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Robert I. Grossman, M.D., NYU Langone Medical Center

Robert I. Grossman

Patient-Centered

Editors’ Note

Robert Grossman, M.D., assumed his current post in July 2007. He joined NYU Langone Medical Center in 2001 as the Louis Marx Professor of Radiology, Chair of the Department of Radiology, and Professor of Neurology, Neurosurgery, and Physiology and Neuroscience. In 2010, he received the International Society for Magnetic Resonance in Medicine (ISMRM) Gold Medal for his pioneering research in magnetic resonance in medicine and biology. He was also named a Distinguished Graduate of the University of Pennsylvania School of Medicine and was awarded an honorary doctorate from the University of Bordeaux, France. Dr. Grossman has authored over 330 publications and five books, including Neuroradiology: The Requisites, a best-selling textbook with over 50,000 copies sold. He also served as Editor-in-Chief of the American Journal of Neuroradiology from 2005 to 2007. Above all, Dr. Grossman is a passionate educator, training over 100 fellows, many of whom occupy prominent positions worldwide.

Institution Brief

One of the world’s premier academic medical institutions for over 175 years, NYU Langone Medical Center (nyulangone.org) is a leader in patient care, education, and scientific research. It is internationally recognized for evidence-based care across an array of specialties, including its five leading clinical areas: cancer, cardiology and cardiac surgery, musculoskeletal, neurology and neurosurgery, and children’s services.

What are your key priorities for adapting to future change and remaining an industry leader?

Our number-one priority at NYU Langone is to provide the highest quality of care and value for our patients. This includes ensuring ease of access and a commitment to protecting their needs throughout the continuum of care. In today’s healthcare environment, much of what used to be done on the inpatient side is now being done in an ambulatory setting. For us, this means offering patients convenient access to care in the neighborhoods in which they live and work, and also reducing our reliance on high-cost hospital-based care. Our goal is to place patients in the hospital only when absolutely necessary – and when it is, to guarantee that patients are coming to an institution that has the highest quality and safety standards.

Today, we have more than 100 sites throughout the New York metropolitan area and about 2,700 physicians in our clinically integrated network. Our expansion is underpinned by a single electronic health record (EHR), which works on both the inpatient and ambulatory side. Our EHR collects patient data across many different locations and stores it in a database. Information is logged into the system in real time, permitting an entire treatment team to have a patient’s most current data at their fingertips. In addition, it’s used to order tests, prescribe medications, file electronic insurance claims, and for billing and scheduling.

Patients can also access their records on their iPhones with MyChart, our patient portal. They appreciate this convenience and it’s been very successful.

Would you discuss what “value-based management” means at your institution?

Value-based management (VBM) is quality divided by cost, which means providing the best care in the most affordable way possible. In other words, improving quality without raising costs – or lowering costs without jeopardizing quality – and this requires innovative solutions.

At NYU Langone, we’ve developed shared goals, created a collaborative culture, and have set a standard in which leadership is never satisfied with the status quo. We’re always looking to engage multidisciplinary teams – from clinical to corporate – to drive quality improvement focused on the development of evidence-based care delivery protocols, the management of high-cost outlier patients, and improving the efficiency of operational and corporate service functions. We believe our efforts are working. For the second year in a row, NYU Langone ranked number one for overall patient safety and quality among leading academic medical centers nationwide that participated in the University Healthcare Consortium Quality and Accountability Study (UHC).

Another thought in terms of delivering value: We’re currently piloting a bundled payments program to assess whether improved cost transparency can significantly lower the cost of Medicare. The pilot is focused on total joint replacements and cardiac valve replacements. Since launching it in January 2013, we’ve already seen impressive trends in these areas with significant decreases in length of stay, discharges to inpatient rehabilitation units, and 90-day readmissions.

You’re known as a very engaged leader and often talk about empowering people and building the team around you. Would you discuss this philosophy of leadership?

My feeling is that in order to have a really great institution, we have to build great teams, and we take enormous pride in our teamwork. We’ve committed ourselves to breaking down silos and sharing information on an institution-wide basis. For example, we don’t have NYU School of Medicine versus NYU Langone Medical Center issues – it’s all one culture. It’s actually what enabled us to respond rapidly to the devastation of Hurricane Sandy and emerge stronger as an institution and a community.

The NYU Langone brand has been reinforced around your Made for New York campaign. Are you surprised to see how quickly it’s caught on?

To be honest, not really. It’s difficult to stand out in a crowded field but I think our approach has been smart and effective. We’re proud to be a creative, nimble, and patient-centered medical center, offering the best we have to give. When we thought about it, we said, “Well, that’s what New York is all about – offering the best of everything.” The best restaurants, museums, and theaters are right here. Out of this grew the idea, “We’re made for New York.” I also think there’s a message in the campaign that speaks directly to everyday New Yorkers. We’re saying, “We’re here for you – wherever you are – in sickness and in health.”

What do you say to young people who want to pursue careers in the healthcare industry?

It’s a great time for them to get into healthcare. There are so many exciting opportunities. The provision of healthcare is a great profession. You never have to worry about your purpose – it is clear: to relieve the burden of human suffering. There is no more noble calling.•