite mission of education, clinical care and research, academic medical centers (AMCs) have long held a unique role in higher education and health care. AMCs provide critical patient care services that often are unavailable elsewhere in communities, including trauma center, burn center and transplantation services. Furthermore, although they account for only six percent of all acute care hospitals, they train 75 percent of physicians. At the same time, AMCs are a critical component of the national safety net, providing 38 percent of all hospital charity care and approximately 28 percent of all Medicaid hospitalizations.1

In what I call the “new normal” of health care, AMCs face significant special challenges that health systems which don’t have a tripartite mission do not face. These include the rising levels of medical student debt, federal funding cuts to medical research, too few federally-funded residency training slots to address the looming physician shortage, substantial losses from Medicare revenue and cumbersome bureaucracies that, if left unchanged, will leave us further behind competitors who are able to provide the same services, but who will do so more efficiently and at lower cost.

AMCs aren’t going away – we have a critical role in research, education and health care – but, we must change and reinvent ourselves in order to survive and thrive.

We’ve navigated tough times before and we will again. Our focus must remain on innovation and rethinking how we do what we do in order to build a health care system that is more effective, safe, efficient, affordable and accessible. This is why we initiated a UMHS strategic plan in 2009 – to position UMHS to thrive and lead in health care’s “new normal.” Our strategic plan creates a roadmap for strategic action, provides a context for identifying and acting on key areas of opportunity and uses for our resources, and defines metrics by which we can evaluate our performance. Successful execution is enabling us to reach important milestones and achieve important outcomes.

We are engaging in strategic partnerships and affiliations to realize greater clinical efficiencies and better serve Michigan families with care in the right place at the right time. This includes creation of the Acute Care for Elders (ACE) inpatient unit at St. Joseph Mercy Ann Arbor, expanding UMHS inpatient services at Chelsea Community Hospital, agreements with Trinity-Michigan, Integrated Health Associates and MidMichigan Health, and our proposed affiliation with Allegiance Health. Additionally, we are on track to open our new Northville Health Center this year and provide more convenient services along the I-275 corridor.

We are negotiating with insurance payers to ensure appropriate and fair fees for complex services while preparing for how we’d survive in a “Medicare reimbursement rate only” world.

We continue to be a national and statewide leader in demonstration projects and collaborations to evaluate shared savings, patient-centered medical home models and the effectiveness of accountable care organizations, including the Physician Organization of Michigan ACO, which is helping nearly 5,000 physicians serve more than 110,000 Medicare patients in Michigan, the Michigan Primary Care Transformation Project (MiPCT) and partnerships with Blue Cross Blue Shield of Michigan.

We are in the process of changing our Medical School curriculum from one that is largely time based to one that is competency based and allows students to progress at their own pace to finish in three to five years.

A taskforce has been formed to evaluate how we might leverage the skills of physician assistants and advanced nurse practitioners in primary care to enable physicians to focus on those things they are uniquely qualified to do, and improve access and the patient experience.

We created Fast Forward Medical Innovation, which recently was awarded $2.9 million from the Davidson Foundation and last year received $2.4 million from the Michigan Economic Development Corporation to fund the U-M Michigan Translational Research and Commercialization for Life Sciences Program (U-M MTRAC). Increasingly, our Medical School is being recognized as a hub of translational research, innovation and entrepreneurship.

In the past several years we have built an impressive and talented team to lead the UMHS Victors for Michigan campaign. Funding raised via this campaign will be an important factor in offsetting some of the costs associated with research and education – the parts of our mission that depend on investment for long term lifesaving and life-changing returns. We are already 45 percent toward our $1 billion goal!

This is a just snapshot to demonstrate that this isn’t business as usual – we are in an exciting time of change and transformation. AMCs need to rethink our current cost structures and decision making processes. We need to evaluate our medical education and training curricula. And we need to continue to advocate for increased national investment in biomedical research.

I was honored to be a speaker at the MCIT all-staff meeting last week. During my presentation I encouraged attendees to be the people at the forefront of innovation and change. I asked them to be the people who discover and invent new tools and technologies that make health care more efficient, accessible, affordable and reflective of patient and family centered care philosophies. I ask the same of all of you. The key word in our vision to create the future of health care is “create.” If you really want to make a difference in the way you approach your work or impact the world, look at your work and the world in a new way – see something unique and find a better way to do it. This is our challenge and our charge. This will define the next generation of leaders and best in medicine.

 

 

1. Association of American Medical Colleges

New President / Exciting New Era

Today, the Board of Regents announced the appointment of Dr. Mark Schlissel, current provost of Brown University, as the next president of the University of Michigan. This is wonderful news for the University and for our Health System. Dr. Schlissel is a remarkable physician-scientist who will bring to the presidency an important depth of understanding about academic medicine and biomedical science. We are extremely fortunate that he will be at the helm as we begin an exciting new era at Michigan.

At the same time, we are privileged to have been led by Mary Sue Coleman, a president with great vision and who has moved the university to unprecedented levels of accomplishment. Given the track record of our president-elect, we can expect to continue this extraordinary trajectory of leadership. This bodes well for the future of the entire university and specifically for our Health System. It is a moment of grand celebration for us and all of our friends and supporters.

Read the University’s announcement here.

GO BLUE!