MEETING MINUTES RECORD Meeting: Board of Directors Date: August 27, 2015 Location: Conference Center Start time: 6:30 p.m. Adjourn time: 8:15 p.m. Members present: Charles Austin, Charlie Kyte, CC Linstroth, Michelle Muench, Steve O Neill, James Schlichting Members excused: Virginia Kaczmarek, Charlie Mandile, Jonathan Reppe Members absent: Staff Present: Steve Underdahl CEO, Scott Edin, Jeff Meland, M.D., Betsy Spethmann,, Ben Flannery, MD (FHMC Medical Director), Gary Anderson (Pharmacy), Kathleen Meier, Jerry Ehn, Bobbi Jenkins (Recorder) Others present: David Emery (LWV), Gretchen Ehresmann, M.D.(Medical Staff President), Mayor Dana Graham (Mayor), Chris Rustad (MCHS), Robert Miller, M.D. (MCHS) Issue/Problem Discussion/Conclusions Action Follow-up/Resolution 1. Call to Order and Approval of the Agenda 2. Good Things Happening 1. Program Spotlight- Pharmacy The meeting was called to order by Charlie Kyte at 6:35 p.m. There were no changes noted to the agenda for tonight s meeting. Steve Underdahl thanked everyone who was involved in the planning and development of the new surgery expansion project led by Jerry Ehn, and also to those who attended the Open House last week. The project was completed on budget and on time, which is almost unheard of. Feedback has been universally positive. Charlie Kyte commented on the recent NH&C FamilyHealth newsletter on how well it was done, and how interesting and informative it is. He also likes the personal story that is always included in the newsletter. Gary Anderson, Pharmacy Director, reviewed pharmacy roles, including distribution, diversion control and clinical functions. Over the past 12 months, 164,463 doses were distributed from the pharmacy department. A pharmacist reviews and approves all medication orders for patients prior to the patient receiving the medication in Med/Surg, First Touch Birth Center, Cancer Care and Infusion Center and the Long Term Care Center. Gary also talked about drug shortages and the fact that we can t always get the drugs we want and it is the role of the pharmacist to make alternative suggestions for providers. Page 1 A motion was made by Charlie Austin, seconded by CC Linstroth and unanimously passed to approve the agenda as presented.
2. Reports Hospital Chief of Staff Report FamilyHealth Clinic Medical Director Report Steve Underdahl commented that he wanted the Board to learn more about the pharmacy functions as so much of the work they do is invisible to most people. Dr. Gretchen Ehresmann reported on the following: Dr. Melanie Dixon resigned as Vice President of the Medical Staff and as Chair of the Perinatology Committee. The Medical Executive Committee (MEC) nominated Dr. Thomas Holt and Dr. Salwa Bakkali-Derksen for Vice President. The election will occur at the end of September at the quarterly medical staff meeting. Dr. Heather Stortz has been appointed at the Chair of the Perinatology Committee through the end of this year. The MEC approved minor revisions to the Restraints for Acute Care and ED policy. Discussions are beginning regarding how we can expand our scope of practice to keep more patients at the hospital vs. transferring to another facility. Dr. Ben Flannery reported on the following: Dr. Melanie Dixon resigned from her position with the Women s Health Center at the end of September to accept a position closer to home. She will be missed by colleagues. Two OB/GYN physicians are starting in the clinics in September, Dr. Nicole Dohm- Palmer and Dr. Kaye Mickelson. Family Practice provider, Dr. Sara Hernberg started earlier this month and is every excited and enthusiastic about the position. CMO Report Dr. Jeff Meland reported on the following: A full-time hospitalist will be added, which will help to increase acuity and standardization. We will continue to work with those physicians who want to continue to work in the program. We are starting to see changes in reimbursements from insurance companies (i.e. some insurance companies require pre-authorizations Page 2 Informatin only.
Allina Clinic Medical Director Report for tonsillectomies done in the hospital). Dr. Ehresmann reported that she is retiring at the end of the 2015. She has been with Allina for 33 years. Mayo Report Dr. Robert Miller and Chris Rustad reported on the following: Mayo continues to offer onsite Grand Rounds for providers, and discussions are occurring with the Joint Advisory Committee regarding provider access to Mayo s simulation center. Dr. Moore, Neurology, is starting on December 3 and will see patients three days a week in Northfield. Dermatology continues to do well with Dr. Kalaaji seeing patients at the Lakeville clinic. A site visit is being scheduled with a plastic surgeon in the near future. The Board inquired about the use of e-icu in Northfield in the future. Chris Rustad responded that this is possibility and would allow Mayo Rochester to monitor critical care patients and keep more patients local. This is not an option for us until we get our new phone system up and running. Discussions are also occurring regarding Telestroke services in Northfield. City Business Update Mayor Dana Graham reported on the following:: Congratulated Betsy Spethmann on her new position as Community Relations Director. The City will be passing a preliminary tax Levy within the next couple of meetings. Once the Levy is passed, taxes are not able to increase at a rate higher than the Levy. Updated the Board on the proposed crosswalk the City is attempting to put in on the corner of Third Street and Highway 3. The City is now working with MNDOT and may consider two crosswalks. CFO Report Page 3
July Financials Scott Edin reviewed the June financials. There was an error on the first page of the financials included in the Board packet that was emailed to the Board. A copy of the revised page was distributed at the meeting. July gross patient revenues were $220,000 above-budget, while deductions from revenue were $402,000 above-budget. Operating expenses were $274,000 under budget. Operating income was $12,000 vs. a budget of ($94,000), and total net income was $252,000 vs. a budget of ($100,000) (year-to-date: 0.3% operating margin vs. 0.0% budgeted). Key positive and negative volumes for July were reviewed, as well as day s cash on hand. Scott noted that the year to date cash on hand was lower than this time in 2014 (195 vs. 215), which is primarily due to the cost of the surgery expansion project which was paid out of operations. Charlie Austin inquired about why we are seeing patient days up and RVUs down. Scott explained that the primary reason is a slowdown in coding. We currently have a two week lag time in coding, which we typically like to keep at 7 days. Scott commented that the Budget & Finance Committee meets in September. An RFP was done for auditing firms. The committee will be reviewing information submitted by the firms. Scott also commented that he will be presenting an update of where we are in refinancing. We may want to take advantage of borrowing when interest rates are low. CEO Report Steve Underdahl reported on the following: Page 4
Patients are now being seen in the new surgery center. The Open House was very well-attended. Moving forward with St. Olaf Health Center Services. A public announcement will be made after school is in session. Strategic and tactical activities are ongoing. Long Term Care discussions are ongoing related to implications of additional funding, potential partners, etc. A full report will be presented to the Board in September. Branding/Naming discussion took place with the City Council earlier in August. A formal update will occur at the September Board meeting. Clinic Access Plan will be presented by Kathleen Meier, Clinic Administrator, later in the agenda this evening. An Ambulatory Surgery Center stakeholder meeting is scheduled next week. Good progress is being made in organizational modernization. A full report will be presented to the Board in September. Process Improvement Methodology is running slightly behind. A plan is being vetted and it is expected to rollout in the third and fourth quarters of this year. Planning for a Ken Bank Wall of Service is currently being discussed. Focusing on service excellence, including Physician of the Year, and people who have been with the organization 22 years, which is how long Ken was here. Community Relations Committee Report Steve O Neill reported on discussions at the Community Relations Committee meeting earlier this evening: Page 5
3. Consent Agenda 4. Presentations/ Discussion/ Action Items Clinic Access Plan Approved minutes from the last committee meeting. Received an update on naming/branding. Received a recap on the August 29 th Surgery Center Open House. Discussed details of the November 18-20 TedMed which is a collaborative effort with the School District. Supporting documentation was included in the packets for the following items on the consent agenda: 07/30/15 Board meeting minutes. 07/30/15 Governance & Planning Committee meeting minutes. Application for Medical Staff Membership/Privileges. Kathleen Meier, Clinic Administrator shared ongoing work related to patient access and specialty care needs. Improved access includes recruitment, extended hours, scheduling, physical space improvement, new same day appointment clinics and clinic operations assessment. Expanded services include: Pediatric Allergist, Pediatric Pulmonologist, Dermatology, and St. Olaf Student Health Services Services Looking to Add: Nephrology Adult Pulmonology Rheumatology Mental Health Same Day Care Services that are expanding: General Surgery ENT Neurology OB/GYN The Board inquired about how it is determined what type of physicians we need to recruit, and noted a need for physicians who have an interest in seeing patient populations in their 60 s and 70 s. CC Linstroth noted that as she looked on the NH&C website for physicians there was only one that had an interest in serving this population and that physician Page 6 A motion was made by Steve O Neill, seconded by CC Linstroth to approve the Consent agenda as presented.
is not taking new patients. Kathleen noted that we are looking at adding another family medicine physician which would allow for additional appointments. Dr. Flannery added that not all physicians interests are listed on the website, and family medicine and internists tend to have more interest in older patients and patients with multiple diseases the longer they practice. As we recruit for physicians we look at the demographics of the community, as well as a broad spectrum of interest and experience of the physicians. EMR Update Jerry Ehn, COO, updated the Board on the Electronic Medical Record (EMR) Evaluation Plan. We are currently considering a replacement of the current EMR because Meditech is currently working on a new product platform, current Meditech platform has presented significant challenges, and regional electronic health record (EHR) market share is dominated by another vendor. The new Meditech platform requires a complete re-wire of existing work, it will not be available for 18-24 months, it will take one year to implement, cost millions to implement, and the current platform would remain but would have few enhancements. The evaluation process includes: Selection of a consultant to help us review vendors and options, Engage key stakeholders, Establish evaluation criteria, Demonstration of system(s), and Recommendation. Timeline: 2015: Select consulting firm, define statement of work and milestones 2016: Complete evaluation with recommendation for fiscal year 2017 2017: Begin implementation of new HER 2018: Complete implementation of new EHR The Board inquired whether leasing is an option. Jerry responded that this will be investigated as part of the evaluation. 5. Roundtable, Announcements and Questions Steve Underdahl thanked CC Linstroth for her work involvement with FMHC and Dr. Flannery in distributing books to pediatric Page 7
patients and promoting reading in early childhood development. 6. Pending Item Organization Modernization Plan Adjourn The meeting was adjourned 8:17 p.m. A motion was made by CC Linstroth, seconded by James Schlichting and unimously passed to adjourn the meeting. Page 8