California Dreaming


IMG_2617The address read, “Scenic Drive, Pebble Beach, California,” and when I arrived at the Community Hospital of the Monterey Peninsula (CHOMP), nestled along the Pacific Coast, I was not disappointed!  In my 25 years of traveling back and forth across our great country, I don’t think I’ve ever been in a more serene and beautiful hospital setting.  I had the pleasure of spending the afternoon with Dr. Steven Packer and his leadership team as they shared their journey into the brave new world of practicing population-based medicine.

Back in 2012, the board of trustees of CHOMP made a fateful decision to invest heavily in the infrastructure and the resources necessary to transform their community hospital from a “commodity-based, let’s reduce prices in order to compete organization” into one of the leading community hospitals in the nation, now setting the standard for population-based care.  For example, they’re working closely with their local competitors in trying to improve the clinical outcomes of all the patients with diabetes.  They’re collaborating across disparate emergency departments to come up with practice guidelines to limit opioid abuse.  They’ve reached out to numerous community organizations to share best practices and they’ve invested in community case managers deeply connected to the work going on in the hospital in order to smooth patient transitions across the continuum of care.  Their work is so successful, that they offer a five-part webinar  program,Population Health Management – A Comprehensive Five Part Certificate Program for California Hospital Leaders.”  We had a wide-ranging conversation with a host of their local leaders, focused not only on the infrastructure for population health management, but “down in the weeds” issues such as improving individual physician performance, creating registries, reducing unexplained clinical variation, and rewarding physicians under a population-based compensation plan.  They posed some challenging questions during our free-ranging conversation that were difficult to answer.  For example, they wanted to know what is the best IT infrastructure for linking physicians in the community in an Accountable Care Organization or in an IPA practice model.  I explained that there are so many competitors in this field that it was not possible to provide an evidence-based response. They also wanted to know which community hospital in the country was further along in the journey on the road to population-based care.  Though there are certainly many contenders I certainly believe that CHOMP has positioned itself as the leader!    


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