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Using maternity-care episodes as templates for improving patients’ experiences


Sanjay Shah, director of strategic innovation at Dignity Health, told FierceHealthcare that when the California-based system considered how it could improve  patients’ experiences, it decided to look at various  moments along patients’ episodes of care by  partnering with a startup focused on maternity care.

Mr. Shah said that the system wants to expand what it has learned so far to other specialties, including oncology and orthopedics, reports Fierce.

“The vision if this is done well, and so far things are going well, is ‘How do we take that experience and extrapolate to other patient experiences? [Maternity] was one we thought if we did right first we could replicate for others.”

The Dignity Health partner, startup Docent Health, studied Yelp responses for maternity patients at four Dignity facilities in Arizona. It found that more than 60 percent of maternity patients who had posted reviews had a favorable view of the experience.

Fierce said: “Many of the comments in the mined data were related to staff and how the patients were treated, with commentary about the hospital staff mentioned in 43 percent of the studied reviews. The study also identified a surprising area these patients were less interested in: Just 2 percent of reviews mentioned billing, an interesting discovery as the costs for maternity care can fluctuate widely.”

Docent has also conducted “welcome calls” about 15 weeks out from delivery to get ideas on what patients expect from care. “The organization identified top requests from expectant mothers, information that organizations can use to benefit other types of patients,” Fierce reported:

  • “Offer a tour: Some pregnant patients would like the opportunity to visit the labor floor and the maternity ward before they give birth.
  • “Provide clear instructions prior to registration: It can be confusing for some patients to understand the requirements for registration and how they can learn more about the care a facility provides.
  • “Ask about prior experiences: Pregnant patients who have had children before want to share their experiences, and that information can be valuable for clinicians to get a better idea of what works and what doesn’t.
  • “Make referrals easy:Expectant mothers will need to set up pediatric care quickly. Offer resources that can speed up that process.”

T0 read more, please hit this link.

Dignity to use non-clinicians to assist expectant mothers


San Francisco-based Dignity Health is offering assistance to expectant mothers with a pilot program using trained nonclinical staff. It’s part of the ever increasing use of non-physician clinicians and non-clinicians to address the increasing service and cost challenges of medicine today.

The program, to be piloted at Dignity Health’s Marian Regional Medical Center, in Santa Maria, Calif., and at Chandler (Ariz.) Regional Medical Center, will use software to help those staff members, called docents, work with patients during their cares at no extra charge to patients.

“Docents will work in conjunction with our clinical care teams, but their roles will differ notably,” says Rich Roth, chief strategic innovation officer at Dignity Health, told Hospitals & Health Networks. “Docents will be fully focused on cultivating relationships with patients and learning their preferences so that we can provide a patient experience that meets the individual needs of the mother-to-be.”

Mr. Roth said that the docents would use technology combined with kindly care to create customized “patient journeys” that take into consideration individuals’ medical histories, preferences and concerns.

“The focus is on an issue most health systems prioritize – to transform the patient experience,’’ Paul Roscoe, CEO of Docent Health, the 18-month-old company  providing technology and services to Dignity for the program. He added that many of the docents have a customer-service background, including in the hospitality industry.

Mr. Roth said that Dignity Health,  which operates in 22 states, may  expand the service to other clinical departments, depending on the  pilot program’s results.

To read more, please hit this link.

Dignity Health in talks to link with an academic medical center


The headquarters of Dignity Health.

San Francisco-based Dignity Health has begun talks with an academic medical center (whose name it wouldn’t disclose) in the Bay Area, as it continues merger talks with Catholic Health Initiatives.

Dignity Chief Financial Officer Daniel Morissette  told analysts that  the system is interested in a possible joint venture with an academic medical center because it would benefit Dignity’s four hospitals in the Bay Area by having a teaching hospital connected with them.

He told analysts that two of Dignity’s hospitals in the area were profitable and two were “challenged.” By connecting with an academic medical center,  the hospitals would be part of a bigger provider network to seek contracts and improve performance, he explained.

To read more, please hit this link.

Dignity-CHI link’s plus and minuses


The talks between Dignity Health and Catholic Health Initiatives on affiliating or doing an outright merger have led analysts to point out  that a link could produce some economies of scale and take advantage of the systems’ complementary geographies but  that there are also some big potential problems, such as the systems’  huge debt.

Moody’s Investors Service says that a merger between the two would be “a net positive.”

An outright merger would create America’s largest not-for-profit hospital company, with combined annual revenue of $27.8 billion and 142 hospitals. The current leader, St. Louis-based Ascension, has annual revenue of $20.5 billion.

San Francisco-based Dignity has leading market-share positions in Southern California, the San Francisco Bay Area, Arizona and Nevada. Dignity has 39 acute-care hospitals and 250 ancillary-care sites.

CHI’s 103 hospitals are  situated where Dignity has none. The system, which posts annual revenue of about $15.2 billion, has 11 big multi-hospital hubs. Modern Healthcare noted that  Englewood, Colo.-based CHI’s hospitals are spread over 22 states, “providing economic diversity that makes it less susceptible to reimbursement pressures in a single state or region that might or might not have expanded Medicaid, for instance.”

But Fitch Ratings says that both systems have high debt, and both have underperformed financially in the past year.  In the case of CHI, that led Fitch to downgrade  CHI’s debt three notches from A+ to BBB+ with a negative outlook.

The publication noted that “high debt levels can be worrisome in an industry going through massive changes in reimbursement from fee-for-service to value-based payments and constant demands for capital to buy new IT systems, upgrade clinical equipment and open patient access points.”

“The teams  {of the two systems} wrestling over whether to join forces will focus on big-picture issues—such as whether larger scale would produce costs savings, better care and a stronger credit structure—so they can reach a conclusion by early 2017. ”

To read the Modern Healthcare article, please hit this link.

Dignity Health and CHI mull merger

The not-for-profit giants have signed a nonbinding agreement to evaluate “an alignment” between the systems.

A  merger would create the nation’s largest not-for-profit hospital company with combined revenue of $27.6 billion ahead of the $20.5 billion of  Catholic-sponsored Ascension. A CHI-Dignity union would make it the second-largest not-for-profit hospital system, with Kaiser Permanente continuing as the largest.

The companies didn’t disclose terms of the agreement, but did  cite   their new partnership, called the Precision Medicine Alliance, which the two systems called America’s largest community-based precision- medicine program.

The  companies’ statement  cited ways in which they say the systems complement each other. For example, Englewood, Col.-based CHI has 103 hospitals in 18 states and focuses on clinical and home-health services in addition to research while Dignity “is well known for its work with innovative, diversified care-delivery partnerships.”

San Francisco-based Dignity Health, with 39 hospitals, operates in 22 states with 9,000 physicians, 62,000 employees and 400 care centers.

To read the Modern Healthcare article, please hit this link.

Dignity, CHI launch precision-medicine program

Two major nonprofit integrated-delivery networks, San Francisco-based Dignity Health and Englewood, Colo.-based Catholic Health Initiatives, have formed what might be  America’s  largest precision-medicine program.

The Precision Medicine Alliance — a partnership formed as a limited-liability corporation between the two health systems — will make genetics-based diagnosis and treatment available at almost 150 community hospitals serving a total of  about 12 million patients a year..

The organization’s initial project  will  focus on diagnostic tumor profiling. Eventually, the program will move into predicting risk of cancer and cardiovascular disease, as well as into pharmacogenomics.

The partnership is  aligned with the  Obama administration’s Precision Medicine Initiative.

Please hit this link to read the whole article.

Urgent-care centers seen continuing to surge



A 2014 whitepaper from McGuireWoods and the Urgent Care Association of America predicted that the urgent-care industry will continue to surge,   estimating that some large metropolitan areas could support two to three times the number of current urgent-care providers than they do now (or at least in 2014).

There’s a sign of this  in Revelstoke Capital Partners’ recent acquisition of SCP Urgent Care, doing business as Fast Pace Urgent Care.

From Becker’s Hospital Review, here are  seven things to know about the transaction in particular and  urgent-care centers’ growth in general.

“One of the players in the transaction is Brentwood, Tenn.-based Fast Pace, a provider of urgent-care and primary-care services. Since 2013, the company has grown from seven clinics in Tennessee to 36 clinics in Tennessee and Kentucky. The growth came primarily through opening 26 new locations and acquiring three locations. Fast Pace is a portfolio company of Shore Capital, a Chicago-based private equity firm focused exclusively on microcap healthcare investments. The other player in the transaction is private-equity firm Revelstoke, which focuses on building healthcare and business-services companies.”

In other notable recent transactions:

Last November, Nashville-based Hospital Corporation of America bought Urgent Care Extra’s Nevada operations, which include 14 urgent-care centers in Las Vegas.

In February, San Francisco-based Dignity Health said it was teaming with Atlanta-based  in a  venture to bring consumer-focused urgent care to the Bay Area.

In August 2015, Boston-based Partners HealthCare announced plans to open as many as 12 urgent-care clinics.

Becker’s noted that these investments are driven partly by the large numbers of  active patients older than 50 who want more convenient care for injuries and illness while being linked to larger systems where their regular physicians may practice and where visits to urgent-care clinics can become part of their medical record.

To read a McGuireWoods white paper on this, please hit this link.

To read a Becker’s Hospital Review overview on this, please hit this link.




Using urgent-care centers to boost population health



Golden Gate Bridge at night.

In this FierceHealthcare interview, Todd Strumwasser, M.D., Dignity Health’s senior vice president of operations for the San Francisco Bay Area, talks about the role of the system’s 12 planned joint-venture urgent-care centers in the San Francisco Bay Area in enabling better management of population health, cutting costs and sharpening focus on the sickest patients.

To read the article, please hit this link.

Using Google Glass for EHRs


Sacramento-based Sutter Health, San Francisco-based Dignity Health, Colorado-based Catholic Health Initiatives, Cincinnati-based TriHealth Inc. and a fourth investor that asked to remain anonymous have made  a combined $17 million investment in Augmedix Inc., a San Francisco startup that uses Google Glass technology to maintain electronic health records and thus free physicians to spend more time with their patients,The Sacramento Bee reported.

The combined systems have more than 100,000 health care providers treating millions of patients nationwide.

Officials said that the  funding will let Augmedix and its investors expand the Google Glass-powered service across health systems and private clinics nationwide.



Wide north-south divide in Calif. health costs


The Golden Gate Bridge, serving a high medical-cost kingdom.


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