Lifespan investing in patient-centric health care

CARE DELIVERY: Lifespan President and CEO Dr. Timothy J. Babineau said that at its “fundamental centerpiece,” health care revolves around the exchange of information. / COURTESY LIFESPAN
CARE DELIVERY: Lifespan President and CEO Dr. Timothy J. Babineau said that at its “fundamental centerpiece,” health care revolves around the exchange of information. / COURTESY LIFESPAN

Lifespan, Rhode Island’s largest hospital network and private employer, with more than 14,000 employees, is investing more than $100 million over the next four years to redesign its health care delivery system, to make it more patient-centric, according to Lifespan President and CEO Dr. Timothy J. Babineau.
A significant part of that investment is the building of a new IT infrastructure, using Epic hardware and software, the same technology company chosen by Partners Healthcare in Boston, one of the largest and most prestigious hospital networks in Massachusetts.
The new IT system will connect all the hospitals and departments within the Lifespan system under one technology platform, eliminating “fragmentation and silos” in the delivery of care, according to Babineau.

PBN: How would you describe what Lifespan is building in terms of its new health-information-technology system?
BABINEAU: Lifespan is about to undertake a fundamental redesign of the way it delivers care within its system, supporting by new IT applications. As I have told the board and our physicians, this is not just an IT project, it is a fundamental redesign of care delivery, supported by a new IT infrastructure.
It is being led more out of my operations shop, rather than my IT shop.
Lifespan is redesigning and re-engineering its health care delivery model.

PBN: Why did you decide to make the change?
BABINEAU: I’ve been CEO at Lifespan for five months. George [Vecchione, the previous CEO], did a spectacular job for 14 years. George brought a particular viewpoint to the system; as a physician, I bring a distinctly different view.
I am committed to make Lifespan a patient-centered [hospital system]. It will be transformative, hard, and gut-wrenching, but it is absolutely the right thing to do for our patients.
PBN: When will it be operational?
BABINEAU: The work is going to begin this spring. We are looking at the strategy [through the lens] of how we want to deliver care moving forward, to eliminate fragmentation in care and in IT systems and standardize workflow. Much of the hard work that needs to be done has nothing to do with putting in the IT software. It involves process-mapping how care is delivered across the system. There are a dozen different ways that patients can be registered into the system. It dovetails with [our work] with lean and six-sigma processes that is all about creating standards in workflow.
One of the things that I am challenged with doing is keeping the enthusiasm going and managing the expectations. It’s not about flipping a switch and everything is perfect. We are starting a journey that will take two and half to three years to complete.

PBN: Is this change similar, say, to a kind of Copernican revolution, where the hospital is no longer at the center of the health care universe?
BABINEAU: In many ways, in the health care universe, for the last 50 years, hospitals have been at the center. … Now, we need to create a system where the patient is at the center, coordinating care around the convenience of the patient, and not a hospital schedule.
If we are to bend the medical-cost curve, [this is where] we need to start.
I need to be careful, as I go out and talk about this, to emphasize that we can’t throw the baby out with the bathwater. Lifespan’s hospitals [and staff] are tremendous, there are so many things about them that are excellent. As we try and create a new future, we need to acknowledge that they are jewels in the crown and not mitigate their value.

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PBN: What is the overall cost of designing the new system of care and building the new IT infrastructure?
BABINEAU: I have received board approval to spend more than $100 million over the next three-to-four years. Well less than half of that is in the IT software. [The major] cost is in redesigning health care, it’s not the licensing fee to Epic.

PBN: What do you see as the value of the new IT system?
BABINEAU: At its fundamental centerpiece … health care is about the exchange of information. We want to be exchanging information at the point of care, so that providers have the information they need to make decisions in real time. Today, much of the information flow is fragmented, some is on paper, some in the desk draw, some of it is in the patient’s primary care office. What we are creating is a seamless, integrated flow of information across the patient’s continuum of care.
We need to think beyond the hospital walls, about the patients before they came to use, and what happens after they leave us.
That’s one of the very appealing aspects of the Epic platform. It’s an integrated platform, centered on the patient, irrespective of the geography of care.
One of the huge advantages of joining the Epic family is that Epic has been around for 20 years, and it being used in some of the best health care systems in the country. As gut-wrenching and as big a change [as this is], we can borrow a lot from other high-performing medical systems, building upon what others have done and has worked well.

PBN: How important will population-management analytics be as a strategic tool, with the goal of moving from volume to value in health care reimbursements?
BABINEAU: Population-management analytics is the holy grail. We are still very far away from being able to manage a patient population in ways that we can do it appropriately.
It’s a great goal, and what we’re about to do with [our new care design and health IT system] will enable us to get to that promised land.
But there are many other steps along the way.
Where we are as a health care system, we have the information, we have the data, we have the cost of care. We are ready to take on the health care needs of a patient population. It’s a great goal, a great idea, but we are a long way from it.
For 23 years, I have been a practicing physician and health care administrator, and based on when I talk to my colleagues in highly integrated health care systems, systems that are several years ahead of us, population management scares us. •

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