Serial Chief Medical Officer & Healthcare Administrator, Medigram Chief Medical Officer, Dr. Art Douville Explains What Program Development Success in Medicine Requires
Do you know what the capability of your hospital is to restore your life or livelihood if you or a loved one gets a stroke? You should because the difference can mean disability vs near immediate recovery or saving your life. Let’s look at the example of the highest level of certified stroke care, the comprehensive stroke designation.
Many stakeholders misunderstand what success means in medicine and how it gets delivered. There are also knowledge gaps on what certifications mean for medicine and the prominence of regulatory success as key to being considered successful. Regulation isn’t something you ignore as a credible actor in medicine. Success is for the most part, improved clinical quality with superior financial results with regulatory recognition. It happens through programs. How do we know that clinical programs are ultimately successful? When the quality metrics, financial results, and regulatory recognition tells us it is. Though before health systems enjoy the fruit of these results, leadership has to come to bear with seed resources to set up the program which will ideally deliver clinical results, which then attracts further funding. With clinical programs operational, then financial results should manifest, and in tandem with regulatory recognition.
In this example because it’s a great one, not just a proud spouse alert, let’s look at the recipe ingredients for one of if not the first comprehensive stroke certification in the U.S. in San Jose, CA co-founded and co-led by my better half and Medigram CMO, Dr. Art Douville. Art began his administrative career fairly early in our marriage and had been building his foundational skills and experiences for years prior.
This concerns a Multidisciplinary neurosciences program for Stroke designed to provide assurances of care such as timeliness and appropriateness of care.
Certified Comprehensive Stroke (highest achievement level) Program Ingredients:
- Neurosurgery
- Neurology
- Requires ICU with neuroradiology
- Creating a program with bylaws that manifested as a new department
- A Neurosurgeon on call is required in case there’s a brain hemorrhage from the treatment
- Then is hired a neuro interventionalist, someone who uses a small wire and coil to do deep, invasive brain surgery
- Specialized technology such as cat scanners
- Interventional suite
Then the program can evolve to include a neurosciences ICU
Cashflow produced is several million a year for a successful program achieving healthy profit over the long term as well as reputation, brand, and other effects.
Keys to clinical program development success:
1) Physician leadership
2) Physician champion
3) Organizational leadership in the form of a highly effective administrative director
4) C suite strength and effectiveness
5) Capital
6) Related Technology
On program development success in medicine:
The key is leadership. In medicine, unexpected leaders can emerge. Though they are not predicted based on being a thought leader or being a financially successful physician tech enthusiast; rather they make themselves apparent through their ability to assemble and drive a multidisciplinary team.
The same ingredients and keys to success apply to system level programs like for sepsis.
Clinical development within the program is then local like in the stroke example above for any other clinical area like infection control/sepsis.
What is Comprehensive Stroke Certification? Learn more:
As technologists, we have to understand and drive towards how health systems define success or we just flap in the wind creating wasteful noise in my view. Of course there are rare exceptions. In our coauthors’ recent policy letter, we proposed the development of core measures for cybersecurity that would result in regulatory oversight and recognition ideally by a body such as the Joint Commission. I hope this post helps illuminate what success means in medicine and stimulates our technical colleagues and luminaries working on certifications to ask how we will get physicians to understand and adopt them.
By Sherri Douville, CEO at Medigram, the Mobile Medicine company. Recognized in 8 categories of top CEOs by Board Room Media (Across SMS, mHealth, iOS, IT, Database, Big Data, Android, Healthcare). Top ranked medical market executive worldwide and #1 ranked in mobile technology categories (mhealth, iOS, Android), #1–2 (on any given day) for the cybersecurity market in the U.S. on Crunchbase. Best selling editor/author, Mobile Medicine: Overcoming People, Culture, and Governance & Advanced Health Technology: Managing Risk While Tackling Barriers to Rapid Acceleration, Taylor & Francis; Series Editor for Trustworthy Technology & Innovation + Trustworthy Technology & Innovation in Healthcare.
Arthur W. Douville, Jr. M.D. is Chief Medical Officer at Medigram and an Attending Neurologist. Dr. Art Douville is recognized with the highest patient experience scores by U.S. News & World Report. He has held numerous leadership and administrative positions in healthcare, including hospital Chief of staff and Chief Medical Officer in two separate health systems, including as Regional Vice President and Chief Medical Officer at Verity Health System in Northern California. In these roles, he oversaw infection control and biohazard assessment in hospital environments, as well as physician relations, including clinical integration, patient safety & quality, regulatory compliance, the development of innovative clinical programs, and physician technology deployment and adoption plans. He was part of the leadership team charged with bundled payment and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) initiatives. As Associate Medical Director of the Crimson Analytic program for the Advisory Board (Washington,DC) his role was helping physicians understand and leverage the data by which they are being measured. Dr. Douville has over two decades of experience in executive physician leadership and has published work in managing change in physician culture, communication, and the adoption of medical technologies including as a contributor to Mobile Medicine: Overcoming People, Culture, and Governance (Taylor & Francis 2021) and Advanced Health Technology (2023). He is in the active practice of Neurology in Los Gatos, California, and acts as a Stroke Medical Director in the Santa Clara County Health System based in San Jose, California.
