Daniel Wolfson Leads Transformational Efforts for Improved Healthcare Delivery

"I grew up in the 60s and went to college in the early 70s. So from the very beginning, I wanted to change society," Daniel Wolfson said of his decades long career.

A sociology and psychology major at Boston University, Wolfson was involved in volunteer work at a state hospital. That work led to a position as a case aid assistant at Mass General on the rehabilitation floor, working with amputees and patients recovering from spinal cord injuries and strokes. In that position, his first job, he was introduced to multiple disciplines of practice and found that very few practitioners were discussing their patients and collaborating to organize their care.

"There were PTs, OTs, nurses, doctors, psychologists, social workers. Why weren't they meeting as a team? They're all treating the same patients. So that was my first entrée into administrative thinking," Wolfson said.

Inspired by this work, he would go on to receive his master's degree in health services administration from the University of Michigan's School of Public Health.

"I've only ever had three jobs," Wolfson said.

Wolfson was the Director of Planning and Research at the Fallon Community Health Plan. During that time, he led the product development team that launched the nation's first Medicare risk contract with the Health Care Financing Administration.

Wolfson served for nearly two decades as the founding President and CEO of the Alliance of Community Health Plans (formerly The HMO Group), the nation's leading association of not-for-profit and provider-sponsored health plans. During his tenure, Wolfson earned national recognition for spearheading the development of the Health Plan Employer Data and Information Set (HEDIS™ which is now referred to as the Health Effectiveness Data and Information Set) and co-sponsoring the Journal of Effective Clinical Practice with the American College of Physicians.

"My philosophy is that in order to change the healthcare system, you need to integrate payment and redesign of the delivery system with an emphasis on primary care. Within a group practice model, the health plan could provide data and infrastructure that would support physicians' care of their patients, while also being cognizant of care utilization and quality, as well as patient safety," Wolfson said.

He has served for 22 years as Executive Vice President and COO of the ABIM Foundation, a not-for-profit foundation focused on advancing medical professionalism and physician leadership to improve the healthcare system. The ABIM Foundation was one of the earliest supporters of the National Patient Safety Board Advocacy Coalition.

This year he celebrates 11 years of the ABIM Foundation's Choosing Wisely initiative with a lofty goal to improve healthcare by encouraging clinicians to have meaningful conversations with their patients to avoid unnecessary tests and procedures, many of which offer little benefit and, in some cases, do more harm than good. The Choosing Wisely campaign began as a partnership with nine physician specialty societies that collectively published 45 recommendations intended to discourage unnecessary care, and has since grown into an internationally-recognized campaign, inspiring similar efforts in more than 30 countries. It now includes more than 80 clinical society partners, with organizations representing physicians, nurses, pharmacists, physical and occupational therapists, and other clinicians outside of allopathic medicine.

"Through a grant from the Robert Wood Johnson Foundation, we worked directly with 14 health systems, each of which implemented at least three recommendations. All 14 worked to reduce the number of prescriptions of antibiotics for adults with respiratory infections and all 14 achieved reductions, with 12 lowering their utilization by more than 20 percent," Wolfson said.

More recently, a 2021 study of 130 articles on Choosing Wisely shows the effectiveness of implementing recommendations through multi-component interventions – for example, feedback, order sets, alerts, clinical champions and clinical pathways. But there is still more to do. Trust between patients and clinicians is a critical component to enable these important conversations about tests and treatments.

Wolfson has refocused his expertise and passion on ABIM Foundation's Building Trust initiative which is addressing the mistrust – particularly among populations who have been historically marginalized – facing the healthcare system. Building Trust is a three-pronged strategy to: Convene leaders to have conversations on the importance of trust; help develop research on the evidence that trust impacts performance; and identify best practices and behaviors that drive trust. The aim is to elevate trust as an essential organizing principle for improving healthcare.

"I always have fun at work and I believe in trying to be on the cutting edge of innovation. I've been lucky to find myself in that position," Wolfson added.

When asked what's next for patient safety, Wolfson said "moral leadership" and people like Dr. Karen Feinstein, who are insisting on incentivizing patient safety, regulating it if necessary, and advocating for using data to make actionable progress in healthcare.

A long-time friend, colleague, and collaborator of and with Dr. Feinstein and the Jewish Healthcare Foundation, Wolfson said, "She has an amazing sense of how to build coalitions, how to move things forward, a real dedication to quality and safety. She's a charismatic leader. She's been persistent and has persevered. And she's shown a lot of vision and leadership all the way down the road. I've always been a fan of hers and a collaborator with her."
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