New COO talks about his role and how he sees the practice changing

Fred Borrelli is a champion for greater efficiency in serving the needs of customer

COO Fred Borrelli is turning his focus to the needs of patients and physicians.

As the new chief operating officer of the clinical practice, Fred Borrelli is doing the same thing he’s done for several years as an administrator in the Department of Surgery: being a champion of service.

Borrelli, who was appointed COO in September, has served Yale for five years, most recently as associate chair and chief of administration in the Department of Surgery. He has worked in health care environments for more than 20 years altogether. He has master’s degrees in both medical management and business administration from the University of Rochester’s William E. Simon Graduate School of Business Administration.

He has held leadership positions in such national organizations as the Association of Academic Surgical Administrators and the Health Care Financial Managers Association, and in community organizations such as the United Way. He lives in Hamden with his wife, Marianne, who he describes as his “true inspiration,” and has two grown children.

Borrelli spoke about his new role and the future of the practice.

How did you become attracted to health care in the first place?

My mother struggled with cancer and then passed away when I was 14. By the time I was 16, I was on my own, working part time as I finished high school and college. I originally wanted to be a physician, but realized that this was not my true passion, so I went in a different direction. My first job in a health care facility was as an auditor in an academic medical center, and in that role I could see that this was a learning environment, and a dynamic and challenging environment.

How have your years in surgery shaped your perspective?

In surgery, the pace is in the here and now. It’s an environment of heightened awareness—in the way service is delivered and information is processed, and in the desire to achieve excellent outcomes. That’s the feeling we want to have throughout our clinical practice. My professional background, which includes corporate banking, the hospitality industry and community-based services, lends itself well from a business perspective. My priority is to focus on the needs of our patients and physicians, because they are our customers and will pursue other options if we don’t exceed their expectations.

How will you contribute to that in your new role?

As COO, my primary role is to get heavily involved in the way we deliver patient care. Historically we’ve been decentralized and had many managers. That has driven our growth, which is wonderful and energizing. But now we need more common threads in the way we interface with patients, so that the experience of the physician and patient is consistently high quality and cost effective.

What are your top priorities for 2013?

I probably have four priorities.

  • Number one, we have to provide a consistent patient and physician experience in our clinics. This means leveraging the expertise of our department lead administrators and chairs, as well as Huron Consulting Group, which we’ve hired to help improve our performance among other things; and working with Practice Director Marie Follo and talented clinic staff to create a culture of excellent patient care. It will involve plant upgrades, improvement in patient satisfaction scores, physician and staff training, and incorporating practice standards at all clinical care locations.
  • The second is to be successful in an Epic electronic medical record environment. That includes working with Huron and our Epic team leadership to ensure that our clinical departments have a successful and sustainable transition.
  • Third, I have the pleasure of working with lead administrators and chairs in Yale School of Medicine departments and with Yale Procurement to identify opportunities to reduce our non-salary expenses by 15 percent. This will be done by optimizing our purchasing agreements, agreeing upon standard vendors for commonly used items, and educating faculty and staff on the impact of effective purchasing programs.
  • Finally, under the leadership of our new CEO, Paul Taheri, who will arrive in March, we have to work with our strategic partners on a long-term ambulatory practice plan. We will be working with Yale-New Haven Hospital on a joint ambulatory strategy. We will be moving aggressively on a branding campaign for the Yale physician practice. We need to move our agendas along with our partners in order to start gaining traction for the future of a regional ambulatory clinical services model.

How do we make all of these things happen?

One place we want to start is with our patient care employees: the billing staff, the registration staff, the medical assistants and those who see patients every day. We need to make sure they have the resources they need to be successful in their positions and that they are trained to adapt to the changing environment, as they are doing with Epic. I’m personally inspired and humbled by the caregiving efforts all of these people devote to helping our patients. For instance, I notice people in our transplant section know each of their patients by name. We need to take the best work of our employees and make it consistent across the practice.

How do you see our partnership with Yale-New Haven Hospital developing?

We’re much more energized around sharing information than ever before. This was always going on at some level, but with (Interim CEO) Michael Berman’s arrival, there is a lot more energy around it. There are more joint meetings and there is a lot more joint service planning. Does it happen all the time, every day? Maybe not, but it’s happening now with the integration of the Saint Raphael campus, and Epic is truly a joint venture. We need to be much more integrated with the hospital if we are going to put ourselves in a position of strength to face the changing economics in health care.

Where do you see the practice a year from now?

I’m excited about the work we are doing now and the new leadership structure that we recently put into place: Daniel Barchi, chief information officer; Carrie Capezzone, chief financial officer; Marianne Dess-Santoro, chief revenue officer; Karin Render, director of strategic planning and development; and Ronald Vender, chief medical officer. By the end of this year I hope to see all of this resulting in solid changes for the practice. We will be more deeply involved in service-line planning with the hospital, which will allow us to do our work with greater efficiency. We will be fully operational under Epic. We’ll have more consistent, reliable and useful data that will help us understand how our individual physicians are doing, and how we’re doing as a group, as well as help us make the optimal business decisions to meet our clinical mission objectives. We will have a full year of Dr. Taheri’s leadership to ensure that we are in a position of strength for the future. All of this will allow us to move the practice forward with a new sense of purpose and confidence.

And five years from now?

We’ll be operating at top efficiency and we’ll be well on our way toward becoming a national destination for care. We know now that we are in a unique situation with the ability to shape our direction as a leader in health care delivery. As long as we strategically manage our expansion, I see Yale eventually being top-of-mind for people seeking care not only locally, but in Texas, California, the Midwest and internationally. That makes this a very exciting place to be.