Modern Healthcare: What are your priorities as the new CEO?
Dr. David Feinberg: We want to take patient-centeredness to the next level. We want to engage with our patients and families in a way that's compassionate and kind, and deliver care that is of the highest quality in a safe and culturally sensitive manner. We want to make our transitions in care remarkably smooth. We want patients to understand their bill.
MH: How would you compare Geisinger to the UCLA system you came from?
Feinberg: At UCLA, it's a balancing act between the teaching, research and clinical operations. At Geisinger, our true north, which is supported by our amazing teaching program and our genetic research, is our delivery system. With that focus, Geisinger has been able to outshine a lot of places.
In acute care, probably the best number that shows you're doing a good job is the observed-to-expected mortality rate. At Geisinger in May, for all our facilities it was 0.5. I never heard of a number that low. We found that for our Wilkes-Barre hospital, it was 0.2. We're saving five times as many people as we're supposed to be saving.
In Los Angeles, there are physicians, including my wife, who provide concierge care to affluent patients with great means. At Geisinger, what I've seen is concierge care with the same level of attention to detail, for the masses. For example, we just learned we overtook Switzerland and we're best in the world in anticoagulation therapy for stroke patients. So we have world-class outcomes delivered in a cost-effective manner.
MH: Could you describe Geisinger's genetic research program and its ethical issues?
Feinberg: Regeneron Pharmaceuticals picked us as a partner because families have stayed here for generations, often in the same house or on the same block. We have 20 years of electronic health-record information, 15 years of radiological data and 30 years of health plan claims data. We ask our families, “Would you allow us to look at your DNA?” We've had a 90% positive response rate. Next calendar year, we'll have 250,000 patients with genomic, clinical and administrative information recorded, with most of their family members in the same study.
How does that impact our patients? We had a teenage female who came in from soccer practice complaining about dehydration. We treated her and asked her to be a part of the study. We then saw in her genomic profile a family proclivity toward cardiac arrhythmia and looked at the rest of the family. We discovered that an uncle died in a restaurant from choking. Most likely, it wasn't choking, but rather a cardiac event. We brought in the whole family and told them the risks.
We've hired a lot of bioethicists and genetic counselors, and brought in patients to give us advice on who should give them the news and how. We found that some people are brother and sister and don't know they're brother and sister. Our default position is that the relationship between patients and their primary-care doctor is the most important. That's how you will get this information back to patients.
So what we have now is not just precision medicine, but anticipatory medicine. We can say, “Here's what might happen to you and here's what you can do to prevent it.” Geisinger is turning 100 years old this month. I think in the next 100 years, the bet Geisinger made on big data is going to be impactful throughout the country and the world.