Ed Epperson: Right way to advance community healthcare

In today’s continually evolving healthcare climate we must be flexible in how we deliver on our mission to improve the health and well-being of the communities we serve. What society has come to expect from healthcare providers is quite clear; deliver more care, with greater patient satisfaction, at lower cost, and at a higher quality ... all at the same time.

A lot to ask? Possibly, but we think these expectations aren’t only necessary, but the right thing to do. The biggest challenge for us is successfully executing these expectations.

Carson Tahoe has always sought excellence in its care, while at the same time expanding the services it delivers to the community. Our quality scores continue to go up, and our costs have been well-managed. Yet we realized several years ago our ability to continue these successes as a standalone entity would be increasingly difficult.

To provide some context — 15 years ago, Carson-Tahoe Hospital realized we had outgrown our facility on Fleischmann and sought to increase services for the community. In realizing this, the next steps were to either remain a public, community hospital; sell to a larger healthcare system; or stay independent and become a private nonprofit 501 (c)(3) organization. After much consideration, and deliberation, the board agreed staying independent would be the best decision for our community. And, with a triple “A” bond rating, we were perched and ready to fly.

We identified an 80-acre parcel at the north end of town and the rest is history. Today, the regional medical center, and the medical campus, are the center for our region’s healthcare essentials, a major employer in our community, and for many — a place of hope and healing.

Fast forward 12 years, and the healthcare scene is evolving at an even faster pace and as unpredictable as ever. In 2013, we realized it was again time to expand our scope of services in order to give our community access to the best possible care, close to home. Once more we had three choices: to remain exactly as we were, become part of a larger healthcare system, or remain independent but partner with a larger research and teaching facility.

The answer was clear. We would adopt a strategy to affiliate with a tertiary teaching health organization … and the search began. In the early stages of exploration, many of us imagined we would be affiliating with a Northern California organization such as UCSF or Stanford. But an interesting thing occurred as we evaluated the affiliation possibilities … our search took us east and University of Utah Health (UUHC) emerged as the preferred partner.

Through the exploration period, we learned we had a lot in common with UUHC; a commitment to provide the highest quality care and ensure the community served is a healthy place to live, work, and thrive. UUHC has ranked among the top 10 teaching, research facilities in the West for the past decade. Its cost to patients is less than half that charged by similar providers, it has great leadership, and an extraordinarily kind, patient-centered staff.

In 2013 Carson Tahoe became an affiliate of University of Utah Health (UUH) and in 2015 we expanded to include a secondary association between the University’s Huntsman Cancer Institute (HCI) and our cancer center. At the time, we were the eighth hospital to affiliate with UUHC; today there are 20; but we’re still their largest and western-most affiliated hospital.

Through these strategic alliances, our community can tap into the world-class research, support and educational resources associated with one of our nation’s top academic institutions.

Some of the benefits of this collaboration include implementing higher standards & protocols to align with UUH; increased access to a wider array of care options such as second opinions and clinical trials for cancer patients; cardiovascular surgery back up; local outpatient management for patients with a challenging medical condition such as a bone marrow transplant; emergency telestroke care where a stroke patient can be “treated” by world-renown physicians at UUH remotely upon arrival at our emergency department; and other countless opportunities.

Most recently, Carson Tahoe’s affiliation is allowing us to transition to the Epic electronic health record system. This software has the capability to maintain electronic medical records while supporting functions related to patient care, registration, scheduling, and billing. Additionally, clinical support for physicians, nurses, and other care providers will be incorporated. Nationally more than 190 million patients have an electronic healthcare record stored in Epic, and that number grows daily. True to its name, Epic is designed to be secure, efficient, and relatively easy to manage; allowing our physicians and staff to concentrate more on quality patient care while maintaining the ability to effectively document accurate patient records.

Without the backing of a major research and teaching healthcare institution such as UUH, Carson Tahoe wouldn’t be able to secure such elite software.

Our affiliation also provides our management team with wonderful resources that otherwise wouldn’t exist. Examples include: physician clinic management, physician leadership training, process improvement, and patient flow expertise. Each of these advantages would be much more expensive, or even cost prohibitive on our own.

In summary, the recent evolution of national healthcare reform has made one thing clear — without partnerships and collaborations, growing to meet the needs of an increasing population is virtually impossible. Fortunately, Carson Tahoe’s size, financial stability, and independent status continue to be advantageous in terms of adaptability and delivery of higher-level services. Through joining forces, Carson Tahoe is poised to continue to provide leading-edge care for generations to come.

Ed Epperson is CEO Carson Tahoe Health.