I grew up on a dairy farm in central Wisconsin. My parents’ encouragement and my interest in science, especially biology and math, led me to pursue a career in medicine.
My husband, Peter Rothe, and I graduated from the University of Wisconsin, Madison Medical School and completed our residencies in internal medicine at the University of Minnesota. We practiced together in Tomahawk, Wisconsin, for two years before returning to Minnesota and joining the Group Health Clinic. Today, HealthPartners, previously Group Health, insures over 700,000 people and employs more than 600 physicians and dentists.
In addition to seeing patients, I took on administrative responsibilities as chief of professional services, which piqued my interest in learning more about strategies to improve quality. During my tenure as medical director for quality improvement (1995-2007), HealthPartners developed award-winning provider reporting and incentive programs. Jurors for the National Quality Healthcare Award (2007) called it “the wave of the future.” The National Business Coalition on Health recognized the program for innovation in value-based purchasing (2006).
I am proud to have helped establish Minnesota Community Measurement (MNCM), a not-for-profit collaborative reporting on healthcare quality of physician practices throughout Minnesota at MNHealthcare.org. MNCM was honored to be the site where President Bush signed the 2006 Executive Order on Healthcare Transparency.
I chair the Network for Regional Health Improvement (NRHI.org) Board of Directors and serve on a number of national committees. My career highlights include being cited in the Institute of Medicine report, Performance Measurement: Accelerating Improvement; receiving the MNCM inaugural 2007 Leadership in Measurement Award; and being offered the opportunity to lead Quality Quest for Health of Illinois.
Major Accomplishments of 2011
The Commonwealth Fund ranks Illinois 42nd on quality and 49th on avoidable costs and hospitalizations. We have the fourth-highest rate of childhood obesity. Our death rate from heart disease exceeds the national average. We are seriously underperforming.
No one—and no one organization—can change this picture alone. Organizations that purport to be doing so are failing. The citizens of Illinois are dying and suffering needlessly. Quality Quest for Health of Illinois’ goal is to improve the health of our communities and the value of our healthcare services.
Quest’s board of directors includes business, community, healthcare and insurance leaders. With their guidance, Quality Quest provides a neutral venue, also known as a regional health improvement collaborative (RHIC), for these groups to come together to address sticky healthcare problems. By working together, we create lasting win-win solutions that would otherwise not be possible.
2011 has been a landmark year for Quality Quest. Most notable has been the establishment of the Central Illinois Health Information Exchange (CIHIE) and allcharts. CIHIE, a nonprofit organization incubated by Quality Quest, is the culmination of two years of extensive planning involving over 200 people across a 20-county region that includes Bloomington, Champaign, Decatur and Peoria. allcharts, the connecting health information exchange software, launched in 2011. Charter member hospitals include Methodist, OSF Saint Francis, Proctor, Advocate Bromenn, Decatur Memorial, and HSHS St. Mary’s in both Streator and Decatur. Other charter members are Heartland Community Health Clinic, Easter Seals, Human Service Center and the University of Illinois College of Medicine at Peoria. With patient permission, allcharts provides immediate access to a summary view of a patient’s health history. When implemented, allcharts will help patients in central Illinois get better results and they will no longer have to answer the same health-related questions over and over again.
This year, Quality Quest’s Generic Prescribing Report expanded to include 55 counties. Generic prescribing is one important strategy for managing runaway healthcare costs. Generics have the same chemical composition and effect as the branded medicine but cost about one-tenth as much. A conservative rule of thumb is that a one-percent increase in generic use decreases medication costs by two percent, for a whopping 100-percent return. Since 2008, generic prescribing has increased by 15 percent in this region.
Our employee “flu” shot reports help raise immunization rates and save lives. By preventing the spread of influenza to vulnerable hospitalized patients, it is estimated that one life is saved for every eight hospital employees who get their flu shots. Getting the shot has the added benefit of preventing employees from needing to take sick time during peak “flu” season when hospitals are busiest.
Another highlight is the Colonoscopy Quality reporting on our website, QualityQuest.org. A local quality team developed a demanding quality standard, the Colonoscopy Quality Index, which gives a doctor credit only when a procedure is completed perfectly. It’s what we all want—every step done to standard. The doctors in central Illinois have stepped up to the plate. Results were approximately 50 percent when the project started. By the first quarter of 2011, that rate was 83 percent. The reports have captured the interest of RAND, a national research organization, and the American Gastroenterology Association, which are interested in working with us on their colonoscopy quality projects.
This year, Quality Quest is aiming to end the unhealthy practice of using drugs to start labor, or performing a C-section for reasons of convenience, before the baby is ready to be born. It is a practice that has become perniciously common over the past 20 years. A full-term pregnancy is 39 completed weeks, period. Anything short of that, without a sound medical indication, puts babies at risk. The safest sign that the baby is ready to be born is labor starting on its own.
Please join us. We are transforming healthcare—together.
How has your organization adjusted to recent changes in the business climate? Accountable Care Organizations (ACO) are a part of the healthcare reform bill that has bipartisan support. Organizations that are serious about succeeding as ACOs need to compare their quality and cost to other organizations. Otherwise, they cannot be truly accountable. RHICs, like Quality Quest, are the appropriate organizations to provide meaningful local reporting for ACOs.
What is your leadership philosophy? I believe that healthcare is filled with compassionate, caring and talented individuals who are constrained by a poorly designed system. By working together, we can change that.
Did you have a mentor in the early stages of your career? I have had the good fortune of working with people who inspire and support me. Quality Quest’s board members include individuals with many talents and much wisdom. They are key to the success I have had. At HealthPartners, I reported to Dr. Maureen Reed, a friend and enthusiastic supporter. Dr. Reed and Mary Brainerd, CEO, graciously shared HealthPartners’ expertise with our competitors to create MNCM. Today, MNCM has some of the most substantial healthcare reporting resources for consumers in the country.
What advice would you give to up-and-coming female professionals? Seeking and respecting diverse perspectives makes one’s solutions stronger. Often, we do not know what we do not know. I resonate with the African saying, “If you want to go fast, go alone. If you want to go far, go together.” iBi