Keeping health care local: University of Utah Health Care teams up with community hospitals in five states to improve access to care.

AuthorStewart, Kirsten
PositionTIMEOUT FOR HEALTH

The elderly woman arrived weak and confused at Teton Valley Health, a community hospital in the remote town of Driggs, ID. Doctors suspected a stroke, but were unsure about whether to transport her to the nearest stroke center for clot-busting therapy.

Time was short. The therapy can prevent disabling brain damage and must be given within hours of a stroke, but it carries a risk of brain hemorrhage and is not administered lightly to patients who must be closely monitored. "That's why we're really careful with it," said University of Utah Health Care (UUHC) vascular neurologist, Jennifer Majersik, whose telestroke team was summoned to examine the Teton Valley patient remotely, via videoconferencing technology. "We concluded it was a TIA (transient ischemic attack), which had already resolved on its own, sparing this woman the unnecessary risks of treatment, and the cost and inconvenience of a transport."

For many years, the university's telestroke program, one of the oldest in the country, has been beaming the clinical expertise of neurologists into underserved areas. This cost-effective, "hub and spoke" approach to care delivery is now being applied more broadly as the foundation of a new, collaborative business strategy: Affiliations.

These non-ownership collaborations enhance care by bringing high-end specialists to small communities that don't have the patient volumes to support hiring their own. They allow community hospital groups to retain local control. And they benefit larger health organizations by building closer connections to referring partners.

"In most cases our affiliation agreements formalize longstanding relationships that we, as the region's only academic medical center, already have with hospitals throughout Utah, Idaho, Wyoming, Colorado and Nevada," said UUHC's CEO, David Entwistle. With the signing of its 12th affiliation agreement late last year, the university doubled its affiliation network, and has plans to add more.

Unlike mergers and acquisitions, affiliations don't change ownership or governance. "Our affiliate partners are strong, locally operated hospitals that understand the needs of their communities," said Tad Morley, UUHC's Vice President of Outreach and Network Development. "Our job is to be their bench strength, to provide the depth and breadth of services they need to continue to successfully serve their patients."

The contracts start broad in scope and develop organically. "It's really an umbrella...

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