This interview with retired U.S. Army Lieutenant General, former U.S. Army Surgeon General and 23rd Chief of the Army Nurse Corps, and now CEO of OptumServe, Patty Horoho, discusses the company’s COVID response, lessons learned, the future and the need for expanded partnerships.
The Onset of the Pandemic
When the pandemic hit, we pulled our team together and had a conversation explaining that this was going to be similar to what it feels like to be going to war. We explained that we would feel as if we had been deployed, that we would be separated from loved ones, would experience death in a way we hadn’t been trained for, that we would be having ethical discussions out of the norm, and that we would have to focus on resiliency.
We went into this with the mindset that we needed to be agile, adaptable, repeatable, reliable and scalable and underpinning all of this was an understanding that we needed resilience from our leaders and what the impact would be to our teams.
One of our first steps was to break down our silos, integrating our teams to ensure we had effective and transparent communication across the board. Fortunately, we had undergone a reorganization the year before that integrated a lot of our services to encourage better integration and collaboration.
Knowing we needed to be adaptable, we developed a resilience model based on a military combat operational strategy, adapted for commercial clients, that would create the opportunity for on-demand resiliency resources.
We realized early on that COVID testing was going to be a key challenge, so we looked at our reserve health readiness capabilities and mobilized teams from readiness exams to begin COVID testing. Within 96 hours of an initial conversation with our client, we had developed a model and had 80 sites up and running. As of early March, we have completed 3.8 million COVID tests across 21 states, have mobilized 5,000 employees and over 3 million pieces of equipment moved to support the effort.
We also understood vaccinations would be the next critical need, so we ensured we had a national emergency response capability prepared. In the midst of the pandemic, OptumServe won a contract across all 64 jurisdictions for data analytics related to vaccinations. Throughout this we have been able to utilize all areas of the company to respond.
Perhaps the most impactful effort we have undertaken is with respect to ensuring under-served and at-risk populations would be prioritized for testing and vaccinations.
Early on we realized the impact of COVID on public health and the gaps in care, we developed a health equity tool to identify, down to a zip code, where those under-served and at-risk populations were. Through a program called STOP COVID, we partnered with local communities, and spiritual leaders to provide testing, transportation, food, health literacy, and safety kits to those who were most vulnerable. Our analytic tool told us where to find those at risk, but it was the unlikely partnerships with community and religious leaders that really drove the success.
Using that same analytics tool, we also added a vulnerability index, CDC guidelines and data, and we developed a prioritization immunization tool that allows for identification of where the biggest impact for vaccinations would be.
As of early March, we have completed 58,000 vaccinations. We partnered with some large Seattle-based employers to support vaccinating community members. We are also working with national chains to set up mass vaccination sites in several states. We want to ensure close relationships with our state and county department of health partners to establish these precious doses of vaccines, are not wasted, and that they are reaching the most vulnerable people in the local communities.
COVID has had such a devastating impact on our nation. Already we have lost more citizens than in combined wars going back to WWII. One of the greatest lessons in all of this is that we need to better understand how we focus on keeping people healthy. The virus clearly showed a significant impact on those with chronic conditions.
The conversation going forward must include how we improve the health of our nation. It will take data analytics and all of the tools we have to extend the reach of health care, better nutrition, and help more people be healthy.
We also take away from this the knowledge of how readily the nation moved to tele capabilities, the way that opened opportunities for care to get to some of the most vulnerable. It also showed us where there are gaps in technology and the internet. This also raises the importance of health equity, of taking bias out of algorithms to ensure processes are in place across the country, to ensure that programs and practices to reduce unintended biases are firmly ingrained in everything we do.
As a nation I also like to believe that our social responsibility increased. That marriage of socially minded individuals and health care entities must continue. We have come to a greater understanding of the negative impacts that social isolation has on mental, spiritual and physical health.
We have also learned about agility, agility in the workforce and embracing the concept of meeting the employee where they can be most productive. Agility also helps with adaptive innovation One of our employees referred to this as being like liquid flowing into the existing gaps to provide solutions where and as they are needed. This is the mindset of OptumServe and serving our clients is in our DNA.
The Military View of Service
That mission of service that is ingrained in the military is also part of our culture within OptumServe, and in so many of the government agencies and industry partners that have been on the front lines of COVID. Within OptumServe, no one had to be asked to work overtime, they just did; no one needed a special invitation to go above and beyond, so many just did because it was what was required.
The challenges the pandemic has created will be seen for years to come. From the impact of isolation to losing loved ones and not being able to have those goodbyes. We need to focus on all of that and not forget the personal and organizational resilience this requires.
Part of our national preparedness and emergency response looks at the concept that there may not be another pandemic but there will likely be another crisis of one kind or another and we need to take lessons learned from this to be ready for whatever may come next.
COVID has presented an opportunity for us to come together as a nation, to focus on gaps in public health and the chance to really make things better. When you focus on readiness, it doesn’t matter what the challenge is, we become part of the solution. With every challenge comes the opportunity to learn and grow.
All of what has been achieved over the past year was through partnership and collaboration across the enterprise, multiple subcontractors coming together to work with clients, and unlikely partners sharing information.
There has been a lot of dialogue at the executive level, about continuing in this mission of focusing externally and working with new partners that we might not have had the opportunity to work with before. When diverse entities with a common goal come together, we can develop solutions that will impact change in policy, funding and practice. When you focus the lens on the mission, that changes the dialogue. We need now to create ecosystems in which we all have a common interest. That is the opportunity ahead.
About Patty Horoho
LTG Patricia (Patty) D. Horoho, Retired, is the Chief Executive Officer of OptumServe. Patty’s distinguished professional career includes 33 years with the U.S. Army, retiring as a Lieutenant General, the 43rd Army Surgeon General and Commander of the U.S. Army Medical Command. She made history being the first woman, first nurse and non-physician to hold these posts.
OptumServe is the Federal health services business of Optum and UnitedHealth Group.