Timothy Pehrson, president and CEO of Oklahoma City-based Integris Health, says that he tries to live without regret. Part of that commitment includes working toward his plan to improve Oklahoma’s state health ranking by the United Health Foundation from 47th to 35th by 2035.
Becker’s connected with Mr. Pehrson to discuss that vision, his leadership of the 20-hospital system, and how a strategy he first observed in the auto industry has helped shape Integris Health’s culture of continuous improvement.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What was the hardest day of your career, and how did you get through it?
Timothy Pehrson: The hardest set of days was during the COVID pandemic — it felt like one long day that never ended. For 18 to 24 months, it was just chaos. I remember when all of a sudden in March, the world shut down and that was the beginning of a very long, dark, challenging time.
First of all, we had to rally around each other. We tried to do our best to keep whatever precautions that we knew at the time would be safe, and really at the very beginning, nobody knew what precautions were safe. Having that strong team was very helpful.
Prior to the pandemic, we implemented a continuous-improvement operating system, called Integris Health Way, which was used across the enterprise and allowed us to see winning and losing and collaborate more deeply together. Those processes and tools were critical for us to be able to understand quickly what was going on in the organization, and then to turn around and redeploy information, resources, etc., back out to the organization. That was a lifesaver.
I also relied on a lot of prayer to steady my heart. As the leader of an organization, you care and are worried about the safety of your caregivers and your physicians. You care deeply about your community, and you want to make sure that you’re doing the right things for them. Finding quiet moments on my own to pray and gain guidance and peace was huge.
I’m also part of several CEO groups, and we got on Zoom calls to share what was going on in our organization and best practices. One of the things we learned in the pandemic is that we as humans like to be with other humans. Part of that human experience is just knowing that other people are walking the same paths as us and it gives us comfort. That collaboration across the country with other CEOs was super helpful in making that long two-year day possible to make it through.
Q: If you could go back in time 10 years, what would you tell yourself to start doing, or start learning about?
TP: I try to live my life in a way that there’s no regrets, but I also think I suffer from CEO disease, which is always looking out to the next thing. Practicing presence and appreciating the moments you’re in is important. My role is to look out and say, “What should we be thinking about and doing?” but it’s also important to sit back, take a deep breath and enjoy the fact that you have the privilege to serve your community and work with amazing people. Amidst all the chaos and uncertainty and the need to look downfield, just enjoying and being grateful for that, that’s the one thing I’d tell myself.
Q: If you could give one strategy to other health system CEOs, what would it be?
TP: Using a continuous improvement operating system is a strategy I learned outside of healthcare. I worked in a community when I was at Intermountain Healthcare with an auto manufacturer that had an amazing plant focused on improving all the time. I went down to their plant and said, “Man, I’ve got to find a way to bring that into healthcare.” That was back in 2006.
I piloted it in a couple of clinical areas, saw amazing results, and made it the operating system for the region that I was running at Intermountain at the time. Over time, I was asked to create that for the entire system. When I left to be the CEO here at Integris Health, I knew I needed to create a similar type of structure.
It’s been remarkable, because it’s helped us accelerate all the other strategies, initiatives, [key performance indicators] and goals in a rapid fashion. If you look at our caregiver engagement when I arrived, it was in the 36th percentile nationally. It’s now 93rd percentile nationally. We’ve implemented nearly 100,000 caregiver ideas. They know how best to improve the work, so we just naturally became better, and they felt engaged because we trusted and believed in them. We knew that they could do it and that if we created a framework for them to win, they’d be able to win.
Q: Picture this. It’s the first day of your retirement. What, if anything, do you worry about regretting? What do you hope your legacy will be?
TP: I believe that every human has different gifts and talents. I’ve tried to do my best to bring the gifts that I’ve been blessed with to help and lift up other people. I’m very hopeful that I don’t look back with regrets.
Oklahoma is not a healthy place. We’re 47th out of 50 nationally, and I have this crazy dream that I’ve been working on over the last few years to help Integris Health and the state move to 35th by 2035. Integris Health’s vision is to be the most trusted partner for health, so we lean into that trust with our legislators, other health systems and other agencies that are connected to people’s health and strive to make improvements.
I’m a believer that because these are big societal issues, these issues are not solved without strong public policy. We created a 501(c)(4), Oklahomans Partnering for Health, and it includes partner organizations, business leaders, universities and Native American tribes. We’re leaning into solutions and trying to think broadly, because the delivery of healthcare is only 15% to 20% of people’s health.
We’ve hired an executive director who is a former leader in the Oklahoma legislature that can help us navigate these [issues]. We’ve seen some significant reforms already that we’ve made over the last six and a half years that I’ve been here. First, we expanded Medicaid through a ballot initiative. The second thing that we did is we changed the way we think about the Medicaid populations. About a third of Oklahomans are on Medicaid, and we’ve transitioned our Medicaid program to a total cost of care, total health approach. It wasn’t just that the management care organizations came into Oklahoma. That’s happened in a lot of other states, but the way that we wrote the legislation requires the [managed care organizations] to help health systems and physicians learn how to manage risk, and think about total health and total cost of care.
We’ve made that adjustment, and then we did some additional work with our state legislature, with the administration at the federal level, and our federal delegation to work on some changes in the way that the Medicaid funding flowed into the state to help in that process of transition. Those are three big reforms that I’m super excited about, and I believe will help us move toward being a healthier state.
I might be crazy to think that we can get to 35th by 2035, but we’ve accomplished some really important foundational work that will then help us prepare for further efforts that will help Oklahomans live healthier, which is the purpose of Integris Health.