Dr. Benjamin Schwartz is president of Corewell Health East, where he leads strategy and corporate decision making for eight hospitals, 155 outpatient sites, and nearly 5,000 affiliated physicians. Dr. Schwartz is board certified in gynecology as well as OB-GYN and has been named a New York top doctor in gynecologic oncology for the past six years. Dr. Schwartz previously served as senior vice president and the physician executive for the Eastern region of Northwell Health in New York, and also serves as an associate professor at several institutions. Dr. Schwartz, welcome to the show.

0:00:51 Muthu Alagappan: I always like to start from the beginning. So the beginning of your career, what first got you into healthcare and helped you decide to become a physician?

0:01:55 Muthu Alagappan: You're now in a leadership position. What was that transition like? Was it conscious, deliberate decision to leave the practice of medicine and move into this type of a role or did it just happen organically?

0:04:07 Muthu Alagappan: Do you miss practicing medicine in your day-to-day job? And if so, how have you dealt with that transition out of that?

0:05:31 Muthu Alagappan: Great. And so you were named president of Corewell Health East in June of this year. Most people are familiar with what it's like to transition jobs, but transitioning health systems, especially at this level, is a very different experience. What was that transition like, leaving Northwell and joining Corewell?

0:09:31 Muthu Alagappan: And so you get into this new system. You're the president now. What are your five-year goals for the system? Where do you want to see Corewell Health East get to in 3-5 years that you're sort of energizing the base around?

0:13:07 Muthu Alagappan: I'm so glad you mentioned making it a terrific place to work. So often when I ask that question, we hear all about the great ways we're going to improve the patient experience and often neglect the staff experience. So I'm really kind of glad you mentioned that. And I'd love to ask you more about creating a culture in a provider organization that's conducive to that. We had Dr. Toby Cosgrove of the Cleveland Clinic on, and he mentioned how at the Cleveland Clinic, where I know you spent some years training, everyone is called a caregiver, whether you're driving a transportation shuttle or cleaning up the operating room or doing the surgery. Are there examples of that type of culture building at Corewell that inspire you or that you're hoping to bring to the system to improve the culture?

0:17:16 Muthu Alagappan: I remember hearing once that I believe UT Southwestern, instead of just phones in the provider workrooms, they actually have video screens attached to the phones because they found that people are nicer to each other when they're on video than when they're just talking to each other on the phone. And as you know, providers, consultants, etcetera, conversations can get heated sometimes. And it was just a striking example of how environment can affect how we behave and how designing environments in a thoughtful way can really improve culture and make people feel respected and things like that.

0:19:25 Muthu Alagappan: Yeah, that's terrific. And I think we continue to be very optimistic about technology's ability to bring people together, to improve culture, to improve the experience, and so exciting to hear that. I'd love to shift gears a little bit and talk more about the recent merger that you alluded to in February of this year with Beaumont Health and Spectrum Health joining together. Mergers and consolidation are happening across the country. From the patient perspective, is this something patients should welcome? And does this ultimately affect patients either positively or negatively when large health systems come together, in your opinion?

0:22:28 Muthu Alagappan: In the case of this merger, I believe both Beaumont and Spectrum were on Epic before the merger. And so I imagine integrating those is a little easier than if you came from two different EMRs. How much of a consideration is that, do you think, during a big consolidation or merger in making sure that the EMRs are the same? Because I imagine that facilitates the record sharing and everything else that's going on.

25:15 Muthu Alagappan: Are there areas that you, in your role right now, would want to look outside of the EMR when it comes to filling a need, solving a problem, developing an innovative strategy? Where do you choose to look to the EMR and where do you choose to look outside?

0:29:00 Muthu Alagappan: We were talking about mergers and the system getting bigger and the advantages that has. One of the disadvantages is likely that it becomes harder to make decisions the bigger you are, of course. And it's also hard to make decisions because there's too many options, like you mentioned, so many different companies and ideas that are vying for your attention. I would love to hear how either at Northwell or now at Corewell, you think about the process of bringing teams together to make a decision on whether to work with a vendor or not. How do you mobilize an organization that big to make a decision and to move through the process of implementing a new technology?

0:33:46 Muthu Alagappan: Yeah, I love the idea of an almost uncoupled or disconnected sandbox where you can try and prove value. Do you think that sandbox can be shared amongst many health systems instead of having each health system have their own version of that? Could there be almost a shared demonstration environment that a company shows value in that many health systems look at to get signal on, does this work or not? Or do you think each health system is unique enough where that needs to exist in collaboration with the health system?

0:35:46 Muthu Alagappan: I'm curious, how do large health systems educate themselves on the merits of a particular vendor today? If I'm buying shoes, for example, I can try it on, I can read reviews. I've got a process for knowing how to vet one shoe versus the other. How do you do that at a health system? Are you talking to peer health systems? Are you looking at industry organizations like Class? How does it work?

0:38:35 Muthu Alagappan: So I think we've got time for one more question. And I want to ask you about automation, which we think a lot about at Notable. You mentioned at Corewell you've got 60,000 employees at Northwell, close to 90,000. I'm sure if you had the option, you'd love 10,000 more to be doing all types of value-based care and other work to make the patient experience better. But that's hard for health systems these days, finding staff and being able to hire them. What are your thoughts on automation and automation's role in the future of health care? At Notable, of course, we have a lot of excitement about automation and digital workforces helping to offset some of the administrative burden that we've found ourselves in. Do you share that same level of enthusiasm? And do you think automation is going to become more mainstream in health care in the next 5-10 years?

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