Community hospitals are a distinct and steadfast breed contending with multiple challenges as they grapple with 21st century care. Their budgets and infrastructures often pale in comparison to their larger peers. Access to capital is tight. Ambulatory care and imaging centers make for fierce competition. The economic recession brings additional challenges. “A lot of facilities are putting construction and major equipment purchases on hold,” shares Brock Slabach, senior vice president at National Rural Healthcare Association in Kansas City, Mo.
But the outlook is not wholly gloom and doom. The U.S. economic recovery package contains significant funding for healthcare IT, which could free up funding for other capital acquisitions. In fact, the long-term dynamics for expanding clinical service remain unchanged, says Slabach. That is, the long-range plan and strategic framework should steer expansions and additions.
Community hospitals that add new clinical services to better meet local needs can garner multiple benefits ranging including improved patient care and increased revenue. This month, Health Imaging & IT visits a pair of community hospitals that added new service lines to their portfolio to better meet local needs. Their business models provide a sound roadmap for other sites.
At 525 beds, St. Joseph Hospital in Orange, Calif., is fairly large for a community hospital, but despite its recent growth, the hospital remains committed to its roots in the community. “We’re focused on the well-being of the community and recognize that prevention is as important as acute care,” explains Renee Mazeroll, executive director of cardiac, pulmonary and vascular services.
Five years ago, St. Joseph Hospital’s commitment to the community led to the development of new cardiac and vascular service lines. The multi-phase project started with a women’s heart center. Sticking to the prevention framework, the women’s center offers calcium scoring, sophisticated lipid panels, arrhythmia screening, peripheral arterial disease screening and risk assessment for sudden cardiac death. A vascular institute and new neuroradiology and interventional radiology services followed over the next few years. The flip side of prevention and screening is diagnosis and treatment; the hospital supports and facilitates care and treatment of cardiac diseases with state-of-the-art technology and imaging modalities.
St. Joseph Hospital adopted a timeline that tackled the largest holes in patient care first. “The literature pointed to differences in women’s needs, and we also knew there were opportunities to improve diagnosis and care of patients with vascular disease,” shares Mazeroll. The next phases followed patient care along the continuum.
Timelines for new service lines reflect national trends, while adhering to local needs. Take for example Maria Parham Medical Center in Henderson, N.C. The center deployed McKesson Corporation Horizon Medical Imaging PACS late in 2008 and plans to integrate digital mammography toward the end of 2009, followed by its cardiovascular lab in 2010. Bonnie Howell, director of imaging and cardiovascular services, explains how timing meets local needs. The hospital’s 50-member radiology group includes eight dedicated breast imagers, and all need access to digital studies. In addition, referring surgeons and oncologists also require access to images. In contrast, a single cardiologist reads cardiac studies, and referring providers typically want reports rather than images. Finally, at 30 studies daily, mammography volume doubles cardiovascular imaging volume. “The need for distribution of mammography images is greater,” sums Howell.
The other factor in the local needs assessment is competition. While community hospitals need to remain competitive in the local market, repeating a competitor’s offering is ill-advised. “I caution hospitals against duplication of services,” says Slabach. Questions to consider include:
- Does the service line meet local gaps?
- Is the offering distinct from other local providers’ programs?