Marc Boom, CEO of Houston Methodist, is preparing for the next 100 years as his institution celebrates its centennial.
“We describe our vision for our second century with six simple words, ‘Unparalleled Safety, Quality, Service and Innovation,’” he says. “We put the words in that order purposely because safety comes first. We note ‘innovation’ because it permeates this institution. Technology and innovation are massive enablers.”
Speaking with Texas Inc., Boom reflects on Houston Methodist’s history and on how technology is transforming patient care as the focus of medicine shifts from treating disease to ensuring health. He also shares his predictions on medicine’s next frontier.
Q. How did Houston Methodist begin?
Things to know about Marc Boom
Favorite quote: “Success is not the key to happiness. Happiness is the key to success. If you love what you are doing, you will be successful.” Albert Schweitzer.
Leadership philosophy: “My most important job as CEO is to reinforce and protect the values and culture of the institution. Then hire the best people who live those values, give them the resources they need, and get out of their way.”
Favorite movies:Shawshank Redemption, Saving Private Ryan.
Hobbies: Gourmet cooking, travel, collecting hand-cut wooden puzzles, pinball.
Favorite recently read fiction book:All the Light We Cannot See by Anthony Doerr.
Best recently read business book as a cautionary tale:Bad Blood by John Carreyrou.
Favorites business book: Good to Great by Jim Collins.
Favorite type of food: Carbonade flamande, which is a Belgian beef stew similar to bouef bourgignom, but made with Belgian beer. Served with homemade pommes frites.
A. Going back 100 years, a doctor named Dr. Oscar Norsworthy, who moved to Houston in the early 1900s, established his medical practice and became a prominent physician here. In fact, he delivered Howard Hughes, a famous baby. In around 1908, Norsworthy built 33 beds in a wing off the side of his home to take care of patients.
Q. The hospital was attached to his home?
A. It was the old days. Medicine was fantastically different then. Hospitals were very different — no antibiotics, they barely had anesthesia, and people did not completely understand germ theory. Surgical techniques hadn’t really been developed. Years ago, in medicine, we could do very little. Often times, the medical profession did more harm than good, and hospitals were often places where patients went to die. It was only at the beginning of the last century that we started to see an early precursor of the modern hospital.
In 1919, Norsworthy approached the Methodist Church to sell his little hospital for several reasons. He was fascinated by the use of radium and what would become the transformational use of radiation in medicine. He was also a strong proponent of high-quality, real medicine — there was a lot of quackery back then, with various concoctions causing all sorts of harms to patients. Norsworthy was involved in efforts to drive “quacks” out of the field. We were also in the middle of the Spanish flu epidemic, and Norsworthy wanted to do something bigger and more sophisticated. Little did he know what he started.
So, Norsworthy sold his hospital to the Methodist Church on the condition that they expand and modernize it. They finalized that deal on the last day of 1919. I think the final price was around $33,000, after Norsworthy forgave some of the original price. He stayed on our Board to see the expansion. In 1924, a 100-bed hospital was opened.
That was our humble beginning, starting with a founder who believed in the highest patient care standards.
Q: How did the hospital do in the ensuing years?
During the Great Depression, the hospital almost closed down. The chief clerk at the hospital, Josie Roberts, saved us from bankruptcy. She became the hospital’s chief executive and eventually brought us into the Texas Medical Center in 1951 where we opened up a 300-bed hospital.
In 1948, Dr. Michael DeBakey, a pioneer in heart and vascular surgery and a giant in American medicine, came to Houston Methodist and helped put us on the map. His accomplishments are too numerous to list. There’s a famous innovation story about how DeBakey went to a fabric store looking for a material to use in vascular surgery, but the store was out of the material he wanted, so he bought a new material called Dacron, which he then sewed with wife’s sewing machine and used in a patient. And it worked! Dacron is still used today.
Over the last 30 years, we’ve been caring for citizens around Houston and around the globe. We’ve become a health care system with over 2,000 beds, 24,000 employees, eight hospitals, a research institute, a specialty physician organization, a primary care physician organization, global healthcare services, and thousands of affiliated physicians. We win numerous awards by focusing on the patient as the center of everything. We’re consistently rated one of America’s “Best Hospitals” by the U.S. News and World Report. We’re faith-based and believe that spirituality plays an enormous role in health care. We’re also values-based and have a set of values called “I CARE” — Integrity, Compassion, Accountability, Respect and Excellence. Our flagship hospital, Houston Methodist Hospital is the largest hospital in Houston with almost 1000 beds. We are not Houston’s largest health care system. Our goal was never to be the biggest, it’s to be the best.
One of my dreams is to give Norsworthy, Roberts, DeBakey and other remarkable people in our history a present-day tour. They’d be proud and astonished at what could happen in 100 years! So when we develop a time machine, that is my first goal.
Q. What are Houston Methodist’s most important accomplishments?
A. I’m most proud of the care we’ve given to millions of people and the countless lives that we’ve impacted.
This place has innovation in its DNA; it’s our future. We built a research institute structured to advance new things — medications, devices, surgical techniques — to patients as rapidly as possible. We’re also focusing on digital innovation. Health care is an interesting field because, more often than not, technology has actually increased rather than decreased the cost of the health care. That cannot continue in the future. We see a huge opportunity in utilizing technology, particularly digital technology, in transforming how we provide care.
Q. Why hasn’t technology decreased costs in health care?
A. On the digital side, electronic records have not really made doctors, nurses and other caregivers more efficient. The goal is to give caregivers more face-to-face time with patients, enriching that experience. Unfortunately, over the last 20 years, technology has tended to pull caregivers away from patients. But I believe we are at a turning point where technology is starting to improve efficiency. If you refill prescriptions or have virtual visits through apps, then technology has already made your experience more efficient. We have to make our clinicians’ experiences more efficient also, so they spend more time with patients. We’re not 100 percent there, but I think technology will enable that.
Q. What are some examples of how you’re using technology to enhance patient care?
A. We are the only health care system in Houston offering virtual urgent care 24/7. You can go to the My Methodist App on your cellphone and get an appointment anytime. Within minutes, you’ll be connected to a live physician. You will see a doctor, using something similar to FaceTime. The physician can diagnose, prescribe medications, recommend emergency care, if needed, and arrange a follow up. It’s incredibly convenient, patient-friendly and affordable. We have been piloting this internally with our employees for about a year and recently went live. It’s ramping up at a reasonable pace. That is just the tip of iceberg in terms caring for patients more efficiently, on their time schedules. No waiting in a waiting room. You don’t have to drive to an urgent care center. That’s a simple but impactful example of the massive transformation underway in digital health. A lot of specialty care and distance medicine will be provided in this way. In a huge state like Texas, with so many small towns, if you’re a patient and need anything more than primary care, you may have to drive hours to a large city. Some of that care can be done much more efficiently through the App.
We’ve also aggressively implemented “My Charts,” so our patients can access their medical records and test results, handle billing, communicate with physicians and refill prescriptions online.
We are piloting computerized bots which do some mundane tasks, like credentialing functions, freeing people up to interact more with patients. We have a chat bot online called “Mia,” (Methodist Interactive Assistant). Mia is available online 24/7 to help job applicants. She prescreens applicants, answers questions, and gets the applicants’ resumes into the system. We’re hiring people through this process.
On a robotic basis, our main campus has two robotic security guards called Holmes and Watson. They have a 360 degree view and are eyes and ears for extending the activities of our security guards. A security officer at the control center can talk to anyone through them. We have other robotic activities happening in Tele-health. Across our emergency rooms, a highly skilled stroke neurologist can assess patients from a distance, when every second counts. We can’t possibly put such specialists in every emergency room everywhere, but we can put them there remotely. There are many opportunities, and you’ll see many more in the future.
Q. With respect to patient care, what areas need the most improvement?
A. I think the biggest frustrations in the US healthcare system are related to efficiency. When people need to see specialists, they have to wait. When they need an MRI, it’s complicated to get in. Healthcare is a large complex system. We think we can make the experience much better, from a digital innovation standpoint.
The clinical and research innovation side also needs improvement. In changing healthcare, we want to get a new procedure — or new drug, or new device — quickly to the patient. Through the lens of our core focus on safety, quality and service, we ask: “Will this make our patient’s lives better?” We need to try many things to find what works best and then quickly implement those things.
We created the Houston Methodist Center of Innovation to devote time and resources to innovation and to help us expedite our advances. It’s being led by Roberta Schwartz and her team, “DIOP,” which stands for “Digital Innovation Obsessed People”. This resulted in dedicated resources to tackle these issues.
So, for example, a typical advance may be discovered in a basic science laboratory. If it’s working in mice, we think maybe it will work in people. Most of the time it won’t, but if it does, the average advance time to patients is around 17 years, with a cost of a couple billion dollars. The tragedy of modern medicine is A) an advance will take 17 years to get to patients (of course, it can’t happen in two minutes either). Or B) the advance never gets to patients.
Our research institute was built with the goal of reducing those 17 years and that two billion dollars, while increasing the success rate. We do this through infrastructure that supports avoiding mistakes that require repeat studies and facilitating collaboration with colleagues — getting people in different specialities talking together about how to tackle big problems. We’ve also created a philanthropic structure to help provide seed funding that isn’t available anywhere else.
Q. What will Houston Methodist look like 10 years from now?
A. The future is bright as can be. We’re well positioned in Texas and can compete with any of the leading medical centers anywhere. We will continue to grow, serve Houston, and lead the way in transforming patient care.
I think the next frontiers in medicine are in neuroscience and psychiatric science, which are obviously interrelated. In those fields, we are in a similar position to where we were with heart disease 30 or 40 years ago and where we were with cancer 20 years ago. We will see a transformation in what we can do for patients. It’s a very exciting time.
Q. What do you see happening in psychiatric care?
A. I think we are entering a transformative time in mental health care, along with neuroscience and neurological care. For centuries, psychiatric illnesses have been poorly understood. However, our understanding of the brain and nervous system has been exploding, and our ability to impact mental health is at an inflection point. We have a major strategic focus in the area, and we are the only (private) hospital system in Houston to have inpatient, acute psychiatry beds for patients in need. We are focused on moving to the next level and creating a wonderful future for mental health care.
That said, mental health is the greatest crisis and challenge area that exists. It’s a terrible challenge everywhere. For a whole host of reasons, mental health care has been poorly understood, poorly accepted, and poorly funded. Even for people with insurance coverage, mental health has been a neglected area nationally and worldwide.
Q. Why is that?
A. It’s complex, of course. There are many reasons, not the least of which is that psychiatric illness has carried a stigma for many, many years. One of the best things happening in healthcare and our culture is that there is broader recognition that there shouldn’t be any stigma attached to mental illness. The patient with depression or schizophrenia or anxiety or bipolar disorder is no different than the patient with high cholesterol or diabetes or high blood pressure. Part of their body, part of the processing, the chemical balances, or the pathways in their bodies have gone awry. There are genetic, environmental, and body-change components, whether we’re talking about mental illness, heart disease, or diabetes. When we think of it this way, the stigma disappears. I’m very optimistic about the future, and I think we are collectively and culturally rethinking mental illness.