Q&A: The role of a chief medical officer in the pandemic era

Sree Chaguturu, MD, is Chief Medical Officer, CVS Caremark, where he focuses on enhancing the quality of services provided to millions of plan members and patients, while also contributing to the overall mission of CVS Health. We sat down with him to talk about his role and how the global pandemic has impacted how he approaches it, as well as challenges and opportunities in the year ahead.

How have your past experiences influenced how you approach your role as the chief medical officer at CVS Caremark?

Before joining CVS Caremark, I had opportunities to work with a number of different health care organizations — as a clinician, consultant, and administrator. That allowed me to learn about the complexity of health care from various angles — ranging from clinical care, managed care, pharmaceuticals, health services, and technology.

This exposure enabled me to build upon my clinical training as a physician and develop a broader perspective and understanding, which helps inform my approach. What has perhaps been the most interesting part of the process is learning to bridge the clinical and non-clinical aspects of my role as a chief medical officer (CMO). As a clinician, the patient is at the center of care and the primary consideration. As a CMO, I strive to bring my variety of experiences to the organization while always keeping patient welfare first.

How do you view your role as CMO?

The role of a CMO is to be data-driven, collaborative, and patient centric. In addition to my other responsibilities as CMO, I am also head of Medical Affairs, which supports a lot of teams within the company. We use our clinical expertise to guide our pharmacy and therapeutics committees, help inform our formulary and product development, support our trade organization in their discussions with manufacturers, and help our clients understand the trends they are seeing in their pharmacy benefit management data. As CMO, my role is to collaborate with my peers and counterparts within all those functions, and to bring my patient-centric philosophy and perspective to that.

For our clients, my role is to be a trusted advisor and work with our team to help our clients achieve their goals.

Most health plans have a medical director role within their organizations, and we play a collaborative role with their clinical departments. That’s much less common among employer clients, where we play more of a consultative role. So they look to us — and to me as CMO — to help them understand and navigate the complex health care environment.

How has the pandemic impacted your role?

The coronavirus pandemic has accentuated and emphasized the core principles of keeping our clinical approach current, nimble, and adaptable to meet ever-changing client needs. Because the novel coronavirus came on so fast — and we initially knew so little about both the virus itself and its pathways of infection, prevention, and clinical impacts — we had to constantly rely on our medical colleagues, both inside and outside the organization, and across the country, to understand what was happening and chart a path forward. It is worth noting that the pandemic is a clinical crisis first, which has had significant economic impact. It’s quite different than other types of crisis situations that our clients encounter, which usually are more economic in nature (such as a stock market crash). Since this has been a clinical crisis, the clinical focus of the role is more critical than ever.

Although we know much more today about the virus and how it expresses itself, during those early months, we were very challenged by the lack of information. We had to confront how to handle our utilization management and ensure continuity of care, making decisions without a clear sense of how long the pandemic would last and if it would have a substantive effect on U.S. health care. I had an opportunity to support our testing, treatment, and vaccine efforts, and bring that knowledge to our clients and members. Internally, that gave me the opportunity for much broader collaboration across the enterprise to ensure continuity for members and be a trusted advisor for our clients.

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How do you see the opportunities and challenges going into 2021?

One of the most important and immediate challenges, of course, will be to contain the COVID-19 pandemic. Now that the U.S. Food and Drug Administration has given emergency use authorization to vaccines for the coronavirus that causes COVID-19, efforts are underway to ensure we have widespread adoption in communities across the country.

Our immediate focus is on the multi-pronged, nationwide education and awareness campaign to both address vaccine hesitancy and provide safe, equitable access.

While many of the public health levers we have used to date to control the pandemic — social distancing, wearing masks, hand hygiene, broad testing, and contact tracing — remain important, we now have a powerful tool to combat it. Our immediate focus is on the multi-pronged, nationwide education and awareness campaign to both address vaccine hesitancy and provide safe, equitable access.

However, other challenges persist and much remains to be done to address them. The COVID-19 pandemic has accentuated the challenges within our health care system, including that of equity and social determinants of health. It is clear that there is a lot of disparity in the current system. We need to make sure that all people have equal access to the care they need. A potential starting point is to build upon the use of virtual care that has emerged as a critical tool during the pandemic, and expand its availability, as well as the services offered. We also need to improve the overall quality of health care by increasing coordination within a fragmented system, closing gaps in care, and making sure patients get the right therapy at the right time. Last but not least, we need to make sure health care is affordable — for consumers and for plan sponsors.

Image source: Licensed from Getty Images, 2021.