Executive Interview: Premier’s Mike Alkire

When Mike Alkire talks about “future-proofing,” he doesn’t mean predicting change. He’s talking about anticipating it and preparing to adapt to it. It’s a mindset, and it’s what healthcare needs, says Alkire, COO of the Premier healthcare alliance.

Speaking at Premier’s recent Breakthroughs Conference, Alkire talked about the need to re-craft care delivery systems, spur innovation, and create scale in a clinical and economic sense. Transformation is underway in virtually every Premier member facility, he pointed out. And more work is needed. “Are we building truly integrated systems?” he asked. “Or will we become extinct or replaced by a new species?” Alkire spoke with the Journal of Healthcare Contracting following the conference. The fufollowing is an excerpt. To read the full article, click here

A matter of scale

In today’s world of IDNs, regional purchasing coalitions and giant national GPOs, one might question the need for even greater scale. Yet Alkire argues that economic trends dictate it. But when he talks about scale, he’s not necessarily talking about greater numbers of hospitals banding together. He is talking about greater alignment among those that do.

Providers participating in Premier’s QUEST program, for example, collaborate to measure, compare and scale patient-care solutions. “They come from various IDNs, some are stand-alone,” says Alkire. “The most important thing is, they benchmark with one another. They take variation out. And they try to understand what top-performing organizations are doing, and glean best practices from them. To the degree you can actually firm that up in terms of an IDN or virtual IDN, the more efficient you will be, because you can automate that benchmarking.

“But I firmly believe that, whatever the flaws that make up the healthcare system may be, there are unbelievable best practices happening every day in our hospitals. So the important thing is sharing them. It’s not that we have a lack of data. It’s ‘What do you do with it? How do you communicate it? How do you put performance improvement programs in place to drive better results?’”

Pit crew mentality

For the most part, healthcare executives are doing everything they can to drive this level of scale, he says. But on a day-to-day basis, their job is to provide what he calls “unbelievable care” to their communities. Larger organizations, such as Premier, are in a position to take the mass of data collected among its facilities and turn it into opportunities, “so people can understand where the gaps are in performance, and begin to share best practices.”

Alkire agrees with surgeon, writer, and public health researcher Atul Gawande when the latter says that today’s healthcare challenges call for a “pit crew” – not a “cowboy” — mentality. Instead of working in silos, care providers – spanning X-ray, lab, surgery, etc. – need to share information in a real-time fashion, he says. The goal is to implement a care plan for patients that crosses the entire continuum of care as well as all geographies.

This isn’t just theory, says Alkire. By benchmarking, sharing and acting like pit crews, the 160 participants in QUEST saved an estimated 25,000 lives and more than $2.85 billion in a 30-month period. Mortality rates dropped significantly. “You can imagine our excitement when we saw we could bend the curve on mortality,” he says. Alkire personally placed phone calls to the most successful institutions and found they were doing all the right things, such as counseling around palliative care, controlling sepsis, making pharmaceuticals available at the bedside, etc. That knowledge becomes even more valuable when it is shared with others, he adds. “It becomes a question of, ‘How do we get that information to the fingertips of clinicians, physicians and executives?’

“The information is out there. But how do you tailor it? How do you make it actionable, so [providers] can take advantage of it?”