The new decade grants us an exceptional opportunity to plan and execute novel ways to transform health care and deliver on our promise to provide the most high-quality, affordable and convenient health care for the communities we serve.
Innovation is at the heart of progress and I could not be more enthusiastic about where health care is headed in New Jersey, despite challenges and unpredictability in our state and the nation.
When I think of innovation, I always think of the late Steve Jobs, whose approach was a combination of daring optimism, true audacity and the brilliance to know when it’s time to take another path. As Jobs said: “Innovation distinguishes between a leader and a follower.’’
We are taking five major approaches to improve peoples’ lives, lower the health care spending arc and build a path forward into a new state of care, one that will put us more on par with peer nations in improved outcomes and more cost-effective care.
First, we are transforming behavioral health care and I would call on all providers in New Jersey and beyond to move this to the top of the agenda.
This is a vital mission and one we must commit to fully because lives are at stake: the suicide rate increased 30 percent in two decades; 1 in 7 children lives with a parent suffering from substance abuse and life expectancy in the U.S. is on the decline again for the third year in a row largely due to opioid deaths and suicide.
These are rightly called diseases of despair and they are gutting too many working-class communities in our state and nation. The bottom line is there are compelling human and economic reasons to change the game. At Hackensack Meridian Health, we believe the path forward in behavioral health care focuses on these three strategies: improving access to care, better coordinating care and innovating treatment.
Our merger with Carrier Clinic last year is already bearing fruit. We opened New Jersey’s first urgent care center with a behavioral health component. Hundreds of patients have been treated; two-thirds for anxiety and depression. They didn’t have to wait for care or seek it in a busy and complicated emergency room.
The cost? 70 percent less expensive than an emergency visit. Now, scale those savings to the 1 in 5 people who suffer from a mental illness in the U.S. and imagine how outcomes would improve and care would be more cost-effective. We plan to open additional centers near our other hospitals throughout New Jersey.
Additionally, we are on schedule to open The Retreat at Ramapo Valley in Mahwah this year, a comprehensive addiction treatment center. This new center will offer more people a needed path to recovery – especially our young adults – and keep them in New Jersey near loved ones.
Treatment must also become more evidence-based. Sadly, millions struggling with mental illness have failed two or more drug therapies. We have enrolled hundreds of patients in a new clinical trial that measures brain activity with the goal of better matching medications most likely to help. If we succeed, not only will we improve outcomes, but we will provide more cost-effective care and scale those benefits throughout our 17-hospital network.
Nurturing new approaches
Second, the investment we make in innovation and discovery must be driven by clinical need. That’s why we launched the Center for Discovery and Innovation (CDI) in North Jersey last year. The focus of the entire enterprise is to deliver novel therapies to patients – it’s the magnet that’s pulling all elements together and ensures we live our mission to transform health care.
The CDI is disrupting standard practices, protocols and paradigms with the goal of streamlining research to produce timely and novel therapies. The strategy is to remove the typical silos which exist in clinical care, research and academia to produce an integrated ecosystem that will be more effective in improving patient outcomes.
Here’s a great example, the CDI is partnering with companies to develop an approach to treating infections that kill 100,000 people each year in U.S. hospitals. At our network, we have lowered these infections by 24 percent. This innovative approach with CDI puts us on track to one day eliminate these deadly infections. Equally significant, the CDI was awarded a $33 million NIH grant last year to help fund this vital research to save lives.
The CDI, and endeavors like it, will ensure that New Jersey remains a vibrant incubator for new approaches to health care.
Third, create a culture of innovation where everyone – support staff, clinicians and care teams and even patients– are encouraged to think out of the box. Our partnership with the New Jersey Innovation Institute resulted in an ideation center that harnesses the best and brightest in science, medicine and technology. The best ideas then reach Bear’s Den, where a panel of experts vets ideas and funds those most likely to succeed.
Our $25 million fund in just three years has already supported major breakthroughs including Pillo, a home health robot that dispenses and refills medication to keep people on track with their prescriptions, and PurpleSun, an amazing device that uses ultraviolet light to kill germs and prevent hospital acquired infections. On that same path, we invested in Adaptive Phage Therapies. The company uses precision-targeted and highly purified viruses known as “phages’’ to take aim at drug-resistant superbugs.
I am also so proud that an innovation from one of our patients is supported by Bear’s Den. Charles Thomas, a Teaneck man and former dialysis patient, developed special clothing to ensure warmth and privacy while patients undergo procedures including dialysis and chemotherapy.
Consolidation and coordination
Fourth, pursue a variety of partnerships to innovate care delivery and improve access and outcomes. There’s no question that partnerships and consolidation are going to continue in the industry, like other industries before us. These mergers and partnerships will continue as long as there’s a value proposition and the communities we serve benefit. Here’s how we approach potential partnerships: can we provide better quality, share best practices in terms of clinical care that the community benefits from, and make health care more efficient and more affordable in the process?
The American Hospital Association reported on the benefits of mergers last year: a 1.1 percent decrease in 30-day readmissions for heart attack; a 1.7 percent decline in mortality for pneumonia; a 2.3 percent reduction in annual operating expenses at acquired hospitals.
Our partnerships are improving care and making it more cost-effective. They include a historic partnership with Memorial Sloan Kettering Cancer Center, Georgetown Lombardi Comprehensive Cancer Center and more.
Consider our most recent growth: our strategic and clinical affiliation with St. Joseph’s Health will enhance cancer care, bring more specialists to North Jersey and result in more outpatient services in Passaic County. Our partnership with three skilled nursing facilities is leading to more coordinated post-operative care, practices that we know lead to better outcomes and lower costs.
Fifth, transform medical education to create a physician workforce better suited for care delivery of the future. All of these investments and strategies to improve health care will be diminished unless we change how we train physicians. This is perhaps the most profound innovation we must embrace.
So many forces compelled us to take a new approach: the U.S. lags other nations in outcomes but we spend so much more; there’s a shortage of an estimated 3,000 physicians in New Jersey; the average medical student graduates $180,000 in debt so we must make a degree more affordable.
This summer, the Hackensack Meridian School of Medicine at Seton Hall University will welcome its third class and I’m thrilled we are part of the solution to prepare future doctors to thrive in a new state of health care.
The innovative curriculum includes: a three-year path to residency; partnering students with patients in underserved communities so they better understand the social determinants of health; and interdisciplinary learning so that graduates are prepared to provide team-based care, which research shows improves outcomes.
Our goal is to maximize health in all of the communities we serve and we do it based on an understanding that health and wellness, as well as disease and sickness, occur where people live, work and play. A great example of our strategy? One team of students worked with a patient struggling with diabetes. They instructed her on better nutrition and after several weeks, the patient lost 15 pounds, reducing the need for some of her medications.
When I’m at the White Coat ceremony, where our young people pledge to dedicate themselves to healing, it reminds me of our purpose. It’s really a sacred thing. We are preparing a new generation of doctors to approach medicine differently, to consider all aspects of a patient’s life, not just their illness.
I believe we will look back on this decade as a gamechanger, a time when health care focused as much on prevention as illness, where we embraced new frontiers in technology and innovation to improve people’s lives and became better stewards of our health care dollars.
Robert C. Garrett is the CEO of Hackensack Meridian Health.