IOWA CITY — Already the state’s largest hospital system, University of Iowa Health Care recently added to its sprawling footprint a 507,000-square-foot, 14-floor Stead Family Children’s Hospital.
It also built a 61,067-square-foot North Dodge Clinic on the east side of Iowa City, is expanding its Iowa River Landing clinic in Coralville and has extended its reach across the region and state with quick-care clinics and hospital collaborations.
New UI Hospitals and Clinics Chief Executive Officer Suresh Gunasekaran said he doesn’t see any halt in the growth.
“I don’t see a future for UI Health Care that doesn’t include growing,” he said in an interview Monday, going on three weeks into the job.
“What the right way to grow is — whether that is a new tower, whether that is more clinics, whether that is more outpatient operations — it probably has to be a check on all of the above and what can you afford over what period of time and what patient impact are you trying to have,” he said.
“But I think growing our services is critical to our future,” he said. “I’ve not been to an academic medical center that has this kind of demand for surgical services.”
Gunasekaran succeeds Ken Kates, who spent a decade atop the now $2 billion a year enterprise, overseeing the 2012 opening of its Iowa River Landing facility, expansion of its off-site clinic operation and construction and opening of its more than $360 million Children’s Hospital.
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That project, while widely praised for its services and mission, also is at the center of controversy for rampant design changes and questionable mismanagement that ballooned the budget, delayed the opening and led to millions of dollars of disputed costs in court and arbitration.
Before his departure, Kates was leading the enterprise’s effort to weather its budget woes — after the hospital reported ending its 2017 budget year with operating income nearly 50 percent below budget and more than 72 percent below the past year. He had announced an $86 million savings and revenue-enhancing initiative.
Gunasekaran, upon his arrival, said he’s been impressed with UIHC’s attention to efficiency. But, he added, “because of the headwinds in health care, we have to continue to push ourselves to drive greater efficiencies.”
In addition to rising supply costs and drug costs and other expenses that used to be standard care, Gunasekaran said, the UIHC’s space issues are a contributing factor.
“It’s really hard to stay efficient when you’re constantly full and you have greater demand for your services than you have resources to meet them,” he said. “One of the things that I’ve learned in my two weeks here on the job is that there continues to be significant demand for our services — far more than we have resources to handle.”
The university is going to have to innovate to respond effectively, according to Gunasekaran. And it was the university’s reputation for innovation, he said, that made his move here from chief operations officer for the nationally-ranked University of Texas Southwestern Health System obvious.
“It was easy for me to move from Texas to Iowa,” he said. “How can a place that has this small of a population have a medical center with this kind of caliber — 13 members of the National Academy for Medicine. That’s unheard of. You don’t do that without innovation.”
Gunasekaran arrives at UIHC during a time of executive turnover. Jean Robillard, vice president of medical affairs for UI Health Care and dean of the Carver College of Medicine, left in fall 2017. Chief Financial Officer Ken Fisher left earlier and Children’s Hospital CEO Scott Turner left later. But Gunasekaran said he has been in communication with those departed leaders. And he’s impressed with the collaboration across the university as a whole.
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He cited partnerships and collaboration as the path forward, but didn’t provide details about what he thinks those joint efforts will be.
“It’s always a very fluid and dynamic environment,” he said. “However, the commitment to partner with others — whether it’s others as referral centers to us, whether we’re going to develop joint programs with them, whether we’re going to simply be better citizens on how we transition care from one setting to another — we have to continue to work on partnerships.”
Such collaboration could manifest through advances in telemedicine, which he said the university needs to continue to pursue.
“It is the future,” e said. “With or without UI Health Care, telemedicine is the future.”
Gunasekaran said he predicts telemedicine technology will be used not only to treat and diagnose patients, but also enable more home recovery — freeing up the in-demand inpatient beds.