Munroe Regional Health System Duke Medicine and Network Services Overview March 13, 2013
Agenda Duke Medicine Background Duke Clinical Affiliations and Network Services Overview History and Evolution Duke Cancer Network Duke Heart Network Duke Quality Network Questions / Discussion 2
Duke s Tradition of Success Extensive experience building Championship Programs 3
Duke Cardiologist Wins 2012 Nobel Prize 4
Duke Medicine - Commitment to Excellence Over 20 Straight Years.. Honor Roll of America s Best Hospitals #8 2012-2013; ranked in top 10 for 23 consecutive years U.S. News & World Report Best Hospital Rankings 2012 2013 Ranked #1 in Southeast Ranked #1 in North Carolina Nationally Ranked Hospital in 13 Specialties: #13 in Cancer # 7 in Cardiology & Heart Surgery #34 in Diabetes & #27 in Gastroenterology Endocrinology # 8 in Geriatrics # 8 in Gynecology #13 in Nephrology #14 in Neurology & Neurosurgery # 7 in Ophthalmology # 9 in Orthopedics # 5 in Pulmonology #10 in Rheumatology # 7 in Urology High-Performing in 2 Specialties: Ear, Nose & Throat Psychiatry 159 physicians recognized regionally and nationally as top U.S. doctors in 50 specialties: 93 physicians recognized in top 1% of nation, including Chief Medical Officers for Network Services: William J. Fulkerson Jr., MD: Pulmonology (Pulmonary and Critical Care Medicine) Harry R. Phillips, MD: Cardiology (Cardiac Catheterization) Linda Sutton, MD: Medical Oncology (Breast, Palliative Care) 5
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Duke Medicine Overview What We Value Transforming medicine and health locally and globally through innovative scientific research Rapid translation of breakthrough discoveries Educating future clinical and scientific leaders Advocating and practicing evidencebased medicine to improve community health 7
Duke Academic Medicine Health Sciences Center reaching More than a Brand out to communities and providing excellence in academic and clinical work Victor J. Dzau, MD President & CEO DUHS, Duke University Chancellor of Health Affairs Duke Clinical Research Institute: The world s largest academic clinical research organization Duke Cancer Institute Research Physician Practice Private Diagnostic Clinic: 1,300+ strong physician practice Duke School of Medicine: Ranked in the top 10 nationally Duke-NUS Graduate Medical School Duke School of Nursing Ranked in the top 10 nationally Duke Physician Assistant Program Ranked #1 nationally Academic Entities Clinical Enterprise Duke University Hospital Durham VA Hospital Duke Raleigh Hospital Durham Regional Hospital Duke Home Care & Hospice Duke Primary Care Duke Affiliated Hospitals (16) and Clinics (45) Duke LifePoint (5) 8
Key Statistics for DUHS, SOM, & SON in 2012 Annual Operating Revenue of $3.3 billion Over 23,000 FTEs Medical Center Campus with 96 buildings located on 210 acres SOM has one of the largest biomedical enterprises with over $682 million in sponsored research annual expenditures Duke University Health System: 61,749 inpatient discharges 1.8 million outpatient visits FY 2012 Community Benefit Summary (in 000 s) Charity care at estimated cost $ 69,093 Unreimbursed Medicaid 33,876 Health Professions Education 55,805 Cash & In-Kind Contributions 11,283 Total IRS Defined $ 170,057 Unreimbursed Medicare 96,038 Bad Debt at estimated cost 24,540 Total Community Benefits $290,635 DUHS provided more than $290 million in community benefit and investment 9
Vision for the Future Duke s Vision has two highly interrelated parts, both critical to the whole World-Class Academic Health Enterprise Regional Integrated Delivery System of Choice DUHS, together with its Duke Medicine partners, will continue to serve as a world-class academic health enterprise DUHS will be a world-class integrated delivery system serving the Greater Triangle and contiguous NC and VA counties 10
History and Evolution of Network Services Network Services links communities to Duke Medicine through innovative programs that promote evidence based medicine, improve community health, and enable research while building relationships with hospitals and care providers Network Service s affiliations enhance local clinical programs in Oncology, Cardiology, and Neonatology DUHS has strong community-based programs in Spine and Orthopedics The goals of Network Services include: To support the delivery of quality health care services at the local level Enhance Duke s reputation for being recognized as a regional and national leader in all areas of medicine in concert with community partners To support the academic mission by identifying new opportunities for research and education in the community setting 11
Network Services Supports Growth and Expansion of Duke Medicine Network Services Comprises Several Teams to Support DUHS, the Private Diagnostic Clinic, and the School of Medicine Duke LifePoint Clinical Programs Support Services Duke LifePoint Quality Program Duke LifePoint Operations Duke Cancer Network Duke Heart Network Subspecialty affiliations & Outreach: Duke Neonatology Network Duke Telestroke Network Duke Quality Network Clinical Contracting Services Financial Services 12
Network Services Provides a Coordinated Approach to Accessing Duke Duke Medicine Duke University Health System PDC/CPDC School of Medicine School of Nursing Duke Clinical Research Institute Network Services Clinical Affiliations Duke Quality Network Duke Cancer Network Duke Heart Network Patient Safety and Clinical Quality Research Medical & Staff Education Program Development & Oversight Affiliate Hospitals & Practices Duke Heart Center Duke Cancer Institute Clinical experts dedicated to leveraging Duke s experience and expertise through coordination and collaboration with local clinical affiliation programs 13
Duke Network Services has developed affiliations in local and distant markets Granville Health System Person Memorial Hospital Danville Regional Medical Center Alamance Regional Medical Center High Point Regional Health System ** Presbyterian Hospital Rutherford Hospital Spartanburg Regional Med Center ** Lexington Medical Center St. Mary s Medical Center Augusta Health Community Memorial Health Center Virginia Oncology Associates Maria Parham Medical Center Nash Healthcare Johnston Health 2 nd location** Scotland Memorial Hospital Southeastern Regional Medical Center Columbus Regional Healthcare Beaufort Memorial Indian River Medical Center (Onc)** Affiliation Map as of December 2012 ** New in 2012 14
Duke Network Services affiliations with Duke LifePoint / LifePoint Hospitals Quality Cancer Heart PDC DICON Other Danville Regional Medical Center Person Memorial Hospital In-process Echo Training In-process Maria Parham Medical Center Twin County Regional Hospitals Marquette General Hospital In-process In-process General Surgery Sports Medicine In-process 15
Additional Benefit From Working with Duke - Leveraging the Duke Brand Co-branding with Affiliate Hospitals 16
Duke Cancer Institute Expertise One of the original 15 cancer centers funded by the National Cancer Act in 1971, with NCI designation as a Comprehensive Cancer Center in 1973 National Comprehensive Cancer Network (NCCN) member Duke faculty and staff with broad representation on guideline committees Consistently ranked among the top centers for cancer care and the highest ranked hospital for cancer care in the South by U.S. News & World Report Along with Mayo Clinic, serves as CALGB/ALLIANCE Statistical Center NCI selected lead for the cancer Biomedical Informatics Grid s (cabig ) Clinical Trials Management Systems (CTMS) Knowledge Center, in collaboration with Northwestern University, and SemanticBits, L.L.C The Hereditary Cancer Clinic is one of only 13 clinical centers for NCI's Cancer Genetics Network Specialized Program of Research Excellence in Breast Cancer Duke Hyperthermia Program is the largest in the Western Hemisphere Preston Robert Tisch Brain Tumor Center rated as outstanding by the NCI peer review group; NCI grant received a perfect score in 2012 for $14m over 5 years DCI faculty member one of 8 appointees to the National Cancer Advisory Board NCI Research Program in Bone Marrow Transplantation and Hematological Malignancies 17
The Duke Cancer Network Advancing Best Practices The Duke Cancer Network Skilled and experienced field team Over 20 years of working collaboratively with affiliates Expertise in building value-based programs Defining best practices and enhancing quality to serve the needs of the community while managing costs and achieving growth Developing program differentiators Multidisciplinary models of care Subspecialty services surgery, supporting disciplines Clinical research offerings Providing training and education Clinical, research, financial Brand Recognition Duke Cancer Institute, NCI Comprehensive Cancer Center, NCCN member organization 18
Duke Heart Center Expertise Ranked 7 th among the nation s best heart programs by US News and World Report for 2012-2013 and in the top 10 since 1993 Duke is a founding site of both the NIH-funded Heart Failure Clinical Research Network and the Clinical and Translational Science Awards Consortium One of nine US sites in the NIH-funded Cardiothoracic Surgical Trials Network Research coordinating unit for the NHLBI Centers for Cardiovascular Outcomes Research Home to the Duke Databank for Cardiovascular Disease the world s largest and oldest such outcomes registry, with information on 200,000-plus patients Home to the editors of The Journal of Clinical Investigation, the American Heart Journal and the Journal of the American College of Cardiology: Heart Failure, premier venues for disseminating critical advances in cardiovascular research Duke faculty chair the ACC/AHA Performance Measures Task Force that champions the development of new performance measures. Several faculty members serve on committees of the ACC/AHA to develop appropriateness guidelines and performance indicators for cardiovascular imaging, PCI, CABG, ICDs, and TAVR. Duke is the coordinating center and analytic engine for national quality initiatives that collect data from US hospitals to improve treatment and outcomes Duke s mechanical circulatory support program among the first US programs approved by the CMS and is certified by TJC for destination ventricular assist devices (VAD) 19
The Duke Heart Network Advancing Best Practices Expertise Strength and depth in Cardiology, Cardiothoracic Surgery, Electrophysiology, Structural Heart, Advanced Heart Failure, Mechanical Circulatory Support and Transplant Experience Dedicated administrative and clinical consultative team: Duke Heart Center Duke Heart Center of Excellence Duke Heart Network Divisions of Cardiology and Cardiothoracic Surgery Brand Recognition Brand synonymous with high quality, leading edge cardiac care 20
Duke LifePoint Healthcare: Overview Overview of Duke LifePoint Duke Medicine Depth of clinical resources Clinical branding & reputation Ability to attract specialists Development of clinical programs Expertise in Clinical Quality and Patient Safety Commitment to quality and service excellence Physician recruitment and retention Commitment to local governance Ability to expand services Support local economy Cultural fit LifePoint Hospitals Long-term financial strength Depth of operational and administrative resources Practice management Access to capital Talent development Building a Network of Hospitals, Physicians and Healthcare Services that are Quality Driven, Adaptive to Change, and Financially Strong. 21
Duke LifePoint Quality Our Shared Model Leadership empowers the workforce by providing resources and promoting a culture of safety, innovation, accountability, service excellence and continuous learning. Performance Improvement is the system that provides the tools to support continuous learning, improved quality of care, and safe practices. The desired Culture of Safety is the environment which rewards teamwork, communication, accountability, learning and mutual respect. Leadership 22
Quality Program Reporting Structure: Duke LifePoint Hospitals DLP Healthcare, LLC LifePoint Hospitals, Inc. Duke LifePoint Board of Governors Duke University Health System Duke LifePoint Quality Oversight Committee Karen Frush, MD Mary Ann Fuchs, RN, DNP William Fulkerson, MD Mimi Huizinga, MD Susan Peach RN, MBA Hospital Board Hospital/ Health Systems Hospital Patient Safety and Clinical Quality Committee Hospital Medical Staff Executive Committee 23
Duke LifePoint Quality Program Promoting Continuous Improvement Perform Annual Assessment Summary: Each Hospital Board has ultimate oversight responsibility for patient safety and the quality of patient care Test and Monitor Results Review and possibly Revise Hospital PI Plan Each Hospital in the network will participate in program Implement Create Annual DLP/Hospital Workplan Determine Needs 24
Questions? 25