New Heartland Health CEO Brings Physician's Perspective

When Mark Laney, MD, became president and CEO of Heartland Health in St. Joseph, Mo., on Aug. 3, it was the first time in a quarter century that someone new had come into the position. However, he brings substantial experience into the job.

As president of Cook Children's Health Care System in Fort Worth, Texas, Dr. Laney formed one of the largest pediatric multi-specialty practices in the United States, developed a network of neighborhood clinics for low-income families, and introduced advancements in evidence-based medicine, clinical informatics, and quality and safety.

Here, Dr. Laney discusses how his experience will help in his new role and some of the challenges and opportunities at Heartland Health.

Q: How does your background as a physician — in fact, as a pediatrician — serve you as CEO? What challenges do you think it might present?

Dr. Mark Laney: The greatest issues hospitals face are around quality and safety of care. My background as a physician allows me to see through the patient's eyes by means of the physician-patient relationship. It is a significant advantage to have trained and worked as a physician and then to be able to translate that experience into a leadership role.

Having a pediatrics background helps because pediatricians tend to be soft-spoken and have a lot of patience — that's what is needed to treat children — and those characteristics translate very well into leadership. This is why a large number of physician-leaders come from pediatrics.

A physician-CEO is still an unfamiliar figure at most of the 5,000 hospitals across the nation. However, those who are familiar with the Cleveland Clinic, Mayo Clinic and the M.D. Anderson Cancer Center know this special relationship works very, very well.

Q: You are moving from leadership of Cook Children's Health Care System in Fort Worth to leadership of Heartland Health in St. Joseph, Mo., which is not just for children and serves a large rural region. How is Heartland different from Cook's?

ML: The only difference is really serving adults and adult medical problems here at Heartland, in contrast with pediatrics at Cook's. The similarities are far greater than the differences. Both organizations are integrated systems, have multi-specialty physician practices, employ 3,000-4,000 people, have multiple subsidiaries including a charitable foundation and serve very large geographic areas. So the similarities between the two are much more striking. When I told my physician colleagues where I was going and described Heartland, they weren't surprised at all.

Q: At Cook's, you helped found the System Clinical Excellence Program, integrating clinical practice, evidence-based medicine, safety, quality and clinical informatics. Why was that program important and how did you carry it out?

ML: That sort of program is the future of modern healthcare. Payors, the government and patients expect high quality, excellent safety and a very robust clinical informatics program. Integrated systems are judged today by their quality and safety; that's what the benchmark is. In the future, this may affect how institutions are reimbursed and how individuals choose healthcare institutions, through greater transparency on the Internet. We put together a committee of interested physicians and groomed one of them to chair the program. Over several years, he obtained funding to be medical director of the program. We integrated that committee with a clinical informatics committee so that we could build the quality and safety goals and tools into the information system that we were using.

Q: You have described Heartland Health, an integrated delivery system with a 350-bed hospital, 90-physician Heartland Clinic and a health plan, as "a real jewel." What impresses you most about it?

ML: There are two things. One is the people. They are passionate, caring and down-to earth. Whether it's a physician, nurse, therapist or the person who works in the lab or in dietary, people make an institution great. Certainly in healthcare that's true.

The second thing is that over the last 20 years this organization has done a great job of creating the infrastructure of an integrated system, which is ideally suited to successfully face challenges in healthcare. Most hospitals consist of just the hospital; they don't have a physician group, a foundation, community education, home health or hospice. These are the pieces that need to fit together to seamlessly create care across the spectrum. Heartland has it all. We are well positioned to be able to deal with whatever comes along in healthcare.

Also, at Heartland we work not just on quality of care but on improving the health of people in our community and region. Our goal is that you don't have to come to the hospital. This is a completely different mindset from 10 or 20 years ago. Lowell Kruse, my predecessor at Heartland, was a visionary who understood that improving community health doesn't just mean teaching people about diabetes or high blood pressure; it also means boosting the number of kids who go to college, are volunteering and understand what it means to be part of a community. Heartland is very advanced in how it reinvests in the region it serves. We're not just building a great hospital but are also improving lives in the community. That's what excites me. It's a great opportunity.

Q: You want to help raise Heartland Health "from good to great." What kinds of plans do you have in mind?

ML: Today, I don't have any specific plans, because, as I've said, the first thing I want to do is listen. I want to listen to patients. I went and visited a patient today. I just walked into a room and asked her how she was doing. She said, "You're the new CEO, aren't you?" And I said, "Yes I am." I asked her how we were doing and if there is anything we could be doing better. I want to listen to employees and also members of the community.

We have the opportunity to be one of the great integrated health systems in America. We also can have one of the greatest multi-specialty group practices, well aligned with the hospital. I truly believe that Heartland can be the best and safest place to receive healthcare, raise a family and live. The size, demographics and resources of the community — they're all here. When people at Cook's asked me why I was leaving I answered that we'd done wonderful things there. The physician group we built was truly amazing. I wanted to go and create some more magic. My strength is in physician relationships, taking a loose affiliation of physicians and molding them over time into a group that is completely aligned with the same goals.

Q: You have said integrated health systems and team medicine have had "a life-long influence" on you, ever since you were a fellow in pediatric neurology at the Mayo Clinic in Rochester, Minn. Can you explain why these concepts are important?

ML: In 1910, Dr. Will Mayo gave a commencement address at Rush College of Medicine in Chicago. He said the time had come for individual physicians to join forces because, at that point in time, the knowledge of medicine was so immense that one person could not know everything. That was almost 100 years ago. He said physicians working together as a group could best meet the needs of the patient. And his divining benchmark was that the needs of the patient come first. Think about how much things have changed, how much more complicated medicine has become today. It only makes sense to me that the team approach of doctors working together would best meet the needs of the patient. It was true 100 years ago and it's even truer today.

Q: What is your biggest goal for Heartland Health in the upcoming year?

ML: My biggest goal is to gain the trust and respect of physicians and staff and articulate my goals and expectations. Remember, this organization had a CEO who was here for 25 years. Even though the hand-off has gone incredibly smoothly, it's still a big change. People need to get used to my style and the fact that I am looking at everything with a fresh set of eyes. That is the most important thing. If we make this transition well, the rest will fall into place.

Q: What do you anticipate as the biggest challenge you will face in the future and how do you think you will work to overcome it?

ML: The biggest challenge is dealing with healthcare reform. My anticipation is that hospitals, group practices and integrated systems are going to be asked to take care of more people that have more complex problems with fewer resources. I think the only way for us to do that is to be extremely efficient and aligned in how we are taking care of our patients. We all have to be on the same team in order to create that efficiency.

Q: What is the best advice you've ever received about running a hospital and who was it from?

ML: The best advice I've received came from Russell Tolman, who was the CEO of Cook Children's Health Care System for 25 years. He looked at not-for-profit hospitals as a sacred trust. He said that the goal of the CEO should be to make sure that that institution was there for the children and grandchildren of the community. He also knew and appreciated that healthcare is not just a business; it's far more complicated than that.

Learn more about Heartland Health at www.heartland-health.com.