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2014 Risk All Star: Jeff Driver

A Driven Visionary

Jeff Driver was an 18-year-old orderly in a hospital emergency room when a child died before his eyes. The child had been misdiagnosed and moved to the wrong floor before his respiratory tract closed up.

The experience launched Driver into health care risk management, where he’s been for a quarter-century, always “chasing the effectiveness” of loss control and patient safety. One could say he’s caught it.

Jeff Driver, chief risk officer, Stanford University Medical Center

Jeff Driver, chief risk officer, Stanford University Medical Center

Driver is no stranger to the risk management limelight — he was president of the American Society for Healthcare Risk Management in the past decade — but Risk & Insurance® is placing him back in the light in large part for the creativity of his most recent efforts as chief risk officer at the Stanford University Medical Center.

The highlight is his creation of a new reciprocal risk retention group (RRG) called the Professional Exchange Assurance Co. (PEAC) to help Stanford keep ahead of mandates from the Affordable Care Act.

All health care entities, particularly hospital groups, are feeling the urge to consolidate because of the efficiencies of size and the drive to create Accountable Care Organizations (ACOs). In California, Stanford faces the twist that state law prohibits hospitals from directly employing doctors; they must be employed through “physician foundations.”

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Stanford has two such foundations with plans to include 500 community physicians within three years. Driver had to devise a way to bring these doctors into the Stanford risk management and patient safety program, while mitigating liability and brand risk.

The particular RRG structure, now in place for nearly two years, works for a few reasons. Namely, it gives the affiliated physicians “skin in the game” because they technically own the captive and will enjoy profit-sharing if losses are kept low.

It also works because Stanford Medical’s other captive—the 20-year old, segregated cell, Bermuda-based SUMIT—cannot provide insurance to for-profit physician groups because of tax rules. So SUMIT still provides coverage and services to its in-house faculty physicians while PEAC steps in for affiliated doctors.

With both, Driver can ensure risk management consistency across the enterprise and that effectiveness he has pursued his whole career.

“He has created a vehicle to kind of indoctrinate these newly acquired physicians in much more modern risk management practices,” said Gigi Norris, Aon managing director.

“Jeff is very visionary … and he is very mission driven.”

Driver and his risk management team of 25 are spreading Stanford’s best practices beyond the university as well. One benefit of the RRG structure is that Driver created another entity, The Risk Authority, to serve as its necessary attorney-in-fact, as well as a service provider for external health care entities.

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It delivers Stanford risk management products and services — like tools for early resolution and loss, claims and litigation management, patient safety consulting and value-driven enterprise risk management — around the world.

Driver’s success comes in part because of his leadership. He is able to build a team, empower its members, and motivate them toward success with his vision.

Success builds trust with senior management, which leads to larger teams, bigger projects and more success.

And he’s succeeded because he’s willing to try anything to succeed.

“If people really focus in on how they can do things better rather than doing the same thing, that would serve our patients and our communities very well,” he said.

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350px_allstarRisk All Stars stand out from their peers by overcoming challenges through exceptional problem solving, creativity, perseverance and/or passion.

See the complete list of 2014 Risk All Stars.

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2014 Risk All Star: Dr. Frank Tomecek

Reducing Patient and Workers’ Comp Pain

Unnecessary surgery is bad for almost all parties involved. It results in more pain and more hospital time for the patient, greater susceptibility for pain medication abuse, larger claims for workers’ comp carriers, and a poorer level of overall health care quality.

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Dr. Frank Tomecek, a neurosurgeon with the Oklahoma Spine & Brain Institute, saw a way to lessen that basket of troubles.

By using electrodiagnostic functional assessments (EFA) to collect more data on muscle and nerve function, he could determine if a patient complaining of pain from hardware in the neck or back really needed to have it removed.

“The EFA determines if muscles are functioning properly, or if there are other nerves or muscles away from the hardware that may be causing the pain,” Tomecek said.

That’s relevant, he said, because in a workers’ compensation case, a patient could attempt to cheat the system by lobbying for a second surgery to increase the size of the settlement.

Dr. Frank Tomecek, neurosurgeon, Oklahoma Spine & Brain Institute

Dr. Frank Tomecek, neurosurgeon, Oklahoma Spine & Brain Institute

By attaching electrodes to a patient’s body and then asking him to perform activities like standing, bending and lifting, Tomecek can see whether the muscles in question are contracting and relaxing as they should, or if the patient is purposely giving no effort in order to exaggerate their pain and strengthen their case for hardware removal.

Other than through EFA, in conjunction with X-rays and other tests, “there’s no true way to diagnose if hardware really needs to be removed,” said MaryRose Reaston, founder of Emerge Diagnostics, who developed the technology — and won a 2012 Risk Innovator™ award for it.

“He took EFA to a new level and developed a procedure to see if it could objectively assess whether removal was necessary and what alternative treatments could help.”

Working on this new application of EFA for just under a year, Tomecek has used it for only about 20 patients, but the results, Reaston said, have been “phenomenal.”

“In the realm of workers’ compensation,” said Sheila Harless, workers’ compensation manager at the Spine & Brain Institute, “I know that Dr. Tomecek has been able to eliminate the need for many hardware removal surgeries.”

“This has protected the patient from the risks of a surgery that may not even help them, and has saved money for the insurance company in the cost of the surgery and in permanent impairment rewards related to additional surgery.”

Hardware removal has posed a particular problem because its criteria are subjective; all it took was a complaint of pain to justify an invasive surgery to extract hardware.

Favorable outcomes were achieved in only 50 percent to 60 percent of patients, according to Reaston.

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With the help of EFA, Tomecek has been able to reduce these surgeries and recommend site-specific physical therapies to treat the root cause of pain, which in turn decreases dependency on high-strength painkillers.

“We’re one of the highest states for prescription drug-related deaths,” Tomecek said. “We’re trying to prevent those events.”

Reaston called Tomecek a “big patient advocate.”

Workers’ comp carriers are likely happy to have him on their side as well.

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350px_allstarRisk All Stars stand out from their peers by overcoming challenges through exceptional problem solving, creativity, perseverance and/or passion.

See the complete list of 2014 Risk All Stars.

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Sponsored Content by Riskonnect

A Dreaming Team

Chris Thorn of Southwest Airlines got creative with his risk management program. Now, the sky's the limit.
By: | September 15, 2014 • 4 min read
SponsoredContent_Riskonnect

Chris Thorn is known as one of the most creative risk managers in the business. After all, his risk management program hit the cover of Risk & Insurance® in March, 2012.

Now the senior manager, payments and risk, for Southwest Airlines is working with Riskonnect, a technology partner that he thinks can take his program to new heights.

“For us, it’s a platform that gives you so many different tools that if you can dream it, you can build it,” said Thorn.

Claims administration

Thorn ditched his legacy risk management information system in 2012 and started working with Riskonnect, initially using the platform solely for liability claims management.

But the system’s “do-it-yourself” accessibility almost immediately caught the eye of Thorn’s colleagues managing safety risk and workers’ compensation.

“They were seeking a software solution at the time and said, ‘Hey, we want to join the party,” Thorn recalls of his friends in safety and workers’ compensation.

SponsoredContent_Riskonnect“For us, it’s a platform that gives you so many different tools that if you can dream it, you can build it.”

–Chris Thorn, senior manager, payments and risk, Southwest Airlines

What was making Thorn’s colleagues so jealous was the system’s “smart question” process which allows any supervisor in the company to enter a claim, while at the same time freeing those supervisors from being claims adjusters.

The Riskonnect platform asks questions that direct the claim to the appropriate category without the supervisor having to take on the burden of performing that triage.

“They love it because all of the redundant questions are gone,” Thorn said.

The added beauty of the system, Thorn said, is that allows carriers and TPAs to work right alongside the Southwest team in claims files while maintaining rock-solid cyber security.

“This has sped up the process,” Thorn said.

“Any time you can speed up the process, the more success you’re going to have when you make offers to settle claims,” he said.

Policy management

Since that initial splash in claims management, the Riskonnect platform has gone on to become a rock star at Southwest in a number of other areas. And as Thorn suggests, the possibilities of the system are limited only by the user’s imagination.

SponsoredContent_RiskonnectWith a little creativity and help from Riskonnect as needed, a risk manager can add on system capabilities without having to go on bended knee to his own information technology department.

In the area of insurance policy management, for example, the Riskonnect platform as built by Thorn now holds data on all property values and exposures that can in turn be downloaded for use by underwriters.

Every time Southwest buys a new airplane, the enterprise platform sends out a notice to the airlines insurance broker, who in turn notifies the 16 or 17 carriers that are on the hull program.

Again, in that “anything’s possible” vein, the system has the capability of notifying the carriers, directly, a tool Thorn said he’s flirting with.

“It is capable of doing that,” he said.

“We’re testing out this functionality before we turn on it loose directly to the insurance companies.”

Carrier ratings

In alignment with the platform’s muscle in documenting, storing and reporting liability and property exposures, the system monitors and reports on insurance carrier financial strength.

If a rating agency downgrades a Southwest program carrier’s financial strength, for example, the system “pings” Thorn and his colleagues.

“Not only will we know about it, but we will also know all programs, present and past that they participated on, what the open reserves are for those policy years and policies,” Thorn said.

“That gives us even more comfort that we have good, solid financial backing of the insurance policies that are protecting us,” Thorn said.

Accounting interface

Like many of us, Chris Thorn didn’t set out to work in risk management and insurance. Thorn is a Certified Public Accountant, and it’s that background that allows him to take creative advantage of the Riskonnect platform’s malleability in yet another way.

With the help of the Riskonnect customer service team, Thorn added a function to the platform that allows him to calculate the cost of insurance policies on a monthly basis, enter them into a general ledger and send them over to his colleagues in accounting.

SponsoredContent_Riskonnect

“It’s very robust on handling financial information, date information, or anything with that much granularity,” Thorn said.

The sky is the limit

Thorn and Southwest are only two years into their relationship with Riskonnect and there are a number of places Thorn thinks the platform can take him that have yet to be explored, but certainly will be.

“It’s basically a repository of anything that’s risk-related, it continues to grow,” Thorn said.

SponsoredContent_Riskonnect“This has sped up the process. Any time you can speed up the process, the more success you’re going to have when you make offers to settle claims.”
–Chris Thorn, senior manager, payments and risk, Southwest Airlines

Not only have Southwest’s safety and workers’ compensation managers joined Thorn in his work with Riskonnect, business continuity has come knocking as well.

Thorn met in July with members of Southwest Airline’s business continuity team, which has a whole host of concerns, ranging from pandemics to cyber-attacks that it needs help in documenting the exposures and resiliency options for.

That Enterprise Risk Management approach will in the future also involve the system’s capability to provide risk alerts, telling Thorn and his team for example, that a hurricane or fast moving wildfire is threatening one of the company’s facilities.

Supply chain resiliency and managing certificates of insurance for foreign vendors are other areas where Thorn and his team plan to put the Riskonnect platform to good use.

“That’s all stuff that’s being worked on by us,” Thorn said.

“They’ve given us the tools, but we’re trying to develop how we’re going to use it,” he said.

This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Riskonnect. The editorial staff of Risk & Insurance had no role in its preparation.


Riskonnect is the provider of a premier, enterprise-class technology platform for the risk management industry.
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