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Know me, care for me, ease my way

Health gets personal with Providence’s Underriner

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Dave Underriner and his family.

When Dave Underriner left Oregon State in 1981 with a forestry degree in hand, he never imagined he would one day manage 19,000 employees as Providence’s regional chief executive.

His role isn’t too hard to imagine given he grew up in health care under the tutelage of a father who led Providence St. Vincent Medical Center, but as a young man he wanted to blaze his own trail – before the pull of impacting lives in a different way brought him back to his health care roots.

Dave Underriner.

Dave Underriner.

“The work you do matters. You touch people in the most important way – their health. It’s not just a job,” says Dave, who started out as an administrative intern with Providence, a not-for-profit Catholic healthcare ministry, in 1981.

Since then, he earned a master’s degree in health service administration from the University of Washington and has served Providence Oregon for over 30 years in advancing leadership roles.

A 2015 Alumni Fellow representing the College of Public Health and Human Sciences, Dave is a recognized leader known for excellent and compassionate service.

“Health care is very special,” he says. “We’re learning; we’re trying new things. It’s an exciting time.”

13 things you should know about Dave Underriner and his vision of health

What he thinks of OSU today: “I received a tremendous education at OSU, and I value the time I spent there and what I learned. It’s great to see OSU grow.”

What drives him crazy: “Defending the status quo and not being willing to advance new approaches to the work we do. Health care is not affordable, and we need to understand that we need to improve health and how we provide health care so that resources are being utilized most effectively. We need to break down traditional silos that have existed in health care and work effectively with diverse groups to transform health in our communities.”

One of biggest problems in health care: “We tend to judge. Take for instance our response to a disease such as cancer versus schizophrenia. Both diseases are very serious, and we have the opportunity and means to treat them. We invest significant resources in diagnosing and treating cancer, but invest limited resources with fragmented care for mental health. We stigmatize and marginalize those with schizophrenia. Behavioral health issues underlay so many societal challenges including poverty, incarceration and health. Why don’t we fund and support the programs to address behavioral health? We can do better.”

Speaking of community health: “We spend more on health care per person than any other country, but are falling behind in key indicators of health. And life expectancy is going down. Our health depends more on our zip code than our genetic code. To improve the health of a community and its individuals we need to reduce poverty, create affordable housing, provide access to food, create jobs and support k-12 and higher education. And we need to do this in collaboration with city and state government, local education, higher education, community partners, business and advocates. Impacting the health of communities is what makes us healthy.”

His vision: “Simplify health for everyone.”

His aspiration: “My goal is for every person to say, ‘I have the information I need to make decisions. The system works for me. My caregivers and the health system know me, care for me and ease my way.’ Care should be patient and consumer centered. As it is, the system is designed for the health care system, and care is episodic.”

Advice: “Focus on what you’re doing and do your best always. Be present. Be open to learning all the time. Be inquisitive. Ask questions. Listen.”

What’s the big deal? Seniors. “We need a better understanding of how to manage seniors’ care. We’re at seeing a dramatic increase in senior care as the Baby Boomers grow older. If we don’t manage this wave, older adults will not get access to the care and support they need. This is a big deal and a big opportunity to rethink how we serve them.”

What will change health care: “How we invest in programs will change health care, and we all have an imperative. There’s a disproportionate amount of money spent on health services versus social services. That needs to change. We’re part of the problem, and we have to transform our systems to be both health care providers and partners in improving health. If we do this well, we will change the demand for expensive care and free resources to invest in earlier intervention, prevention and social services. This includes managing lives, not admissions; forming ACOs [Accountable Care Organizations] to manage covered lives; committing to total cost of care over time; rethinking the continuum of primary care to include digital access, retail access, episodic access, integration with behavioral health, and outstanding medical management for chronic disease; finding and training population health management leaders; investing wisely in technology; and moving on the Triple Aim* – fast.”

Is there a game changer? “Technology. We need to be high tech and high touch.”

What we need to care more about: “Poverty. Jobs create dignity, and we should work to create a good childhood for every child. Partnering with business, government, education and not-for- profits will be critical. Housing, hunger, education and childhood obesity – the social determinants of health – are key. One size does not fit all, we need to understand our diverse populations and their needs and develop solutions that understand the unique needs of our diverse communities. We manage a lot of diverse populations, and as a community we should care a lot about poverty.”

Service to others: He serves on the boards at the Oregon Association of Hospitals and Health Systems, Volunteers of America Oregon, Oregon Health Leadership Council, Health Share of Oregon, Oregon Business Council, and Our House of Portland, which provides services to people with HIV/AIDS. He is an honorary board member of Delta Society, an organization dedicated to improving health through the use of therapy and service animals, and is a former board member of the Portland Business Alliance, Trillium Family Services and Janus Youth Services.

About Providence: Five states; 77,000 employees; 3,500 employed physicians/1,000 in Oregon; 25,000 RNs; 34 acute care hospitals; 500,000 enrolled in its health plan; 19 hospice facilities; 22 assisted living facilities; $15 billion in assets; serves 3.7 million people

* The Triple Aim involves improving how patients experience care – including quality and satisfaction; improving the health of populations; and reducing the per capita cost of health care.