Northwell Health

Thomas McGinn, M.D., Lisa Alvarenga, Northwell Health

Thomas McGinn and Lisa Alvarenga

Facilitating Integration

Editors’ Note

Previously, Dr. Thomas McGinn served as Northwell Health’s senior vice president and executive director of Medicine Services and chief of the Division of General Internal Medicine at Mount Sinai Medical Center. McGinn, chair and professor of medicine at Hofstra Northwell School of Medicine, is a diplomate of the American Board of Internal Medicine, earned his medical degree from SUNY Downstate College of Medicine in Brooklyn, and completed his residency in internal medicine at the Albert Einstein College of Medicine/Bronx Municipal Hospital Center. He also received a Master of Public Health degree from Columbia University.

From 2010 to 2017, Lisa Alvarenga served as Northwell’s vice president of Medicine Services. Prior to Northwell, Alvarenga assumed positions with progressive responsibilities at the former North General Hospital in Manhattan, including associate administrator of Ambulatory Care, senior vice president of Planning, and executive director of the Diagnostic and Treatment Center. Alvarenga holds a bachelor’s degree from the University of Pennsylvania and an M.B.A. in healthcare administration from Baruch College/Mount Sinai School of Medicine.

Would you describe your effort to integrate your physician network?

McGinn: Lisa and I are setting up what we’re calling the Office of the Physician Network, which includes various entities that need to interface and connect better. We’ve also grown a large independent physician association (IPA), and we have a very large joint venture arm.

In addition, we are bringing in more medical practices that are maintaining much of their infrastructure and will not be folded into the various service lines.

We needed a central office that coordinates all of our joint ventures, large medical groups, all of the health system’s clinical service lines, and the IPA. We also needed to put some strategy around it, so that was the thought process behind it.

Lisa and I are here to facilitate integration and best practices among these different entities throughout the entire network.

Historically, service lines had been thought of to be focused on their own areas. How important is it that there be close coordination across all the lines?

Alvarenga: It’s essential. Those opportunities exist, and we have to figure out how to bring them to the table quickly, particularly as we face growing competition in some of the markets on Long Island.

This is all very new, but everybody acknowledges those opportunities exist.

Historically, there has been a great deal of collegiality across the service lines, but this formalizes it.

For Northwell Health, what role will the hospital play going forward, and will the outside facilities continue to grow?

Alvarenga: There’s always going to be a need for in-hospital care but more services are being delivered in an ambulatory setting. It’s what the consumer wants and what makes the most sense from an economic point of view and a patient safety point of view.

McGinn: There will have to be some continued shifts, particularly in the smaller hospitals. The biggest change agent is going to be ambulatory service centers and it will start to change the definition of what a hospital is.

We predominantly have an outpatient organizational infrastructure, but it still includes inpatient. It also includes all physicians within the Northwell Health system, so much of this is about transitioning communications and the integration of health data.

How important is it for a large leading health system today to have the education component?

McGinn: Ours is an innovative medical school that is forward thinking and integrated with an innovative health system that is also forward thinking. Without the medical school and the research center, we wouldn’t be attracting the talent we are. We’re using our talent pool the minute they are ready, and it’s the engine behind a lot of creativity and innovation and will continue to be so for the future.

There is a lot of interesting back and forth between the community providers and the academic clinicians. Being a new school and relatively new on our research front, we’re more open to the back and forth with the community providers, which is a strong point of our health system.

What efforts have gone into enhancing the patient experience at Northwell Health?

Alvarenga: We are spending a great deal of time investing in what the health system has coined “the culture of care.” We’re making sure our teams have the tools necessary to keep patient-physician relationships from being minimized.

We spend a lot of time with staff reviewing the patient experience on an ongoing basis. It’s a challenge, but we’re lucky that we are a very innovative organization that introduces new tools all the time to enhance the patient experience.

What makes Northwell Health so special?

McGinn: It’s an organization that doesn’t box one in, so it allows people to take on challenges important to them and search for solutions. It’s less rigid in terms of job descriptions, so there is always opportunity to work outside the confines of one’s well-defined role.

How important is it that the diversity of the patient base be mirrored within the workforce?

Alvarenga: Northwell has a tradition of women in leadership positions. As we expand into new geographies serving an increasingly diverse group of patients, it is important that our workforce reflect the populations we serve. It is an ongoing focus that has become more important over time.