Smartphone – what will it think of next!

I recently read a Wall Street Journal article discussing the transformation of the healthcare system with technology.

You may have heard me use the expression that it is my hope that the transformation comes from us, inside the healthcare system. The likelihood that the transformation will come from outside the system is great because we often get caught in the trap of knowing how the process works and find it difficult to imagine how it could be different or better.

I know I have given you this challenge before, but if the sky was the limit, how would you use technology to change healthcare?

For me, my healthcare technology fantasy is related to time.

There are many times that I know something is wrong, but I don’t feel it is “wrong” enough for me to take off from work and make a doctor’s appointment. My doctor is not close by and in order for me to see him, it requires at least a 3-hour block of time between 9 a.m. and 5 p.m. during the week. So, unless I am hacking up a lung, I am not taking the time to see him.

I haven’t crossed over yet to the minute clinics, but I am starting I might give it a try. I wish I could e-mail my doctor and tell him my symptoms, or send him a photo of a rash and see if he can diagnose it just by looking at the picture. Then he could help me work through it without having to come in.

It might sound bogus to you now, but over time it’s definitely something that could happen in health care! After all, we use the VGo robots now with some of our patients so our doctors can check on them remotely.

So what is your technology wish?

Talks of Hospital Mergers Begin

Yesterday, five North Jersey hospitals announced plans to sell, explore a merger, and seek a new buyer to help solidify their existence in this turbulent health care market. Children’s Specialized nor our partner RWJ were among them. Take a breath.

We knew this was coming.

Is Children’s Specialized talking with other health systems or hospitals about mergers or acquisitions? As a member of the Robert Wood Johnson Health System, we stand strong under their powerful umbrella of services. The system is in constant state of conversations with many because of their strong market position. We provide such specialized care that our services will always be unique and the talk of us “merging” with another pediatric rehabilitation hospital is non-existent. We have a 120 year history of providing services for children with special needs and we will see it through for another 100 years.

What does this mean for you? Change is happening all around us and the best way we can remain in the forefront of this evolution is to remain vigilant at responding to doctors and hospitals who want us to care for their kids, improve our processes, cut expenses and continue to improve the quality of our care. Even if our services are so unique, we still are a “health care service provider” and we are faced with the same challenges as all hospitals. Our reimbursement rates are decreasing, our federal and state funding is diminishing and the funding we do receive will be based on the quality of the service we provide and patient satisfaction.

Below is an article that was in today’s Star-Ledger detailing the news about the mergers.

I will continue to share this information with you and give you an opportunity to ask questions. Please don’t hesitate to contact me or your supervisor.

We will discuss this further as we pick up another round of our employee meetings. Keep an eye on the intranet for a schedule. Meetings to begin in late February.

- Amy

Star-Ledger/NJ.com - Thursday, February 02, 2012, 7:35 AM

Big hospital merger plans part of dizzying day for N.J. medical industry
By Susan K. Livio and Seth Augenstein/The Star-Ledger

It was a dizzying day for the hospital industry Wednesday, as executives from five North Jersey hospitals announced plans to sell, explore a merger, and seek a new buyer to shore up their stake in the state’s competitively "harsh" health care market.

Industry experts said even more sales and consolidations were looming as hospitals brace for the financial consequences of the federal health care reform law — insuring more people while cutting costs — which will take effect in two years.
Kerry McKean Kelly, a spokeswoman for the New Jersey Hospitals Association, said health care reform was driving a lot of the discussions about consolidation and partnerships. "There might be a single payment for an ‘episode of care’ that would be divided between home health aides, physicians, nursing homes, hospitals," she said.

In addition, she said New Jersey’s "harsh marketplace," with high costs and limited reimbursements, was also forcing hospitals to rethink their business model.
The state Department of Health and Senior Services must approve any hospital sale or merger.

According to Wednesday's announcements:
• Hackensack University Medical Center and its investment partner, LHP Hospital Group, announced the purchase of Mountainside Hospital in Glen Ridge for $190 million — $160 million more than owners Merit Health Systems paid in 2007. Hackensack and LHP are already awaiting state approval to reopen Pascack Valley Hospital in Westwood.

• Ascension Health Care Network of St. Louis, Mo, the nation’s largest Catholic hospital system, confirmed that it is talking to St. Mary’s Medical Center in Passaic and St. Joseph’s Regional Medical Center in Paterson, for the "potential creation of a new Catholic health care system in New Jersey," a spokesman for Ascension, Joe Orlando, said.

• Prime Healthcare of California dropped its bid to buy Christ Hospital in Jersey City. "Christ Hospital must now work through very difficult financial challenges, and it remains to be seen if there is another viable way forward," said Peter Kelly, the hospital’s president and chief executive.

• St. Luke’s Hospital and Health Network announced it would add Warren Hospital in Phillipsburg to its roster of facilities in of Lehigh Valley, Pa., with plans of reviving maternity services and investing up to $6 million in its intensive care unit.

Industry insiders also expect an announcement soon regarding Barnabas Health, the state’s biggest hospital chain, which has held lengthy talks with the University of Medicine and Dentistry of New Jersey over University Hospital.

The two said in a statement that they were pursuing an affiliation, but that any change would "preserve the clinical, academic and research alignment between The University Hospital and the UMDNJ New Jersey Medical School." Industry observers have said this simply means Barnabas Health would run University Hospital.

The new owners of Mountainside told employees there would be no layoffs, and that services would be expanded if the state Department of Health and Senior Services approved the sale.

"There will be no impact to staff at all — everyone will be hired for the same positions and same salary,’’ a spokeswoman for the hospital group, Pat Ball, said. "There are no plans to discontinue services."

The collapse of talks involving the purchase of Christ Hospital by Prime Healthcare — which is under investigation in California — was welcome news for the nurses’ union, which publicly fought the sale

"This welcome withdrawal of Prime Healthcare from its intended purchase of our community hospital represents a new opportunity to protect access to quality health care for our patients and residents," said Ann Twomey, president of the Health Professionals and Allied Employees.

Ascension’s arrival would preserve the dwindling presence of Catholic hospitals in the state, said Donald Malafronte of the Urban Health Institute. "St. Mary’s has been marketed around for awhile," he said, while St. Joseph’s is carrying a lot of debt.

Sharing the Changes of Healthcare

There are times when the healthcare industry is in an uproar and I may only share information with you sporadically. Partly because maybe I am trying to not make you worry or maybe it is because I assume if I am hearing these things, you are hearing them too. This year we did not make the Best Places to work from Modern Healthcare. From the comments on the Modern Healthcare Survey, it is clear that we need to do a better job of communicating what is going on in our hospital industry. So here it goes - Here are some of major changes that have happened in the 2010 in the hospital industry that have affected many hospital employees and people who receive care.

RWJ Rahway in July of this year reduced management’s salary by 10% across the board and all other employees by 5%. They took back a week of vacation from all management employees and have stopped the hospitals contribution to the 403B plan.

RWJ Hamilton and St. Peter's Hospital in New Brunswick were forced to lay off 200 employees each or not fill positions that were currently open due to their decreased census. St. Barnabas announced the sale of all of their long term care services, impacting 600 employees.

Many hospitals throughout the state have frozen wages and have stopped any contribution to their 403 B plans.

State employees had to agree to seven furlough days, (meaning they can’t work, nor will they get paid for that day) In addition, a new law requires an increase in their health benefits contribution.

Beginning January1, Medicare will reduce its payments to NJ acute care hospitals by $1 BILLION a year, each year, for the next 10 years.

Economists say that the recession is over, but the financial growth may never reach the levels of before September 2008.

The State of the NJ is facing a $12 BILLION loss in 2011. The Governor has committed that he will not raise taxes and this loss is after his difficult reductions made in last year’s budget.

So why do I tell you all of this? There will be more hard times ahead for the State of NJ and for all of the healthcare industry. Besides continuing to deliver high quality care and make wise management decisions, we must continue to distinguish ourselves with our positive culture, delivery of high quality care and your commitment to our children and their families. It is being able to live our values each and every day, even though there may be chaos and tumult going on all around us. As much as we can, this Senior Leadership team is going to work hard to mitigate the pressures of the outside world but we are going to need to make changes in order to do that.

In 2010 we began an effort to systematically review every thing we do - every process, every contract, every thing to ask our selves are we doing this in the most efficient way for our families and our staff? There have been great things that have come out of that review, and we have uncovered many opportunities to make more improvements. That work will be part of what we do each and every day - not a one time project. It is much like the changes we have made in reference to quality improvement. This process is not to make “more” money for the organization but knowing that our reimbursement is going to be flat or reduced, we need to make sure we have money to continue to meet increased salaries, health insurance and reward employees for your superior work.

So what does this all mean for you? It means that the work that we have done to date, improving the quality of care we give, including our families in helping solve problems, being focused on becoming the most efficient organization we can be, all are a strong foundation for the challenges that we will face. I am absolutely confident that we will come out the other side of these challenges an even stronger organization, more resolute on doing all that we need to for our kids.

What I need from you are your thoughts on how best to engage all of you in this constant change that is going on. I truly want you focused on continuing to do great work but I know you need a context to understand why we are doing the things we are doing. Please give me your suggestions on how best to connect with you and make sure we are doing the best job possible to align all of our goals with the realities that we are facing.