Hospitals focus on antibiotic overuse as CMS prepares new mandate
Skip to main content
MDHC_Logotype_white
Subscribe
  • My Account
  • Login
  • Subscribe
  • News
    • This Week's News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • People
    • Regional News
    • Digital Edition
    • Biden administration warns fully meeting vaccine demand could take 'months'
      Regulation Tracker: Biden reviews Trump's final rules
      Anthem's Q4 profits drop 41% with added COVID costs, patient care
      Small Massachusetts medical facility to shut down in 2 years
    • Biden administration warns fully meeting vaccine demand could take 'months'
      Hospital system rebuked after offering vaccine to donors
      Thousands of Portland's healthcare workers not vaccinated
      Lab stakeholders welcome Biden moves on COVID-19 testing, suggest additional steps
    • Thousands of Portland's healthcare workers not vaccinated
      Ascension’s St. Mary’s Hospital Surgery Center at Towne Centre and Allegheny Health Network’s Bethel Park surgery center
      Hospitals see opportunity, risk in ambulatory surgery centers
      Health suffers as rural hospitals close
      Medicare ACO participants fell in 2021
    • Billing, antitrust exemption changes upend negotiations between insurers and providers
      MAIN-Health Bill_iStock_i.jpg
      Insurance-tech firm MultiPlan makes $155M buy after blank-check deal
      Last-minute COVID costs cut into UnitedHealthcare's $396 million operating income
      CMS approves rule forcing insurers to ease prior authorization
    • Regulation Tracker: Biden reviews Trump's final rules
      Hospital system rebuked after offering vaccine to donors
      Thousands of Portland's healthcare workers not vaccinated
      CMS pauses three Trump-era proposed rules
    • Anthem's Q4 profits drop 41% with added COVID costs, patient care
      jesse ford salud revenue partners headshot
      Sponsored Content Provided By Salud Revenue Partners
      How to succeed on self-pay: think ‘balance integrity’
      KPMG says deal activity will stay high in '21: 10 takeaways
      By the Numbers: 20 largest healthcare investment banks in 2020
    • Studies extend hopes for antibody drugs against COVID-19
      Google to convert office space for COVID-19 vax clinics
      Dr. Karen DeSalvo
      Next Up Podcast: What to expect with telehealth and healthcare technology in the next four years
      Next Up Podcast: What to expect with telehealth and healthcare technology in the next 4 years - Transcript
    • Amid COVID health worker shortage, foreign-trained professionals sit on sidelines
      China pushes conspiracy theories on COVID origin, vaccines
      50% of Americans make resolutions. Fewer than 27% keep them over time.
      Data Points: Sticking with your resolutions
      An older man wearing a mask receiving a vaccine.
      Want more diversity in clinical trials? Start with the researchers
    • Humana names first chief equity officer
      WEb_i.jpg
      Q&A: Dr. Cliff Megerian, University Hospitals' soon-to-be CEO
      ZentyWeb_i.jpg
      Tom Zenty is leaving a legacy of transformational growth at University Hospitals
      Cerner names Erceg as new CFO
    • Midwest
    • Northeast
    • South
    • West
  • Insights
    • ACA 10 Years After
    • Best Practices
    • InDepth Special Reports
    • Innovations
    • The Affordable Care Act after 10 years
    • New care model helps primary-care practices treat obesity
      doctor with patient
      COVID-19 treatment protocol developed in the field helps patients recover
      Rachel Wyatt
      Project to curb pressure injuries in hospitals shows promise
      Yale New Haven's COVID-19 nurse-staffing model has long-term benefits
    • Michellene Davis
      Healthcare leadership lacks the racial diversity needed to reduce health disparities
      Dr. James Hildreth
      How medical education can help fight racism
      Modern Healthcare InDepth: Breaking the bias that impedes better healthcare
      Videos: Healthcare industry executives describe their encounters with racism
      Quotes from rebadged employees
      Outsourcing IT, revenue cycle takes toll on internal culture
    • A phone screen showing the question, "Mary we hope this information was helpful and we'd like to keep guiding you. Are you interested in knowing when it's your turn to receive the vaccine?"
      Chatbots, texting campaigns help manage influx of COVID vax questions
      A woman with a wearable sensor talking to her provider.
      Wearable sensors help diagnose heart rhythm problems in West Virginia
      self service station
      COVID-19 pushes patient expectations toward self-service
      Targeting high-risk cancer patients with genetics
  • Transformation
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Highmark Health inks six-year cloud, tech deal with Google
      Study: 1 in 5 patients report discrimination when getting healthcare
      HHS proposes changing HIPAA privacy rules
      Android health records app launches at 230 health systems
    • California hospitals prepare ethical protocol to prioritize lifesaving care
      Amazon, JPMorgan Chase, Berkshire Hathaway disband Haven
      Digital pathways poised to reshape healthcare continuum in 2021
      Healthcare was the hardest hit by supply shortages across all U.S. industries
    • A phone screen showing the question, "Mary we hope this information was helpful and we'd like to keep guiding you. Are you interested in knowing when it's your turn to receive the vaccine?"
      Chatbots, texting campaigns help manage influx of COVID vax questions
      A woman with a wearable sensor talking to her provider.
      Wearable sensors help diagnose heart rhythm problems in West Virginia
      New care model helps primary-care practices treat obesity
      How hospitals are building on COVID-19 telehealth momentum
    • Regional insurers bet big on virtual-first plans
      MedPAC votes to boost hospital payments, freeze or cut other providers
      Most Next Gen ACOs achieved bonuses in 2019
      Congress recalibrates Medicare Physician Fee Schedule after lobbying
  • Data/Lists
    • Rankings/Lists
    • Interactive Databases
    • Data Points
    • Health Systems Financials
      Executive Compensation
      Physician Compensation
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
    • Wellstar CEO calls adapting for the pandemic her bold move
      Howard P. Kern
      Recognizing the value of telehealth in its infancy
      Dr. Stephen Markovich
      A bold move helped take him from family doctor to OhioHealth CEO
      Dr. Bruce Siegel
      Why taking a hospital not-for-profit was Dr. Bruce Siegel’s boldest move
    • Barry Ostrowsky
      Ending racism is a journey taken together; the starting point must be now
      Laura Lee Hall and Gary Puckrein
      Increased flu vaccination has never been more important for communities of color
      John Daniels Jr.
      Health equity: Making the journey from buzzword to reality
      Mark C. Clement and David Cook
      We all need to 'do something' to fight inequities and get healthcare right, for every patient, every time
    • The missing piece in our fight against COVID-19: primary care
      Ambulatory surgery centers offer extraordinary value in a high-cost healthcare system
       Alan B. Miller
      Looking ahead with optimism as we continue to transform healthcare
      Dr. Bruce Siegel
      By protecting the healthcare safety net, Biden can put us on the path to a stronger country
    • Letters: Eliminating bias in healthcare needs to be ‘deliberate and organic’
      Letters: Maybe dropping out of ACOs is a good thing for patients
      Letters: White House and Congress share blame for lack of national COVID strategy
      Letters: VA making strides to improve state veterans home inspections
    • Sponsored Content Provided By Optum
      How blockchain could ease frustration with the payment process
      Sponsored Content Provided By Optum
      Three steps to better data-sharing for payer and provider CIOs
      Sponsored Content Provided By Optum
      Reduce total cost of care: 6 reasons why providers and payers should tackle the challenge together
      Sponsored Content Provided By Optum
      Why CIOs went from back-office operators to mission-critical innovators
  • Awards
    • Award Programs
    • Nominate
    • Previous Award Programs
    • Other Award Programs
    • Best Places to Work in Healthcare Logo for Navigation
      Nominations Open - Best Places to Work in Healthcare
      Nominations Closed - Health Care Hall of Fame
      Nominations Open - 50 Most Influential Clinical Executives
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Top 25 Minority Leaders
    • Top 25 Women Leaders
    • Excellence in Nursing Awards
    • Design Awards
    • Top 25 COOs in Healthcare
    • 100 Top Hospitals
    • ACHE Awards
  • Events
    • Conferences
    • Galas
    • Webinars
    • COVID-19 Event Tracker
    • ntt data logo lockup webinar
      Sponsored Content Provided By NTT DATA
      Webinar: Mistakes I’ve Made — Confessions of a Healthcare Cybersecurity Expert
      bright.md logo lockup webinar
      Sponsored Content Provided By Bright.md
      Webinar: Enabling a hybrid care model — Streamlining the patient path to both telehealth and in-person care
    • Leadership Symposium
    • Healthcare Transformation Summit
    • Women Leaders in Healthcare Conference
    • Workplace of the Future Conference
    • Strategic Marketing Conference
    • Social Determinants of Health Symposium
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Minority Leaders Gala (2022)
    • Top 25 Women Leaders Gala
  • Listen
    • Podcast - Next Up
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
    • Dr. Karen DeSalvo
      Next Up Podcast: What to expect with telehealth and healthcare technology in the next four years
      Carter Dredge
      Next Up Podcast: Ready, set, innovate! Innovation and disruption in healthcare
      Next Up Podcast: COVID-19, social determinants highlight health inequities — what next?
      Ceci Connolly
      Next Up Podcast: How to navigate the murky post-election waters
    • Beyond the Byline: Regulators aim to boost value push with fraud and abuse law updates
      An older man wearing a mask receiving a vaccine.
      Beyond the Byline: Verifying information on the chaotic COVID-19 vaccine rollout
      doctor burnout
      Beyond the Byline: How healthcare supply chain struggles contribute to employee burnout
      Beyond the Byline: Covering race and diversity in the healthcare industry
    • Leading intention promote diversity and inclusion
      Introducing Healthcare Insider Podcast
    • The Check Up: Dr. Joseph Kerschner
      The Check Up: Dr. Joseph Kerschner of the Medical College of Wisconsin
      The Check Up: Chip Kahn
      The Check Up: Chip Kahn of the Federation of American Hospitals
      The Check Up: Trenda Ray
      The Check Up: Trenda Ray of the University of Arkansas for Medical Sciences
      The Check Up: Dr. Kenneth Davis
      The Check Up: Dr. Kenneth Davis of Mount Sinai Health System
    • Video: Ivana Naeymi Rad of Intelligent Medical Objects
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Government
December 20, 2014 12:00 AM

Hospitals focus on antibiotic overuse as CMS prepares new mandate

Maureen McKinney
  • Tweet
  • Share
  • Share
  • Email
  • More
    Print
    Nancy Large, a clinical pharmacist at 65-bed Sonoma Valley Hospital, does daily “rounds” with Dr. Javeed Siddiqui to review all antibiotics ordered during the past 24 hours as part of the hospital's telemedicine-based antimicrobial stewardship program.

    Antibiotic resistance is a threat to national security.

    That's how President Barack Obama described the rapid growth of such resistance when he issued an executive order in September instructing HHS and the Defense and Agriculture departments to take aggressive action on the issue.

    The president cited federal data showing that at least 2 million Americans are infected with drug-resistant bacteria each year and 23,000 die as a result. He emphasized the critical need for improved antibiotic stewardship—coordinated practices promoting the appropriate use of antibiotics—in healthcare facilities. Federal officials say such programs are among the most effective ways to curb resistance and reduce the number of hard- or impossible-to-treat infections.

    A growing number of hospitals are instituting stewardship programs, which experts say not only improve patient outcomes, but also reduce costs and lengths of stay and lower antibiotic-resistance rates within hospitals. Those efforts have been bolstered by looming federal action that would make the inclusion of a stewardship program a requirement to participate in Medicare.

    But many hospitals—especially smaller, community facilities—face tough challenges, often related to inadequate staffing and resources. Increasingly, however, those hospitals are using telemedicine, local partnerships and other creative strategies to push stewardship forward.

    Intermountain Healthcare is conducting a 15-hospital study on running stewardship programs in smaller hospitals. Kenmore Mercy Hospital, a 155-bed facility in Buffalo, N.Y., is collaborating with independent physicians in its accountable care organization to educate its staff on antibiotic best practices. Other smaller hospitals in California and Minnesota have contracted with infectious-disease, or ID, specialists to lead their programs.

    “We can't control how fast bacteria develop resistance or how fast we develop new drugs, but antibiotic stewardship is 100% under our control,” said Dr. Arjun Srinivasan, associate director for healthcare-associated infection prevention programs at the Centers for Disease Control and Prevention. “I would go so far as to say antibiotic stewardship is one of the most important things we can do.”

    Stewardship initiatives vary widely. But in a March report, the CDC listed the core elements for such programs, which include a commitment from senior leadership, tracking and reporting of antibiotic prescribing patterns and resistance, clinician education and the appointment of a single person to lead the effort.

    Benefits of stewardship programs

    Stewardship programs, the CDC recommended, should implement at least one intervention, such as prior authorization for certain restricted antibiotics, antibiotic dose optimization, or prospective audit and feedback. The last involves someone outside the treating team reviewing antibiotic orders and cultures and advising clinicians on recommended changes.

    In addition to improving patient outcomes, stewardship programs save money, in most cases more than paying for themselves, Srinivasan said. According to data cited by the CDC and the Infectious Diseases Society of America, a comprehensive antibiotic stewardship program can reduce antibiotic use by 22% to 36%, with annual savings of $200,000 to $900,000. “It's a win across the board,” Srinivasan said.

    Officials estimate that roughly half of the nation's hospitals have some kind of antibiotic stewardship program. But little is known about how robust those programs are and their interventions. “We need better data,” Srinivasan said. The CDC is planning in 2015 to add several questions about stewardship to its annual survey, distributed to the more than 4,000 hospitals that report healthcare-associated infection data to the CDC's National Healthcare Safety Network.

    He predicted that in the coming year, hospitals will look more seriously at implementing stewardship programs or beefing up the ones they already have. That's at least partly because CMS officials have said the agency plans to add antibiotic stewardship to its hospital conditions of participation, a move Srinivasan said would have “a transformative effect.”

    Dr. Shari Ling, deputy chief medical officer in the CMS' Center for Clinical Standards and Quality, confirmed that the agency plans to propose a condition of participation for antibiotic stewardship in 2015, with an implementation window in 2017. Currently, California is the only state that mandates that hospitals have stewardship programs.

    The challenge for the CMS, Ling said, will be ensuring that the new rules allow for differences in hospital size and resources. “The condition of participation has to permit flexibility so that all facilities can engage in a way that's meaningful for them,” she said.

    Large academic medical centers, for instance, usually have specialized infectious-disease doctors and pharmacists who can guide stewardship programs, while smaller hospitals rarely do. And smaller hospitals often lack the money and IT infrastructure that larger facilities can use to boost their efforts.

    Srinivasan said the CDC tried to address that variation in its March report. “We tried to boil it down to program functions instead of employee titles so that it was useful to all hospitals,” he said. “Our goal was to say, 'Here are the things you need to do, but who does them will depend on who you have available in your facility.'”

    MH Takeaways

    Smaller hospitals look to telemedicine and partnerships with infectious- disease experts to establish best practices on appropriate use of antibiotics.

    The needs of smaller hospitals

    Another challenge is that there are few studies—and no randomized controlled trials—that provide evidence-based guidance on how to implement antibiotic stewardship in smaller hospitals, said Dr. Eddie Stenehjem, medical director of antimicrobial stewardship at 21-hospital Intermountain Healthcare, headquartered in Salt Lake City. “Most of our data comes from large urban hospitals,” he said. “We have no idea what really works in a smaller hospital.”

    Stenehjem and his colleagues are trying to find out. They are in the midst of a 15-month randomized trial, launched in March 2014, that includes 15 Intermountain community hospitals, some with fewer than 20 beds. Each hospital was assigned to one of three groups, receiving a high-, medium- or low-level antibiotic stewardship program.

    The low-level group received a set of stewardship best practices, antibiotic usage data and training for the hospitals' pharmacists. In contrast, hospitals in the high-level group received best practices and usage data, a more robust curriculum, monitoring of antibiotic restrictions by an off-site infectious-disease pharmacist and review of each culture by an off-site infectious-disease physician. Stenehjem said he hopes the study, scheduled to end in June, will shed light on the needs of smaller hospitals and which stewardship initiatives work best for them.

    Riverton (Utah) Hospital, a 92-bed facility, is in the high-level group in Stenehjem's study. The hospital had no formal stewardship program before the study, said Jennie Barlow, a clinical pharmacist. But 10 months in, the hospital's pharmacists and physicians now rely on support from Stenehjem and his colleagues. “I hope the study shows that the high-level approach is the one that works best, because it's great to have the extra help,” she said.

    That support from an ID specialist is especially valuable when advising a physician about appropriate use, said Karla Snow, Riverton Hospital's pharmacy director. “If a physician ordered a restricted antibiotic before, we didn't always feel comfortable pushing back,” she said. “Now our physicians know we have ID physicians on board.”

    Hospitals that don't have outside help, though, still can make progress, Snow said. She advised starting small with “low-hanging fruit,” such as intravenous-to-oral conversions, when IV antibiotics are switched to their oral version. That's a change that reduces the risk of infection, improves patients' mobility and lowers costs. Antibiotic timeouts—when antibiotics are reviewed after 48 hours to assess whether they are being appropriately used and whether they are still necessary—are also relatively easy to implement, she said.

    Creative solutions

    Kenmore Mercy Hospital in Buffalo had several of those stewardship components in place but had never pulled them together into a formal program, said James Bartlett, the hospital's lead clinical pharmacist. Then in 2012, its parent, Buffalo-based Catholic Health System, was recognized as an ACO under the Medicare Shared Savings Program, which provided financial incentives to collaborate and improve outcomes. “All of a sudden, we had all these different groups in our ACO that were looking for ways to optimize care,” Bartlett said.

    Kenmore Mercy partnered with an independent physician group within its ACO to launch a stewardship program at the hospital. The physicians group provided the infectious disease support and helped to educate Kenmore Mercy's physicians and pharmacists on antibiotic best practices. “We have a meeting every day where we review cases with an ID physician,” Bartlett said. “And every single one of our pharmacists rotates through the lead stewardship role so they can get used to it and learn from the ID physicians.”

    During the first year, the program saved more than $145,000 on drug purchasing alone, he said. Pharmacist-initiated IV-to-oral conversions increased 688%, compared with the previous year. And physicians accepted the recommendations of infectious-disease physicians nearly three-quarters of the time.

    Like Stenehjem, Bartlett noticed the dearth of research about antibiotic stewardship programs at community hospitals. He and a colleague wrote an article describing their experience designing an antimicrobial stewardship program, which was published in June in the American Journal of Health-System Pharmacy.

    Bartlett acknowledged that Kenmore Mercy's program would have been harder to implement without the help of its parent health system and the other members of its ACO. “Without that support, our program would not look the way it looks now,” he said.

    One option for small, stand-alone hospitals looking to implement stewardship programs is telemedicine, said Dr. Javeed Siddiqui, founder and chief medical officer of TeleMed2U, a Roseville, Calif.-based company that offers a telemedicine-based antimicrobial stewardship program. His company provides stewardship services for three California hospitals, including 65-bed Sonoma (Calif.) Valley Hospital and 48-bed Ukiah (Calif.) Valley Medical Center. California hospitals are especially motivated to try telemedicine, he said, because state law requires that hospitals have antibiotic stewardship programs.

    Siddiqui serves as the infectious-disease physician for all three hospitals, working with each facility's pharmacists, hospitalists and microbiology staff. “Telemedicine is just the vehicle,” he said. “Those hospitals have an ID physician—me. I'm part of their medical staff.”

    Since its program began, Sonoma Valley Hospital has seen its use of flouroquinolones and piperacillin/tazobactam—two categories of broad-spectrum antibiotics—drop by 80% and 70%, respectively, Siddiqui said. The hospital's resistance rates also dropped.

    Despite the evidence of the benefits of stewardship, Siddiqui has encountered pushback from a few physicians. “There are still some physicians at Sonoma who don't want my input, but I think we have about 90% of them on board and I'll take that any day,” he said.

    The CDC's Srinivasan pointed to another antibiotic stewardship model that might work for community hospitals. Dr. Gary Kravitz, an infectious-disease specialist with St. Paul (Minn.) Infectious Disease Associates, runs stewardship programs at five local hospitals, including 192-bed St. John's Hospital and 232-bed St. Joseph's Hospital, both in St. Paul, and 86-bed Woodwinds Health Campus, Woodbury, Minn. He started in 2002 by developing a stewardship program for 398-bed United Hospital in St. Paul, where he was on staff. “I think we were getting paid about $50,000 to do the program and the hospital saved that much just on pharmacy costs in the first year,” he said.

    His results were so strong that over the next few years, he took the business proposition to other hospitals, negotiating renewable contracts to design and oversee stewardship programs.

    With the right training, general pharmacists can lead antibiotic stewardship efforts as long as they have access to an infectious-disease specialist to review difficult cases, such as when they are unsure about which drug is appropriate, Kravitz said. “There's a lot of ways to make this work, but you need people who are really interested in doing it.”

    Srinivasan said 2015 promises to be a big year for advancing stewardship programs. “There is much more awareness of the problem now and stewardship efforts that have been underway for a long time seem to be coming to fruition,” he said. “I think we're going to see a lot of good work that will carry us into the future.”

    Follow Maureen McKinney on Twitter: @MHmmckinney

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    It's a secret: California keeps key virus data from public
    It's a secret: California keeps key virus data from public
    New York state investigates drug price spikes during pandemic
    New York state investigates drug price spikes during pandemic
    Sponsored Content
    Get Free Newsletters

    Sign up for free enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today

    The weekly magazine, websites, research and databases provide a powerful and all-encompassing industry presence. We help you make informed business decisions and lead your organizations to success.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS
    • Instagram

    Stay Connected

    Join the conversation with Modern Healthcare through our social media pages

    MDHC_Logotype_white
    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2021. Crain Communications, Inc. All Rights Reserved.
    • News
      • This Week's News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition
    • Insights
      • ACA 10 Years After
      • Best Practices
      • InDepth Special Reports
      • Innovations
    • Transformation
      • Patients
      • Operations
      • Care Delivery
      • Payment
    • Data/Lists
      • Rankings/Lists
      • Interactive Databases
      • Data Points
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Award Programs
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Top 25 Minority Leaders
        • Top 25 Women Leaders
      • Nominate
      • Previous Award Programs
        • Excellence in Nursing Awards
        • Design Awards
        • Top 25 COOs in Healthcare
      • Other Award Programs
        • 100 Top Hospitals
        • ACHE Awards
    • Events
      • Conferences
        • Leadership Symposium
        • Healthcare Transformation Summit
        • Women Leaders in Healthcare Conference
        • Workplace of the Future Conference
        • Strategic Marketing Conference
        • Social Determinants of Health Symposium
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Minority Leaders Gala (2022)
        • Top 25 Women Leaders Gala
      • Webinars
      • COVID-19 Event Tracker
    • Listen
      • Podcast - Next Up
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing