Healthcare Matters

We’ve all heard it said, “there’s no such thing as bad publicity.” The theory goes that even if what’s being said is awful, the publicity is still supposed to be good because your name is on the top of people’s minds, keeping you relevant. What a crock! The idea that there’s no such thing as bad publicity is absurd. What do you think British Petroleum (BP) might have said after the oil spill in the Gulf? How about Toyota after all the recalls or Tiger Woods after his dalliances became public? The truth is, bad publicity has done serious damage to brands of all types and sizes.

Just ask UPMC.

Pittsburgh’s venerable health system just announced a significant 5 year $100 million deal with Oracle (yet another lightening rod) to build a next generation healthcare analytics platform that should prove significant for the entire industry. But when you “Google” UPMC to dig a little deeper into what’s being said about this high profile big data initiative, it’s overshadowed by a rash of bad and recent press. You get one part sugar and three parts bitters. Not that UPMC hasn’t shown great resilience in shaking off what it views as parochial criticisms, but this time it’s a little different.  An  investigative series exposing the extent of UPMC’s empire building was very recently published in the Pittsburgh Post-Gazette. And local politicians are now calling for UPMC’s nonprofit head with far less constraint than they have historically.

The juxtaposition is compelling.

• In a press release published just yesterday, UPMC and Oracle introduced their big data initiative by asking the following questions: “What if a doctor could easily predict which treatment would be most effective and least toxic for an individual breast cancer patient, based on her genetic and clinical information? What if an intelligent electronic medical record could flag patients at risk for kidney failure, based on subtle changes in lab results? Or what if physicians could tell from the medical records of a large population of patients when the next outbreak of flu might occur and have the right kind and quantity of vaccine ready? The press release indicated that these are just a few of the scenarios behind the initiative. UPMC’s Chief Medical Officer, Dr. Steven Shapiro, talks about the initiative using language that should be near and dear to readers of this blog. Shapiro says, “We’re trying to develop evidence-based pathways; and once we develop some standards around care delivery, we’ll see where that leads us. But it’s really about reducing variation and optimizing care models,” he emphasizes. “From a population health standpoint, we need to standardize care delivery and reduce variations in care, and then add that variation back to the individual, once we understand the individual patient’s disease profile.”

• But in yet another story published in yesterday’s Pittsburgh Post-Gazette entitled, “UPMC Should Put Civic Duty Over Profit,”  a local city council person made her feelings well known: “It has become clear that our community can no longer afford its current arrangement with UPMC… while things are working out great for UPMC’s bottom line, the same cannot be said for the rest of us.” Everything from attacks on its business practices and executive leadership to very directed queries aimed at calling UPMC’s tax exempt status on the carpet.

UPMC is a bonafide industry leader in medical research and healthcare information technology development. And if you do the math (I’m not sure Pittsburgh’s local media has), at more than $500 million in reported annual charitable care/contribution, it probably meets the antiquated standards for tax exempt status while most nonprofits in the US don’t even get close. But none of that matters. It doesn’t because UPMC is awash in bad press, mostly of its own doing, and it’s catching up now and having an impact that cannot be quickly dismissed, regardless of how close its executives can circle the wagons.

The standards for tax exempt status –especially in healthcare— need to be re-visited, re-written and actually enforced. If such standards were tied to KPIs  meaningful to the communities at whose convenience these organizations serve, then compliance could be readily determined and everyone could get on the same page. Adding 30 million to the list of insured is going exacerbate the problem, so it’s time to fix it properly and eliminate these senseless tugs of war.

—Tom Finn