Hospitals are changing with the times, particularly with the introduction of new technologies, as well as a changing funding paradigm. Special Sections Editor Brad Graves, with the help of Health Care Reporter Jared Whitlock, asked several senior hospital executives about the advent of new technologies and approaches — in short, what we might expect from the hospital of the future. Here are their edited responses.
CEO UC San Diego Health
Q: Health care is moving toward an emphasis on outcomes and value rather than volume. How is your hospital system preparing for this shift?
A: We’re in the midst of a service delivery transformation that we think will position UC San Diego Health as, not only the regional destination for the treatment of complex illnesses, but also the health system of choice for healthy populations who want access to more basic services, including a wide range of wellness services with the security of knowing patients have access to a vast array of nationally recognized specialists if needed. As part of that transformation, UC San Diego Health is aggressively expanding its regional footprint through the expansion of our community affiliations and the development of our Community Care sites in neighborhoods where our employees and patients live and work. Convenience, access, and an enhanced digital platform for patients are major components of the UC San Diego Health strategic plan. We want patients to have access to the highest quality services and providers in the region from their homes, in their neighborhoods, or at the most advanced facilities without the stress and hassles that typically surround health care.
Q: From a business perspective, what’s the greatest challenge and opportunity in San Diego health care right now?
A: From the prospective of providers of health care services, our greatest challenge is balancing the health care needs of our most vulnerable populations with the funding available to support their care. Looming cuts to Medi-Cal inpatient reimbursement via the Disproportionate Share Hospital Program will only exacerbate this problem, especially for systems like UC San Diego Health which are highly dependent on these funds to maintain care levels for these vulnerable patient populations. UC San Diego Health remains committed to serving the community including those who suffer from mental health, substance abuse and homelessness issues, but today’s system of care is highly fractionated. This leaves gaps in transitions of care and creates high utilization in expensive venues like inpatient beds and emergency departments.
With new energy from the county, city and other key community services organizations, we have a real opportunity to come together to provide a more integrated approach to health care and the social determinants that impact health care. This will only work if we have aligned systems the link health care and social services and the funding models that create a cohesive approach, versus today’s patchwork of disparate systems. As an example, UC San Diego Health is in discussions with San Diego County’s Health and Human Services Agency to create a more coordinated model of care for those needing extended mental health services in both inpatient and outpatient venues. This would create more predictability and stability for patients and caregivers, and reduce total cost of care.
Q: San Diego is a genomics hub, with companies like Illumina based here. How can hospitals incorporate genomics into care?
A: Genomics is the study of the entire complement of genes at once. It provides not just the big picture, but also reveals its interconnections and nuances. In other words, how genes and other epigenetic factors relate to and influence each other in health and in disease. Whole genome sequencing has become a major driver of basic health research, but is also being applied increasingly to actual treatments as findings move from the lab to the clinic. Some of the earliest advances and applications have been in the treatment of cancers through precision medicine, which identifies drugs specifically proven to be effective against a patient’s particular tumor mutations. The Molecular Tumor Board at Moores Cancer Center at UC San Diego Health epitomizes this approach, analyzing and developing personalized treatment protocols for complex cases. This particular approach can only be found at our NCI-designated Moores Cancer Center. [The abbreviation stands for National Cancer Institute.] A soon-to-be published paper by UC San Diego researchers will report that genomics analysis that results in a prescribed combination of targeted therapies that cover a multitude of tumor mutations is even more effective at improving the lives and survival rates of patients with advanced, metastatic cancer.
See More: Executive Q & A