Alumna Makes Amazing Things Happen
In the late 1970s, healthcare was undergoing a sea-change. As costs rose, hospitals for the first time were beginning to be paid not whatever amount it cost them to treat but what Medicare and health insurance companies determined they should reimburse. At the time Emme Deland—now one of the top healthcare administrators in the country as senior vice president and chief strategy officer at NewYork-Presbyterian Hospital—was at the beginning of her career and looking for a change too.
She had graduated magna cum laude from Harvard with a degree in Modern East Asian studies and gone to work in international banking. It seemed a good fit but, says Deland, the opportunity to innovate in healthcare intrigued her. Living on W. 168th Street at the time, where her husband was enrolled in medical school, she entered the joint MBA/MPH program at Columbia, splitting her time between what became the Columbia Mailman School of Public Health and the Business School. “I wanted [to do] something that would be interesting and would improve the lives of people,” she says. “I was never going to be a doctor since I fainted at the sight of blood.”
The program proved to be the perfect merger of her interests and skills, with the coursework at Columbia Mailman giving her a foundation of historical, statistical, analytical, and epidemiological understandings. Deland spent the ensuing decades putting that training to work in leadership roles. “The field was very young for people with MBAs,” she says with a laugh. “I probably couldn’t get a job now.”
Since 2000, Deland has been responsible for developing clinical and corporate strategies for NewYork-Presbyterian, a 4,000-bed, $8 billion academic healthcare system encompassing six campuses and affiliated with Weill Cornell Medicine and Columbia University’s Vagelos College of Physicians and Surgeons. She oversees the hospital’s response to healthcare policy changes, guides strategic investments, leads physician leadership education, and is responsible for the identification, adoption, and commercialization of new technologies such as telehealth and artificial intelligence. In 2017, for example, Deland helped launch NYP OnDemand, which became one of the most comprehensive telehealth programs in the country and one of the Hospital’s core offerings, making up some 20 percent of patient encounters. All of the initiatives she leads serve the bigger goal—imparted in her public health training—of improving access to care and lowering costs. Perhaps not coincidentally, it was during Deland’s tenure that the Hospital adopted its tagline, “Amazing Things Are Happening Here.”
After graduating with an MBA in 1980—she completed her coursework for an MPH but never wrote her thesis—she immediately got a job at a healthcare consultancy newly launched to address the business side of healthcare. Her MBA helped her get her foot in the door, but her public health training at Columbia Mailman gave her an edge that’s kept her at the top of her field. When her husband began his residency in Boston, she benefitted from an informal network of women in healthcare who were breaking down barriers and ascending into leadership positions. (The women dubbed themselves the A-team and were profiled in the New York Times in 1995). It was through this network that Deland was asked to join a new center for cost-effective care at Harvard Medical School. There, funded with a million-dollar grant from Blue Cross/Blue Shield, she began to investigate such questions as why costs for hip replacements and vascular grafts were more expensive in Boston than they were in California.
Thirty-some years later, Deland is amazed that healthcare leaders are still having the same conversations about quality of care and evidence-based practices and decisions. (Even at home, she admits, she’s been known to ask her husband, an orthopedic surgeon: Did you really need to order that MRI?) “The tools are slightly different,” she says, “but influencing change is as difficult today as it was then.” She remembers, for example, an effort in the 1980s to shorten hospital stays for patients from one week to 48 hours after gall bladder surgery, when she brought together an anesthesiologist, surgeon, floor nurse, and pharmacist to talk about changes in care to help patients recover more quickly. “It was the first time they had ever talked to each other … they’d all taken care of the same patients but they hadn’t actually talked about how that care was going to be delivered,” Deland said. “It was a lesson to me on how challenging communication is in healthcare. That lasted with me forever.”
At Brigham and Women’s Hospital, she moved quickly up the career ladder, becoming the number-two person running a new ambulatory care center. Back in New York City, she joined Mount Sinai as chief of staff for CEO John Rowe (now the Julius B. Richmond Professor of Health Policy and Aging at Columbia Mailman) before joining NewYork-Presbyterian. Over the years she has hired Columbia Mailman graduates, who she says share the qualities she says are most important: “they’re analytical, articulate, literate, creative, and engaging.”
The changes she saw in healthcare at the start of her career continue at a rapid pace. The industry is undergoing a transition from a fee-for-service approach to value-based healthcare, in which providers are paid based on their patients’ health outcomes. Other forces are at work too. “There’s no question that millennials are expecting to have more convenient healthcare, and there’s no question that when you’re really, really sick, you’re still going to want to go to an academic medical center. But this is a zero-sum game,” she says. “We all have to improve patient experience and quality and access and reduce costs.” In that heady whirl of challenges, the secret for finding evidence and making a case for innovation has also remained consistent across the decades—and it comes down to leadership. “You have to accumulate credibility and trust,” she says. “And you need to convince people that we’re all on the same side.”