challenges for small rural hospitals

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Atlantic General Hospital & Health System To create a coordinated care delivery system that will provide access to quality care, personalized service and education to improve individual and community Our Mission:

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Response by Michael A. Franklin, FACHE, President/CEO, Atlantic General Hospital/Health System

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Page 1: Challenges for Small Rural Hospitals

Atlantic General Hospital & Health System

To create a coordinated care delivery system that will provide access to quality care, personalized service and education to improve individual and community health.

Our Mission:

Page 2: Challenges for Small Rural Hospitals

AGH Population Density Map

Each Dot equals 100 People

MD Core

MD Secondary

DE Core

DE Secondary

Source: ARC GIS and 2010 US Census data.

Page 3: Challenges for Small Rural Hospitals

AGH Service Area Population

• Berlin ZIP Code (21811) has an estimated population of 23,573 and accounts for 63% of the Maryland Core service area (MDC) population, and 21% of the total service area.

• The Berlin (21811) and Millsboro, DE (19966) ZIP codes combine to equal 41% of the total service area population.

• The total service area has an estimated population of 110,018.

• The total service area has TWICE the percentage of people in the 65+ age cohort than the state or US.

MD Core Name 00- 17 18- 44 45- 64 65+ Total%of MDC %of Total

21811 BERLIN 4,405 5,845 7,214 6,109 23,573 63% 21%21842 OCEAN CITY 1,472 2,826 3,387 2,822 10,507 28% 10%21813 BISHOPVILLE 533 592 787 410 2,322 6% 2%21841 NEWARK 155 191 223 114 683 2% 1%21872 WHALEYVILLE 125 152 190 105 572 2% 1%

MD Core Total 6,690 9,606 11,801 9,560 37,657 100% 34%MD Secodary Name %of %of Total21851 POCOMOKE CITY 1,702 2,084 1,859 1,195 6,840 39% 6%21863 SNOW HILL 932 1,510 1,370 933 4,745 27% 4%21850 PITTSVILLE 679 880 685 312 2,556 15% 2%21874 WILLARDS 669 827 635 272 2,403 14% 2%21864 STOCKTON 109 157 140 81 487 3% 0%21829 GIRDLETREE 82 125 123 71 401 2% 0%

MD Secondary Total 4,173 5,583 4,812 2,864 17,432 100% 16%DE Core Name %of DEC %of Total19975 SELBYVILLE 1,288 1,735 2,291 2,267 7,581 91% 7%19944 FENWICK ISLAND 62 102 282 300 746 9% 1%

DE Core Total 1,350 1,837 2,573 2,567 8,327 100% 8%

DE Secondary Name %of DES %of Total19945 FRANKFORD 1,632 2,282 2,406 1,667 7,987 17% 7%19966 MILLSBORO 4,045 5,459 6,536 6,074 22,114 47% 20%19939 DAGSBORO 1,129 1,558 1,825 1,419 5,931 13% 5%19970 OCEAN VIEW 960 1,281 2,383 2,226 6,850 15% 6%19930 BETHANY BEACH 301 506 1,359 1,417 3,583 8% 3%19967 MILLVILLE 25 27 46 39 137 0% 0%

DE Secondary Total 8,092 11,113 14,555 12,842 46,602 100% 42%Total Service Area 20,305 28,139 33,741 27,833 110,018Total Service Area 18% 26% 31% 25% 100%Maryland 24% 36% 27% 13% 100%United States 24% 36% 26% 13% 100%Source:ThomsonReuters Healthcare

2011 Population Estimates

Source: ARC GIS

Page 4: Challenges for Small Rural Hospitals

ICU TELEMEDICINE

Page 5: Challenges for Small Rural Hospitals

Rural Maryland Hospitals Form Unprecedented Collaborative to

Improve Patient CareMon Apr 28, 2008 10:00am EDT

Page 6: Challenges for Small Rural Hospitals
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MED/SURG CONNECTIVITY

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care.connection

• Decreased noise• Improved patient satisfaction• Increased patient safety

Personal units installed in each patient room October 2012 in conjunction with room redesigns

Connection with PERKS upon project go-live

Page 12: Challenges for Small Rural Hospitals

eStrategy Continues…eCare – July 2010• Remote 24 hr monitoring of critical patients in ICU

Wireless phones provided to nursing staff – October 2012• Connection to telemetry• Nurse call• Text capability• Scanners for those giving meds

Additional cardiac monitoring capabilities – October 2012

Introduction of Smart Pumps – coming in February 2013• Increases safety in medication administration

Page 13: Challenges for Small Rural Hospitals

PSYCHIATRIC TELEMEDICINE

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Page 15: Challenges for Small Rural Hospitals

LookingAhead

for our Community

How do we accomplish a Patient Centered Medical Home?

Improved Communication within Healthcare Community

Patient Portal

Faith Based Partnership

Page 16: Challenges for Small Rural Hospitals

Health Care Innovation Awards: Maryland  ATLANTIC GENERAL HOSPITAL CORPORATION   Project Title: “Expand Atlantic General Hospital’s infrastructure to create a patient-centered medical home”Geographic Reach: MarylandFunding Amount: $1,097,512Estimated 3-Year Savings: $3,522,000Summary: Atlantic General Hospital Corporation, which serves largely rural Worcester County, Maryland, is receiving a grant to improve care for Medicare beneficiaries with either a primary or admitting diagnosis of congestive heart failure, chronic obstructive pulmonary disease, or diabetes, who currently rely on high cost ER visits and Acute Care admissions. The corporation plans to expand infrastructure and create a Patient-Centered Medical Home, increasing access for patients needing non-emergency episodic care and reducing hospital admission rates and emergency department visits for these Medicare beneficiaries.Over a three-year period, Atlantic General Hospital Corporation will create three new jobs and train 75 workers. New hires will include a patient care manager, a patient advocate, and a care team coordinator.

Page 17: Challenges for Small Rural Hospitals

Achieved NCQA Level 2 Recognition for Berlin Primary Care & Townsend Medical Center locations in Oct. 2012

Received $1.1 million federal grant in July 2012 from CMS to expand PCMH to Health System PCP offices for Medicare patients

• Recruitment of a care coordination team underway

• Funding also includes purchase of 12 computers for Faith-Based Medical Home partners

Patient-Centered Medical Home