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Weekly UpdatesMark R. Neaman, FACHE, the 2009 ACHE Gold Medal Award recipient, has dedicated his professional career to not only building a world-class healthcare system but also reaching beyond his local community to elevate the quality of care for all Americans. As president and CEO of NorthShore University HealthSystem (formerly Evanston Northwestern Healthcare) in Evanston, Illinois, Mr. Neaman oversees a system of four hospitals, a medical group, and a research institute.
Mr. Neaman started his career in 1974 as an administrative assistant at Evanston Hospital. Two years later, he was promoted to assistant to the vice president of patient care services. For the next six years, he moved into a series of vice president positions within the hospital. In 1984, he was named president of Evanston Hospital and executive vice president/chief operating officer of Evanston Northwestern Healthcare (ENH). In 1992, he was appointed president and CEO of ENH. Under his leadership, ENH became one of the first healthcare organizations in the country to successfully launch a systemwide, state-of-the-art electronic medical record system. In addition, ENH was honored with the Davies Award from the Healthcare Information and Management Systems Society (HIMSS). Mr. Neaman was named IT CEO of the Year by HIMSS and Modern Healthcare in 2005.
From 2005 to 2006, Mr. Neaman served as chair of the Healthcare Leadership Council, a Washington, DC group that aims to improve the quality of healthcare for all Americans. He is also a leader within the Illinois healthcare community, having played a key role on the Illinois Hospital Association's Medical Liability Reform Steering Committee and served as a member of the association's board of trustees from 1989 to 1994. He is a member of several professional organizations, including the American College of Healthcare Executives, American Hospital Association, Association of American Medical Colleges, Healthcare Leadership Council, International Hospital Federation, Health Insights Foundation, and the Institute of Medicine of Chicago. He has received numerous educational and professional recognitions, including the Robert S. Hudgens Memorial Award for Young Healthcare Executive of the Year from ACHE, the Distinguished Alumnus of the Year from The Ohio State University, and On the Rise executive from Fortune magazine.
Mr. Neaman earned both a master of science degree in business and healthcare administration and a bachelor of science degree from The Ohio State University.
Dr. Grazier: Congratulations on receiving ACHE's Gold Medal Award! Can you identify events in your career that were pivotal to your success?
Mr. Neaman: One of the early high points was getting a fellowship at Evanston Hospital in 1973. This post brought me to Chicago and led me to my mentor, Bernie Lachner [FACHE], who was also a Gold Medal Award recipient. That mentoring relationship was not only invaluable but also encouraged my interest in serving as a mentor. Another highlight was receiving the ACHE Robert S. Hudgens Memorial Award for Young Healthcare Executive in 1988 and becoming president of Evanston Hospital in 1984. This was an important juncture in my career in that locally I was gaining more responsibilities because of my position and nationally I was gaining more visibility because of the Hudgens Award. A third critical moment was being named president and CEO of Evanston Northwestern Healthcare [now NorthShore University HealthSystem] in 1992. In this position, I have had the opportunity to serve the healthcare field on a national level through my affiliations with professional organizations such as ACHE, the AHA, and the Healthcare Leadership Council. Many times, transformational results can spur careers and, more importantly, organizations onward.
Dr. Grazier: Our readers may benefit from knowing how you and Bernie Lachner forged and sustained a mentoring relationship.
Mr. Neaman: It was a mutual effort. Bernie was open to mentoring me, and I took the initiative to pursue the opportunity. Our relationship was strengthened by our interactions. He helped me better recognize that everyone has a different style and responds in different ways. Part of the responsibility of a leader is to work with and work through those differences.
Dr. Grazier: What is your management philosophy?
Mr. Neaman: To me, management is a subset of leadership. I don't manage as much as I help lead. Our organization has 4 hospitals, a 600-physician group practice, both teaching and research programs affiliated with the University of Chicago, 9,000 employees, and a $1.5 billion budget. With a system this size, I have to rely on many people to manage the day-to-day activities. As a leader, my main responsibility is to set our direction and time frames--that is, what do we want to achieve in one week, one year, or ten years? Also, I have to monitor our progress by establishing measures of success. We can't know how close we are to the goals if we don't measure our performance.
Dr. Grazier: Who helps you lead?
Mr. Neaman: NorthShore is supported by a large leadership team, including the board of directors; 12 department chairs; 4 hospital presidents; and the presidents of the medical group, research institute, and foundation. Each of these leaders oversees the operations and staff in his or her own area. We stress the fact that we are a system of care, not just one place of care. In this way, patients can come to any of our facilities or doctor's offices and receive consistently high-quality service and care. By thinking of our organization as a system, the leadership team is more united, regardless of any individual area of responsibility. Our electronic medical record [EMR] technology ties all of this together.
Dr. Grazier: In 2005, you received HIMSS and Modern Healthcare's CEO IT Achievement Award for leading the EMR planning and implementation at Evanston Northwestern Healthcare. How was it that you were one of the first movers on EMR ?
Mr. Neaman: The Institute of Medicine's 1999 report To Err Is Human identified avoidable medical errors that were happening in hospitals across the country. That publication was a wake-up call, and many leaders in the field began to ask themselves, "What could we do about this problem? How can we improve the care we provide to patients and their families?" This response, along with evidence-based quality initiatives at ACHE at the time, spurred us to move forward. We realized that simple things like illegible handwriting were causing errors in medication administration and other clinical orders. An EMR system, on the other hand, eliminates this problem and provides an easily accessible record of drag allergies, medical history, and other health matters that could complicate the patient's care.
Dr. Grazier: How does NorthShore serve the needs of its community?
Mr. Neaman: Our system serves thousands of patients every day throughout our service areas. Although we have had the privilege of serving many of our patients for a long time, we continue to build relationships with them and develop initiatives that advance the health of the entire community, not just those we serve or those who have financial means or health insurance. For example, we recently launched a cooperative with the Lake County Health Department that aims to improve diabetes management in the home to prevent a distress arrival at the emergency department. This effort will use NorthShore's resources, such as our EMR technology and network of primary care physicians.
Dr. Grazier: How has the current economic turmoil affected your operations?
Mr. Neaman: No one is immune or isolated from the down draft of this economy. What we have been experiencing is probably different from what some other organization is going through: We are serving more patients and seeing double-digit growth in volume. However, our bad debt is up, free care is up, and charity care is up, and Medicaid payments are in distress. Although we are providing more services, we are getting paid less. Obviously, this situation puts a squeeze on our overall finances.
NorthShore's system of care, however, works to our advantage. Because of our systems approach, we have been able to reduce our overhead costs by integrating functions such as accounting and finance, human resources, and advertising. With centralized operations, we save money. Again, none of this would be possible without our EMR, which is another advantage that 99 percent of healthcare institutions in the United States do not have.
Dr. Grazier: What parts of President Obama's healthcare reform plan do you think are most and least likely to succeed?
Mr. Neaman: I'm not a prophet, so I don't know what will pass or not pass. One of my concerns, which is shared by others on the Healthcare Leadership Council, relates to the overall financing of healthcare. More people--baby boomers, specifically--are becoming Medicare eligible, but the federal government has been cutting Medicare reimbursement to hospitals and doctors. If healthcare reform means all Americans will be on a Medicare-type payment system, that change will be tough on healthcare providers. When the federal government fully finances all aspects of healthcare delivery, healthcare will inevitably be under-resourced. As a result, there will be long lines for services. The data are clear in Canada: Patients have to wait up to 17 weeks to see their primary care physician and 2 years to get hip implants. That kind of queue will not fly well in America, where people are not used to waiting. As we reform healthcare delivery and financing, we also need to consider competition, choice, and innovation.
Dr. Grazier: What do you think of the health insurance exchange? Would its implementation help your organization's bad debt and charity care levels?
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