"The Ronan Report" provides insight about the activities at the Western Maryland Health System in Cumberland, Maryland, and about the changes taking place in healthcare today from a CEO's perspective.

Thursday, May 28, 2015

Defining Population Health

A few months ago, I was asked to assist Adam Levenson, who is with the Masters in Health Administration program at George Washington University, and participate with other thought leaders in health care to help define Population Health.  The sense is that there is no set definition of Population Health, but you will see that there are some interesting responses.  I have attached the link to the GW Blog and the responses from me and the other thoughts leaders.  I hope that you find it useful.


Tuesday, May 26, 2015

The Trip of a Lifetime

I am finally back from a two-week vacation to Italy.  The reason for the trip started last year when my son-in-law was going through a horrific battle with cancer.  Throughout much of last year, he had close to 60 chemotherapy treatments as an inpatient and his knee and part of his femur were replaced this time last year.  It was certainly a year that we would all like to forget. Since his last chemotherapy treatment in mid November, he is doing well.  

During the course of his many treatments, Pamela suggested that after all of this is done, we needed to take a trip.  She suggested Italy, while they were thinking a week at the beach somewhere.  Pamela wanted them both to have something very special that they could look forward to and it worked.  Jessica had never been to Italy and Terrell was there the summer after graduating from VMI but doing so on a very limited budget.  Both were very excited.  So, what do we do with Lauren, who had already been to Italy when she was in high school and then with the Naval Academy Glee Club. (She actually got to sing in St. Peter’s at the Vatican on that trip).  Of course, we took her as well.  After all she had just completed ten years in uniform serving our country, it was the least that we could do!  

The trip was an overwhelming success.  Everyone had a wonderful time and I have hundreds of photos to prove it.  We saw some unbelievable places and if you haven’t had to opportunity to visit Italy, I would highly recommend it.

Wednesday, May 20, 2015

Keeping the Brightest and Best Right Here at Home

Guest Blogger:
Karen Johnson, Executive Director
Western Maryland Health System Foundation

Fourteen years ago, the Western Maryland Health System Foundation made a commitment to provide scholarships for local students pursuing higher education as healthcare professionals.  Using donated funds, scholarships were developed, with generous terms offering as much as $5000 per semester.  This spring, the program crossed a significant milestone:  to date, over $1,000,000 has been committed to WMHS scholars.  One hundred sixty-four individual students have been given the chance to fulfill their dreams.  Untold thousands of patients have been cared for by those very students.  

While a wonderful opportunity for students, admittedly, this strategy was to our benefit as well.  In addition to supporting local students, our vision was to grow a pool of local talent to serve the Western Maryland Health System community.  To borrow a phrase, our hope was to keep “the brightest and best” right here at home.  And that is exactly what has happened.

Take Amy.  She knew she wanted to be a nurse from earliest childhood, and applied for a WMHS scholarship as a high school senior in 2003.  Since graduating from the nursing program at Allegany College of Maryland, she has been a valued employee in the WMHS Emergency Department. In May, 2015, she was named Employee of the Month, cited as an excellent clinician with a passion for her work, a dedicated team member and community (EMT, firefighter) volunteer.  Now that’s a great investment!

In April, we announced our latest group of promising scholarship winners:   Samantha Jones, Chloe Bauermaster, Teresa Kline, Kimberly Adams, Pamela Jenkins, and Carla Weaver.  In an interesting commentary on today’s ever-changing healthcare arena, each woman is already an RN and pursuing a bachelor’s degree in nursing.  

The WMHS Foundation is honored to be a part of making dreams come true.  And in addition to the original scholarships, we now manage scholarships for several individuals or families who have established those opportunities.  If you would like to consider creating a “health care dream” scholarship, we’d be happy to help you.  The Foundation number is 240-964-8003, or email me at karenjohnson@wmhs.com.  

Wednesday, May 13, 2015

Hospital Week Recognition

In recognition of Hospital Week, I am both honored and blessed to have the opportunity to work with some amazing people day in and day out. During this week at WMHS, we are also recognizing the years of service anniversaries for over 300 employees, with 22 having over 40 years of service.  The dedication of these employees continues to be remarkable and the recognition so very well deserved.  

This is my 40th year to be in health care and I have been fortunate enough to have celebrated Hospital Week for that many years. Throughout my career in health care, I have worked with thousands of exceptional people over these many years and how they have served our patients, families and each other has been with unwavering dedication.  The support that has been provided, the care that has been rendered and the lives that have been saved continues to go almost unrecognized outside of health care.  The media has an unfavorable view of health care with the exception of nurses, who have the greatest trust as a profession.  Thank God for our nurses!  

In 2013, when I was asked to sit for an interview with the New York Times on our (very unique to the industry) value-based care delivery model, I was extremely reluctant. But, I did.  Fortunately, the interview went very well and the article was both very well written and favorable toward health care.  Since then, there has been incredible recognition of our care delivery model and it has been achieved through the success of our clinical providers, nurses, care coordinators, community health workers, pharmacists, technicians, therapists, service providers and the list goes on.  We continue to be blessed!  Enjoy the recognition this week as it is so well deserved.

Wednesday, May 6, 2015

Ever Increasing Visits to the ED, Really?

The other day there were a series of stories that some ED physicians were seeing a dramatic increase in ED visits nationwide.  Virtually, every news outlet carried the results of a survey that was conducted by asking 26,000 ED physicians their impressions as to the volume that they are seeing in their EDs.  Seventy-five percent of the 2,000 respondents indicated they were experiencing an increase in ED visits since the Affordable Care Act (ACA) took effect.

It is important to note that not all EDs are seeing increases in volumes; in fact of those surveyed, 5% saw a decrease.  At WMHS, we have seen a decrease over the last two fiscal years from 58,164 visits in 2012 to 52,555 visits in 2014.  We have achieved that intentional decrease by increasing primary care practices throughout the community, partnering with area urgent care centers, bolstering our own urgent care centers to keep the level 1 and 2 patients out of the ED and treat them in less intensive settings, delivering more care outside of the acute care setting, delivering much more care in the home, as well as paying more attention to the sickest of the sick and better addressing their chronic conditions in the primary care arena and within our Center for Clinical Resources.  

We continue to work with our ED partners, MEP, on our value-based care delivery model.  They support our ED, as well as manage our Observation Unit, provide practitioners for our SNFist Program (hospitalist type services in area skilled nursing facilities) and we are in discussions with them to provide coverage in other areas of the health system.  We work with them in partnership.  They understand the shift from volume-based care delivery to value-based care, and we are constantly exploring new opportunities to benefit them, our patients and WMHS.

The numbers may be increasing now nationally with so many more individuals being covered through the ACA and Medicaid, as has been the case in Maryland.  However, that will have to change going forward to achieve the objectives of the ACA through a new primary care infrastructure and a host of other initiatives in caring for patients in the most appropriate setting.  As the nation follows Maryland's lead in reducing care that is provided in the ED, as well as the acute care setting, you will see an overall decline in ED and other related utilization.

Thursday, April 30, 2015

Pinnacle Award

Last evening, we celebrated our Values in Action awardees from May 2014 through April 2015 (aka Employees of the Month).  The 12 awardees are invited to bring family, friends and co-workers to join with them in the celebration.  The evening culminates with selecting one of them as the Pinnacle Award winner (or Employee of the Year).  

The Values in Action Committee has to select the Pinnacle Awardee, which is a very challenging job.  These employees do some amazing things on the job as well as in their personal lives; they are truly stars.  We are so fortunate to have many of these types of individuals throughout WMHS and the Trivergent Health Alliance.  

Well, last evening our Pinnacle Award winner was Leona McTaggert, Activities Coordinator at Frostburg Nursing and Rehabilitation Center (FNRC).  She is the first Pinnacle Award winner from FRNC and we are thrilled with the outcome.  To hear her co-workers and residents say such wonderful things about her is so rewarding.  They say when she walks in the building or a room, she lights it up.  Leona goes above and beyond day after day to bring joy to lives of the FNRC residents, and we are honored to have her at FNRC.  

The Value in Action Awardees
May 2014             
     Lois Cook - Information Technology
June 2014            
     Adele Rice - Behavioral Health
July 2014             
     Jane Adams, RN - Hospice
August 2014        
     Kevin Niemeyer - BioMedical Engineering
September 2014  
     Barbara Lamberson - WMHS Clinics and Practices
October 2014       
     Kim Jackson - Care Coordination
November 2014   
     Jeffrey  Hobbs, RN - Emergency Department
December 2014    
     Leona McTaggart - Frostburg Nursing and Rehabilitation Center
January 2015       
     Anita "Chere" Thacker, RN - Medical Oncology
February 2015      
     Mary Walker, Environmental Services
March 2015          
     Laura Lepley - WMHS Clinics and Practices
April 2015            
     Jill Mazzeo - Financial Services

I had the honor of presenting the Pinnacle Award to Leona,
along withKevin Turley, Vice President of Operations.

Wednesday, April 29, 2015

The Cause and Effect of Standing Down

It was evident on Monday afternoon, evening and night that the Baltimore City Police were ordered to stand down.  On Tuesday morning, there were numerous police experts commenting on news shows as to the embarrassment that they felt for their brothers and sisters in blue.  Being pelted with rocks, bottles, bricks, paint cans and trash cans on fire and not being able to do anything.  Allowing businesses to be looted and burned to the ground and not being able to do anything, but just stand there.  The comments and actions, or lack thereof, from the leadership at Baltimore's City Hall will have ramifications for years to come.  By allowing the lawlessness to occur and the Mayor actually saying things like "we gave those who wish to destroy the space to do it" and the Police Commissioner saying "people ask why we didn't act faster--these are 14, 15 and 16 year old kids who should know better but they are still kids, we had to take that into consideration."  The businesses in Baltimore will pay dearly for those comments as well as the actions of those "kids" primarily with ridiculously high insurance premiums.

Even those businesses that were not affected will see their premiums rise significantly.  Someone will have to pay for those astronomical claims that the insurers will have to pay to those businesses affected by the riots or those that simply has their business interrupted due to safety concerns, closures or curfews.  Every time there is a report of a hurricane, home owners in hurricane prone areas receive a premium hike in their wind, hail and flood insurance almost instantaneously.  I exaggerate, but not by much.  These businesses will be severely impacted in so many ways: decisions to rebuild / reopen; can I afford to stay in business; do I relocate to a safer section of the city; will the police and City Hall have my back the next time; will tourism and conventions dry up for the next several years; the questions are endless.

I am not one to openly criticize another executive unless I have walked in their shoes.  I have never dealt with riots, thank God.  I have learned that although you can't prepare for every possible situation, you have to be as well prepared as you possibly can; that didn't seem to be the case on Monday.  One would have thought that after Ferguson, Missouri, every big city would have gone to school on what happened there and had a plan to address rioting, looting, lawlessness, etc.  I have also learned that under such circumstances you need to be heavily scripted and well prepared when dealing with the media; that too didn't seem to be the case in Baltimore.  I have admired Mayor Rawlings- Blake from a far since she won her last election with 86% of the vote.  The last week was, if anything, a great learning experience for the leaders of Baltimore.  Hopefully, all will go to school on what happened and Baltimore will be a much better city as a result.