Massachusetts | 50 states of population health

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SAUL WEINGART, MD, PhD. CMO of Tufts Medical Center (Boston)

On the top challenge

"The greatest challenge we're facing in our organization and in our area is how to think about redesigning healthcare in a way that meets the needs of patients more so than hospitals, clinicians and insurance companies.

For example, we take great pride in the fact that our patients' labs are drawn by 5 a.m. so our physicians, when they round at 6 or 7 a.m., can make clinical decisions to expedite care. But if I were a patient, I'm not sure I would want to be awakened at 5 a.m. to get my labs drawn. It's challenging for patients. When I think about the rise of information on the internet, the rise of minute clinics and the use of alternative medicine, those are all diagnostic of the fact that traditional healthcare providers may not be building a system that meets patients' needs. Patients want care when and where they want it, and they want to be able to talk directly to their doctor. They want to be able to schedule their appointments on their smartphones. They want to have all the care — but only the care they need."

On the hospital's response

"We're doing things on a couple of different levels to address this. On a regional level, we're part of a network — a system of hospitals and docs and practices that are much more focused on serving patients and providers in the community rather than in an academic medical center. The question is, how does an academic medical center keep care in the community? How do we support local practitioners to do what they do best, which is take care of their patients? We send our specialists to community hospitals so patients can get ICU-level care or neurosurgery close to home.

The other things we do include using technology to allow patients to book appointments online, including ED visits. We have a tool that allows patients who want to be seen in the emergency department to schedule that appointment on their smartphone or on their home computer and, instead of waiting to be seen, they wait at home. We also have a campaign to get our staff aligned around the concept of what we call 'thoughtful anticipation,' which is all about learning from industry leaders like Amazon, REI and Zappos about how to anticipate families' needs before they have them. Finally, we're teaching our front-line employees how to develop projects that improve patients' experience, like reducing the wait for valet parking or using an app that sends smartphone reminders to introduce new patients to the care team before they walk in the door. We are trying to leverage technology, engage staff, and think systematically about how we would deliver care if we weren't the care deliverers, but the care recipients."

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