A Great Decision for Our Country…. Our Work Continues!

Today, the Supreme Court announced its decision that the Patient Protection and Affordable Care Act is indeed constitutional. This was a great decision for our country. Our health care system is not meeting the needs of the American people, it is too costly, and it is placing unacceptable burdens on our industries, especially on small businesses, where most of our jobs are created. The Affordable Care Act sets in motion many necessary changes to get us to better health, better care, and lower cost.

We of the GBMC HealthCare system have been worried that the law would be found unconstitutional but we were committed to moving forward with the transition of our system to a "fee for health" model no matter what the justices decided. Now, we will have no excuse! It’s now clearly on us. We must stay in action.

We have a great hospital, a great hospice, great doctors, and great nurses. We have great clinicians of all sorts and a wonderful leadership team and fantastic support staff. Everyone is working very, very hard. We have come a long way and the metrics support this. But we have a long way to go to get to perfection for every patient, every time. We have a long way to go to create the system of care that is integrated and that anticipates what the patient will need before she needs it.

But we are well on our way. At our hospital, errors and near misses are now much more likely to be reported and our “time to action” in using what we learn from errors to redesign the system is shorter. Our people are now much more likely to understand the causes of patient harm, that people make mistakes and that we must design systems to mitigate the effect of human error.

In the hospital, we have appropriately moved to electronic ordering and record-keeping to make information necessary for the care of a patient more visible and reliably available. We have embedded many evidence-based order sets in the computer system to help assure that patients get the right care.

We are measurably cleaner and measurably better at communicating with our patients. We have created a better organizational model for empowering our physician leaders. It is very hard to create the necessary workable structure to get private-practicing physicians to believe that they have a voice and that it is heard. I think we are closer now to that reality.

We have been known at GBMC as being a great surgical hospital. We have recruited a number of surgeons from other hospitals who have begun working at GBMC to fill gaps and to restore our surgical case volume. When the evidence is that a patient needs surgery, we want it done in our hospital.

We have created the Greater Baltimore Health Alliance and have welcomed nearly 20 privately practicing primary care providers to go with our nearly 80 employed primary care providers to serve as the fulcrum of integration. They are nearly all now using the same electronic outpatient record and that information is available to clinicians throughout our system. In a few weeks, we will begin implementing our electronic medical record in specialists’ offices and connecting our record to those specialists who already have their own computerized record. We are looking forward to GBHA being accepted as an accountable care organization in the very near future. We will have our first GBHA Board meeting and our first Specialty Advisory Board meeting by the end of the month and we hope to have some exciting news to report around July 10^th!

Our GBMA primary care offices have extended their appointment hours and the GBMA leaders are working on an after-hours plan the will reduce the need for the use of non-integrated urgent care centers. Our Hunt Valley office has achieved level 3 patient-centered medical home status and by the end of the year, the rest of the offices will have achieved the same distinction. We have implemented our patient portal, myGBMC, so that the patient can get access to his or her records and help coordinate his or her own care. On August 1, we will launch our new Geckle Diabetes Center. Building on our diabetes educational center, we will now have a team that oversees diabetes care throughout our system and that will be actively working to continually improve diabetes outcomes and avoid hospitalizations.

We have recreated our employee health insurance plan to attract our people to stay within our system for their care. This new plan will give us the opportunity to generate better health and care for our own workforce and their dependents.

These are certainly exciting times. They are times of change for the better. Our community needs us to do this. Future generations are desperate for us to be successful. We must keep moving towards our vision.