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St. Luke's Blogs

'The status quo ... is not acceptable'

By Dr. David C. Pate, News and Community
August 13, 2012

I’ve asked John Kee, St. Luke’s Health System vice president of physician services, to share his experience and thoughts about how we’ve evolved and what challenges we face going forward. His perspective is presented here. I’ve introduced John in a previous post, and you’ll be hearing more from him and other members of our executive team as our journey of transformation continues.

I’ve been with St. Luke’s for six years, starting in June 2006, but I’ve worked in Idaho health care since 1976, when I started working out of McCall as a traveling controller for several rural hospitals. The opportunity to work in management roles in the rural and urban sectors, and to work with physicians in a role encompassing education and practice management, has provided me with valuable insight into both the hospital and physician work environments.

St. Luke’s reputation for high-quality care and the organization’s desire to improve were the elements that attracted me. St. Luke’s has long been concerned with safety, timeliness, efficiency, effectiveness, equitability, and patient-centeredness, and I could see the value that increased coordination across the region would bring to those priorities. The vision of a locally managed regional health care system, connected through efficient technology and strong physician relationships, allowing patients to access a continuum of care across the geographic region, is a compelling one.

And there were other elements: the fact that St. Luke’s is Idaho-based, providing a firm foundation for local decision-making; its role as a regional leader in rural relationships and its respect and support for local, community-based health care; the reputation and tenure of its leadership, including now-retired CEO Ed Dahlberg and Gary Fletcher, our System chief operating officer; and St. Luke’s reputation for following through on commitments. I found those aspects motivating, and I still do.

Over the past several years, we’ve developed an increased understanding of the crucial role of physician leadership in the health care delivery system of the future. Physicians are empowered, by virtue of their licenses and their training, to manage the delivery of essential health care services. They are the professionals empowered to write orders for clinical care, and are in the best position to collaborate with patients to ensure they receive the right services at the right time, and to directly influence the effective and efficient use of health care resources. We need their very active participation to ensure we make decisions that are patient-centered and that optimize resources. At the same time, we’re experiencing and continuing to develop increased financial and clinical integration via extended relationships.

A systemic approach also expands the opportunity for us to share administrative resources in areas such as electronic health record development, claims processing, and financial expertise, and gain cost advantages through the effective sharing of administrative resources.

Our various locations have benefited from these developments. The Magic Valley community, for example, needed the borrowing capacity to replace an acute care facility, medical office buildings, and other related infrastructure. It would have been difficult to raise the necessary capital to take the type of risk required to replace these facilities, but St. Luke’s Health System had the necessary capital strength to make these needed improvements a reality.

We are still coalescing. That’s logical; after all, it was only six years ago that our System originated with the addition of Magic Valley. It’s a challenge to overcome fragmentation in a delivery system when each entity and each physician operates separately, but it’s happening. We are establishing governance that puts patients first and keeps them there, that places the best interests of the patient at the forefront.

Critical to our improvement plans for the next several years is the optimized integration of our myStLuke’s electronic health record. We expect patients, physicians, and the System as a whole will receive immeasurable value from our new electronic records vault.

Another critical piece is our work with physicians to help them establish and implement evidence-based practice protocols, so that we can continue to build on our record of quality, and at the same time, reduce waste in the delivery system. Both of these initiatives, our electronic health record and our physician integration efforts, will improve access to care for everyone, in many ways.

From my perspective, St. Luke’s is well-positioned to execute on its vision and to improve on its delivery system. There are risks and unknowns, of course, and regulatory burdens and unclear coordination between regulatory bodies that often are in conflict or create additional costs. But we have established tested and trusted relationships with physicians and communities, relationships that we believe will serve us well into the future.

I believe the only thing that may stand in our way, ultimately, is us. Change is tough. We all tend to be comfortable with the status quo.

But the status quo in health care is not acceptable. We need to improve care, improve health, and lower the rate of cost increase. We’ve got an unprecedented opportunity, and I’m glad to be part of the St. Luke’s solution.


About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.