Traditionally, American healthcare has had a "two-silo culture," with administrators kept separate from physicians, says Martin Merry, M.D., of Exeter, N.H.
Merry, a medical staff leadership consultant, says leaders-no matter what the industry-commonly make the mistake of understanding what they need from others without understanding what others need from them.
In the context of health systems, hospital executives "tend to be not comfortable around physicians . . . and physicians tend to be suspicious of administrators," Merry says. "They need to open communication lines."
Many leaders of the 2,200 hospitals aligned with the VHA follow its doctrine of promoting healthy relationships between those who wear dark suits and those who wear white coats.
"You need to keep docs engaged," says James Lederer, M.D., medical director for performance improvement at Novant Health, a VHA member in Winston-Salem, N.C. "Docs tend to be disengaged, and the administration doesn't do enough to bring them back. There's a disconnect. When there is no engagement, there is a lack of trust."
In February, Indianapolis-based Community Hospitals, a VHA affiliate, opened the much-publicized Indiana Heart Hospital. The "all-digital" specialty hospital came to fruition because administrators listened to a group of cardiologists who saw the benefits of electronic medical records, according to Glenn Bingle, M.D., senior vice president for medical and academic affairs at Community.
With both medical and administrative leadership sold on the idea, other physicians on staff bought in as well.
"It would be impossible to do it without" medical leadership, Bingle says. "The administration is not affected by this technology, but the physicians are."
Physicians, of course, have a longstanding reputation for being technophobic, but VHA is helping on that front with HEALTHvision, a company it spun off three years ago.
In addition to being the technology behind the LaurusHealth consumer health content that is integrated into the Web sites of more than 800 hospitals. HEALTHvision provides physicians with a purchasing portal and a reference tool for clinical care.
"We have this out there for hospitals to use to get their physicians using technology. It becomes a very easy way for them to get their doctors online," says Jonathan Teich, M.D., CMO of HEALTHvision and an attending emergency physician and medical informaticist at Brigham and Women's Hospital in Boston.
"We care also about how we can improve clinical quality. We want to make sure doctors have the right information and access, (both) in the hospital and remotely," Teich says.