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Winter 2006 - Vol.1, No.3
Out of The Hospital, But Not Out of Touch!

Jan L. Bergen
Senior V.P., Ambulatory Care, and Chief Mission Officer

Advancing technology, heightened efficiency, and increasing cost pressures on employers and consumers, are changing the delivery of healthcare in America. Consumers increasingly expect diagnostic and treatment options to be less invasive and available in outpatient settings. Expectations about service are expanding as people seek health care during non-traditional weekend and evening hours. Consumers now take for granted and deserve such conveniences as scheduling and registration on-line, same day appointments, immediate access to results, and concierge level services. It is increasingly challenging for healthcare providers to meet and exceed those expectations, particularly within the outpatient setting, while still maintaining the overall financial stability of the health system.

Lancaster General has responded over the past decade by placing seven community-based outpatient facilities throughout Lancaster County in areas such as Elizabethtown, Willow Street, and Lititz, as well as in Lancaster city. Our goal is to provide cost-efficient services such as clinical laboratory, physical therapy, and basic radiology within 10 minutes of where people live or work. The specific array of services at each site varies according to the unique health needs of that community, so before developing a new ambulatory center, we analyze health data and trends, and interview consumers, community leaders, and physicians. To improve overall access to care, we also strive to complement diagnostic and treatment services with primary and specialty physicians whenever possible.

Sites that serve small populations can provide basic services efficiently, whereas some highly specialized services can only be delivered efficiently at the Health Campus, which serves a larger patient population. Our ability to offer diverse services there is the direct result of partnerships established with primary and specialty physicians that share our vision for the Health Campus, which is currently home to more than 40 practices. These include the specialties of ophthalmology, internal medicine, cardiology, rheumatology, dermatology, general surgery, urology, and plastic surgery, among others, comprising an aggregation of expertise that facilitates sophisticated outpatient services such as surgery, endoscopy, renal dialysis, and pain management.

Physicians and hospitals nationwide are finding new ways to work together to improve the quality and efficiency of health care. Locally, this type of clinical and business partnership is exemplified by The Physicians’ Surgery Center, Lancaster General, in which 32 physician investors are working with Lancaster General to create a state-of-the-art outpatient surgery center. By aligning financial and human resources and creating shared incentives, we can deliver highly coordinated care in a convenient location at lower cost. In years to come, we expect similarly compelling benefits to prompt other physician-hospital partnerships not limited to surgical environments; they could include shared clinical leadership, and joint ownership of facilities and technology.

Finally, it is a key aspect of Lancaster General’s organizational vision to enhance community benefit by making sure that all residents receive equal access to superior inpatient and outpatient care regardless of their ability to pay. Accordingly, we are partnering with physicians, other hospitals, and Federally Qualified Health Centers (FQHCs), to build a system of outpatient care that is responsive to the needs of the medically underserved.

In Lancaster City, this will require an expansion of capacity in our clinics and FQHCs that provide primary care and basic outpatient services to the uninsured or minimally insured. In the rural reaches of the county, we are pursuing other models of care. Through the volunteer efforts of hospitals and physicians, we hope to assure that all county residents have a “medical home,” i.e. a relationship with a primary physician and hospital that assures coordinated health care. Otherwise, the uninsured will continue to rely on hospital emergency rooms as their primary healthcare provider. While that unfortunate habit is not unique to Lancaster, we are committed to reversing that tendency in our community. Entirely aside from the fact that such a routine is costly and inefficient, it constitutes bad medicine because it deals only with acute illnesses, and ignores the need for preventive care and maintenance of wellbeing.

Lancaster General is committed to improving the health status of the communities we serve. By providing ease of access to high quality outpatient services, and continuously working to meet or exceed our customers’ expectations, we strive to serve as an essential healthcare resource for Lancaster County.