Andrew Agwunobi, MD, serves as the Chief Executive Officer and Executive Vice President for Health Affairs at UConn Health.
On May 10th, Dr. Andrew Agwunobi will present at Becker's Health IT + Clinical Leadership 2018. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place May 10-11th 2018 in Chicago.
To learn more about the conference and Dr. Agwunobi's session, click here.
Question: Who or what are the disruptors that have your attention? Why?
Dr. Andrew Agwunobi: The increasing trend towards physician employment is one of the biggest disruptors in the market. The most obvious reason is that he who owns the physicians wins the local competition for patients. But the opportunity is much deeper than that. Health systems with employed physicians are in a better position to align the goals of executives and providers. They are also better able to deliver on the "value" promise for risk-based contracts, ACOs and other initiatives that rely on high quality, low cost and population health management. Finally, such health systems are better able to coordinate and implement campaigns to improve patient experience and day-to-day operations. However, it is not enough to simply employ physicians; health system executives must learn how to engage their employed physicians for maximal success.
Q: What did you notice about your healthcare experience the last time you were at the receiving end as a patient?
AA: As both a patient and a physician, I was surprised how much the clinical diagnosis now relies on "tests" rather than the physician examination. This, along with the pace of technological change, tells me we are entering an era where artificial intelligence will become the first line of care for patients. In its simplest form, patients will first consult with a computer over the internet. After the patient enters his or her signs and symptoms, the computer will generate the probable diagnoses, indicate the necessary lab tests, and if necessary, generate a specialist referral. Eventually the computer may even email prescriptions to a pharmacy.
Initially, physicians will likely review the computer-generated information prior to a regular physician visit (i.e., AI will serve as an adjunct to, not a substitute for, the physician visit). Eventually, however, AI will replace some physician visits, allowing the patient to take control of his or her care. For example, the patient will schedule the indicated imaging procedures at a freestanding outpatient facility, the lab tests at a strip mall retail lab, and perhaps only speak to a physician or mid-level provider over the phone or internet to obtain a prescription.
This level of consumerism will force unprecedented change in our industry. It will force down healthcare prices and cause the rapid and widespread adoption of price-transparency. Ironically, like the advent of freestanding ambulatory surgery centers, the quality of care will probably not suffer — in fact it may improve — and patient satisfaction will increase.
Q: When was the last time your organization responded to concerns or needs expressed by physicians? What unfolded?
AA: Over the last two years we responded to physician-leaders' concerns about being disengaged from the budgeting process. The physicians were upset they were "blamed" when their departments missed budget, but they had no understanding of what went into the budgets and little control over those inputs. As a result, we implemented a "physician business empowerment" process, which included executives meeting with the physicians monthly, educating them on their budgets, providing customized financial reports, giving them more decision-making authority, holding them to mutually agreed-upon targets, and providing them with department level financial incentives for performance. Physician satisfaction rose, and most of the involved departments did better than budgeted by the end of the first year. Most importantly, the physician leaders became deeply involved in the successful management of their areas of responsibility. This markedly increased physician engagement.