Needed: Customer-driven health care
Dr. Maini: First, you have an aging population and an increasing availability of new medical technologies and effective pharmaceuticals that patients want. Second, waste and medical errors lead to more expense for patients. Third, evidence-based medicine is not practiced near the extent that it should. Specifically, I am referring to systems by which a physician applies algorithms to patient symptoms. These include the questions that should be asked and the necessary tests that help physicians make the right decisions in the least amount of time. Medical knowledge is so vast, and it is simply impossible for the human brain to keep up with everything without such tools.
WBJ: What steps is Fallon Clinic taking to curb costs?
Dr. Maini: We emphasize three areas: good prevention measures, early diagnosis, and early intervention with effective treatment. We have documented evidence of the improvement in outcomes that result from applying this approach in a disciplined way. A report by the Massachusetts Health Quality Partnership also shows that Fallon Clinic is considerably ahead of other healthcare providers in delivering preventive measures. All this adds up to high quality medicine, which is also cost-efficient medicine.
WBJ: Can you cite some examples of specific prevention programs?
Dr. Maini: Based on patient history, our medical records system automatically reminds physicians when preventive tests are needed, such as mammograms, colonoscopies, cholesterol screening, and PSA tests for prostate cancer. In addition, our case managers on an ongoing basis monitor patients with specific diseases, such as diabetes, congestive heart failure, or hypertension. We are even evaluating video conferencing through a desktop computer that links patients with case managers, as well as delivering the results of glucose testing for diabetics via the Internet to the doctor’s office.
WBJ: What are some of the essential elements in your quality focus?
Dr. Maini: Patient safety, such as reducing medication errors, is part of it. But we also have a major program in customer service. Our focus groups with consumers showed that health care, though it is a service industry, does not behave like one. People expect to get a physical exam within a couple weeks—not six months. If they have an immediate problem, they expect to see a physician that day. They want their phone calls to the doctor’s office returned quickly, and they want test results and prescriptions filled in a timely fashion.
We made the strategic decision to invest a massive amount of resources into customer services. This involves customer service training for all employees and changing our hiring practices to include behavioral screening to insure that candidates, both physicians and staff, share our customer-service values. For feedback, we conduct ongoing patient satisfaction surveys on our physicians, and to some degree compensation is tied to those survey results. We also have a new director of customer service excellence who monitors this entire process. When a complaint is lodged, our goal is to research it so it never happens again. In the last two years, our complaints have dropped by about 60%.
WBJ: How have investments in technology affected your health care?
Dr. Maini: We’ve invested several million dollars in upgrading our phone system, which has reduced patient complaints by 70% in one year. We’re also spending more than $20 million to transform our medical records to an entirely digital system (see separate story this issue). On the treatment side, we’ve trained urologists to use robotics for minimally invasive prostrate surgery. The result is that patients recover much faster, reducing costly hospital stays. Our surgeons use laparoscopic equipment to do a whole host of minimally invasive procedures. With these approaches, the cost to employers is sharply reduced, because people return to the job much earlier.
WBJ: What role will health care play in the State’s economic future?
Dr. Maini: Health care and life sciences are huge employers, but our future growth is linked to other sectors, such as the formation of new business. We hope that state and local government will do more to attract people and businesses to Central Massachusetts. So in the final analysis, all of us are tied together.
This interview was conducted and edited for length by WBJ Chief Editor Larry Maloney.
Editor’s Note: On March 13, the Fallon Clinic announced that Executive VP Stephen Pezzella would serve as acting president while Dr. Maini recovers from an illness.
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