Sentara CEO Howard Kern: What if Jeff Bezos ran Sentara Healthcare?

Amazon's increased presence in healthcare has caught the attention of many hospital and health system leaders who are vested in a healthcare model that is at risk of being disrupted. So far the company has considered a number of patient-centered initiatives, but what would it look like if Amazon CEO Jeff Bezos took the helm of a major integrated delivery system?

First and foremost, Amazon is a customer-driven organization. Mr. Bezos is obsessed with the customer to a degree that, frankly, healthcare leaders are just now beginning to recognize and integrate into their strategies. Amazon has rooted its website and products in a desire to make the customer's life easier, and if he ran a health system, I think Mr. Bezos would cast a discerning eye upon issues such as scheduling and wait times, and reevaluate the way providers use technology. There are many opportunities to improve the patient experience through personal and mobile technologies, and though some health systems have taken initiative in the digital age, our industry-wide push should be much stronger. The complexity of healthcare scares many patients, and centering the experience around familiar technological devices would do wonders to ease their experience. 

Amazon's obsession with the customer has driven its development into a logistical powerhouse. If Mr. Bezos took control of Sentara, I'm sure it wouldn't be long before he examined the system's supply chain management strategy. Amazon does a phenomenal job of bringing services and supplies to customers in an efficient way, and though Sentara does its best to maximize those capabilities, Mr. Bezos' experience and outsider perspective would surely help improve these processes and drive significant savings in supply cost.

Healthcare leaders stand to learn a lot by examining Mr. Bezos' approach toward processes. A good process serves the provider so they can serve the customer, but one of the most dangerous epidemics gripping our industry is that we have stopped focusing on the outcomes of our processes. Mr. Bezos refers to this fallacy as "managing by proxy." If patients complain about an undesirable outcome, the first thing many clinical leaders do is defend the process that drove the outcome, so long as they followed protocol. Instead of swearing by adherence to protocol, we should examine the process itself to see if it can be improved. Do we own the process or does it own us? If Mr. Bezos ran my health system, he would be constantly reevaluating our processes not by cost optimization or operational efficiency, but by the true value that they bring directly to our patients and members.

Some pundits point to value-based care as a sign that healthcare stakeholders are beginning to take a closer look at outcomes. However, in our zeal to find the ultimate process for value-based care, attention to outcomes has fallen by the wayside. Mr. Bezos would find this unacceptable. Though many leaders have publicly embraced the concept of value-based care, Mr. Bezos would likely see it as just another process. If that process did not achieve the ultimate goal of providing valuable, quality outcomes for patients, he would interrogate it with his trademark rigor.

Anyone familiar with the number of individuals and organizations that orchestrate the payment and delivery of care knows that misalignment is a troubling reality within our industry. Healthcare is extremely siloed, but Mr. Bezos has made his fortune by streamlining efficiency among numerous players to deliver the best product as quickly as possible. I believe Mr. Bezos would take innovative steps to challenge healthcare's misalignment and integrate the model to create efficiency and savings for our patients and members.  His long-term view of success would drive Sentara's development into a system fully aligned to maximize the value to our consumers.  Under his watch, Sentara would rapidly become the first, most convenient choice for our patients and members for all their healthcare needs.

One trademark of Mr. Bezos' leadership style is his high-velocity approach to decision-making, a far cry from the drawn out processes of healthcare executives are accustomed to, mired in bureaucracy. More can be lost by indecision than wrong decisions. Research has found high-performing CEOs do not necessarily stand out for making great decisions all the time; rather, they stand out for being more decisive.

In healthcare, the classic scientific method that anchors clinical processes has spilled over into the realm of executive decision-making. Waiting for 90 percent of the data is necessary when dealing with research or clinical procedures, but healthcare leaders risk becoming bottlenecks for their team when they take too long to decide or do so without conviction. At Sentara, Mr. Bezos would accelerate the on-going movement to establish the organizational agility and decisiveness we need to turn industry headwinds into tailwinds. 

In his 2018 letter to shareholders, Jeff Bezos said it forever remains day one at Amazon, even as the company nears a $1 trillion valuation. Maintaining that hunger and staving off complacency is what has led to Amazon's sustained success, and it is this mindset that will propel the company into the future. Healthcare leaders must realize that unless we take a page out of Mr. Bezos' book — and soon — he'll be the one writing our story.

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