Despite abruptly leaving the Clinic amidst cloudy circumstances and vague explanations in July 2009, former Chief Operating Officer Strand was the Clinic’s fifth-highest paid employee in 2010 at $1.3 million. What’s more, he received the largest raise, 18 percent, of any of the Clinic’s employees who were paid more than $1 million last year. Not too shabby for a guy who didn’t work one day at the health system the entire year.

In 2009, Strand received $1.1 million from the Clinic, making him the renowned hospital’s sixth-highest paid employee that year. In each of the last two years, Strand has been among the two highest-paid employees at the Clinic who don’t hold medical degrees.

So the obvious question becomes: Why was Strand’s severance so generous? Unfortunately, answering that one isn’t so obvious.

A Clinic spokeswoman declined to answer specific questions about employee compensation, such as whether Strand is due any money from the Clinic in 2011.

A spokesman for Strand’s new health IT company, LifeNexus, didn’t return a call.

Certainly the absence of full transparency on both sides about why Strand left – and the considerable size of his severance payments – invite speculation that he was pushed out. A lack of clarity around his role, plus a strained working relationship and personality conflicts with Clinic CEO Toby Cosgrove, led to Strand’s exit from the Clinic, one source said.

The story of Strand’s departure from the Clinic can’t be told without mentioning his wife, former Clinic Chief Experience Officer and an industry star in her own right, Dr. Bridget Duffy. The Clinic announced Duffy’s departure at the same time it did Strand’s. In public comments, the Clinic would only at the time allow that the Strand and Duffy’s departure was “mutual” and that the two “wanted to move on, move back home to California.” When reached by the Plain Dealer shortly after their departures were announced, the two ex-employees declined comment.

Regardless of the circumstances surrounding their exits from the Clinic, Strand and Duffy seem to have found success in their post-Clinic lives. They cofounded ExperiaHealth, a consulting firm that aims to help hospitals improve the patient experience and was acquired about a year ago by Vocera Communications.

In June, Strand joined Broomfield, Colorado-based LifeNexus as CEO, though he lives in San Francisco, according to his LinkedIn page. LifeNexus has essentially created a credit card that contains a user’s personal health information, such as prescription, insurance and emergency care information. LifeNexus’ personal health card can also be used as a debit card to pay for deductibles and copays.

Here’s a video of the company’s former CEO, and Strand’s predecessor, discussing the card.

The last time spouses David Strand and Dr. Bridget Duffy made news in Cleveland, they were heading out of town.

Strand, then the Cleveland Clinic’s chief operating officer, and Duffy, its chief experience officer, left the Clinic in July 2009 amid a cloud of unanswered questions, vague explanations and – for Strand at least – a golden parachute. His $527,000 severance payment vaulted him to second in Cleveland Clinic compensation in 2009, trailing only CEO Dr. Toby Cosgrove.

Regardless of the circumstances of their departure, Strand and Duffy certainly seem to have found success in their post-Clinic careers. They started a San Francisco consulting firm that was later sold. And while Duffy continues to run that organization, Strand has moved on with a healthcare consulting company.

Duffy also continues to build her own personal brand as a patients-first innovator.

Through a spokeswoman, Strand and Duffy declined interview requests.

Soon after leaving the Clinic, the couple started ExperiaHealth,which  aims to help hospitals improve the patient experience. That, incidentally, was Duffy’s charge when she came to the Clinic to as its first ever chief experience officer. “ExperiaHealth works with organizations around the globe to create strategies that restore the human connection in healthcare,” the company explains on its site.

Clients include major heavyweights like Mayo Clinic, Kaiser Permanente and HCA, according to a statement from Vocera Communications, which acquired Experia for an undisclosed sum in November.

Duffy stayed on as Experia’s CEO after the acquisition, though it’s unclear exactly what, if any, Strand’s current role is with the company. He’s listed on Experia’s team page, but no title is associated with his name.

A company spokeswoman, who works for an outside public relations firm, wasn’t clear on Strand’s role with Experia.

The news release announcing the Experia sale noted that Strand would “continue his San Francisco-based healthcare consulting and management services business, KenwoodHealth Group.” The company apparently doesn’t have a website, though the domain names kenwoodhealth.com and kenwoodhealthgroup.com remain ripe for the picking.

As COO for the Clinic, Strand led day-to-day operations at the Clinic’s main campus and managed business units in Northeast Ohio and Florida. In public comments, the Clinic would only at the time allow that the Strand and Duffy’s departure was “mutual” and that the two “wanted to move on, move back home to California.” When reached by the Plain Dealer shortly after their departures were announced, the two ex-employees declined comment.

An internal memo that the Clinic sent to employees said only that the couple left “to pursue other opportunities.”

As with nearly all breakups, there was obviously lots more going on behind the scenes than anyone would say publicly. Are departures ever truly “mutual?” If the break really was mutual, why did Strand get a half-million-dollar-plus severance payment? Why leave so soon, when Strand and Duffy had joined the Clinic just two years earlier? If the two left the Clinic intending all along to start their own company, why not just say so from the beginning to head off the inevitable speculation that arises from the use of such vague language as “other opportunities” and “mutual departure”?

From the outside looking in, Strand had a pretty sweet setup, so why would he want to leave without having secured something better? He was, after all, among the top executives at one of the nation’s most prestigious hospitals, and it’s not like the money was bad. In 2009, his compensation was $1.1 million, making him the highest-paid non-MD on the Clinic’s staff, and sixth-highest paid employee overall. Factoring in a $527,000 severance payment, Strand ranked second.

Strand joined the Clinic in July 2007 as its chief emerging businesses officer responsible for developing new revenue streams in areas outside the Clinic’s core focuses of medicine and medical research, as well as overseeing projects like the health system’s growth in Abu Dhabi. He stepped into the COO role in August 2008, holding onto it for less than a year.

In Cleveland Clinic’s post-Strand era, the health system has apparently chosen to eliminate the chief operating officer role. “There was a restructuring after [Strand] left,” Cleveland Clinic spokeswoman Eileen Sheil said.

William Peacock III took part of the job, becoming the hospital’s chief of operations, overseeing the health system’s facilities and services. Pediatrician Dr. A. Marc Harrison, previously titled the director of medical operations, was appointed chief medical operations officer in the weeks after Strand and Duffy’s departure.

Dr. Michael Modic

CLEVELAND, Ohio — Cleveland Clinic has picked the leader of its neurological institute to lead its emerging business division.

Dr. Michael Modic led the development of the Clinic’s Lou Ruvo Center for Brain Health in Las Vegas, Nev., and the expansion of its eRediology services, according to a Clinic release. He’ll continue as chief of the Neurological Institute while serving as the system’s chief emerging business officer.

This announcement fills the final duties left vacant after the departure of David Strand and Dr. Bridget Duffy in late June. Strand was the Clinic’s chief operating officer and Duffy, its chief experience officer.

The Clinic has used five staff members to share the duties of those two positions: Dr. A. Marc Harrison and Bill Peacock are running clinical and building operations, formerly managed by Strand, while Sarah Sinclair and Dr. James Merlino will manage duties related the Office of Patient Experience.

Peacock, who now has the title chief of operations, will also take over emerging business activities at the Clinic’s Abu Dhabi facilities.

The chief emerging business officer position is charged with finding new revenues outside of the Clinic’s core strength of medical research, and partnering with other health-care organizations. In the past year, its work has included a for-profit Wellness Enterprise, an expanded reference lab and software licensing agreements. The job is a critical one for several reasons, including that it offers the Clinic a chance to increase its revenues by selling, sometimes with little adjustment, assets that it hadn’t previously monetized.

Modic will work with Clinic executives in the next several months to review the emerging business strategy, assess new ideas and expand opportunities, according to the release.

Sarah Sinclair

CLEVELAND, Ohio — Cleveland Clinic will use two staff members — including a recently hired executive chief nursing officer — to fill the leadership opening in its Office of Patient Experience.

Sarah Sinclair, who oversees nurses throughout the system, and Dr. James Merlino, vice chairman of the Clinic’s Digestive Disease Institute, will “collaboratively” lead the office, according to a Clinic press release. They fill a void left when Dr. Bridget Duffy, who ran the office, left the Clinic along with spouse David Strand, who was the chief operating officer.

The two left last month to “pursue other opportunities” in California, which is where they came from two  years ago to take their positions at the Clinic, according to a memo distributed to Clinic staff. Two weeks ago Clinic officials redistributed some of Strand’s duties when they named executives to oversee clinical operations and manage the facilities.

Both Sinclair and Merlino will continue to serve in their position. Merlino entire medical career is in the Cleveland area, beginning with his graduation from the Case Western Reserve University School of Medicine in 1997. He joined the Clinic as a colorectal surgeon last year.

Sinclair joined the Clinic in February as its first ever executive chief nursing officer, which is similar to the job she held at Memorial Hermann Health System in Houston.

Duffy was the first leader of the Office of Patient Experience and did it alone. But Clinic officials through its release stated that the collaborate approach “mirrors the structure implemented within each of Cleveland Clinic’s 26 clinical institutes, in which a physician experience officer and nursing experience officer spearhead improvement initiatives within their institute.”

“Physicians and nurses are key to providing an exceptional patient experience,” Sinclair stated in the Clinic’s release. “This new infrastructure will enable Cleveland Clinic to deliver the best patient experience by utilizing the talent of each staff member and employees, who are all essential components of patient care.”

The patient experience office is one way the Clinic is adjusting to health rankings and Medicare, which now gives more weight to patients’ opinions. The office came up with new designs for patient gowns and a “healing service division” that offered counseling and stress reduction to patients.

With these duties filled, the Clinic needs to assign someone to take over Strand’s role overseeing its emerging business division.

Dr. A. Marc Harrison

CLEVELAND, Ohio — The Cleveland Clinic has made the first changes in its executive staff since the sudden departure two weeks ago of its chief operating officer and chief experience officer. The changes address oversight of the medical operations and facilities management at the hospital.

The Clinic still needs to assign responsibilities for its emerging business division, and for improving patient satisfaction and experience. Spouses David Strand, the Clinic’s chief operating officer, and Dr. Bridget Duffy, its chief experience officer, who had been doing the emerging business and patient satisfaction work left in June for San Francisco to “pursue other opportunities,” according to a memo distributed to Clinic staff.

Dr. A. Marc Harrison, formerly titled the director of medical operations, is now the chief medical operations officer. Harrison is a pediatrician, an authority on the design of intensive care units and is credited with developing the hospital’s critical-care transport program, which has increased out-of-state visits to the Clinic.

William Peacock III is the hospital’s new chief of operations and will oversee the health system’s facilities and services. Peacock previously managed the health system’s construction projects, including the main campus’ signature Miller Family Pavilion and Glickman Tower projects.

The two will work closely together to integrate the clinical and operational sides of the Cleveland Clinic, said Eileen Sheil, executive director for media and public relations.

Additional changes will be announced later, Sheil said.

David Strand

CLEVELAND, Ohio — Two top Cleveland Clinic executives have left amid a reorganization of the health system and its leadership.

Spouses David Strand, the Clinic’s chief operating officer, and Dr. Bridget Duffy, its chief experience officer, have left for San Francisco to “pursue other opportunities,” according to a memo distributed to Clinic staff.

The memo said areas around “medical operations, emerging business, and patient experience” were being realigned to make the health system more efficient and better support the Clinic’s clinical areas. Spokeswoman Eileen Sheil declined to discuss the changes. But the memo said staff would learn more about the restructuring in the coming days.

Strand was key to the health system’s new business strategy. He came to the Clinic in July 2007 as its chief emerging businesses officer responsible for developing new revenue streams in areas outside the Clinic’s core focuses of medicine and medical research, as well as overseeing projects like the Clinic’s growth in Abu Dhabi. He retained these responsibilities when he became chief operating officer last August.

Emerging businesses are critical for the Clinic, which is trying to increase revenues as operating profit margins narrow for most  hospitals. Early efforts included a Wellness Enterprise and an expanded reference lab. The Clinic also recently licensed a piece of software to a financial services company.

Equally important was Duffy, who was charged with improving the patient experience at the Cleveland Clinic at a time when health rankings and Medicare give more weight to patients’ opinions. She focused on everything from redesigning patient gowns to artwork; navigation to a “healing service division” that offered counseling and stress reduction to patients. The position was the first-of-its kind at the Clinic.

Duffy outlined her philosophy on changing the patient experience in the video below.