Share ThisOur vision is a world where everyone embraces health. In our Remarkable Leadership series, we talk with people who are making that vision a reality by leading the work to create a new system of health, empower our customers and communities, and better support every individual’s health journey.
Dr. Sricharan Chalikonda, chief medical operations officer and chair of the Surgical Institute at Allegheny Health Network
“If there’s an area of health care that someone wants to disrupt, AHN is the place to do it,” says Sricharan Chalikonda, MD, MHA, FACS, and AHN chief medical operations officer and chair of the AHN Surgical Institute.
Allegheny Health Network (AHN) is doing just that as part of Living Health, a simpler, better coordinated, more proactive and personalized health ecosystem for individuals and their clinicians. Change of this magnitude requires collaboration across clinical and operational workflows, putting doctors, nurses, and clinician leaders like Dr. Chalikonda in a unique position to drive improvements.
“I’ve always been taught to treat every leadership opportunity as a term. This gives you a finite amount of time to make a real impact and an immediate opportunity to start shaping successors,” he says.
In this Q&A, Dr. Chalikonda shares his perspective on the key drivers of an improved health care system: clinician leadership, value-based care, a start-up mindset, and robust data and analytics.
Catherine Clements: What brought you to Allegheny Health Network?
Dr. Sri Chalikonda: Two things really attracted me to AHN. First, there was the commitment to being a clinician-led organization. Second, the organization’s model and mission to reinvent health care was really compelling to me. We’re in such a unique position to improve the way patients receive care holistically because of the close alignment between payer and provider functions.
Catherine Clements: Was clinician leadership always in the cards for you?
Dr. Sri Chalikonda: I have always loved clinical practice, but I also liked the operational and leadership activities that I had been exposed to. I knew this would be a great way to balance a clinical practice with leadership opportunities.
I spent most of my career at the Cleveland Clinic, which has always been a clinician-led organization, so I really didn't know any different. But what I’ve seen of health systems that aren’t structured this way just confirms for me that the future of health care is clinician-led.
Catherine Clements: I understand you dedicate 1.5 days a week to seeing patients in the Center for Digestive Diseases and Cancer Institute. Why is it important for you to stay active in the clinic?
Dr. Sri Chalikonda: Maintaining a clinical practice, rounding in the hospitals with residents and colleagues, and spending time in the operating room are all important to me. It really grounds me, and I think makes you overall a better leader.
On the administration side, it’s easy to get caught up in what’s happening in a meeting. It makes all the difference to know how those meetings can impact people and change lives dramatically on a day-to-day basis. I think it’s valuable for everyone who can be a clinician leader to continue to keep your clinical practice where possible.
Catherine Clements: Between the clinic and your leadership roles, which include chief medical operations officer, chair of the AHN Surgical Institute, overseeing perioperative nursing, the transfer center and shared responsibility of IT operations — how do you balance it all?
Dr. Sri Chalikonda: Over the years at AHN, I've been fortunate to have an amazing team that performs independently and autonomously with me providing strategic oversight. This approach was intentional to develop spectacular leaders — and they’ve all exceeded what I could achieve on my own. It really has not been me balancing all those things, but instead having a team of doctors, nurses, and administrators under me that keep these functions going on seamlessly. This enables me to focus more on providing strategic direction and leadership than day-to-day operations.
Catherine Clements: Any good books that you’ve read recently?
Dr. Sri Chalikonda: Most recently, I read a great book called Essentialism: The Disciplined Pursuit of Less by Greg McKeown. It’s fascinating to me to look at examples of where if you focus on what you’re doing and allow other people to do the work, you can accomplish more with the goal of doing less. Some of the best leaders say “no” more than they say “yes.”
Catherine Clements: In your opinion, what is currently the biggest obstacle to improving health care?
Dr. Sri Chalikonda: I think the biggest obstacle is misaligned incentives. Nationally, provider networks are struggling to maintain margins based on insurance reimbursement, which means that they are incentivized to provide care at a higher cost, equating to higher revenue. With a greater focus on population health, the goal is to keep people out of the hospital and provide care that's overall less expensive over the course of someone's lifetime. Right now, the financial incentives don't really align to provide that. At AHN, we’re really looking at how we value clinicians based on positive outcomes for patients versus the fee-for-service model.
Catherine Clements: What else makes AHN stand out from other health systems?
Dr. Sri Chalikonda: We function somewhat like a startup, and innovation is really encouraged. We’re not overly hierarchical when it comes to sharing ideas. Being clinician-led means wearing many hats, because just like any startup, we are creating new roles and jobs that don’t currently exist. This attitude also makes it a dynamic, fun place to work. And as a clinician-leader, it's exciting because you know that the decisions you make are ultimately going to help patients.
Catherine Clements: I like the startup analogy. Can you share some examples of AHN’s latest innovations?
Dr. Sri Chalikonda: Absolutely, there’s a lot of groundbreaking work happening across the network. In the cancer space, we’re really excited about Dr. David Bartlett’s “moonshot biomarker program.” This initiative looks at identifying, treating, and preventing cancers before they form — essentially curing patients before more advanced treatments are needed. Currently, we treat advanced malignancies through surgery — but in a perfect world, cancer surgeons like me will be out of work.
Another focus area for AHN, particularly during the height of the pandemic, has been better protecting health care workers. One of the ways we executed on this was through the adoption of elastomeric masks. Given these reusable respirators are typically used in industrial settings instead of health care settings, we created a protocol for implementing this type of PPE. We know that this pandemic is by no means over. And within our lifetime, we may have another serious infectious event that is airborne. We’d really like to see how our research can help develop the next generation of masks that are more comfortable and allow for better communication.
Through a research grant from the National Institute for Occupational Safety & Health (NIOSH) and the CDC, we’re also assessing how respirators can better protect staff in the operating room with surgical smoke.
A final example of innovation is how we’re changing decade-long scheduling practices for operating route cases. This type of logistical modernization will allow us to see more patients, particularly during a time of shorter staffing.
Our leadership welcomes that type of disruptive thinking.
Catherine Clements: Part of the Living Health strategy is putting patients and clinicians at the center of the model. Can you tell me more about how AHN is executing that?
Dr. Sri Chalikonda: Patients have always been the focus of our care delivery model, but what’s newer is our focus on clinician wellness. When we look at putting technology in place to help care for patients, we are also addressing how that workflow can ease administrative burdens of the clinician.
For example, right now, we’re working to reduce the amount of prior authorization for our patients by identifying value-based providers. This enables us to reduce clinician burnout by minimizing the administrative load. There’s also a team working to identify the right care programs to reduce unnecessary or wasteful care. Simultaneously, we have many AHN physicians collaborating to build and execute the Living Health strategy.
Catherine Clements: Five to 10 years from now, where do you see the health care industry going?
Dr. Sri Chalikonda: I think we’re going to see a focus on hospital operations, specifically advanced analytics. Through predictive modeling, we can make decisions to improve our supply chain, transfer center, surgical operations and more.
If you think about how the logistics around delivering packages has evolved over the last 10 years, you could have never imagined you’d be able to order something through Amazon, and it's there the same day. This is a great example of how the analytics have stepped up to the need.
When patients weren’t as sick and there were more hospital beds available throughout the country, you didn’t have to have the same logistics capability we have now. So, as our logistics capabilities grow, you'll really see the world of medical operations function much more efficiently in the future. I expect we’ll use predictive analytics to let us know how many patients will need care by day of the week, and by region, and to help facilitate discharges. I think this model is where we go in the future.
A prime example of this operational optimization is AHN’s rapid expansion of telehealth. Before the pandemic, our network was performing a handful of video visits and telehealth consults a week. By the end of 2020, we had carried out nearly 500,000 virtual engagements — that’s almost a 5,000% increase over 2019 volume. Many different teams stepped up to ensure we had the infrastructure, bandwidth and training needed to take care of as many patients as possible in a remote environment.
Catherine Clements: What is AHN’s top priority at this point in the pandemic?
Dr. Sri Chalikonda: The biggest priority we have now is our ability to provide great care for the large influx of patients we are seeing from throughout the region. We utilize an AHN operations center that manages many of these logistical issues. This is how patients are brought into the network from other hospitals or inter-hospital transfers.
The pandemic has caused a shortage of all kinds of workers, and health care workers are not excluded. Nationally, this has caused a lot of stress on the entire health system. At AHN, we’re actively working to expand services across the network to hospitals that previously may not have had certain service lines. This enables our sickest patients to get into our tertiary and quaternary centers. There are many moving parts, but our focus is to ensure our sickest patients get the care needed for the best health outcomes possible.
Sricharan Chalikonda, MD, MHA, FACS, is the chief medical operations officer and chair of the Surgical Institute at Allegheny Health Network. A nationally recognized physician leader and pioneer in the use of highly advanced surgical procedures for abdominal cancers and other diseases, he joined AHN in 2018 from the Cleveland Clinic.
At AHN, Dr. Chalikonda leads clinical operations for the network’s physician organization, a role that includes oversight of surgical services provided at AHN’s inpatient and outpatient facilities. He also maintains his surgical practice as part of AHN’s Center for Digestive Diseases and Cancer Institute.
Dr. Chalikonda earned his medical degree from Kasturba Medical College and a master’s degree in health care administration from Ohio University. He completed his general surgery residency and a fellowship in minimally invasive and bariatric surgery at the Cleveland Clinic, and a surgical oncology fellowship at UPMC.
Dr. Chalikonda is a Professor of Surgery at the Drexel College of Medicine and has published numerous scientific articles, abstracts and book chapters about issues and advancements in his field, including the surgical treatment of pancreatic cancer, the treatment of peritoneal surface malignancies and minimally invasive treatment of liver disease.
Of his many achievements, Dr. Chalikonda shares his early work in robotic surgery was his most impactful. This innovation took operations that previously required a large incision and now could be performed either minimally invasive through a laparoscope approach or with the use of a surgical robot. This vastly improved patient outcomes, including shorter recovery times, reduced pain and minimal scarring.
He is a fellow of the American College of Surgeons and was named one of Pittsburgh Magazine’s "Best Doctors" in 2019.
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