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Oct 13 Message from Leadership

Published October 13, 2014

Message from Preston Simmons, Chief Executive Officer

I am pleased to share with you all the great work that is being done to put our strategy and infrastructure together to manage the health of our population.  The focus of many in the Northwest Region is to respond to the evolving economic world which is changing from a "sick care" business model into a proactive one.  The challenge in front of us is to provide care in different and innovative ways and to reward the patient/clinician partnership, which is really a  business model focused on health.  This is a much better way to provide care and aligns with why we all went into health care.  The result for the country if we do this right, is to have improved overall outcomes for the health of a population at a lower cost.  This also allows us as citizens to reinvest those savings back into our communities for such things as education and enhanced infrastructure.

As you have likely heard, Providence has developed an Accountable Care Organization (ACO) called the Providence Swedish Health Alliance.  This is a network of select Hospitals and Ambulatory groups that will provide care in a coordinated manner for a population of patients.  We’ll be rewarded if we can manage the patient population's care though meeting quality and service outcomes and do it more efficiently than ever before.  This is also referred to as taking economic risk for a population.  Our first major foray into this is the partnership with Premera in providing services under a Medicare Advantage Program which is a managed care program for those age 65 and older.  This program provides more services to patients and at a lower cost than a traditional Medicare program.  We are about to launch our 2015 enrollment period, so be sure that your Medicare-aged friends and family members look for programs that contain the Providence Health & Services network like the Premera Medicare Advantage Plans.

Our ACO contract with Boeing offers a managed care program to a portion of their employees.  This new program provides an enhanced set of service and delivery innovation options to those choosing the Providence Swedish Health Alliance instead of traditional insurance options.  The innovations and learnings we develop through the Boeing ACO will be able to be transferred to all our patients over time. This will help us to continue our trend of continuously improving the patient experience of care-- one of the biggest reasons why patients are choosing our system for care over other options they might have.

Two concrete examples of new care innovations are Care Management and Transitions in Care:

Care Management is a program being developed within the NWR Ambulatory Division (PMG) to care for our patients who are medically frail and complex or are dealing with multiple chronic conditions.  The care management team builds relationships with patients to help them self-manage their complex medical conditions and navigate a sometimes confusing medical system.  The care management team, made up of registered nurses, medical assistants/transition associates, social workers, and pharmacists, engage patients in understanding their health conditions and how to manage them at home.  In partnership with the patient’s primary care provider and specialist, the team helps patients create a "W-W-W Plan" of their own (Who, When, and Where to call when they have symptoms indicating problems, and  What they need to do to become self-reliant.)  Care management is a relationship based care, creating enduring relationships and alignment between clinicians across the continuum of care.  By ensuring the patient gets the right care, at the right time, in the right care setting, their experience is better, health care costs are diminished, and their health outcomes and quality of life improves.

The Transitions in Care program is a key element of Care Management.  A team of registered nurses, social workers, and transition associates work with the patient and their family or caregivers to ease their way from hospital to home, or another facility, making sure key information is communicated and appointments for follow-up with the specialist and/or primary care provider are in place.  Patient's loved ones or caregivers can find it challenging to remember or make sense of all the instructions the patient receives when they are discharged. For this reason, the Providence transition planners call within 24-72 hours after discharge to answer any questions that may have arised.  For the complex and medically frail patient, a registered nurse will call them several times over the next month to make sure the patients are progressing, doing well, and following up with their ambulatory care team.  Already there have been some excellent “catches” to improve patient safety, for example, in one call at 24 hours after discharge the RN discovered the patient’s home medication regimen and hospital discharge medications could cause a drug to drug interaction and immediately advised the patient to see their primary care physician before continuing to take their home medication.

These are just a few of the many examples that we are caregivers are continuing to work together for the betterment of our community. Thanks for all that you are doing to support the Mission of Providence and our core strategy to build healthier communities, together.