The hospital’s 2014 annual report, presented to Oxford City Council June 16, reflects an 11 percent drop in the number of inpatient discharges from 2013 to 2014. The hospital also continued to spend more money than it brought in, resulting in a margin loss of $1.4 million in 2014.
“You can tell there’s a trend there and it did impact last year our total revenues, net revenue and our bottom line,” Hehemann said at the June 16 council meeting. “… That of course is a trend none of us want to see and can tolerate.”
Hehemann affirms though the hospital is in “solid financial shape” due to having a “good amount of cash on our balance sheet.”
The affiliation agreement with TriHealth, reached in January, includes a $17 million commitment from the Cincinnati health system. That included $9.5 million spent to install and launch the electronic medical record system Epic.
TriHealth will also dedicate $3.5 million to expand clinical services and $2.5 million to support an expansion and renovation of the emergency department.
“We’re working hard with our new affiliate TriHealth to address future admissions, future outpatient volumes, future programs, specialty visits, more primary care providers in the community, a little bit greater outreach and community marketing programs to try to convince folks that the hospital is providing as good as care here as anywhere else you can receive in the Cincinnati Dayton marketplace,” Hehemann said June 16.
By late July, the community will start to notice six new exteriors signs at the hospital reflecting its affiliation with TriHealth with new colors, logo and name.
A technology ‘Big Bang’
The hospital on July 1 not only launched its brand new electronic health record, but replaced all phones, computers, and adopted the “TriHealth portfolio” of about 30 modules used in all clinical and business departments, said Pam Collins, chief patient services officer at McCullough-Hyde.
“We took every system we’d been using and replaced it with TriHealth’s,” Collins said, dubbing it “the Big Bang.”
Everything from payroll, accounting, billing, purchasing, pharmacy, laboratory, email domain and how physicians manage patient data is fully integrated into the TriHealth system. The investment totaled $10 million.
“We’re not only improving on the clinical side and being able to deliver more efficient care, but on the business side of things, we’re taking a giant leap forward to be on the same platform as TriHealth,” Hehemann said.
Collins said at midnight July 1, there were about 80 workers from TriHealth on site to make sure the conversion went smoothly. They will continue to help with the transition and have been training staff since May.
“It’s been exciting; our staff were ready,” Collins said. “Epic is a regional standard in health systems in Cincinnati and Dayton.”
John Ward, chief information officer for TriHealth, said the nice thing about Epic is that all the modules — including radiology, imaging, obstetrics, oncology, heart monitors and laboratory — continuously “flow into Epic” to provide up-to-the-minute information on X-rays, images, lab results and more. He said physicians can also access the system remotely.
Collins said the hospital hopes its affiliated physician offices will adopt Epic too. Pinnacle Orthopaedics and Sports Medicine — now part of TriHealth’s Orthopedic and Spine Institute — moved to Epic at the end of June.
Dr. Kami Park, board certified in family medicine, said she splits her work between the private practice Oxford Internal Medicine and as a hospitalist for McCullough-Hyde. She said the launch of Epic has gone well and called the system “efficient.”
“The physicians are happy with it for the most part,” Park said. “TriHealth has done a lot to help us prepare and provides a ton of support.”
Park said Epic is “much easier” to use when compared to the hospital’s previous system.
“The flexibility to personalize the system to meet individual physician needs; it’s more adaptable,” Park said.
Ward said Epic enables the hospital to run specific reports based on populations and chronic diseases, such as diabetes or high blood pressure. That way the clinical staff can better identify patients that need more outreach and education.
Over the past six months, Ward said TriHealth has been converting McCullough-Hyde’s historical patient information, going back at least seven years, to be accessible in Epic.
“At all ambulatory sites and hospitals, their information is available,” Ward said. “It creates a better continuity of care for patients.”
Another perk of Epic is its “Care Everywhere” initiative that launched in 2013. It allows any hospitals enrolled to share patient information when needed.
Ward said if a local patient is injured while on vacation or in a different city, that hospital can access their medical history. Since 2013, TriHealth has exchanged 5 million patient records with 140 organizations in 43 states, according to an April statistics report from Epic.
Patients in Oxford now have access to MyChart, an online patient portal, where they can view their lab results, ask their physician a question, or request an appointment.
Future construction
A major construction project at McCullough-Hyde will begin in October. The hospital will spend $12.3 million to renovate and expand its emergency and surgical departments over six phases.
“Since 2010 we’ve had a plan to update emergency department and operating rooms; it’s the most needed area of facility improvement,” Hehemann said.
The emergency department will grow from the current 6,800 square feet to 15,000 square feet, Collins said. After construction it will have 12 rooms of equal size — some of the existing rooms are too small for even a stretcher, Collins said.
“The project will create a more efficient, larger, more modern and safer space, ultimately improving community access to enhanced emergency services,” according to the 2014 annual report.
The ambulance entrance will remain, but a new lobby will be built out fronting Poplar Street between the ambulance entrance and main entrance of the hospital.
“There will be a new waiting area but the goal is they will be taken straight into triage and care will begin,” Collins said.
Within the 12 emergency rooms, one will be a dedicated trauma room with space for two patients. There will also be a “multi-purpose room” for three needs — a secure room for psychiatric or suicidal patients; a negative pressure room for infectious diseases; and decontamination.
Plans for the surgery department include adding a fourth operating room and two more endoscopy rooms. The surgical suites will also be moved to become more central to the hospital.
“To modernize, enlarge, and create more efficient operating rooms and supporting floor space to improve access for the community to enhanced surgical care,” according to the annual report.
The architect is Champlin Architecture and construction manager will be Messer Construction. Hehemann said a builder will be contracted in September to begin in October.
The new emergency department should be ready by fall 2016. A timeline for the surgical department hasn’t been set.
Cost will be $6.8 million for emergency department; $5.5 million for the operating rooms; and $1 million in equipment, according to Hehemann. TriHealth has committed $2.5 million to the project, and the hospital will launch a capital campaign in September to raise a minimum of $1.5 million.
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