The Hospital That Could Cure Health Care

The following article was printed in the most recent Newsweek magazine and truly tells the story behind why Cleveland Clinic is a leader in healthcare, controlling costs, providing quality care, and doing all of this in an efficient way: http://www.newsweek.com/id/224585

"Long Time Gone"..."Ode to Family (and Joy)"

Well, I recognize that it has been over TWO months since I last posted to the blog. I don't usually like to wait that long to post, HOWEVER I have been extremely busy with both work and family! Both of which are great things to be busy with in life.
As I consider the most important things in my life I ensure you that, without hesitation, I will ALWAYS (always) consider my family to be most important. I work for my family and so a career is a priority, BUT it is not my family. I worship, pray to Heavenly Father, and believe in my religion for my family and so religion is a priority, and it is because it teaches me of an eternal family. I love to play sports, eat well, and stay healthy so that is definitely a priority, BUT only because it means that I may live longer to be with my family. I LOVE MY FAMILY!
From a professional point of view, family is what makes me want to be successful, work hard, learn new skills, be a leader, and help individuals. My career is something that I share with my family.....it is our career. We share the good and the bad moments, the advances and the setbacks, the education and the teaching and the daily stories.
Each member of my own little family teaches me about leadership and life in their own significant way. I learn from my wife (Kara) crucial skills to be a leader. She teaches me about organization, planning, being on time, caring for others, and working hard. My three year old son (Will) teaches me important skills about following and being a part of a team. I learn from him all about accomplishing a goal as a team, seeing the bright side of little happenings, and even living through things I don't want to do even though they make me a better person. My new little son (Eli), whom we just adopted, has taught me a tremendous amount in his young, two-week old, life. He has taught me to appreciate my blessings, to role with changes in life and enjoy them, and to work with the team that you are given to accomplish the same goal.
I hope we all realize that the FAMILY is the greatest way to learn skills that are applicable across any career success, business idea, political platform, entertaining venue, OR religious belief. Family (a husband, wife, and their children...in most cases) is a wonderful blessing that I am very thankful for at this time in my life!
Kara, Will, and Eli....I love you, miss you, and can't wait to have you back home in the next few days....it feels like it has been an eternity.

Healthcare Reform....Buffett Style

As the debate around healthcare reform heats up there a so many different options around a better healthcare system. The ideal situation would include decreasing costs (bending the cost curve), improving access to healthcare by providing insurance to the over 46 million uninsured, redefining quality and value, improving reimbursement for preventive care, and most of all changing the behavior of the American people! How do we please all the stakeholders; patients and family members, providers, payers, employers, pharmaceuticals, and so many others?

Well, I figured that since healthcare reform involves finances and amazing intelligence, the only person in this enormous world that would have the answer would be Mr. Warren Buffett himself. The American Capitalist, the genius of investing, one of the greatest minds of this century!

So, on April 17th I had the opportunity of spending a day with Mr Buffett in his home town of Omaha, NE. As a part of my MBA education I was one of 20 or so that was able to meet with him, spend time in his Nebraska Furniture Mart, eat lunch with him, and sit down with him for a couple of hours to ask him questions about investing, life, business, finances, AND healthcare. I was the first lucky soul from our program to ask him a question.

My question was phrased as follows; "Mr. Buffett, considering that our nation is currently spending near 17% of our GDP on healthcare and having a large baby-boomer population that will soon need increased resources and financing from the system.....how do you feel we can prepare now to support these changes and who should be responsible for the funding of the system?"

This was Mr. Buffett's reply, "Well (long pause).....would you allow me to phone a friend on this one? (laughs all around)" Obviously showing that even he, the genius of geniuses, doesn't have the answer. He then stated, "Even though we need a big change, most constituents are fairly happy with how things are, so they don't want to make a major overhaul. Basic healthcare for everyone is needed, and yet we may need to ration certain levels of care; that is done financially." Last, but certainly not least he mentions something very telling, "In reality, I don't have the answer to that question. Ask me an easy question like, 'What will the stock markets do in the short-term?'"

The morals/lessons/take-aways of this story:

1. Mr. Buffett thinks that knowing what stock markets will do is a simple task compared to how do we change and finance the future of healthcare. This is not a simple task at hand.


2. Mr. Buffett believes that most constituents are "fairly happy with how things are". However, I can speak for hundreds and probably even thousands of healthcare stakeholders that we are not happy about it.


3. We must improve the system and we can't just continue status quo. We need disruptive change, not incremental and we'll all have to take responsibility....individually and together.

I have to say that in general our healthcare system is doing wonderful things. I get to witness on a daily basis the things that are being done to improve the lives of individuals. Miracles do exist, I know it (more on that in another post), BUT we have to be willing to change.

PS I still respect Mr. Warren Buffett and think he is an absolute Einstein!

Food (FAT FREE) for Thought!

As a part of reaching out to all employees and communicating the importance of what our health system, Cleveland Clinic, is doing, Our CEO Dr. Toby Cosgrove visits a different regional hospital each month. He takes the chance to explain to employees, staff physicians, and administration what strategic moves we are making, how we are preparing for the future of healthcare, and what changes needed to be made in our system and in general.

I went and listened to him speak to employees at our Fairview Hospital on the west side of Cleveland. He took questions that ranged from the role of Health IT and integration, international expansion, employed vs private practice physicians, policy changes in healthcare, AND the future model of care delivery.

As a part of discussing the future model of care delivery Dr. Cosgrove talked about two changes that need to occur in order for healthcare reform to truly "sticky".

1. We need to drive efficiency by promoting a true healthcare "system" with complete integration.
2. We must reduce and control the healthcare/disease burden.

I would like to focus on the second change that has to occur. In recent years we have seen that our nation has become one of TOO MANY wants and desires. We want things NOW and in EXCESS. Well, these things have come back to bite us. Not only is debt and financial distress increasing, BUT our weight is also increasing. Clinically there is now a new classification of obesity. In bariatrics, the "Super Obese" are individuals with BMIs (Body Mass Index) between 80 and 100. To put this in perspective a normal person has a BMI between 18.5 and 24.9, an overweight person has a BMI between 25 and 29.9 and an obese individual has a BMI of over 30 (http://www.nhlbisupport.com/bmi/). So, we are talking about 3 times the "obese" BMI. These individuals weigh in the 1,000 pound range. Obviously, the bad habits of eating too much, consuming the wrong diet, and living sedentary lives are catching up to us.

In essence, there is a huge cost that comes along with obesity and treating complications or co-morbidities that are derived from obesity, such as heart disease and diabetes. In fact, last week I was touring our Cardiovascular ORs and spoke with one of our well-known heart surgeons. He said that the amount of time and resources required to perform surgery on an obese patient is many times greater than that of our normal patient. The point is that obesity (and other lifestyle related conditions) is costing the overall healthcare system. These costs have been documented quite clearly in this article.

This article demonstrates that obesity costs the system $147 billion each year. As Dr. Cosgrove mentioned today, if we were to eliminate obesity from our nation (obviously a big goal, but dream with me here) we would be able to completely cover the over 45 million uninsured individuals through the saved costs....healthcare reform requires a "healthy change". That includes ridding the system of smoking......an issue that costs the system another $100 billion a year!!! When will we decide to live healthy lives? Time for me to stop eating my nightly dose of ice cream...self-control here I come!

INNOVATION...A Current Must for Healthcare

For this post I refer to a brief article that I recently read. It was written by a friend of mine, Andrew Buhayar of Sg2 (a healthcare intelligence group). Here is a link to the article... http://members.sg2.com/content-detail-standard/default.aspx?contentid=7792222189707788447

In essence, the article communicates the need that we have in healthcare to refine our current thinking/care/model while at the same time identify new, creative, "innovative" ways of providing that same care. My first point is that we must work on both the current and future of healthcare. This topic is a passion of mine for many reasons. While I was at Mayo Clinic I worked with Andrew (the author of the article mentioned above) at the SPARC Innovation Lab where we identified care delivery needs and then provided innovative solutions for those needs. We would pilot these ideas, receive feedback, and then alter and try again. I saw the value that it provided to the provider AND the patient. I have also learned that if we are truly trying to be "patient centered" then we must do whatever it takes to please the customer/consumer/patient WHILE maintaining our own needs. The "WHILE" is an important distinction, and I believe that we can do both at the same time.


We read in the brief article by Andrew that Netflix is taking the steps to always be on the look-out for creative ways of providing their product. Well, many industry leaders are doing the same thing. This brings me to a second point. Many industries hold answers to the problems in healthcare (auto, airline, restaurant, hotel, media, manufacturing, entertainment) we just have to be willing to draw from the principles of those industries and apply them to healthcare. One of the major reasons I chose to complete an MBA instead of just an MHA is because of the education and exposure to other industries and principles they apply to improve performance, output, and customer satisfaction. In future posts I will discuss specific examples of this behavior, including; Disney and their guest experience, Toyota and LEAN, Southwest and "Time flies when your having fun", and many others. Other industries can teach us a lot if we are willing to learn!

Although this post is fairly short and unclear the point is simple. Change is inevitable, so let's prepare now by implementing for the future. I quote partially from Andrew's Sg2 Article. In order to meet the demands that we face ALONG WITH the patient demands we must continue "tirelessly refining what works today, while investing in activities that will disrupt the future." The patient must be a part of this "open innovation". I am a firm believer that the system must be changed and part of that change must be initiated by our own healthcare culture.

Ambitious, Human, Humble, Resilient

Thinking about a theme for the first management/healthcare centered post that I would make I searched through my file folder that is stacked full of little business and healthcare articles, quotes, and notes. Every so often, usually once a year or so, I will open up this folder and just look through the topics, concepts, poetry, themes, and models that I have considered important throughout my education and early career.

In the middle of all the articles and other paper I found a half-sheet, glossy program that I had been saving for nearly 5 years. On October 15, 2004 I was 2 months away from finishing my undergraduate degree at Utah State University in the College of Business. I knew that my career would be in healthcare and so I attended a presentation by a Ron K. Labrum, the President and CEO of a division of Cardinal Health. He was the guest speaker for the Dean's Convocation in the College of Business.

I don't remember much about the talk....other than things I wrote down and the fact that I felt embarrassed for the school seeing as how the presentation was given in the Business Building Auditorium which at the time was run-down, old, and dirty. The cleanliness of the auditorium is beside the point, however I would like to discuss those few notes that I jotted down during the presentation. Mr. Labrum shared a video with us of a physician in a busy downtown, urban hospital. The physician made a special point, and is something that I could use as my personal mission statement. He stated the following about leaders in healthcare (specifically referring to physicians), we must be;

"Ambitious enough to try my hardest the whole time,

Human enough to make mistakes,

Humble enough to accept the changes,

Resilient enough to bounce back."

Ambitious, human, humble, and resilient! I view these as the principles and characteristics of true leaders. There must be a recognition that throughout our lives we will not ALWAYS make the correct decisions or moves. However, we should try our hardest whether we are right or wrong, accept the changes that we need to make up, and continue work for something better. The thought this physician left was motivating and thought provoking.

Now, I know that simply sharing a principle or reading a special thought does not change behavior or lifestyle. These "soft" messages are simply motivating and can trigger action that if done consistently can become a part of lifestyle.....or an individuals mission statement!

As a sidenote, the only other note that I took during the speech was a thought of my own. I noted that one of the reasons I chose to become a hospital administrator is because "as administrator you put in to place systems and structures for the delivery of care." I recognize the importance of my job and hope to follow after the mission of being "ambitious, human, humble, and resilient."

*Ron K. Labrum (bachelors degree from Utah State University, College of Business) is still with Cardinal health and is now the CEO of their Healthcare Supply Chain Services.

The First Post

As an introduction, my name is Scott (Morty) Mortensen. I am married to an amazing, beautiful, caring woman named Kara. We currently have one little 3 year old boy named William. I enjoy healthcare and during my free time love ALL sports, reading, and all sorts of movies.

I have been intrigued with healthcare and leadership my whole life. I have chosen to follow my passions in life as a hospital administrator. Currently I am employed at Cleveland Clinic in Cleveland, OH as an Administrative Fellow. My career started in 2004 at Intermountain Healthcare (an amazing organization) where I learned the importance of reimbursement by acting as the Business Office Liason and Patient Financial Advocate for the Emergency Department at Logan Regional Hospital. From 2006-2009 I completed a Masters of Healthcare Administration (MHA) and a Masters of Business Administration (MBA) at the University of Minnesota's School of Public Health and Carlson School of Management respectively. While completing my graudate education I worked at Mayo Clinic (2007) in Rochester, MN in the Department of Medicine and SPARC Innovation Lab...an amazing experience. While there I offered recommendations on improving resource utilization costs specifically in the area of CHF and Pneumonia and the diagnostic tests (lab, radiology, etc) that are related to such diseases.

I was also fortunate enough to work for UnitedHealth Group, one of the largest insurance/health plan companies in the nation. UHG, at the time, had 6 core business areas and I worked in the company they owned called OptumHealth. I was able to experience the importance of a clinical network, recruiting physicians, the credentialing process and all the major concerns that are linked to offering health plans and products to members of a network. While at OptumHealth I was able to provide a solution to move the over 70,000 network provider files to an electronic format. This was another wonderful learning experience!

During my final year as an MBA/MHA student I worked as a Healthcare Consultant for Carlson Ventures Enterprise (more-or-less a subsidiary of Carlson School of Management). The major project that I led, with 4 other consultant students, was a collaboration between HealthEast Care System, Blue Cross Blue Shield of MN, Ecumen, and Ucare. These players were interested in a new, innovative model for the care of baby-boomer patients with chronic diseases such as heart failure, diabetes, and Alzheimers. After researching, ideating, seeking patient input, and developing a plan we formed a model of care for the future. We were able to present our recommendations to a load of different stakeholders including Sg2, and the Minnesota Department of Health, not to mention the sponsors of the project. A magnificent opportunity!

This blog will act as a journal of my insights, thoughts, expressions, learnings, and frustrations as they relate to healthcare and business in general. I keep this blog in order to organize my own life BUT also invite others that may be interested to follow along and provide their "two cents" on any given topic. So, here we go (Kara will be so proud of me)....