Health & Hospitals System Board Meeting March 26, 2010

A speaker in the public comment period related his bad experience which involved duplicate dental x-rays and a prolonged wait for dental services which in the end were not available, which information should have been known prior to referral. The Board recognized it as indicative of poor quality service and referred the issue to the Quality Committee.

Chairman Warren Batts reported on his visits to four Ambulatory & Community Health Network of Cook County ("ACHN") clinics. He found one adequate and the others very limited. Among deficiencies were few computers to expedite record keeping.

His remarks coincided with this month's Board Education, which was on the status of Information Technology. There has been progress, but equipment is still not adequate to implement Electronic Medical Records. The capital investment would be ~ $1.2 million. CCHHS would now have a rating of 4, having moved from a 1 in 2007; the ideal would be 6 to 7. About 50% of U.S. hospitals are below the ideal rate. December is the target date to eliminate paper documentation. Nursing is lagging and needs an advisory committee to expedite. With all hospitals now on one system, scheduling and billing should improve.

CEO William Foley discussed progress on leadership goals. There has been a delay in moving accounts payable and payroll functions to the CCHHS from the County. Using two different systems delays action, but a resolution appears near. Assessment of manager restructuring should be complete by July 1, leading to workforces changes. The goal is a reduction in costs of $106 million. He referenced the recently passed Health Care Reform legislation and noted one downside in its reduction in DSH allocations by the State. He also anticipates that public hospitals will have to compete with private hospitals for the increased number of Medicaid eligible patients. He projects a need to address clinics and primary care and a new demand for specialty care, better regional access, and the need to improve quality and manager accountability. The Strategic Plan continues to be refined.

In the Strategic Planning process, the consultant sees uncovered populations, more demand and a competitive marketplace. Overall goals continue to be accessible care, ease of entry, accountability, quality, continuity and cost-effectiveness. The big issues are potential re-configurations, ACHN clinics, Fantus Clinic, partnerships and community engagement. The next meeting of the Board on April 30 will be primarily a Retreat session to focus on the Strategic Plan.

With regard to partnerships, a joint consulting project with University of Chicago regarding use of Provident Hospital was discussed. Thus far a 5 week process has included a market assessment to determine the community need. It revealed a very fragmented market in the service area with more than 50% of inpatients out-migrating. Questions remain regarding the need for inpatient services at Provident. Both parties want to postpone furthur consideration until issues, including governance and capital improvements are resolved. The future of Provident Hospital is an important piece of the Strategic Plan.

Committee minutes were approved.

--Submitted by Observer Nancy Staunton