Dartmouth-Hitchcock Medical Center's CEO looks to the future

LEBANON, N.H. (WCAX) Dartmouth-Hitchcock is celebrating its 125th anniversary this year. The Medical Center's new president and CEO has been on the job for less than one year. She spoke with Adam Sullivan about what the next 125 years will look like.

"It is exciting, but things are moving fast," said Dr. Joanne Conroy, who took over the reins at Dartmouth-Hitchcock Medical Center in the summer of 2017. The 1977 graduate of Dartmouth College is the former CEO of a hospital just outside of Boston. She now leads the most rural academic medical center in the country, where 60 percent of inpatients come from outside the Upper Valley.

"We have to figure out how to care for those people differently. Because it is not a ten minutes drive for a follow-up appointment. It is a two-and-a-half hour drive," Conroy said.

It's no surprise that Conroy says new technology will play a big role during her tenure. She points to DHMC's connected care telemedicine as an example and says more and more patients will be treated at home. "I actually think older people are going to have larger screens in their homes where physicians will actually be able to see them and they will be able to see their providers," she said.

She also says more day-to-day data will be collected, similar to Fitbits, monitoring chronic diseases to prevent problems rather than reacting to them. "I think there will be a lot of automatic downloads of what people are eating, what their blood sugar is, what their heart rate and blood pressure are on a continual basis," Conroy said.

Of course, it all comes with a cost, and Conroy says current reimbursement rates aren't sustainable. She says Medicare currently pays about half of what commercial insurance covers for the same procedure. She foresees a shift to "broader risk contracts" in partnership with insurance companies, which provide more coverage while moving away from a fee-for-service model, and instead focusing on keeping people healthy," Conroy said. "I don't know how we get from here to there, but most people say that is inevitable, that's where we are going to end up."

DHMC has had money problems in the past. In 2016 its bond rating was downgraded due to a budget shortfall and 84 people were laid off. The rating was recently bumped back up, thanks in part, Conroy says, to improved efficiency. "Are we getting the best prices for our supplies and our pharmaceuticals? Are we using our available inventory of both beds and providers?" she said.

And some of the work as a hospital CEO takes place outside the facility's walls, attracting a new generation of patients as the population continues to age. "That is why we're are also talking to the CEO's in the Upper Valley about affordable housing, about how do we build thriving industries up here. How do we create an environment where young people actually want to live here and grow their family," she said.

And as the changes happen, this certified anesthesiologist says it will all be centered around patient care. "I think we have to spend a lot of time with patients to figure out how do they want their care delivered," Conroy said.