When it comes to collaborating with other healthcare providers, academic medical centers and health systems can have trouble making connections, says Tim Goldfarb, CEO of Gainesville, Fla.-based UF Health Shands, an affiliate of University of Florida Health.
"Community physicians and hospitals see academic places as aloof and really uninterested in what they do," he says.
However, UF Health (formerly UF&Shands) is far from detached when it comes to improving community care in
Although the two healthcare organizations are still crafting the protocols needed to fully implement the network, Mr. Goldfarb says once it's finished it could potentially expand to include interested community hospitals and medical groups and might serve as a foundation for accountable care organizations, albeit not ones that would encompass both UF Health and Orlando Health.
"We're separated by a hundred miles and a couple hours driving so it's unlikely you'd have a single Medicare ACO that would straddle that geographic footprint," he says. "But…once you have that infrastructure in place, that infrastructure could be used by the Orlando Health team to build ACOs in the
Mr. Goldfarb says the network originated with discussions Orlando Health and UF Health began about a year ago in anticipation of the industry's shift toward emphasizing population health management. UF viewed
The two organizations' educational affiliation began in 1991, and, in fall 2010, they announced they would collaborate to form joint clinical programs in pediatrics, neuroscience, oncology, women’s health, transplantation and cardiovascular medicine. They also expressed their intent to develop compatible electronic medical records and information systems and tackle other initiatives to provide better, more accessible care.
In their work to build the clinical integration network, Mr. Goldfarb says the health systems have established a clinical and financial data management team serving both organizations, presenting information specific to a particular physician, patient or population of patients.
Orlando Health and UF Health have also implemented interoperable technologies so they can share data across the spectrum of care, from outpatient to inpatient.
Another aspect of the network's infrastructure involves population health management expertise. "UF Health has a team of people who do case management and longitudinal care review" for the hospital's Medicaid population, Mr. Goldfarb says. "We're using the things that we've learned from that effort, and we're combining those teams and that infrastructure piece into the clinical integration network as well."
The network isn't quite fully operational yet. The two health systems still have to develop joint protocols for participating physicians. They plan to use existing protocols available from groups such as the American Society of Clinical Oncology.
"When the infrastructure and the protocols come together, we will truly have an integrated product that we could discuss with payers," Mr. Goldfarb says.
However, he emphasizes that the initiative isn't driven by payer contracting concerns and advises other healthcare organizations seeking to develop similar networks not to view them primarily as business ventures.
"The reason you're doing it is to take care of populations of patients in a very consistent way," he says. "If you concentrate on that issue, all other things will follow."
Although academic entities like UF Health may have trouble convincing community providers they're interested in more than the business side of a clinical integration network, Mr. Goldfarb says it's possible to win the hospitals' and physicians' trust. He says UF Health has spent months in discussions, getting to know providers personally and gaining a level of understanding.
"We must and we do convince prospective partners that we're not the smartest people in the room, we're not arrogant, and we really want to partner to improve patient care," he says.
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