Trinity Health
President's Letter

Robert V. Stanek
President and CEO
May 2009

It has been one year since Catholic Health East launched our Comprehensive Care Management initiative.  This system-wide effort is a value-based, person-centered, collaborative system of support and caring that promotes health-enhancing relationships through efficient and effective care.  Comprehensive care management connects individuals with information so that they can make informed decisions about providers, services and programs that support their holistic and spiritual needs throughout their lives.

Implementing a new care model across a system as large as Catholic Health East is a complex, multi-year endeavor.  To help guide and support this multi-pronged initiative, a Comprehensive Care Management Council was established; this group’s primary responsibility is to assure careful coordination and continuous progress toward achieving CHE’s 2017 Preferred Delivery Model.

The Council is providing oversight and direction to the implementation of MIDAS+, our new hospital case management system.  This new system will help CHE make a quantum leap forward in the evaluation and provision of efficient medical care. Using Midas+, the case manager identifies appropriate levels of care and considers alternative therapies and resource usage. To measure improvement in medical care efficiency, the practitioner presents care providers with specific opportunities to improve and monitors their progress over time.

Midas+ provides a suite of tools – including online documentation, physician referral, electronic mail, and online faxing - for tracking and authorizing services across the continuum of care, so that our RHCs can transform their entire review processes to a paperless one. Hospital case managers have been trained extensively in this new system, which will launch system-wide in June 2009.

The Comprehensive Care Management Council was also recently charged with providing direct oversight to the achievement of system-wide goals in three key metrics: Medicare Length of Stay, clinical denials, and 30-day readmissions to CHE hospitals.  These three metrics are key to the success of our system-wide ACT initiative, which is focused on identifying, analyzing and implementing clinical transformation opportunities that will result in superb clinical outcomes and enhance quality and safety across the system.

In order to test various aspects of the CHE Care Management model, three pilot programs have been identified and are now in various stages of planning and implementation.  Pilots exist at Mercy Health System of Southeastern Pennsylvania (MHS) and Keystone Mercy Health Plan (KMHP), St. Peter’s Health Care Services and CHOICES, a geriatric care management program in  the Albany area, and the Sisters of Providence Health System / Physician Integration Model.

At the most recent Council meeting, the Technology Sub-Committee provided a detailed overview of one of its key priorities for 2009: the importance of medication adherence.  This is a phenomenon that has enormous clinical as well as financial implications.  Studies show that about half of the 1.8 billion prescriptions dispensed annually in the United States are not taken correctly by patients.  Medication non-adherence results in approximately $177 billion annually in direct and indirect costs to the U.S. economy, including $47 billion for drug-related hospitalizations, billions more for nursing home admissions, as well as tens of thousands of deaths each year.

Since medication adherence is a topic of great importance to our patients and residents, as well as to our entire health care ministry, it is a phenomenon that requires our attention and action.  There is a major role to be played by our clinicians, and a broad range of enabling technologies that can help mitigate this situation.  Some already exist.  For example, “talking pill bottles” that verbally remind patients when and how to take their medications are in use by pharmacies throughout much of Northern California.  And more sophisticated “remote dispensing systems” have been shown to improve adherence rates in patients with diverse chronic illnesses from baseline levels of 35-55% to levels in excess of 90 percent.  With the use of HealthTech resources and a first-hand review of existing companies, CHE will explore the feasibility and benefits of selecting a Remote Medication Management System(s) that are or will shortly become available on the market, for use in our facilities and with our patients and residents system-wide.

More than 45 years have passed since Bob Dylan released his song The Times They Are A-Changin’.  The words are as true today…in the world of health care…as they were during the social upheaval of the 1960’s:

Come gather 'round people wherever you roam
And admit that the waters around you have grown…
Then you better start swimmin' or you'll sink like a stone
For the times…they are a-changin'…

Forget about how much health care has changed in the last 45 years; consider how different it is from just FIVE years ago!  As we cope with enormous waves of change throughout the health care industry, we must remind ourselves how blessed we are to live in an age of unimagined technology…and wonder drugs…and where “talking pill bottles” and “remote medication management systems” are not dreams…they are reality. As together we “continue swimmin’” toward our 2017 Preferred Delivery Model, I thank you for all of your hard work, support and commitment to our Comprehensive Care Management initiative, and for your continued dedication to be a transforming, healing presence in the communities we serve.

Sincerely yours,
Robert V. Stanek
President and Chief Executive Officer,
Catholic Health East

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