Latest / Becker’s Healthcare Podcast / Lynn Fulton, CEO of Maui Health System

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Lynn Fulton, CEO of Maui Health System · Becker’s Healthcare Podcast

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Hello, and welcome to the Becker's Hospital Review
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podcast. My name is Will Riley from r
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one. I am here today with Lynn Fulton.
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Lynn is the CEO of Maui Health System.
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Welcome to the podcast, Lynn. Thank you, and
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good morning. Morning.
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Lynn, to start us off, can you tell
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us a little bit about,
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your role,
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Maui Health System, and the community that you
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serve? Yes. I'd be happy to.
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I joined Maui Health two years ago, as
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the CEO, and Maui Health is the only
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hospital on Maui.
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We operate actually three facilities,
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Maui Memorial Medical Center. We have Kula Hospital
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that's in upcountry Maui, and then, Lanai Hospital
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on the island of Lanai.
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So we are the gateway to health care
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really for our community. We partner with a
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lot of the independent
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physicians and physician groups on the island as
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well as with the systems that are on
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Oahu and the other islands.
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But if you need care on Maui,
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hospital care, you're going to come to Maui
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Health. Got it. And tell us about the
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community that you serve. I imagine it's a
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an interesting mix of
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residents and visitors.
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What does it look like? It is.
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You know, Maui enjoys
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a robust visitor presence that, you know, we
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love having our tourists. However, when we look
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at the demographics for most of the individuals
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that come to Maui Health, they are our
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residents. And so we feel deeply about our
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commitment to our community.
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We serve the entire Island Of Maui as
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well as the Island Of Lanai.
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So we've we view that as our,
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service area. However, our emergency department does see
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a fair number of visitors,
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as they come on vacation and maybe partake
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a little bit too much on what the
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island has to offer.
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Okay. Okay.
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Like, how many people live on Maui roughly?
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Like, what 150,000
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Okay. People call Maui home. Okay. Okay. Got
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it. Got it.
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And, like, what's the makeup of that in
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terms of, like, the population from a medical
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perspective? Are they old? Are they young? Is
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it Medicare?
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Like, what does that look like? It's very
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similar to other rural communities, honestly. You know,
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before coming to Maui, I served the OSF
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health care system in Bloomington, Illinois,
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and that's in McLean County. Very similar demographics
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for number of people as well as what
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we have on Maui.
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You know, we are an aging demographic
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Uh-huh. Just like a lot of areas are.
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However, we do have a number of young
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families as
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Hawaii enjoys multigenerational
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living. A lot of people that were born
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on the island wanna stay on the island
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and stay close to family, because that's our
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culture, and we love that. And that's really
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been an opportunity for us to be able
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to bring them into health care field so
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that they can continue to treat their friends,
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family, and neighbors. Got it. Yeah. Okay. I
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wanted to ask you about
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workforce, actually, because one imagines, you know, everyone
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would want to live on Maui, but perhaps
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that's not probably not as simple as that.
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How how what's it like attracting a workforce
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on maybe both the clinical side and the
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administrative side? You know what? It it is
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both. You know, there's people I I don't
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know if a day goes by when I'm
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on the Mainland that people don't say, oh,
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it must be wonderful to live on Maui,
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and it is. It's a beautiful place. However,
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it is it's not always easy to live
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on an island. And when you're recruiting from
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the mainland,
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our costs are higher. You know, today, about
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90% of the food on Maui has to
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be shipped in, and so that can that
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just shows you, you know, the increased cost
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of living for the people that live there.
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So that is an added hardship as we're
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recruiting. So what we've really done is look
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at how can we train on island,
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so that we're able to really promote from
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the community that we serve. And we've had
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a lot of success in that. You know,
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we coming from Illinois going into Maui, I
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was actually
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really happy when I looked at our fill
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rate for nursing vacancies.
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And we have, we have really great nurses,
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at Maui Health, and we have a wonderful
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training program
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that's in partnership with University of Hawaii. So
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in that area, we do really well. Now
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in the areas that we don't train on
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island, that's where we have a hardship. So
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respiratory therapy, imaging technology,
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and today, physicians. Now that that is one
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thing that we do have a strategic initiative
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that we're starting so that we can offer
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eventually training for physicians on island. And how
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about on the administrative side if you think
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about, I don't know, like, patient facing functions
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or scheduling and maybe revenue cycle functions and
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and so on? How does that work out
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from a staffing perspective? That that can also
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be difficult, you know, because we, I hate
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the word competition, but we do compete with
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all of the hotels and the resorts
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for a lot of that talent. Sure. And
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so we have to be,
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competitive. Yeah. But sometimes people would rather work
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in hospitality than health care, and so we
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really have to look at that. We try
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to keep as much as we can on
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the island
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so that we are employing the people that
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depend on Maui to live. However, in some
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areas, we have had to outsource
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and,
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or allow people to work virtually from the
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mainland.
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I was gonna ask you then about technology
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because one would imagine then in that kind
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of environment that technology be could be quite
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a good enabler potentially of different ways of
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working both on, again, clinically and administratively.
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You are exactly correct.
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We have had to really expand that even
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just in the two years I've been there,
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allowing
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some of our employees to work remote. Now
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when you deliver health care, that is still
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very much a human experience, which is why
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I always say our first choice is always
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to have somebody there.
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But where we can't do that, we do
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have areas that we allow people to work
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remote,
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if
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their role is completely non patient facing.
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Got it. Yeah. Okay. And what kind of
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technology infrastructure
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are you using,
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to to help make the health system run
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and make all that work? Well, we have,
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you know, the usual. You know, we we,
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operate off the Microsoft Office suite. And with
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Teams, you can do almost everything remote.
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I'm sure, you join me. And how many,
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Teams meetings do you have in a day,
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with individuals, sometimes in the next office and
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then sometimes across the Pacific Ocean?
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We do enjoy great connectivity,
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on Maui, which is something that, I'm very
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thankful for. So we are able to connect
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with our partners that are on the Mainland.
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Got it. Got it. Got it. And what
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about, like, new technologies? Are you introducing any
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exciting new technologies as you as you make
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this all work? It's a a great question,
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and we have a lot on the horizon.
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You know, when when we look at our
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since I arrived two years ago, you know,
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one of our
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first objectives was to solidify our workforce. You
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know, how do we make sure that we
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have the right people in the right pipeline
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so that we can staff our all of
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our facilities. And we've done a pretty good
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job with that over the last twenty four
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months. We still have some work in some
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areas.
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However, we're feeling a lot more,
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stable in that. And so now as we
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move forward, we're looking at areas for technology.
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You know, one of the things that we've
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been evaluating is the instance of Epic that
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we're on today.
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Knowing that it may not be what we
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want for the future, you know, we we
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would really enjoy a more what I would
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call out of the box Epic because as
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Epic brings on their AI tools, we want
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to be able to deploy those, for our
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clinicians as well as our support staff. So
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we're really looking forward to that, in the
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future. Right. Okay. Okay. Very good. Can Can
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you talk a little bit about the, the
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payer landscape
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that you work in work within? Just break
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it down for us perhaps. Sure. You know
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what?
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Again, it's it's the same and then different
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from what I was used to. You know,
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in Illinois, we had especially central, Illinois, we
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had less managed care, than what we have
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out in the West Coast and in Hawaii.
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You know, predominantly, Kaiser Permanente
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and Blue Cross Blue Shield are the the
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two large commercial payers, in Hawaii. We have
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others, but those, I would say, are the
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dominant. And then, of course, Medicare, Medicare Advantage,
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and then Medicaid.
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Now the state of Hawaii has been very
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progressive,
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in their support of health care for people
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on the islands. And so our,
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our Medicaid, we are reimbursed fairly well for
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Medicaid. They did some parity work between Medicare
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and Medicaid
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that have helped us, and the hospitals,
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in Hawaii.
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Got it. Got it. And is there a
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tension in the dynamic there? You said not
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perhaps, unusually,
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with with the, government payers, but on the
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commercial side, or is it a is it
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a collaborative?
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Well, I smile as the best way to
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answer it. And I would say with the
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with the HR one, big beautiful bill, whatever
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you wanna call it, you know, there is
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I have a a lot of,
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discontent with where that's going to bring us
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over the next twenty four months, especially, you
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know, when you look at three forty b
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and some of those those programs that we
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rely heavily on as a rural hospital serving
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an island. Yeah. Now with the payers, you
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know, the payers are
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up against,
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similar mountains that we are in health care.
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Right? As you look at,
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the numbers of individuals that are entering the
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commercial market versus the aging and the increased
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acuity that we're seeing in the hospital, their
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costs are going up as well. So I
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think there's always that push and pull between
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hospitals and payers.
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I now I would leave it at that.
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That's that's probably
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best described described it. We want more money.
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They wanna give us less. Sure. Sure. Sure.
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Sure. Sure. How how what what are some
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what are some ways through that? I mean,
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you you talked about, like, your epic upgrade,
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for example. Is technology gonna help you with
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that in terms of maybe automating processes or
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increasing visibility into things? Like, what what are
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some things that you can do? It absolutely
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will. The other,
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initiative that we're working really hard and also
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partnering with our our Kaiser Permanente partners on
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is what we call Care Without Delay.
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In better managing patients through their episodes of
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care and their post hospitalization.
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You know, when you look and if a
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patient is supposed to have a one point
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o ratio for their hospital stay and you're
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at 1.2,
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that means, you know, you're point two over
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what that patient needed. And so you're expending
10:51
additional resources to care for a patient that
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should have been discharged.
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And so we're really looking at, you know,
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what parts do we need to own as
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a health system. You know? Did we need
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to get them into imaging faster? You know?
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Were we able to begin their care process
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as soon as possible? Were we actually planning
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for their discharge when they were admitted to
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the hospital? So we have a number of
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what I would call operational efficiencies that we
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are looking at, and we've been able to
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make a lot of progress over the last
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year, but that's really what we have plotted
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out for the next twenty four months is
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to continue on that road because that will
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help us. It'll help with staffing. It'll help
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with bed availability, and it'll help us with
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our cost infrastructure.
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Got it. Yeah. Okay. What about partnerships within
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the community? Like, how how how do they
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help you run an effective health system? You
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know, they're really imperative.
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I I went to the opening session today,
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and the CEO from Providence spoke a little
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bit to partnerships. And I I couldn't agree
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more with everything that he said. And as
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I look at Hawaii as a whole,
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there's not a lot of population. And so
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we really do need to lock arms together
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so that we can care for the communities
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that we serve, and, that's really what we've
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been doing. You know, how do we meet
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with our hospital association, and how do we
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leverage the data that we have to be
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able to connect to care? And also to
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the nonhospital
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partners. You know, we have a lot of,
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nursing homes, for instance, skilled nursing,
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facilities.
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We have rehabilitative
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care. All of those
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providers are really imperative for us to be
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able to treat our patients effectively and then
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get them on to their, healing outside of
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the hospital. Got it. Yeah. Okay.
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Let's wrap it up with your some you
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you know, perhaps you could give give us
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a few of your key key priorities for
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next year. You've talked a little bit about
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technology. What else is on your agenda?
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You know, one of the number one things
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is our culture. You know, there's a lot
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of changes coming to health care. And at
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the end of the day, we are people
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taking care of people. And so the culture
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and how we connect with each other is
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really the most important thing that we do.
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And
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we're going to lead with that over the
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next year on how do we
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better connect with all of our employees so
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that we can hear their ideas, their thoughts,
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and,
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a little bit of connecting that why with
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them as we move forward and continue to
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advance care on Maui. Wonderful.
13:17
Lynn, thank you very much indeed. It's been
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a pleasure talking to you. Thank you. Thank
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you. Thank you.