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Real Issues : Real Solutions

SUMMER 2011

AmeriHealth New Jersey, Inc. Focus On Innovation

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Real Issues : Real Solutions

CONTENTS

06 AmeriHealth New Jersey, Inc. IN-FOCUS STORIES 12 Dental Health Associates 14 Saint Francis Hospital and Medical Center 18 Androscoggin Home Care & Hospice 21 Hill Country Memorial Hospital 24 Hometown Urgent Care 26 Jamestown Regional Medical Center Foundation 30 John J. Pershing VA Medical Center

Judith Roman, President /CEO

33 Melissa Memorial Hospital 36 Health New England 40 Medical Center Health System 44 Southwest College of Naturopathic Medicine 48 Tuba City Regional Health Care Corporation 50 The Children’s Hospital of Philadelphia 54 The Royal Jubilee Hospital 58 Colonial Behavioral Health 64 MEDIC Regional Blood Center

HCE EXCHANGE

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the organization is committed to helping its customers understand the ramifications of reform and make the best choices for their organizations. “We understand that folks need to have access to health insurance and that many of the specific questions about the healthcare-reform legislation at some level remain undefined, and we don’t have all of the answers—no one does,” Roman said. Roman added that she wants AmeriHealth New Jersey to be a resource for customers and

Concentrated focus, wide in scope AmeriHealth New Jersey, the organization is the

government is key to developing expertise that can

only statewide health insurer focused exclusively

benefit AmeriHealth New Jersey’s clients. “We have partnered with our state legislators

“We are a New Jersey-based organization

and regulators so that we work together to shape

focused solely on the needs of New Jersey-based

the future course, because many of the decisions

businesses and public entities,” Roman said.

will be left up to the state,” Roman said. “It’s a fed-

phasis on small and medium-sized organizations in the state, specifically employer groups with 51

eral healthcare-reform bill, but a lot of the execution will be at the state level.” Roman boils the purpose behind reform down

to 500 employees. Unlike many insurance carri-

to three specific areas—quality, accessibility,

ers who have to battle the regulations of multiple

and affordability.

states, Roman said AmeriHealth New Jersey can with “our undivided attention,” thus allowing the

Reform: Making sense of it all

organization to help shape the future of New Jersey

As the debate regarding healthcare reform esca-

healthcare.

lated, insurance providers often bore the brunt of

focus on New Jersey employers and regulators

Because its attention is focused on New Jersey, Roman said AmeriHealth New Jersey’s growth formula is more specific and revolves around finding

Unlike many other providers throughout the country, AmeriHealth New Jersey concentrates on one area—New Jersey. Together with its affiliate, AmeriHealth Administrators, AmeriHealth New Jersey insures 210,000 people in the state.

her organization with confidence. Roman believes that forging relationships with the right people in

AmeriHealth New Jersey places a strong em-

Founded in 1995, AmeriHealth New Jersey is a state-based health-insurance provider whose mission is to help its customers and members maximize wellness in every conceivable way.

employers have decisions to make, they can consult

According to Judith Roman, president and CEO of

on serving New Jersey customers.

AmeriHealth New Jersey, Inc.

members on the newest mandates, so that when

public and political outrage. Roman feels this is a matter of misperception. “What I think is misunderstood by the aver-

the right product mix, maximizing customer satis-

age consumer about health-insurance premiums

faction, and strengthening broker relationships.

is that 87 cents on every dollar that’s collected in

“We can actually pay more attention to de-

premiums pays medical claims,” Roman explained.

veloping the type of product that the New Jersey

“At the end of the day, a company like AmeriHealth

customer is demanding or that the mid-sized

is working on approximately a two-percent margin

customer with 51 to 500 employees is demanding,”

and an 11-percent administrative cost.

Roman stated. “And we can do that with a specific,

“So if you take that dollar and you’re spending

exclusive focus because we’re concentrating on

87 cents to pay the medical claims that come in

one market.”

from the doctors and the hospitals and other medi-

Blazing an innovative path AmeriHealth New Jersey’s exclusive focus on the state of New Jersey has become more beneficial with the passage of healthcare reform. Roman said

cal providers and you have about two percent that is profit, you’re at just under 90 percent. That leaves 11 cents to run your business,” she said. One of AmeriHealth’s objectives as an insurance carrier is to secure the best value for its HCE EXCHANGE MAGAZINE

7

we actually controlling the costs?’� Roman said. “And I think those are some of the unanswered and undefined areas because the cost to deliver the care continues to rise, but we want to make sure that we offer more services to more people.�

Growth on the horizon To meet the demands of today’s healthcare indus-

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try, Roman outlined several areas in which AmeriHealth New Jersey is focusing its growth strategy. These areas include maintaining strong insurancebroker relationships; developing the right product mix; maximizing customer satisfaction; and deliver-

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ing services that lead to strong customer-provider relationships. As with most organizations, branding is essential to this strategy. “In order for people to do business with us,� Roman said, “they need to know who we are. Five years ago, we were not very well-known in the state.�

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However, AmeriHealth New Jersey’s statewide anonymity has started to fade. “Someone recently said, ‘Boy, folks that work in members. The cost of premiums often depends on

your company are everywhere,’� Roman recalled.

the cost of services from physicians, hospitals, and

“We try to brand ourselves across the state. We

ancillary healthcare providers.

participate in different opportunities that support

Essentially, AmeriHealth New Jersey buys the

the community.� Roman described AmeriHealth New Jersey as

healthcare provider’s services for its customers. Those providers often require higher reimburse-

being very community-minded. “Our employees take the commitment very

ment from the insurer because their costs are

seriously,� she stated. “We are out almost every

continuing to rise. “When hospitals increase their rates, it drives

weekend doing something on a volunteer level.� AmeriHealth New Jersey is especially involved

the insurer to increase their premiums,� Roman said. “If that hospital bill keeps going up every

in supporting the Special Olympics New Jersey.

AmeriHealth Administrators, Inc. Having always operated out of two different offices, AmeriHealth Administrators, a national third party ad-

Roman believes this move will increase efficiency

ministrator, provides hospitals and health systems with

and effectiveness in meeting the needs of custom-

tailored health benefits plans and multi-tiered networks

ers and clients throughout the state.

that promote your domestic services. With over 20 years’ experience, we understand the unique perspective of being

Satisfying the customer

an employer and health care provider. We work with each

When an employer is shopping for health insur-

client to design innovative, result-driven solutions that

ance, most of them base their selections on price,

benefit the health of your organization.

network, and service. Roman said listening to the customer is es-

“We volunteer at the summer games and the

year, then the premiums keep going up every year because we use that money that we collect in pre-

winter games,� Roman said. “We sponsor a run

sential when developing products and services for

miums to pay that bill.�

through the Lincoln Tunnel every year. We also

one simple reason. The customer typically has a well-defined budget.

sponsor a run across the Ben Franklin Bridge down

munity, educating on healthy behaviors, working

of rising costs and burgeoning premiums. Often-

in South Jersey and Philadelphia with the Larc

with people to understand risky lifestyles, and life-

times, Roman explained, the hospitals will com-

School.�

style changes to improve overall health,� Roman

aligned with what the customer can afford,� she

explained. “We work hard to encourage the same

said. “And whether that be a narrower network or a

behaviors with our employer groups.�

broader network or more deductibles and co-in-

The crux of the reform debate lies in the issue

AmeriHealth New Jersey also collects and

plain that their hard costs are going up, facilities are aging and in dire need of renovation, technolo-

delivers food donations to the Ronald McDonald

gy and pharmaceutical advancements are required,

House and participates in the United Way’s annual

etc.

Day of Caring. “The culture of our company is really centered

“When we all evaluate the affordability act, these are the areas where we ask, ‘Well, how are

around healthy mind, healthy body, helping com-

“We need to design the products that are

In the summer of 2011, AmeriHealth New

surance or co-pays, we need to be able to have that

Jersey became even more visible and centralized

flexibility in developing the products that meet that

when both of its offices came together at one loca-

customer’s expectations and ability to pay

tion in Cranbury, NJ.

the premium.�

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

9

3,500 hospitals. When we do have someone that has employees outside of the area, we do have access to cover them seamlessly.”

More than just growth Roman emphasized that AmeriHealth New Jersey’s goal is to help its customers and members maximize wellness in every conceivable way.

AmeriHealth Casualty and CompServices, Inc. provide workers’ compensation services including insurance and third party administrative services.

AmeriHealth New Jersey offers a comprehensive wellness program that consists of on-site services, reimbursements, and discount opportunities to help members and their families lead healthier lives. AmeriHealth New Jersey strategists are constantly asking themselves, “How do we keep people healthy? How do we prevent disease? Once we identify those with chronic diseases, what are the opportunities that we have to help them improve the quality of life and minimize the impacts of disease?”

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Roman said it first starts with prevention and education. “When you look across the country at the large corporations that have thousands of employees, many of them have these health and wellness

AmeriHealth Casualty and CompServices, Inc. AmeriHealth Casualty and CompServices, Inc. provide workers’ compensation services including insurance and third party administrative services. We understand the difficulties employers face balancing the needs of providing quality healthcare to injured workers and returning them to work as soon as appropriate. Our programs are designed to contain workers’ compensation costs, reduce administrative burdens, and provide quality care to injured workers.

of our business is sold through those insurance-

programs, but the market of 51 to 500 really wasn’t

broker relationships.”

receiving much focus,” Roman said.

Networking with doctors, hospitals, and other

AmeriHealth New Jersey was the first in the

ancillary providers is also important for growth. Ro-

state to bring employer on-site wellness programs

man said that AmeriHealth New Jersey has worked

that are traditionally reserved for larger companies

for the last five years to develop a strong provider

to small and mid-sized New Jersey-based organi-

network throughout the state of New Jersey. As a

zations. These wellness activities include on-site

result, AmeriHealth New Jersey now has the larg-

screenings for such diverse needs as blood pres-

est provider network in the state.

sure, cholesterol, body mass index (BMI), and blood

“We’re contracted with every hospital except for one acute-care hospital,” Roman said, “and we have now surpassed the other insurers in the size of our physician network.”

And AmeriHealth New Jersey does strive to listen to its customers in every possible way. “We’re very open when it comes to having insurance-broker roundtables or bringing employ-

The final piece of the strategic puzzle is service.

and weight management. “Wellness has such huge economic implications,” Roman said. “We know there is a tremendous amount of money that employers can save at

Roman offered one example as to how they service

the same time because for every dollar on average

a customer whose scope of employment is not

that’s invested in these programs, they get three in

limited solely to New Jersey.

return when it comes to saving money on services

ers in to discuss what direction they’re headed and what they need from us,” Roman said.

sugar to programs related to smoking cessation

“Occasionally a New Jersey customer will have employees in another state,” Roman said. “When

When it comes to education and wellness, AmeriHealth New Jersey strives to practice as a company what it preaches to its customers. “We encourage our associates to complete personal-health profiles,” Roman said. “And we allow them to get their preventive screenings and physician visits on company time. If an associate goes for a mammography or a prostate screening or whatever is required from the American Medical Association for that individual’s age bracket, we will give them time off for preventive service.” This is known as the Time Off for Preventive Screenings (TOPS) program. “This incentive encourages healthy behaviors and also contributes to early detection, which is very important,” Roman said.

Investing in people Roman said people, the human resources behind the business, are AmeriHealth New Jersey’s most valuable asset. After all, growth and wellness strategies can only be executed successfully if the right people fill the right positions. Over the past five years, Roman said that AmeriHealth New Jersey has rejuvenated its senior management team. She wants the best individuals running the sales, marketing, and health-services areas of the company. “What’s most important to us at AmeriHealth New Jersey is that we enhance the health and wellness of the people and communities that we serve and that we strive to be the best performing healthinsurance plan in the state of New Jersey whether it be through access or quality or affordability.” By Pete Fernbaugh

and claims.” These educational programs often result in

that happens, we contract with the largest PPO

cost reduction on premiums, Roman added. Many

said it’s equally important to cultivate strong broker

(preferred provider organization) network that cov-

employers use this as an incentive for employee

relationships “because approximately 95 percent

ers the nation with almost 690,000 providers and

participation in wellness programs.

In addition to listening to customers, Roman

Practicing what they preach

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

11

02 | Dental Health Associates

A trio of core-focus values Dental Health Associates is a multispecialty practice with both general dentists and specialists in virtually every office. Each office generally has somewhere between three and four full-time, gen-

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eral dentists and additional part-time to full-time specialists. “We do everything from episodic emergency

Dental Health Associates’ values start with customer

care for indigent patients to boutique dentistry on

service and quality care. Then, the organization

business executives,” Lisman said. “We work on

focuses on employee job satisfaction, growth, and

everyone from infants to geriatrics. We look to be

development. Finally, Dental Health looks to the

an all-in-one, one-stop place for our patients. While

growth and profitability of the practice itself.

there are some spot procedures that are referred

“All three core-focus values work in a symbiotic

out, most things are handled in the scope of our

relationship,” Lisman said. “Should, at any time,

practice. We pride ourselves at providing great

a conflict develop between one or more of Dental

value to both our patients and our third-party pay-

Health Associates core-focus values, the conflict

ers. We have a phenomenal infrastructure in terms

should be resolved in favor of the higher of the core-

of systems that we have developed and invested in.

focus values.”

We have a very dedicated, long-term core staff of individuals. Many have been with us for 15-20 years.”

Investing in a large dental practice The nine offices of Dental Health Associates are linked by one database. The phone center in Phillipsburg allows them to answer a call to any individual

Dental Health Associates

office when the phone rings more than twice. The call-center staff can make an appointment for the patient as if they were in the caller’s intended office.

Dr. Clifford Lisman joined his father’s dental practice in 1978. His father’s practice was one of the few that remained in Irvington, N.J., after the nationwide riots of 1967. “The practice transformed from being what he initially started in the late 1940s, a blue-collar practice, to being primarily a Medicaid practice,” Lisman said. “Through to the 1990s, there was virtually no fee increase in Medicaid, so he had to develop the ability to do quality work and yet keep costs contained.”

Dr. Clifford Lisman

This set of circumstances left Lisman poised to profit when managed care came about in the late 1990s.

This is only one example of the ongoing investment Lisman makes in the practice. “Probably our greatest accomplishment is the development of a system that allows us to manage— literally—8,000-plus different fee plans and to do it very well,” Lisman said. “We are utilizing software that we are developing on our own and have been using over the last several years. It is phenomenal in terms of being able to manage different plans.” For example, most software programs would be able to indicate to a provider that a sealant is a benefit, but would not be able to distinguish if there

“For us, it was a boom as it literally doubled and tripled our fee income, whereas most practices were looking at cuts of 30 to 40 percent,” he said. “That scenario gave us a base in terms of being accountable to marketplace conditions that most other practices didn’t have. It gave us the ability to both preserve the quality of values that my dad preserved in me and at the same time, to be concerned about overhead, to be concerned about cost.” As a corporate entity, Dental Health Associates was started in February of 1986. The organization currently has nine offices and more than 50 dentists. Dental Health has the largest number of pediatric dentists of any practice in the state of New Jersey. Its total staff numbers more than 300. Income was just shy of $27 million for tax year 2010.

were various limitations on reimbursement for that sealant. It might be covered up to age 14 on one plan and age 17 on another. In one plan it might cover only molars, and in another, it might cover molars and pre-molars. One plan might have a frequency limitation of every three years while another says once in a lifetime.

“Our system has the ability to add in those type of rules, and when a provider plugs in a treatment plan—not with 100 percent accuracy, but with a high degree of accuracy—he will be able to present to the patient what their responsibilities are upfront,” Lisman said.

The future of dentistry Lisman said he has spent the last decade making sure the infrastructure of his practice is sound. Though they have consistently upgraded and improved offices, Dental Health has recently added its first new office in 10 years. “I fully believe we are poised now to significantly expand both in terms of growth as well as adding on additional offices,” Lisman said. by T.M. Simmons

HCE EXCHANGE MAGAZINE

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03 | Saint Francis Hospital and Medical Center

Predicting the future Saint Francis had to adapt the project to several changing elements throughout the course of the tower’s construction. Early planning began in 2005. The original intent was to replace only the emergency department, but talks then led to including more operating rooms. Finally, a feasibility study led the hospital to decide on including inpatient

A quiet environment is a healing environment.

rooms for the Connecticut Joint Replacement Institute as well. Falaguerra said the hospital began meeting

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with stakeholders and the architect immediately to determine needs. While developing preliminary design plans, Saint Francis submitted the CON for

With the Responder5 nurse call we provide a proactive approach to patient care.

the replacement tower. Construction started in 2008 and was completed in April 2011. Throughout those six years

Saint Francis Hospital and Medical Center

from planning to completion, much has changed in technology, healthcare delivery, and sustainability practices. Falaguerra said Saint Francis was able to plan for and accommodate those changes through-

Weathering the recession in the United States has been a challenge for many healthcare organizations. To save money, many have had to put renovations or new facilities projects on hold. However, Saint Francis Hospital and Medical Center in Hartford, Conn., has come through the recession with a new 318,000 square-foot tower that has greatly expanded the hospital’s capacity and technological capabilities.

out the design process. For example, flexibility was built into the entire project. The emergency rooms are all identical, allowing them to expand and contract based on volumes. He said this also aids in staff education because they encounter the same equipment and set-up in all rooms. The 23 operating rooms also followed the same

Robert J. Falaguerra, Vice President of Facilities, Support Services, and Construction

Robert Falaguerra, vice president of facilities, support services, and construction, credits the organization’s success with early planning, communication, and coordination. “Communication with stakeholders started early in the process and continued throughout the life of the project,” he said. “Any new development has to deal with changes that occur in the time between conception and occupancy. Technology changes, people change, service-delivery changes, even philosophy can change. You have to try to predict what would happen if the technology we’re talking about as a possibility today becomes reality when the building is finished.” The John T. O’Connell Tower, which was named for the son of the primary benefactor of the tower who lost his battle with cancer, houses a new emergency department, new operating rooms, a separate floor for the Connecticut Joint Replacement Institute, three floors of private inpatient rooms and rehabilitation gyms, and a new rooftop heliport to service the emergency department.

Another major change in design over the past decade has been the increased focus on sustain-

plan, being built identical for interchangeability. The

ability and evidence-based design. Saint Francis

new tower has a hybrid OR of about 1200 square

incorporated these elements by using recycled

feet. This room can do vascular surgery, cardiac

materials, high-efficiency energy devices, and

catheterization, angioplasty, and other complicated

other sustainable items. The hospital also used

procedures. Furthermore, the high-tech equipment

documented design efforts that promote “high

can be moved out of the way so the room can be

efficiency and high touch.”

used as a traditional OR suite. To plan for the digital future, Falaguerra said

“Our architects took into account current documentation in the design of the emergency

builders ran a parallel set of equipment cables so

department and operating rooms,” Falaguerra

that new cables wouldn’t be needed as future com-

said. “We used lighting elements known to pro-

munication equipment was added. The tower has

mote healing and be functional for medical staff.

voiceover IP throughout and includes many high-

The colors and finishes we chose were based on

tech systems that allow for communication

historical evidence pointing to their promotion of

and integration within the hospital and with exter-

efficiency and

nal facilities.

patient comfort.”

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

15

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and completed the project. Many companies had to put projects on hold in the recession. This project puts us about three to four years ahead of our competition.” Saint Francis Hospital and Medical Center is a 617-bed facility with two campuses, including tertiary care services, a trauma center, joint-replacement institute, a 60-bed rehabilitation center, a heart and vascular institute, an MS treatment and research center, and inpatient behavioral health. The hospital has big plans for the future, including renovating the space left from the old emergency room, operating rooms, and some of the former patient floors. Falaguerra said the previous operating-room space is adjacent to the new tower and will be renovated to create a new PACU and locker room to service the expanded operating room. Additional outpatient women’s services, a new morgue, and a pathology department will fill the area vacated by

Managing the transition Falaguerra said the transition process began about six to eight months before the tower’s completion.

the previous emergency room. by Patricia Chaney

Staff developed a written orientation guide, and leadership met with all stakeholders to go over what they could expect in the new facility. “For the transition, we had a training guide with three levels--an orientation to the space, training on the new equipment, and fire training and evacuation planning,” Falaguerra said. “Each group of stakeholders also met with architects and administrators to talk about the move. Our communication with stakeholders was a key part of our success in being able to keep the project moving and coming TRUMPF Medical Systems, Inc. 1046 LeGrand Blvd

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in a leading position when compared with its competitors. “Our planning was ahead of the curve,” Falaguerra said. “We stayed ahead of the recession

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17

04 | Androscoggin Home Care & Hospice

Shackley hopes that home care and hospice can gain more recognition for the services it provides not only to patients, but also to the healthcare system as a whole. Androscoggin has been working with physicians, hospitals, and other healthcare

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organizations in Maine to help collect data on outcomes and cost. “We are already planning for the future of accountable care organizations (ACOs),” she said.

station in the office where a nurse looks for abnor-

“The health system and physicians in our area see

malities.

us as a critical element of the team. We work with them to develop care plans for common diagnoses so that the message and education is consistent

out of the hospital. Shackley said this service has

across the continuum of care. We all have a goal

greatly improved patient care and saves healthcare

of improving healthcare from a patient-outcomes

dollars overall, but as of now, it is not reimbursed.

Doing more with less

Providing quality care for patients

Trying to do more with less is a common theme at

Androscoggin offers the following three pri-

all healthcare organizations. The home-care and

mary programs: home care that provides care for

hospice industry faced huge cuts recently with the

individuals just out of the hospital for congestive

passage of the Patient Protection and Affordable

heart failure, wound care, orthopedic injuries,

Care Act. In preparation, Shackley said Androscog-

and other issues; hospice that visits individuals in

gin began streamlining processes and increasing

their homes, nursing facilities, or at the company’s

efficiency to help budget available dollars.

hospice house; and palliative care for patients who

Shackley said the staff was given small laptops

With the aging population increasing in numbers throughout the United States, the need for healthcare groups that provide services to older patients is rapidly growing within the industry. As patients age, they often face more comorbidities, leading to more hospital visits and higher costs of care. Ways to manage these costs is a priority issue for the healthcare industry going forward. Home care and hospice are services that have long been part of the healthcare industry, but these services have often been overlooked.

Julie Shackley, President/CEO

want some treatment options above comfort care,

and cell phones to maintain real-time communica-

yet still want to benefit from the skills of the agency

tion and be able to document in patients’ homes.

and staff.

The organization also set up a physician portal to share care plans and send orders electronically. “In 2010, we were able to shave off about $1

Because care is given in patients’ homes, home care and hospice has typically been a silent part of the healthcare system. Androscoggin has increased

million in expenses,” Shackley said. “We de-

visibility and services through a 14-bed acute

creased office spaces, invested in technology, and

hospice-care facility. This facility serves patients

streamlined our systems and processes. We still

who are at the end of life and are unable to be man-

have more work to do and are looking at ways to

aged at home or at a nursing home.

increase volumes and expand services.” Even in light of budget cuts, Androscoggin

“Home-care services are key to some of the successes that government is talking about, yet our voice is small within the industry,” said Julie Shackley, president and chief executive officer of Androscoggin Home Care and Hospice, headquartered in Lewiston, Maine. “We already have programs that manage chronic conditions and help reduce hospital readmissions, saving money for the entire healthcare system.”

The nurse can then notify a physician or make medication changes, ultimately keeping the patient

perspective and a cost perspective.”

Androscoggin Home Care & Hospice

measures. It then transmits that data to a central

Shackley said the organization faced some skepticism early on for the hospice house, but after

always puts patient needs first. Shackley said the

being open for five years, it has been completely

company began offering telehealth, which is a

embraced by the community. It has provided a great

small box in a patient’s home that cues the patient

service to patients who are still able to fulfill their

to take blood pressure, weight, glucose, or other

end-of-life wishes.

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

19

05 | Hill Country Memorial Hospital

Hill Country Memorial Hospital Much of the healthcare debate in the United States focuses on large healthcare facilities, regional healthcare systems, and urban healthcare. According to the 2000 U.S. census, however, there are still independent regional hospitals providing care to the nearly 21 percent of Americans who live in rural areas. Hill Country Memorial Hospital, located about 80 miles west of Austin, Texas, is one of those hospitals. Opened in 1971, the hospital received contributions for its construction from 93 percent of households in Gillespie County.

Steve Sosland, COO

“We want to lead the way for rural healthcare, which is a huge responsibility” said Steve Sosland, chief operating officer. “We have nearly 500 volunteers, and our history of community support has given us a vested interest in staying an independent nontaxsupported facility to care for our community.”

“Many of our patients are discharged home from the hospice house,” she said. “They are able to get their symptoms and pain management under control enough to return home and pass peacefully where

“We are fortunate to be trusted in the community.”

most individuals prefer.”

Having a home in the community

A community of support

Sosland has a realistic view of what Hill Country

patient survey that helps determine a patient’s

Memorial can and needs to provide to the commu-

experience at a particular hospital. The hospital has

nity. Hill Country is an 86-bed acute-care hospital

also received awards for quality in Texas.

Shackley feels that a large part of Androscoggin’s success is the support it receives from the community. The organization cares for about 7800 patients and families in about seven counties. It has about 350 employees and close to 400 volunteers. She said staff, leadership, and volunteers are included in decisionmaking for the company, particularly in the development of the company’s mission and values. “We are fortunate to be trusted in the community,” Shackley said. For the coming year, Androscoggin is looking to increase efficiency, expand services, and promote their existing services. “We have a lot to share,” she said. “We have significant experience and the same passion and goal that many in the healthcare industry do.” by Patricia Chaney

serving an eight-county area. The primary service

scores. The Hospital Consumer Assessment of Healthcare Providers and Systems survey is a

In addition to core measures, Hill Country

lines offered are orthopedics, women’s services,

is pursuing initiatives to enhance its three main

and geriatrics.

service lines. It opened a destination joint center in

“We are not trying to be all things to all people,” he said. “We have evaluated the top procedures we

2011 with a focus on patient experience. “Patients are greeted throughout the hospital

do and the top procedures we refer elsewhere. But

by name, and care is focused on wellness,” Sosland

we want to make sure we are providing value to our

said. “Joint-replacement patients are well, so we

patients so that they don’t have to drive 80 or 100

don’t treat them like they’re sick.”

miles to receive care.” Sosland said the hospital’s current focus is on quality, safety, and patient-experience measures. These measures are critical not only to providing

A goal of the center is to lower the total hospital stay to 2.2 days, which is about half the length of the average stay. Hill Country has also developed a state-of-the-

good patient care, but also to prepare for a future

art breast center and a unique collaboration among

pay-for-performance fee structure.

specialists focused on breast care. The hospital

Hill Country Memorial has consistently ranked in the top 10 percent of the nation for HCAHPS

holds a monthly multidisciplinary breast conference where imaging-center specialists, radiolo-

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

21

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1

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“We use the golden-compass symbol to focus on our true north. In the absence of direct guidance from a leader in the hospital, our true north gives staff members direction in putting patients first always.” Following a golden compass Sosland would attribute much of Hill Country’s success to its guiding principles and Golden Compass Leadership Development System. “We use the golden-compass symbol to focus on our true north,” he said. “In the absence of direct guidance from a leader in the hospital, our true north gives staff members direction in putting

gists, pathologists, oncologists, and surgeons come together to review every case from the previous month. Sosland says this allows for discussion of

RWD

patients first always.”

Lean is more than a set of tools that provide

and principles. The other seven points on the com-

temporary improvements. It is a new way

how to most efficiently treat each patient and an

of thinking. It is a comprehensive operating

opportunity to capture lessons learned.

system and a culture that promotes continu-

“We feel this conference is leading the way for

ous improvement. RWD has a team of experts

rural health,” he said. “It is an initiative we hope to

who focus on transferring knowledge so that

expand to all medical and surgical departments,

your entire staff can instill the methodologies

and it allows us to work toward one of our goals of

of Lean to drive sustainable improvements and

creating value for patients in rural areas. We also

achieve operational excellence.

share our data with other rural healthcare centers.” Other initiatives include investments in two cath

He said the true north is the hospital’s values pass are individual development, skills development and competencies, team building, behavioral development, business acumen, strategy, and organizational skills. These points are taught to staff at all levels and are looked for when hiring new staff. The hospital’s three core strengths also set it apart from other facilities—community support, quality patient care, and a “spirit of calling.” Through volunteers and fundraising, the hospital receives incredible support from the community it

labs and adding teleneurology to improve geriatric

serves. The “spirit of calling” is one area that Sos-

care. Teleneurology has allowed the hospital to

land feels is unique at Hill Country Memorial.

provide 24/7 stroke care.

“We have an active staff that believes working here

To prepare for the future, Hill Country Memorial

is where they belong, where they can apply their

has implemented Lean processes throughout the

talents to provide care for patients,” he said. “We

hospital to improve efficiency. It has also purchased

seek to hire the people who believe healthcare is

a 53-acre site for future service-line growth. Work-

their calling.”

ing with consultants, Hill Country plans to expand by Patricia Chaney

services based on the needs of the community.

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

23

06 | Hometown Urgent Care cases that distract from more severe and lifethreatening incidents. As the Hometown website puts it, the centers’

Enhancing the Health of Your Community

services help a hospital “focus on the patients who need you the most.” It also quotes the Centers for

“It Shouldn’t Cost an Arm and a Leg to Have a Broken One Treated”

Disease Control (CDC) as stating, “68 percent of the people who visit an ER do not need to be there.” More so than hospitals, primary-care physicians may see urgent care as competition. Not so, Hometown feels. Instead, they can provide care for patients when a PCP is not on duty, when the PCP’s office is closed, or it is after-hours. Hometown sees itself as a complement to the work of PCPs,

LabCorp strives to be a valued partner in the physician/patient relationship. LabCorp provides physicians with access to a broad portfolio of tests, ranging from diabetes and cholesterol screening tests to highly specialized genomic and esoteric assays. Through this relationship, our clients can benefit from the latest in technology and their patients can receive timely, quality results.

and they promise to always follow up with the PCP.

Hometown Urgent Care

Supporting employers Hometown is also concerned about workplace safety. Therefore, the centers’ services don’t just stop at treating work-related injuries. Hometown

Hometown Urgent Care, based in Dayton, Ohio, seeks to be more than your average urgent-care facility. Instead, Hometown seeks to deliver what it calls “The Complete Visit.”

also wants to help employers reach their

According to Hometown’s website, www.hometownurgentcare.com, the organization is the largest urgent-care company in the state of Ohio. Founded in 2005, Hometown’s purpose from the beginning was to successfully manage and run Urgent Care and Occupational Health Centers. Hometown is backed by a business arrangement with Miami Valley Urgent Care.

and staff members who are well-versed in BWC

safety goals. Workers’ Compensation (BWC)-certified physicians protocol. Services include providing First Report of cation with the employer, employee data collection claims assistance, and rehab updates.

Within six years, Hometown has embedded its footprint on Ohio’s healthcare map. In Columbus, Hometown operates seven centers. Ten offices can be found in the Dayton area, and a few others can be found at other points around Ohio. With the exception of a few locations, each center is opened seven days a week, 24 hours a day. Because many emergency-room visits are for matters that are less than fatal, Hometown seeks to be a cheaper and more efficient alternative. For example, a visit to the average ER for a minor injury

Physicians and staff members are also wellversed in the OSHA 300 log and the Department

search. In fact, the organization has established

of Transportation (DOT) standards, not to mention

a division, Hometown Urgent Care & Research

specializing in all drug programs required by OSHA

(HUCR), devoted to this end.

Each center provides treatment for any minor injury or illness, whether it’s a cut or a sprain, an infection or a cough. Each center is equipment with

Hometown’s website describes HUCR as “state-

Hometown can provide back evaluations and

of-the-art clinical research company dedicated to

ergonomic assessments, functional capacity evalu-

adult, pediatric, and geriatric phase II-III-IV clinical

Patients do not have to make an appointment to

ations (FCE), hearing exams, pulmonary function

trials, with specialties in family practice, urgent

receive these services.

tests (PFT), respiratory evaluations, and wellness

care, pain management, infusion, CNS, oncology,

screenings.

and radiology.”

When it comes to insurance matters, Hometown’s fully staffed billing department will walk

Hometown can also perform flu shots, tetanus

With eight full-time physicians who specialize

patients through the process, from start to finish.

shots, hepatitis A and B shots, and TB shots. As

in family practice, internal medicine, and anes-

If a patient is uninsured and self-pay, Hometown

with its patients, Hometown’s services save em-

thesiology, along with the benefit of being able to

offers services at discounted rate. They also offer a

ployers time and money.

use Hometown’s fully equipped centers, HUCR is

Helping hospitals and PCPs

a Hometown center is one-third cheaper than an

and the DOT.

labs and on-site prescriptions, EKGs, and X-Rays.

to Hometown will cost that person at most $200.

less at a Hometown Center. The average co-pay at

Hometown Urgent Care is also dedicated to re-

ranges from $75-$150.

would cost someone $1200 or more, whereas a visit

from two to four hours in an ER to 30 minutes or

Focused on research

ER co-pay, ranging from $20-$50, whereas an ER

free Care-Card program.

Furthermore, the average wait time is reduced

/DERUDWRU\ &RUSRUDWLRQ RI $PHULFD +ROGLQJV $OO ULJKWV UHVHUYHG

Injury (FROI) within 48 hours, consistent communiand reporting, transitional work assignments, BWC

Convenience for the patients

To find a location near you, visit www.LabCorp.com.

To that end, Hometown has a team of Bureau of

According to the website, Hometown vows to “provide a comprehensive illness and injury recovery plan that returns the patient to work as quickly

If Hometown is providing care for minor injuries

as possible, without compromising the quality of

and illnesses, then this relieves stress from hospi-

patient care.”

fulfilling its foundational goal of becoming a leading clinical-research company. by by Pete Fernbaugh

tal ERs that are often bogged down with

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

25

07 | Jamestown Regional Medical Center Foundation

Jamestown Regional Medical Center Foundation As children, most of us were told the story of “The Little Engine That Could.” Simply put, it’s about a small train engine that manages to pull a large train over a towering mountainside simply by the strength of its will and the optimism of saying over and over again, “I think I can. I think I can.” In many ways, the Jamestown Regional Medical Center Foundation could be called “the little foundation that could.”

Jan Barnes, Foundation Director

Charged with securing philanthropic gifts for the 25-bed, critical-access Jamestown Regional Medical Center (formerly known as Jamestown Hospital) in Jamestown, N.D., the foundation has only one person out seeking funds, Jan Barnes, foundation director. “This is a very small foundation,” Barnes said. “It’s just myself raising the money, and then, I have an assistant, and I have a program coordinator that coordinates the events. So it’s just three of us.” Despite this, the foundation has been successfully raising capital for some of the hospital’s largest endeavors, including raising $5 million for its brand-new, state-of-the-art, $52-million facility on the outskirts of Jamestown. So far, Barnes has raised $3.9 million from a town of 15,000 and the surrounding areas.

Resisting change

“Therefore, we were trying to do work that was

The main challenge Barnes encountered in her

completely different than it was in the thirties.”

campaign was convincing the predominantly elderly

With the initial resistance, it took some cre-

population that a new hospital was even needed.

ative thinking on Barnes’ part to start raising the

Most objected to seeing the hospital move to the

$5 million from the community, but in the end, the

immediate outskirts of town. As Barnes explained,

solution was simple. She began another newsletter

this could not be avoided.

in addition to her quarterly “Appleseeds” newslet-

“We had absolutely no place to grow there,”

ter. In this newsletter, though, she printed stories

she said. “We were up against a hill, so we couldn’t

of the people who were giving larger gifts to the

go out. We were in the middle of the town, so there

new facility, naming something, and telling why

was no place to add on.”

they were doing it.

Jamestown started as an inpatient hospital,

“The more people the community saw giving,

but a good share of its business is now outpatient.

the more they got on board,” Barnes said. “Now, I

Barnes explained that updating the hospital to

really don’t have a lot of challenges, except for the

support outpatient services became a piecemeal

fact that I could run out of people! Everyone wants

endeavor and a situation that could not be handled

to join in on a successful endeavor.”

anymore. “We had remodeled the old hospital at least 6 times, and it was a 1930s building,” she said.

The community is now completely supportive of the new hospital. As Barnes described it, this local enthusiasm is a complete turnaround from the

HCE EXCHANGE MAGAZINE

27

puff, and a central fetal monitoring system for the

Probably the most important event that the foun-

aren’t just a number, and it isn’t just the bottom

Family Birthplace; a pediatric protection system

dation has is the “Hour Club,” an employee-giving

line. We actually want to do what’s best for

for Patient Care Services; and an auto box for

program. Employees can give their hourly wage or

the patient.”

Respiratory Care.

an hour of vacation to the foundation each month,

come to Jamestown Regional Medical Center are

hospital had never had before,” Barnes said. “The

pay period. It is an easy way to give without any

a family member of someone who works there, a

total for this equipment was $323,653. We are now

hardships.

neighbor or a friend of one of the employees. This

“All these were pieces of equipment that the

campaign’s early days. In fact, the campaign has attracted a list of big donors, including Basin Electric Power Cooperative out of Bismarck, Thrifty White

Being in a small town, many patients who

and this is taken directly out of their check each

working on some equipment for our new Orthopedic Surgeon, which is also a first for us.”

At this time, the foundation has 155 employees

personal connection ups the stakes in providing

in the program who have pledged $185,000 over

quality care. In fact, many pieces of equipment

the next five years to help with the new hospital.

that the hospital has obtained have been pur-

Stores, Alerus Financial, First Community Credit

Other drives and events

Union, Gate City Bank, Jamestown Sun and Forum

Raising money for the new facility is only one of

are wonderful, and they don’t just come to work

Communications, Otter Tail Power Co., Wells Fargo

Barnes’ responsibilities. Throughout the year, the

to do their jobs. They actually care about giving

pieces of equipment for the new hospital that

Bank, and many larger individual donors.

foundation hosts different events to keep dona-

back to the place that employs them. I started this

many smaller hospitals just wouldn’t have, and it’s

tions flowing into the hospital’s coffers. The big-

program 15 years ago, and I can’t even begin to

because of our great community and their desire

gest event is “Breakfast with Santa,” which is held

tell you how many pieces of equipment and how

to support the hospital,” Barnes said. “They want

every year on the Saturday after Thanksgiving.

many programs they have helped with through the

to support the hospital, because after all, it all

‘Hour Club.’”

comes back to them.”

“At the beginning of this large endeavor, I was petrified,” Barnes said. “$5 million is a huge amount of money for a small town whose people

“We have a really fun day for the kids where

weren’t all on board with the new hospital, then you have the uncertain economy and the fact that I

they come and they’re served breakfast by elves,”

didn’t hire a consulting firm to help. However, now

Barnes said. This is followed by entertainment, such as

I feel so good at how it’s going, and I know I can

“It’s fantastic,” Barnes said. “Our employees

Finally, there’s “The Big Splash,” held annually in January. This campaign brings in over

magicians, clowns, or a storybook reading. It

cally, participants jump into a pool in the middle

been phenomenal.”

concludes with an appearance by Santa and Mrs.

of winter.

Clause who give each of the children a gift. Every-

“The nice part is, we don’t do much with it,”

came from a man with whom Jan worked for the

thing for the event is donated, and all of

Barnes said. “The HOGS from Harley Davidson

last two years. Upon his passing, he left $1.6 mil-

the proceeds go to support the hospital’s chil-

actually put it on. I just show up and thank them.”

lion to the new hospital. It was not only the largest

dren’s services. “Partners for the Future” whose initial goal was to

Making community come first

raise one million dollars for the hospital’s endow-

Barnes emphasized that Jamestown Regional

ment fund.

Medical Center is a community-owned hospital.

The foundation also has a campaign titled

gift of the campaign, but it was also the largest gift in the history of the foundation. These gifts and donations have gone a long way in purchasing equipment for the new center.

“That’s where I went around to smaller busi-

“So far, since we have started the campaign, we have bought several pieces of equipment for the

nesses that couldn’t give us big amounts of money

new medical center,” Barnes said. “These

and asked them for a $100-a-year donation for

were all, of course, from donations from the com-

our endowment fund,” Barnes said. “Partners for the Future” has been so suc-

munity again.” The hospital has been able to buy an infant protection system, an infant warmer with a neo-

cessful that the campaign is now going for its

“We have bought lots and lots of different

by Pete Fernbaugh

$10,000 each year for the Hospice Program. Basi-

reach that total mark of $5 million! It has Probably the best-known gift of the campaign

chased from community donations.

This is why local support is so vital to Jamestown’s success. “We are not owned by any big conglomerate, and we want to remain independent, because at

“They want to support the hospital, because after all, it all comes back to them.”

the stage of being independent, what we do is what is best for the patient,” Barnes said. “They

second million.

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

29

08 | John J. Pershing VA Medical Center

Bringing physicians and patients together Because of their relatively isolated location in rural Poplar Bluff, Mo., the John J. Pershing VA Medical Center relies extensively on telemedicine services made possible by electronic-medical and patient-information records. The VA system as a whole is known as a world leader in electronicrecords management. “We can seamlessly transfer a patient from Poplar Bluff to St. Louis,” Costie said. “The doctor can look into the medical record as if he’s sitting in Poplar Bluff and vice versa. We have a very nice partnership between the specialty physicians at St. Louis and the primary care doctors here at Poplar Bluff.” Because Pershing VA doesn’t have the critical mass of patients required to justify many specialty services, the center doesn’t do surgeries, and they partner heavily with doctors in St. Louis to make sure all of their patients’ needs are met. Telemedicine technology is in widespread use throughout Pershing’s clinics and the main medi-

John J. Pershing VA Medical Center

cal center. “If a patient shows up and they need a mentalhealth consult … or maybe their surgeon is in St. Louis and they are following up on a hip replace-

In southeast Missouri, three hours from any major metropolitan city, the John J. Pershing VA Medical Center serves an area that is home to approximately 50,000 veterans, about half of which utilize the hospital’s services. “That’s a good market share for a VA hospital,” Chief Executive Officer Glenn Costie said. “It reflects the economics of the area and the number of veterans who have actively served and who qualify for a high number of benefits. It’s a very patriotic area with a lot of focus on veterans.”

Glenn Costie, CEO

The main medical center houses 18 general medical beds and 40 long-term care and rehabilitation beds. Primary-care and mental-health services are also provided by outpatient clinics in Cape Girardeau, Sikeston, West Plains, and Farmington, Mo., as well as Paragould, Ark. Overall, they have approximately 560 employees and operate on a $100 million budget.

ment, we get them together on the TV system and they can see each other and they use cameras that are medically certified that allow very spe-

in the veteran population. Department of Veterans Affairs Secretary Eric K. Shenseki has made eliminating homelessness among veterans a top priority, and in 2009, he set forth a five-year plan to that end. The John J. Pershing VAMC has a number of programs to serve homeless veterans in its 27-county catchment area. Services are available through primary care, mental-health care, and dental care. Programs also include community care for the severely mentally ill, treatment groups, emergency housing, employment assistance, case management, and community outreach and collaboration. “On any given day, around 107,000 veterans are homeless in America with up to 66,000 of them known to be ‘chronically homeless,’” Costie said. “At the Poplar Bluff VA Medical Center, we are committed to using the programs and resources available to us, to help eradicate veteran homelessness in southeast Missouri and northeast Arkansas.” Patient Aligned Care Teams (PACT) are being put in place to shift the focus of hospital/ patient interactions. “It is something you are starting to hear about in the private sector, but the VA felt this was so important, they really want to lead the charge,” Costie said. He added, “Normally, when you go see a doctor,

cific focusing and very detailed images,” Costie said. “It’s innovation to bring the patient as close as we can to the physician.”

Treating the whole person

INDUSTRY PARTNERS ResMed www.resmed.com

Another focus of the VA, nationwide and at the Pershing VA, is to put an end to homelessness

HCE EXCHANGE MAGAZINE

31

09 | Melissa Memorial Hospital

you are coming in with a symptom. You’ve got the

One method they have used is to maintain infor-

sniffles or something that hurts, and we treat what-

mational booths whenever there is an event that

ever you came to us about. We usually don’t look at

attracts a lot of people. Whether it’s a county fair or

the whole person. We look at your symptom. The

a big agricultural event, they will take their comput-

change in our culture is that we have now assem-

ers to the site and sign patients up on the spot.

bled all of our primary caregivers. This includes

“We saw a four percent increase in the number of

a doctor, a nurse, the clerk that checks you in, a

veterans we served last year primarily because of

pharmacist, a mental-health provider—all of them

those outreach efforts,” Costie said.

work with the same group of patients.”

Another big event that Pershing hosted was a

Each panel of 1,000 to 1,200 patients is covered

concert for a charity group that supports veterans.

by the same group of people. While a veteran is be-

They had to apply for the event and ended up being

ing treated for a symptom, they go ahead and follow

one of 17 cities in the country selected.

up on other health issues, whether it’s how the patient is managing diabetes or high blood pressure

Leading in healthcare

or how they might be mentally handling an upcom-

The VA continues to be a leader in healthcare,”

ing holiday season.

Costie said. “You’ve got to keep sharpening your

“It’s not just treating the symptom, it’s treating

saw. Everybody is getting better. You are seeing

the whole patient,” Costie said. “And it is grow-

other healthcare groups with electronic healthcare

ing into things like chiropractic, acupuncture, and

records. Our next innovation in getting ahead of the

holistic medicine. I have a staff member who runs

pack is offering these patient-aligned care teams. If

a clinic one day a week for meditation … He can tell

you are one of our veterans, you’ll be receiving bet-

me many stories about patients who have chronic

ter care because we are treating you as the whole

pain who have been able to wean themselves off

patient, not just your ailment.”

the pain medication through meditation and find a way to make the pain go away. I don’t know how it

by T.M. Simmons

works, but he’s been very successful with that. All of this comes together under this patient-aligned care.”

Melissa Memorial Hospital

Community Outreach Pershing VA is currently about a year into a huge outreach effort. Nationwide, veterans tend to re-

Melissa Memorial Hospital is a 15-bed critical-access hospital in Holyoke, Colo. MMH has 100 employees, 78 of whom are full-time. The hospital also maintains a rural health clinic and an ambulance medical services organization.

main confused about the benefits they have earned, and the medical center is specifically working to communicate and educate the large population of veterans in the area. “Whether you served in war or in peacetime,

In February 2008, MMH moved into a new, 48,500 sq.-ft. facility on-schedule and $1 million below budget. This facility localized both their clinic and hospital under one roof. Since that time, the size of the organization has grown by roughly 50 percent.

for four years or for two years, by your service, you’ve earned these VA benefits,” Costie said. “There are a lot of rules and regulations about how those benefits roll out, and I understand why there is confusion. We continue to try to alleviate that

John J. Ayoub, FACHE, Administrator/CEO

uncertainty.”

Real Issues : Real Solutions

“It just allows us to provide the care that we know we can in a healing environment that is conducive to the best outcomes of our patient,” John J. Ayoub, FACHE, administrator/CEO, said. MMH’s growth is evident in its statistics. In 2007, the hospital had revenue of $5.7 million. By 2010, that had multiplied to over $10 million gross revenue. During that time, MMH has increased both recruitment of personnel and retention of providers. In 2007, the hospital had one full-time doctor and two part-time nurse practitioners; it now has three full-time doctors, two part-time doctors, and two full-time nurse practitioners.

RED CAPITAL GROUP® is proud to have provided FHA financing for Melissa Memorial Hospital.

A unified staff Ayoub is effusive in his praise for both the hospital’s staff and board of directors. Because the hospital is a political subdivision of the state of Colorado, they are supported through a mill levy in their district. Their board of directors is thus comprised of five elected members. Ayoub said these individuals are attuned to the needs of the community. Most of MMH’s staff is from the local region, so they have their personal lives invested in the hospital because they’re often

As a leader in health care finance with a specialized hospital finance team, RED understands your needs and can provide financial or advisory services for renovation, expansion or new construction projects through FHA, USDA and bond financing.

treating friends and family members. Furthermore, most of the medical staff has been with the hospital for several years, thus it is built around a core of unified, caring, and involved professionals. For example, Dr. Dennis Jelden, chief

www.redcapitalgroup.com/hospitals

of staff, has been in the community for 13 years.

614.857.3159

Ayoub describes Jelden as a “work horse that ties

Offices_COLUMBUS, OH_CHARLOTTE, NC CHICAGO, IL_DALLAS,TX_FAIRFIELD, CT_NASHVILLE, TN NEWPORT BEACH, CA_RESTON, VA_SAN DIEGO, CA

the place together.” “We now have a cohesive medical staff that really brings the culture of caring and culture of healing that we want,” he added. “I tend to think that I am professionally blessed with a phenomenal team. The people and employees are really invested in the organization’s success.” The new facility also gives employees a sense of pride that is only bolstered by the tremendous support they receive from the community. For example, the Melissa Memorial Hospital Foundation had pledged $600,000 toward the new building.

RESPONSIVE SOLUTIONS FOR CHANGING TIMES

From a town of 2500 people and a service area of fewer than 10,000, the foundation was able to bring in $750,000. This all came to a hospital that grew out of a tiny

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brick building. “I am continually amazed at the support that we get from the community,” Ayoub said.

Owning the vision Beyond MMH’s core set of values, Ayoub has sought to instill within his employees a sense of ownership. Protecting the Healthcare Industry www.kahlinsurance.com

“I meet with every single employee on their first day of orientation,” he said. “I emphasize with

Kahl Insurance Services is a proud partner of Melissa Memorial Hospital

them that we are here for people. This is a very real responsibility.”

He also cultivates a team mentality. He strives to create for his employees a vision that ties each individual into MMH’s success. “Taking care of people is an awesome responsibility,” he said. “And it’s something we strive to do to the best of our ability every day.”

A field of challenges Ayoub is constantly encouraging his team to grow in their professional lives, especially with healthcare reform looming on the horizon. “What does that mean for those of us within a small rural organization?” he asked. “How will the efforts on a federal and then a state level impact us as an organization and a community?” Being a small organization, MMH is faced with many financial challenges, not to mention the reality that it can’t be all things to all people. “Sometimes that is disappointing for some folks,” Ayoub said. “For example, we can’t do dialysis because it’s not an overwhelming need.” Other avenues, however, provide a great deal of service for the community at great personal expense to the hospital. For example, MMH’s ambulance service loses a great deal of money every year. In spite of this, Ayoub said the board has decided it is an important service that the community needs. Modern advancements don’t always come easily to the hospital either. For instance, MMH’s rural health clinic just went live with EMRs in August of 2010. “As with any new tool, it takes a while to become as efficient and proficient as possible,” Ayoub said. “So we took a dip in the patients we could see while we worked it out.” Now, the clinic is gaining the benefits it hoped to see from EMRs, including less redundancy and more accuracy. The organization is now looking at EMRs for the hospital, even though they know there will be learning curves that come with the implementation. “One of the things we need to make sure that we don’t do is to get overextended,” Ayoub said. “We want to make sure that when we start a project, we make it a major focus.”

Aware of the patients Ayoub is devoted to ensuring that MMH gives their patients every tool they need to take care of themselves. If they don’t have those resources, then he sees it as the hospital’s duty to link the patient up with home care, a nursing home, a loved one, or a neighbor who can see that they get adequate care. To this end, MMH is a proud member of the AHRQ’s Project RED (Re-Engineered Discharge). “We’re here to serve our community,” Ayoub said. “It doesn’t do us any good to care for the patient in our hospital and then discharge them and not care what happens to them.” MMH’s board of directors was one of the first boards in Colorado to adopt a Never Event policy, a standard which defines six categorical events that should never happen in a hospital. Even though there is a great deal of talk at the federal level with regards to tying payments into these events, many exceptions would be made for critical-access hospitals like MMH. The MMH board rejects these loopholes as a default excuse. “Our board said that these are events that should never take place in any high-quality healthcare organization,” Ayoub said. “We decided to hold ourselves to this standard whether Medicare holds us to it or not.” Therefore, if a patient experiences a negative outcome that should not have happened, as categorized by Never Event, they are not charged by MMH for their care. “I’m proud to be associated with an organization that will say this is the right thing to do, whether somebody’s looking or not, whether somebody’s going to base your payments on it or not,” Ayoub said. “We’re here to do the best thing for our community, and we’re going to hold ourselves accountable to that regardless.” by by Pete Fernbaugh

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

35

10 | Health New England

If the president came here… As the healthcare-reform debate raged in 2009, the 280 employees of Health New England, located in Springfield, Mass., were upset. They agreed that the

traley Peter S ; ; 20 4,5 633 ,59

country’s healthcare system needed reform. They felt that the debate brought worthy issues to the

the roving to imp edicated of the people serve. and lives health ities we commun in the

'

forefront. What upset them the most, however, was the way in which insurance companies were being characterized. As Straley tells it, his employees were insulted that politicians, including President Obama, were inferring that organizations like their own were part of “the big, bad insurance companies.” Many HNE associates came to Straley and begged him to write to Mr. Obama, asking him to refrain from making these insinuations. “We take it very personally that we’re trying to help folks,” Straley said. “I think that if President Obama came here and saw how our organization operates and sat in and listened in on the phone calls, in his next speech, he would say that he has met one insurance company who is doing it right.” In serving 120,000 members in western Massachusetts, the $400-million per year Health New Eng-

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land is rated as one of the top plans in the country for customer service. And Straley hastens to clarify that this is not an accident. It is a corporate strategy. “It reflects the people who work here,” he said. “They have a customer-oriented attitude.”

Growth amidst challenges Perhaps this focus on the customer is why Health

Health New England

New England is expanding at an unprecedented rate. “We are growing at a time when the economy is challenged,” Straley said. “We’re growing for a number of reasons.”

It’s no secret that insurance companies are not loved by everyone. In some cases, this is understandable.

One of these reasons involves two new product lines that HNE has rolled out over the past few years—the Medicare Advantage Product Line and the Medicaid Managed Care Product Line.

But as Peter F. Straley, president and chief executive officer of Health New England, will tell you, not all insurance companies deserve this rap. There are many out there who want to see their communities get the best health services around, and as a result, these companies make the customer, not the bottom line, their highest priority.

Peter F. Straley, President/CEO

“At HNE, our promise to our customers is to help them to get the most out of their healthcare benefits,” Stralely said. “If there is a problem, no matter what it is, we will help them solve it. It is with this filter in mind that we approach each call.”

Medicare Advantage is a product that is offered on a voluntary basis to people who are eligible for traditional Medicare, yet prefer the advantages of a more “managed-care” style approach. Nationally, roughly a quarter of Medicare beneficiaries choose such a product.

HCE EXCHANGE MAGAZINE

37

did is it more or less froze the market for small

will only be met if three things occur,” he said.

employers,” Straley said.

First, there needs to be near-universal high-quality

In the early fall, when the rates were unfro-

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health-insurance coverage. Straley emphatically

zen, companies discovered that people were now

stated that this insurance has to be high-quality.

more educated and sensitive to rate differences,

“It’s not just some flimsy excuse for insurance,” he

thanks to the high level of media coverage and

said, adding that he believes they have developed

political conversation the review had received.

such a system in Massachusetts.

Health New England has historically been a

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Second, Straley said the delivery system has to

competitively-priced market offering. Although

be redesigned and reengineered. HNE is “em-

they do not always have the lowest rates in the

broiled in that right now.” Straley said HNE has a

market, their plan is established, well-known,

unique role to play since they are on both sides of

and perceived to be of high value. Following the

the equation, being an insurer and being sponsored

review, customers flocked to HNE, causing the

by a provider.

company to see its commercial membership grow

We are certified by the American Society of Healthcare Engineers to work in all medical facilities.

Finally, the customers have to take responsibil-

substantially over the last year.

ity and be accountable for their own health.

Then, there are the internal positives. Three

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years ago, HNE started to lay the groundwork for

nation until we as a nation adopt healthier behav-

what has become the Opportunities for Improve-

iors and healthier habits,” Straley said. “We all

ment Program, a company-wide initiative that

know this intellectually, some people practice it,

sought to engage all HNE associates in improving their workplace and work processes. This process is based upon pioneering work done by Dr. Alan Robinson from the University of Massachusetts and published in his book “Ideas Are Free.” “This has been really profound in that departments that have really embraced this are improving their operations, their ability in reporting

Similarly, the Medicaid Managed Care product is a

favorably on their metrics, their customer service,

voluntary offering for those individuals who qualify

and everything they do on a continuous basis,”

for state-supported Medicaid coverage, but want a

Straley said.

more “managed-care” style approach. In Massachusetts, the majority of Medicaid beneficiaries are

Striving to be different

enrolled in a managed-care product.

HNE employees pride themselves in putting forth

These lines represent a change in focus for the company. Over the last 25 years, HNE has concen-

their best effort to help members get “the benefit of their benefit.” “High-quality health insurance is the single-

trated on reaching out to the commercial market, but thanks to Medicare Advantage and Medicaid Man-

most important benefit that employees get after

aged Care, HNE can now include the government end

their salary. In some cases, people work for

of healthcare in their service lines.

benefits more than salary,” Straley said. “It is

The second reason for HNE’s growth is the

very expensive. It is very important. We take the

healthcare reform that took place in Massachusetts.

attitude that you and your employer, depending on

“Massachusetts is the epicenter of healthcare re-

the product, have made a big investment in this,

form, and this past year, the administration decided

and you ought to actually get the benefit from it.” When customers call HNE, they are often sur-

to essentially institute for the first time a rate review of all managed-care plans, and effectively what that

“We are not going to bend the cost curve as a

prised to discover that a real person is answering

the phone. An even bigger surprise is discovering that this person is actually sitting in Springfield, and as Straley emphasized, most of the time, that person grew up in the Springfield area, so they have an idea of local healthcare needs. Eighty percent of the time, customer issues are resolved over the phone during that first call. “That person’s job is to help you resolve the issue,” Straley said. “Our job is to get from no to yes and to get there with a smile. And you can tell that the people who work here like their jobs. Not only

but most can do better, including myself.” Straley knows this personally as Hampden County, where HNE is located, has the lowest health status of any county in Massachusetts. Neverthless, as an insurance provider, Straley said the issue always comes back to his doorstep. “We own that. We are ground zero for the cost debate, and we are 100-percent committed to moderating cost trends, maybe even to reversing them a bit.” BY Pete Fernbaugh

does that come across on the phone, but it is also evident based on the retention of associates in our call center.”

The reform debate Straley believes that the healthcare-reform debate is primarily a debate about affordability and cost. While he understands the political expediency of blaming insurance companies, he believes that ascribing full blame to them is a mistake. “We are actually the industry that can drive this change, and we believe our type of plan, which is a provider-sponsored health plan, is uniquely positioned to do this, because this is a challenge that

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

39

11 | Medical Center Health System

Onward and upward

Also incorporated into this building are cardiac-

Currently, MCHS is constructing a $42-million,

rehab and urgent-care facilities, a diabetes center,

100,000 sq.-ft. addition to their facility that will

and a sports medicine, lab, and imaging area along

serve as the Center for Women and Infants and

with physician office space on the second floor.

will open in January 2012. It will feature 12 labor

“A lot of it is geared towards the after-care and

and delivery rooms, 30 private postpartum rooms,

preventive-care model that you’re seeing go across

20 newborn nursery beds, 30 private neonatal

the nation,” Ruiz said.

intensive-care rooms, three state-of-the-art cesarean-section suites, and an advanced infantsecurity system. Their $16-million Center for Health and Well-

Facing uncertainty with confidence Like any organization facing the fickle future of

ness, also recently constructed, will offer pre-

healthcare, MCHS is bracing itself to confront the

delivery and post-partum exercise classes in its

unexpected. Ruiz cited the growing self-pay popula-

Mission Fitness division. As part of this center,

tion of indigent care as a primary challenge, along

MCHS is offering a program that is devoted to

with healthcare reform.

transitional healthcare needs with a special focus on cardiac-rehab and physical-rehab patients. This

“No one knows what that will turn into or morph into,” he said.

fitness facility opened in October 2010 and special-

The system is working on building flexibility into

ized in getting people more involved in developing

its resources so it can efficiently adapt to future

an overall healthier lifestyle, rather than the typical

technological changes. Also, Ruiz said they are

weightlifting programs.

seeking to adapt a more outcomes-based, quality-

Medical Center Health System Medical Center Health System in Odessa, Texas, grew out of Medical Center Hospital. Originally an 85-bed facility, MCH has grown to become a 362-bed facility that has been servicing the people of Permian Basin for over 60 years. In a few short months, they will be expanding into a 422-bed facility and primary referral center for 17 West Texas counties. While West Texas is large geographically, Tony Ruiz, COO of MCHS, said that other than the twin cities of Odessa and Midland, the population is sparse, making MCH’s, and with it the system’s, accomplishments and ambitions even more impressive.

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Last year, for example, they received a little over 13,600 admissions and just under 50,000 emergency-room visits. The facility houses 15 operating rooms and 1700 employees. Their annual net revenue is approximately $250-million with their gross revenue being in the $650-million range. Their trauma center has achieved Level-III status and is currently under review to become a Level-II later this year.

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“We need to make sure that we’re understanding

“One of the ways we try to reduce our costs is to

featuring Quiznos, Austin Grill, and Starbucks. This

and not losing sight of the values that comprise the

strengthen our negotiating power with multiple

is all part of an effort to acquire new and innovative

mission of our hospital,” he said. “I think what I am

hospitals and multiple health systems,” Ruiz said.

revenue streams while providing a more visitor-

trying to do is become more focused on reducing and probably most importantly, looking for more

They’ve also been very successful with a lot of im-

portive in all of our initiatives,” Ruiz said. “We’ve

revenue streams and potential service lines.”

plantable devices, especially in the areas of cardiac

been able to work with our medical staff to deliver a

and orthopedics.

better product. Our competition has made us work

To that end, the system is developing multiple

and implementing a very detailed strategic plan,”

more databases for the sake of charting outcomes,

Ruiz said. “Since I’ve been here, we’ve worked with

communicating between providers, and measuring

Med Trans air ambulance and Acute Care Surgical

performance.

Specialists out of Dallas to help cover and to help

vices. So the community has benefited from that.” Still, Ruiz said that it’s going to be a rough five to 10 years. “We can see that the changes that are taking place are going to require hospitals to make some

up an inpatient rehab and developed or expanded

dramatic changes just to stay solvent.”

ment lays out that future for us to some degree.”

many programs, which give us more integration

However, he believes that MCHS is well-

and control in improving the community’s health

equipped to face these changes by remaining in-

and solidifying our position as the market leader in

novative and adaptable to inherent change in

Many of MCHS’ investments are focused less on

this area.”

the industry.

building and more on upgrading.

MCHS has even ventured into retail in a joint venture with Morrison Food Management. This

try to do our best to renovate and replace our capi-

partnership has seen the hospital and one of MCHS’

tal as much as possible so we use those resources

outpatient surgery centers develop a food court

wisely,” Ruiz said. MCHS strives to be very transparent and open with the public regarding all of their investments, whether it’s the $16-million Center for Health and Wellness or medical equipment. Last year, for example, MCHS purchased a Siemens 3 Tesla MRI system along with a da Vinci robotic surgery system. Their OR-surgical suites

cian-owned hospitals poses another challenge for

have been renovated over the last three years,

MCHS. Over the last seven years, two new physi-

making them larger for current and future equip-

cian-owned hospitals have started up in the region,

ment upgrades and adapting the infrastructure for

which essentially is a fairly small community of

technology that wasn’t available 20 years ago.

100,000 people.

Currently, MCHS is working with McKesson in gaining meaningful-use designation. Ruiz said they

important, challenges of federal and state budget

expect to have complete electronic documenta-

cuts, decline in reimbursements, communication,

tion fully implemented this year for physicians and

and physician engagement

all clinical staff. They also work through the Texas

tains its focus.

harder to improve our quality initiatives and ser-

strengthen our trauma program. We’ve opened

“Rather than building a lot of new buildings, we

Ruiz is adamant, though, that the system main-

“Our board has been very good and very sup-

prepare for the future,” Ruiz said. “And the govern-

Improving what they have

MCHS is also facing the common, but no less

“Our success has been based on innovation

safer transitions. MCHS is also focused on evolving

“A lot of these initiatives are developed to

Of course, increased competition from physi-

friendly atmosphere.

their electricity contract by $1 million annually.

initiatives, including improved quality initiatives and

based formula for the hospital’s operations.

Over the next three years, they expect to reduce

costs where we can, becoming a little bit leaner,

Purchasing Coalition to ensure the wisest investments and most beneficial contract negotiations.

Real Issues : Real Solutions

by Pete Fernbaugh

12 | Southwest College of Naturopathic Medicine

Reaching out and giving back Nearly 30,000 patients are treated each year through the college’s patient-care services. These

Bringing Medicine Together

services are split between the medical center located on the college campus in Tempe and eight community clinics with whom SCNM either collabo-

In collaboration with healthcare

rates or solely staffs.

professionals, AMS was provided with

The outreach clinics began in the mid-1990s.

unprecedented opportunities to evaluate

The Arthur M. Hamilton Elementary School Clinic

the entire system of healthcare delivery

in Phoenix, Ariz., exemplifies these community

and developed this knowledge into sound,

partnerships. Started eight years ago, the college

reliable practices.

worked with the school to raise funds to break

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ground for a clinic that is now opened five days a

HeliosND Offering a practice management solution for the Integrative Medicine community with highlights on case studies, supplement prescribe and inventory management. HeliosMD Featuring a customizable turnkey practice management solution for physicians in every specialty.

week and serves not just the Hamilton students, but also the entire Murphy School District. “These are children who have the misfortune of being born into poverty and a lot of them are chil-

Other Services

dren of undocumented parents, so they don’t have

· · · · · ·

access to routine care,” Dr. Paul Mittman, chief executive officer of SCNM, said. SCNM also works in a women’s shelter, an HIV clinic, a mobile medical center, a community health

Electronic Medical Record/Practice Management Software Document Imaging Release of Information Services (ROI) Staffing Services HIPAA Compliance DNA Testing

center, and two drug and alcohol rehab facilities.

American Medical Solutions, Inc.

SCNM doctors are trained in both patient exam-

Southwest College of Naturopathic Medicine

ination and assessment and are qualified to write prescriptions and conduct routine office procedures along with a range of alternative therapies such as acupuncture, clinical nutrition, manipulation, homeopathy, and botanical medicine. They also

studies, but these commonplace procedures aid

work closely with other practitioners and medical

them in looking a little deeper into the patient’s

Since 1993, the Southwest College of Naturopathic Medicine and Health Sciences (SCNM) in Tempe, Ariz., has been training medical students of all backgrounds to apply nature to medicine.

facilities to insure that patients get the best care.

potential medical issues.

Currently, the college enrolls 373 students in the doctor of naturopathic medicine program. This discipline is a four-year doctoral program that requires a bachelor degree and a pre-med background to be considered for admission. Over 900 naturopathic doctors have graduated from the program since the institution’s founding.

The term “naturopathic medicine” sounds strange

other factors might be underlying the diagnosis,”

and almost cultish to the uninitiated, but Mittman

Mittman said.

Explaining naturopathic medicine is quick to explain the common sense behind this medical discipline. “If you picture a doctor who combines the best

Dr. Paul Mittman, CEO

11036 N 23rd Avenue, Suite 6, Phoenix AZ. 85029 P. 602.997.7041 | F. 602.997.7126 www.americanmedicalsolutions.com

The college has more than 70 full-time and adjunct faculty who bring vast expertise and experience to the students. Many faculty are world-renowned and leaders in their fields, including Dr. Yong Deng, M.D. (China), L.Ac, department of acupuncture and oriental medicine chair, author of “Encyclopedia of Chinese and U.S. Patent Herbal Medicines,” and director of the International Association of Integrated Medicine (IAIM); Richard Laherty, Ph.D., department of medical sciences chair and recipient of an NIH Individual Postdoctoral Research Service Award; and Matthew Baral, N.D., department of pediatrics chair, who serves as the pediatric contributing editor to the “Natural Medicine Journal” and the “International Journal of Naturopathic Medicine” and is the founding and current president of the Pediatric Association of Naturopathic Physicians.

“All of this helps us to form a very in-depth history of the patient that then helps us to understand the diagnosis and to look deeply to see what

For example, a doctor sees 10 patients who suffer from migraines. The doctor gives the diagnosis, “headache-migraine.” Conventionally, Mittman

of western and alternative therapies, you would

explained, the treatment follows an algorithm

be talking about a naturopathic doctor,” Mittman

whereby the doctor will start with a solution that

said. “So, on the one hand, you use the foundation

is designed to mitigate the pain. If the migraines

in the biomedical sciences to understand people

persist, the doctor will then prescribe medication

and health and then illness and combine that with

to hopefully prevent the migraines.

conventional and alternative therapies.” Naturopathic doctors still look at a patient’s

However, Mittman asked, what if you looked more closely at those 10 individuals and found that

medical history and still conduct physical exami-

several of the patients are women who experience

nations, along with routine lab work and imaging

migraines at the same time each month? HCE EXCHANGE MAGAZINE

Real Issues : Real Solutions

45

That could indicate a hormonal component is in-

SCNM opened the center with electronic health re-

capacity to have an impact on health and healthcare

volved. Or maybe, after a closer examination of the

cords (EHRs) already in place. With few exceptions,

today and in the future, and how to diversify revenue

patients, you find that certain foods trigger the mi-

there are no paper charts, giving doctors immedi-

sources.

graines for certain patients. Removing these foods

ate access to patient records. SCNM is also about

from their diets just might remove the migraines.

to streamline its referral process both in the center

where we don’t end up as a school with a host of

and for doctors outside of the facility.

competing programs competing for limited dollar,”

Another patient has migraines and cervical pains. You find that the headache started after this

“We’re looking at how to do all of that in a way

“Our students are being trained right off the bat

he added. “What are the types of programs that are

patient was involved in a vehicular accident, a pos-

in this system,” Mittman said. “They’re not going

going to need the most as we move forward?”

sible culprit behind the migraines.

to have to unlearn charting on paper, as they move

SCNM is also looking at adding health education,

into the technology that’s going to become the stan-

wellness, nutrition, and post-graduate programs.

“Just looking to individualize the diagnosis and also paying particular attention to those lifestyle

dard in healthcare.”

“How do you get a school that’s operated in a

diet, has an impact on the diagnosis,” Mittman said.

A long-term passion

certain way to be more efficient? How do you break

pathic doctors, but also medical doctors, acupunc-

Mittman has been CEO of SCNM since 1999. His

out of that and change, but not undo the culture of

“Are they eating a diet that promotes inflammation

turists, chiropractors, psychologists, massage

passion for naturopathic studies is contagious, as

the institution?

or regulation of inflammation? Most inflammatory

therapists, and biofeedback technicians. This helps

is his passion for the power individuals have to

mediators, including prostaglandins, originate as

to create an integrated atmosphere of internal

change themselves.

fats, so depending on what kind of fats a person

communication among that group, and it also

“When patients are empowered to understand

“In the United States 80 percent of the $2.5 trillion

eats, the more likely they’ll have inflammation or

helps with referring out patients who might require

their illness and to make therapeutic life changes,

we spend on health care goes to treat preventable

more or less inflammation.”

diagnostics.

whether it’s diet, exercise, stress management,

conditions and chronic diseases that have their roots

or biofeedback, remarkable things happen,”

in the way we live our lives,” Mittman said. “If we

Mittman said.

want to have a healthy society and not bankrupt our

factors that could affect a person’s health, their

Saturated fats or trans-fats can affect inflam-

On staff, the new center has not just naturo-

The medical center also has six classrooms

More than a medical issue

mation in one direction, while mono-unsaturated

built onto it where students will conduct chart

fats and other essential fatty acids can push it in

and case preview and review. Each classroom has

the other direction.

wireless technology that enables them to access

progressive areas of study, Mittman said SCNM

the school’s digital collections and subscriptions.

is always looking to the future, ready to move and

block the process further downstream, the COX

The classrooms also have a digital-closed circuitry

embrace innovations that can improve their prac-

2 inhibiter, then why not make sure the body has

monitor system. From any classroom, students can

tices, while letting go of practices that don’t work.

more substrate that’s going to promote a regulation

view each of the exam rooms (but only if patients fill

Mittman emphasized how important it is to “not get

daunting challenges is one that I believe will include

in inflammation rather than promoting inflam-

out a consent form allowing themselves to be ob-

stuck in the past.”

naturopathic medicine,” he said.

mation in the first place?” Mittman asked. “So

served). Students can observe physicians or other

combining diet with other therapeutic life changes

students, and doctors can watch students.

“Rather than relying solely on drugs that can

(exercise, stress management) is the core of what

“From a learning standpoint, it really enhances

As one of the leaders in one of the most

He noted that SCNM is the first naturopathic

country, we have to address our healthcare issues at their root causes.” Mittman firmly believes that’s where naturopathic medicine comes in. “A future where we successfully tackle these

SCNM, he said, values goodness, both to our

medical school in North America to take the leap

bodies and to others, above all else. The college

into EHRs, and the 2010 curriculum revision, a

requires students to do community service and

roll-out that will take four years to complete, is the

encourages senior executives to serve on boards and

most significant curriculum revision in naturopathic

to participate in the community in as many different

studies in 30 years.

ways possible.

we do.”

the process,” Mittman said.

Training the students

in 2010 for first-year medical students that will

In the fall of 2010, 80 students enrolled at SCNM,

require them to begin practicing physical exams on

giving the institution its largest incoming class

their first day. This program will have students start

them into one Human Biology block oriented by the

inside, I think people are limited in how healthy they

in SCNM history. In 2009, the college purchased

by working with each other, then with standardized

various organ systems,” Mittman said. “Rather than

can be,” he said. “If you believe in the idea of holism,

property that is adjacent to its Tempe campus. On

patients and finally with regular patients. Students

having it be discipline-oriented, having it system-

you have to think of health as more than just a

that property was a building that SCNM has now

will also start working with physicians in the field

oriented means that when students are covering

medical matter.”

converted into a brand-new medical center.

as early as possible.

the cardiovascular system, they have a team-taught

The new building combines some innovative

The school also introduced a new curriculum

In 2002, SCNM became the first naturopathic

“We took the biomedical sciences and blended

course, covering it in anatomy, physiology, bio-

“If there’s something that’s missing deep down

It is Mittman’s wish that the medical community would unite, bringing all forms of medicine together.

features not only for SCNM’s specialization, but

medical school to put all of their class material

chemistry, etc. It is coordinated, so that’s it hap-

also for medical education in general.

online, giving students the ability to access notes.

pening all at the same time rather than being split

physicians and practitioners who come from differ-

With Welch Allyn, Southwest pioneered an arrange-

among several courses.”

ent backgrounds who work together in as seamless

“When we designed the center we included feedback from patients, students, and our faculty,”

ment in which each student would receive a full

Mittman said. “So, we feel that it has a real patient-

diagnostic set upon entering the program.

As Southwest moves into the future, Mittman said the institution is looking to address several

centered feel to it. We incorporated some technolo-

questions, including how to grow the school both

gies that are real assets to our patients and the

numerically and physically, how to increase their

“How wonderful it would be when you would have

a way as possible for the benefit of each patient.” by Pete Fernbaugh

students who are learning.”

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

47

13 | Tuba City Regional Health Care Corporation

The hospital was previously under control of the

provide long-term care on campus, and to offer

Indian Health Service, a division of the U.S Depart-

smaller independent living/health-service facilities

ment of Health and Human Services. The change

in the eight chapters it serves.

to self-governance has allowed Tuba City to create

INDUSTRY PARTNERS DaVita, Inc. www.davita.com

ing and pursue more community-based opportuni-

Becoming a community engine

ties for funding rather than only receiving available

Tuba City’s desire to become a larger facility and

federal dollars.

to provide more services and support to the com-

The change in leadership hasn’t come without

munity was part of the organization’s impetus for

challenges. Although it’s been nine years since

spirit,” said Joseph Engelken, chief executive of-

pursuing self-governance. With healthcare in-

the change, within healthcare, transitions can take

ficer. “Our medical staff is very involved; all our

equality being a major issue throughout the United

time, especially with the federal adjustments in

physicians are employed. We are becoming an

States healthcare system, Tuba City felt self-deter-

reimbursements and delivery modalities. Engelken

integrated community engine.”

mination allowed it to close the gap in healthcare

said most of the physicians have worked both

disparities among Native Americans compared with

within the Indian Health Service as well as the

primary and specialty community clinics Tuba City

other citizens. In addition to focusing on quality

private sector.

runs in addition to the main hospital campus. Self-

care, Tuba City is dedicated to growing the com-

new jobs, establish a 501(c)(3) branch for fundrais-

“Our hospital board has an entrepreneurial

By integrated, Engelken is referring to the 12

governance has benefitted the healthcare corporation as it has completed many new projects.

Adding and expanding

Engelken said quality is always a focus at Tuba City, and the hospital has increasingly added services in the past couple of years. In 2010 and early in

In 2010, Tuba City opened a 34,000 square-foot

2011, the hospital began offering 24-hour MRI and

ambulatory medical facility on campus and an out-

CT-scan services, 24/7 pharmacy, a regional mail-

patient primary-care center on campus. Expanding

order pharmacy, along with electronic medical

community services, Tuba City also opened the

records. Future plans include continued growth of

Sacred Peaks Health Center, a primary-care facility

the trauma system and cardiovascular services.

in Flagstaff to serve more Native-American beneficiaries in Arizona.

Tuba City is also looking into opportunities to serve the northern region of its service area, to

munity and ensuring the hospital is a communitydriven engine.

challenges.”

The entire Tuba City Corporation serves about

Tuba City Regional Health Care Corporation (TCRHCC) is situated in Tuba City, Ariz., and serves the western part of the Navajo and Hopi Reservations. The hospital is a 75-bed acute-care regional medical center with burgeoning centers of excellence in trauma, diabetes, and cardiovascular services. Tuba City has new advancedmedical technology you rarely find in Indian country.

Joseph Engelken, CEO

Tuba City is dedicated to providing the best care possible to the Native American communities it supports. The health system furthered that mission in 2002 when it shifted decisionmaking from the U.S. government to a local board comprised of community members.

Tuba City continues to work through those daily

6,000 square miles, and the hospital receives about

challenges with continued focus on quality care for

410,000 patient visits annually. It has a referral or

the patients they serve. Quality improvement is key

beneficiary base of about 75,000 individuals.

to reducing costs and building consumer trust.

“Our board believes in community-based planning and care,” Engelken said. This mission can be seen through the hospital’s

Remembering the goal Engelken said the goal of Tuba City is to become a

addition of 450 employees in the past six years. On

regional medical center of excellence, but it must

a Navajo reservation, this number is huge in terms

still be anchored in community-based care, “so we

of economic development and sustainable commu-

don’t get too full of ourselves.”

nity life. Engelken said Navajo nations typically have

Tuba City Regional Health Care Corporation

“Change is always complex and tough,” he said. “But it is more rewarding to overcome those daily

“Our mandate as a tribal health organization is

about a 40-percent unemployment rate. Seventy-

to serve primarily Native-American beneficiaries,”

three percent of the workforce at Tuba City is

he said. “Consumer expectations for care are al-

Native American.

ways increasing, and we are working hard to ensure

“Through self-governance, we are helping

we maintain the trust of our patients. As we work

grow a business that was traditionally done only

toward becoming a center of excellence, our clinics

by the Indian Health Service,” Engelken said. “Our

are a vital vehicle to keeping us grounded in the

workforce is adjusting to the change and becoming

communities we serve.”

more entrepreneurial. We are moving increasingly toward a Navajo, Hopi, and other Native-American

by Patricia Chaney

tribe executive team driving the health system.” For CEO succession planning, the board this year started an innovative Associate Executive Officer (AEO) mentorship program so a Navajo or Native-American CEO is ready to tale the helm of this expanding healthcare system when Engelken’s tenure concludes in four years.

HCE EXCHANGE MAGAZINE

49

14 | The Children’s Hospital of Philadelphia

Ranked among the best When The Children’s Hospital of Philadelphia says it’s the best, this is not just a self-aggrandizing institutional opinion. It’s a fact. When U.S. News and World Report released its 2011-2012 rankings of “Best Children’s Hospitals 2011-2012,” CHOP was ranked in all 10 categories of pediatric specialties and tied overall for first place with Children’s Hospital Boston. CHOP ranked first in the neonatology, pulmonology, and diabetes and endocrinology categories, and in the seven other U.S. News categories—cancer, cardiology and heart surgery, gastroenterology, nephrology, neurology and neurosurgery, orthopedics, and urology—CHOP was ranked as part of the nation’s top four. “It’s my pleasure to congratulate our staff and to thank them for their hard work and the excellent care they provide to all the children that we serve regionally, nationally, and internationally,” Steven M. Altschuler, M.D., chief executive officer of CHOP,

The Children’s Hospital of Philadelphia

said on a video post on CHOP’s news blog. In the February 2009 issue of Parents magazine, CHOP was ranked as the best overall pediatric hospital in the United States, and number one in emergency medicine, neonatology, and pulmonolo-

The Children’s Hospital of Philadelphia (CHOP) was founded in 1855 and holds the distinction of being the nation’s first pediatric hospital. Over 150 years later, it is still breaking ground and progressing toward the future, all in the name of keeping children healthy.

Steven M. Altschuler, M.D., CEO

CHOP began as a single, 12-bed hospital. It is now a 516-bed campus located in University City, Philadelphia. More than 1.1 million outpatient visits and 28,000 hospital admissions were handled in 2010 by CHOP. According to U.S. News and World Report, CHOP performs 7,000 annual inpatient and 17,162 outpatient surgeries. Its ER received 85,450 visits in most recently reported year. CHOP houses cancer, cardiac, and fetal-surgery programs, a rehabilitation facility, an ambulatory care center, and research space that exceeds 640,000 square feet. Its Care Network extends to Pennsylvania and New Jersey patients in more than 50 locations.

gy with the cardiac and cancer centers and CHOP’s orthopaedics division ranking number two.

Advancing medical research CHOP is involved heavily in many areas of medical research. Beginning 80 years ago in a single basement room, CHOP’s research arm experienced early successes that led to the founding of CHOP’s Research Institute in 1972. According to the CHOP website, www.chop.edu, the CHOP Research Institute was, appropriately

with the CHOP organization. It is also considered to be one of the largest pediatric research programs in the country. Throughout its long history, the institute has led the way on many innovative medical breakthroughs, including measles, mumps, and rubella vaccines and a balloon catheter for cardiology. It has also contributed to the development of the FDA-approved vaccine known as RotaTeq. As documented in the Aug. 11, 2011, edition of the journal Nature, CHOP’s Center for Applied Genomics, founded in 2006, recently participated in the most extensive genetic study of multiple sclerosis to date. Orchestrated by the International MS Genetics Consortium, the study compiled data from scientists in 23 research groups across 15 countries. According to CHOP’s website, “The genomewide association study (GWAS) of samples from nearly 9,800 MS patients and 17,000 healthy control subjects replicated previous genetic findings and identified 29 novel gene variants linked to increased risk of the debilitating neurological disorder. “ The Center for Applied Genomics provided 6,000 of these samples to the study for the purposes of examining frequent gene variants among MS patients. “In addition to our own studies, the pediatric biobank we have built at the Center for Applied Genomics over the past few years, which includes over 100,000 DNA samples, is a major resource for genetic researchers worldwide,” Hakon Hakonarson, M.D., Ph.D., director of the center, was quoted by CHOP’s website as saying. “Our biobank has contributed in a major way to various international research programs aiming at resolving the genetic causes of some of the most common and serious diseases that affect both children and adults.”

enough, the United States’ first pediatric research department, and today, it is an independent entity

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

51

Putting family first For an organization as renowned and respected as CHOP, it would be easy for them to get lost in their Dräger Dräger is a proud supplier of anesthesia solutions to the Children’s Hospital of Philadelphia. Dräger develops innovative equipment and solutions people the world over trust when lives are on the line. “Technology for Life” means more than merely guaranteeing technical excellence. It means assuming responsibility for the lives of those who use our products and depend on them. Technology for Life is both our guiding principle and the central challenge that we draw on for inspiration and motivation. “We do everything we do with passion— and we do it for life.” (Stefan Dräger, Executive Board Chairman)

own prestige. However, as stated on their website, it all comes back to family. Some of the highlights of CHOP’s philosophy of care include ensuring that family remains the constant in a child’s life: respecting racial, ethnic, cultural, spiritual, and socioeconomic diversity; full disclosure of information to families; nurturing the developmental needs of children; and supporting the family unit during a child’s time with them. “The staff of The Children’s Hospital of Philadelphia respects each family’s values, needs, cultures, resources, and strengths,” CHOP states on its website. “We strive to provide the highest quality of care by successfully blending patient care, education and research.” by Pete Fernbaugh

15 | The Royal Jubilee Hospital

An Elder-Friendly, Sustainable Hospital One-third of admissions and one-half of overnight

couch in the rooms. We provide a kitchenette central to the units and try to incorporate family

stays at Royal Jubilee are from patients ages 75

involvement throughout the whole process.”

and older. This is one of the facts that came to light

A Universal Design for Future Flexibility

when the hospital began developing a strategic approach for upgrading the new patient units. “We did research around what the needs of the elderly were,” van den Broek said. “All sorts of physical changes happen to adults as they age, and we realized that most hospitals are not designed for older adults. They are designed for younger adults. “To make it worse,” he continued, “most hospital environments—this is well-established in the literature—are essentially toxic for older adults. Shiny floors, white walls and floors, lack of handrails, clutter and lots of obstacles, overhead paging, high noise levels, rigid hours around food delivery and meds—all of those things serve to disorient

The Royal Jubilee Hospital

tions to visiting hours. We included a sleeper

older adults, and the older they are, the more frail they are, and the worse the hospital is for them.”

Every unit in the Patient Care Centre is identical. None are customized for any particular program. The floors may be currently divided into rehabilitation services, heart health, and oncology, but any floor can be converted into another service line in a short period of time because the underlying infrastructure is the same. Gases, mechanical, and information technology are built into every wall. The fixtures merely change to fit the need. “If we wanted to convert the whole building to mental health, we’d simply valve off the gases and maybe re-drywall those rooms. In a matter of a week or two, we’d be able to convert the

This actually increases the length of the hospital stay for patients “who are otherwise not so bad,” van den Broek said. “They get sicker as you are

While the diagnostic and treatment portion of Royal Jubilee Hospital on Vancouver Island was upgraded in 2002, until this year, inpatients were staying in facilities built as early as the 1920s. The $300-million Patient Care Centre project was initiated to address this issue. It began in July 2008 and was completed in December 2010. Patients were moved into the upgraded facilities in March 2011.

trying to care for them.” The residential-style design plan included windows that open wide, garden spaces, and green roofs. “What we found is that what is good for the elderly was also consistent with sustainability,” van den Broek said. The décor is earth-toned with subdued and indi-

“We had an aging series of buildings,” Rudi van den Broek, chief project officer and general manager of special projects for the Vancouver Island Health Authority, said. “We live in a high seismic zone, and the height and condition of our inpatient units was a concern. Functionally, it was obsolete. We had a high rate of falls, injuries, and hospital-acquired infections, so we knew we had issues.”

rect lighting. They used plenty of sound-absorbing materials and lots of wood, from wood-grained flooring and handrails to cabinetry. “We also included features for families,” he said. “We revised our policy so there are no restric-

The LEED Gold facility has 425,000 square feet and houses 500 patients. Of the approximately 106 known evidence-based design features, more than one hundred have been utilized in this new facility. HCE EXCHANGE MAGAZINE

55

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Monk Healthcare was proud to be a part of this great project. whole facility,” Broek said. “That’s big flexibility because over the next 50 years, we don’t know exactly what our program mix is going to be. When we look back at our buildings that are 50 years old today, we are using them for different programs and services

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than we once imagined.” Both vertical and horizontal shafts for extra capacity were installed throughout the building. Everything from ventilation systems to circuit boards and cable is ready for expansion.

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Royal Jubilee has also been focused on seamlessly integrating all aspects of the electronic medical record. The new smart beds in the facility have the capability of weighing the patients and uploading that information into the medical record. All vital signs can be electronically placed into the patient record. The capacity to drive the clinical

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display from the footwall monitor has been built in so that a patient can see their records and have a telehealth conversation with providers.

We congratulate all those involved on the Royal Jubilee Hospital–Patient Care Centre.

I would encourage folks to use evidence-based design. There are a lot of features out there that not all the architectural firms know about. From a fiduciary and a stewardship obligation, you need

Passing on the Keys to Success

to put it into the design. You need to incorporate

“From my perspective, it’s a large project,” van

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all the clever information you can.”

den Broek said. “20,000 pieces of equipment, 2,000 doors. 1,400 rooms. A lot of details to make sure we get them right. “We chose the principles of evidence-based design, elder-friendly and sustainability, before any pen went to paper, before there were any specifications, any drawings,” he added. “It was a founding principle. You’ve got to make that call very early.

“We chose the principles of evidence-based design, elderfriendly and ustainability.”

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HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

57

16 | Colonial Behavioral Health

An aggressive community force Founded in 1971, Colonial is entering its 40th year of operations. It has 203 employees and a budget of $13.3 million. Colonial services four localities with an approximate population of 150,000 and saw 4,530 individuals during its last fiscal year of July 2010 through June 2011. Colonial offers services for the entire life span, from children’s services to senior services, including crisis services (with a crisis counselor being available 24/7/365); day programs for adults with mental-health disorders and intellectual disabilities; residential programs for individuals facing intellectual disabilities; a full range of outpatient individual, group, and family services for children,

and licensed clinical social workers inside

adults, and seniors in each diagnostic category;

those clinics.

two intensive outpatient programs for adults with substance-abuse disorders; and enclave employ-

munity that helps pull them together rather than

ment work for individuals with intellectual or devel-

split them apart, and we’re proud to be a part of

opmental disabilities.

that,” Coe said.

More than a year ago, Colonial opened the Center (GWCAC) as an expansion of its children’s

Reaching out to the working poor

services. This center will act as a centralized child-

With its primary source of revenue being Med-

assessment service for the community, parents,

icaid, the continual cuts to this program have

and providers who are looking to get assessment

challenged Colonial in multiple ways.

Greater Williamsburg Childhood Assessment

Colonial Behavioral Health

Located in Williamsburg, Va., Colonial Behavioral Health is a communitybased public provider of services for those dealing with mental-health issues, intellectual and developmental disabilities, and substance-abuse disorders. Colonial is one of 40 independently operated Community Services Boards across the state of Virginia. Considered to be a part of the public system, each center operates together in several ways, but each is independently governed by a locally appointed board of directors. Each center also has a designated service area.

David A. Coe, Executive Director

Colonial serves the upper peninsula of Virginia, including the city of Poquoson, as well as America’s Historic Triangle of Jamestown, Williamsburg, and Yorktown.

“We have a lot of positive things in the com-

referral and a one hand-off to providers. As part of

“We’ve had the challenge of Medicaid all

its services, the center offers an electronic web-

along,” Coe said. “In the community in which we

based database of information designed to help

live, there is a lot of tourist activity, not a lot of

parents and guardians locate over 400 services in

large industry, so we have a disproportionate

the area.

number of individuals in our community who

‘With this electronic backbone, folks can get a picture of what’s going on,” David A. Coe, executive director, said. “They can get an idea of who provides

are working multiple part-time jobs in tourist industries or hospitality industries.” Unfortunately, most of these individuals

what service, transportation options, what insur-

make too much money to qualify for Medicaid,

ances are available, and so on.”

but the nature of their work doesn’t bring them

Colonial is actively working with local and

health insurance. As Coe noted, 60 percent

primary-care clinics, community health centers,

of the population in Colonial’s service area is

and free clinics in the area on integrating behav-

comprised of the working poor. While some of

ioral healthcare with primary healthcare. These

the clinics in Virginia have 75-80 percent of their

efforts include providing training and telepsychiatry

budgets provided by Medicaid, Colonial only

consults. Colonial has also embedded psychiatrists

has 30 percent of its budget funded by Medic-

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

59

When it comes to increasing revenue streams, Colonial has created a private entity, Colonial Health System, Inc., whose purpose is to move Colonial into business lines that are not traditionally operated by community mental health centers. Coe hopes that this can generate dollars from completely different sectors, especially with the increasing Medicaid challenges posed by healthcare reform. “We’re really looking to begin leveraging differthe skills and expertise on budgeting, cost containment, regulatory knowledge, and program planning. Middle management, by and large, had not been trained in this area. “Up to that point, all of those core business functions were held by a very few people, and many

ent aspects of healthcare revenue into our community,” Coe said. “It is possible to position yourself strategically and squeeze every penny at the same time.” by Pete Fernbaugh

of our middle managers did not have expertise in those and had not been developed in those areas,” Coe said. Anasazi Software aid. With state budgets being cut, this conundrum

Coe embarked on a mission to transfer this knowledge from senior-management levels to

Anasazi Software is proud of its 13 year partner-

middle-management levels. A group was created

“In recent years, we’ve taken much more in

ship with Colonial Behavioral Health. Our custom-

named QuILT (Quality Improvement Leadership

the way of cuts than we have in ways of growth, so

ers’ success is our best marketing campaign. This

Team) that concerned itself with training middle

one of the things that we came to realize is that we

is best exemplified by our funded National User

management in areas that included health and

can’t think like other Community Services Boards,

Group, which puts our customers in control of

safety planning, disaster preparedness, licenser

because our payer mix is different, the funding

the future of our ONC Certified EHR and assists

issues, data management, human rights, regulatory

sources we have relied upon are different, and we

organizations like Colonial Behavioral Health with

issues, etc.

have to take a different view of how strong and

acquiring HITECH Meaningful Use Funds.

becomes more tangled and problematic.

“We’ve taken the time over the last few years

stable those funding sources are,” Coe said. “So

when we’ve had budget cuts and we’ve had cut-

we’re needing to try to take a little more control of

backs and we’ve had to close some programs and

our own destiny.”

restructure some programs to reposition ourselves for the next generation of healthcare, and much of

Facing destiny through innovation

that has been done through the middle-management restructuring and development program,”

For Coe, controlling Colonial’s own destiny means

Coe said.

two things—arming employees with skills and exploring new revenue streams. About four years ago, Coe began to realize that senior-management personnel possessed most of

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

61

17 | MEDIC Regional Blood Center

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Haemonetics

MEDIC Regional Blood Center Supplying the demand In spite of the many challenges affecting healthcare organizations in 2011, MEDIC continues to make a

In the midst of a shaky economy and uncertain developments in the healthcare industry, one Knoxville, Tenn.-based organization continues to move ahead, doing what it’s done best since 1958—collecting and distributing blood to hospitals in its area. MEDIC Regional Blood Center serves 21 counties in east Tennessee, meeting the blood needs of 27 client hospitals in that region. A private, not-for-profit facility, MEDIC was founded as a centralized base from which blood could be collected, tested, and distributed to area hospitals. Since its founding in 1958 by Carl Nelson, M.D., MEDIC has achieved this goal above and beyond expectations. It is now a recognized leader in its region and a valuable resource to the hospitals in the various communities it serves.

valiant effort in keeping up with the demands and needs of its client hospitals. “That has become more challenging in recent

Haemonetics’ comprehensive software portfolio helps enable an Arm to Arm® blood management solution, tracking and monitoring blood units along points in the supply chain, including blood drive and donor management, blood processing, blood distribution, and transfusion management.

years because of a number of factors, but I feel good about the service we provide and the things we do to support our hospitals,” Jim Decker, MEDIC’s chief executive officer, said. It helps in no small way that MEDIC has shown consistent growth and a steadfast adherence to its core values during its 53 years of existence. Chief among these values is a dedication to MEDIC’s client hospitals and by extension, the patients in those hospitals.

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

63

Key to its mission is a definitive passion for the safety

think our community residents appreciate that, and

recruitment and inventory control, as well as our

and well-being of the surrounding communities.

I know it is appreciated by our client hospitals.”

staffing methodology.”

The organization’s name provides an acronym

In recent years, however, MEDIC has seen an

However, Decker points out that MEDIC can

that defines these values—Membership, Excellence,

unfortunate development as blood donations have

only do so much since many of the future factors

Dedication, Integrity, and Caring.

declined.

that would influence policy and organizational

“We view the service that we provide as being

“During this period of economic downturn,

strategy in the present remain murky and pliable.

extremely important and a vital component within the

many of our local companies have either downsized

regional healthcare-delivery system,” Decker said.

or gone out of business,” Decker said. “Since the

shakes out a little bit more, it’s hard to determine

majority of our blood is collected at mobile blood

exactly what course of action we need to take

Surviving rough times

“Until the impact of the healthcare reform

drives, and many of these are on location at a

because right now some things are still somewhat

Blood drives are vital to MEDIC’s operations, and

company, there is simply a smaller pool of donors

uncertain,” Decker said.

Decker stressed the importance of community in-

available to us. We’ve had to look at other venues to

volvement in maintaining MEDIC’s blood supply.

conduct blood drives to offset this trend.”

“Since our service area covers 21 counties, it

Sticking to its focus Decker believes there is one practice that makes

is extremely important that we work with all lo-

Surveying the future

cal groups, including schools, churches, and other

Technologically speaking, MEDIC is in the middle

organization no matter what the future brings. This

community organizations,” Decker said. “We stress

of implementing a new computer system that will

practice is the nurtured and focused attention MED-

the importance of blood donation and the fact that

provide a major upgrade to its capabilities, espe-

IC gives to its hospital clients. From the beginning,

all blood we collect goes to serve our 27 hospitals. I

cially with respect to collecting information on all of

MEDIC was established as a partnership with local

its donors and tracking the products they have for

hospitals, and it continues to refine and expand that

distribution.

partnership.

“In early 2012, we plan to go live with the El Dorado Blood Establishment Computer System developed by Haemonetics Software Solutions. This will provide a tremendous enhancement over our current system,” Decker said. MEDIC is also looking at new lines of business that would provide it with additional growth opportunities and new revenue streams. One example

MEDIC stand out in its area and that will sustain the

“We’re very proud of what we’ve accomplished over the past 53 years.”

Decker said there is a continuous stream of information that is shared between MEDIC and its hospital clients with the goal being a solid communication base that enables both parties to know what they can do for each other. “We’re very proud of what we’ve accomplished over the past 53 years,” Decker said. “We know we’re going through difficult and challenging times

is cellular therapy, a service that is already being

right now as things are somewhat uncertain, but

provided by many other blood centers across the

I think the good news is that we feel we have a

United States.

handle on the majority of those issues and are

All of these endeavors are part of a larger initiative that seeks to strongly position the organization for a future that is anything but certain. This begins by looking at MEDIC’s operations from an efficiency and productivity standpoint. “We’re trying to reassess our model to make sure that we are doing things in the most efficient

“We look forward to another prosperous 50 years.”

taking steps to address them. We look forward to another prosperous 50 years.” by Pete Fernbaugh

manner,” Decker said. “We have spent considerable time evaluating key processes, such as donor

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

65

SUMMER

2011

Real Issues : Real Solutions

HCE Exchange Magazine EDITORIAL Editor-in-Chief Tiffany Ford Editor: In-Focus Pete Fernbaugh Contributing Writers Teresa Pecoraro Jacqueline Rupp David Winterstein Meghan White Tracy Simmons Kathy Knaub-Hardy Editorial Associates Levent Nebi Deepa Bhatia Lori Ryan Anami Mittal ART DEPARTMENT

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