Ultimately, the pandemic accelerated collaboration. After working with advisors, mediators, and various stakeholders to build a partnership, the heads of institutions eventually revolved around and split one representative from each institution, said Jacono, who represented MetroHealth in discussions that had been going on for months.
“I think what the five CEOs said is that we should put a small team together, remove all outside influences and put you in one room and see what you can come up with,” said Jacono.
All five institutions have worked with each other in different ways over the years – some formal (joint ventures and investments, institutional research and grants) and others informal between friends or neighbors.
But previous attempts to get all five behind a project didn’t materialize for various reasons, Jacono said.
“It was more platitudes than substance,” she said.
This time it looked different.
Scott Cowen, interim president of the CWRU, said the five institutions had good relationships in the past and had a lot in common. They had no reason to get together as a group beforehand, he said.
“JobsOhio encouraged us to come together and through that conversation we learned that we can do a lot more together than we ever thought possible,” said Cowen.
Dr. Jim Merlino, the clinic’s chief clinical transformation officer, invited representatives from the other four institutions to dinner in August where they “were pretty straightforward about the challenges we were going to face,” he said. Health systems compete for patients, universities compete for students, and all five compete for investment and philanthropy dollars.
They found common ground in a common enemy: COVID-19.
Building a framework for each organization to continue its own work and expertise with the assistance of others also helped solidify the plans for collaboration. Instead of mixing resources and creating a common governance, each institution could bring its own focus and expertise to reinforce the work of the partners.
“So it doesn’t force either of us to take a detour, but it does force us to split up among the other four institutions so that we can get there faster,” said Jacono.
Although CSU President Harlan Sands believes the efforts would have come together without COVID-19, he said the pandemic has changed the nature of the partnership. It brought health systems together in ways that made the group think about health care in a post-pandemic world, including socio-economic factors and the unequal distribution of health care in the United States, he said.
“I think the pandemic is drifting where this group work is going and how it’s going to be good not just for the Cleveland Clinic or UH or Metro, but for all of Cleveland’s citizens as well,” Sands said.
Whether the new ways of working together are sustainable is the “million dollar question,” Merlino said, adding he was optimistic. With the structure they put in place and the commitments made by the leaders of the organizations, “we will uphold it,” he said.
Historically, the notion that competition should separate businesses from one another has set the trend that institutions should take care of themselves, Sylvan said. And while they will continue to compete when it makes sense, the communications channels established last year and formal commitment to collaboration in the Cleveland Innovation District mark a new chapter.
“Of course, at the end of the day, a patient is a patient when it comes to community,” said Sylvan. “And I think it took some catalyzing event like a pandemic to force us to get rid of the ego and force us to think about ‘coopetition’ versus pure competition. And I think those elements are likely to be sustained. “
Reporter Michelle Jarboe contributed to this article.
