Jay Bhatt, D.O., just stepped into his new role as chief medical officer of the American Hospital Association and president of its education and applied research arm, the Health Research & Educational Trust. He joins the AHA by way of the Illinois Health and Hospital Association, where he was chief health officer, overseeing its Institute for Innovations in Care and Quality. Bhatt, a 39-year-old practicing internist who lives in Chicago, recently sat down with H&HN to talk about his background and why he was interested in taking on this new role.
You continue to practice medicine. Is it hard to give that up?
BHATT: It is hard to not spend as much time with patients because that is what I care about — caring for and interacting with patients. They teach me so much and I’m grateful for the opportunity to help optimize their health. Connecting with patients and helping to make a difference in their lives, and in their health, is a key reason I went to medical school and it is why I will continue to practice. Practicing medicine also gives me important insight into the policy issues and the quality and safety issues facing our field. When I talk with leaders and clinicians, they understand that I’m on the front lines of care as well, and again, I hope this insight will help guide my work here at the AHA and HRET. Despite the rapid change occurring in the field, what will remain constant is our commitment to advance health and the relationships among patients, their families and the care team. As we navigate the changing landscape, we must be innovative, employ cross-sector solutions and learn from other industries. We need to always maintain a sense of empathy and humility in our work. We also must not lose sight of the joy, of the excitement, of the reason we went into health care.
How did you become interested in health care?
BHATT: My father was a pharmacist on Chicago's South Side and I spent my early days with him at his pharmacy — a small, five-room shop that included a nurse, a pediatrician and a family doctor. We would go to people’s homes after work to deliver medications because they couldn't afford to get to the clinic. Health is low on the list of priorities for those who are vulnerable and underserved. I began my formal education studying economics and I saw how economics influenced the health choices people made, which then impacted their health outcomes and ability to reach their highest potential for a prosperous life. I also began to understand the misalignment of incentives in health care. With this background, community health was a guiding force early in my education and career. While in college, I went to a South Side barbershop for a haircut, and ended up becoming involved with some local doctors to put a clinic in the back end of that barbershop. The message: 'If you want to get your hair cut for free, then you’ve got to be seen by the doctor.' These were black men who weren’t accessing health care and had significant chronic disease, cancer or HIV. Over the course of five years, this effort started to make a significant difference. Clients started making different choices about health, rates of chronic disease began to decline, participants began to spread health education among their neighbors, wives and children, and even helped each other get jobs. My involvement in this program was pivotal. It helped to crystalize the two things that I wanted to do in my life — become a doctor in underserved communities as a vehicle for social change, and empower communities to change their future.
What convinced you to pursue this position with the AHA?
BHATT: This is an extraordinary time in health care with tremendous opportunity to improve health care delivery. I find myself energized by the transformation that’s underway, and intrigued by the unique role that the AHA is able to play in helping hospitals and health systems redefine themselves. I am excited about the opportunities for collaboration among the AHA, HRET and other partners. A great example is the HRET Hospital Improvement Innovation Network where the AHA, HRET, American Organization of Nurse Executives, Institute for Diversity in Health Management and other personal membership groups are coordinating to improve quality. Much possibility exists in partnerships and collaboration. This role links many passions: improved quality, physician engagement, eliminating disparities and involving patients and families to reduce errors and improve reliability and efficiency. The AHA has also recognized the untapped potential of data collection and analytics and is developing a more robust data strategy for the future, which excites me.
How will your work with the Illinois Health and Hospital Association influence what you do with the AHA?
BHATT: Spending time in the field with hospitals and health systems, from urban to rural to critical access to academic medical centers, gave me a window to the key quality, safety and clinical issues facing the field. Some grappled with similar challenges related to access or behavioral health while others had distinct challenges related to transformation or population health management. I saw folks who were moving the dial on quality and safety metrics, who were identifying nontraditional partners, and who were changing culture. Those who were successful were listening to patients and families and were building strategic relationships between clinicians and administrators. I am grateful to have had an amazing team at the IHA, which I also see here at the AHA — both driven by making a difference.
What can the AHA do to better connect with physicians?
BHATT: We want to advance the notion of regulatory relief; provide education, tools and resources to reduce the incidence of burnout and increase resiliency; encourage and support the use of team-based training; identify key competencies and encourage adoption. We also want to build a cadre of physicians who are engaged in the policy issues that affect them. We want to support, amplify and grow state hospital association physician executives. We want to help physicians understand transformation and strategies for future success through in-person training, meaningful webinars and by creating regional networking opportunities. A cadre of upstreamist physicians are needed who understand the root causes of illness, how to elicit information from patients and which interventions result in high-value care. We also will convene physician leadership across the country to help advance physician partnership. These include CMOs, hospital-based physicians, and those engaged in risk-based arrangements. These issues, reforms and partnerships must remain on the physician’s radar in order to become agents of change in shaping how our health care system evolves to deliver on health across the continuum.
What do you think the AHA will look like in 10 years?
BHATT: Clearly, the American Hospital Association has a rich history of success in advocating for members. It also has exercised leadership in moments of opportunity, whether that was the Affordable Care Act, performance improvement, community violence or the equity of care campaign. That’s due in large part to the smart and dedicated people who work at the association, and members that are doing extraordinary work in the field. The AHA is a strong membership organization and I anticipate that we will continue to effectively support the field as it adapts to the rapid changes underway in the delivery and payment systems. We are going through the largest change management experience health care has ever seen, and we need tools, resources and collaboration to ensure that we’re successful in this process. In 10 years, innovation and integration will still be key themes; advocacy and policy will be critical; knowledge transfer, thought leadership and being an agent of change will be key. I imagine that AHA leadership will continue to encourage hospitals to be engaged with their communities in ways that help march toward accelerating adoption of evidence-based practices and testing the next practice using the data to improve and inform policy discussions. I see the work at the AHA becoming broader and extending beyond hospital walls, as well as continuing to adapt advocacy, policy and education to improve the health of all individuals. I hope we continue to create opportunities and pathways for the many, many initiatives in which the association is involved, from HIIN to TeamSTEPPS to high reliability, to learn from one another and become more coordinated.
What are the top two or three things on your to-do list as you transition into this role?
BHATT: There is much to be proud of in terms of the past work of HRET, and I plan to build on that to improve reliability and reduce variation in care delivery. We will continue to provide the field with a platform of applied research and implementation science through spotlighting and sharing innovations and testing, as well as advancing evidenced-based practices. Advancing physician alignment and clinician engagement into the work of quality will prompt a better future because they are key drivers to better care. I want to improve coordination and alignment with the AHA’s activities to accelerate the pace of improvement, advance high reliability, engage patients and their families, translate data into insight and action, advance health equity and help members to redefine their hospitals for the communities they serve. Digital and social media strategies can help to tell the hospital story and illustrate what is possible for prevention and care delivery.
What data will you draw on to help you shape this work?
BHATT: Hospitals have enormous data assets that, if curated and leveraged, can advance care. An example could be looking at claims data downstream — for instance, amputations related to diabetes. By understanding where more amputations are happening through geospacial modeling, we learn where chronic disease is accelerating and what we need to do as a care delivery system. It also can give you insight into how a community can be redeveloped to help improve health outcomes. Predictive analytics, machine learning, hotspotting, geographic information systems, artificial intelligence and public data all will be important tools to bring to bear. Hospitals can be more impactful in aligning outreach activities through the use of community health needs assessments and data available from community partners. Patients and families also share important data and insights to help improve care delivery. We have to help our members become adept at using nontraditional, qualitative data to also advance the field.
THE BHATT FILE
Who has had the greatest influence on your career?
• I would say my patients, those I encountered with my dad while growing up, those from whom I’ve been able to learn through medical school and those who continue to shape my view of health and health care through my practice. They’ve coached me, given me insight into how our care delivery system could be better and inspired me to become a better clinician.
What takes up your time outside of work?
• I love dancing. My patients call me the 'dancing doctor' because I teach dance to people in Chicago as well as my patients. I’m also a big sports fan and enjoy being outdoors and active. I also love spending time with my family and keeping up with new innovations in technology. I strive to be innovative in my own thinking and work, engaging in ongoing learning and improvement and playing to where the puck is going, not only to where it is currently. I think that part of our work at the AHA is to play where the puck is going for our members.
What are you reading right now?
• Ta-Nehisi Coates’ book Between the World and Me and then I’m reading The First 90 Days, which is about getting up to speed when you first start a new gig.