Newly Created M Health Fairview Aims to Change Health Care in Minnesota and Beyond

By Thomas Crocker
Wednesday, December 5, 2018

Driven by the shared vision of two new leaders with ambitious goals, longtime partners Fairview Health Services, the University of Minnesota and University of Minnesota Physicians have created M Health Fairview, a united care delivery system that combines the best of academic and community medicine throughout the state and supports the work of researchers aiming to shape the future.

Earlier this year, after more than two decades of collaboration, Fairview Health Services, the University of Minnesota and University of Minnesota Physicians announced the expansion to their five-year M Health partnership to create a nationally renowned health system, M Health Fairview. The system encompasses 12 hospitals, including the University of Minnesota Medical Center, 56 primary care clinics and a variety of other services. Set to formally begin Jan. 1, 2019, the new partnership agreement calls for Fairview Health Services’ annual contribution to the University of Minnesota Medical School to increase to $50 million by 2022, a boon for the school’s research in leading-edge fields, such as neuroscience, artificial intelligence, bioengineering and immunotherapy. The agreement runs through 2026, and the parties can opt to extend it for 10 more years in 2023.

Blazing a Shared Trail

M Health Fairview is, in large part, the product of collaboration between two leaders with a fresh vision of what Fairview Health Services, the University of Minnesota and University of Minnesota Physicians can achieve together.

Jakub Tolar, MD, PhD, Dean of the Medical School and Vice President for Clinical Affairs at the University of Minnesota, has been a member of the university community since he enrolled as a graduate student 26 years ago. Most recently, he served as Executive Vice Dean of the medical school before taking on the role of Dean in October 2017. An oncologist by training, Dr. Tolar is keenly aware of medicine’s current boundaries and believes the university’s partnership with Fairview Health Services can help push the university outward by funding discovery.

“Advancement comes from research and innovation — from dismantling a disease in the lab, finding out why it’s acting a certain way, testing treatments in an empiric way and then applying them at the bedside,” Dr. Tolar says. “The beauty and tremendous strength of academia and our university lies in our ability to carry out this process in a full continuum from basic science to clinical science. Having the depth and breadth to apply science in the broadest possible way while keeping it disciplined and focused is the foundation of what this partnership with Fairview Health Services will enable.”

Fairview Health Services President and CEO James Hereford stepped into his role in late 2016 after spending more than 20 years in healthcare administration, including, most recently, as Chief Operating Officer at Stanford Health Care in California. He was attracted to Fairview Health Services due to its relationship with the University of Minnesota — one he believed could be even stronger. Hereford and Dr. Tolar developed a relationship based on mutual trust that proved key in establishing M Health Fairview.

“We recognized the self-evident opportunity around broadening and leveraging the academic relationship across a broad community platform, and it was compelling that our organizations should go forward together, but not as they had been,” Hereford says. “This expanded partnership isn’t a whole merger, but it allows for a level of alignment, simplicity and opportunity for a shared destiny that we simply didn’t have before.”

Hereford envisions M Health Fairview as nothing less than a reinvention of the conventional healthcare organization as an integrated, academic physician-led, service line-organized care delivery system that, above all, is patient-oriented. That kind of comprehensive system — one that stretches from the wellness side of medicine to the highest levels of tertiary and quaternary care — does not exist in Minnesota, Hereford says, but M Health Fairview plans to change that. Dr. Tolar recognizes M Health Fairview’s potential to streamline and simplify how patients experience health care.

“Major market disrupters like Apple and Amazon capture the consumer experience and make it easier,” he says. “What we’re going to offer with M Health Fairview is an elegant solution that comes through understanding and owning the patient experience. We will move the center of gravity of the stress that comes with illness from patients and their families to us. We’ll own that complexity.”

“In four to five years, we’ll be able to look at the progress we’ve made as a result of this partnership, and Minnesota will be the better for it.”
— James Hereford, President and CEO of Fairview Health Services, on his medium-term vision for M Health Fairview

Letting Academics Lead

The “kernel” of the M Health Fairview agreement, Dr. Tolar says, is a leadership structure that places academic physician leaders at each level of the organization and pairs them with operations leaders — a relationship that mirrors the one Dr. Tolar and Hereford share.

“Putting academic professionals in positions of leadership is the best way to ensure evidence-based practices and standards are followed throughout the healthcare system,” Dr. Tolar says. “Our training as experimentalists and quantitative scientists helps spread innovation through the system while keeping primary care at the highest possible quality.”

Community-based physicians are an essential component in achieving the unmatched clinical care Dr. Tolar and Hereford envision.

“We have a big tent when it comes to collaborating with physicians of all associations throughout the state, whether academic or nonacademic, employed or independent,” Hereford says. “The only price of admission to that tent is the pursuit of excellence. As we’ve selected academic leaders for M Health Fairview, we’ve done so with that in mind. We’ve selected leaders who are inclusive and committed to the level of clinical excellence our patients deserve.”

“In this decade, we’ll disrupt the healthcare system in the United States in a major way.”
— Jakub Tolar, MD, PhD, Dean of the medical school and Vice President for Clinical Affairs at the University of Minnesota, on his expectation for M Health Fairview

Care Organized Around Service Lines

Part of reimagining the typical healthcare system model is rethinking how hospitals will fit into it. Care organized around hospitals is a relic of a bygone era, Hereford says. To meet the challenges of the future, healthcare systems must think in terms of service lines that intersect and interact as patients move through each stage of a treatment journey. That is precisely how M Health Fairview will approach delivered care.

“In specialties such as oncology and cardiac care, one needs a multitude of specialists to organize around the patient,” Dr. Tolar says. “That is why we do not think in terms of departments, but service lines. Patients don’t care in which field the physicians treating them trained. What they care about is getting the best care, and that care doesn’t live in separate departments, but across the full spectrum of medicine. I give credit to Hereford for being fully supportive of this service-line, patient-centered concept.”

Untethering care delivery from buildings and department-centric organization promises to rely, in part, on leveraging technology, including telemedicine.

“We have an opportunity for technology-enabled care, whether that’s classic telemedicine or other kinds of virtual access,” Hereford says. “A challenge in rural medicine is having access to the level of expertise that people in urban areas take for granted, so how do we bring experts to patients without making them drive for hours? Technology can help us overcome that challenge.”

Access to specialist care is a problem M Health Fairview helps to solve. Another is ensuring care is standardized throughout Minnesota based on the latest best practices.

“It doesn’t matter if a patient lives in Hibbing or Hugo,” Dr. Tolar says. “We want patients to receive the same level of specialty care they would get if they lived in Minneapolis or Minnetonka. The way to do that is to fully develop and deploy what we know to be the best standards of care. That’s what this partnership will help us do.”

Primary Focus

The key to success at M Health Fairview — the result of a recently expanded partnership involving Fairview Health Services, the University of Minnesota and University of Minnesota Physicians — are primary care physicians (PCPs) throughout Minnesota. “They are the front door to everything we do,” says Jakub Tolar, MD, PhD, Dean of the Medical School and Vice President for Clinical Affairs at the University of Minnesota.

“Focusing on the maintenance of health and the subclinical factors that can determine whether disease occurs will be part of the innovation and whole-state landscape of this partnership,” Dr. Tolar says. “We will make the data we collect from all parts of primary care available to physicians and patients alike, improve access to primary care, and look to primary care as a key area in which to measure the cost and value of the services we provide.”

At Fairview Health Services, an effort is underway to replace the “one physician, one patient, one exam room” model of primary care delivery with one that better serves clinicians and patients alike.

“As economic pressures in health care build, we can’t simply ask PCPs to work faster,” says James Hereford, President and CEO of Fairview Health Services. “If we put them on a hamster wheel, they’ll burn out, and that’s not good for them or our patients. Thanks to our relationship with the University of Minnesota, we can teach and train PCPs in a new model and influence the broader primary care landscape. That also presents an opportunity for the university, as a teaching institution, to bring in other organizations to share what we’re learning. That’s part of the advantage of this relationship that we’ve embarked on as M Health Fairview.”

Building on a Legacy of Innovation

The University of Minnesota has a storied history of medical discovery and innovation — physicians there pioneered the use of the cardiac pacemaker and performed the first successful bone marrow transplant — and M Health Fairview will help further that legacy by boosting funding for research at the University of Minnesota Medical School. The school will focus its research efforts in areas in which it is already a recognized leader, such as regenerative medicine and genomics.

“Telemedicine and genomics practically form a continuum because they’re bound by the ability to navigate big data,” Dr. Tolar says. “With the super computers here on campus, as well as our Institute for Health Informatics and College of Science and Engineering, we’re in a sweet spot that can place us at the forefront of developing truly smart algorithms — the deep learning necessary to capture and harness digital information so we can design better approaches to care.”

Through its network of hospitals and clinics, as well as the use of technologies, M Health Fairview will deliver the latest innovations in care to patients throughout Minnesota.

“We’re in the early days of understanding genomics and next-generation biosciences and how they will impact clinical care, but it’s undeniable that they’re going to change how we think about care processes,” Hereford says. “Having a major university’s resources and expertise gives us a differential opportunity to drive change in care delivery as the science evolves. The expansion of information in health care is accelerating so rapidly that no single entity can steward it, but being part of the knowledge management process is huge for us.”

For Dr. Tolar, pushing the boundaries of medicine means returning to the medical school’s roots.

“Game-changing discoveries have been made at this university,” he says. “We know how to do these things because we’ve done them before. Harnessing the ability to advance medicine lies at the heart of this new partnership. I’m very excited about it. We have an opportunity to build something here that makes Minnesotans proud and continues to fulfill the land-grant mission set forth by the university’s founders.”


To learn more about M Health Fairview and what it means for the present and future of health care in Minnesota, visit mhealth.org.