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September 30, 2014

Academic medical centers a dying beast?

Staff photo Dr. John Halamka, chief information officer at Beth Israel Deaconess Medical Center in Boston, delivers the keynote address at Worcester Business Journal's forum, Worcester2025 Health Care, on Tuesday morning.

A cross section of health care leaders made predictions for the next 25 years of the industry at Worcester Business Journal’s Worcester2025 Health Care forum Tuesday morning, and not all bodes well for area providers.

Delivering the keynote address Tuesday was Dr. John Halamka, chief information officer at Beth Israel Deaconess Medical Center in Boston and a practicing emergency physician.

Halamka foretold a grim future for academic medical centers to a packed house of health care stakeholders at Coral Seafood Restaurant in Worcester.

“The academic medical center is a dying beast,” Halamka said.

Halamka wasn’t trying to offend colleagues participating in Tuesday’s panel, including Dr. Eric Dickson, president and CEO of UMass Memorial Health Care (UMMHC). He was addressing a hard truth that Dickson and other panelists also acknowledged Tuesday: When it comes to health-care delivery in the future, the lowest-cost setting will prevail.

This is good news for the retail health care clinics, like MinuteClinic owned by CVS, which have been popping up in Central Massachusetts and across the country in a post-Affordable Care Act environment that favors their more efficient model for treating people with relatively minor illnesses.

Home health agencies and community-based physicians and hospitals also have the opportunity to do well, while large academic hospitals, like UMass Memorial Medical Center in Worcester, must reinvent themselves.

“I think John’s comments are spot on in terms of (academic medical centers) … If they don’t reinvent themselves, they are dying beasts,” Dickson said.

But he thinks it can be done, and that UMMMC will remain relevant well into the future. Dickson said using innovation and technology will allow the hospital and the entire UMass system to deliver better care to patients at a lower cost. Some surgeries that used to require lengthy hospitals stays, for example, are now outpatient procedures, according to Dickson. That’s thanks to new, minimally-invasive surgical techniques.

Meanwhile, UMMHC has cuts its overhead by divesting, Dickson noted. The system sold its laboratory business and Wing Memorial Hospital in Palmer in the last 18 months in order to become more efficient.

Halamka: IT streamlines care, providers will see softening of regulations

Much of Halamka’s address focused on information technology and how it’s being employed by providers to deliver more coordinated care to patients. The federal government is requiring providers to adopt electronic health records (EHRs) and illustrate they’re using them in a meaningful way by October 2015.

That’s generally positive, according to Halamka, because providers in different locations can share information about a patient’s health in order to deliver more effective treatment. Still, Halamka questioned whether the health care industry is ready to adopt this technology across the board.

“The EHRs are actually capable but the ecosystem and the culture isn’t totally ready,” Halamka said. He noted that revised regulations will be announced in the coming weeks that may give providers more options for complying than prior regulations.

The federal government is also requiring providers to standardize the coding system for identifying medical conditions — a large administrative burden, Halamka said.

Also participating in Tuesday’s panel were Dr. Armin Ernst, president and CEO of Worcester-based Reliant Medical Group; Steven MacLauchlan, president and CEO of Saint Vincent Hospital in Worcester; and Dr. Tobias Barker, vice president of Medical Operations at MinuteClinic.

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