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FUTURE OF HEALTHCARE
More technology, training and outsized medical buildings on the horizon. The past few years have seen massive disruption in the healthcare industry due to the pandemic, the rise of telemedicine, digital technology and labor shortages. Many organizations are setting their eyes on the future and navigating ways to provide greater service to their patients and clients. Three Chicago-area executives in the retail pharmacy, health care network and construction spaces share their thoughts on the technologies and trends that may shape the future of healthcare with Crain’s Content Studio.
KELLY JO GOLSON
Brand & Consumer Experience Officer Advocate Aurora Health mediarelations@aah.org 630-572-9393
KELLY JO GOLSON, chief brand and consumer experience officer, is responsible for consumerism, brand, marketing, digital strategy, public affairs and internal communications across Advocate Aurora Health. A leader at Advocate Aurora and Advocate Health Care since 2007, she has nearly 30 years of industry experience, including leadership roles with Methodist Healthcare System, St. Luke’s Episcopal Healthcare and Memorial Hermann Healthcare, all in Houston. Golson is a member of the Xealth board and has served in a variety of leadership roles with the American Heart Association.
What are major hospital networks doing to stay ahead of patient care needs? Kelly Jo Golson: We’re taking an active approach to digital health transformation, rather than trying to react to changing consumer habits and the shifting industry around us. We need to anticipate what’s next. And we need to keep up our work on health equity, acknowledging that social determinants of health and access to care play a big role in the lives and well-being of our patients and communities. We’re focused on coordinating with community partners and working across state lines to tackle the challenges in our industry, because none of us can address these big problems alone. We’re stronger when we work together. What are health systems doing to address mounting cost pressures?
Golson: This is a big challenge for many industries, and ours is not immune, especially as we continue to work through the ripple effects of the pandemic. Labor shortages and supply chain issues have significantly increased costs, and we face inflationary pressures on expenses like food, utilities and technology, too. Health systems cannot pass along these costs to patients, and we must be financial stewards of our resources. That’s why we are using these challenges as an opportunity to accelerate transformation. For example, we recently launched the creation of our Consumer Engagement Center. Over the course of this work, we will be integrating dozens of call centers into a single, personalized point of contact that can connect patients end-to-end across our entire system. While this move will provide millions of dollars in efficiencies, more importantly it will improve wait times, accelerate self-service options and expand proactive personalized outreach to help individuals live their healthiest lives. Meanwhile, we’re investing in outpatient and home-based services closer to where consumers live and work to keep people healthy and out of the hospital. How are health systems adapting as more nontraditional competitors enter the market? Golson: We can’t say this enough — the healthcare industry is ripe for transformation. As more techcentric consumer companies enter the market, health systems like ours are motivated to embrace new care-delivery systems and digital experiences that improve outcomes and affordability. We’re working with Xealth and Omada to more easily prescribe digital tools that help consumers manage conditions like diabetes. These partnerships create a seamless experience for consumers to get the care they need with tools they can access anytime and anywhere. How have advancements in technology — both medical devices/equipment and digital transformation of patient data — impacted the industry? How are digital-first strategies shaping healthcare today? Golson: The digital healthcare revolution of today is the foundation on which the future of our industry will be built. Our consumers and
providers are increasingly relying on digital tools in nearly every facet of their lives, and we need to be right there with them. That’s especially true when these tools can improve care and health outcomes.
better understand how conditions affect populations, and then provide the best individual care possible. Traditional doctor visits will always be important, but the only way we’ll truly transform care is by launching new delivery models.
“OUR CONSUMERS AND PROVIDERS ARE INCREASINGLY RELYING ON DIGITAL TOOLS IN NEARLY EVERY FACET OF THEIR LIVES, AND WE NEED TO BE RIGHT THERE WITH THEM.” — KELLY JO GOLSON, ADVOCATE AURORA HEALTH If we’re going to create new clinical knowledge and understand how to impact chronic illnesses, we need to come together to share data to truly get insights. That’s why we invested in Truveta, a collaborative that is aggregating de-identified data to advance medicine and make patient lives better. Meanwhile, electronic health records and predictive analytics are powerful tools in providers’ hands, as they can use patients’ data to both
How does empowering consumers affect patient engagement and health outcomes? Golson: When we make healthcare more convenient through easily accessible digital tools, consumers are more likely to take an active role in their healthcare journey. Patients who seek out preventive, regularly
scheduled care will be healthier, better manage their chronic conditions and ultimately stay out of the hospital. Our LiveWell app allows consumers to get personalized wellness information including guided meditation, health news and healthy recipes — and search for convenient ambulatory care sites and physicians. Consumers can chat with their physicians, schedule appointments, request prescriptions, view diagnostic tests and facilitate virtual visits. With greater access to information, patients are better equipped to make informed decisions about their care. We’ve seen tremendous success closing the gap in uncontrolled hypertension in our Black and Hispanic communities by providing blood pressure cuffs, educating patients to take regular readings, using remote patient monitoring to check in, and supplementing with nutritional guidance, medication management and community support. Through this initiative, we’ve seen a 13% reduction in uncontrolled hypertension.
HERE FOR YOU 24/7 With the LiveWell app, essential health and wellness information is right at your fingertips. Schedule a virtual visit or appointment, keep up with your health data, and much more.
Scan the code to download the LiveWell app. aah.org/livewell
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FUTURE OF HEALTHCARE
More technology, training and outsized medical buildings on the horizon. As a Senior Vice President at Leopardo Companies, GIANCARLO PACINI has amassed an impressive portfolio totaling more than 2 million square feet in projects. With expertise in healthcare work, his experience ranges from medical office buildings to multi-acre master site and hospital expansions. Pacini earned a bachelor of science degree in building construction management from Purdue University and is an active member of the American Society for Healthcare Engineering and the Healthcare Engineers Society of Northern Illinois.
GIANCARLO PACINI
Senior Vice President, Institutional Leopardo Companies JGPacini@leopardo.com 630-918-8494
housed under one roof. Outpatient clinics have become a one-stop shop for medical needs housing everything from immediate care and imaging to women’s services and urology. Some medical-office buildings (MOBs) even have small surgical center attachments. The suburbs are the perfect spot for these massive MOBs because the land required is more readily available and
How is the healthcare landscape in Chicago changing? How/where are the major hospital networks growing? Giancarlo Pacini: The city will never stop growing, but space is limited. To capture more patients, major players are making strategic consolidation and expansion decisions. Services that were previously spread across multiple lease locations are now
professionals, provide the desired level of care and positively impact the patient’s experience. Private equity investment has also sparked more programmatic build outs of clinics — both private and insurance networks — which is expanding the geographic coverage areas for these players.
How is private equity influencing the healthcare system?
How has the pandemic changed or accelerated construction projects in the healthcare sector?
Pacini: Private equity has been a game changer for healthcare. Providers used to own the real estate and when private equity entered the mix, it presented the opportunity for providers to reanalyze their strategy. Who owns the building is of little
Pacini: The pandemic underscored the importance of essential construction projects. At the beginning, all construction was halted — even critical projects. This hard stop gave healthcare developers time to regroup and reposition themselves
“TO CAPTURE MORE PATIENTS, MAJOR PLAYERS ARE MAKING STRATEGIC CONSOLIDATION AND EXPANSION DECISIONS. SERVICES THAT WERE PREVIOUSLY SPREAD ACROSS MULTIPLE LEASE LOCATIONS ARE NOW HOUSED UNDER ONE ROOF.” — GIANCARLO PACINI, LEOPARDO COMPANIES the patient base is already there. With each successful suburban project, these providers refine the real estate model that they can replicate in out-of-state expansion efforts.
consequence to the patient. Sell backs free up capital for investments in technology, medical equipment, training and development. These upgrades help attract top medical
for a post-pandemic world. As soon as projects were greenlighted, the need to deliver was immediate. The current backlog of projects is still causing schedule crunches in our sector. The pandemic also fundamentally changed how immediate care facilities operate. While the operational changes (like waiting in your car to be called for your appointment) may be temporary, many changes may become the new standard. HVAC design — how air enters and leaves the facility, how it is cleaned and recycled through — is incredibly important. We see changes like this as positive outcomes from the pandemic that will keep people healthier and prevent the spread of disease. How has hospital design changed in the last decade and how is that impacting constructability, delivery and/ or schedules?
ONE OF THE NATION’S PREMIER HEALTHCARE CONTRACTORS
Pacini: The size of buildings has grown significantly. A 40,000-squarefoot MOB used to be big and today a typical MOB averages between 60,000 and 75,000 square feet. What is housed in the building has also changed — more departments like immediate care, physical therapy, women’s services, imaging, lab services, and cancer care are all found under one roof. Buildings are aesthetically more pleasing too. Architects are designing spaces with more glass, more natural light, and more focus on creature comforts for patients and staff. We even see an infusion of regional flair — with nods to local history or native flora and fauna.
What remains unchanged is the increased focus on speed to market. Healthcare is in a major turf war and speed to market is huge. Prefabrication and modular building is continuing to build steam as well. We are building components — headwalls, MEP systems, doors and hardware — offsite which improves quality, reduces congestion on the jobsite and saves time. Tech is powering all this. Field staff are equipped with iPads and can push updates to all the trades immediately. No one is carrying around the wrong set of drawings. Sustainability has taken center stage in other verticals. What green building initiatives are you seeing in the healthcare sector? Pacini: Healthcare construction has always had high standards for sustainability, especially in new construction hospitals and medical campuses. Recently more MOBs are pursuing sustainable initiatives in an effort to reduce their energy consumption. As energy prices continue to escalate and the grid in many parts of the country becomes more stressed, we expect to incorporate renewable energy systems into more projects, which help provide resilience and redundancy. How is the supply chain impacting healthcare projects and what’s being done to overcome present challenges? Knowing early in the process what the pain points will be is critical. Project teams must pin down where everything is coming from and when it will be delivered — from rooftop units and generators to door frames and plumbing fixtures. Right now the most volatility is with critical infrastructure equipment where delays can really impact the schedule. With 45 years of relationships, we’ve been able to lean on alternative manufacturers to keep things on schedule. Beyond materials and goods, the construction industry is also managing unprecedented shortages in skilled labor. Much like other industries — restaurants, retail, and hospitality — employee shortages have had an impact. We’re applying the same proactive approach we use to overcome supply chain challenges to our people pipeline. We look at staffing forecasts well ahead of job starts, seek to develop our current team with mentorship and training opportunities and keep an eye out for the right players to add to the team whether the need is now or in the near future.
BRAD ULRICH is the group vice president for pharmacy operations and services at Walgreens. In this role, Brad leads pharmacy operations for nearly 9,000 retail and specialty pharmacies and is responsible for retail and specialty pharmacy services such as immunizations, improving patient health outcomes as well as ensuring patient quality and safety. Brad is a pharmacist by training and throughout his career has advocated for accessible healthcare in communities and the role pharmacies can play through prevention, education and treatment.
BRAD ULRICH
Group Vice President of Pharmacy Operations and Services Walgreens info@walgreens.com 800–925–4733
How did the COVID-19 pandemic impact the way that healthcare professionals (pharmacists, providers and more) serve patients? Brad Ulrich: The pandemic caused a shift in the way consumers think about their pharmacists and the role they play in their health. Pharmacists were often seen as the main resource around vaccination information and COVID prevention. This has strengthened the relationship consumers have with their local Walgreens pharmacists and has now set an expectation for pharmacists to play an even bigger role in their healthcare services.
Is there an opportunity for pharmacies/pharmacists to continue playing a bigger role in their patients’ healthcare, particularly in the chronic disease management and immunization spaces? Ulrich: There is a huge opportunity for pharmacists to play an even bigger role in patients’ lives. This past year, 253 million doses of COVID-19 vaccines were administered by pharmacies, and we’ve seen more patients turn to their local pharmacists to help them understand and manage their chronic conditions. We are leveraging the technology and tools to create efficiencies that allow our pharmacists to focus on providing more clinical services, driving greater medication adherence and establishing more meaningful connections with patients and providers. In states where it’s allowed, we are piloting programs that include HIV testing and prescribing PrEP, upper respiratory tests and treatments, and programming supporting asthma and COPD patients.
“WITH PHARMACISTS’ CLINICAL EXPERTISE, ACCESSIBILITY AND INTIMATE KNOWLEDGE OF THE COMMUNITIES THEY SERVE, THEY CAN PLAY AN IMPORTANT ROLE IN FILLING GAPS IN CARE, REDUCING COSTS AND IMPROVING PATIENT OUTCOMES.” — BRAD ULRICH, WALGREENS Now, Walgreens is laying the groundwork for new areas of pharmacist care, including testing and treating routine illness, providing comprehensive care for chronic conditions like diabetes and asthma, solving adherence barriers and supporting health equity. We believe that enabling our pharmacy professionals to focus on these activities for which they are licensed, explore new career opportunities, and provide expanded patient care not only helps us better serve our communities but allows for more fulfilling and purpose-driven work for our team members.
What kinds of efforts are you putting in place to recruit and retain staff with the current national labor shortage? Ulrich: The U.S. healthcare system is under significant strain, facing a shortage of primary care physicians, a rapidly aging population, unequal access to care and spiraling costs. With pharmacists’ clinical expertise, accessibility, and intimate knowledge of the communities they serve, they can play an important role in filling gaps in care, reducing costs and improving patient outcomes.
At Walgreens, we are expanding pharmacists’ ability to practice skills that draw on the reasons they went into pharmacy to begin with. We’re enabling greater patient engagement and care and improving inventory management to enhance the customer experience all while expanding our pipeline of future community leaders as part of the patients’ overall care team. What will be the key components to ensuring sustainability as the healthcare industry evolves to encompass new treatment models? Ulrich: As the healthcare industry evolves, with pharmacy taking on a larger role in patient care, a key component to ensuring sustainability will be broadening pharmacists’ capabilities and freeing up their time with consumer-centric, technology-
enabled clinical services that improve health outcomes and lower cost of care. For example, while many retailers utilize centralized fulfillment centers, Walgreens is among the first pharmacies to leverage micro-fulfillment centers. These centers remove routine tasks and excess inventory from the pharmacy by filling prescriptions at a central location. By removing this work from the pharmacy, pharmacists get additional time to focus on providing patient care and clinical services, expanding on the critical role they provide in communities. How will the shifts and evolutions we’ve discussed impact communities of color and historically underserved populations? Ulrich: Pharmacists, an everaccessible resource on the frontlines of care, play an important role in driving health equity. With nearly 9,000 stores across the country—574 of those in Illinois—combined with telemedicine and other digital tools, Walgreens pharmacists can support continuity of care, provide important medication and disease state education, facilitate access to financial assistance and address other common barriers to care in underserved or rural areas.
During the pandemic, we set up an incubator in Chicago in about 20 locations and tested out different concepts to find the best way to provide communities access to vaccine distribution, testing and medication. We spoke with pharmacists and technicians directly working in these communities to see what was working best. Because of this approach, we have seen a lot of traction on being able to drive equity, or at least access to care. What is technology’s role in advancing the way people receive health care? Ulrich: Technology’s potential to improve the way patients receive health care is continuously advancing. We’re leveraging automation across our Walgreens stores and pharmacies to create a better customer experience and create efficiencies behind the counter. In fact, Walgreens saw a 37% increase in digital pharmacy traffic year over year. And Our Save a Trip Refills® program allows customers to align multiple prescriptions to one date. More than 5.6 million patients were enrolled as of Aug. 31, 2021, saving an average of three pharmacy trips a year. The Walgreens app has more than 75 million lifetime downloads.