The Value of an Integrated Healthcare System How MaineHealth Serves Its Communities, Members and Employees better, working together
MaineHealth is a not-for-profit, integrated healthcare system of leading, high-quality providers and other healthcare organizations working together so our communities are the healthiest in America. Members Lincoln County Healthcare (Miles Memorial Hospital and St. Andrews Hospital & Healthcare Center) Maine Medical Center Maine Mental Health Partners (Community Counseling Center, Counseling Services Inc., Integrated Behavioral Healthcare, Mid-Coast Mental Health Center, Spring Harbor Community Services, Spring Harbor Hospital) Pen Bay Healthcare (Pen Bay Medical Center) Southern Maine Medical Center Waldo County Healthcare (Waldo County General Hospital) Western Maine Health (Stephens Memorial Hospital) HomeHealth Visiting Nurses Maine Physician Hospital Organization NorDx (laboratory services) Synernet (medical transcription, credentials verification, clinical engineering and workers compensation insurance services) Affiliates MaineGeneral Health Mid Coast Health Services New England Rehabilitation Hospital of Portland St. Mary s Health System
Better, Working Together As the largest health system in the state, MaineHealth plays a vital role as a healthcare provider and employer in Maine. With a presence in 11 of Maine s 16 counties and with more than 14,500 employees through our member and affiliate organizations, MaineHealth has a deep commitment to the health and success of the state. Operating at the intersection of the health, business, education, not-for-profit and public spheres, we feel a responsibility to advocate for policies that best promote the health of the people of Maine. MaineHealth believes that taking a leadership role in public policy is a critical element of working together so our communities are the healthiest in America. With one of the oldest and poorest populations in the country, Maine faces significant challenges in maintaining a healthy population. Our focus on quality, safety, accessibility, cost of care and community health guides our efforts to deliver exceptional care to our patients and improve the health status of our communities. MaineHealth Facts* Employees 9,385 (members) 14,627 (members and affiliates) Charity care and bad debt (data reflect actual cost of providing care) $53,334,345 Outpatient visits to MaineHealth hospitals 3,304,133 Emergency department visits to MaineHealth hospitals 134,708 Outpatient surgeries in MaineHealth hospitals 34,839 Inpatient surgeries in MaineHealth hospitals 19,783 Births in MaineHealth hospitals 3,663 Number of physicians working in MaineHealth hospitals 1,514 * 2011 figures 1
Guiding Principles MaineHealth is driven by our commitment to provide quality healthcare in the communities we serve. Healthcare is a unique relationship between those who receive it and those who provide it not only because it involves matters of life and death but also because the vulnerability of the sick confers extraordinary responsibility on caregivers. MaineHealth believes this care relationship is based in moral and ethical responsibility. We pursue our work guided by these principles, always striving for the ideals they embody: The relationship between caregiver and care receiver must be preserved and protected All people must have access to necessary healthcare Care must be of the highest possible quality Each individual s dignity and worth deserves respect. People are entitled to the information they need to make informed decisions Responsible lifestyle decisions are an important individual responsibility People should know who is taking care of them and how policy decisions are made Healthcare is a local matter and is best governed at the community level Our responsibility extends to society at large 2
better, working together Notable System Initiatives MaineHealth works closely with member organizations to identify successes and make ideas and resources available to all members. Here are some notable system initiatives: Clinical Improvement Registry/ Nurse Care Management The Clinical Improvement Registry was created in an effort to address the high cost of chronic illness while enhancing patient quality of life. The CIR allows caregivers to track health information for patients with chronic illnesses such as diabetes, asthma and cardiovascular disease. When a patient is identified as high-risk, the patient is referred to a care manager for one-on-one education and support. Health Index Initiative The Health Index Initiative is a systematic approach to measuring overall performance of MaineHealth system initiatives. Improvements in health status of the communities served are monitored and evaluated; the cost and quality of and access to care provided by MaineHealth organizations are also assessed. The Health Index Initiative tracks progress on six key health indicators: child immunization rates, tobacco use, prevalence of obesity, preventable hospitalizations, cardiovascular mortality and cancer mortality. Clinical Integration Programs MaineHealth takes a leadership role in developing programs to improve chronic illness care in Maine through its clinical integration programs. Clinical integration is an effort to achieve a coordinated system of clinically appropriate and cost-effective care. In the clinical integration model: Care is provided in a coordinated way across the continuum of care Care occurs in the most appropriate setting Care involves caregivers from all disciplines Care supports a collaborative practice among clinicians Care improves community health status See a full listing of clinical integration programs on page 6. 3
VitalNetwork MaineHealth VitalNetwork, an electronic intensive care unit, is staffed by specially trained doctors and nurses who monitor patients at nine intensive care units across Maine through a wireless remote system that includes cameras and microphones in the patients rooms. VitalNetwork offers added support to the around-the-clock staff caring for our patients. With VitalNetwork, patients gain another set of experts monitoring their condition. The patient s local physician is responsible for the patient s care, while the VitalNetwork physician regularly makes virtual rounds and alerts the attending physician of any important changes. The system monitors blood pressure, heart rate and rhythm, oxygen levels, lab results, medications and X-ray results. Shared Health Record Electronic Medical Record MaineHealth s Shared Health Record initiative is developing and implementing a systemwide integrated electronic health record for providers and patients. The largest project in the history of MaineHealth, the SHR vision is to achieve one patient, one record across the entire MaineHealth system. Center for Quality and Safety The Center for Quality and Safety provides systemwide direction in the identification, prioritization, implementation, measurement and communication of quality and safety initiatives. CQS serves system members and clinical integration programs, with a focus on data management, analysis and reporting; education and consultation on improvement science and methodologies; program evaluation to assist with design and implementation of methods to assess the effectiveness and value of programs; and accreditation and regulatory support regarding quality and patient safety activities. Administrative Services MaineHealth members have access to a number of operational and administrative services that help members offer quality care and keep costs down. Contracting services MaineHealth works on behalf of its members to write single signature contracts, relieving members of the need to negotiate contracts on their own and members may realize better terms than they could negotiate as a single entity. Credit rating MaineHealth s positive credit rating can be advantageous for members negotiating loan rates. 4
Information services MaineHealth provides direct support to systemwide information projects such as the Shared Health Record. This investment provides a significant opportunity for members to improve patient care an opportunity that would not be available to many of our smaller members without the benefit of a large system. Health insurance MaineHealth s large pool of employees helps keep employee healthcare costs down an especially big advantage for members with few employees. Legal services Our legal services include one signature contracts that cover all our member organizations. Audit and compliance The MaineHealth audit and compliance team helps members prepare for audits and conform to regulatory requirements faced by healthcare organizations. Government relations MaineHealth s government relations division advocates for policies that best promote the health of the people of Maine. Marketing and communications The MaineHealth marketing department develops marketing plans; preserves brand standards; and creates systemwide materials, including the annual community benefit report, community health impact series and advertising campaigns. Market research Many hospitals, especially smaller organizations, would be unable to conduct large-scale, regular market research without the benefit of several hospitals pitching in to bring the costs within reach. Supply chain services MaineHealth s supply chain team helps keep the cost of goods and services down for our member organizations. Professional services from other members For example, Synernet provides outsourced administrative services that help save money and employees time, improve quality, and allow organizations to redeploy resources to core care activities. Strategic planning MaineHealth provides its members with in-depth strategic planning services to help each member organization meet its longterm planning goals. Best-practice sharing Our boards and management teams benefit from sharing advice and best practices across the system. Meeting challenges together The depth of the system allows MaineHealth members to meet challenges such as healthcare reform and the transition to an accountable care model as a highly competent and experienced team. 5
better, working together Clinical Integration Programs Clinical integration is an effort to achieve a coordinated system of clinically appropriate and cost-effective care. AMI/PERFUSE Program The AMI/PERFUSE Program helps caregivers provide the highest-quality care and achieve the best possible outcomes for patients who experience an acute myocardial infarction (heart attack) regardless of the patient s point of entry into the MaineHealth system. A network of providers ensures that heart attack patients receive timely, evidence-based treatment. Asthma and Chronic Obstructive Pulmonary Disease Our AH! Asthma and COPD programs work to adapt quality measures that reflect evidence-based guidelines and national trends for demonstration of quality care. The programs provide training and education about lung health treatment, medications and devices. The development of patient and provider education material is a key component of program efforts. Diabetes The Target Diabetes Program helps improve care and outcomes for people with type 1 and type 2 diabetes and increases public awareness of diabetes. In collaboration with the MMC Physician-Hospital Organization, the program works to adopt quality measures that reflect evidence-based guidelines and national trends for demonstration of quality care. The development of patient and provider education material is a key component of program efforts. Elder Care Services Elder Care Services enables the MaineHealth system to deliver high-quality, cost-effective care in partnership with older adults. Elder Care Services includes representation from all MaineHealth members and affiliates. Emergency Medicine The Emergency Medicine Program improves the quality of care received by patients in the emergency departments of MaineHealth member and affiliate hospitals. The program works to streamline processes and to effectively meet the acute medical needs of patients in the emergency department. 6
Heart Failure The Heart Failure Program improves health outcomes for patients with heart failure by promoting and supporting best practices in care at MaineHealth hospitals and across all care settings. The program provides a comprehensive, integrated approach to support patients and their families as they move from one care environment to another. Hospital Medicine Program The Hospital Medicine Program improves patient care across the continuum of care. Hospitalists play a large role in ensuring that care is patient-centric and occurs in the most appropriate setting. Hospital patients are sicker today than they were in past decades, and treatment regimens are more technologically complex than ever before. These realities, combined with pressures on hospitals to control costs, increase efficiency, improve patient outcomes and reduce medical errors, are changing the nature of inpatient care. Infection Prevention The Infection Prevention Program works to reduce infection rates, improve outcomes for patients and decrease preventable hospitalizations across the MaineHealth system. The program aims to reduce hospitalacquired infections through improved hand hygiene compliance. Mental Health Integration The Mental Health Integration Program works to improve patient care by bringing mental health clinicians into medical settings and by improving the collaboration between medical and mental health providers. The goal of the program is to help people get effective and efficient care for mental and behavioral health problems. Oncology The Oncology Program promotes high-quality oncologic care across the system, ensuring easy access and effective transitions among specialists and locations. The program provides training for clinicians on cancer care guidelines, improves the availability of clinical trials, improves access to genetic services and improves the overall delivery of cancer care. 7
Palliative Care The Palliative Care Program promotes palliative care (medical care or treatment with a goal of preventing and relieving suffering) across the system. The initiative includes clinician education on identification of patients who may benefit from palliative care, provision of palliative services for complex medical conditions, addressing ethical issues and engaging patients in discussing the goals of such care. Partnership for Healthy Aging The Partnership for Healthy Aging is a collective enterprise established by MaineHealth to improve services to older adults and support their active participation in self-managing their healthcare by linking clinicians, evidence-based programs and community services. The PFHA engages local and statewide organizations in developing, translating and disseminating programs that improve the health status of older adults and their caregivers. This collaborative approach ensures that effective, evidence-based programs address community needs and are accepted by older adults and their caregivers. Perioperative Care The Perioperative Care Program is the continuum of care that includes preoperative evaluation, operation, postoperative care and transition across all MaineHealth acute care hospitals. Pharmacy and Therapeutics The Pharmacy and Therapeutics Program works to improve outcomes of patients in the MaineHealth system by reducing variations in care and promoting best practices. The program seeks to coordinate purchasing and performance initiatives in MaineHealth hospitals. Pre-Hospital Care/Emergency Medical Services This program works with hospital emergency medical services medical directors to support obligations in education, quality management and case follow-up. The program also works to standardize the quality improvement process of difficult calls and procedures and to provide education opportunities and credits for emergency medical technicians to maintain licensure. Preventive Health The Preventive Health Program works to deliver consistent, high-quality, preventive healthcare across the MaineHealth region for adults and children by providing best-practice, evidence-based tools and support to primary care practice teams. Its purpose is to provide a preventive health focus for patients and providers that helps reduce the prevalence and severity of chronic disease. 8
Stroke The goal of the Stroke Program is to improve care for stroke patients who arrive at MaineHealth member and affiliate hospitals within three hours of symptom onset. Each hospital in the MaineHealth system collects and shares data, which is then analyzed and reviewed to determine opportunities for quality improvement initiatives. The program aims to standardize stroke care across the continuum of providers within the MaineHealth system by using evidence-based guidelines to improve outcomes for stroke patients. Telehealth The Telehealth Program works to improve the health status of our communities by integrating, advancing and optimizing the use of telehealth technologies. Current telehealth technologies include connections among hospitals, such as bringing specialists to rural areas, connecting providers to patients homes and remote monitoring of patients in critical care units in most MaineHealth hospitals. The technologies include desktop units and mobile carts. Transitions of Care The Transitions of Care Program works to ensure that patients receive excellent care throughout the transition from hospital to home and to community-based provider. Too often, patients experience challenges in the coordination of their care, resulting in poor outcomes and avoidable hospital readmissions. This program works to improve patient outcomes and reduce unnecessary readmissions by supporting best practices for provider follow-up visits, coordinating medications and patient and family education, and enhancing the communications critical for excellent care once the patient leaves the hospital. 9
better, working together Employee Programs Works on Wellness Works on Wellness is a comprehensive program to maximize the health, quality of life and overall well-being of MaineHealth employees and their families, with the complementary goals of reducing unnecessary and inappropriate use of health services, reducing annual increases of healthcare costs, reducing illness-related absences and increasing productivity/work performance. Education for Healthcare Providers Educational Services MaineHealth Educational Services delivers educational opportunities to healthcare providers and professional staff on topics pertaining to the delivery of high-quality, efficient, evidence-based, patient-centered care. Physician Leadership Development Fellowship The cornerstone of this program is a series of learning sessions. Each session is based on a critical element of successful leadership and features national and local faculty. 10
better, working together Community Health Improvement Programs Cancer Resource Center MaineHealth Cancer Resource Center s website (www.mainehealthcancer.org) offers those affected by cancer in the state of Maine a sophisticated, comprehensive, highly accessible regional cancer resource. The website provides up-to-date cancer information and links individuals with resources in their local areas, including screening events, doctors, clinical services, support groups and health education programming. CarePartners* CarePartners coordinates the provision of free or low-cost comprehensive medical care and pharmaceuticals to low-income, uninsured residents in Cumberland, Kennebec, Lincoln and Waldo counties. The program was designed for those who fall between public and private coverage programs. There are more than 950 physicians and eight hospitals that participate in the volunteer provider network. Center for Tobacco Independence* CTI manages Maine s comprehensive, statewide tobacco treatment initiative, supported by the Partnership for a Tobacco- Free Maine (including the Maine Tobacco HelpLine, Tobacco Medication Program and tobacco training programs). CTI also consults with employers regarding tobacco policy development, treatment and education; manages Maine Medical Center s inpatient, outpatient and employee tobacco treatment programs; and conducts research relevant to tobacco. From the First Tooth* From the First Tooth promotes oral health in babies and young children ages 6 months to 3½ years at well-child visits with healthcare providers. The goal of the initiative is to reduce the incidence of dental caries, a transmissible disease, by increasing the number of young children who receive preventive oral healthcare, beginning with the eruption of their first tooth, which occurs around the age of 6 months. * Partner program, working with other care providers in our communities 11
Learning Resource Center The Learning Resource Center is a network of five health education centers and a statewide Parkinson s Information and Referral Center. The center is staffed by professional health educators with expertise in behavior change, self-management support, decision support, health literacy, cultural competence and chronic disease. LRC services are available to the public and include health education classes, a free library of health books, brochures, and shared decision-making tools and videos. Let s Go!* Let s Go! is a community-based initiative that promotes healthy eating and active living for children, youth and their families. Let s Go! partners with community organizations, such as Healthy Maine Partnerships, and health systems and works across many sectors of our community (healthcare, schools, after school, early childhood and workplace). MedAccess* MedAccess is a comprehensive medication assistance program that increases access to low-cost or free prescription medications for individuals throughout Maine. MedAccess achieves this goal through a variety of methods, including direct assistance by MedAccess staff, medication management, website information, healthcare provider education programs and free community educational classes. The staff assists individuals with completing free drug applications to pharmaceutical companies patient assistance programs; obtaining information on local, lowcost generic programs; and cost strategizing to avoid the Medicare Part D doughnut hole. Raising Readers* Raising Readers is a health and literacy program that provides quality children s books to all Maine children, from birth to the age of 5, at each well-child visit with a healthcare provider. Since 2000, Raising Readers has provided more than 1 million books free of charge to Maine children, regardless of their family s economic means. The program has been funded by the Libra Foundation since its launch. Shared Decision Making Resource Center The Shared Decision Making Resource Center works to improve provider-patient communications by offering healthcare providers resources, training and technical assistance on health literacy, cultural competence and shared decision-making best practices. Its purpose is to provide value to physicians and other members of the healthcare team so that they can provide the highest-quality, most accessible healthcare at the lowest cost. * Partner program, working with other care providers in our communities 12
better, working together MaineHealth, serving as the corporate parent to our diverse membership, provides a unified voice to communicate our system s commitment to excellence and safety in clinical care, medical education and research. It s the collaboration of our members that brings the MaineHealth mission working together so our communities are the healthiest in America to life. It s the powerful collaboration of our members that makes our system bigger because it s better not better because it s bigger.
110 Free Street Portland, Maine 04101 (207) 661-7001 www.mainehealth.org better, working together