One of the impacts of the The Affordable Care Act will be the radical transformation our American health care system must undergo in a very short period of time. Essentially, we must move from a hospital system to an integrated health care delivery system, with patients at the center of all we do. Lifespan has already begun that transformation, and part of that process requires us to make important investments that are critical to our future survival. These investments are being made even as we undertake an operational reorganization that seeks to dramatically lower our expenses. Recently I have been asked “How can we make so many investments, given the financial challenges we are facing?” My response is “How can we not?”
Let me briefly review some of the activities we have been working on over the past year, which include expanding beyond our hospitals’ campuses, broadening the services we provide, investing in a new electronic health record system and partnering with new physician groups.
One of our major strategic goals as a system is to ensure that we provide care in settings that are more patient focused and cost effective and that we ensure better continuity of care. That is why we have opened ambulatory care centers in areas around the state. You may remember that in 2011 we opened the RIH Surgery Center at Wayland Square. In January 2013 Lifespan’s East Providence Ambulatory Center opened with a branch of Lifespan Laboratories as well as a Cardiovascular Institute satellite that offers office visits, comprehensive testing services and routine implantable device checks. In the coming months, outpatient dialysis and wound care treatment will also occupy the building. An ambulatory care center in East Greenwich opened in February with a CVI satellite and a Lifespan lab; pediatric specialty clinics and a Comprehensive Cancer Center infusion center will soon be added. These outpatient centers address a common barrier to care. By locating services, testing and treatment in communities around the state, we make it easier for people to access the services when they need them and where they need them—often in their own communities. The result is often earlier diagnosis, better adherence to treatment regimens, more cost-effective care and, eventually, better outcomes and a better patient experience.
There also are barriers for those who are treated and discharged from the hospital. In May, a Lifespan pharmacy will open at Rhode Island Hospital. With a pharmacy on site, the discharged patients will not have to walk or drive to get prescriptions or rely on friends and family to do so—they will be able to leave the hospital with the medicines they need. This will remove another barrier for patients, and make it less likely they will be readmitted to the hospital because they were not able to get to a local pharmacy and pick up the medicines they need for their recovery. Once we have evaluated the success of this new pharmacy, we will be looking at our other hospital campuses to see if opening additional locations makes sense.
As we begin to move off our main campuses into the communities we serve, it becomes even more important to have an electronic health record (EHR) that locates all of the patient’s information in one place. It should not matter whether the individual was tested in East Greenwich, had lab work in Portsmouth, or has been referred to a specialist with an office in East Providence; all the information should be in one location and accessible to our physicians and nurses no matter where they are. We recently signed a contract for a new EHR system (Epic) that will do just that, and during the next two years we will be getting the system up and running. When it is in place, physicians will be able to better manage patients, coordinate care, improve outcomes and control costs.
As we explore new models of care at Lifespan, we are also exploring new models of payment to support this innovation. Remember, we are trying to move from a system that rewards volume to a system that rewards value. Recently, we announced the creation of an accountable coordinated care organization, or ACCO, with UnitedHealthcare due to launch this summer. The ACCO will include our acute care hospitals and physicians who will provide coordinated care to the approximately 21,000 people in Rhode Island who are enrolled in UnitedHealthcare’s employer-sponsored benefit plans. Designed to enable across-the-board communication among physicians to improve care and patient satisfaction, the emphasis of the ACCO will be on outcome-based payments rather than reimbursement-based solely on volume of services delivered. This new ACCO is one example of new reimbursement options that seek to improve outcomes while controlling costs that we are exploring with our local and national payers including Blue Cross and Medicare. More to come on this very important topic in the future.
Finally, there are many new and exciting partnerships with physicians and other health care providers underway. Last year we announced our intent to partner with Gateway Healthcare, the state’s largest community mental health system. The partnership will make behavioral health services more accessible and enable people to remain at home while receiving the care they need. We are hopeful that regulatory approval of this partnership will be forthcoming shortly. We have also just announced that the Women's Medicine Collaborative has partnered with OB/GYN Associates, one of the state’s largest obstetrics and gynecology practices. This partnership gives patients more options, ensures better coordination of care and enhances Lifespan’s commitment to women’s medicine. These two partnerships are designed to make care easier to access, to make the transitions of care more seamless, and to ensure patient-focused care in the most cost effective setting.
As we continue to improve the way we deliver care, we will explore partnerships and alliances and payment options that we believe will make the people in our community healthier. We have an opportunity to remake a system that has been breaking down over decades all across America. Here in Rhode Island I am energized by the possibility of creating a health care system that works for everyone—patients and caregivers alike.
In the steadfast pursuit of excellence, I remain,
Timothy J. Babineau, MD
President, CEO of Lifespan
President, Rhode Island Hospital