October 22, 2007

IN THIS ISSUE

Editor's Column: Health Information Exchange Needs A New Perspective
Panel: Health Care Strategy Could Mean More Jobs
St. John Health Has New CEO
DWCHA Update
WSU Appoints Interim Chief Of OB/GYN
Beaumont Acquires Bon Secours
Insurer Requires Docs To Go Electronic

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Editor's Column: Health Information Exchange Needs A New Perspective

By JOSEPH WEISS, MD
The Oct. 1 E-mail edition of the Detroit Medical News carried an article chastising physicians for not joining the Southeast Michigan Health Information Exchange, SMHIE.

The article describes SEMHIE as one of seven “regional health information exchanges across the state funded by a $4.5 million federal grant.” The information exchange is to develop a system whereby doctors, hospitals, employers and government agencies can share health information in a seamless, transparent manner. The information exchange will be “a self-sufficient business model, a system that is patient centric and interoperable,” one leading “to better and more accurate record keeping.”

The article notes that SEMHIE will operate under the guidance of a leader in “health informatics.” The DMN article ends by urging physicians again to join this noble enterprise.

But no physician will step forward.

First, SEMHIE provides no information on what computer knowledge a physician should bring to the table. We have already endured too many computer experts speaking in jargon, using the lectern to present an advertisement for themselves.

Second, physicians are suspicious of the words “seamless,” “transparency,” “informatics” and “stakeholders.” These terms have no meaning in our daily experience, and should be reserved for the wordsmiths of information technology.

Third, physician experience with organizations like SEMHIE is one of being drawn into 2-3 meetings a year of a subcommittee that never connects with the total organization. Each meeting becomes interminable and ends with no assignments, conclusions or decisions. Volunteer members cannot put in the effort needed to move forward or coordinate with others in the organization. 

Fourth, physicians have seen that similar organization like GDAHC(Greater Detroit Area Health Council) do little but take credit for any health reform occurring in Wayne County. We see the Detroit Wayne County Health Authority showing scant activity and no authority.

Correction:

The Editor’s Column appearing in the Oct. 8, 2007 e-edition, “Value-Based Insurance Design: Good Idea or Just Another Floater,” inadvertently confused results of an Asheville, NC, study with those of a study at the University of Michigan. I regret any confusion this error may have caused to the University of Michigan and/or its staff.

-- Joseph Weiss, MD

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Panel: Health Care Strategy Could Mean More Jobs

Gov. Jennifer M. Granholm joined with Southeast Michigan business leaders Oct. 15 in applauding a state health care panel's assessment that a shared health care strategy for the region would help make Michigan a leader in the life sciences industry, creating tens of thousands of new jobs in the future.

"Southeast Michigan represents an untapped life sciences economic development bonanza for the entire state of Michigan," Granholm said. "When we all collaborate to leverage the region's considerable life sciences assets, our shared vision will make Southeast Michigan a world-class development zone for biosciences, biotechnologies, the health care industry, and pharmaceutical manufacturing."

The Panel on Medical Education and Research was established by the Detroit Regional Chamber and Detroit Renaissance - in cooperation with Gov. Granholm - last May to assess medical education, research capabilities, and indigent health care needs in Southeast Michigan. The 18-member panel, chaired by former Congressman and Michigan Senator Joe Schwarz, included representatives from businesses, universities, state agencies, insurers, and local government. As part of its work, the panel completed a benchmark study of best practices in other regions of the country - including Baltimore-Washington, Boston, Cleveland, Los Angeles, New York, Philadelphia, Raleigh-Durham, San Diego, San Francisco, and Seattle.

The study illustrates how other regions have successfully organized their life sciences development efforts - with a clear emphasis on how medical, education, and research institutions can combine effectively to support growth in this sector.

"This report defines the strengths and the deficiencies in medical education and postgraduate training throughout our state and illustrates the potential for collaboration between venture capitalists and researchers in the life sciences," Schwarz said. "We recognize that greater cooperation between our premier healthcare-providing institutions and academic health care training centers is critical to success."

The panel's recommendations for growing the medical education and research sector in the region include:

-Complete an asset map and economic impact study of the region's life sciences sector - an important first step for leaders such as the Greater Detroit Area Health Council (GDAHC). The study's results also should be publicized to promote life sciences growth in the region.

-Form a Detroit Regional Health Care Economic Development Council to implement the panel's recommendations - led by the Detroit Regional Chamber, Detroit Renaissance, GDHAC, and other critical regional partners.

-Expand opportunities to co-locate life sciences research assets and technology companies through university partnerships. This work could include expanding business accelerators that specialize in the unique needs of the life sciences sector.

-Continue efforts to enhance and promote technology transfer from universities to businesses, recognizing the importance of the process to economic development.

-View health care as a critical economic sector, not just a supplier or product of population growth or demographic shifts, and include it in the region's business leadership structure.

-Develop a strategy to attract venture capitalists to grow business in the sector and provide a portal to access this capital.

-Provide a one-stop shop for centralized health care information that facilitates the growth of the health care industry regionally.

The panel also states in its final report that institutions critical to continued success in the Detroit region - such as Wayne State University and the Detroit Medical Center - need to pursue more partnerships together if health care economic development efforts are expected to thrive in the 21st century. 

Further, the panel also called on the Detroit Wayne County Health Authority (DWCHA) to develop a comprehensive, long-range plan for an effective delivery system that meets the health care needs of the region. In addition, the panel embraced new strategies to improve access to primary care in the region, such as supporting efforts to make quality health care coverage affordable and accessible, and to continue to expand the use of primary care nurse practitioners as a way to increase access and improve quality in underserved areas.  

A complete copy of the panel's report can be found at www.michigan.gov <http://www.michigan.gov/> .  

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St. John Health Has New CEO

St. John Health has new CEO
St. Louis-based Ascension Health has named Patricia Maryland president and CEO of St. John Health effective Jan. 1.

Maryland, who returned to Michigan in mid-September to oversee Ascension’s five health systems in the state as ministry market leader for Michigan, replaces Elliot Joseph who is moving on to become a senior executive with Ascension.

In that role, Joseph will be responsible for developing international strategies for carrying out Ascension’s mission and strengthening the boards of Ascension’s local health care systems.

“This is an important area of strategic focus for Ascension Health and one that will benefit greatly from Elliot’s leadership,” said Robert Henkel, president of health care operations and COO of Ascension.

Maryland will keep her role with Ascension’s five Michigan health systems.

Maryland, former DMC Sinai-Grace Hospital president and senior vice president of The Detroit Medical Center, left Michigan in 2003 to become executive vice president and COO of St. Vincent Health and president of St. Vincent Hospital and Health Services in Indianapolis.

Last month, she returned to Michigan to oversee strategies and operations of Ascension's five health systems, which include Detroit-based St. John Health and account for more than 25 percent of Ascension's total revenue.

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DWCHA Update

The following is an edited update from the Detroit Wayne County Health Authority.

Message from Chris Allen

As our current fiscal year comes to an end and we begin anew, this is an exciting time for the Detroit Wayne County Health Authority.

This fall marks a critical juncture in our efforts to ensure the integrity of the safety net in Detroit and Wayne County. As the health care landscape continues to change in Detroit and the number of uninsured grows throughout Wayne County, the Health Authority is focusing its attention on the immediate needs of East Side Detroit, as well as promoting the development of new access points in locations like Hamtramck and Wayne.

We're extremely pleased with the $10,000 grant from the United Autoworkers Union Community Action Fund, which will partially underwrite community outreach initiatives to help enroll eligible children in Detroit and Wayne County in appropriate health insurance programs. We also welcome Patricia Fairchild, who will coordinate the Southeast Detroit Planning Team efforts.

While we are actively seeking funds to sustain our mission, we are confident that our fiscal stability has been ensured, in large part, thanks to our partners in  the provider community. We are now focused on identifying large operational grants, as well as project grants, to expand our capacity to serve the region. Creative administrative initiatives, such as the Medicaid outreach services we provide for Oakwood Healthcare, are among the areas we will focus on and expand in the near future.

The DWCHA:

-Through its Primary Care Network Council (pcnc), has convened the East Side Detroit Planning Team to provide active and engaged leadership in planning for improved access to necessary medical services for uninsured and underinsured Detroit residents in zip codes 48207, 48213, 48214 and 48215.

-Supports the East Side Detroit Planning team is charged with improving the coordination and delivery of primary care services in southeast Detroit. The group is moving forward with the development of a five-year plan that will be completed within one year. The plan, when fully implemented, will be a model program providing a "medical home" for uninsured and underinsured residents in southeast Detroit. The committee is chaired by Sister Mary Ellen Howard, RSM, executive director, St. Frances Cabrini Clinic and co-chair, pcnc, and Herbert Smitherman, MD, president  and CEO, Health Centers Detroit Group.

-Is involved with a new FQHC designated to extend health care services for uninsured and underinsured

-Along with the Michigan Primary Care Association, McGregor Fund and Beaumont Hospitals played an instrumental role in the application process

-In partnership with Southwest Solutions, a human services, housing, and economic development provider, Covenant Community Care, Inc., a health center serving the uninsured and underinsured, has received a nearly $2.3 million grant from the Health Resources and Services Administration division of the US Department of  Health and Human Services. The grant, which comes with an enhanced Medicaid billing rate and status as a federally qualified health center, will fund operations for three years and will help strengthen the local health care safety net for thousands of uninsured and underinsured residents in Southeast Michigan.

A major feature of the collaborative will be its focus on the integration of primary health care and mental health care, also known as behavioral health, for persons with mental illness. The collaborative will operate its integrated primary, dental, and behavioral health care clinics and pharmacies at the West Grand Boulevard site of Covenant Community Care, and the Waterman site of Southwest Solutions.

-Received grant from UAW Grant to assist with enrollment of children outreach. The Health Authority recently received a $10,000 grant from the UAW Community Action Program to support community outreach for the enrollment of children in appropriate health care insurance programs. The grant will be used to underwrite a part-time community outreach worker.

-Medicaid outreach program at Oakwood delivers significant outcomes. The Health Authority initiated an agreement with Oakwood Healthcare in April to

provide oversight responsibility for Oakwood's Medicaid outreach and enrollment

services. The Health Authority has trained approximately 20 staff and patient advocates

-Is involved in Medicaid outreach and enrollment activities at Oakwood's main campus, Annapolis, SouthShore, and Heritage hospitals, as well as Oakwood's Skilled Nursing Center. The Health Authority receives over 100 Medicaid approvals monthly and has over 1,000 cases pending. The conversion rate is 93.33 percent.

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WSU Appoints Interim Chief Of OB/GYN

School of Medicine Dean Robert Mentzer has named Theodore B. Jones, M.D., as interim chair of the Department of Obstetrics and Gynecology.

Dr. Jones, an associate professor, joined the School of Medicine faculty in 1991 and is presently director of the divisions of Maternal Fetal Medicine and Reproductive Genetics in the Department of Obstetrics and Gynecology, as well as chief of Obstetrics at Hutzel Women's Hospital. His special interest focuses on treating pregnant women with medical conditions such as diabetes and hypertension. Dr. Jones is an active clinical researcher and is an investigator for the NICHD International Pediatric and Perinatal HIV Studies Network. Since joining the faculty, he served as associate chair for education, as well as program director of the Obstetrics and Gynecology Residency Training Program. He is a graduate of Temple University Medical School, and completed his internship and residency at Baylor University Medical Center in Dallas.

"Dr. Jones is a skilled and compassionate academic physician with the depth and breadth of experience to lead this exceptional, nationally renowned department," said Dean Mentzer. "I am delighted to welcome Ted Jones to the school's senior leadership as we embark upon 'Vision 2011,' our strategic plan."

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Beaumont Acquires Bon Secours

Beaumont Hospitals and Bon Secours Health System Inc. have reached a final agreement to transfer ownership of Bon Secours Hospital in Grosse Pointe and its affiliated Michigan nursing and assisted living facilities to Beaumont effective Oct. 1, 2007.

The agreement followed the dissolution of a joint venture between BSHSI and Henry Ford Health System that created Bon Secours Cottage Health Services. With the end of the joint venture, BSHSI transferred ownership of Cottage Hospital to Henry Ford Health.

The transfer of Bon Secours properties from BSHSI to Beaumont takes effect immediately. Terms of the agreement are confidential. Bon Secours Hospital, a 289-bed hospital, is being renamed Beaumont Hospital, Grosse Pointe.

The Sisters of Bon Secours Nursing Care Center and the Bon Secours Place assisted living facility in St. Clair Shores will become ShorePointe Nursing Center and ShorePointe Village. The nursing center and assisted living facility will be operated under a joint venture subsidiary of Beaumont and its nursing home partner, Premier Health Care Management.

Bon Secours Cottage employees are maintaining their employment with their respective new owners.

"Bon Secours Health System is pleased with its choice of two outstanding local health systems to ensure patient care in Grosse Pointe continues. At the completion of our due diligence process, we are confident that as Beaumont Hospitals secures Bon Secours and Cottage Hospital returns to sole ownership by Henry Ford Health System, the mission and values of Bon Secours will continue," says Richard J. Statuto, president and CEO of Bon Secours Health System.

"We know what Bon Secours means to the residents of the Grosse Pointe community," says Beaumont President and CEO Kenneth Matzick. "As we put a new name on the door, we do so with the utmost respect for the Sisters of Bon Secours and with a promise to continue to serve the community with the kindness and compassion they have come to expect."

Jeffrey Collins, former CEO of Bon Secours-Cottage Health System, will serve as Interim Hospital Director of Beaumont, Grosse Pointe.

With the addition of the Grosse Pointe Hospital, Beaumont Hospitals becomes a three-hospital regional health care provider with a total of 1,696 licensed beds, 18,000 employees and 3,000 physicians in Oakland, Macomb and Wayne Counties.

In addition to its hospitals, Beaumont Hospitals is comprised of seven community-based medical centers in Oakland and Macomb Counties (Royal Oak, West Bloomfield, Rochester Hills, Lake Orion, Warren, St. Clair Shores, Macomb Township), five nursing centers, a Research Institute, home care services and hospice.

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Insurer Requires Docs To Go Electronic

While insurance companies are getting behind greater electronic communication among doctors and their patients by paying for such care, Partners HealthCare System is forcing the use of electronic health records on the physicians in its community network, according to HIT News.

Primary-care physicians who have not implemented or agreed to implement an EHR by Jan. 1, 2008, are out of the Partners network, said Tom Lee, chief executive officer of Partners Community HealthCare, the physicians network of the Boston-based hospital system. The implementation of EHRs throughout the physician network will allow information across the system to flow in a timely and more efficient manner, he said.

"We did it with a lot of care and thought; if you're going to be one of us, this is the criterion," Lee said. Partners hasn't lost any doctors yet as a result of the decision, but some physicians are complaining about the change. Lee said he recognizes that the mandate seems "tough." He added: "Believe me, some of (the doctors) are mad."

Partners expects to lose 15 to 20 primary-care physicians this year because of the mandate, and could lose some patients if those doctors stop referring them to Partners hospitals, Lee said. The Massachusetts-based hospitals in the system include 746-bed Brigham and Women's Hospital, 90-bed Faulkner Hospital and 902-bed Massachusetts General Hospital, all in Boston; 233-bed Newton-Wellesley Hospital, Newton Lower Falls; 169-bed McLean Hospital, Belmont; and 417-bed North Shore Medical Center, Salem; as well as rehabilitation institutes and research centers.

The board's decision, made in March, was not just about electronic records-Partners is striving for even higher performance and outcomes from its hospitals, and using EHRs is one way to improve efficiency. "We're asking people if they want to go down the road of really integrating their care with colleagues," Lee said.

There are about 5,000 doctors in the Partners network. The primary-care doctors have until the end of 2007 to implement either Partners' EHR or one created by GE Healthcare. If they don't have the EHR but sign an agreement to implement one in 2008, they will retain their network status. At this point, specialists have through 2008 to implement an EHR, but by Jan. 1, 2009, any physician still not connected is out of the network.

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