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SDBJ Q&A: Tackling Two Roles at Palomar Health

HEALTHCARE: Ryan Olsen Creating ‘Integrated Delivery System’

For Ryan Olsen, the motivation behind his dedication to his dual roles of chief executive officer of Palomar Health Medical Group and chief operating officer of Palomar Health comes not from prestige of title, but from the satisfaction of service.

“I think that leadership is an honor,” he said. “I believe in the concept of being a servant leader in which you’re there to facilitate removing barriers for the staff and physicians; they’re the reason that I have a job in healthcare. I come at it from that mentality.”

Ryan Olsen
CEO/COO
Palomar Health Group/
Palomar Health

Olsen said he chose his path in healthcare after witnessing different illnesses impact his family and the communities he grew up in – Chicago, New York, Los Angeles, and the Bay Area.

“I really felt I wanted to be in healthcare on the provider side,” he said, but was “inspired to change paths” toward healthcare management by a retired Air Force colonel he met working in an assisted living facility while completing his undergraduate studies at UC San Diego.

“He said, ‘From my experience, if you can serve the people that are running the organization, it’s going to bring you great satisfaction.’ That’s when I made the transition,” Olsen said.

After completing his undergraduate degree In Health Sciences, Olsen went on to earn a Master of Public Health and Health Service Policy & Management degrees from the UCLA Fielding School of Public Health.

Following post-grad studies, Olsen went on to work across several health systems including Providence St. Joseph Health, Cedars-Sinai Kerlan-Jobe Institute and MemorialCare Saddleback Medical Center in chief executive and chief operating officer roles before taking the CEO role at Palomar Health Medical Group in 2020.

Last year, Olsen expanded his role at Palomar by taking on the job of chief operating officer of Palomar Health, which he said was partially driven by the “shrinking nature of healthcare to grapple with administrative costs.”

“But more importantly, it’s creating an integrated delivery system with continuity between the medical group and the hospital,” he added and cited the example of radiological studies at Palomar. “In the hospital and on the medical group side, you can create an integrated patient care model in which different radiologists have specialized and results are given to the highest priority. Integrated systems are creating those bridges that weren’t necessarily there before.”

In addition to his dual leadership roles at Palomar, Olsen still finds time to train and compete in triathlons; coach and play basketball with his three children; and serve on the boards of the UCLA Health Services Alumni Association and the UCLA School of Public Health Alumni Association.

The San Diego Business Journal recently caught up with Olsen to learn more about his work at Palomar Health and some of the key issues, from his vantage point, facing healthcare today.

SDBJ: A recent report shows that San Diego County’s population will soon be the oldest it has ever been, on average. How does Palomar Health prepare for these types of large demographic shifts?

Olsen: As healthcare systems, we must do everything we can to deliver the extraordinary care that Palomar Health is known for.

We must be excellent for all generations of care, and our focus on an integrated delivery system is an element of delivering to the older adult population. It is essential to structure our network of care strategically – creating convenient locations for primary care to ensure patients stay healthy; and the hospital care when patients need it.

We achieve this by focusing on high-volume, high-quality centers of excellence like orthopedics and cardiac care and ensuring the community has local access to ICU and emergency care. For example, you might have to make sacrifices and bring local center of care into one hospital, like we’ve recently done with our OB services at Palomar Medical Center Poway. This decision, although difficult, presents an opportunity for expansion of the much-needed adult services in Poway: adult medical surgical, intensive care and emergency department beds. Additionally, this transition has also allowed for an even more comprehensive obstetric, neonatal and pediatric care center of excellence in Escondido.

Post COVID, what has stayed and what has returned to ‘normal’ operations in healthcare?

In outpatient care, if you look prior to the pandemic, merely 8% of our visits were telehealth. Throughout the pandemic, we saw roughly 80% of visits through telehealth. Currently, we’ve settled down in the 16% range for telehealth services.

In good news, our community is returning to their regular, in-person health screenings to ensure strong prevention. Since returning to normal operations, our general surgeons have seen cases where a tumor has grown, or another condition was manifested because patients waited to receive care during the pandemic. Our focus is to use our Palomar Health Medical Group primary care network and Jean McLaughlin Women’s Center for Health and Healing to make it convenient for patients to receive their basic recommended screenings, which are saving lives.

Within the hospital, we are all adjusting to the post-pandemic state. Like other health systems, we have experienced staff and physician burnout and are taking active steps to support and retain our team with culture of care and support for employees from our Palomar Health Foundation and leadership team. As an organization, we are embracing the “new normal” and will be there for our team, our patients and our community every step of the way.

How is Palomar Health looking at ways to address those staffing shortages? Is this going to be a long-term problem?

Hospitals and health systems across the nation are struggling to retain and recruit healthcare staff. If we focus on the nursing side first, Palomar Health’s HR and nursing leaders did an amazing job in reimagining a lucrative incentive program focused on nurse retention. This limited time program allows full-time Palomar Health RNs to earn $100,000, which will be dispersed through a three-year commitment period. We are thrilled to offer this unparalleled, rewarding program to circumvent the unprecedented supply and demand issue in nursing.

Could this stabilize over time? We’re certainly hopeful, but so many nurses have transitioned careers or gone to work in outpatient studies. We are emphasizing our focus on attracting and retaining our world-class nurses by rewarding them with the compensation they deserve at an organization that is committed to providing high-quality care to our community.

In an effort to combat physician shortages, we’ve created a physician-led model that brings back the joy of medicine to our extraordinary team. Palomar Health has done this by creating pathways of leadership and shared governance in which our world-class physicians are able to lead the organization of Palomar Health Medical Group.

We also have retention and hiring difficulties with medical assistants, lab technicians, radiology technicians and CNAs, so we are collectively coming up with innovative ways to make sure that we maintain a culture where employee engagement and retention is prioritized, no matter what role you play on our team.

How is Palomar Health looking to address the mental health crisis?

Palomar Health’s President and CEO, Diane Hansen, and my predecessor, Sheila Brown, had an incredible vision around behavioral health and how we can continue to meet the growing mental health needs of our community. Because of this vision, we’ll have a new behavioral health hospital on this campus within 3 years. That’s an exciting, necessary addition that will provide better care and an extraordinary patient experience across the continuum of behavioral health.

Dr. Scott Kane is the physician leader for our psychiatric program.  We’ve already established components of great inpatient treatment by our extraordinary team of psychiatrists, as well as our Crisis Stabilization Unit. Palomar Health has successfully built out a continuum with the behavioral health hospital being the last piece to create a full continuum to take care of the community in the way it best deserves.

California is considering implementing an Office of Health Care Affordability (OHCA) that will require reporting of data and various healthcare transactions. What effect will it have on costs, care?

Palomar Health has stayed ahead of the legislation and continues to track and report our costs. As a public institution it is our duty and honor to do so, ensuring we provide extraordinary value in healthcare for our community and that we’re aligned with working with OHCA to lower the cost of care to the highest quality. It should be noted that value in healthcare is the quality outcome divided by the cost (Porter and Lee, The Strategy that will Fix Healthcare Harvard Business Review, 2013).

Healthcare, like other industries, is being hit by vexing inflation and staffing issues, has some larger systems that are losing hundreds of millions per quarter. Palomar Health is experiencing these same pressures. We are committed to lowering administrative costs through lean process improvements and artificial intelligence in areas like scheduling and registration.

We must continue to deliver better costs to employers and patients. For example, growing our network of care has reduced the total spent per physician almost by half because we’re able to create economies of scale, a better network of care and are able to work with our local payors to create the appropriately aligned incentives around population health. We do this all while focusing on quality metrics that drive financial performance, not just cost reduction.

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