HCA’s Ravi Chari takes physician leadership to heart

Physician Ravi Chari was named president of HCA Healthcare’s West Florida division in May 2018. Chari had been in the HCA system since 2008, when he joined as chief medical officer of Centennial Medical Center in Nashville.

Before his work at HCA Healthcare, Chari was professor of surgery and chief of the liver surgery and transplantation division at Vanderbilt University Medical Center. During his tenure, he was drawn to the business side of medicine and how those factors could ultimately deliver better outcomes for patients. “I was fascinated by the business world and fascinated by the extent of information and science behind the body of knowledge called management,” Chari says.

After earning an MBA at Vanderbilt’s Owen Graduate School of Management, he received a call from a physician colleague who asked if he’d like to be the chief medical officer at Centennial. He acknowledges having to research what a CMO does, before taking the position. “I had not really considered that as a path,” he says.

Historically, a CMO’s role is filled by a person on the medical staff who functions as an ombudsman, or representative, for doctors to administrators.

“In modern times, as in our company, the CMO is the CEO of quality,” Chari says. “I felt that it was a way for me to enter a part of a health care management system team and help get to a point where I could learn more about the real-life business aspect of running a hospital and delivering care beyond bedside, which I was very familiar with.”

While in the CMO position, Chari started a program called Clinical Excellence, which was created to find the variations in health care and how those in turn affected outcomes for patients. Why there were vast differences in what was ordered, what was done, the length of stay and in some cases, the outcomes? These were questions Chari wanted answered.

“With that, we had to find a way to uniquely engage physicians, in a collaborative way, to help reduce this variation and our approach was one that we created … which was data-driven, physician-led and patient-focused,” he says.

During this period of discovery, a new role was created, the division chief medical officer, which Chari moved into. In that role he was able to move up to a corporate level, where he could implement Clinical Excellence across the entire HCA Healthcare company.

That led him to where is he is today.

He was long driven toward what started him down his path: to use data to improve the health care system and the world.

During his early days as a doctor and a surgeon, he says he was often frustrated by some of the roadblocks in reaching patients who needed treatment. “Sometimes, it felt like it was easier to get patients in from out of the country than it was from within the state,” Chari says. “I was also looking at other things going on from a decision standpoint: care  protocols, preauthorization and trying to understand how those decisions are made. And [another] component was looking at our outcomes as a nation, relative to our spending in health care. Seventeen or 18 percent of our GDP, about $3 trillion dollars, is what we spend, and yet when you look at outcomes, global markers of health, like length of life or maternal and fetal death rates, the United States doesn’t actually do that well.”

These observations helped build a belief that Chari still holds to this day.

“Someone is making decisions in health care, likely well-informed, however their data set may not be the same as me, as a clinician. I wanted to learn more about how those decisions were made and what predicates business decisions,” he says. “Sometimes practices don’t evolve, not out of ill intent, but being head-down busy or just being unaware, so how do we engage those physicians? The most important thing we can do is create an accountability system.”

Chari says HCA Healthcare is a good fit for his experiences and views. Its  culture is built on innovation and a motivation of delivering quality care, he says.

The health system has invested significantly to create its clinical data warehouse, which pulls together data and helps to create protocols for being able to better predict outcomes.

Care beyond the hospital

HCA has a foundation of philanthropy which stems from the beliefs of its founders, physicians Thomas Frist and Thomas Frist Jr. Frist Jr. was a founding member of United Way’s Tocqueville Society in 1984, which was created  to recognize and honor those who made major financial contributions to United Way.

“Our mission statement for HCA is, above all else, we’re committed to the care and improvement of human life,” Chari says.

One of the organizations that Chari and HCA employees enjoy working with is the American Heart Association. “When I look at this area, and I look at the biggest challenge we have to improve human life in our community, heart disease is a driver,” Chari says.

Because of the nature and prevalence of heart disease, it’s time-sensitive and, depending on certain life decisions and proper diagnosis, can be manageable or lethal. Many people are touched with some component of it.

“We have to find a way that we’re helping improve the condition of life in our communities,” Chari says. “In all of our areas, the one thing the teams get real jazzed up about is the Heart Walk [fundraiser]. Last year, our system in West Florida was the No. 1 health system fundraiser in the entire state of Florida.”

Chari also says he and his team support the Go Red for Women campaign and the Heart Ball.

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