In order to successfully implement and sustain hospital improvements, there needs to be administrative and clinical collaboration.
Healthcare financial leaders from across the country gathered at the HFMA-ANI conference in Las Vegas last week to discuss strategies for rethinking and reshaping the business of healthcare in order to derive more value out of what they do and better support patient care. When speaking with attendees at the event, it was clear that CFOs realize that to successfully implement and sustain hospital improvements, physicians must be engaged in the process or these initiatives will fall short— or fail altogether.
Although the past few years have been challenging for healthcare executives, there is now a rising awareness of how CFOs and CMOs’ initiatives and concerns overlap. In fact, their spheres of influence are arranged much like a Venn diagram: while a CMO focuses on quality, physician utilization and satisfaction, and CFOs manage revenue and costs, their concerns overlap when considering things such as the impact of CMS changes, ICD-10, and accountable care, as well as the acquisition physician practices will have on organizational growth. These points of imbrication are the key to ensuring quality patient care as well as a strong financial bottom line, and it is clear that collaboration between clinical and financial leaders has never been more important.
At ANI, I took the stage with Money Atwal, the CFO and CIO of Hawaii Health East, to discuss the important role executive and physician collaboration plays in successfully driving an integrated strategy across an organization. A big part of this is “silo integration,” or extending the olive branch after perhaps years of tension between clinical and financial areas in order to move forward together.
To gain buy-in for financial initiatives, CMOs and physician leaders need to be educated on the implications their care delivery decisions have on operations, just as CFOs need to be cognizant of the impact their decisions have on their clinical colleagues. Money and I have both found first-hand that the three best practices to align and engage physicians with CFO initiatives include:
1. Identify clinical champions and collaborate regularly. Include them in steering committees and talk to them on their turf. Listen and learn what matters to them, and ask detailed questions about their day-to-day activities, including workflows.
2. Involve physicians in IT selections and implementations, and include practicing physicians during every step of the process.
3. Educate the broader medical staff about the clinical benefits of change – from technologies deployed to process improvements. Leverage tools and strategies, such a Six Sigma and lean processes, to streamline workflows, and reduce costly work-arounds and duplicated efforts.
CFO-CMO collaboration will result in strategies that make sense from both clinical and financial perspectives, and lead to better patient outcomes. But it starts with shared understanding of one another’s concerns and challenges, and open discussions where both sides can learn about the logic and rationale behind different technological and process-related choices, including EHRs, clinical documentation improvement (CDI), physician preferences for vendors, supplies or procedures and quality metrics in patient care. Developing plans in tandem will yield more thoughtful and successful decisions that improve the overall care being delivered and that strengthen the organization.