When Andrea Rosler became the vice president of human resources at Huntsville Hospital in 1993, the hospital was, well, just a hospital. During her tenure, however, it’s since expanded to encompass seven different hospitals, as well as a number of care services and physician practices. Now, the Huntsville Hospital Health System is the third largest publicly owned hospital system in the nation. Across northern Alabama and southern Tennessee, the organization is responsible for about 1,800 patient beds and roughly 12,000 employees.
It’s a far cry from the quaint vision of healthcare that first inspired Rosler. As a child growing up in Meridian, Mississippi, she often accompanied her grandfather to the hospital he owned and operated in rural Alabama. “I just remember how excited the patients were to see him. He knew everybody,” she recalls with a chuckle. “He knew everybody’s family. He probably birthed all their children.”
This was in the late 1960s and early 1970s, and her grandfather’s hospital was located in a small town that was primarily African American. “At the time, a lot of places were very segregated, but it wasn’t there, from what I remember,” Rosler says. “I realized, not at the time but in retrospect, what a great thing that was for a small community in Alabama.”
Rosler carried that inspiration through her studies at Millsaps College in Mississippi and the University of Alabama in Birmingham, knowing all the while that she wasn’t necessarily cut out to be a physician. Instead, she did a directed study in human resources at a county hospital in Jackson, Mississippi, and after graduate school, she worked as an administrative resident at Huntsville Hospital. She was hired as VP of human resources after nine months and has been there since.
“At the time, we were much smaller,” Rosler says. “We were a hospital; we weren’t a healthcare system at the time.”
“Providing healthcare on the front lines—where most of us spend most of our time, which is at work—is a strategy that we see for the future of our health system.”
She has been in this same role since 1993, but her duties have evolved considerably. At first, Rosler developed a big-picture view of the hospital by working on the business end of a variety of departments, including nursing, pharmacy, and even security and parking. “When you have that kind of opportunity, you’re constantly growing and learning,” she says.
In 1994, Huntsville Hospital acquired the first of several surrounding hospitals. Rosler soon found her role shifting toward those acquisitions, as well as how best to align the goals of those organizations with the goals of Huntsville. “As the organization grows and changes, you spend less time transacting the business and more time shepherding the business,” she says.
During acquisitions, Rosler says that it’s important to recognize that each hospital has its own culture, its own way of doing things, and a great deal of organizational pride. For her, it’s not about urging Huntsville’s acquisitions to take on the organization’s practices as much as it is integrating them into the established culture. “We want each and every hospital to have their own identity,” she explains.
That idea of personalization and identity is emblematic of Rosler’s larger ideas regarding healthcare. Just as her grandfather worked to develop personal relationships with his patients, Rosler is steering Huntsville Hospital toward doing the same with its employees. In 1998, she established the hospital’s first employee clinic, an onsite office dedicated to staff members in need of care for chronic or acute illnesses. Here, they could be seen quickly and efficiently so they could get back to work. “That was the goal twenty years ago,” Rosler says, noting that it has since evolved into something even more beneficial.
With inspiration from the Asheville Project, which provided education and personal oversight for city employees with chronic health problems, the program has become even more personalized. “We were able to take a look at our employees that either had diabetes or prediabetic conditions and put them in a program where they were able to manage their care,” she says. That includes care managers and programs designed to help with exercise, diet, nutrition, or other treatments that can help alleviate chronic conditions.
It seems to be working. Both employees and their spouses have seen hemoglobin A1c results drop from 7.5 percent to 7 percent (anything above 7 percent is an indicator of possible diabetes), and the percentage of employees with diabetes dropped from 11 percent to 8 percent—well below the state average. Rosler also notes a dip in medical costs. “Our per employee, per month medical care cost has been reduced by 2.2 percent,” she says. “It’s hard to draw a line and say that it’s because of our programs, but it’s a little unprecedented and unusual.”
Huntsville Hospital also branched out by helping to start an employer-sponsored clinic for local government employees. Rosler says they’re also in the process of building a program for employers on the west side of Huntsville.
Rosler is confident that employer-sponsored healthcare is a trend that will soon find a foothold in the workplace. “We’re going to see more and more pressure to treat acute illnesses on a concierge kind of basis, right at the workplace,” she says. Rosler touches on a prevailing trend in the healthcare space right now: personalized care. She discusses the importance of having a practitioner that is helping to direct patients in the most efficient and effective care, as opposed to patients waiting months to go see a specialist only to find out that’s not what they needed. The goal is to keep people out of the hospital, to keep them from having unnecessary tests and unnecessary procedures. “Providing healthcare on the front lines—where most of us spend most of our time, which is at work—is a strategy that we see for the future of our health system,” she says.
Rosler is most excited when speaking of the practitioners who have been working closely with the employers to determine the specific needs and goals for that employee population. “They really feel like they’re practicing medicine again,” she says. “When I think back to my granddaddy, he took out appendixes, delivered babies, and knew everybody in town. It’s interesting to talk to the physicians that we have in our clinics who are grateful to do the same kinds of things. It brings it full circle.” AHL
