Lahey Clinic: Fully Integrated Care
Physician Group
Written by Amanda Gaines   
Tuesday, 01 January 2008
Lahey Clinic: Fully Integrated Care - Health Executive - RedCoat Publishing
Dr. David Barrett outlines the elements that led this integrated group practice to success.
Lahey Clinic is playing catch up. In the late ’80s and early ’90s, the multi-specialty group practice experienced a piece of the growth of other similar organizations, but as a not-for-profit organization, there wasn’t enough revenue to expand.

Lahey Clinic: Fully Integrated Care - Health Executive - RedCoat Publishing
Dr. David Barrett, President and CEO
In the early 2000s, the organization decided to undertake a robust philanthropic campaign to raise money for a $135 million expansion. It succeeded in raising the funds, and not a moment too soon. In the past eight years, in addition to doubling its revenue, the demand for Lahey Clinic services has grown at an exponential rate.

When determining where to expand, the administration wanted the project to focus on areas that could provide an almost immediate ROI, especially because the project was funded using philanthropic dollars. “We went to our grateful patients, corporate donors, foundation, and board and laid out our expansion plan, which included new hospital beds, ORs, ICUs, and procedural areas,” said Dr. David Barrett, president and CEO. “The strategy was based on the strong demand for service, and as a tertiary referral center and academic medical center in the suburbs of Massachusetts, we needed to respond to that demand.”

Phase one of the $135 million expansion was completed in December 2005 when the organization expanded its Burlington medical center by adding 36 patient beds, 150,000 square feet of hospital and clinical space, an expanded recovery room, a 24-bed ICU, five ORs, and a four-level parking garage. Then, in January 2007, the organization finalized plans for a $50 million expansion at its Lahey Clinic Medical Center, North Shore. The project will add 63,500 square feet to the 162,000-square-foot facility, which will include a larger ED and two new floors of expanded medical services..

“Like at our Burlington location, the Peabody medical center is a very convenient destination for people seeking healthcare,” said Barrett of the location’s proximity to the North Shore Mall. “By adding that square footage, we will be able to keep up with the demand.”

Digitized environment
In addition to the Burlington and Peabody locations, Lahey Clinic has 11 group practices located across the Commonwealth of Massachusetts and a third medical facility in Lexington. With roughly 500 physicians and 5,000 support staff members, facility expansion wasn’t the only way in which the organization needed to grow.

In November, the organization announced it had selected Allscripts as the vendor of choice to develop and implement an organization-wide EMR. As with many healthcare institutions, Lahey is moving to a completely digitized environment. It already uses Meditech and IDX for its billing and scheduling system, and the implementation of the Allscripts clinical piece will allow for a fully integrated patient medical record.

“We already have one medical record for each patient, so if a patient comes to internal medicine and is then transferred to orthopedics, that entire medical record follows them to any of our locations,” Barrett said. “Allscripts lent itself to that type of medical practice, and it will interface with our Meditech and IDX systems. Lahey also plans to add a portal system developed by Orion that will allow affiliated doctors and hospitals to integrate with Lahey regardless of the type of electronic medical record they may have.”

A product has yet to be selected for Lahey’s hospital setting, but Barrett said it will need to fit into the Lahey continuum of care that calls for one medical record, in the same way the ambulatory piece (Allscripts), set to be fully implemented in 2008, will be. “This system will reduce our redundancies while making it easier for physicians and patients to maneuver through our system.”

Fully integrated practice
Collaboration with internal and external customers is an important element of the Lahey culture. As a fully integrated group practice, most of the organization’s physicians are salary based and work together with the patient as the primary focus. One of the more unique elements of the culture is that the doctors and the medical centers work together as one corporate structure.

“For clinical innovation to really make a mark, you must have collaboration between healthcare professionals, but in many locations, there is a subtle adversarial relationship between hospitals and physicians,” Barrett said. “Here, it’s all one system. What’s good for the hospital is good for the doctor, and vice versa, and we extend that practice to other healthcare providers in our region.”

Although that mentality has been a part of the Lahey culture since its founding in 1923, fostering it is not always easy. It was therefore understandable when the American College of Healthcare Executives named Barrett Healthcare Executive of the Year in June 2007. It was also understandable when Barrett thanked his fellow coworkers when he received the award.
“This award would not be possible without the dedication of Lahey’s nurses, physicians, and staff,” he said at the time. “We are a team determined to improve healthcare in Massachusetts.”

And he wasn’t exaggerating. In September, Leapfrog chose Lahey Clinic as one of 33 adult hospitals to be designated a Leapfrog Top Hospital out of 1,285 hospitals that participated. And in October, the Premier healthcare alliance recognized Lahey Clinic as one of only 49 hospitals in the US to be in the top 1% of acute inpatient facilities of the 4,700 facilities eligible for the award. According to Barrett, these awards are recognition of the organization’s dedication to patient safety and clinical excellence.

“I come to work everyday concerned about how this organization is performing, not only as a considerate provider but also in delivering the highest quality and safest healthcare,” he said. “We are equally focused on the quality, safety, and caring of our patients and of our physicians and personnel. We won’t let up on our dedication, but these awards mean we’re, at the very least, on the right track.”
 
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