Disrupting the Status Quo

We are in the midst of what may well be the most confusing, turbulent period in the history of modern medicine. This book seeks to cut through the fog and confusion that enshrouds the health care industry to provide clarity on where the industry stands today and where it is headed. The book defines the major challenges in health care through the journey of Northwell Health, one of the largest provider organizations in the country. The central issues in what is nearly one-fifth of the United States economy are played out daily within this not-for-profit organization. Northwell is New York state's largest workers, and $11 billion in annual revenue. The book candidly portrays key leaders within Northwell on the most vexing challenges in health care: How to provide primary and specialty care spending; how to create and sustain an internal system of continuous learning to enable employees at all levels to stay current in an industry that is changing at warp speed; how to provide emergency services in a world where natural disasters and acts of terrorism are inevitable; how to identify new revenue streams to offset reductions from Medicare and Medicaid; and how to push outside the walls of hospitals and clinics to improve the overall health of individuals and communities by working on determinants of health beyond the typical medical practice. The book exists at the intersection of medicine, business, social and public policy. Harvard's Michael Porter has written widely on health care arguing that it is time "for a fundamentally new strategy," but what, exactly? Where is the industry headed? What do the changes and the turbulence mean for patients, doctors, nurses? This book is the product of a learning journey both humbling and rewarding. Over time, lessons learned, improvements made, innovations conceived, have advanced Northwell Health in ways that, some years ago, might not have seemed possible. Northwell has become a national leader not because it is perfect, but because it remains steadfast in its journey to remain humble enough to know that whatever success may be achieved, the journey is about continuous learning and improvement. The goal of the book is to provide a deeper, clearer understanding of what is happening in health care and why; to help illuminate a pathway forward for patients and caregivers most of all, but also for policy-makers and the employers and others who pay for care.

Charles Kenney is an executive at Northwell Health where he serves as Chief Journalist. He worked as an editor and reporter for 15 years at The Boston Globe and hosted a weekly version of Meet the Press on the Boston CBS television affiliate. He is the author of The Best Practice: How the New Quality Movement is Transforming Medicine (Public Affairs 2008), which the New York Times described as "the first large-scale history of the quality movement." He is the author of Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience (CRC Press, 2010), for which he was awarded the 2012 Shingo Research and Professional Publication Award. He is the author, with Maureen Bisognano, CEO of the Institute for Healthcare Improvement, of Pursuing the Triple Aim: Innovators Show the Way to Better Care, Better Health, and Lower Costs (Wiley, 2012). He is co-author with Jack Cochran, MD, former Executive Director of The Permanente Federation, of The Doctor Crisis (Public Affairs, 2014). His latest book is Virginia Mason's Story: A Leadership Journey in Health Care (CRC Press, 2015). He serves on the faculty of the Institute for Healthcare Improvement in Cambridge, Massachusetts. He is also the author of six other nonfiction books and three novels.

Preface; Chapter 1: Mission; Chapter 2: Building an Integrated Network; Chapter 3: Redefining Medical Education; Chapter 4: Learning Obsession; Chapter 5: Emergency Preparedness; Chapter 6: What Does Quality Care Look Like?; Chapter 7: Rory: "I got the ball"; Chapter 8: The Best Financial Strategy: Reduce Patient Suffering; Chapter 9: Beyond the Horizon