As the healthcare industry faces major changes and restructuring, large healthcare systems are at the forefront of leading and influencing those changes.
In Charlotte, N.C., Carolinas HealthCare System (CHS) serves the Charlotte metropolitan area and surrounding areas in North and South Carolina. The system is a driving force in the region with 38 hospitals, nearly 800 care locations, and more than 60,000 employees.
With patient encounters at around 10.5 million annually, being chief medical officer for a system this size can be a daunting challenge. But Executive Vice President and CMO Roger Ray, M.D., says it’s exciting to be part of such a large organization during this critical time in healthcare.
“We recognize that the entire industry is on an economically unsustainable path, and we have to look at what changes allow us to provide more value over time, while still recognizing that healthcare is a large part of the economy in the communities we serve,” he said. “The opportunities that exist are substantial and gratifying. This is some of the most fulfilling professional work that goes on in our country, and I am grateful to have a voice in an organization such as Carolinas HealthCare System to help guide the transformation of healthcare going forward.”
Bringing innovative solutions for care delivery
With such a large geographic area and limited specialists, CHS has developed innovative care models to deliver quality care across the region to a diverse set of patients.
The system has about 100 critical-care beds across two states, but board-certified intensivists are a limited resource. So CHS has established remote ICU monitoring to provide assistance to patients throughout the region. The system also has some of the nation’s largest accredited multi-hospital networks for treatment of stroke and heart attack. Certified neurologists are connected with hospitals to aid in diagnostics remotely.
In addition, the Levine Cancer Institute is a first-of-its-kind approach to cancer care. The Institute distributes expertise and resources strategically throughout the region. It has 30 oncologists and 12 charter-member institutions. In January 2014, the Institute is expanding to offer a hematologic-malignancies unit to treat patients who need bone-marrow transplants.
CHS is also one of 26 large organizations “fully engaged” as a Hospital Engagement Network (HEN) through a federal initiative to improve quality and safety and enable hospitals to work collaboratively. “Fully engaged” means the system is regularly reporting data on all 10 measures. HEN hospitals receive federal funds to reduce 10 types of harmful events by 40 percent and reduce readmissions by 20 percent in two years.
Being a strong force in the community
As a large organization, CHS has an influential economic impact on the communities it serves. The system has nearly $8 billion in net revenue annually. Uncompensated care and community benefit runs about $1.16 billion annually, which is nearly 20 percent of the system’s operating budget.
Premier facilities in the system include Levine Cancer Institute, Levine Children’s Hospital, and Sanger Heart & Vascular Institute. By covering a large geographic area, the system sees a diverse range of patients from all ages, backgrounds, and income levels.
“We understand our communities and put functions and assets in place to meet their individual needs,” Ray said.
He added that CHS has a system-wide initiative to improve health literacy in order to help patients receive the information necessary to guide their own healthcare. CHS recognizes the difficulties in transitioning between care sites and levels and how imperative it is for patients to understand and adhere to treatment plans.
Another common need in most communities is quality mental-health care. In North and South Carolina, as in many other areas across the country, behavioral health is in a crisis situation. CHS is building a $36-million behavioral-health hospital to meet this need and provide high-quality inpatient care.
“We are devoted to increasing capability to address this currently unmet need,” Ray said. “In our current environment, this isn’t a business line that is going to be profitable, but it is needed to benefit our community.”
Increasing connectivity
In the coming years, CHS is focused on increasing connectivity and collaboration through its hospitals and care site. The system has an electronic medical record deployed in all ambulatory, acute-care, and post acute-care sites. Six hospitals have achieved Healthcare Information and Management Systems Society (HIMSS) Stage 6 for implementation.
“We are focused on continually improving not only quality of care, but also coordination of care,” Ray said. “We want to use our scale and turn it into synergy that’s meaningful for patients and communities. We plan to grow integration, alignment, and connectivity.”
-by Patricia Chaney
