Transforming Community Health

[00:00:00] Patrick Mcgill: That’s why I always tell young leaders who always ask, say, what can I do? And my answer is, when a door cracks open for you. Go through the door. You’ll never regret it. There may be days that are hard. There may be days that you’re thinking, why did I sign up for this? But at the end of the day, at the end of the, whatever journey that you’re on, you’re never going to regret it and never stop pushing yourself. I’m my worst critic when it comes to a lot of these things. But I also know that I’m also my best advocate that I can push forward.

Narrator:  From Healthcare IT Leaders, you’re listening to Leader to Leader with Ben Hilmes. Our guest today is Dr. Patrick McGill, Chief Transformation Officer at Community Health Network. Patrick shares his unique perspective on healthcare innovation as both a CTO and a practicing family doctor.
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[00:00:45] Ben Hilmes: Good afternoon, Dr. McGill. welcome to a leader to leader. I’m excited to have you here and really excited because community hospitals are a passion of mine. Been in the industry for a long time. And, you know, as I’ve worked around the country, you come to the recognition that 80 plus percent of healthcare is delivered in communities. And so the work that’s done inside those hospitals and health systems is extremely important. And when I look at Community Health Network, I see an organization that is living in to their name. You’re striving to meet your patients where they are through your hospitals, your clinics, you have urgent care centers, you’ve created a virtual strategy, you’re even in the local Walgreens. So,I’d love to start with you just giving us a high level overview of Community Health Network and tell us a little bit, you know, about the diverse footprint you have across central Indiana.

[00:01:40] Patrick Mcgill: Well, first off, thanks for having me on I always appreciate it to sometimes tell our story that, like you said, a lot of health care in this country is delivered in organizations like Community Health Network. So really appreciate the opportunity. Community Health Network was founded over 60 years ago, and it really. The name is, telling. It was founded by people in the community who wanted a health system on the east side of Indianapolis, and so it’s grown since then as an integrated health system. So we have the largest primary care footprint in central Indiana. We have a very robust, oncology partnership with MD Anderson. So we’re one of the six member partners with MD Anderson. So cancer is a huge. footprint and priority for us. Our North Hospital delivers the most babies of any hospital in the state eight years in a row. we have a very robust cardiovascular, service line, product line. we are the leader in behavioral health delivery, inpatient and outpatient, in addictions.
We even have an addictions hospital. in central Indiana so we’re very proud of, like you said, we meet people where they are, we meet them with primary care, we meet them with specialty care, and we really, cradle to grave, really pride ourself in the care that we deliver. Our brand promise is exceptional care simply delivered.
And so that’s what we wake up every day. trying to achieve.

[00:03:06] Ben Hilmes: That’s phenomenal a lot of those things are really important. And, I sit on a board here in Kansas City with LLS. So, you know, the whole mindset that we can actually cure cancer. Pretty exciting. And the fact that you’re partnered with one of the most Preeminent, health, uh, cancer institutions in the world is pretty exciting. a lot of facilities, a lot of service lines, health systems tend to organize themselves one of two ways, vertically or horizontally. You hold a, belief that, you know, healthcare should be delivered horizontally. explain to me what you mean by that and maybe some practical examples for our listeners.

[00:03:44] Patrick Mcgill: Yeah. So one of the things I always talk about is many health systems are organized vertically. We just talked about many of our product lines or service lines. We talk about hospitals. We talk about clinics or ambulatory delivery, but that’s not how patients. experience us. They come into the system and they have a problem or they have a need that they expect us to deliver, whether that’s in a primary care setting or in a hospital or in a, referral to a specialist. And so people experience us horizontally, and I think it’s our job as health system as, a health system leaders or, through transformation or innovation or technology. So how do we create that experience to where they can experience it horizontally, and not with the friction that they run into every time they have to go through another vertical? So we really talk a lot about how do we shift from that vertical to the horizontal mindset. Oftentimes it is just a mindset, and it’s a way that you have to organize your processes, how do you configure your EMR, how do you really break down those friction points that are occurring, that are really frustrating for many people, and quite frankly lead to delays in care or poorer outcomes.
And so that’s what we always talk about. We’re always talking about how do you really think horizontally. Because that’s how we live every other part of our life, right? I always use the example that Amazon is a platform of thousands of sellers. But if you had to interact with each seller individually when you wanted to buy something off Amazon, you never would do it, right? So Amazon has created that horizontal experience for buying. And I think that’s what health systems should strive to do as well, really build that platform that people want to experience.

[00:05:29] Ben Hilmes: I love it. So the whole concept of integrating centered around the patient experience is a mindset change, because I mean, ultimately, from a vertical standpoint, it may work for the vertical piece, but based on the relative experience of the customer where I talk a little bit about that later, too. It’s really important to really drive that horizontal mindset. Love it. we’re going to talk about your career in a little bit, but you trained as a family practitioner. but you’re the chief transformation officer in that you have a lot of things. So you have pop health, value based care, you have the data strategy, you own all of IT, then you have digital strategy, which is different than data strategy. And then you have analytics. So my question, and I used to be the chief integration officer for Adventist Health. So looking horizontally, how do we drive integration? And I always was thinking about what are the biggest levers I have to drive change. I would love to understand across your portfolio, how do you bring all of those things together? To drive meaningful change.

[00:06:34] Patrick Mcgill: Well, certainly, like you said, I mean, I’m not in my role for, by accident. And so, oftentimes I do see myself as a change agent, you know, a transformation agent at the end of the day, really waking up every day, thinking about different ways to transform the organization, how we deliver care. The quality of care, the experience of care, how can we do it with technology? How do we make people more efficient? How do we make our caregivers more efficient? And so there’s several levers that we can pull. And I think COVID taught us, highlighted some of those. One is, how do we get more bang out of technology? And I think with this wave of generative AI that, some people say is hype, some people say is reality. how do we get more out of technologies like generative AI, for example? How do we really have people working at the top of their license? In our emrs and we’ve now experienced emrs for 10 15 20 years for some organizations So are we maximizing the emr capabilities?
And that’s a, topic in and of itself for a conversation You think a lot of it is people And if you think about health care delivery, which is a little bit different than other organizations or other industries we are still 80 percent people, and at the end of the day, we’re still people taking care of people.

So, how do you change behaviors? and a lot of it comes through data. A lot of it comes through modeling. A lot of it comes through, you know, just showing a different way or thinking differently. Now, we often use a partnership strategy for some of these things. I always joke and say, you know, you’re never a prophet in your own town. So, sometimes it takes a third person or a third party coming in to say, This is the way we should be doing things. And so that’s how we’ve organized as a health system, right? We brought together I. T. and analytics and pop health and value based care and, digital strategies and experience analytics. All of these things roll up to transformation because, at the end of the day, this is my marching order from my boss, the CEO. If I’m not making people a little uncomfortable, we’re not transforming anything. And so we need to move, it might be an inch at a time, it might be a mile at a time. We need to move the organization forward.

[00:08:51] Ben Hilmes: I don’t know more than a handful of chief transformation officers that have I. T. under their purview. I grew up at Cerner Corporation and our founder, Neil, you know, he felt passionately. We all felt passionately that technology was the biggest lever. We had to drive meaningful change. I love seeing that you are putting technology at the center and using it in the right way, getting the most value out of it, but you’re using technology to drive. Meaningful transformation. I think it’s a leading edge and to be commended. let’s talk about, you mentioned ai. it’s probably pretty interesting as you can put multiple lenses on that whole topic, so I’d love to hear you comment on it from a physician perspective.
And then at the same time as a change agent perspective, because they probably conflict in a lot of ways, but finding some way to use AI in a meaningful way is really going to be important.

[00:09:50] Patrick Mcgill: well, let me take a step back. we’ll wear the technology hat first. So wearing the technology hat, I do think there’s a lot of promise with AI, generative AI and other technologies. Now, I think we’re at the early stages. We’re at the beginning. So let me go back and put my clinical hat on. You know, I think there’s a lot that has to change, not just with technology, for us to see widespread adoption of AI, in healthcare. Mainly, The medical legal structure, right? So who’s responsible when the algorithm makes a mistake? I think there’s a lot of things that just live outside of a health system that have to be examined decisions have to be made.

And I think the first one is the medical legal structure. And so that, is probably 10 to 15 years away when you think about it. Now, are there technologies that we can implement today? Absolutely, we are. I mean, there’s a lot of assistive technologies. Where you’re not removing the clinician or the decision maker, but you’re assisting them, you’re surfacing information to them. You’re helping them be more efficient, whether it’s working in the EMR or helping them to make business decisions. I mean, I think about there’s clinical use cases, right? the assistive intelligence that clinicians need. There’s business.needs that we have. We have a whole analytics team that builds dashboards and reports.

How much of that could be automated through AI? We have a whole finance team that’s building proformas and looking at business cases. How much of that could be automated? Through A. I. I think there’s a ton of things that happen in the white space of health care. It’s not a direct patient doctor clinician interaction. So think about prior authorization, referral management, appointment scheduling, just navigation through the system that could all be improved with A. I. So, you have to clarify the question when we talk about it in health care. So do I think it’s real? Yeah, absolutely. Do I think it has a ways to go in some areas clinically? Absolutely, but I think that we have to continue to push forward

[00:11:53] Ben Hilmes: Yeah, I think that’s right. we’ve spent feels like multiple decades, getting the plumbing in right, digitizing healthcare and now you’re able to take advantage of these. Second order, second layer capabilities. I think it offers promise, but it also creates risk. And so making sure we got responsible people like yourself leading the charge, making sure that we’re bringing balanced perspectives to that is really important. So thank you for that for sure. let’s pivot and talk about leadership a little bit here. you’re a chief transformation officer, but trained as a physician. Most of the time when I meet a physician that’s now over on that side of the house, it’s because they showed up to the wrong meeting and agreed to take on something gnarly.

I’d love to hear your journey, how you went from being a practitioner to now leading at a very high level of driving a lot of really important objectives.

[00:12:48] Patrick Mcgill: Yeah, so I always laugh and say i’m kind of an accidental leader accidental intel informaticist accidental transformation officer so full transparency. I don’t have the kind of the noble sexy. This is why I wanted to do this story When we implemented Epic in 2012, I was a practicing physician. I was very busy. I was the medical director of two nursing homes. I had a full family practice. and my intention quite selfishly was. I don’t want this new E. M. R. to disrupt my productivity like you had heard about all the time. So I said, I’m gonna get involved in the optimization because I want to have a seat at the table to make sure that this tool, while it’s very robust and has tons of capabilities, doesn’t disrupt what I’m doing. that was very early on when epic was just starting their physician builder program. So I became a physician builder. I was tapped on the shoulder to do that. That led to, hey, can you take on some quality improvement work? How about you get involved in pop health? that led to, a couple other, you’re right. It’s shoulder taps. It’s you’re in a meeting. Hey, can you do this? Hey, we think you’d be good for that. in 2018, we made the decision as an organization to pull analytics out of IT. And create a chief analytics position, that reported directly to the CEO. And so I was asked to be the first chief analytics officer. And then about nine months later, we’ve decided to put it underneath that role. And that’s really what started kind of the current, structure that we have. But over those years. You know, I was heavily involved in our pop health work. We had several joint ventures on pop health. I was heavily involved in our value based contracting and the contracting work. And now through all of that work, I have a strong passion for health equity. So I lead our health equity work. and then I have some other operational areas like hospice and palliative care and home care, and that have just kind of evolved. But when you take a step back and think about it, there is a lot of, Method behind the madness of how the structure is because It tends to drive performance. And so you’re right. I don’t have an I. T. background. I don’t have an analytics background. I’m a family physician who has an undergraduate chemistry degree and. you know, I still practice. I was in clinic today, seeing patients and I’m very proud of that. So I do think that gives me the ability to walk the walk and I have to, experience everything that we’re transforming in the organization.

[00:15:11] Ben Hilmes: the fact that you’re still practicing. I kind of equated to eat your own dog food to some extent and experience all the change you’re driving into your organization because ultimately you are a change agent. by title by the work you do. and, you know, I assume people will go Oh, my God. Here comes Dr McGill. That means something’s going to change. So change makes people anxious. you know, if you’re not changing or growing, you’re dying. So would love to know how do you not only just bring people along, but how do you get them to embrace the change?

[00:15:44] Patrick Mcgill: you know, we talk about change as the scary thing, but we have change in our life and everything else that we do. think about the changes that we’ve experienced just in the last couple of years with. COVID and the pandemic, how many times did you door dash before the pandemic? And now how many times do you actually go sit in a restaurant? I mean, I think that we’re changing and it’s completely changed our restaurant experience. It’s completely changed our travel experience. It’s completely changed a lot of things. So for us to sit back and say, health care is not going to change or we can’t change or that’s not the way we do things. We can’t change, I think, quite frankly, is naive. And it’s irresponsible. We have to change. Healthcare changes, technology changes, the medications that we use, the treatments that we use have changed. And so for someone to say, well I graduated from medical school 20 years ago, I don’t need to change? Again, that’s naive and irresponsible in a lot of ways. And so I think we often talk about that. it’s not about change for just change’s sake. It’s how do we embrace change and really how do we embrace transformation, which implies almost more of an evolution. I can come in tomorrow and change your workflow. But let’s talk about how we evolve the workflow. Where are the friction points? Where are the things that we can make better? Where are the quick wins? it’s change management 101 at the end of the day, but it’s really engaging folks in the front line, the clinicians, the operators about how do we make
their job and their day to day better.

[00:17:19] Ben Hilmes: as we continue to move forward, I think it’s incumbent on us as leaders. to step in and drive that transformational change. So. very important.

[00:17:28] Patrick Mcgill: Well, so let me give you an example. just to tie that up. I’m a mid-career physician, I’ve been practicing for about 20 years, probably have about 20 years to go. when I finished my residency, HIPAA didn’t exist, EMRs didn’t exist, ACOs didn’t exist, Medicare Advantage didn’t exist. Now, you could argue, those four things have absolutely transformed healthcare. But when I finished training, those things didn’t exist. So to think that transformation and change doesn’t happen in health care, again, really irresponsible.

[00:18:03] Ben Hilmes: I think that’s absolutely right. I’ve heard you on a couple of other podcasts and one of them, you were talking about this whole connect to purpose. it’s really a powerful message. tell me more about that.

[00:18:14] Patrick Mcgill: Yeah, so we start every meeting that I lead. weekly meetings with our transformation leadership team. I start them with the analytics team. we always start with a Connect to Purpose. And so that serves a couple things. We started it during the pandemic, because, oftentimes we heard People were working, especially in IT and analytics and technology, 12, 14 hours a day.
They were working long days, but they really didn’t see how their work connected to what was happening. We all heard about healthcare heroes and the people that were going into the hospital and fighting COVID. So we started this as a way to let’s connect to our purpose. At the end of the day, the technology teams are here to serve the patients. At Community, we call everybody a caregiver. Whether you physically touch a patient or not, you’re a caregiver. And because we all play a role to support patient care and taking care of people. And so we always start these meetings and other, gatherings with the Connect to purpose. It allows people to tell a good story how they experienced the health system. Maybe how a technology or a project that they worked on influenced somebody. Maybe a story that somebody told them. It could have been a personal story of a family member or a friend that experienced health care. So It really is connecting back to why we do what we do every day.
And it’s something that, quite frankly, I’m very proud of because it allows people who don’t lay hands on patients. To understand how they connect to the mission of the organization.

[00:19:44] Ben Hilmes: That is fantastic. you know, ultimately healthcare is very personal, right? some level, it’s going to be us. It’s somebody we love. It’s. people we know and work with, et cetera. So having always connected to that purpose, I think is really. Empowerful thing to do. So thanks for setting the tone on that. I’m going to try to figure out how do we do that and what I do. So that’s a good takeaway for me. you’ve had a ton of success early, your career was a skyrocket and you are at a very high level, already, and those are going to be important things for that people can learn from.
But Let’s talk about setbacks, because I think sometimes you learn even people as successful as you often get, hit with obstacles or get push back or get knocked down. I’d love to hear about obstacles you faced along the way. What are some unique ways you overcome those obstacles? just to share with our audience that. some of the things you may have done to get past some of those

[00:20:39] Patrick Mcgill: Yeah. You know, I think we all have obstacles, right? so I’ll tell you a personal clinical story in leadership administrative story. So the first one, the first practice that I went into right out of residency was after a physician was that had been in practice for 20 plus years was killed in a plane crash. And the hospital that I was working for asked me, can you cover this practice? I walked in the practice the staff was still there didn’t know any of the patients didn’t really know the physician at all And so you talk about under fire right out of the gate this young guy That’s a month out of residency is walking in to take over this, community Icon and so what I always tell people when they ask me what was your greatest leadership lesson believe it or not That was one of them So the amount of, empathy, that had to occur, the amount of, how do you create change? Because he and I are different people. We trained in different generations, and we had different backgrounds, and we practiced differently. So how do you, really evolve a practice, that really was someone else’s into your own and put your own stamp on it? you know, if you want to talk about it administrative, not every project that I’ve led has been successful. We’ve had a couple in particular, I talk about all the time was a project that I led called patient care redesign. It was really the patient center medical home. many years ago.
And in my opinion, it was a failure, There are some things that persisted, right? But it was a failure because we didn’t have aligned incentives between the physicians and the operators and the organization, the health system. And so that was a lesson learned for me about you’ve got to align incentives. if you’re going to drive change,

Ben Hilmes:  What I’m taking away from this, those are two great stories, but one is you consistently have put yourself out there, even despite it being hard, right? Nobody said it was going to be easy, to step into a clinic where you’ve had a major tragedy and you’re like you said, yes, you stepped yourself in there, knowing it would be hard. To then on the administrative side, change like that is not easy, And despite all the challenges you, even when you got knocked down, I always tell my teams, uh, you know, if you get knocked down, be sure to pick something up there down there while you’re down there.
And so I love that you’ve kind of picked things up as you’ve been met with some challenges and you’ve learned from them and you keep pushing forward and keep putting yourself out there.
So thanks for sharing those stories.

[00:23:01] Patrick Mcgill: that’s why I always tell young leaders who always ask, say, what can I do? And my answer is, when a door cracks open for you. Go through the door. You’ll never regret it. There may be days that are hard. There may be days that you’re thinking, why did I sign up for this? But at the end of the day, at the end of the, whatever journey that you’re on, you’re never going to regret it and never stop pushing yourself. I’m my worst critic when it comes to a lot of these things. But I also know that I’m also my best advocate that I can push forward.

[00:23:31] Ben Hilmes: That’s great. Last question. you’re the one guy in your health system that wakes up every day Thinking about all the next you’re really pushing About how do we evolve this? How do I transform this if you had a crystal ball and you were saying gosh Here’s what 10 years from now looks like What’s the same and what’s not the same

[00:23:52] Patrick Mcgill: So I think the same is, you know, I think we’ll still have hospitals, we’ll still have ERs, we’ll still have surgery centers, we’ll still have ICUs. I think the pandemic taught us that we do need that infrastructure. to say that bricks and mortar hospitals are going to go away, probably not now. What do I think will look different? I think we’ll have more care in the home. I think hospitals at home and some other programs in the home are really at an inflection point and they’ll take off. I absolutely think that we’ll have more technology, smarter, assistive technology to help. Get physicians and, apps and clinicians off the keyboard. So things like ambient and, AI within the EMR will absolutely have some of that. I still think you’re gonna have to have a doctor patient relationship. You know, I don’t think that AI is gonna eliminate that, patient clinician doctor, patient doctor a PP or a a PP fit patient relationship. at least in the near future, we’ll have that. I think virtual care, we’ve seen it take off. We’ve seen it fall back. We’ve seen it take off again. I think we’ll have pockets of virtual care. it will be very interesting. with the aging of the population, how do we transition enough care to meet the demands as the population ages? And I think that’s something that will fundamentally force change within our health care delivery system. just to sum it up, I think you’ll see a lot of change in the next 10 years, but I think you’ll see some things that really don’t change in the next 10 years, too.

[00:25:19] Ben Hilmes: I think you’re spot on. I made the list. I’m going to put them in a vault and then 10 years we’re going to do this again.
We’ll
[00:25:26] Patrick Mcgill: I’ll talk to you in 10 years. You can tell me how wrong I was, and that’s fine.
[00:25:30] Ben Hilmes: I think it’s, I think you’re, you’re, you’re mostly right. So that’s really, really good. Well, just want to say thanks for joining us today on leader to leader.
Dr. Mayville, you’ve been fantastic. I think the insights, the, uh, commentary on specific things about your professional world, about your leadership journey, and then, you know, little nuggets along the way have been really insightful.
[00:25:50] Patrick Mcgill: Again, I really appreciate the opportunity to have me on and talk to you today.
[00:25:54] Ben Hilmes: Thanks so much.
[00:25:55] Patrick Mcgill: ​
[00:25:57] Ben Hilmes: As a practicing family physician, Patrick’s got such a unique perspective on healthcare innovation. Here are my takeaways from our conversation. One, siloed, horizontal healthcare delivery doesn’t serve the needs of patients.
two artificial intelligence can be a helpful ally, but it is no replacement for the human touch of the doctor, patient relationship. Three leadership. Isn’t just a role. It’s a journey. Patrick’s path from a clinician to an influential healthcare leader was paid by his willingness to embrace opportunities and continually cultivate his own professional growth.
So what did you think? What were your big takeaways from the episode? I’d love to hear from you on our social media channels or drop me an email from our website at healthcareitleaders. com.
[00:26:43] Narrator: Thanks for joining us for Leader to Leader. To learn more about how to fuel your own personal leadership journey through the healthcare industry, visit healthcareitleaders. com. Don’t forget to subscribe so you don’t miss any insights and we’ll see you on the next episode.