Kutscher: There's also an immersion component that asks executives to pull back the curtain and share with their competitors what goes on behind the scenes, maybe even proprietary information. Is that part of the goal of the fellowship, to have that sort of collaboration?
Frist: The immersion component, which is about a third of the course, will be deep and unprecedented. The ... very intimate interaction [will be both] with CEOs who will be sharing their toughest challenges to their own companies and to their own careers.
The second component of the immersion is to open up and break down barriers to encourage collaboration, and that might be with doctors and hospitals, it might be doctor inpatient with outpatient group, it might be home healthcare with hospitals, it might be academic health centers and community hospitals. But to break down barriers and the silos to ensure collaboration.
The third component of the immersion will be to engage the participants in activities that will be active and interactive. For example, looking at the new and important role in the future of personalized medicine, we will likely walk each participant through a immersion process of discussing the implications of privacy issues surrounding exchange of genetic information, going so far as even to take their own blood and submit it for DNA analysis to make it real and tangible, the sort of implications of having that information that may predict you're going to have heart disease 10 years later or Alzheimer's 20 years later—the tough issues that introduces into the healthcare system.
They'll go through appropriate genetic counseling, as part of this immersion course, to open up this world of how technology and genomics and the Internet and social media is so radically transforming healthcare today and how it will be very different tomorrow.
Kutscher: Do you expect to see more of that sort of collaboration among the for-profits working together going forward?
Frist: I think so. The world is going to demand it, and in this world of increased consolidation, which is being caused by the call for more seamless care and more efficient care and less waste, it will demand for-profit institutions both sharing information—whether it's health records or claims data—but also for-profits working with academic places. So one of the goals clearly will be much increased collaboration, greater transparency and more accountability as a part of doing business.
Kutscher: What are some of the other healthcare priorities that need to be addressed?
Frist: First and foremost will be the cost issue and how to maximize value, which means measuring outcomes and results.
No. 2, the biggest shift going on, and thus challenge to be addressed, is the shift of risk from government, from payers, and from business, over to consumers and to providers—the doctors and the hospitals.
That shift is a huge challenge, because providers—doctors especially, but doctors and hospitals—are not accustomed to managing risk. And the consumers are going to be greatly empowered with information, and that will increase all sorts of issues, like privacy issues and the like.
The third, which is a product of the Affordable Care Act, will be the access issues surrounding the newly insured, both in Medicaid, as well as through the state exchanges. Do we have enough primary-care physicians? If we have enough of primary-care physicians, will they be able to find a specialist? Is the workforce of nurses and physician assistants sufficient?