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Witness Testimony of Daniel F. Evans Jr., President and Chief Executive Officer, Indiana University Health

Good Morning. On behalf of Indiana University (IU) Health, thank you for your focus on improving access to health care services for our nation’s veterans. IU Health is committed to honor their service by continuing to work with our VA partners in Indiana to meet the health care needs of those men and women who have served our country in the armed services.

IU Health is Indiana’s largest and most comprehensive academic health system, and one of the busiest health systems in the United States.  IU Health has nearly 30,000 team members in more than 20 hospitals and health centers throughout our state.  IU Health is one of Indiana’s largest safety net hospitals, providing nearly $183 million in free or reduced-cost care, benefitting over 139,000 patients.

IU Health also has a unique partnership with the Indiana University School of Medicine (IUSM), the nation's second largest medical school and a national leader in medical education and research.  IU School of Medicine residents rotate between our system and the Roudebush VA medical center in Indianapolis.  

Like the VA system, the IU Health system is both complex and diverse.  Our system spans the state and includes an academic health center, one of the nation’s preeminent children’s hospitals, and 12 other community and critical access hospitals.  Our patients range from those with basic primary care needs to those with most complex or severe ailments imaginable.     

It is not easy to change any large and complex health organization, whether it is IU Health or the VA health system.  However, we at IU Health firmly believe that systematic changes are necessary. Those who pay for and receive our services are increasingly – and rightfully – demanding accessible, high quality and more affordable care.

To that end, as part of IU Health’s recent system-wide strategic planning effort, we have set the very aggressive but achievable goal of improving productivity by 25 percent over the next five years.  We know we must invest in our strengths while simultaneously finding ways to eliminate the waste and inefficiencies in many of our processes in order to bring enhanced value to our patients.

IU Health has established a system-level Office of Transformation to change the way work is done throughout our organization.  A key tool in implementing this transformation is the Lean process improvement methodology, which is used widely in other industries but is only more recently being adopted by healthcare systems.  With the assistance of the widely respected firm, Simpler, which specializes in Lean transformation, we have successfully launched Lean initiatives in all of our hospitals, as well as in our employed physician group. These projects are empowering our team members to re-shape their daily work, and have already led to an estimated $10 million in savings and improved outcomes.  For example, one of our hospitals successfully reduced its 30-day readmission rate by 38 percent using more consistent patient education.

We know that people increasingly expect to get their healthcare in the same way they get most other services today – quickly and conveniently.  They want to be able to schedule appointments online, take advantage of evening or weekend appointments, and use video visits for primary care appointments.  These are not radical concepts, except perhaps in our industry!

Responding to the needs of our patients, IU Heath now offers same day appointments to patients seeking primary care services.  Patients are given one number to call to schedule an appointment with an IU Health primary care provider either that same day or the following day.  And, patients now also have access to online scheduling, including same day appointments.  To fulfill our commitment to improved access, we are changing the way that we work.  We have worked with our primary care providers to offer extended hours at their offices to accommodate evening or weekend appointments.  We now include “access” as a component of our compensation model for primary care providers to advance the system’s overall goal of improving our patients’ ability to access our providers at their convenience.  Participating physicians have standardized the appointment types that they offer and set aside time in each day to be available for same day service.  We centralized scheduling to enable our team to balance a patient’s preference to be seen by his own provider with his need to be seen quickly in order to drive the best overall outcome. 

IU Health will continue to look for creative ways to enhance patient access by increasing the number of venues where we provide care, the way we schedule patient visits, and how we leverage technologies like telemedicine to help our patients and care teams stay connected. 

The VA academic affiliates – schools of medicine and their associated clinical group practices – have been long standing partners with the VA in accomplishing its statutory mission.  IU Health is honored to be a VA partner through a variety of means, including providing contracted specialty services to our VA partner at the Roudebush medical center in Indianapolis.  We would respectfully recommend to the Committee that they expand contracting with health systems such as IU Health to increase access for veterans to the world-renowned healthcare services available to the American public. 

Thank you again for allowing IU Health the opportunity to testify on these important issues.  We are committed as you are to ensure our nation’s veterans receive the care they deserve when they need it most.  IU Health stands ready to work with this Committee and our VA partners to meet these demands today and in the future.