Latest / Becker’s Healthcare Podcast / Dennis Disch, MD, MMM, FACC Vice President, Hospital-Based Specialties, Advocate Health

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Dennis Disch, MD, MMM, FACC Vice President, Hospital-Based Specialties, Advocate Health · Becker’s Healthcare Podcast

• 0:02
  This is where health care leadership comes together.
• 0:04
  Becker's sixteenth annual meeting brings more than 3,500
• 0:07
  hospital and health system executives and nearly 800
• 0:11
  speakers to Chicago, April 13 through the sixteenth.
• 0:14
  This year's event includes keynote conversations with Dallas
• 0:17
  Cowboys legend Troy Aikman and former president George
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  w Bush. For the agenda and event details,
• 0:23
  visit beckershospitalreview.com
• 0:25
  and click on the events tab in the
• 0:27
  upper right. We're looking forward to hosting you
• 0:29
  in Chicago.
• 0:32
  This is Graceland Keller with the Becker's Healthcare
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  podcast, and we are recording live at the
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  thirteenth annual CEO and CFO roundtable.
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  I'm currently joined on the podcast this morning
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  by doctor Dennis Disch, who is the vice
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  president of hospital based specialties at Advocate Health.
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  So, doctor Disch, thanks for being here. I'm
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  gonna first have you start off by introducing
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  yourself and telling us a little bit more
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  about your background.
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  Good morning. Thank you very much for the
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  opportunity to be here. I've been looking forward
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  to the discussion.
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  So as you mentioned, I, serve as the
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  vice president over the hospital based specialty service
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  line for Advocate Health.
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  A little bit about Advocate Health. We're the
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  third largest nonprofit health system in the country.
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  There are three state based divisions to Advocate
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  Health. There's the North Carolina Georgia combined division,
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  the Illinois division, and the Wisconsin division. So
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  the way we think about hospital based specialties
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  at Advocate Health, we actually combine five service
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  lines within one large service line because we
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  really think fostering collaboration
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  among those service lines is important.
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  So I oversee all five of those service
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  lines for the Illinois and Wisconsin divisions and
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  serve as the physician leader. So those specialties
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  are anesthesia,
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  radiology,
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  hospital medicine,
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  critical care medicine, and emergency medicine.
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  I love what I do. It's a it's
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  a really great role to be in right
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  now because what it really allows me to
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  do is focus on fostering collaboration,
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  among a very talented group of physician leaders
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  who are experts in their specialty as well
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  as their
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  we really think that collaboration
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  fosters moving hospital based care forward in sort
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  of a synergistic way.
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  We also I also get to foster the
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  collaboration of those leaders
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  with our hospital based operational leaders across all
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  27 of our hospitals in our Illinois and
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  Wisconsin division. So,
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  again, another full sort of synergy to move,
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  the process of really creating operational efficiency,
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  and financial success across all of our divisions.
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  Prior to that, I actually spent two years
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  with Advocate Health overseeing the cardiovascular service line.
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  I'm actually trained as a cardiologist and spent
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  a lot of my early earlier career with
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  cardiovascular service lines. And then prior to that,
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  I was with CorWell Health in Michigan where
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  I served,
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  as the service line leader for cardiovascular for
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  the South Region of CorWell Health as well
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  as the chief medical and chief operating officer
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  for one of our hospitals.
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  Wonderful. Well, thank you for taking the time
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  to be here this morning. And first question
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  for you as we start our conversation,
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  can you elaborate on your growth strategy over
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  the next year or two? Yeah. It's a
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  really great question. You know, in hospital based
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  specialties, we we have to kinda think about
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  growth in a little different different manner than
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  I'm used to as a cardiovascular service line
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  leader. So, you know, for the our ambulatory
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  specialties and our,
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  procedural and surgical based specialties,
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  you know, growth really means,
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  growing market share, growing practices,
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  providing additional
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  procedures and advanced surgeries
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  that really that our patients and our communities
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  can benefit from.
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  With hospital based specialties, we're not really asked
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  to go out and create organic growth in
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  the community. So when when we think about
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  growth potential,
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  what we really try to focus on really
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  is two things. Number one is, creating inpatient
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  capacity within our existing hospitals so that that
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  so that we can actually accommodate more of
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  those acute care admissions that are necessary to
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  the emergency department and those elective admissions for
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  the advanced procedures and surgeries that our specialists
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  in our communities really rely on.
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  The way we do that is by really,
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  again, leveraging those leadership teams with each specialty
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  as and having them work closely with our
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  hospital leadership teams to really, drive operational efficiency
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  so we can move patients through their hospital
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  admissions
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  with the highest degree of safety, which is
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  important to patients, but also with the highest
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  degree of efficiency, which is important to our
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  financial bottom line and to making sure we
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  have enough capacity.
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  And then the second way in which we,
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  think of growth
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  is that we're a very large health system,
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  and these are five very large service lines.
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  So we really have to constantly be focused
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  on, recruiting and retaining top talent.
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  Just to to give you to put some
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  numbers on that, across our five specialties for
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  27 hospitals, we employ over 1,800 providers, including
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  physicians and APPs.
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  So we're constantly in recruitment mode, and so
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  we really have to not only nail the
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  recruitment side of things, and we're fortunate that
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  we have a lot of very talented recruiters,
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  with whom I get to work, and also
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  to retain those physicians. And so we really
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  have to have robust wellness and well-being policies
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  as well.
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  Absolutely.
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  And tell us about the most exciting and
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  impactive
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  initiative or project that you're currently working on.
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  Yeah. Great question. So, you know, in hospital
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  based specialties, we're really trying to focus on
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  identifying,
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  initiatives that really leverage
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  the,
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  the the collaboration
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  among the five service lines, number one. So
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  in other words, trying to synergistically think through
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  how to solve the problems that our hospitals
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  and their administrators are facing
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  by getting these minds together across their specialties.
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  But then we're also trying to look at
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  initiatives that also leverage new technology that Advocate
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  is increasingly becoming known for. So, for example,
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  we have some really,
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  robust virtual health programs
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  and hospital at home programs,
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  as well as some really robust AI programs.
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  And so one of the ones I'm, actually,
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  most excited about is what's called our we
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  just kicked this off, is what's called our
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  ED boarding project. So any hospital administrator will
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  tell you that definitely in their top five
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  list of difficulties that they're dealing with is
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  trying to solve the ED boarding crisis.
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  And that's especially,
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  relevant
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  in some of our larger,
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  especially teaching hospitals in in big cities such
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  as Chicago and Milwaukee.
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  It's something that no patient wants to do.
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  They don't wanna sit in the emergency department
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  for extended periods of time, and it certainly
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  creates inefficiencies in our hospitals that we just
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  can't afford to have. And so what we've
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  asked our teams to do across critical care,
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  emergency medicine,
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  hospital medicine, and even radiology
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  is really to start that collaboration
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  process earlier as soon as the patient walks
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  in the door. Some of our triage, activities,
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  if the patient's not acutely ill or seriously
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  ill, can can actually be accomplished by our
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  teletriage program, for example. So we can start
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  figuring out what not only what is the
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  patient's diagnosis, but what is their disposition
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  much earlier in the process. And then instead
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  of providing that
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  diagnosis
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  and disposition process sequentially,
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  in other words, traditionally, what happens is emergency
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  department
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  physician sees the patient, and then they decide
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  if they're sick, and then they order tests,
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  and then they decide if they need to
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  see critical care or if they need to
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  see hospital medicine, and those physicians say I'm
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  waiting on the test results.
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  We're really asking these groups to to communicate
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  earlier, so perhaps we can move that patient
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  out of the emergency department more quickly and
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  into an acute care bed,
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  in an appropriate setting, even if those test
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  results aren't back. One thing we discovered in
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  this process is that
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  one contributor to the ED boarding issue is
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  that there's a hesitancy to move the patient
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  out of the emergency department to the floor
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  because as soon as they do that, they
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  tend to go from the top of the
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  imaging queue to the bottom of the imaging
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  queue. So now they can't get their CT
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  scan. So we're really trying to challenge that
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  notion and ask our,
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  our,
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  physician leaders to really move people through more
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  expediently.
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  That's gonna accomplish at least four things. Number
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  one, is it gonna create a quicker diagnosis
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  and disposition for the patient?
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  It also allows the patient to be the
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  recipient
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  of multidisciplinary
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  decision making earlier in the process of their
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  ED admission.
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  Of course, it's gonna they're gonna spend less
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  time boarding in the emergency department. And then
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  lastly, they could potentially avoid actually admission. We're
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  actually actually going to tailor onto this our
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  very
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  very significant and very, successful hospital home program,
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  for advocate that started in the Charlotte,
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  region, Charlotte market, and is now being extended
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  to several hospitals in our Illinois and our
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  Wisconsin markets. So some of those patients who
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  traditionally would sit in the emergency department waiting
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  for an inpatient bed could be candidates to
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  have to be admitted directly to the hospital
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  at home program. So that's just another way
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  in which we're really trying to, to decompress
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  our our emergency departments and really handle that
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  challenge.
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  And as we close out our conversation,
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  what is the most important thing care executives
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  should do right now to make sure their
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  organizations are successful in the future?
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  Yeah. You know, there there are a lot
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  of challenges, and we're in a financial environment
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  of which everyone is aware, that is really
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  making, providing
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  high quality,
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  efficient,
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  nonprofit health care increasingly challenging in in our
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  country. So there there are lots of things
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  to do. A couple come to mind in
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  terms of things that I think need to
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  be on the front of mind of health
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  care executives.
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  Number one, and I I I look at
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  this through the hospital based specialties,
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  lens, is that we have to be,
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  we have to be willing to have earlier,
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  more honest, ongoing conversations with our very valued
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  independent physician groups. We have a lot of
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  those who provide the services that I just
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  mentioned in the Chicago area,
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  less lesser so in the Wisconsin our Wisconsin
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  division, but quite a few really valued independent
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  partners. And a lot of them provide these
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  these specialty services such as anesthesia, critical care,
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  emergency medicine, and even and and even hospital
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  medicine.
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  The pressures that nonprofit health systems are feeling
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  from a financial in this financial environment with,
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  rising costs of providing care and declining reimbursement
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  is something that is actually being felt perhaps
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  even more acutely by our independent physician partners,
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  especially in these specialties where they can't, you
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  know, they can't offset their their,
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  cost and grow their revenues with an ASC
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  or by doing outpatient procedures and that sort
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  of thing. So what we found is that
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  the business model that worked for them two
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  years ago may not work today. So we
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  wanna have those conversations with them earlier and
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  say, hey. Listen. If this is still working
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  for you and we're meeting our metrics together
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  and, and you can still make this work
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  from a business standpoint, then great. We value
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  you as a partner. But if this is
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  becoming increasingly difficult for you, we'd rather have
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  that conversation about whether an an employment type
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  situation makes more sense for everybody
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  earlier rather than later. We see this most
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  acutely in anesthesia where, you know, the the
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  the sudden exit of an anesthesia group, from
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  our system dramatically disrupts care and does not
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  give us the ability to take care of
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  our patients in the way that we want
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  to. So we would rather be prospective and
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  thoughtful about that ahead of time rather than
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  have to react to a situation once it
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  falls apart. And then the last thing I'll
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  mention is that we really have to take
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  good care of our APP in a position
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  workforce.
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  That's something that Advocate Health is very intentional
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  about. We started a program a couple years
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  ago called Best Place to Care, and we've
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  noticed a dramatic improvement in our engagement and
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  alignment scores through that program. We're also active
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  participants in the AMA's
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  join medicine program, along with a number of
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  other large health systems. So I think through
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  those two things, we're gonna be able to
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  increasingly demonstrate to our APP and physician colleagues
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  that, Advocate really is a great place to
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  work. And that'll that will then allow us
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  to to really maintain the type of services
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  that our patients and our communities deserve.
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  Wonderful. Well, doctor Disch, thanks so much for
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  joining me today on the Becker's Healthcare podcast.
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  Again, we are live at the thirteenth annual
• 11:48
  CEO and CFO roundtable.
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  Thank you.