A sweeping panorama of the city of Brewer comes into view from Michelle Hood's sunny fifth-floor office at Eastern Maine Healthcare Systems. Perched atop a hill along Route 1A, the building overlooks a Lowe's store across the street, a Walmart Supercenter home to a new EMHS clinic and, in the distance, Bangor's skyline.
Four years ago, Hood enjoyed far less breathing room. As the chief executive of four hospitals in Montana, she could walk a mere three blocks to the doorstep of her top competitor in Billings. Despite the tight quarters, or perhaps because of them, Hood established an effective relationship with her rival's management. The experience would prove solid training for her next job as president and CEO of EMHS, a key player in a state health care network known more for rivalry than cooperation. "There's not enough resources to go around," Hood says matter-of-factly. "I consider it a waste of resources when there's competition."
Resources have been a major focus for the nonprofit EMHS over the last year, as it tended not only to its seven member hospitals and other institutions but also stepped in to revive the troubled Down East Community Hospital in Machias. Hood's collaborative spirit kicked in when the state came calling last summer, asking her to volunteer EMHS as an operator in its planned receivership of the hospital.
Hood could have said no, and many executives would have given the facility's laundry list of deficiencies and the high-profile death of patient that first launched a federal investigation into its practices. But her first reaction was yes, Hood says. "That is our mission, to provide access to quality health care in this part of the state." Her second reaction: "Let me sleep on it," she says.
Earlier this month, DECH was awarded a full state license after operating on a conditional basis since 2008. The hospital's board must be reseeded and further governance issues addressed before the state can petition the court to remove the receivership status. But the full license marks a major milestone for the hospital and Hood hasn't ruled out continuing a relationship with DECH in the long term.
While she had professional experience with turnaround efforts, Hood had never before dealt with a hospital's receivership. She told the state she needed full disclosure, and was given court approval to review sealed documents from the DECH investigation before committing EMHS to the receivership. Maintaining trust, not only with regulators and industry types but also with the public, depends on such openness, Hood says.
"Leadership has to be consistently transparent," she says. "You can't just be transparent when it's convenient to do so." That includes handling news like the system's recent move to lay off 50 employees from its flagship Eastern Maine Medical Center in Bangor and a decision to eliminate more than 30 positions and the obstetrics department at its Blue Hill Memorial Hospital. "The public is skeptical of big organizations," Hood says. "We try to demonstrate the fact that health care is local."
The Blue Hill hospital is now on more solid financial footing, having converted a $4.2 million operating loss in fiscal year 2009 to a slight loss in 2010, with gains expected for FY 2011. The personnel cuts have also yielded $2.1 million of an overall $2.9 million in savings in 2010 over the previous year. Erik Steele, chief medical officer for EMHS, is serving as interim administrator. But a search for a new CEO is kicking off now that finances have stabilized, as Hood was loathe to drop a turnaround job in a new executive's lap.
Despite Hood's aversion to competition, she's clearly proud of EMHS' besting of hundreds of other organizations to win a prestigious national patient safety award in December. The VHA Foundation, a national group that encourages leadership and innovation in health care, and the National Business Group on Health Care recognized EMHS with the National Health System Patient Safety Leadership Award. The 30-member system was cited for linking executive compensation with quality and safety outcomes, board education and its role as a founding partner of a statewide coalition to reduce hospital-acquired infections.
EMHS also won attention for its mission — unabashedly promoted on a towering banner in the main office's lobby — to become the country's best rural health care system by 2012. Achieving that vision includes specific benchmarks, such as eliminating preventable errors and reducing costs per case to reflect Medicare reimbursement levels.
The plan to reach the 2012 goal calls for, among other objectives, working with outside organizations to help prevent and manage chronic disease. An effort like that was unheard of in Maine until 2007, when EMHS, MaineGeneral Health and MaineHealth announced they would collaborate to improve health care services and lower costs statewide. Hood had been on the job only about a year at when the deal was struck, and has since also worked with other Bangor area providers such as St. Joseph Hospital.
Hood's lack of turf consciousness brings much-needed fresh air to Maine's health care scene, according to Devore Culver, executive director of Portland's HealthInfoNet, a centralized system that allows health care providers, including EMHS, to share patients' electronic health records. "The fact is the relationship of large providers in the state is different because she's here," he says.
Although friction among providers has eased, the health care community's exchanges with law and policy makers could improve, Hood says. Despite the research she did to land the her job, Hood says that strained relationship caught her off guard. "That kind of tension I was a bit surprised about," she says.
Tough decision-making is inevitable in a state where government seeks to provide for a diverse population in areas with widely varying economic conditions, Hood says. "Health care is the economic engine of many of the communities in this state," she says. For its part, EMHS covers about 70% of Maine's land mass and 40% of its residents.
Hood is now collaborating with the state Department of Health and Human Services and other providers to explore improving the delivery of mental health services in Maine. Counting The Acadia Hospital in Bangor, an acute psychiatric facility, as one of its members, EMHS is working to address fragmentation of physical and mental health services. As Maine's population continues to age and the attendant mental health issues become more prevalent, viewing the complete patient makes sense, according to Hood. "It's a great opportunity to improve care for individual patients and the population as a whole," she says.
Favorite place outside work: On the water
Leadership icon: W. Edwards Deming, for his works on using quantitative and qualitative analysis to improve organization
Maine's biggest challenge: Bringing the state's economy up to the national average
Maine's biggest opportunity: Business and economic development, largely through better tapping Maine workers' creativity
Best business advice: Be honest
Eastern Maine Healthcare Systems
43 Whiting Hill Road, Brewer
President and CEO: Michelle Hood
Members: 30, including seven hospitals
2009 operating budget: $908 million
Jackie Farwell, Mainebiz staff reporter, can be reached at firstname.lastname@example.org.