While the events of that clear, fall day served as a wake-up call for the entire country, it deeply impacted the health care community as well.  Hospitals are a critical resource for the nation, especially in times of crisis.  While emergency preparedness is an issue that was taken very seriously by hospitals, 9-11 served as an impetus to heighten the level of preparedness within hospitals.  After 9-11, the Federal government provided states and large urban areas with funding to strengthen the capabilities of hospitals and health care systems to respond to public health emergencies and medical disasters.  With that funding, hospitals were able to dedicate more resources to emergency preparedness, to be ready for whatever the future may bring; a biological emergency (we reaped the benefits of our planning during the H1N1 pandemic), natural disaster (who can forget Hurricane Katrina or the blizzard here last February), chemical emergency (such as the massive oil spill in the Gulf), a radiological emergency (like the one cause by earthquakes in Japan), an explosion or other event that causes mass casualties. Incidents like this occur regularly around the world.

Unfortunately, ten years after that fateful day in September, our country is in a recession, which means hospitals are facing massive budget cuts.  Budget cuts jeopardize hospital preparedness for the cataclysmic event we hope never comes as well as other emergencies and medical disasters.  While September 11th changed history, an important lesson it has taught us is that emergency preparedness is a 24 hours a day, 7 days a week, 365 days a year responsibility.  Let’s hope that this anniversary will raise awareness about the importance of the medical community in our lives and in the nation’s preparedness.  It would be unimaginable if we as a nation didn’t do all that we could to be equipped for what the future holds.

Do you remember where you were and what you were doing on 9-11? Share your story with us.

Left to right: Julio Silva, MD MPH, chief medical information officer, Rush University Medical Center; Dan Yunker, VP at MCHC; Rod I. Hart, Client Partner, CSC Healthcare Group; Terri Jacobsen, director, Health Information Exchange; Dr. Stephen Ondra; Kevin Scanlan, President/CEO of MCHC; Mary Anne Kelly, VP at MCHC; Peter Ingram, VP & CIO, Sinai Health System; Mari Franks, program manager, Health Information Exchange; Edward Barthell, Director Connected Health, Microsoft Health Solutions Group

The MetroChicago HIE had the honor to meet with Dr. Stephen Ondra who is a member of President Obama’s Executive Office. He works closely with the President of the United States along with the leaders of many federal agencies, such as Centers for Medicare & Medicaid (CMS), Health & Human Services/Office of the National Coordinator (HHS/ONC), Department of Veterans Affairs (VA) and the Federal Drug Administration (FDA). Dr. Ondra is also a native to the Chicago-land region, attendee Rush Medical School and practiced for many years at Northwestern Memorial Hospital.

The tone of the meeting was informal, but the enthusiasm and excitement that surrounded the meeting was felt by everyone in the room. Dr. Ondra was energized to hear about the successes of the MetroChicago HIE and was eager for feedback on how the government could be of service to the initiative. Ondra indicated how the MetroChicago HIE was unique in the sense that it has formed in the midst of the American Recovery & Reinvestment Act of 2009 (ARRA) along with the Patient Protection & Affordable Care Act (PPACA). He was thrilled that the MetroChicago HIE has leveraged every aspect of health reform that has come out of Washington over the last 3.5 years.

Ondra communicated that President Obama and his Administration encouraged starting early when it comes to patient and consumer engagement within the community. He indicated that dialogue within the community is critical to the success of this project and similar projects occurring throughout the country. Ondra also encouraged us to involve VA hospitals and providers in our efforts for HIE as well as engage the soldiers returning from overseas in workforce development opportunities.

Dr. Ondra will continue to work with the MetroChicago HIE to connect our project management staff with other members of the President’s Executive office, including the Chief Technology Officer, Aneesh Chopra. Ondra also will connect the MetroChicago HIE with the right individuals on the local level who are members of the ONC along with the VA.

We are extremely grateful to have had the opportunity to meet and learn from Dr. Stephen Ondra, and we are hopeful that this is the start of an ongoing dialogue with Washington D.C.

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Adventist La Grange Memorial Hospital: Facebook - 4square

Adventist Midwest Health: Twitter - 4square

Advocate Health Care: YouTube - Facebook - Twitter - LinkedIn

Advocate Bromenn Medical Center: Twitter

Advocate Christ Medical Center/Advocate Hope Children’s Hospital: Twitter

Advocate Condell Medical Center: Twitter

Advocate Good Samaritan Hospital: Twitter

Advocate Good Shepherd Hospital: Twitter

Advocate Illinois Masonic Medical Center: YouTube - Facebook - LinkedIn - 4square

Advocate Lutheran General Hospital/Advocate Lutheran General Children’s Hospital: Twitter

Advocate Trinity Hospital: Twitter

Captain James A. Lovell Federal Health Care Center: YouTube - Facebook - Twitter - Blog

Carle Foundtaion Hospital: YouTube - Facebook - LinkedIn - 4square

Jesse Brown VA Medical Center: Facebook

Children’s Memorial Hospital: YouTube - Facebook - Twitter - LinkedIn - 4square

Delnor Hospital: Twitter - LinkedIn - 4square

Edward Hospital: YouTube - Facebook - Twitter - LinkedIn - 4square

Department of Veterans Affairs Edward Hines, Jr. Hospital : Facebook - 4square

Holy Family Medical Center: Twitter - 4square

Kishwaukee Community Hospital: YouTube - Facebook - Twitter - LinkedIn - 4square - Blog

La Rabida Children’s Hospital: YouTube - Facebook - Twitter - LinkedIn - 4square

Little Company of Mary Hospital and Health Care Centers: YouTube - Facebook - Twitter - LinkedIn - 4square

MacNeal Hospital: Facebook - LinkedIn - 4square

Memorial Health System: YouTube - Facebook - 4square

Memorial Hospital (Carthage): YouTube - Facebook - Twitter - 4square

Mercy Hospital & Medical Center: YouTube - Facebook - Twitter - 4square

Methodist Medical Center: Twitter - 4square

NorthShore University HealthSystem: YouTube - Facebook - Twitter - LinkedIn - 4square

Northwest Community Hospital: YouTube - Facebook - Twitter - LinkedIn - 4square

Northwestern Memorial Hospital: YouTube - Facebook - Twitter - LinkedIn - 4square

Palos Community Hospital: YouTube - Facebook - Twitter - LinkedIn - 4square

Passavant Area Hospital: YouTube - Facebook - LinkedIn - 4square

Provena Covenant Medical Center: Facebook - 4square

Provena Health: YouTube - Facebook - Twitter - LinkedIn - 4square - Blog

Provena Mercy Medical Center: Facebook - Twitter

Provena Saint Joseph Hospital (Elgin): Facebook - Twitter - 4square

Provena Saint Joseph Medical Center (Joliet): Facebook - 4square

Provena St. Mary’s Hospital: Facebook - 4square

Provena United Samaritans Medical Center: Facebook - 4square

Rehabilitation Institute of Chicago: YouTube - Facebook - Twitter - LinkedIn - 4square

Resurrection Health Care: YouTube - Twitter - LinkedIn - 4square

Riverside Medical Center: YouTube - Facebook - Twitter - LinkedIn - 4square

Rush Oak Park Hospital: Facebook - Twitter - 4square

Rush University Medical Center: YouTube - Facebook - Twitter - LinkedIn - 4square - Blog

Rush-Copley: YouTube - Facebook - Twitter - 4square

Saint Francis Hospital: Twitter - 4square

Saint Joseph Hospital: Facebook - Twitter - 4square

Sherman Health:  YouTube - Facebook - Twitter - 4square - Blog

Swedish Covenant Hospital: YouTube - Facebook - Twitter - LinkedIn - 4square

University of Chicago Medical Center: YouTube - LinkedIn - 4square - Blog

Valley West Community Hospital: Facebook - Twitter - 4square

What are your plans for Social Media Day? If you are not celebrating this year, do you plan to celebrate next year? Let us know!

Dr. Steve Ondra, an executive who works in the Office of Science and Technology in the White House called to learn  more about the MetroChicago Health Information Exchange (HIE) we launched earlier this year. Dr. Ordra told me he and others in the White House had heard a lot about our HIE and wanted to learn more.

Needless to say, we’re very excited about the opportunity of hosting Dr. Ondra and discussing our HIE with him.  We’ll be joined by our technology partners, Microsoft and CSC, as well as a few members from our Advisory Committee.

We’ve made great strides as we’ve moved our HIE from planning to implementation. To learn more, please click here for our latest Executive Summary.

Check back next week and get an update on what occurred at the meeting.

Earlier this week we held our Annual Meeting of the membership. There are certain business items that we are required by our bylaws to bring to the membership for their approval.

At this year’s meeting, the membership elected three new MCHC Board members; Michael Eesley, CEO of Centegra Health System, Dennis M. Murphy, executive vice president and chief operating officer of Northwestern Memorial HealthCare and Tracy Rogers, vice president and chief operating officer of Alexian Brothers Health System.

(Left to Right) Dennis Murphy, Kevin Scanlan, Tracy Rogers and Michael Eesley

I look forward to working with each of these very talented health care executives as well as our other talented board members as we prepare for the impact of health care reform.

To help us get some additional intelligence, I invited Don Wegmiller, a nationally recognized health care expert to share the results of interviews he conducted with more than 35 CEOs of health care delivery systems nationwide.

These interviews confirmed many of the same finding we’ve developed over the past year during our meetings with the executive teams of more than 60 of our member hospitals.

The bottom line-the health care delivery system is going through significant change. Virtually every aspect of the delivery system will be impacted, some which we can quantify today, others are best guesses and still more (Medicare ACO’s) no one knows for sure.

While the picture in side of my crystal ball on the health care delivery system of the future gets a little clearer each day, the clarity of that vision is far from 20/20.

MCHC has been actively involved in workforce development for more than 20 years. We made the decision to “grow our own” to meet the expected shortages of health care professionals in the coming years. We targeted Hispanic and minority students as they are underrepresented in the health care work force.

As a former high school teacher, this has been a project near and dear to me. I try to get over to the school every few months to meet with the students and the faculty to learn firsthand, how the program is working. The picture below is me meeting with a group of students. We talked for about an hour on a wide range of topics and issues. They updated me on several projects they are working on, their “shadowing” experiences at some of our hospitals, the success of their softball, volleyball and basketball teams and their plans for the end of year dance.

They are especially excited about moving to their new campus on the west side of the city. They’re also looking forward to mentoring the incoming class of freshman students in August, and I think, excited about being the veteran sophomore class. A few even talked about graduation only being a few years away.

Whatever the future health care delivery system becomes as a result of the health care reform debate, I’m confident we have that next generation of health care professionals ready and willing to step in and make significant contributions.

As part of our Wellness initiatives, I challenged our staff to Bike with the Boss, personally pledging $ 1 per mile ridden by the MCHC Team to a charity. Although few in numbers, we collectively rode 250 miles. When I asked the group what charity I should donate to, the unanimous answer was The Care Fund. The Care Fund was set up by several Hospital Associations after Hurricane Katrina to provide assistance to hospital employees affected by Hurricane Katrina. MCHC was one of the founding contributors. With the recent flooding and tornadoes, the Fund was reactivated. Along with a $5,000 donation from MCHC, I was happy to add my personal donation of $250. To learn more about The Care Fund, go to www.thecarefund.net.

For one week every year in May, our state honors the work of Emergency Medical Services (EMS) workers. This year, Governor Pat Quinn proclaimed the week of May 15th through 21st Emergency Medical Services Week in Illinois. EMS workers – first responders, emergency medical technicians, paramedics, nurses, doctors and others – work tirelessly to make sure that those in need are cared for when they are sick or hurt.  EMS workers’ skill, compassion and dedication to help their fellow citizens are nothing short of amazing. They are willing to put themselves in harm’s way to help others – look at what they did on 9-11.  It certainly takes special people to do their work. Wouldn’t it be great if they were honored all year long for their hard work and dedication to saving lives and comforting those who are sick or injured?

There are many hospitals that stand in support of EMS workers. In Illinois there are 66 EMS “resource hospitals” – hospitals that voluntarily take on an integral role in assuring that the EMS systems function on the cutting edge of medicine. There are also 64 committed hospitals in the state that serve as trauma centers – the highest level of care that can be had for victims of trauma. This year’s theme for EMS Week is “EMS-Everyday Heroes.” Let’s remember this theme and thank the EMS workers every opportunity we can! Remember, EMS workers are always there for you!

You can enhance your knowledge on these topics on July 28, 2011 at MCHC’s “Topics in Healthcare Construction, Design and Equipment Planning” seminar. There is NO COST to attend.

Additionally, the ACO concept has been mentioned in most meetings and I think the challenge has been in the details including the unknown costs and how to identify them. This is where I think the AHA white paper helps the industry organize their thoughts on how model the costs of an ACO infrastructure.

After reading through the paper myself and after reflecting on what we heard in our meetings from the Chicago area market, a few thoughts come to mind:

• The Medicare “Shared Savings Program” alone will not be enough to sustain the costs associated with building and running an ACO. Those hospitals that plan to pursue ACO’s will need to align with the other payers to generate an aggregate return on investment in the long run.
• The paper provides guidance on the need for primary care physicians. This is a growing challenge for all markets.
• From a cost perspective it’s interesting to compare the stand alone costs associated with the five hospital system example. The total cost for the five hospital system is two times on an annual basis but it is nearly half the cost on a per hospital basis. And the additional costs are being driven by the incremental drivers of EHR, additional care coordination and discharge resources which would be expected because of higher volumes from more hospitals. There definitely appears to be an economy of scale for the core expenses associated with operating an ACO supporting the recent M&A activity in our market.
• The paper showcases some of the anticipated healthcare information exchange costs (HIE) and is favorable validation of the HIE effort that MCHC is implementing for the market at a per hospital startup and ongoing cost structure that is much less than examples provided.

The most painful part of the transformation taking place in our industry may be the simple fact that to operate many have to straddle a reimbursement world that has one part in the current fee based system and another in a conceptual world that has unclear expectations. This white paper from the AHA is worth the time to read and for me created a good foundation on how to organize thought as they relate to the costs associated with operating an ACO. Let me know what your observations are after you read though it.