Medical Center Health System: Tony Ruiz, COO

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Medical Center Health System in Odessa, Texas, grew out of Medical Center Hospital. Originally an 85-bed facility, MCH has grown to become a 362-bed facility that has been servicing the people of Permian Basin for over 60 years. In a few short months, they will be expanding into a 422-bed facility and primary referral center for 17 West Texas counties.

While West Texas is large geographically, Tony Ruiz, COO of MCHS, said that other than the twin cities of Odessa and Midland, the population is sparse, making MCH’s, and with it the system’s, accomplishments and ambitions even more impressive.

Last year, for example, they received a little over 13,600 admissions and just under 50,000 emergency-room visits. The facility houses 15 operating rooms and 1700 employees. Their annual net revenue is approximately $250-million with their gross revenue being in the $650-million range. Their trauma center has achieved Level-III status and is currently under review to become a Level-II later this year.

The organization itself is affiliated with Texas Tech University Health Sciences Center. There are 55 residents within the hospital who are working in three different residency areas–OB/GYN, family practice, and internal medicine. MCHS has also achieved fellowships in both hospitalist and geriatric medicine.

Onward and upward

Currently, MCHS is constructing a $42-million, 100,000 sq.-ft. addition to their facility that will serve as the Center for Women and Infants and will open in January 2012. It will feature 12 labor and delivery rooms, 30 private postpartum rooms, 20 newborn nursery beds, 30 private neonatal intensive-care rooms, three state-of-the-art cesarean-section suites, and an advanced infant-security system.

Their $16-million Center for Health and Wellness, also recently constructed, will offer pre-delivery and post-partum exercise classes in its Mission Fitness division. As part of this center, MCHS is offering a program that is devoted to transitional healthcare needs with a special focus on cardiac-rehab and physical-rehab patients. This fitness facility opened in October 2010 and specialized in getting people more involved in developing an overall healthier lifestyle, rather than the typical weightlifting programs.

Also incorporated into this building are cardiac-rehab and urgent-care facilities, a diabetes center, and a sports medicine, lab, and imaging area along with physician office space on the second floor.

“A lot of it is geared towards the after-care and preventive-care model that you’re seeing go across the nation,” Ruiz said.

Facing uncertainty with confidence

Like any organization facing the fickle future of healthcare, MCHS is bracing itself to confront the unexpected. Ruiz cited the growing self-pay population of indigent care as a primary challenge, along with healthcare reform.

“No one knows what that will turn into or morph into,” he said.

The system is working on building flexibility into its resources so it can efficiently adapt to future technological changes. Also, Ruiz said they are seeking to adapt a more outcomes-based, quality-based formula for the hospital’s operations.

Of course, increased competition from physician-owned hospitals poses another challenge for MCHS. Over the last seven years, two new physician-owned hospitals have started up in the region, which essentially is a fairly small community of 100,000 people.

MCHS is also facing the common, but no less important, challenges of federal and state budget cuts, decline in reimbursements, communication, and physician engagement

Ruiz is adamant, though, that the system maintains its focus.

“We need to make sure that we’re understanding and not losing sight of the values that comprise the mission of our hospital,” he said. “I think what I am trying to do is become more focused on reducing costs where we can, becoming a little bit leaner, and probably most importantly, looking for more revenue streams and potential service lines.”

To that end, the system is developing multiple initiatives, including improved quality initiatives and safer transitions. MCHS is also focused on evolving more databases for the sake of charting outcomes, communicating between providers, and measuring performance.

“A lot of these initiatives are developed to prepare for the future,” Ruiz said. “And the government lays out that future for us to some degree.”

Improving what they have

Many of MCHS’ investments are focused less on building and more on upgrading.

“Rather than building a lot of new buildings, we try to do our best to renovate and replace our capital as much as possible so we use those resources wisely,” Ruiz said.

MCHS strives to be very transparent and open with the public regarding all of their investments, whether it’s the $16-million Center for Health and Wellness or medical equipment.

Last year, for example, MCHS purchased a Siemens 3 Tesla MRI system along with a da Vinci robotic surgery system. Their OR-surgical suites have been renovated over the last three years, making them larger for current and future equipment upgrades and adapting the infrastructure for technology that wasn’t available 20 years ago.

Currently, MCHS is working with McKesson in gaining meaningful-use designation. Ruiz said they expect to have complete electronic documentation fully implemented this year for physicians and all clinical staff. They also work through the Texas Purchasing Coalition to ensure the wisest investments and most beneficial contract negotiations.

“One of the ways we try to reduce our costs is to strengthen our negotiating power with multiple hospitals and multiple health systems,” Ruiz said.

Over the next three years, they expect to reduce their electricity contract by $1 million annually. They’ve also been very successful with a lot of implantable devices, especially in the areas of cardiac and orthopedics.

“Our success has been based on innovation and implementing a very detailed strategic plan,” Ruiz said. “Since I’ve been here, we’ve worked with Med Trans air ambulance and Acute Care Surgical Specialists out of Dallas to help cover and to help strengthen our trauma program. We’ve opened up an inpatient rehab and developed or expanded many programs, which give us more integration and control in improving the community’s health and solidifying our position as the market leader in this area.”

MCHS has even ventured into retail in a joint venture with Morrison Food Management. This partnership has seen the hospital and one of MCHS’ outpatient surgery centers develop a food court featuring Quiznos, Austin Grill, and Starbucks. This is all part of an effort to acquire new and innovative revenue streams while providing a more visitor-friendly atmosphere.

“Our board has been very good and very supportive in all of our initiatives,” Ruiz said. “We’ve been able to work with our medical staff to deliver a better product. Our competition has made us work harder to improve our quality initiatives and services. So the community has benefited from that.”

Still, Ruiz said that it’s going to be a rough five to 10 years.

“We can see that the changes that are taking place are going to require hospitals to make some dramatic changes just to stay solvent.”

However, he believes that MCHS is well-equipped to face these changes by remaining innovative and adaptable to inherent change in the industry.

-by Pete Fernbaugh

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