Israel Rocha, Jr., Calls for Innovative Partnerships to Promote Better Health, Cook County Health CEO discusses his passion for health equity at CHEF C-suite event
By Chris Gay, CareAdvisors
CareAdvisors is a CHEF Platinum Sponsor.
Cook County Health CEO Israel Rocha, Jr., recently spoke to a group of healthcare industry leaders at an exclusive Chicago Health Executive Forum (CHEF) C-suite event. The former CEO of NYC Health & Hospitals Elmhurst and Queens Hospitals shared his views on the role of public health and his compelling vision of collaboration with community partners to address the health disparities we see across Chicago. As CEO of CareAdvisors, a CHEF Platinum Sponsor, I had the distinct pleasure of moderating the event, engaging the esteemed hospital executive in a robust discussion. In this article, I highlight some of the most notable information shared at this important CHEF event.
A Strong Infrastructure
“Some of the legislation that we were happy to support is to have hospitals report more about the safety net…and to work with hospitals and clinics to appropriately report their charity care, to always have a monitoring system in place…In addition to that, I would say one of the differences between the New York market and the Chicago market is the New York market has adopted things like HIE, which is a health information exchange — has had the identified global sets of data to be able to do risk management across geographies and groups and we haven’t done that as frequently here in the Illinois market. I think there is some opportunity for us to look at lessons that were learned in other states. We do have to look at how we can start to map out the data to look at long-term care availability to be able to diagnose and triage faster. And we need to learn how to share data a little bit better to help patients when they are going between different providers, health plans…
“Internally, I hope to try to share data, where possible, and to bring the interoperability standards that are coming forward….to allow EMRs to communicate with each other for the benefit of the patients. We need to find how that can be done easier because I think EMRs are meant to free patients, not to keep them.We need to find ways we can share that data and make it available.”
Constricted Access to Social Services
“From a provider’s standpoint, we are working to be more available and that is why we are creating more sites across the county to be available and accessible to patients. I think it starts with access. Our system has some challenges right now…we have a process where you are assigned a primary care provider and you have to be seen by that healthcare provider. But people want to see healthcare now, and sometimes there’s some difficulty on how you balance those healthcare needs. You do want a medical home to render the more complicated parts of medicine, but you sometimes just want to cure your earache and you don’t want to wait a week to see your provider. So, how we balance those needs, how we balance those access points, and how we make it easier for people to get assistance is the journey we all have to do together…We are interested in working with and talking to everyone at the table on how we can re-innovate healthcare.”
Innovative Partnerships
“We want to work with communities closely in developing those programs…as healthcare providers, we do have to partner with CBOs because our patients probably spend less than, I would say, 3% of their overall time with a healthcare provider in a clinic or hospital setting. The majority of their lives are going to be spent in the communities where they live and work. If we don’t have partners in that space, then we fail to help patients mitigate or get the services that they need. And so, our goal is to bridge those two by working with community providers to expand the community health service line…So being able to get those services is important to us at all levels, whether it be an intensive outpatient therapy following a psychotic break, or even during preventive health and mental wellness assistance, or even where we work doing community advocacy with police to be able to change what happens now and to re envision what community policing could be with a Mental Health Service Corps by their side. So, I think there are a lot of opportunities where we can work together in either value-added services, like food, nutrition and housing services, or whether it would be wrap-around services for what I call supportive health management…How we create those programs together is what we are looking to do in all the different service lines.”
Bridging the Gap
“I would love to do warm hand-offs between all levels of care: between acute care, primary care, specialty care…to have that warm hand-off and integrated medical management program. We have some….started with CountyCare [health plan] and we want to expand and test and trial some of those products… but we also need to work with actual providers, to help fill that gap and build partnerships.
“We want to find out how we can bridge those gaps…right now, we do a lot of talking at each other, but not to each other, and so it would be helpful to find out why a patient is not compliant and where is the dropoff rate. And so, what we can do as a health system and as a provider is to have some workgroups in place that help us manage some patients in real time and do case studies to figure out why a patient didn’t make it to the different level of care and try to test real-time interventions going forward with those types and groups of patients to see if it works to increase compliance.”
Training Tomorrow’s Physicians
“We are mitigating and expanding our programs. We’re either trying to bring in more students or see how we can access more services. Right now we work with all programs across Chicago, so I don’t think there’s one institution that Cook County does not work with. You have UIC, Rush, Northwestern, University of Chicago…we have residency training programs and expansions with everyone.
“We really do want to see how we can create more community-embedded residency education, training and teaching programs. The table is open. We do have slot availability and we do want to make sure that we work with others to get them going. Right now, we are expanding neurosurgery, we are expanding neurology, we are expanding some of our psychiatry programs, as well as alot of our other key residencies to be able to accommodate more students and more training opportunities and more provider availability.”
Pandemic Lessons Learned
“It was a challenge in New York to move quickly…hopefully kept Chicago from seeing some of the things that New York saw. Meaning, I hope no one had what we had: we were a 545-bed hospital at our peak at the original onset of COVID, and we surged to over 800 patients, of which 395 were ICU-level patients. That was quite an ordeal and that volume spurt happened In less than two weeks. So you go from normal everyday operations to having to handle that type of mitigation. What I brought with me, and will forever be part of me, is the desire not to let it fail.
“I think people, in time, will understand…there was a picture that was my greatest pride point — but was misunderstood — the lines that you saw inside of the ED and they were used on television or were used outside of Elmhurst Hospital…what people didn’t understand is that there was no shortage of hospitals. When you are in New York City you are two minutes from another hospital. Those lines were there because we had the services and we had the trust of the community.
“When the community felt that they needed help, they said they were going to go here and this is where they were going…The trust is what helped, but the trust also meant that people were getting seen, they were getting assistance, and they were getting care.
“What I brought with me [to Cook County Health] was the desire not to fail and that no matter what the objective, and no matter what the object is, that if we work together, as a community and as a hospital, as a health system and as providers, there’s always a way — no matter how bad it can get — to be able to meet and provide care to the patients that need it.
“We saw it when we had our mass vaccination program, when we didn’t know how to get everyone vaccinated, Cook County Health stepped forward and through its programs, we were able to vaccinate over 850,000 people directly and 1.2 M with assistance, and really helped to bolster the availability of vaccinations quickly by setting up mass vaccination centers, and getting them efficiently operating.
“That’s the step that I really want to bring forward. That we will not fail, we will be there and we want to be sure everyone who needs care gets it and that we are there to provide it.”
About the Author:
Chris Gay is the CEO of CareAdvisors, a Chicago-based healthcare technology firm that provides value-based social care to some of the largest U.S. health systems and health plans. The CareAdvisors team previously built one of the largest navigation programs in the nation, helping more than one million Illinois residents enroll in social services and gain access to resources. Contact Chris at chris@care-advisors.com.