Providence Health Care, the Inland Northwest’s largest provider network, has transitioned effectively with its Renton, Wash.-based parent, Providence Health & Services, which merged with Irvine, Calif.-based St. Joseph Health in 2016, says Elaine Couture, regional chief executive of Providence Health Services.

The combined network, Providence St. Joseph Health, is now the third-largest nonprofit health care system in the country and has a presence in seven states. Spokane now serves as the regional head of the organization’s Washington/Montana region, of which Couture also serves as the executive vice president.

Couture assists in the oversight of 13 hospitals, more than 2,000 employed providers and more than 23,000 caregivers across a total of 220,000 square miles, Providence Health & Services statistics show.

The Journal sat down with Couture recently to talk about the constantly changing health care industry and what consumers can expect to see in the future.

Journal: Let’s just start with the cost of health care. Do you foresee medical costs falling anytime soon?

Couture: I can’t say I do, but we have to bring the cost down. There’s no doubt about that in my mind. Our outcomes aren’t any better than some other places (globally). I don’t know what the solution is to that, but we really have to make this much more affordable. Health care is something that everybody needs. Personally, to me, health care is still a right and not a privilege.

Journal: What are some other leading priorities for 2018 that Providence will address?

Couture: When people still think about health care, one of the things that patients and consumers are thinking about is the structure of the hospital setting. While that’s still a very important part of what we provide, into the future, we’ll continue to ask, “How do we create a more consumer-friendly system that consumers can navigate better, and how do we keep people out of the hospital as much as possible?”

Journal: What does that entail from your vantage point?

Couture: Some of the things that we’ve identified as being very important are, for example, embedding different disciplines into the primary care offices—such as mental health. Also, we’ll continue to open up more express cares (Providence Express Care Virtual), more urgent cares; places where people can go to be seen that gives them immediate access to someone who can tell them if what they have is serious enough to have to go to the hospital.

Journal: Personal use of technology continues to proliferate. Do you see that continuing among consumers as it relates to health care?

Couture: Yes, we’re continuing our work on existing and new digital applications that will connect us more to the consumer and what they want. We can schedule a flight and check in with an app, but yet that’s not always available to the consumer as they’re trying to make medical appointments. There will be a lot more of that in the future. I also see medical developments in area of artificial intelligence with Alexa (Android), Siri (Apple iOS) and Watson (IBM) being able to answer medical questions from a device.

Journal: What are some other issues you see now that are having effects on the medical community within Providence’s Washington/Montana footprint?

Couture: I think the thing that’s high on everybody’s mind right now is around the opioid crisis and mental health. And that’s not just the health care system, but entire communities. I have business people telling me that they’re being challenged in their own industries because they can’t find enough employees who can pass a UA (urinalysis).

Journal: Tell me about some other initiatives being developed within the Providence St. Joseph’s system.

Couture: One of the things that’s emerging is the whole idea of individualized medicine, which is, looking at the scientific wellness of what’s in your genetic makeup. Your risk factors aren’t going to be the same as my risk factors. We’ve got an entire institute on scientific wellness that’s beginning to emerge with some pretty unique things for consumers.

Journal: The health care sector remains a growth industry. Are there enough bodies to go around for all the jobs that will eventually need to be filled?

Couture: There’s going to be a shortage in all types of professions, and not just in health care. For us, it’ll be physicians, nurses, social workers, pharmacists—it’s just going to happen. What I think is becoming important, and something that we’re focused on is asking, “How can we make sure people are working to the top of their license?”

Journal: What does that mean?

Couture: Seeing the physician may not be the appropriate person to see depending on what it is that you’re coming in for. We need everybody, nursing assistants, nurses, physician’s assistants … working up to the level of their licensure to provide care for patients.

I do think there will be new jobs that will be created out of health care, and we’re starting to see them emerge now. Case workers, who’ve been trained by us but don’t have medical backgrounds, now are helping people with chronic diseases navigate the health system.

We have writers, accounting experts, finance experts, engineering technicians—the gamut is so large. If we try to do everything in the future the way we’ve done it in the past then we’re going to have problems.

Journal: You’ve spent your entire career in the medical field. Are you still enjoying it?

Couture: I’m having a great time. The thing that excites me about health care right now is that I’m helping to create a system I’m going to be engaging in more and more as I get older.

Some of the disruptions occurring in health care, while sometimes they can be concerning, I still believe there are a lot of good things. We’re getting away from the paternalistic-maternalistic kind of interaction that it used to be between medical professionals and patients to now empowering consumers to be equipped with the right questions and really taking charge of what it is they want in their health care experience.

I just think this is a real exciting time to be in health care. There’s still something very sacred in taking care of people.