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Turbo-Charging Clinical Transformation: A Conversation with Fairview’s Terry Carroll, Ph.D.

April 10, 2013
by Mark Hagland
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Terry Carroll, Ph.D. of Fairview Health Services in Minneapolis, talks about what it really will take to transform the healthcare system

Five years ago, Terry Carroll, Ph.D. joined Fairview Health Services in Minneapolis as its senior vice president for transformation and CIO. With the educational background of a Ph.D. in biomedical engineering, and a number of years’ experience as the CIO of several different types of patient care organizations, Carroll came to Fairview—an integrated health system that encompasses seven hospitals (including the flagship University of Minnesota Medical Center, Fairview, and six community hospitals), the 500-plus-provider Fairview Medical Group, and Fairview Physician Associates (representing 1,500 affiliated physicians), as well as a range of other services, including home healthcare, hospice, assisted living, and retail pharmacy. Carroll’s IT team numbers 360, and operates on an annual spend of $114 million.

Carroll, who came to Fairview to help lead healthcare transformation, will be speaking at the Healthcare Informatics Executive Summit being held May 15-17 in San Francisco, where he will participate on a panel discussion titled, “How Will Population health and Analytics Support ACOs, Bundled Payments, and the Medical Home?”

Dr. Carroll is particularly well-positioned to participate in that panel discussion, as Fairview Health Services is one of 32 patient care organizations participating in the Pioneer ACOs Medicare Shared Savings Program.

Carroll spoke recently with HCI Editor-in-Chief Mark Hagland to share his vision of the future of healthcare, and his work helping to lead delivery transformation at Fairview. Below are excerpts from that interview.

You have an unusual professional title, “senior vice president for transformation and CIO.” Can you unpack the elements involved in that title, and their significance?

The elements in my role include innovation, transformation, and information, as well as involvement in the healthcare policy space. My interest in pursuing all this is to try to take an innovative and design approach to how we might start to change the healthcare system. That’s where my passion is. I’ve fulfilled the CIO role in a number of organizations. But I have a passion for transformation. What happened was that when I came here to Fairview five years ago, I had been doing some consulting work for Mark Eustis, who was the CEO at the time [Eustis retired in July 2012], on how to transform the IT organization that we had here. And at the time, they didn’t have the CIO. In fact, he actually asked me about four times to be the CIO before I accepted; but I had been the CIO for several different smaller or specialized patient care organizations, including McGee Women’s Hospital in Pittsburgh and Bay State Health System in western Massachusetts, and I told him that if I were to take the position here, a considerable portion of it would have to be transformational work, and not core day-to-day operations management.

So transformation was included in your title when you came to Fairview five years ago?

Yes, that’s the only reason he was able to get me to come here. My proposition to the CEO was, I’ll oversee the IT stuff, but what I really want to focus in on is the transformation part. And he welcomed that. But it turns out that after we got started on that, the healthcare reform process was getting underway. And back in late 2008, when the state of Minnesota was going through some difficult times, and the CEO went to the biannual meeting with the governor to complain about state budget healthcare cuts, the CEO then, Mark Eustis, said, I can’t defend a broken system any longer. And we have to do something about it. And the governor at that time was Tim Pawlenty. And Tim basically said, I get it, I hear it, can you have a plan on my desk in two weeks?

And so in the consulting work we had done, I had created capabilities—we had worked with some Silicon Valley people—to work through challenges like that pretty quickly. So we mobilized people pretty quickly; and we worked to develop a plan for changing the economics associated with healthcare costs in Minnesota. And that started us down a whole path, in which we looked at how to begin a transformation process.

And that led to important discussions with some health plans, in particular, Medica, at that time, which led to opportunities to look at new care models. And so the approach we took organizationally was to develop an ambidextrous organization that could focus both on operations and on design work. The idea is that you can use some of the same capabilities you’d have in a technology environment, to rapidly develop new care models and other concepts. And in doing that kind of work, we employed new technologies. So we use decision accelerators, which are strategy events, where we gather people together to set directions and develop strategies, in sessions that last a day or two, but to develop strategies in that timeframe that normally would play out over an entire year’s time.