Leadership. It is what 2010 AHA Chairman Richard P. de Filippi says hospital leaders can count on from the AHA as they face the uncertainties of health care reform and a changing health care environment.
De Filippi plans to work with the AHA to bolster its support of members on a number of fronts, whether it's dealing with the impact of health reform legislation, promoting stronger hospital governance, expanding hospital-led initiatives to improve patient care and lower costs, or broadening workforce diversity and building a thriving workforce that can meet future challenges.
Health reform. As Congress considers how to advance health reform (see story above), the AHA continues to press lawmakers for changes that will enhance hospitals' ability to provide safer and more effective patient care, notes de Filippi, who has been a hospital trustee since 1977 and is the former chairman of Cambridge (MA) Health Alliance. If reforms are enacted this year, de Filippi says the AHA will work closely with its state, regional and metropolitan hospital association partners to assess the impact on members, and "go back to Congress to work for whatever improvements may be necessary."
He believes the reform legislation now being negotiated on Capitol Hill will lead to much-needed improvements by better integrating and coordinating the nation's health care delivery system. "We may have to look out over the entire 10 years of the plan before we see the full fruits of reform, but I am optimistic that it will bring substantial benefits," he says, adding that "everyone in the field recognizes that changes are necessary."
Clinical integration. But realizing reform's true potential requires Congress to remove longstanding regulatory barriers to clinical integration among hospitals, physicians and other caregivers, he says. Improving patient outcomes by delivering higher quality care and making the medical system more efficient are "tied to changes in the partnerships between physicians and hospitals and other provider components along the whole health care spectrum," he says.
Electronic health records. Another key issue is how the Centers for Medicare & Medicaid Services (CMS) defines "meaningful use" of electronic health records (EHR). The definition will determine which hospitals and physicians qualify for more than $17 billion in health information technology (IT) funding under the 2009 "American Recovery and Reinvestment Act."
The AHA and hospital leaders have criticized the Dec. 30 EHR regulations issued by CMS and the Office of the National Coordinator for Health Information Technology, saying they would seriously limit hospitals' ability to access the IT funds. De Filippi says getting "realistic" EHR rules is an AHA priority, because the program should be a "kick start for some hospitals and a boost for others" in implementing EHR systems.
De Filippi became AHA chairman on Jan. 1, succeeding Tom Priselac, president and CEO of Cedars-Sinai Health System in Los Angeles. He is a managing partner of the Ariano Partnership, a consulting group that works largely with emerging technology-based companies.
During his tenure as chair of the Cambridge Health Alliance, the organization grew from a single city-owned hospital to a regional award-winning health care system. Today, the Alliance is a major Boston-area safety-net academic health system with more than 20 community health centers, a managed-care organization and physicians' organization.
Stronger governance. De Filippi is only the second hospital trustee in the association's 112-year history to serve as AHA chairman. He serves on the AHA Center for Healthcare Governance's national board of advisors, and says the Center's resources and programs can help hospital and health system boards manage the accelerating rate of change in health care.
Hospital and health system boards "have been very slow in bringing about innovations and initiatives, but this is an area where the Center can provide those strong beacons of light that point the way to the future," he says.
Quality and patient safety. In a similar vein, the AHA is exerting strong leadership in the national quality movement through its involvement in the Hospital Quality Alliance (HQA), de Filippi points out. AHA President and CEO Rich Umbdenstock is HQA's chairman. And de Filippi says the AHA this year will step up its support of hospital quality-improvement initiatives through Hospitals in Pursuit of Excellence, a program that shares what is best and what is working from hospitals and health systems across the nation.
"These are areas where AHA leadership will have a highly positive impact on the field and where hospitals can demonstrate that they will lead the way for change and improvement by example," he says.
Workforce and diversity. De Filippi last year chaired the AHA's long-range policy committee, which helped develop the new AHA report, "Workforce 2015: Strategy Trumps Shortage."
The AHA report describes projected long-term hospital staff shortages brought on by changes in the health care delivery system, a tighter labor market and a long training pipeline for health professionals, among other factors. The report offers findings and recommendations to help hospitals meet the challenge through strategies that redesign work, retain existing workers and attract the "Millennial" generation of younger workers.
"We can do this," says de Filippi. With four generations coming together in the workplace, interlaced with multiple cultures, communication must be flexible and appropriate, he says. Hospital leaders need to understand the different skills, experiences, work habits and learning abilities of their staffs in order to maximize their effectiveness.
He emphasizes that expanding workforce diversity throughout the organization will be key to success. With millions more minority and immigrant residents promised coverage under health reform, it is increasingly important for hospitals to respond to the changing face of health care. Providing culturally competent care will be critical, and "we should view it as an opportunity," he says.
