Tom Kurtz, Chief Administrator Officer at Memorial Healthcare shares how his organization was able to steer clear of merger or acquisition and maintain their 100 years of independence. By working with a variety of partners, focusing on their most important goals, and targeting those service lines that best met their vision, Memorial Healthcare became a destination neurology hub, bringing in patients from across 26 states. Today, his organization continues to see steady growth and high quality scores, most recently achieving a Five-Star Quality rating from CMS.
Title: Building a Vibrant Community Through Independence
Guests: Tom Kurtz, Chief Administrator Officer, Memorial Healthcare
Host: Christine Parent, Associate Vice President, MEDITECH
Tom: We decided rather than being fiercely independent, we need to be interdependent. We need to take a look at what our partners can bring to the table. What can we do ourselves and how do we combine those in such a way that we are providing the best level of care to our community as possible.
Christine: Welcome to another episode of MEDITECH Podcast. We're the leader in healthcare technology empowering you to be a more informed healthcare consumer and provider. Hear the latest from our friends and colleagues in the U.S., Canada and abroad on topics we think you should know about.
Today, I'm joined by Tom Kurtz, Chief Administrative Officer at Memorial Healthcare in Owasso, Michigan. Memorial recently celebrated its 100th anniversary as an independent not-for-profit hospital. As a lifelong resident of Owosso, Tom is passionate about helping Memorial maintain its independence by investing in the technology, staff and services needed to succeed. Today, his organization is not only the go-to destination for care in their community but also a leading provider of sub-specialty neurology services across the region and beyond.
Welcome Tom. Thank you for joining me today.
Tom: Well thank you Christine. I'm excited to be a participant in the podcast today. I'm happy to share all of the great work that we do at Memorial.
Christine: So Tom, you've been a model of success for other independent hospitals. Strong quality scores, steady growth and a subspecialty neurology service line that brings in patients from well beyond your community, but that was not always the case. Can you take us through your journey?
Tom: Sure and some of this actually predates me here at Memorial. In 2011, Memorial Healthcare was actually looking at an RFP process to go through an acquisition. We were in that same struggle that many independent healthcare institutions across the country have had over the last several decades. I was a community member, and at the time I was working for another organization in a similar role and understood that as a community member and what that meant for our community to be acquired by an outside institution. And so we took a look at those partners and we have many— we are geographically located in the middle of a triangle between three larger metropolitan areas between Flint Lansing and Saginaw— and so unlike some other organizations that have taken that acquisition journey, we don't have a singular partner that we identify with. We have many friends and we have many organizations that we partner with for very specific service lines and things like that. We know the needs for our patients in our community and so when our organization was looking at those RFPs and the solutions that were being presented to us, we looked and none of them felt right.
We are a community hospital with a community feel. That next patient that comes through the door could be a family member of yours or one of your co-workers. We are a very tight-knit community. We are the largest employer in our community and so that economic responsibility for us in our community is one that we take great pride in as well. And we find that it's very mutually beneficial for having a high quality health care system in a community to have a vibrant community and it's mutually beneficial in both ways. You can't have a vibrant healthcare institution without having a vibrant community. So that community role was very important to us and so when we took a look at those RFPs.
Our board had a decision to make. They involved the executive team quite significantly and they decided that none of these RFPs made sense for us as an organization. Shortly thereafter in 2015, I joined the organization and we continued a lot of those discussions. We took on as an executive team on our board. We built upon our three-year strategic planning process. We go through between the executive team and the board every three years to take a look at our goals and objectives that we have as an organization and in 2015, we started looking at what is it that we're really looking for from our partners. What can they provide to us and to make a long story incredibly short, what we found out is not one single organization can provide us all of the things that we were looking for and also, we found that many of those things we're looking for if we spent the time working internally rather than looking for someone else to do it for us, we could accomplish it just as well, if not better than many others.
And so we looked at many things. We looked at quality. We looked at brand recognition. We looked at technology needs at the time. You know, when I was brought in we were looking at a new EMR platform because we were dated in what we had for not only the acute side but the ambulatory side as well. We looked for access to capital. We looked at recruitment for physicians and what we decided and we actually, we did this on the whiteboard, we put all the things we were looking for, all of our partner organizations and us and we put check boxes of who could provide that to us. And what we found really quickly is that by internalizing our efforts, spending more time looking at ourselves rather than outside, that we can achieve a majority of those things and so we decided rather than being fiercely independent, we need to be interdependent. We need to take a look at what our partners can bring to the table. What can we do ourselves and how do we combine those in such a way that we are providing the best level of care to our community as possible.
Through that strategic planning process for the last three year cycles, we've had multiple iterations. But they're all the same. They come with the same top four strategic priorities. One engagement. Focusing on our people, our providers, our community. The engagement of all the stakeholders within this organization is a top priority for us and closely behind that is quality and safety and why do I say it's behind engagement? Well without an engaged workforce, we can't achieve those quality measures. If we take care of our employees and our providers, they will take care of our patients. So quality and safety is our number two. Third is financial stewardship. No margin, no mission. We hear that in many organizations. We have to be able to sustain ourselves moving forward. So we have to retain the financial stewardship in order to keep the doors open. And lastly is growth. We knew that we had interesting opportunities in front of us. Primarily in the neurology service line and others to where we can grow beyond our own community and outside of that traditional community hospital to build a service line that could have a regional and potentially nationwide presence.
And so those four strategic priorities, coupled with our board's intent to retain control locally within our organization is really what's garnered us on this journey and since that time, we've had year after year of double-digit growth. We've had increasing financial performance.
Obviously, Covid has thrown a wrench into many of those plans, as it has in so many other organizations. But prior to Covid, we saw one year of 26 percent growth. The next year was 13 percent growth. Even last year with rounding out the end of Covid, we saw almost an 8 percent year-over-year net revenue growth. So all of these things put together have really contributed to us as a growing organization in size, growing in quality and growing in reputation. So that really in a nutshell is the journey that we've gone on in the past 11 years, as an organization, really transforming us from what you would see as a traditional community hospital to one that's growing and thriving.
Christine: Wow, that's an incredible journey and story that you guys should be very proud of.
So Tom, you spoke about the importance of preserving your own goals and values. Can you elaborate on why remaining independent was so important to your organization?
Tom: Well there's a lot of reasons why being independent is important. One, as I mentioned, being that community asset and being governed locally is very important for us to retain, to ensure that one we're meeting the needs of our patients and two, we're not drifting and we're not seeing service lines exit our community instead of seeing them blossom and grow. And as I mentioned earlier, the geography within which we serve our patients, we serve seven counties. Our furthest practice is about 35 miles away. So we have a 35 mile radius that we serve in terms of our practices and so we have many friends.
Some of our partners in terms of tertiary quaternary care centers are not the same for every service line. We have strategic partnerships for cardiology with one institution, pediatrics with another, neurosurgery with a third and that similarly was in the same discussion when we were looking at EMR solutions. We were looking at potentially doing a community connect style implementation and what we found in both the EMR selection process, as well as the independence conversation, is when you pick a friend, you also pick your enemies. And so we wanted to ensure by remaining independent that we are doing what's best for our patients by maintaining those great relationships with all organizations, rather than just one.
So it was very important for us that independence kept the doors open for all the tremendous services that are available in the state of Michigan and with that, we are not tied to any one of them for any reason. We can go that best of breed approach for those service lines and that service line development.
Christine: Well you seem very passionate about the health of your community. So expand on that a little bit. What fuels you?
Tom: Well as you mentioned in the introduction, I've been a long time community member. I've been in this community for 18 years and I've worked for two of the three largest organizations in the county and I have built my family here. My kids go to school here. I can see my house from my office. The community is very important to me and I read a book a couple of years ago by Quint Studer. It's called building a vibrant community. It's a really good read. It's a quick read. It's about the story of Studer's company and how they revitalized Pensacola Florida. Taking a look at that mutually beneficial relationship between a strong healthcare system and a strong community and how the healthcare system helped grow the community. Not to benefit the hospital, but to benefit the community and how the community growth could, in a byproduct, grow the health and wellness of the healthcare institution as well.
And I know that being a part of the community is only one aspect of it but we in our guiding principles know what being a community hospital means and I mentioned that a second ago that next patient that walks in the door could be you or your family or your co-workers family and we treat every patient that comes through the door with that mentality. That could be one of our employees family members and so we have built service lines around that in the entirety of the continuity of care from the ER visit to the inpatient stage, the post acute setting to long-term care facilities and assisted living centers. We have all of those service lines within our organization to meet that entire care continuum of those patients. We work very closely with other health care entities in our community, the FQHCs of the world and the long term care facilities and independent providers and those types of things and it's very important for us to have that strong community because that means we can have a strong health care system as well.
Christine: So what strategies helped you turn things around and become so successful within your community?
Tom: We follow the four disciplines of execution. It is very important for us that we focus on the wildly important. The WIGs, if you will, our wildly important goals. One of the things that the four disciplines of execution will tell you. If you have 10 goals, you're likely not to complete any of them. If you have four or five, you might complete one. If you have two or three goals, you're likely to complete those two or three and so that strategic planning process we go through with our board and executive team and the entirety of our organization, we do just that. We focus on the wildly important. We build those goals. I mentioned those to you already. The four strategic priorities that we have and we build upon those with every constituent within our organization, our executive team. We use the leadership engagement module. It's another Studer product but to track our performance.
So we have very measurable objective goals that we all agree to. Our executive team chooses the same goals every year that are ratified by the board and we all succeed or none of us succeed. And we cascade those goals throughout the entirety of the organization. The directors council does something very similarly. Our managers do the same, down to our staff, that all of their goals that they set for themselves from our organization feed up to the ultimate success of our wildly important goals and we keep that lean tool as our scorecard and we keep ourselves accountable to our board, to ourselves, as the organization to ensure that we achieve each one of those things.
Christine: So Tom, have you found support from within the MEDITECH community? And if so, can you describe that?
Tom: Yeah, that's one of the things that I've really enjoyed. I came from outside of healthcare. So I came from higher education before coming into healthcare to select a new EMR. So that was a fun task and it really was one that we relied upon. Many of our partners and other MEDITECH sites, to help us, guide us on that journey. We did a full RFP process. We looked at the big three, if you will, when it came to EMR implementations. We had been a MEDITECH MAGIC customer for 20 plus years and really built a great implementation of MEDITECH MAGIC. But we knew that with our growing ambulatory sites and our growing organization, we needed to have an enterprise medical record. We needed to have something that encapsulated the entire care continuum. From ER visit through ambulatory to inpatient state to ambulatory settings. So we looked at multiple sites. We went and did a couple of different site visits before selecting MEDITECH Expanse. The MEDITECH community through the Physician and CIO forum, through HIMSS and through MUSE and many of those other areas.
We've had multiple conversations with organizations like Halifax and organizations like Avera on how they've implemented the system to ensure that we aren't trying to reinvent the wheel. And so it's very important for us to rely upon that MEDITECH community. Particularly because of somewhat limited resources being a community hospital and knowing that we're getting the biggest bang for the buck out of the investment that we do make in that EMR system.
Christine: So your organization's mission is not just to survive but to thrive and your focus on neurology has really given you that opportunity. Can you walk us through this service and how it has contributed to your success?
Tom: Absolutely, and this is one of the things that we love to talk about within our organization. Our focus on neurology really didn't start because we wanted to build a neurology practice. It started because we onboarded a few neurologists that were very interested in our ability as an organization to pivot. To move quickly, to adapt and to give focus on growth in a business sense. We had some very entrepreneurial neurologists. We started with one and now we have 13 and we're just about to open in the next month our new 100,000 square foot neural ortho and wellness center because of that growth in neurology.
We have patients coming from 26 different states, in several different countries here to see our sub-specialists and that's one of the things we did focus on is subspecialty neurology. We have three providers that do nothing but see multiple sclerosis patients, MS patients. We have another provider that does movement disorders and muscular dystrophy. We have other providers that focus on memory care. A headache specialist, neuro ophthalmology and so we've focused that subspecialty service line around taking care of patients from distance and taking care of patients that see a general neurologist that need that subspecialty care.
And so in this building that we're opening, we've built a new patient model around that patient experience. Particularly because many of them can be coming from a distance. So that new facility. It has a 3t MRI in the basement. It has physical therapy in the building and the patient rooms are almost like hotel rooms where patients and their families can stay for the day because they know they're going to be there for a while. They're going to come in. They're going to get their imaging study done. They're going to meet with the provider. They're going to do some physical therapy, timed walks and physical therapy assessments. They're going to come back and they're going to have a holistic scope of service. We have a lab in the building. They'll have a holistic scope of services that they've done to really assess the patient. Give them the best treatment plan possible and for those remote patients, give them a treatment plan that they can work on with their general neurologist in another location. So we're building that new building around that destination concept and that's worked out very well for us.
There's an article done in Crain's Detroit about how a community hospital remained independent and became a neurology hub in the process. Very interesting read. About us as an organization, about how we've gone through this transformation process since 2011 to now. How we've built that neurology practice and how we've built that subspecialty care and how we've built that really service line model around growth and meeting the care needs of those patients in a very unique way. That neurology service line has been something that we've used as a pillar and something that we can continue to build other service lines to that level of complexity.
Christine: Well that's an incredible journey and transformation as you described. So Tom, you talked a lot about your financial improvements, which you know, that's been very impressive. Have you seen any clinical improvements or clinical outcomes as a result of bringing forth some of these new programs?
Tom: Absolutely and our strategic plan outlined several goals for quality and safety and one of the things that we're very proud of is our recent achievement of CMS five-star rating and so that's something that we achieved a full year ahead of schedule and our strategic plan and with that we also track our patient engagement through all of our patient satisfaction scores and we track those in conjunction with all of our partners. One of the things that we're very excited to see is our biggest improvement has been on the willingness to recommend score. In the past, there's something like 11 metrics in the Press Ganey patient engagement surveys that we do and we have been top in our region on 10 of the 11 and now we have just finally gotten that willingness to recommend up to the top in our region as well. So our quality scores have definitely been improving along with the strategic planning process.
Christine: So changing the script a little bit, I'm going to end on a fun note with you. I hear that you're working on your own podcast for Memorial. What is the aim of your podcast?
Tom: Well, we have several and the different podcast ideas are going to largely revolve around one community. So what are the service lines that we have at Memorial? What are the things that we're doing at Memorial? What are the things that we can teach our community to keep themselves healthy and keep them out of the hospital system? So we're going to have a general podcast around tips and tricks for general wellness. Now half of that new facility that we are starting up as a community wellness center. So using that as a basis to bring in our diabetes educators. To bring in our orthopedic surgeons, talking about how to safely achieve those new year's resolutions without, if you haven't been exercising in a while, without injury and those types of things. We do something similar with our local television stations that we have, those monthly spotlights of things of different service lines we have within the organization.
So it'll be a community focused podcast about all the different service lines we have and the other one we have is neurology focused. So it's the one we have now and we've gotten a couple of episodes recorded. It's going to be MS focused talking about managing your care and managing your care throughout the care continuum of that disease state. So looking at multiple sclerosis is going to be that concept of that second podcast and we're really excited. Again in our new building, we have a brand new podcast studio that's going to be audio and video and we're very excited about getting some of that content out.
Christine: Well that sounds exciting. So just to follow up on that a little bit, more in delve a little bit more into Tom, are there any particular podcasts that you follow or that are your favorites? Even if it's outside of healthcare?
Tom: I do have a singular favorite. It's called 20,000 hertz, 20k.org. It is a sound designer that looks at the history of sound in many different ways. There's one on underwater microphones and how whales’ communication has changed over the decades with the increasing sound levels in the oceans. There's one, it was very interesting to me. We're not too far from Windsor Ontario and there was one called the Windsor hum. About a hum that was heard in the city. So in my favorite episode, it's called the gift. It is about Amar Bose and how he gifted the Bose company to MIT to continue research and continue operations of that company and ensure it's run in an appropriate manner. To never lose focus on research but also never lose focus on the success of the business. So 20,000 hertz is my favorite podcast. I listen to every episode that's out there.
Christine: Well thank you Tom Kurtz for joining us today on the MEDITECH podcast.
I am so glad to have helped out with your podcast today and thank you for inviting me.
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