HCM-FPX5314_MusiKeti_Assessment 1-1
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Assessment 1 Instructions: Aligning Strategic Initiatives to Goals
Keti Musi
HCM-FPX5314: Driving Health Care Results
Prof. Stocker
Capella University January 23, 2022
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NewYork-Presbyterian Overview NewYork-Presbyterian (NYP) is one of the nation’s most comprehensive, integrated academic health care delivery systems, dedicated to providing the highest quality, most compassionate care, and service to patients in the New York metropolitan area, nationally, and throughout the globe. NYP was founded nearly 250 years ago with the fundamental belief that every person deserves access to the best care. NewYork-Presbyterian encompasses 10 hospital campuses across the Greater New York area, more than 200 primary and specialty care clinics and medical groups, and an array of telemedicine services. NewYork-Presbyterian has four major
divisions: (1) NewYork-Presbyterian Hospital, (2) NewYork-Presbyterian Regional Hospital Network, (3) NewYork-Presbyterian Physician Services, and (4) Community and Population Health. NewYork-Presbyterian Healthcare System’s mission is to be a leader in the provision of world class patient care (i.e., high quality, fiscally responsible healthcare services that meet the needs and expectations of the communities they serve), teaching, research, and service to local, state, national, and international communities. The communities NewYork-Presbyterian services,
which spans from New York City to the counties just outside of NYC, represent a broad diversity
of demographics, socioeconomics, and health service utilization needs. NewYork-Presbyterian is an 11-hospital system that experiences 2.6 million patient visits annually. The system employs 10,000-plus physicians and is equipped with 4,000-plus certified beds.
Strategic Initiative Analysis
The healthcare sector is going through a period of transition and transformation stemming
from rapid technological advancement, an aging and diverse population, major disruptors, payment and reimbursement restructuring, health policy shifts, cost increases, and more (Bowen et al., 2009). The three main themes of healthcare transformation and reform are increasing
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(expanding) access, improving quality, and reducing costs. The shift in the consumer life cycle/process demands satisfaction with the quality of care delivered, the ease to accessing such care, and the cost-effective delivery. Now, more than ever, quality, access, and costs are the kingpins to any successful healthcare organization, no matter the type. An effective healthcare organization enhances community wellness and balances the three-legged stool of health care: access to services, quality care, and cost effectiveness (Blumstein, 1994). These three components – access, cost, and quality – are often referred to the iron triangle
of health care (van der Goes et al, 2019). The premise of the iron triangle is that an improvement in one area results in a decline in at least one of the others, putting the organization and the community it serves are at risk (i.e., illustrates the inherent trade-offs in healthcare systems, that at any time, you can improve 1 or potentially 2, but it had to come at the expense of the third). While this is typically true when the current methods of healthcare delivery and finance are simply expanded, there is a role that healthcare transformation and reform can play in achieving a multi-faceted positive outcome. As a senior leader of a NewYork-Presbyterian, I have been charged with performing a complete analysis of the organization, starting with the evaluation of its ongoing strategic initiatives dealing with access to services, quality care, and cost effectiveness. NYP has been able to survive and flourish in the healthcare industry due to its viable long-term and short-term strategies, that enable it to be the leading healthcare system in providing outstanding patient and community care by increasing access, improving quality, and reducing costs, while making its financial outcomes more sustainable and straying away from the core of their mission, vision and
strategies (Child & Rodrigues, 2011). However, NYP will need to embrace technological advances to drives continuous competitive improvements in access, quality, and cost. Below are
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innovative strategic initiatives (which are interconnected and interdependent) allowing NYP to exploit all opportunities and mitigate the threats or challenges it may face to providing its patients and communities with increased access, improved quality of services, and reduced costs (i.e., cost-effective care).
Access to healthcare refers to the “timely use of personal health services to achieve the best health outcomes” (IOM, 1993). Access to health care consists of four components: (1) coverage, (2) services, (3), timeliness, and (4) workforce (Gulliford et al, 2002). Providing access to affordable healthcare is vital to health (both physical and mental). NewYork-
Presbyterian has developed strategies to improve (enhance) access to their care (i.e., breadth of services) for those in all the communities that it services. One of the key strategic initiatives is pivoting to digital strategies to improve access to care and drive down costs. NYP is leveraging the latest digital technologies and innovations like telehealth services to deliver enhanced patientcare, with the ability to extend their services beyond hospital’s walls (i.e., finding new ways to bring their world-renowned care to a patient’s home). NewYork-Presbyterian Hospital continues to invest in a suite of digital health services (ex. remote patient monitoring, teleparamedics, virtual urgent care, video visits, second opinion, inter-hospital consults, express care, etc.) to provide patients with easy access to expert doctors from Columbia University Vagelos College of Physicians and Surgeons and Weill Cornell Medicine.
Improving quality of patient care has become a priority for all health care providers with the overall objective of achieving a high degree of patient satisfaction (Rao, 2002). Quality care refers to “quality improvement focuses on care that is safe, timely, effective, efficient, equitable and patient-centered” (IOM, 1993). NYP is committed to continually improving the quality of care (across the full continuum of care) they provide to their patients. NYP is updating its clinical
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operations across its health system, implementing consistent best practices, and enhancing the promise of technology and data analytics. NYP has undertook a holistic diagnostic review to understand its current state, identify the priorities and opportunities for further organizational (functional) integration based on a set of criteria for desired state, and develop a strategic roadmap (i.e., coordinated, and prioritized guide) based on the NYP’s criteria. Once NYP identifies these opportunities, it will implement the step-change improvement plans for short-
term results and long-term sustainability and achievability, then allocate resources to the efforts. This will enable NYP to deliver quality and efficiency in the delivery of health care services. The rising cost of healthcare is a front-and-center issue nationwide, particularly for patients (Hussey et al, 2013). NewYork-Presbyterian are consistently trying to the balance between reducing costs, delivering positive patient experiences, and maintaining patient outcomes. However, simply reducing spend in areas like staff, equipment, and supplies can hinder NewYork-Presbyterian’s ability to deliver quality care and excellent patient experience. To continue meeting community healthcare needs, NYP is thinking and acting strategically about
managing cost, while improving care cost (as well as access and quality). NewYork-Presbyterian is aiming to improve operational efficiencies associated with economies of scale, reduced administrative and overhead costs, improved integration of care, reduction or elimination of redundant services, shared costs for expensive IT infrastructures and purchasing, access to a robust network of system resources, equipment and facility upgrades to reduce hospital operating
costs (by 15%−30%) – savings that NYP will pass on to patients and their health plans, translating into average price decreases of hospital/medical services (by 6%−18%) for patients. NewYork-Presbyterian is looking to use data science (both descriptive and predictive analytics), machine learning (ML), artificial intelligence (AI), natural language processing (NLP) and deep
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learning (DL), and advanced optimization algorithms to enhance access to care, improve quality of care across the full continuum of care cost effectively.
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References
Bowen, D. J., Kreuter, M., Spring, B., Cofta-Woerpel, L., Linnan, L., Weiner, D., . . . Fernandez, M. (2009). How we design feasibility studies. American Journal of Preventive Medicine, 36(5), 452–457. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859314/
J.F. Blumstein, “Health Care Reform and Competing Visions of Medical Care: Antitrust and State Provider Cooperation Legislation,” Cornell Law Review 79, no. 6 (1994): 1459–
1506, 1482. Retrieved from https://scholarship.law.cornell.edu/cgi/viewcontent.cgi?
article=2532&context=clr
Child, J. and Rodrigues, S. (2011). How Organizations Engage with External Complexity: A Political Action Perspective. Organization Studies, 32(6), 803-824. Retrieved from https://books.google.com/books?
id=vfzeBQAAQBAJ&pg=PA329&lpg=PA329&dq=Child,+John+,+%26+Rodrigues,
+Suzana+B.+2011&source=bl&ots=9CDTbuuc4k&sig=ACfU3U1JLij9-
gsyJlHdSKFcdiYUNMB8Ng&hl=en&sa=X&ved=2ahUKEwjwxragvs_oAhV8lHIEHXK
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%20%26%20Rodrigues%2C%20Suzana%20B.%202011&f=false
Gulliford M, Figueroa-Munoz J, Morgan M, Hughes D, Gibson B, Beech R, Hudson M. What does 'access to health care' mean? J Health Serv Res Policy. 2002 Jul;7(3):186-8. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12171751/
Hussey, P. S., Wertheimer, S., & Mehrotra, A. (2013). The association between health care quality and cost: a systematic review. Annals of internal medicine, 158(1), 27–34. Retrieved from https://doi.org/10.7326/0003-4819-158-1-201301010-00006
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Institute of Medicine, Committee on Monitoring Access to Personal Health Care Services. Access to health care in America. Washington, DC: National Academy Press; 1993. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK235882/
Rao, G. N. (2002). How can we improve patient care? Community eye health, 15(41), 1–3. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1705904/
van der Goes, D. N., Edwardson, N., Rayamajhee, V., Hollis, C., & Hunter, D. (2019). An iron triangle ROI model for health care. ClinicoEconomics and outcomes research: CEOR, 11,
335–348. Retrieved from https://doi.org/10.2147/CEOR.S130623