Robert C. Garrett | CEO and Thought Leader

— Davos, Switzerland Hub Culture

“In the past, the center of the health care universe was the hospital.

The future center of the health care universe is going to be the smartphone.’’

“Artificial intelligence is a big game changer in health care.

Through predictive analytics we can really save lives.’’

— New York Nasdaq TV

Commentary: Lessons from Davos on how to transform healthcareFebruary 7, 2019By Robert C. Garrett

My latest trip to Davos to participate in the World Economic Forum last month was a productive and exciting gaze into the future of healthcare delivery: a world of healthcare with no address, greater immersion in population health strategies and a global push to advance mental health treatment.

It’s a sizable agenda for four days and many of us emerged with a renewed commitment to partner to improve outcomes and reduce costs, to continue our investments in technology that’s radically changing care delivery, and to expand the march to value. Here are four takeaways from my conversations with global and national healthcare leaders:

First, we are moving at lightning speed in advancing technology, especially in the realm of telemedicine, developments that are truly transformational and deserve complete support. In a sense, smartphones are allowing us to live in a world where healthcare has no address and we can connect with our physicians from our bed if necessary. Kaiser Permanente has set the bar in America with half of its total patient-physician encounters annually conducted through telemedicine. Our network and many others are rapidly expanding this vital service.

Globally, technology is even more transformative. China’s largest online health platform, Ping An Good Doctor, just announced a pilot of “one-minute clinics’—1,000 units that look like a vending machine attached to a telephone booth that provide online consultations and carry 100 categories of common drugs cryogenically refrigerated to ensure quality. The Jetsons could not have dreamed up this advance.

Second, let’s move faster to integrate population health strategies into care delivery. In a world with 2 billion people over the age of 65 and 76 million baby boomers in the U.S. hitting their golden years, healthcare must adapt. This means more community-based care, more longitudinal care rather than episodic treatment and a renewed commitment to focus on prevention so we can slow the arc of spending for future generations.

Why? There’s an urgent need to address chronic illness. Diabetes alone costs $727 billion to treat worldwide – that’s 12% of total spending on adults. Meanwhile, depression is not only one of the costliest chronic illnesses, it’s also the major reason people are too disabled to work.

Third, Davos is the perfect incubator for potential partnerships and leveraging partnerships is a core business strategy for so many healthcare organizations in the U.S. and globally. Partnerships deliver value for patients, employers and payers, with innovative approaches that give consumers what they want, even as their needs evolve. Hackensack Meridian Health’s recent merger with Carrier Clinic, a highly respected behavioral health provider in New Jersey, is expanding access in every sphere of care: inpatient, outpatient and addiction treatment. We plan to open new drug treatment centers, including one this year, as well as New Jersey’s first behavioral health urgent-care center. This strategy will divert patients from the emergency department, get patients the expertise they need faster and more conveniently and lower costs.

Fourth, and it builds on the previous point, we must harness our collective will to radically improve the treatment of people suffering from mental illness and substance use disorder. I was so heartened to learn that Prince William and New Zealand Prime Minister Jacinda Ardern were the hot ticket in Davos. So many wanted to attend their discussion on mental health.

It takes a village to improve care at home and abroad to expand access so that all citizens can enjoy health and obtain treatment that’s more convenient and affordable. Here’s to bringing many success stories to Davos in 2020.

“ It’s a sizable agenda for four days and many of us emerged with a renewed commitment to partner to improve outcomes and reduce costs, to continue our investments in technology that’s radically changing care delivery, and to expand the march to value. ”

As a health care leader for 35 years, I have watched with pride how our collective will to save lives and improve the quality of life in New Jersey and the nation has paid huge dividends. Deaths from cancer plummeted 25 percent in a generation in the U.S. Joint replacement grants us decades of extended mobility our grandparents could only dream of. Precision medicine is on a path to make treatment almost as unique as our fingerprints. But there is an appalling health crisis that is on a reverse trajectory – more women are dying of complications from pregnancy and childbirth in recent years and black women are three to four times more likely to die in childbirth than white women. On Wednesday, January 23rd, New Jersey marks the second observance of Maternal Health Awareness Day. Thanks to the leadership of Governor Phil Murphy, First Lady Tammy Murphy and Health

Commissioner Shereef Elnahal, New Jersey is shining a light on this critical issue to better understand what we can do as a community to raise awareness about maternal health and safety and prevent any more women from dying in childbirth. This is a great opportunity to harness our collective will to invest in research, enhance education and improve outcomes. Remember when President Kennedy vowed to put a man on the moon? Let’s commit to doing better for our mothers with that same spirit of determination and collaboration. It’s a must. The U.S. is only one of 13 countries where the maternal mortality rate is worse now than it was a generation ago. And despite our best intentions, experts tell us that half these deaths are preventable. Additionally, the loss of 900 women in the U.S. as a result of pregnancy or delivery complications is occurring while we are spending more on care delivery. We live in the richest country in the world, yet our mothers are dying at a higher rate than mothers in some developing countries. Experts are researching several possible causes for the increase in deaths as well as the disparity

in outcomes based on race and ethnicity. High blood pressure and cardiovascular disease are two of the leading causes of maternal death, according to the CDC. Hypertensive disorders in pregnancy, including pre-eclampsia, have been on the rise in the past two decades. Our network, Hackensack Meridian Health, has significantly lowered C-section rates throughout our entire network –down to an average 26 percent, well under New Jersey’s rate of 36 percent. We made it our mission to improve outcomes. We consulted with the American College of Obstetrics and Gynecology to engage the nation’s leading experts in maternal health and labor. We selected top specialists who formed multi-disciplinary teams who meet weekly to discuss these vital issues. We also created a blue-ribbon panel of internal and external experts to ensure our goal to improve outcomes is aligned among clinical staff, hospital leaders and network executives. This panel is being co-chaired by former First Lady Mary Jo Codey and Kathy Ellis, a member of our Board of Trustees. Additionally, the Hackensack Meridian School of Medicine at Seton Hall University is deeply committed to eliminating racial and socio-economic disparity in health outcomes. A key feature of the innovative curriculum is the focus on community-based care and the social determinants of health. Many other health networks and community organizations are working tirelessly to change the narrative. The Partnership for Maternal & Child Health of Northern New Jersey deserves much praise for their aid of pregnant women, including conducting daily outreach in many communities to help women access health care and social services. Several other states are also working to improve the odds for women. California through the California Maternal Quality Care Collaborative (CMQCC) has been working to address high rates of maternal deaths and in the last five to seven years reduced deaths by 50 percent by focusing on best practices and listening to mothers. We are deeply committed to saving lives in New Jersey and we call on all hospitals and health networks to join the state’s Maternal Mortality Review Program, an effective initiative to track outcomes. Together, we can collaborate and end this crisis. Robert C. Garrett is the CEO of Hackensack Meridian Health, New Jersey’s largest health network.

Sunday, January 27, 2019By Robert C. Garrett

N.J.’s gains must include safer pregnancies

“ This is a great opportunity to harness our collective will to invest in research, enhance education and improve outcomes.”

The stories of furloughed federal employees trying to make ends meet are wrenching; a woman even sold her plasma so she could feed her children. With 5,000 federal employees in New Jersey going more than a month

without a paycheck in the nation’s longest shutdown, it’s imperative for all of us – neighbors and non-profits, corporations and community leaders, universities and health care systems - to lend a hand. This week, Rutgers University announced it will allow students to continue their studies even if tuition bills go unpaid due to the furlough. Restaurants and caterers are offering free meals to impacted workers in New Jersey and across the nation. Stephen Colbert is even hawking coffee mugs – inscribed with “Don’t even talk to me until I have my paycheck’’- to help furloughed workers. The silver lining in this national crisis is that we are witnessing Americans helping Americans. We take care of our own. At Hackensack Meridian Health, we announced a policy last week to waive co-pays and deductibles for furloughed federal employees seeking care in our emergency rooms and our urgent care centers. We don’t want families delaying treatment, especially when the start of the year means unmet deductibles – not to mention flu season. Other health networks announced similar policies this week, including RWJ Barnabas Health in Livingston, Holy Name Medical Center in Teaneck and Cape Regional Health System in South Jersey. This means that even more federal employees - dedicated Coast Guard forces who protect our shores and the TSA agents who make travel more secure - can get some help with their medical bills when their paycheck isn’t coming in. As a major industry that contributes nearly $24 billion to New Jersey’s economy, we in health care leadership take our role as corporate citizens seriously. And in this national crisis, it is our duty to do what millions of Americans have done so willingly - let furloughed workers know we’ve got your back. It’s heartening to watch communities and industries across the nation rally around government employees. Food banks are popping up. Some banks

are offering low-interest loans. In the nation’s capital, residents are signing up to buy a furloughed worker a beer. It is clear what resonates in these divided times: our communities are still capable of connection. This is a welcome antidote to the negative view of government most Americans express in various polls. As the furlough continues, families go without paychecks and increasingly there are real-world complications for the rest of us. Over the weekend 10 percent of TSA workers called in sick, saying they could not report to work due to financial limitations. While our elected leaders try to reach an agreement, let’s continue our efforts to help furloughed employees and be inspired by the can-do American spirit on display in our communities and our neighborhoods. We’re witnessing countless efforts, grand and humble, in which people retreat from their hectic schedules and put someone in need in their orbit. There’s a touching story of a woman in Atlanta, a furloughed TSA agent who turned to a local food pantry when she couldn’t afford groceries. Despite the stress in her own life, she made sure her colleagues knew about the program and drove them there if they needed a ride. There’s the chef in Memphis who was scrolling through his Facebook feed late at night and was moved to action because so many neighbors and friends were fearful about providing for their families as the furlough dragged on. The chef posted online asking people to help out. He awoke the next morning to an army of volunteers pledging on-line to help. Dozens of families have enjoyed his Tuscan spinach chicken. Here’s to hoping this collective goodwill inspires our leaders in Washington to reach an agreement. Robert C. Garrett is the CEO of Hackensack Meridian Health, New Jersey’s largest health network.

Thursday, January 24, 2019By Robert C. Garrett

NJ comes together to help those furloughed

“ It is clear what resonates in these divided times: our communities are still capable of connection.”