a conversation with dr. john maguire

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JohnMaguire,M.D., servesas theChiefMedicalOfficer forGeneralDynamicsHealthSolutions. Inthis capacityDr.Maguire provides oversight into clinical and health IT strategies in the government,commercialandinternationalsectors.PriortojoiningGeneralDynamicsHealthSolutions,Dr.Maguiremanaged emergency departments for the Inova and Sentara Health Systems, based in northernVirginia.Asanexperiencedclinician,Dr.Maguire’sexpertiseincluderunningfree-standingandhospital-basedemergencydepartments,administeringmedicalstaffdevelopmentandtraining,andoverseeingpatientsafetyandriskmanagement. In2010,hestoodupSimplicityUrgentCareCenter inArlington,Va.,whichoperated for fiveyearsprior tobeingacquiredbyagrowinghealth system.Dr.Maguire’sexperience also includes work with PHI Air Medical, a helicopter transport and medvac system. InadditiontohisworkwithGeneralDynamicsHealthSolutions,Dr.MaguirecontinuestoworkwithPHI

AirMedical,aswellascompleteoccasionalshiftsasanemergencyphysicianatInovaFairfaxHospital.

In this edition, Dr. JohnMaguire is virtually interviewed byDr. JohnAgwunobi, Leavitt Partners’ FuturePanelmember. Dr.Maguire discusses how healthcare technology provides ample opportunities to engage patients and improve populationhealth.

DR.AGWUNOBI:Dr.Maguire,youhavequiteanexcitingbackground.Ihavetotellyouit’salsoveryexcitingtosee that people like yourself, practicing physicians, are part of the General Dynamics Health Solutions team. IknowthatGeneralDynamicsHealthSolutionshasbeenamajorleaderinhealthcaretechnologyforover50years.Ialsoknowthatgiventhecurrentrevolutionofhealthcaretechnology,thesemustbeveryexcitingtimesforyou.

TellmeaboutthetimesinceyoujoinedGeneralDynamicsHealthSolutions.What’sgoingonthere?Itsoundslikeanexcitingcompanyatanexcitingtime,nowpartlyledbyyou,aclinician.

DR. MAGUIRE: I have a tremendous degree of interest in doing something new. I’ve been working in clinicalmedicineforquiteafewyears,runningemergencydepartments,workingonhospital-widequalityinitiativesandtakingcareofpatientsintheED.However,Ifeltlikeitwastimetodosomethingdifferent,andIwasreallyexcitedtojoinGeneralDynamicsHealthSolutions.

Manyofmypeershavegrownoutofclinicalmedicine,butGeneralDynamicsHealthSolutionswantedsomeonewhowasstilltakingcareofpatients;that’spartofwhatinspiredmetotaketherole.Althoughweareknownasasystems integrator,weprovidemanydifferent typesofsolutionsandservices forhealthcareorganizations,andwe’vebeendoingsoforover50years.Honestly,thebreadthofourworkblewmymind.Forexample,weoperatelarge-scalecontactcenters,interactingwithandeducatingbeneficiariesenrollingininsuranceprograms.Fouroutofevery10Americansengagewithourcontactcenters.

Wealsodoclinicalworkprovidingnationwidemultidisciplinaryclinicalcareandconduct research insupportofactive dutymilitary personnel and veteranswho suffer from traumatic brain injuries andpost-traumatic stressdisorder,orPTSD.

As examples of our work in the data management and analytics space, General Dynamics Health SolutionsconductsanalyticworktosupportinnovativepaymentsystemsfortheNationalHealthServiceintheUK,aswellas stateside for theMedicaid Program in Arkansas. In both cases, the reimbursements are quality-driven andreward-based,asopposedtofee-for-service.

December2015

AconversationwithDr.JohnMaguireHealthcareintelligenceinterviews

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Ourworkextendstothecommercialhealthmarketaswell,providingclinicalhelpdeskandtechnologysupportforaMaryland-basedhealthsystem.Wehopetocontinuetogrowourworkwiththemtoincludeprovidingdatawarehousingservicesandtransitioningthehospitalintoasecurecloudenvironment.

DR. AGWUNOBI: Yes. I’m struck by the fact that in this role you have not only had an opportunity to impactpatientshereintheU.S.,butgloballyalso.Youmentionedsomeoftheworkyou’redoingintheUK.Perhapsyouwanttoexpandonthat.

DR. MAGUIRE: In the UK, we provide analytics for a system that reimburses providers for delivering qualityhealthcare.Generalpractitioners,or“GPs”astheyarecalledintheUK,areequivalenttoprimarycarephysicianshereintheUnitedStates.They’rethebackboneofthecarenetworkinasystemwheretheyprovidecarefor100percentofthepopulation.TheNHScreatedasystemwhere10to15percentoftheircompensationislinkedtohitting quality metrics. We do the analytics work supporting the program, determining a GP’s success in theprogramandidentifyingopportunitiesforimprovement.

DR.AGWUNOBI:Thatisamazing.Trulyaglobalopportunityforgrowthandamazingworkbeingdonearoundtheworld and, of course, here in theU.S. In the end, theU.S. has seen quite a dramatic push or an explosion of

activity within healthcare. Healthcare legislation and conversations over thelastfewyearshavegeneratedanintensefocusonpatientsandonpatientcare,andsubsequently,therehasbeenaddedfocusonthepracticeofmedicineandphysiciansspecifically.Iaminterested,Dr.Maguire,toknowwhyyouchosetobecomeaphysician?

DR.MAGUIRE:IoftenthinkbackabouthowIendeduponthepaththatIamon. I think I can sum itupby saying I like thechallengeand I like theoutcomeofpotentiallyhelpingapatientthrough trying circumstances. In the emergency department, you’re making hard decisions with limitedinformation, or sometimes potentially incorrect information, and you have to do it rapidly. It’s an incrediblyrewardingchallenge.

DR. AGWUNOBI: Yeah, it does strikeme that todayduring the timeof technologyand technology integration,thosechallengesthatdroveyoutobecomeaphysiciancannowbehelpedandfurtheradvancedbytechnologyandbycompaniesliketheoneyou’reworkingfor,GeneralDynamicsHealthSolutions.

DR.MAGUIRE:Absolutely!AsI’veworkedthelast15to20years,Istillenjoytakingcareoftheindividualpatient,but I’m also excited by the opportunity to affect populations of patients, particularly as payment solutions,modelsofcareandtheirassociatedtechnologychangeoverthenextfivetosevenyears.

DR.AGWUNOBI:Therearesystemsandprocessesthataregoingtobelargelydata-driven.They’regoingtorequiremuchof thetechnology,databasesandskills thatyouandGeneralDynamicsHealthSolutionsbringtobear.Aswetalkaboutwherethepatientistoday,there’sasensethattheworldisevolving.Doyouhaveasenseofwhatthefuturelookslikeforpatientcareandforpatientsindividually?

DR.MAGUIRE: Right now it sounds almost ominous. There are farmorepatientsthan there are primary care physicians to care for them; however, there areopportunities to address that issue using differentmodels of care. Ifwe considerthe millennial generation, we get a high percentage of 20 to early 30-year-old

Thereistremendousopportunitytouse

technologytomonitorandcontrolpartsoftheirownhealth,creatingamuchmoreengaged

groupofhealthypatients.-Dr.Maguire

IlikethechallengeandIliketheoutcomeofpotentiallyhelpingapatientthroughtryingcircumstances.

-Dr.Maguire

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patients who are healthy and rarely visit the doctor. I think that there is tremendous opportunity for thatdemographictousetechnology,suchaswearabledevicesandvirtualhealthcoaches,tomonitorandcontrolpartsoftheirownhealth,creatingamuchmoreengagedgroupofhealthypatients.Furthermore,patientswithreadilytreatable conditions like hypertension should easily be monitored remotely with more frequent input from a“health coach,” rather than waiting extended durations between primary physician visits. Care plans forstraightforwarddiseasesshouldbeprotocol-based,onlyoccasionallyneedingphysicianinput.

DR. AGWUNOBI: It’s almost a “back to the future” typeanalogywherehealthcare comes to thepatient, stayswiththepatientandfollowsthepatientcontinuously,butit’snotreallyaboutaphysicianbeinginthepatient’shome.It’sabouttechnologylinkingpatientstotheirphysicians,totheirhealthcareproviders.

All of us at different times will be a patient of a healthcare system. Give me yourthoughts onwhat the patient sees today as he or she interactswith healthcare andhow we might all try to make healthcare a more accessible, relevant andcompassionateproviderofcare.

DR.MAGUIRE:Ithinkthatthecurrentsystemcanbeafantasticpatientexperienceforacutetreatmentofdiseaseorinjury.Unfortunately,the“system”isnotpatient-centric.Health records are health system-centric, not portable, and not entirely open to thepatient. This plagues the patient with multiple chronic medical problems. Until

incentivestrulychangeandwesolvetheproblemsofinteroperability,lifeasapatientwithchronicproblemswillremaindifficult.Despite these challenges, paymentmodels are changing and the industry iswell-positioned toleveragenewtechnologytosolvetheseproblems.Thereisalightattheendofthetunnel.

DR.AGWUNOBI:Onceagain,thatkindoftechnologyisgoingtobeabigfacilitator.It’sgoingtohelpdramaticallyaswetrytoimprovetheoverallhealthcareexperienceortheexperienceoflivingwithillnessorpassingthroughdisease.Technology isgoingtohelpnot justtheproviders,doctors,systemsandpayers,butultimately it’salsogoing to improve the patient experience. And I get the sense as I listen to you, Dr. Maguire, that patientengagementandpatientexperiencearecriticallyimportanttoyoupersonally.

AsyoulookoutintothefutureandfromthestandpointofyourrolenowatGeneralDynamicsHealthSolutions,whatexcitesyouthemost?

DR. MAGUIRE: Across the spectrum of expertise at General Dynamics Health Solutions, it’s easy to see thepositiveimpactthecompanyishaving,fromengagingandconnectingpatientstotheirhealthcarethroughcontactcenters, toworking at the forefront of datamanagement and analytics to drive better health information andrewardqualitycare,todeliveringmedicalresearchprogramsandoutfittingadvancedmedicalfacilities.Thegreatthing isthat Istillgettoworkwithpatients,andthroughGeneralDynamicsHealthSolutions, Igettoworkatamoremacro-levelandimpactlarge-scalehealthinitiatives.It’sanhonorandagreatopportunity.

DR.AGWUNOBI:Well,itdoessoundlikeexcitingworkandanexcitingfuture,andIcongratulateyou.Itlookslikeyou’re going to continue to impactmany patients and lives in your current role. Thank you. It’s been such anhonor speaking with you. Is there anything else we haven’t covered that you really want to include in theconversation?

DR.MAGUIRE:Weneed togetourarmsaroundusing technology tomanagepopulationsofhealth. Therearemanyopportunitiestousetechnologytomaintainthehealthofpatientsoutsideofhospitals.Whenyouinteract

Unfortunately,the“system”isnot

patient-centric...Thisplaguesthepatientwithmultiplechronicmedicalproblems

-Dr.Maguire

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withtechnologyonaday-to-daybasisviayourmobilephone,thesimplicityofthedeviceisamazing.Weneedtotakethatsametypeoftechnologyanduseitintermsofhowpatientsinteractwiththeirhealthcareproviders.It’sthose littlesteps therethatwillmakethemostdifference in the individualpatients’ livesand inpopulationsofpatients.Weneedtoleveragethattechnology.

DR.AGWUNOBI:Outstanding!Thankyousomuchforspeakingwithus.