Cadence Conversations

How Rush made quality its brand: A conversation with Dr. Brian Stein

Episode Notes

Join host Eve Cunningham, MD, Chief Medical Officer at Cadence, in conversation with Brian Stein, MD, Vice President and Chief Quality Officer at Rush University System for Health.

Rush is a leading academic health system in Chicago with a national reputation for quality — ranked in Vizient's top 10 among academic medical centers for 13 consecutive years and a six-time U.S. News & World Report Best Hospitals Honor Roll honoree. In this episode, Drs. Eve and Brian explore how Rush has embedded quality into its organizational identity, what it takes to maintain consistent care in an academic medical center, and why remote patient monitoring became a strategic priority.

Their conversation focuses on:

• How Rush treats quality as a brand differentiator rather than a compliance exercise — and the operational principles that make that sustainable
• Why academic medical centers face a unique quality challenge with trainee turnover every 2–4 years, and how tight processes compensate for that churn
• What made Rush an early adopter of remote patient monitoring, and the three-part filter Dr. Stein uses to evaluate any new technology
• Why patient retention on RPM surprised him more than the clinical outcomes — and what's driving long-term engagement
• How to think about short-term clinical wins versus long-term cost savings, and the payer misalignment that makes proving ROI difficult
• Where patient stratification is heading — matching the intensity of remote intervention to individual patient needs
• Where Rush is placing its bets on AI, from diagnostic radiology and pathology to virtual nursing and operational efficiency

Dr. Stein is a partner of Cadence and not compensated for this podcast.

Segments:

• [00:05] Introduction — Eve welcomes Dr. Stein to Cadence Conversations
• [00:39] Origin story — How research on administrative claims data led to a career in quality
• [04:02] Crew resource management — Team-based training and hardwired safety tools at Rush
• [05:46] Blood administration errors — How barcoding through Epic reduced a recurring safety issue
• [07:47] Quality as brand — Why Rush treats quality as a competitive differentiator, not a compliance exercise
• [09:47] Telling the quality story externally — CMS star ratings, US News rankings, and public credibility
• [11:36] Quality in an academic medical center — The trainee turnover challenge and why tight processes matter
• [14:52] Innovation and new care models — Why care beyond the walls became part of Rush's strategy
• [17:28] The case for RPM — Better outcomes, easier provider workflows, and not breaking the bank
• [20:34] What surprised him — Patient retention and engagement exceeded expectations
• [22:13] Evaluating the data — Blood pressure control, goal-directed therapy, and the cost-effectiveness question
• [24:30] Patient stratification — The future of high-touch vs. lighter-touch remote interventions
• [28:05] Research priorities — Short-term clinical wins vs. long-term cost savings and the payer challenge
• [31:50] Chronic disease as a lifetime journey — Why sustained engagement matters
• [33:09] AI at Rush — Augmented intelligence in radiology, pathology, virtual nursing, and access centers
• [36:23] Closing — Optimism grounded in a strong quality culture

Key Takeaways:

• Quality becomes sustainable when it's treated as organizational brand identity, not a regulatory requirement — and when you make it easy for clinicians to do the right thing.
• Academic medical centers face a unique challenge: trainee turnover every 2–4 years means quality can't rely on individual education alone — it must be embedded in process and systems.
• The most surprising outcome of Rush's RPM journey was patient retention — patients stayed engaged for years in a program category where attrition is typically high.
• The future of remote care delivery is patient stratification: matching the intensity of the intervention (high-touch human + tech vs. lighter-touch tech-enabled) to the patient's needs.
• AI's near-term impact in health systems will be augmented intelligence — creating efficiency in diagnostics, operations, and access — not replacing clinical judgment.