In health care, it's all about access

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In the last three weeks, Yale New Haven Health and its affiliates have cut the ribbon on a new inpatient geriatric psychiatric unit at Westerly Hospital and announced plans to develop a health center on the Mohegan Tribe’s reservation, where YNHH will serve as the preferred provider for tribal members and employees.

Company executives soon will return to Westerly Hospital to celebrate the opening of a Smilow Cancer Hospital Care Center there.

Hartford HealthCare opened a new health center in Pawcatuck in August, not long after breaking ground on a $24 million medical building off Interstate 95 and Coogan Boulevard in Stonington’s Mystic section. In September, it opened a new cardiology unit in Norwich.

Clearly, the corporate consolidation of health care in the region has occasioned greater access to medical services, a trend marked by more than the proliferation of brick-and-mortar facilities.

“Southeastern Connecticut is very important to Yale New Haven Health’s vision and strategy. At L+M, that’s the reason for our affiliation,” said Patrick Green, president and chief executive officer of L+M Healthcare, which includes Lawrence + Memorial Hospital, Westerly Hospital and the Visiting Nurse Association of Southeastern Connecticut.

“It’s all about providing high-quality, timely access to care,” Green said. “People rely on us for emergency care, specialty care, primary care. We've been committed to that right from the start. The question was whether we were going to try to move a lot of that care to New Haven — that was never the plan.”

Green said YNHH’s investment in Westerly is evidence of its commitment. A study of the community detected the need for both the geriatric psychiatric unit and a cancer treatment facility.

The Smilow Cancer Hospital Care Center in Waterford had opened in 2013, prior to L+M’s affiliation with YNHH.

“When I wake up in the morning, I start thinking about how we can provide access to care that’s convenient,” Green said. “It has to be at the right time, at the right place and at the right price. We’re a low-cost provider. It’s part of our mission to treat people regardless of their ability to pay.”

Competition among providers is a factor in the number of satellite medical facilities that has sprouted in the region, a factor neither Green nor Jeffrey Flaks, Hartford HealthCare’s president and CEO, seemed eager to explore.

“This is a very unique moment in health care,” Flaks said in a recent interview. “Today, the work we’ve done over the last decade to build and integrate our system has matured. Now we can really make a difference in patients’ lives.”

Electronic record-keeping and other technological advances also are key to fostering greater access to health care.

Flaks said Hartford HealthCare, for example, has been aggressive in implementing CareConnect, a digital system that links patients and providers to medical records and test results, and facilitates communication, appointment-making and billing. Tens of thousands of patients have been enrolled in the system.

Flaks, clearly a CareConnect fan, related how it worked when his teen-age son sustained an ankle injury. Flaks' son accessed the system via a smartphone app to make an appointment, choosing the most convenient location from among several available in the Hartford HealthCare network. He was directed to a particular room at the facility he chose and was preregistered in advance. When he arrived, his records already were being displayed on a monitor. A nearby radiologist was ready to read his X-rays and communicate with his primary physician.

“It was all happening around us,” Flaks said.

Hartford HealthCare and Yale New Haven Health, which also has implemented electronic record-keeping, have embraced telemedicine, another innovation that can improve access to care. In telemedicine, a patient can communicate with a physician or other health care professional in another location via a Skype-like application that provides video and voice communication between computers, tablets and mobile devices.

“We can’t replicate the services we provide in every community we serve, so telemedicine — virtual visits — can be an option in some cases. We’ve been doing it for a couple of years now,” Green said. “If my primary (physician) in New London wants me to see a neurologist in New Haven, we can have that telemedicine right here.”

Looking ahead, Flaks said health care providers will seek to provide even greater access to care by remotely monitoring patients.

“If we can engage people in their homes, we can foresee things and perhaps intervene more quickly,” he said. “Personalized medicine is emerging.”

A Hartford HealthCare physician demonstrated the benefits of remote monitoring earlier this year when he inserted a tiny sensor into a heart patient’s pulmonary artery in an outpatient procedure at The William W. Backus Hospital in Norwich. The battery-free device transmitted data to the doctor’s office, enabling the doctor to prescribe medication changes without requiring the patient to make an office visit.

Green, too, touted the promise of patient monitors, “predictive analytics” and other ways of increasing access to care. Still, he said, YNHH will continue to invest in infrastructure, as it’s been doing at Westerly Hospital and at L+M, where it is undertaking an $81.6 million expansion and renovation of its emergency department.

Of course, Green said, health care providers have to stay focused on wellness — “trying to keep people from getting sick in the first place.”

Ultimately, he said, "people want health, not health care.”

b.hallenbeck@theday.com

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