Building “Systemness” through Service Lines

Amanda Henson, MSHA, MBA, FACHE

This is the first of a monthly blog series on how the author created a streamlined oncology service line within her health system to help improve clinical outcomes across all sites.

I’ve spent most of my career focused on building successful cancer programs at single sites of care housed within academic- or community-based hospitals. These programs all have their own unique cultures within well-defined service areas. But although the cancer programs I’ve worked with are part of larger health systems, they did not operate as true elements of the whole. Rather, they often felt like SINOs (systems in name only).

I started my current role as system service line vice president of Baptist Health with all the humility in the world, preparing myself to be immersed in the cultures of each individual hospital within our nine-hospital system. I observed the success of our CEO and other senior leaders within the C-suite, who navigated the (sometimes) rocky terrain of the individual elements of Baptist Health to make changes on behalf of the whole system rather than single sites of care. This meant developing a clear vision and goals, fostering strong collaboration with individual sites, using data to drive decisions, and always keeping the patient as the focal point.

Baptist Health has made deliberate and tactical decisions through the years to bring together a health system that covers the entire state of Kentucky and Southern Indiana to function as a collaborative entity. Almost two years ago, Baptist Health brought me on to realize the CEO’s vision of establishing service lines around the health system’s leading patient care services. The oncology service line became the first service line for Baptist, followed by cardiovascular and orthopeadic services.

A couple months before I started my position, a timely article came out from Modern Healthcare titled, "Health Systems Are Working to Live up to Their Name,” in which the author, Harris Meyer, discusses the concept of “systemness.” At the macro level, this article speaks to the heart of the challenges and opportunities facing system executives. It reminds the reader of a core responsibility for successfully integrated health systems: ensuring clinical, operational, and financial efficiencies to facilitate highly reliable and clinically superior patient care outcomes across all sites.

The rise of value-based care and the unknowns of future payment models are expediting the pace at which health systems are leveraging their networks to reduce the costs incurred by variations in care while promoting consistent quality patient outcomes. Meyer cites the challenges many CEOs face when doing the difficult work of standardizing clinical processes and outcomes across a healthcare system. Whether leaders can overcome these challenges determines how successful they will be in engaging with the health system’s end users (staff, physicians, clinicians, and hospital leadership) to implement effective systematic change.

I reference this article because not only does it speak to the varying levels of integration with which health systems across the country are struggling, but it also provides a glimpse into the layers of work that are necessary to successfully build an integrated service line. By creating service lines within Baptist Health, the health system has engaged and empowered the physicians within our medical group to have conversations about how best to achieve consistently reliable care and clinical best practices.

Using outcomes data and working with physicians and staff across Baptist Health’s nine markets, I helped guide the oncology service line to patient outcome-driven collaboration in summer 2019. I learned early in this process that top-down-driven changes to large-scale reorganizations were a recipe for disaster that often did not successfully stick. Building trusting, collaborative relationships across its different markets has helped Baptist Health identify opportunities to standardize its best practices.

In my subsequent posts, I will talk about the many ways I approached my new role as system service line vice president at Baptist Health and how COVID-19 both derailed and accelerated its oncology service line. I will specifically share how I engaged clinicians, staff, and site leaders across the health system to develop common goals for the oncology service line and describe how we have worked together to improve clinical outcomes and metrics across all sites. Finally, I will walk through some of the challenges I have experienced and the lessons I learned from my missteps.

Amanda Henson, MSHA, MBA, FACHE, is the system vice president of oncology and cardiovascular services lines for Baptist Health, the largest not-for-profit health system in Kentucky, with nine hospitals throughout the state and southern Indiana. Amanda has served in oncology leadership roles for more than 15 years, ten of those with Baptist Health. She earned her master’s degrees in business administration and healthcare administration from the University of Alabama at Birmingham. She is a fellow with the American College of Healthcare Executives, and she serves on the board of trustees for the Association of Cancer Care Centers.