• Embed Doc
  • Copy Link
  • Readcast
  • Collections
  • CommentGo Back
Download
 
VOLUME 18 NO. 6
n
inside.duemediine.o
n
June 2009
S
ometimes, it seems there are asmany o stories extraordinary careat Duke University Health System asthere are stars in the sky.Here’s one story:An elderly couple had been inan auto accident, and they had beenbrought to Duke University Hospital.They needed critical care. They gotthat care rom Mark Shapiro, M.D.,and the sta members o Unit 2200.The woman’s condition was worsethan her husband’s, so Shapiro thought-ully requested that the sta bring thehusband, who was on a stretcher, to herroom so they could speak to each otherone last time.A week later, when the amily de-cided to withdraw lie support, thesta again moved the husband to theroom next to his wie’s room, so thatthe amily could be with both as theypassed away within two minutes o each other.Another shining example comesrom the Birthing Center.The team was leaving work when Juanita Hughes, RN, BSN, noticeda man yelling or help in ront o thehospital.The man’s wie was in labor andvery near to delivering the baby inthe car.As Hughes delivered and tookthe baby to the ull-term nursery,Anne Bedoe, RN, Cathy Cronquist,RN, and Brittany Watson, RN, BSN,stayed with the mother until the EMSunit could arrive.The baby and mother were bothsae and well cared or, thanks to theteam’s quick action.For their eorts, Shapiro re-ceived the Physician Award and theteam rom the Birthing Center wonthe Team Award in Duke UniversityHospital’s Strength, Hope and CaringAwards. They are just a ew stars rec-ognized recently.
Read eve mre stries  extrardiary cm-mitmet i a special display  Pages 6 ad 7.
medical inormation
HhVw s ss
th HhVw p p psss100,000 ss.   wh's s pp.Pg 3
Patient & amily care
Wg  
a vg w sgwg   s pv h p  xp.Pg 5
reminder
Hv  v h
d' g  ph Wk c Sv bJ 5. S  g s.
D
uke University Health System’spresent success propels it into theuture.That momentum comes romconcerted eorts to continually ndways to make sure the health system ishealthy in years to come. For DUHS,the course to that uture lies on twoparallel paths.The rst is expense management.The second is strategic investmentin growth opportunities. Both areimportant.On the surace, belt tightening tosave money might seem inconsistentwith a plan to spend money onstrategic projects. But it isn’t. Indeed,the two eorts are interconnected, andare crucial or assuring that DUHS cancontinue to provide the very best healthcare to a growing North Carolinacommunity.“There is a direct connectionbetween how we use resources now
Tw pathst the uture:
see FUTURE, p.2
“Thee is a diet onnetionbetween how we useesoues now and how wean invest in the utue.”
— William J. Fuleson J., M.D.
Sgh, Hp & cg
Mark Shapir, M.D., i lab cat, surruded by the team rm Duke Uiversity Hspital’s Uit 2200. Shapir received the verallPhysicia Award i the hspital’s Stregth, Hpe & Carig recgiti prgram.
Photo by duke Photo
Expese ctrl,strategic ivestmet
Extaodinay stoies, extaodinay people
 
Iside Duke Medicie
and how we can invest in the uture,”said William J. Fulkerson Jr., M.D.,senior vice president or clinicalaairs. “Expense management andtargeted investment are the two pathsthat we are ollowing to that utureaccomplishment.”
Maagig expeses
Last month, Inside Duke Medicine ea-tured a cover story about how a DUHSinitiative — begun months beore lastall’s onset o the global economicdownturn — has allowed health systemleadership to produce signicantsavings through close and coordinatedattention to expense management andrevenue enhancement opportunities.(Read “Prepared or the Future” onlineat
http://inside.dukemedicine.org
)This initiative has been successulin allowing DUHS to identiy morethan $50 million in recurring savingsannually. These recurring savings, andthe continuing eort to nd additionalsavings, are reinorced by two impor-tant DUHS goals — a commitment to ahighly-skilled and dedicated workorce,and a dedication to not do anythingthat would weaken patient care orpatient saety.For example, aculty physiciansworked hand-in-hand with procurementocers to make choices that wouldresult in savings rom the long list o surgical supplies the organization buys.At the same time, this eort ocused onensuring that patient care and saetyremained the top priority and that theworld-class care that Duke Medicineprovides would not be aected.“We are not making knee-jerkreactions to what’s happening in theeconomy,” said Kenneth Morris, seniorvice president or nance. “We havehad success ollowing our long-termstrategic plans, which call or growth tobetter serve the patients o our region,North Carolina and beyond. Expensemanagement allows us to right-size thenancial structure o our organizationso that it can be prepared or currentand anticipated conditions, and toprovide resources or uture growth.”Morris said that the impetus orinitiating the expense managementprogram last March was the result o aconviction among DUHS leaders thatthe health system needed to anticipatehealth care reimbursement reductionsand other possible economic pressures.Even beore the global economictravails, DUHS leaders were thinkingabout the importance o saving or theuture.
Strategic ivestmets
Identiying $50 million in expensesavings and revenue means there willbe resources available or the majorcapital projects that the health systemhas been planning and studying.For many years, DUHS leadershave recognized a need or greatercapacities at Duke University Hospitaland Duke Cancer Center. Similarly, theDuke University School o Medicine,ater a long and thoughtul re-accredidation process, identied needsor more biomedical research space anda new student-ocused learning center.To support the Duke Medicinemission — excellence in patientcare, research and medical education— means investing in the inrastruc-ture and programs that underpin oursuccess.But it is not just about buildingbuildings.“The ocus is always on thepatients who will be cared or inthese proposed acilities, as well asthe valued employees who make thispossible,” Fulkerson said. “Strategicinvestments are really investments inpatients and employees.”Health system leaders have beencareully and conscientiously consider-ing potential strategic investments andobserving daily the conditions o themarketplace and economy. The deci-sions to build an addition to DUH, anew cancer center and a learning centerare business decisions that DUHS lead-ers continue to plan or and on whichthey anticipate moving orward.Over the past several years, DUHShas been making such careully consid-ered strategic investments.New clinics that expand the healthsystem’s ability to serve more patientsin the growing greater Triangle regionhave been built in Wake County.The health system and DurhamCounty have deepened and rearmedtheir commitment to Durham by agree-ing to a long-term extension o thelease on Durham Regional Hospital.A new, renovated home or thePhysician’s Assistant Program hasbeen opened near downtown Durham,which will aid a program critical tothe expansion o eective new modelso care. The new acility also providesspace or its uture growth.And Duke HomeCare andHospice, already providing care ormore than 1,000 end-o-lie patientsthroughout the Triangle, opened a new12-bed Hock Family Plaza hospiceacility earlier this year.Those investments won’t be thehealth system’s last. As the expensemanagement initiative has shown,every employee will have a hand inmaking sure DUHS saves money so wecan invest in uture success.The resources we manage well, inevery department, contribute to theorganization’sability to plan orstrategic growth,said Fulkerson.The twopaths — expensemanagement andstrategic invest-ment — lead tothat point.“By being disciplined aboutexpense management we optimize ourorganization,” Fulkerson said. “Anoptimized organization can iden-tiy the resources needed to expand.Expansion, when we are ready, willmean even greater opportunities orthose who work at Duke UniversityHealth System.”
n
2
Jn 2009
INSIDE VOLUME 18, ISSUE 6
n
ConTACT USCampus mail:
duMC 104030
Deliveries:
2200 W. Main S.,Si 910-b, dam, NC 27705
Phe:
919.660.1318
E-mail:
iinsi@mc..
CREDITS
 
Cart:
Js ta
STAFF
 
Editr:
Ann Zi
Maagig Editr:
Ma Scin
Sciece Editr:
k Macm
Desiger:
Vanssa dJng
Iside olie Editrs:
 bi Sagg an ein PaCpig © 2009d univsi ha SsmInsi d Micin,  mpnwspap   d univsi haSsm, is pis mn  dMicin Nws & Cmmnicains.y cmmns, s ias an pcniins a awas wcm anappcia. dain  smissinsis  15  ac mn.
Duke Uiversity Health System has recetly made several strategic ivestmets. Justthree  them are, clckwise rm the upper right, Duke HmeCare & Hspice’s HckFamily Pavili, Duke Medical Plaza Kightdale i Wake Cuty, ad the ew hmer the Physicia Assistat Prgram i Durham.
 
Ile PhotoS
“The ous is always on the patients whowill be aed o in these poposed ailities,as well as the valued employees who maethis possible. Statei investments ae eallyinvestments in patients and employees.”
— William J. Fuleson J., M.D.
FUTURE, ct.
on tHe coVer
 
HealtH Summit
3
Jn 2009
Iside Duke Medicie
H
ealthView, DukeMedicine’s patientinormation portal, is nearlytwo years old now and prov-ing to be wildly successul.The portal, at
https://healthview.dukehealth.org
,provides patients with anecient, secure and easy-to-use online tool combiningscheduling, clinical andbilling unctions.Its suite o tools, sayDuke Medicine leaders,oers patients, providersand even the U.S. healthcare system an exciting andempowering innovation.The numbers agree.More than 100,000patients are now registeredon the site. They’re using itaround the clock and evenaround the globe, logging onrom near and ar to checklab results, pay bills — total-ing more than $10 million soar — and schedule ollow-up appointments.Duke Medicine em-ployees and their amiliesmake up a quarter o the portal’susers, said Pete L’Engle, senior pro-gram manager or eHealth in DukeHealth Technology Solutions. He isproud o the portal’s progress, andanticipating more unctions — manyrequested by patients themselves —over the coming years.There’s no need to wait, though.HealthView oers a number o veryuseul tools.Through the portal, patients canschedule their own appointments —routine, sick or ollow-up visits, aswell as annual exams — at all DukePrimary Care practices, Duke FamilyMedicine and Duke Children’sPrimary Care. And when you realizeyou’ve just scheduled your physicalexam or the same time as yourdaughter’s ballet recital, just clickthe Cancel Appointment button andstart over.Advanced registration is alsonow available or many Duke clinics,so patients can ll out and updatecontact inormation prior to arrivingor an appointment. That means amore ecient visit.As an appointment day comescloser, patients receive e-mail remind-ers. Across the Private DiagnosticClinic, said Rex McCallum, M.D.,associate medical director, no-showrates are down 10 percent. Patientswho use HealthView actually missewer appointments than those whoaren’t signed up or the system.That’s why physicians andclinic sta have actively encouragedpatients to provide their e-mailaddresses. Once a patient’s email ad-dress is entered into the HealthViewsystem, he or she can create anaccount and make use o the site.(HealthView is not used by DukeMedicine or marketing purposes,and won’t use patient e-mail ad-dresses or messages unrelated to aperson’s medical care.)And, soon ater an appointment,patients receive e-mail messagesabout any laboratory results thathave been posted to a person’saccount. Over the last year, patientsviewed one million results, withmore than 300,000 o those resultsreports annotated by providers ineBrowser to give patients clarity onwhat the results meant.Most lab results are availableto patients one to seven days aterthe test, though providers can makeresults available sooner. Lipid paneltests, or example, are availablealmost immediately, saidMcCallum, since patientswho get these tests areusually amiliar withthem and already manag-ing cholesterol levels.But, to comply with stateand ederal regulations,the results o some tests,such as HIV antibodytests, are blocked entirelyrom HealthView. John Anderson,M.D., chie medicalocer o Duke PrimaryCare, said that patientsand providers uniormlylike HealthView.“Patients appreciatethe transparency and e-ciency that HealthViewprovides, and thephysicians like the wayHealthView empowerstheir patients to be moreinvolved in managingtheir own health care,”he said.Anderson and otherDuke Medicine leadersare encouraging allemployees to use and understand theportal, and to help patients see thevalue o the tools there. Posters andbrochures promoting HealthView areprominently displayed now through-out DUHS clinics and waiting rooms.“It’s good or the organizationas a whole because it’s very patientcentered and also gives us a competi-tive advantage in the marketplace,”said McCallum.Nationally, electronic medicalrecords and online health inorma-tion vaults are seeing intensedevelopment, as stimulus moneyrom the American Recoveryand Reinvestment Act o 2009,and products rom Google andMicrosot, pour resources into thetechnologies.Asi Ahmad, vice president o diagnostic services and chie inor-mation ocer, points to the utureo HealthView, which will includee-visits and secure communicationsbetween patients and their healthcare providers.“With HealthView, DukeMedicine has an innovative suiteo tools that puts patients in controlo their health care inormation,”said Ahmad.
n
HealthView succeeds as vital patiet tl
Psters thrughut Duke Medicie cliics prmte the HealthViewprtal t patiets ad emplyees alike.
 
duke CreAtIVe SerVICeS
new partership, udigseeks health ivatis
d univsi ha Ssm’s nging caa-in wi dam cmmni gps, as ansins  impv a an a ca accss a maj sp wa Api 28 wi  anc a niq  ca dam haInnvains (dGI).dhI’s saing pin is awaing gans a wispp 10 caaiv duhS-dam pannings  ass maj a pms in damCn. t cangs ang m ascna, asma, canc an a isas ias, hIV/sxa ansmi isass,mana a, pain managmn, ssancas an snis' a.A  panning pas ns in dcm, sm  10 pans ma  sc  vpmn as n i pnia  ing anw appac  impving a in dam.Paning wi  dam cmmni in is in iniiaiv is a ig pii ca an a ai-azing sp naina in canging  ac Amican a ca.“tis is wa  a ca m is a a,"sai Vic J. dza, M.d., psin an Ceo duhS an canc  a aais a dunivsi. "I’s  cmmni aing cag  iswn a wi duhS ing is scs as apan s a w can cm p wi  s pa  a  vn in dam.”t dhI iniiaiv, annnc a  8 Annad/dam ha Smmi, an  is  aca cangs as m mns  caaininvving ns  d psnaivs anm an 90 cmmni agncis, ganizains,sinsss an sins.dhI cs a cmmimn  duhS  ca acna    cmmni is  inipms an fn was  a wi m.l Micn, M.d., caiman   dpamn Cmmni an ami Micin, sai dhI sa nw visin: wispa, cmmni-cs cacnvnin  w  m,  acing w an w pp accss  a cassm, wa ca  n, wa i css, anwa  cms a.t inmain wi  sa wi cmmni an s  cnsan fn ssm  ma i as fcin an as civ aspssi, Micn sai.“t a man cmmni ganizains a aaa a a w impving a ca indam,  w nw i is n ng,” sair Cai, M.d., ic   dtansaina Micin Insi an c-cai  dhI vsig cmmi. “t sin is nging   m mn. t sin wi cmm  cinain  , s  mciv inmain cng an wingg  ini an impmn  spacics m an  w.”ning cms m  Naina Insis ha an d Micin. eac panning pjcwi civ p  $100,000   s   n  a. eac pjc n wi  psn anvaa  min w i mvs wain  nx pas.
reSourceS
of 00

Leave a Comment

You must be to leave a comment.
Submit
Characters: ...
You must be to leave a comment.
Submit
Characters: ...