The pace for change in health care has quickened. Not long ago virtually all innovation in health care came on the clinical side. Great strides were made to lengthen life spans and fight what were once certain-death conditions like cancer and heart disease. But little was being done to modernize the business of delivering health care.

Today we not only demand progress with outcomes, but we also are more concerned about expanding access and delivering health care at a cost our society can sustain. Cost has become a major hurdle in our efforts to continue to improve patient outcomes. The government is addressing the issue of access, but to make it work we must address the spiraling costs of delivering state-of-the-art care. We must operate the business with all the innovation we have demonstrated on the clinical side.

In our organization, we've cut costs by $120 million. We've achieved this through limiting use of agency nurses, reducing overtime, negotiating prices with vendors, optimizing space and standardizing clinical utilization. Our target is another $100 million in savings this year. At the same time, we continue to invest in our community. In 2010, Swedish provided about $70 million of community services throughout the Puget Sound, including charity care, free community health education classes, free health screenings, etc.

At Swedish, we are constantly looking for ways to transform care. Central to our transformation is the full deployment of an electronic health record system that requires a significant up-front investment, but will improve accountability, the experience for patients, the quality of care we can provide and ultimately should result in significant savings in the cost of care delivery.

Last year we brought together leading experts to discuss solutions to the ongoing health care crisis. We identified key steps that organizations can take to improve care delivery at the local level. Among them: Make payment reform a priority to reward for desired outcomes; make the consumers and patients a priority through the provision of evidence-based information to enable informed decisions, and offer incentives to all stakeholders to make good health care decisions.

In the future, a hospital may not be the center of a health care system as it is today. As we focus on wellness, prevention and chronic-disease management, relationships with providers and community leaders will be paramount. Hospitals will continue to provide acute care, but they also will need to serve as community organizers to engage all stakeholders in the delivery system. All of this must be done with a focus on reshaping the patient experience.

Innovation can come in many forms. The Global to Local initiative, in partnership with Swedish Health Services, the Washington Global Health Alliance, Public Health—Seattle & King County and HealthPoint, models how successful methods being used in the developing world can be implemented to improve health in areas with similar disease rates in this country. The goal is to address disparities in local health care by applying global solutions to address underserved populations.

A health care system does not run on facilities alone. We are a people business and it takes great people to make a system work. As we've grown to serve greater need, Swedish has grown the number of physicians it employs from 400 to more than 800. Physicians are positioned uniquely to influence care delivery and maintain quality relationships with our patients, and must help capture savings from EHRs and other system changes designed to reduce costs.

As we reposition Swedish, our challenge going forward is to improve productivity from all our employees. It will require a sharp eye on costs and a commitment that can sustain our growth.

Rodney F. Hochman, M.D., is president and CEO of Swedish Medical Center in Seattle.

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