Fixing health care: From Greeley to Phoenix, Dr. Robert Groves works to improve patients’ health

Dr. Robert Groves got his first taste of what it was like to be a doctor through his father, who was a general practitioner in Albany, Ga.

The vice president of health management for Banner Health and chief medical officer for the Banner Health Network, who spent much of his career working as a pulmonologist and critical-care physician in Northern Colorado, says he grew up going on house calls and on morning report at the hospital with his father.

Groves’ father was the first doctor in the area to have a mixed waiting room.

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“He faced some interesting challenges in his career, but I always appreciated how grateful people were for the work he did. It captured my imagination,” Groves said. “How would it be to do those kinds of things for people and have that gratification, if you will, of being of service?”

His father encouraged him to go into internal medicine because of its flexibility. He later chose pulmonology and critical care as his specialty after serving his residency in internal medicine at Dallas’ Parkland Memorial Hospital.

He completed a fellowship in pulmonary and critical-care medicine at the University of Alabama at Birmingham Medical Center and Birmingham VAMC from 1989 to 1992. He had a choice of either taking a job in the Midwest or coming to Colorado to set up an independent pulmonary practice and serving the critical-care patients at North Colorado Medical Center in Greeley.

He chose Colorado. He moved to Greeley in 1992 and spent most of his career in the state until he took a job with Banner Health in September 2005, helping lead its Tele-ICU program.

Banner at the time was looking for physician input from the Western region on its Tele-ICU program. Groves liked what he saw. He was asked if he might want to lead the program at some point and he said he was. A year or so later, Banner called him up to take the medical director Tele-ICU position in Mesa, Ariz.

Many doctors weren’t sure they liked the idea of a Big Brother-like program, keeping tabs on them via cameras in the critical-care units.

“What we discovered is, it made the job of the intensivist at the bedside easier,” Groves said. Many intensivists don’t get enough sleep or are fighting fires elsewhere in the hospital, so having someone available virtually “was a huge step forward,” he said. “Not just for the doctors but for the critical-care nurses.”

The value of the Tele-ICU became even more apparent when hospitals started getting in a lot of new graduates and became short on nursing staff.

“Having seasoned nurses available is also a huge value responding to a request for help at the bedside,” Groves said.

Having virtual critical-care doctors and nurses available also helps a hospital identify adverse trends before they become adverse outcomes, he said.

“Nurses at the bedside, increasingly they are newer and are asked to document more. They can only be in one place at one time. It is not always possible for human beings to be good at surveillance,” Groves said.

The computer is much better at discovering trends in the numbers that a passing nurse might not notice. The virtual ICU also aids in what Groves calls dotting the ‘I’s’ and crossing the ‘Ts,’ like remembering to properly position patients every day to prevent bleeding ulcers. The system also helps measure what staff are doing to make sure the hospital continues to improve its quality of care, he added.

“I used to tell folks that what I want is a critical-care physician to be alert, create relationships with family and patients and influence the trajectory of health improvement by recognizing complex patterns and intervening appropriately. I don’t want them to worry about dotting the ‘Is’ and crossing the ‘Ts.’ Let the computer do it. It freed them up and raised the level of professionalism, in my view. It also allowed us to create an opportunity for a career that previously was a young man’s career.”

Groves’ boss, Dr. John Hensing, executive vice president and chief medical officer at Banner Health, said that Groves was an early adopter and enthusiastic supporter of the Tele-ICU program. “So much so, we ended up hiring him to help us implement one of the largest installations of the E-ICU in the country, and he was critical in the early efforts to help other critical-care physicians see and understand the value of an electronic monitoring system, including the physicians behind the camera monitoring patients remotely.”

The system allows Banner to monitor patients in all seven states where it operates.

To take this job, Groves moved to Arizona for a couple of years, commuting back and forth to Colorado to be with his family.

“I was flying my kids out every other weekend to visit. I was missing Colorado so much,” Groves said.

He finally asked if he could trade off, two weeks in Colorado and two weeks in Arizona. During that time, he would spend one weekend a month as a critical-care doctor at North Colorado Medical Center.

It was three years ago, when he was asked to be vice president of health management for Banner Health, that he fully made the move to Phoenix.

When asked what motivates him, Groves said that he believes health care in our country is badly broken. He said there is not just one piece of the industry that is broken but that costs are escalating and the quality of care is suboptimal.

“It is expensive, unreliable, the service is poor, and we are hurting more people than we should. That’s the facts. Everybody knows that. I want to be part of the solution. I want to help fix health care,” he said. “I believe physicians and nurses have a responsibility to leverage our experience and knowledge to help fix it in a way that makes the most sense for everyone.”

Groves believes there is about 30 percent waste in the current system.

“We could do better quality while significantly reducing costs. I do believe the experience of the patient can be vastly improved,” he added.

His current role at Banner allows him to come up with solutions to these problems, and his boss believes he is the right man for the job.

“He is a values-driven gentleman, a well-trained critical-care physician and an excellent communicator who is able to win people over to his views,” Hensing said.

He added that, “we really want to get out and improve health as opposed to just treating them when they are ill. Robert is the medical leader responsible for making that happen. It is a big job and a very important one because a lot of health care in the U.S. is moving increasingly to improving health rather than managing illness; shifting insurance-like risk to provider organizations like Banner as opposed to having it held at a classic insurance company. It’s another major transformative effort for change that Robert is heavily engaged in. We’re lucky to have him.”