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San Diego Health Care Supplement to: sddt.com/healthcare09 Friday, January 30, 2009 / Vol. 124, No. 22 Wireless health care growing industry, source of future jobs By PADMA NAGAPPAN independently, through wire- dent and co-founder of the explore the many opportuni- lic, was founded in San Diego Philometron , an early-stage Special to the Daily Transcript less sensors that inform them WLSA, which was formed in ties to use wireless technolo- in 1999 and still houses its company working on distrib- Advances in wireless tech- about movements and 2005. The organization gies to advance the delivery of research unit here, although it uted wireless human sensing nology have made it possible changes in their blood pres- brings together all the key health care. The organization has shifted its headquarters to technology. to transmit data from remote sure, etc. players in one place, to create works to close the gap Conshohocken, Penn. Awarepoint has developed a locations, free consumers who At the center of this exciting partnerships, licensing deals between wireless information It developed a mobile car- radio frequency (RFID) tech- were tethered to old-fash- new field that affords increased and financing. technologies commonly used diac outpatient telemetry nology and real-time location ioned communication devices mobility and freedom to “Important activity was tak- in other industries and the device that provides real-time system for hospitals and and open up a whole new field patients and continuous moni- ing place all over the world in systems used by health care monitoring and round-the- patients; and Santech, a start- — wireless technology for toring for physicians and care- this space, and to place San facilities and the pharmaceu- clock analysis and response up focusing on weight man- health care. givers is the industry organiza- Diego on the map, we needed tical sector. for patients, who could be at agement, uses an accelerome- The convergence of these tion Wireless Life Sciences to connect the various stake- Developments in wireless home, traveling or at work. ter in tandem with a GPS and two areas has enabled medical Alliance, which helps compa- holders. I contacted Qual - devices for health care have Other companies involved heart rate monitor to track the staff to remotely monitor the nies leverage San Diego’s comm, Motorala and others heated up in recent years, and in advancing wireless health patient’s location, activity vital signs of patients with advantage wireless technology and we set up the WLSA annu- San Diego is now home to care technology include Vocel, level and their daily diet. chronic ailments or those as well as life sciences. al summit,” said Sobrian, who roughly 30 companies in this which developed the Pill recovering from surgery who spearheaded the initiative. fledgling industry. Phone medication reminder; ViSi from Triage Wireless can now be discharged earlier. The facilitator The WLSA facilitates the CardioNet (Nasdaq: Triage Wireless , which is Triage, founded in 2004, It also facilitates caregivers to Camille Sobrian, COO of opportunity for life sciences BEAT), the first company in working on a noninvasive vital keep track of seniors who live CONNECT, is also the presi- and wireless companies to this emerging field to go pub- signs monitoring device; and See Wireless on 6 Saving primary care medicine, the foundation of a rational health care system By JOSEPH E. SCHERGER the primary care level is lost. San Diego County Medical Society NPs and PAs are part of the The collapse of primary solution in primary care, but care medicine has been in there remains a critical need the news for several years, for primary care physicians. and the problem is getting The history of primary worse. Recently, only 2 per- care medicine has several cent of today’s medical stu- ups and downs over the past dents indicated they wanted 50 years. Prior to and after to go into primary care. World War II, most physi- Training programs in pri- cians were general practi- mary care are closing. Two tioners (GPs). The 1960s hospitals in Phoenix in the saw the first “age of special- past month have indicated ization,” and very few med- they would no longer train ical students became GPs. In family physicians. Most resi- 1969, a new specialty, family dency positions in general practice, was born, and internal medicine and fami- there was a resurgence in ly medicine are filled with the 1970s as family practi- doctors educated in other tioners replaced GPs as the countries. new breed of family doctor. Yet primary care is the FPs experienced a decline foundation of any rational in the 1980s similar to today, health care system. Studies as high-tech medicine began have shown that the overall to flourish and many spe- Photo: Ben Benschneider (Southwest Washington Medical Center) health of a population cialist incomes became Daylight in the patient’s room enhances patient comfort and promotes healing while adding to the sustainability of the facility. depends more on primary much greater than those of care than the number of FPs and general internists. Daylighting in the health care environment specialists. Preventive medi- cine and common health problems are best treated in Internal medicine is the largest specialty in medi- cine, yet in the 1980s and the need for pain medication. tions such as The Center for pain and took 22 percent less primary care, saving the today the great majority of How sustainability Here in California and in Health Design (CHC) analgesic medication per hour, more serious and unusual internists subspecialize into can improve lighting, many other states, code (www.healthdesign.org) have resulting in 20 percent less problems for specialists. fields that have higher requirements and mandates analyzed several patient sce- pain medication costs. If not physicians, who will incomes, such as cardiology, hospital operations, for LEED and other sustain- narios as it relates to daylight Effects of day and night on fill the gap in primary care? gastroenterology and der- patient outcome able design measures require in hospitals. Their findings, infants: Preterm infants who Nurses have stepped up and matology. attention and detail to how along with numerous other were exposed to a night/day created programs to train FPs and general internists By DENISE FONG daylighting can be positively studies that have been con- pattern of light spent more primary care nurse practi- made a comeback in the and JEFF HANKIN deployed. The results are bet- ducted, show the benefits of time sleeping, less time eating, tioners (NPs). Physician 1990s with the beginning of Sparling ter facilities, improved finan- daylight in the healing process. gained more weight, spent assistants (PAs) have managed care (HMOs). Daylight is often linked to cial performance, happier Sunlight and pain medica- fewer days on ventilation and emerged and are providing HMOs looked at FPs and sustainability as a key design employees and healthier tion: In a recent study, 89 phototherapy, and displayed primary care in many set- general internists as “gate- element that provides many patients. patients undergoing elective enhanced motor coordination, tings. However, NPs and keepers” and realized lower benefits. Exposure to daylight cervical and lumbar spinal compared to infants who were PAs work best when they health care costs if everyone in the health care environ- Benefits of daylight surgery were assigned to both exposed to constant light and work with physicians as had to be seen by a primary ment has long been linked on patients sunny and shady rooms fol- noise. It is important to note “physician extenders.” When care physician (PCP) before with patient wellness and staff Evidence-based design has lowing their operations. that intense light may be a NPs and PAs work alone in being allowed to see a spe- satisfaction, and new research shown how natural light Patients who were exposed to danger to the developing reti- primary care, quality may cialist. PCPs are FPs, gener- suggests that lighting can affects patient health and well- 46 percent higher intensity nas of premature infants; this suffer and the efficiency of improve sleep patterns of eld- ness. To promote research- sunlight experienced less per- treating most problems at See Medicine on 6 erly patients, and even reduce informed design, organiza- ceived stress, reported less See Daylighting on 2 Pfizer’s CEO makes big play with $68 billion Wyeth deal By LINDA A. JOHNSON With it come a trove of vaccines, Kindler, a 53-year-old Harvard in July 2006. “It was a moderate-risk, high- The Associated Press biotech drugs, veterinary medicines Law School graduate and former By then, investors were starting probability-of-success type of deal,” TRENTON, N.J. — Jeff Kindler — and consumer health products, legal clerk to U.S. Supreme Court to look ahead to the “patent cliff ” he said. Heupel would rather have took over as chief executive of drug- many as well known as those it gave Justice William J. Brennan Jr., has when generic competition would seen Kindler show “longer-term maker Pfizer Inc. (NSYE: PFE) in up, including Wyeth’s Chap Stick, an unusual pedigree for a pharma- hit Lipitor, the cholesterol treat- vision” by buying technology-driven August 2006, just in time to sign Centrum vitamins and Advil and ceutical CEO. ment that is the world’s top-selling biotech companies with greater off on his predecessor’s $16.6 bil- Anacin pain relievers. He worked as a partner at law drug and the source of $1 out of growth prospects than Wyeth. lion deal to sell off all its iconic con- “He’s done a lot of things in his firm W i l l i a m s a n d C o n n o l l y , as every $4 that Pfizer makes. That’s Monday’s news obscured “dire” sumer health brands, from short tenure,” said Edward Jones General Electric ’s (NYSE: GE) top now expected in November 2011, numbers in Pfizer’s quarterly earn- Listerine to Sudafed — to become a analyst Linda Bannister, from cre- lawyer and as a vice president for and six other drugs with sales total- ings reports, from a big net income pure pharmaceutical company. ating stand-alone business units McDonald’s Corp. (NYSE: MCD), ing more than $4 billion are expect- drop and weak profit forecast to a After 2 1/2 years of layoffs, paring with more accountability to where he was general counsel and ed to face generic competition that slashed dividend and huge layoffs, research operations and other restructuring research and develop- then president of some of its restau- year and the next. noted Heupel. restructuring, Kindler’s first bold ment to get out of areas where rant brands, including Boston Acquiring Wyeth will get Pfizer “We won’t know whether it’s a step — an answer to investor Pfizer doesn’t have a competitive Market and Chipotle Mexican Grill. past the Lipitor loss and was the good deal until we get a few years demands to take action ahead of a advantage. He became Pfizer’s general counsel right choice among large pharma- out and see how well they’ve inte- 2011 revenue crash — is to spend “He’s taken the steps that he and an executive vice president in ceutical companies, said David grated,” Heupel said. “That’s what four times as much to rediversify needed to take internally to get the 2002, moved up to vice chairman Heupel, health-care portfolio man- we’re going to have to grade him on the company by acquiring rival right structure in place” to make and head of corporate affairs in ager at Thrivent Large Cap Growth a year or two down the road.” Wyeth. the big deal, she said. 2005, and then was tapped as CEO Fund. Source Code: 20090130crk 2 FRIDAY, JANUARY 30, 2009 • San Diego Health Care • THE DAILY TRANSCRIPT Close-up: Jason Howe Awarepoint CEO finds growing market for its location systems By ERIN BRIDGES “My daily life has been real- In about eight days, ing initiative, we can track Howe also focuses on build- The Daily Transcript ly going and assessing the Awarepoint can outfit a 1.2 daily living of people at home,” ing and maintaining a good To say Jason Howe and his market and out there evangel- million-square-foot hospital. Howe said. “We can monitor corporate culture. He holds team at Awarepoint Corp. izing for the space, meeting The company’s closest com- how often they are eating, Friday town hall meetings and have been busy this year with customers and making petitor, he said, estimated it sleeping, bathing or using the provides employees with would be an understatement. sure the team is on track,” he would take eight months to toilet.” lunch, institutes programs for Howe, chief executive officer said. cable it. Family members will be able continued learning, and pro- for the company, racked up The company installs and “In eight months, we saved to monitor these actions from vides corporate membership more than 430,000 miles maintains its RTLS in the somebody’s life,” Howe said. home, giving senior citizens at a fitness gym. domestically in 2008 rallying roughly 30 to 40 hospitals that “And we did it at so much less freedom and independence Employees are expected to interest in the company and its already have it. And so far it cost.” while also ensuring their work long hours, but Howe product while understanding has been a successful system. One reason Howe can keep health and well-being. also expects them to have fun. what the market needs, what is “They built something that the cost down is that every- Moving forward into the “Your job is to have fun working and what is not. really makes a difference,” thing can be monitored from new year, Howe will be focus- here,” he said. “If you’re not In November, he announced Howe said. “Even though we San Diego. ing on where the company having fun, you’re not produc- the company raised $13.3 mil- have great financial outcomes, And the payment plan needs to be in the health care tive. If you’re not having fun lion in a Series D round of we’ve had amazing clinical makes the product more market and continue to build and we can’t find a way, this venture capital financing led outcomes.” appealing to facilities, he said. a strong team. isn’t the place for you.” Jason Howe by Cardinal Partners and In at least three cases, the “We’ll outfit a hospital in an “My first job is hiring great Howe views everyone at joined by Venrock and exist- system saved lives at an Army amount of days, and we don’t people,” he said. “I’m a lot Awarepoint as his customer, teamwork. ing investor Avalon Ventures. medical center. charge them until they’re sat- more average than the and has an open-door policy. The last part is important to The funds will help “We were able to get an isfied it’s working,” he said. smartest bear, but I hire really “If I am ensuring that the company’s success, which Awarepoint fuel its growth infusion pump out of service “Then we charge per asset per well.” they’re successful, Awarepoint includes four patents and fil- and meet the demand for real- that was providing 10 times month. We don’t hold them to While the product contin- will be,” he said. “My manage- ings for another 16. time location systems (RTLS) the medicine necessary,” he long-term contracts.” ues to gain popularity and the ment style is one of giving peo- Though Howe is the big in both domestic and interna- said. “It already led to the Right now, the company company grows, Howe said he ple a lot of autonomy. I wel- man in charge, he certainly tional markets. The company’s demise of one soldier and was focuses on acute care facilities, does not expect the San Diego come mistakes, as long as doesn’t try to take all the cred- technologies can improve hos- about to be used on another.” but plans to move into more work force to increase to more they’re made only once.” it. He knows it’s far from a pital process management by Not only is the Awarepoint long-term and assisted living than about 50 people. The Howe said a culture has one-man show. offering location and move- product successful, it also can facilities. new money was in part to been instituted at the compa- “Teamwork is how we get it ment information to remotely be implemented significantly “What really floats my boat draw new engineering talent ny that they call A-POINT: all done.” monitor equipment and peo- faster than a competitor’s is that as the population ages, and to get more service people accountability, passion, objec- firstname.lastname@example.org ple. product, Howe said. and with the independent liv- in the field. tivity, integrity, novelty and Source Code: 20090130cre Daylighting Medicine and business: Strange bedfellows Continued from Page 1 ronments more cost effectively should be considered in the and minimize energy use and By TOM GEHRING force and as community lead- pullback) and extraordinary the ‘70s is gone, and he’s design of NICUs. waste, many incentives San Diego County Medical Society ers who deeply care about the debt (usually between never coming back. As every- Effect of sunlight on infants: through state and national The fundamental tension public good, we cannot accept $200,000 and $250,000 for one seeks to reduce the A study of infants who were organizations now exist to between the Hippocratic an imbalance between the physicians graduating from expense of health care, com- born before, during and after assist health care designers. Oath and the realities of eco- ethos of healing and harsh residency programs), mean petition for the shrinking awnings were built on a facili- Regulations such as California nomics are at the center of economic realities. Yet it that San Diego County is los- compensation dollar within ty’s obstetric ward windows Title 24 and programs such as nearly every significant issue seems the pendulum has ing badly in the race to recruit the physician community over a four-month period the U.S. Green Building in health care today. I joke swung toward appeasing the new physicians. For more increases. This has a number revealed that exposure to nat- Council’s LEED initiative all with my physician, when we demands of economics, than 10 years, a past presi- of unwelcome consequences. ural daylight through glass encourage the use of daylight- are alone in the exam room, resulting in an unsustainable dent of the San Diego County Small or solo physician prac- windows may reduce the rate ing methods and controls. that there are two unseen trajectory for both physicians Medical Society (SDCMS) tices, who cannot compete of neonatal jaundice. Many power utility companies presences tugging her in and patients. and the only specialist in her with their large group and both public and private opposite directions: So what does the future field for a significant portion brethren, are becoming rarer, Design energy conservation organiza- Hippocrates, who laid down hold for patients in San Diego of North County, has been particularly in the more Patient rooms have signifi- tions offer research, planning, the fundamental principles of County? unable to recruit a younger urban portions of San Diego cant opportunity for daylight modeling and often financial healing over two millennia The waits will get longer. doctor to join her practice; County. Health insurance design. The configuration of the assistance to projects utilizing ago, and Adam Smith, the There are multiple data she just can’t pay the young plan reimbursements are con- room elements and the ceiling effective daylighting pro- Scottish preacher who articu- sources that suggest while the physician enough. Not sur- tinuing to ratchet down, heights are key to successful grams. lated the basics of economics overall number of San Diego prisingly, it takes a long time requiring physicians to see daylight design. Patient rest- about two centuries ago. County physicians is ade- to be seen in her office. more patients, and therefore rooms near the core walls rather Conclusions Every physician today, quate, there are many geo- The macroscopic result is spend less time with those than the exterior walls allows Effective daylighting strate- whether a solo practitioner in graphic and specialty areas obvious: The data from patients. A recent article in for better daylight penetration gies help to create a healthy Alpine or one of more than where San Diego County is SDCMS’s 2007 Workforce The Wall Street Journal high- but must be balanced with clin- and sustainable environment 500 Kaiser Permanente unable to recruit and retain and Compensation Survey lighted the use of out-of-town ical requirements to see into the for patients and staff. physicians, has to deal with an adequate supply of physi- indicates that a number of locum tenens, or physician rooms. Keeping the ceilings and Evidence-based research the tension between healing cians. The average middle- specialties, and some primary temps, to handle shortfalls. windows high at the perimeter shows that time-tested light- and economics. More impor- income wage earner is care physicians, are experi- Good luck with that visit to contributes to enhanced day- ing strategies such as daylight- tantly, every patient in San unsympathetic to physicians encing longer and longer the emergency room. The fed- light. Glare control is necessary ing reduce cost and mainte- Diego County is affected, making “less than they waits. eral mandate — referred to by for both optimum examination nance, produce energy savings whether they know it or not. should,” but the harsh reality Finding a doctor who takes the acronym EMTALA — that visibility and patient comfort. It and lead to enhanced patient So why must San Diego is that physician reimburse- Medicare, Medi-Cal or any all patients must be assessed can be achieved using a variety comfort and recovery times. County’s business leaders care ment in San Diego County is other government program and stabilized in the emer- of solutions from window cov- about San Diego County well below average. “Move to will get harder. As the overall gency room is laudable. But erings, to passive light control Fong, IALD, LEED AP and physicians being pulled in Montana, double your pay,” is cost of health care continues the tension between wanting features in the architecture, to Hankin, P.E., LEED AP are two diametrically opposed an appealing recruiter come- to increase — now more than to provide emergency care motorized blinds. principals with Sparling, a directions? As individuals, on. 16 percent of GDP and more regardless of the ability to pay specialty consulting and elec- who sooner or later will need Low reimbursements, cou- than $2.2 trillion annually — and the harsh reality that Incentivizing daylighting trical engineering firm. a physician, as business lead- pled with high housing costs everyone seeks to cut costs. both physicians and hospitals To build health care envi- Source Code: 20090130crb ers requiring a healthy work (even in light of the current Those that cannot bargain on cannot work for free, coupled an equal footing lose in the with the unwillingness of negotiating room. health insurance plans to pay For example, the federal for delivered services, will government has held physi- result in fewer physicians in cian Medicare reimburse- the emergency room (particu- ments essentially flat for the larly specialists), fewer emer- last nine years, even before gency rooms and more factoring in inflation. Why? patients. To hold down costs. How? What to do? I wish there Because you can’t bargain were a simple remedy, but the with the Feds — it’s take it or sad fact is there is no silver leave it. While inflation- bullet and no magic potion. adjusted reimbursements are The Obama administration, down, and costs are up, it is led on the health care front by not surprising that physicians former Sen. (and soon to be are increasingly unwilling to Health Czar) Tom Daschle, take on Medicare patients. will attempt to address the Given the burgeoning elderly issue. For a detailed descrip- population and the reduced tion of where the Obama number of physicians willing administration thinks we are, to see Medicare patients, the and how it thinks we got here, prospects are not good if you review the first three parts of are a Medicare patient. And Daschle’s book, “Critical.” His the problem is dramatically answer is, interestingly, not worse for state programs like more money. His answer is a Medi-Cal and county pro- smarter and more efficient grams such as CMS. way of using the same amount Marcus Welby, the avuncu- of money. lar and kindly TV doctor of For at least the last decade, physicians and hospitals have been asked to accept lower and lower government and The Daily health insurance reimburse- ments, in the face of increas- Transcript ing expenses and simultane- ous demands for increased Founded April 3, 1886 quality, while still seeing the www.sddt.com ROBERT L. LOOMIS, Publisher uninsured for free. This tra- jectory defies economic reali- George Chamberlin, ty and is at odds with the Executive Editor Joseph Guerin, Editor Hippocratic Oath. The solu- Richard Spaulding, Real Estate Editor tion that we develop — and Jennifer Chung Klam, we must develop a solution Special Sections Editor soon — must balance the Tracye Grimes, Web Editor principles of the Hippocratic Ellen C. Revelle, Oath and the laws of econom- Publisher Emerita ics. San Diego Daily Transcript P.O. Box 85469 Gehring is executive direc- San Diego, CA 92186–5469 tor and CEO of the San Diego (619) 232-4381 Web site: www.sddt.com County Medical Society. Source Code: 20090130crd FRIDAY, JANUARY 30, 2009 • San Diego Health Care • THE DAILY TRANSCRIPT 3 Roundtable discussion Keeping up with expenses: Health care costs hit providers hard By THOR KAMBAN even hundreds of millions of BIBERMAN dollars the health care The Daily Transcript providers must “eat” and still The financial markets are manage to keep the doors not only taking their toll on open. workers and those who might Bardin said the Scripps have to let them go; health health care system spent $240 care providers are getting million in what it calls “com- slammed as well. munity benefit” expenses last The state of the health care year. While some of these industry was the topic of a expenses are due to such fac- recent roundtable discussion tors as community outreach, at The Daily Transcript offices Bardin said 75 percent to 80 and hosted by Waste percent of those expenses are Management Healthcare due to unreimbursed costs. Solutions. Most of the unreimbursed Michael Bardin, a Scripps expenses are not a result of Health spokesman, said he the completely uninsured, but has put the brakes on the bulk due to inadequate reimburse- of his health care system’s cap- ments by Medicare and Medi- ital projects until the markets Cal. improve. As noted by Zara Marselian, “This affects every campus CEO of La Maestra that Scripps operates,” Bardin Community Health Centers , said. “It’s not that we have All photos: J. Kat Woronowicz unreimbursed expenses can given up on these projects, but Representatives from the local health care industry said they now face tough choices about what their facilities can do without in hit community clinics hard as they have been slowed down.” these tough economic times. well. One project that could be “We got no money from the “If you’re talking about the when a job is lost, he said. Gary Rossio of the VA San were or higher. impacted is a proposed $203 state at all last year,” cost of health care, what is Hospitals in California have Diego Healthcare System said With the economy the way million renovation and expan- Marselian said. “We have 98 that?” said Julie Adamik, another problem. By 2013, that up until recently, con- it is, Tam said this might be sion at Scripps Mercy sites in the county and Employee Benefits Training their facilities must be seismi- struction costs led to the cost the time to renegotiate some Hospital in Hillcrest. The patients either don’t have and Solutions president and cally sound. While many of seismic retrofits increasing upcoming construction con- upgrades would double the insurance or can’t even pay CEO. “It’s so ambiguous and health care systems are simply at the rate of 1.5 percent per tracts. size of the emergency room, the sliding scale they have to confusing.” building new facilities, others month. “Do we need to rebid the and the intensive care unit pay.” Adamik cited the case of a must retrofit. Either way, with Steel and concrete costs work? That’s a question we would be enlarged as well. The nonprofit La Maestra routine colonoscopy done in capital markets in flux, this have actually settled some- have to ask,” Tam said. Bardin said plans are still Community Health Centers, the same hospital and another could quickly become an what in recent months, but email@example.com moving ahead for the Scripps which provides job training done a year later. The medical unfunded mandate. labor costs are still where they Source Code: 20090130cra Cardiovascular Institute that and meals as well as health bill had more than doubled would be constructed on the care, experiences some from close to $2,000 to more campus of the Scripps 80,000 visits annually. than $4,000. Memorial Hospital in La La Maestra has been able to “We need more transparen- Roundtable Participants Jolla. The project, which garner enough funds to build cy,” Adamik said. gained a $30 million Howard Julie Adamik, President & CEO Gary J. Rossio, Former CEO a 32,000-square-foot LEED She added that higher co- Charitable Foundation Grant Employee Benefits Training and Solutions VA San Diego Healthcare System (Leadership in Energy and payments and deductibles two years ago, isn’t cheap. A Environmental Design) Gold have been another part of the 2007 report pegged the cost at Michael Bardin, Corporate Senior Director Steven Scott, Vice President & General Manager building being constructed scenario and, again, people for Government/Public Affairs Anthem Blue Cross of California $430 million for a facility that near its Fairmont Street head- often can’t pay. would include 168 inpatient Scripps Health quarters in City Heights. Steven Finden, a Barney & Michael Simonsen, Director of Public Affairs beds among other functions. Marselian said patients Barney insurance broker, said Kim Bond, President San Diego Medical Services Enterprise Dr. David Tam, Pomerado often wait so long for what while the managed care system Mental Health Systems Hospital chief administrative would have been routine care has worked reasonably well for Dr. David Tam, Chief Administration Officer officer, said his Palomar that they end up flooding decades, as health insurance Steve Finden, Principal Palomar Pomerado Hospital Pomerado Health System is emergency rooms when the costs shift from the employer Barney & Barney already faced with cost over- situation becomes dire. That, to the employee, many people Sheila S. Trexler, Shareholder runs at its more than $800 she said, makes everyone’s are finding they may be able to Ron Hesley, President Neil Dymott million, 333-bed Palomar health care more expensive, insure themselves but not their Burnham Insurance BB & T Hospital being constructed and could be deadly. dependents. Tim Tucker, District Manager along Citricado Parkway in “Many people are going “A lot can’t afford depend- Zara Marselian, CEO Waste Management Escondido. Now with capital without preventative care,” ent contributions,” Finden La Maestra Community Health Centers Healthcare Solutions (sponsor) markets the way they are, Tam Marselian said. said. This is especially true has had to determine what the Marselian said in some hospital could do without. cases hospitals become so full “Do we change the healing that they go on bypass, and gardens? We have to look at ambulances must go to anoth- what we can do to cut costs,” er facility. She recalled that he said. happening at the Sharp Healing gardens may be Hospital in Chula Vista. important for speedier recov- “What if someone in Alpine eries, but hospitals have a has a heart attack and much more fundamental need Grossmont Hospital is on — survival. The California bypass?” she asked. Hospital Association reports a Another issue is that 73 percent increase in unre- charges can vary widely for imbursed costs in the state in seemingly comparable proce- the past year. That may mean dures completed within a year tens of millions of dollars or of each other. Tim Tucker, left, district manager of Waste Management Healthcare Solutions. Dr. David Tam, chief administration officer of Palomar Pomerado Hospital. 4 FRIDAY, JANUARY 30, 2009 • San Diego Health Care • THE DAILY TRANSCRIPT Hospitals Listed by Number of Licensed Beds # of Licensed Beds # of Staff # of Nurses Hospital Specialists Year Address Annual Local Gross Year # of Staffed Beds Specialty Services Offered Executive(s) & Title(s) Established Phone, Fax # of Staff # of Revenue Established in San Diego URL Physicians Employees # of Acute Beds Scripps Mercy Hospital* 700 4077 Fifth Ave. n/a 936 Trauma, cardiovascular, neurology, neuro- Chris Van Gorder, President/CEO; 1 San Diego CA 92103 450 $1,771,153,858 surgery, stroke, oncology, bariatric and general Tom Gammiere, Chief Executive 1924 1890 (619) 294-8111, (619) 686-3530 1,300 2,527 surgery, orthopedics, spine services www.scripps.org 650 540 650, Combines Level 1 trauma center, regional burn center, UCSD Medical Center, Hillcrest Hillcrest, 800 multi-organ transplant program, cancer center, 200 W. Arbor Drive Thornton cardiology, pediatrics, women’s services, child 2 San Diego CA 92103 540 1,065 Combines n/a and adolescent health, Alzheimer’s disease Richard Liekweg, CEO 1966 1966 (800) 926-8273, (619) 543-3781 n/a HIllcrest, research center, senior behavioral center, health.ucsd.edu N/A Thornton neonatal intensive care Sharp Grossmont Hospital 446 Behavioral health, cancer treatment, cardio- 5555 Grossmont Center Drive 509 1,170 vascular, emergency and critical care center, $435,418,000 Michele Tarbet, CEO; Kari 1991 (this 3 La Mesa CA 91942 434 (fiscal year) hyperbaric oxygen therapy, orthopedics, reha- Cornicelli, CFO 1955 location) (619) 740-6000, (619) 461-7191 644 2,887 bilitation, robotic survey, sleep disorders clinic, www.sharp.com 358 skilled nursing/hospice, women’s health 397 Dr. Arthur A. Gonzalez, Tri-City Medical Center Cardiovascular, stroke assessment and care, 431 710 President/CEO; Suellyn Ellerbe, 4002 Vista Way center for wound care hyperbaric medicine, COO/CNE; Allen Coleman, VP, 4 Oceanside CA 92056 330 $924,992,071 wellness center, orthopaedic center, general Strategic Services; Robert 1961 1961 (760) 724-8411, (760) 940-5792 550 2,284 and specialty surgery, family birth center, radi- Wardwell, CFO; Debbie King, VP, www.tricitymed.org 291 ology Foundation 392 Arthur M. Flippin, M.D., Medical Kaiser Foundation Hospital 500 1,700 Blood donor center, labor and delivery, NICU, Director; Nathaniel L. Oubre Jr., 4647 Zion Ave. PICU, ICU, head and neck surgery, neuro- Sr .VP/Exec. Director; Chris 5 San Diego CA 92120 392 n/a surgery, oncology research center, genetics, Crisafulli, Medical Group 1967 1967 (619) 528-5000, (619) 528-7535 13,729 7,330 cancer registry Administrator; Barbara Grimm, www.kaiserpermanente.org 392 Medical Group Administrator Sharp Chula Vista Medical Center 343 361 645 Bloodless medicine, cancer care, emergency, 751 Medical Center Court $240,979,000 heart care, hospice, orthopedics, rehab, skilled Christopher Boyd, CEO; Rick King, 1989 (this 6 Chula Vista CA 91911 343 (fiscal year) nursing, weight-loss (gastric bypass, lap band), CFO 1955 location) (619) 482-5800, (619) 482-3535 490 1,503 women’s and infant’s services www.sharp.com 243 334 $666,687,000 (fiscal Cancer treatment, emergency department, Sharp Memorial Hospital 880 1,019 year), (includes Sharp heart, vascular and thoracic surgery/services, 7901 Frost St. Mary Birch Hospital robotic-assisted surgery, home care, hospice, 7 San Diego CA 92123 334 for Women, Sharp orthopedics, physical rehabilitation, multi- Tim Smith, CEO 1955 1955 (858) 541-3400, (619) 541-3514 992 2,674 Mesa Vista and organ transplant, weight-loss (bariatric) sur- www.sharp.com 286 Sharp Vista Pacifica) gery, wound and ostomy outpatient center Palomar Medical Center 319 321 843 Trauma center, emergency department, cardio- 555 E. Valley Parkway vascular, oncology, general medical/surgical 8 Escondido CA 92025 420 n/a services, birth center, neonatal ICU, pediatric Michael Covert, President/CEO 1950 1950 (619) 739-3000, (760) 739-2180 515 n/a unit www.pphs.org 413 Scripps Memorial Hospital La Jolla 307 9888 Genesee Ave. n/a 978 Trauma, cardiovascular, neurosurgery, neurolo- Chris Van Gorder, President/CEO; 9 La Jolla CA 92037 281 $1,291,327,276 gy, radiation oncology, orthopedics, obstetrics, Gary Fybel, Chief Executive 1924 1924 (858) 626-4123, (858) 626-6122 800 2,569 bariatric, general surgery, gastroenterology www.scripps.org 293 Paradise Valley Hospital 301 2400 E. Fourth St. 225 419 10 National City CA 91950 301 n/a General acute care hospital Luis Leon, PA-C, Ph.D., CEO 1904 1904 (619) 470-4321, (619) 470-4282 300 1,515 www.paradisevalleyhospital.org 301 261 Kathleen A. Sellick, President/CEO; Rady Children’s Hospital 353 1,077 Cardiology, cardiovascular surgery, dermatol- Dr. Irvin Kauffman, Chief Medical 3020 Children’s Way ogy, orthopedics, transplant, autism, hematol- Officer/Sr. VP, Hospital Affairs; 11 San Diego CA 92123 270 $1,082,261,681 ogy/oncology, neontology, Marj Peck, VP, Patient 1954 1954 (858) 576-1700, (858) 966-4957 653 3,617 allergy/asthma/immunology, craniofacial Services/CNO; Meg Norton, Sr. www.rchsd.org 261 VP/COO; Roger Roux, Sr. VP/CFO 204 Cardio-pulmonary services, complementary Sharp Coronado Hospital 252 126 and alternative therapies, emergency depart- 250 Prospect Place $61,848,000 ment, home care, hospice, long-term care, Marcia Hall, CEO; Susan Stone, 1994 (this 12 Coronado CA 92118 175 (fiscal year) orthopedics, outpatient behavioral health, RN, MSN, CNO, COO 1955 location) (619) 522-3600, (619) 522-3782 268 578 rehabilitation, vision-saving laser treatment for www.sharp.com 46 glaucoma Sharp Cabrillo Skilled Nursing Center 180 3475 Kenyon St. 891 24 Skilled nursing, senior resources, rehabilitation, 13 San Diego CA 92110 86 n/a outpatient surgery, eye center Daniel Gross, CEO 1958 1958 (619) 221-3400, (619) 221-3509 1,073 n/a www.sharp.com 10 Scripps Green Hospital 173 10666 N. Torrey Pines Road n/a 468 Cardiovascular, oncology, orthopedics, neurolo- Chris Van Gorder, President/CEO; 1991 (this 14 La Jolla CA 92037 168 $877,801,890 gy, neurosurgery Robin Brown, Chief Executive 1924 location) (858) 455-9100, (858) 554-6869 n/a 1,277 www.scripps.org 173 Sharp Mary Birch Hospital For Women 169 $666,687,000 (finan- 3003 Health Center Drive 501 603 cial data reported Labor and delivery, mother and infant care, 1992 (this 15 San Diego CA 92123 169 (and audited) annual- neonatal intensive care unit, robotic gyneco- Mary Henrikson, CEO 1955 location) (858) 939-3400 (619) 541-4165 619 914 ly as a part of Sharp logic surgery, services for women of all ages www.sharp.com 169 Memorial Hospital) 149 $666,687,000 (fiscal Sharp Mesa Vista Hospital Adult psychiatric, child and adolescent psychi- 143 152 year) (financial data 7850 Vista Hill Ave. atric, chemical dependency, cognitive therapy Kathleen Lencioni, CEO; Michael is reported and audit- 1998 (this 16 San Diego CA 92123 149 ed annually as part of program, dual recovery program, eating disor- Plopper, M.D., Chief Medical 1955 location) (858) 694-8300, (858) 278-5920 171 504 ders treatment, electroconvulsive therapy, Officer Sharp Memorial www.sharp.com 0 older adult psychiatric services Hospital) Scripps Memorial Hospital Encinitas 138 354 Santa Fe Drive n/a 408 Rehabilitation, orthopedics, spine, neurology, Chris Van Gorder, President/CEO; 1978 (this 17 Encinitas CA 92024 124 $469,527,231 stroke care, cardiology, obstetrical Carl Etter, Chief Executive 1924 location) (760) 753-6501, (760) 633-7356 550 1,159 www.scripps.org 138 119 Combined with Level 1 trauma center, regional burn center, UCSD Thornton Hospital, La Jolla UCSD Medical 147 multi-organ transplant program, cancer center, 9300 Campus Point Drive Center cardiology, pediatrics, women’s services, child 18 La Jolla CA 92037 119 Combined with n/a and adolescent health, Alzheimer’s disease Richard Liekweg, CEO 1993 1993 (619) 543-6163, (619) 543-5423 n/a UCSD Medical research center, senior behavioral center, www.health.ucsd.edu 119 Center neonatal intensive care Pomerado Hospital 107 15615 Pomerado Road 0 n/a Emergency department, outpatient surgery 19 Poway CA 92064 0 n/a center, general medical/surgical, birth center, Michael Covert, President/CEO 1970 1970 (858) 613-4000, (858) 613-4764 n/a 750 neonatal ICU www.pphs.org 0 Sharp Vista Pacifica Hospital 16 $666,287,000 (finan- 7989 Linda Vista Road 21 6 cial data reported Chemical dependency, substance abuse treat- 1998 (this 20 San Diego CA 92111 14 and audited annually ment programs, continuing care (after inpa- Dan Valentine, Director 1955 location) (858) 637-6920, (858) 637-6959 24 21 as part of Sharp tient care) programs, family care program www.sharp.com 0 Memorial Hospital) * Figures include Scripps Mercy Hospital, Chula Vista location, 435 H St. Data Source: The Hospitals and their Web sites. Listed by Number of Licensed Beds. This is a partial list; a more complete listing can be found at sourcebook.sddt.com. N/A: Not Applicable, n/a: not available, wnd: would not disclose. It is not the intent of this list to endorse its participants, nor to imply that a company’s size or numerical rank indicates its quality or service. We reserve the right to edit listings or to exclude a listing due to insufficient information. The following hospitals did not repond to our survey: VA San Diego Healthcare, Alvarado Hospital, Bayview Hospital and Mental Health, Naval Hospital-Camp Pendelton, Naval Medical Center, San Diego Hospice/Hospital, Kindred Hospital, Villa View Community, Fallbook Hospital, Kindred Hospital. Compiled by Robin Scott, firstname.lastname@example.org. Last updated 1/2009. FRIDAY, JANUARY 30, 2009 • San Diego Health Care • THE DAILY TRANSCRIPT 5 Close-up: Zara Marselian HeadNorth supports spinal La Maestra CEO serves as change agent cord injury survivors By JILL ESTERBROOKS Marselian said “will improve take out lines of credit, By RANDAL SCHOBER In addition, HeadNorth aims Special to the Daily Transcript care delivery, expand capaci- reduce operating hours and HeadNorth to help and enhance the quality When La Maestra ty to serve more clients and put a freeze on hiring simply While spinal cord injuries of life for people faced with the Community Health Services have a positive impact on to keep clinic doors open may not be on the front of daily challenges of a SCI CEO Zara Marselian found the area environmentally until “our hard-earned funds many people’s minds, these through its grant programs. out that patients at her clin- and economically.” flowed again.” types of injuries happen In 2008 the foundation ics were having trouble put- The new LEED-designed Marselian is used to scrap- around each of us on a daily assisted 40 local San Diego SCI ting food on the family table, building project will enable ing together grants, dona- basis. According to the survivors with more than she opened a Food Pantry. La Maestra to retain its tions, government funds and University of Alabama $150,000 as part of its When it came to her atten- position as the largest revenue from services to National Spinal Cord Injury Response ONE and Response tion that folks were in dire employer in the central San cover La Maestra’s $6.7 mil- Statistical Center, there are TWO grant programs. need of dental work, she Diego neighborhood with its lion annual budget. 11,000 new spinal cord injuries The Response ONE program found a way to provide den- 145 professional and sup- “I always seemed to gravi- every year, with an American meets recipients during their tistry services, too. port staff members who tate toward services for peo- sustaining a spinal cord injury initial and critical hospital And when demand for speak 19 languages. ple in need,” she said. “And I every 49 minutes. According to rehabilitation process immedi- medical and social services And the new facility could- like challenges, so this is the the university, the average cost ately following the injury. With kept increasing by double- n’t come at a better time. place to be.” Zara Marselian for first year paraplegics is the help of some of digits year after year, she With the county’s unem- Marselian, 49, was born in $209,074 and $470,833 for HeadNorth’s board members launched a $10 million capi- ployment rate reaching 7.4 San Diego, the daughter of ing the money to expand quadriplegics. and volunteers who also are tal campaign to consolidate percent, La Maestra’s City Yugoslavian immigrants. existing programs and start Since its inception in 2006, paralyzed, each recipient a labyrinth of 14 patchwork Heights clinic, as well as “My family might have up new services to meet the the HeadNorth Foundation receives not only $1,000 to buildings in the City Heights those in El Cajon, National been poor in money, but we needs of the community.” has raised more than $1 million help them with immediate neighborhood of San Diego City and Lemon Grove, have were very rich in cultural Her most recent endeavors to provide essential support financial needs but encourage- into one centralized loca- been increasingly crowed diversity,” said the graduate have been establishing and guidance to individuals ment, resources and hope that tion. with needy residents — both of San Diego High School micro-enterprise training and families affected by spinal they can continue to live fulfill- “It’s just the way we grow, unemployed and the work- and San Diego State for small home-based busi- cord injury (SCI). ing lives. meeting the needs of our ing poor, who don’t have University. nesses and cutting-edge A large part of HeadNorth’s The Response TWO pro- families,” said Marselian of insurance through an Since her early teens, telemedicine services. mission is to support research gram provides financial assis- the San Diego-based organi- employer yet earn incomes Marselian knew she wanted Because many of the clin- for spinal cord injuries in the tance to local SCI survivors zation that provides pri- greater than the government to work with needy popula- ics’ patients lack the language hopes of finding a cure for who continue to live with mary, pediatric and dental limits for assistance. tions “who wanted to skills or transportation need- paralysis. To support that paralysis. These grants are used care, mental health counsel- “We’ve been fielding a improve their lot in life.” ed to visit out-of-area special- effort, the foundation recently for the purchase of various ing, and job training and record number of requests As a community college ists such as ophthalmologists pledged $975,000 to Burnham gifts, which include converted placement services to under- for assistance during these teacher in the 1970s, she saw or podiatrists, Marselian said Institute for Medical Research vans, exercise equipment, voice served, ethnically diverse uncertain economic times a wave of South Vietnamese that by using cameras, com- to support cutting-edge stem activated software, house individuals and families from people who are already immigrants who needed a puters and TV screens, they cell research. The funding, part ramps, rehabilitation services, throughout the county. financially stressed,” said hand, not just to learn the can now offer real-time, of HeadNorth’s Chronic Spinal hand-cycles, lifts and standing She sees the organization Marselian. Her clinics pri- English language, but also to interactive communications Cord Injury Project, will sup- frames. HeadNorth is dedicat- as a “change agent.” marily serve the low-income get social services and between patients and con- port efforts by Dr. Evan Snyder, ed to assisting SCI individuals “They are the ones making and medically underserved, assimilate into American sulting physicians. stem cell program director at to live active, enjoyable and the change; we just help mostly either Latino immi- culture. “Telemedicine is a practi- Burnham, and Dr. Mark purpose driven lives. facilitate that change and grants or refugees from With this in need in mind, cal, cost-effective alternative Tuszynski, director of the HeadNorth was founded by empower them by teaching South East Asia and Africa she later helped found La to the more traditional face- Center for Neural Repair at the Eric Northbrook, a prominent them how to ask questions without health insurance. Maestra as an immigration to-face way of providing University of California, San member of San Diego’s real and where to seek assis- “With no county hospital, amnesty and training pro- medical care,” she said, not- Diego, to use stem cells to treat estate community, after he was tance,” she said. our clinics serve as the safe- gram, and then added a ing the successful program chronic spinal cord injuries. injured in a motorcycle acci- Other changes are in the ty net for the community,” medical clinic in her home in the organization currently The Chronic Spinal Cord dent in January 2006. The works. With the recently she said. 1991. has with cardiologists at Injury Project hopes to use accident left him paralyzed announced $1 million dona- The jump in jobless rates “We had nothing at the Scripps/Mercy Hospital. stem cells to regenerate spinal from the chest down, yet his tion from Kaiser Family is just one of the many chal- beginning, except a lot of Other areas she’s explor- cord neural cells, which have spirit was unbroken. Just one Foundation and underwrit- lenges she’s faced in recent need,” said Marselian, who ing are telemedicine services been found to develop in adult month after his accident, in the ing of an $18.5 million bond months. has been recognized locally for rural communities and rats with acute spinal cord midst of his own recovery and initiative made possible by If providing health care and nationally as an ambi- teletraining for employees at injuries. This specific study is rehabilitation, Northbrook, Anthem Blue Cross, con- for low-income and unin- tious champion for the cause all sites. unique in the nerve regenera- along with his wife Denise and struction can now get under sured families weren’t chal- of serving the uninsured. Looking ahead, Marselian tion research community and close friends, established the way for La Maestra’s new lenging enough, last fall During the past 18 years, said while she is very hope- hopes to bring light to a possi- HeadNorth Foundation upon 34,660-square-foot “green” during the state budget the clinic has grown and ful about the health care ble cure for this type of debili- realizing there was a great need health care center that impasse, she was forced to now, along with three others changes that might be ush- tating injury. to those who suffer an SCI. (National City, El Cajon and ered in by the new Obama This is not the first time that While Northbrook was still in Lemon Grove), serves administration, she realizes HeadNorth has aided UCSD’s rehabilitation, HeadNorth’s 65,000 patients annually it will take time for major Center for Neural Repair in its first recipient was 24-year-old with a paid staff of 145 doc- changes to take place. mission to find a treatment for Matthew Clinton, a fellow Waste Management’s tors, dentists, counselors, teachers, social workers and In the meantime, she hopes La Maestra can gain spinal cord injuries. In 2007, HeadNorth donated $50,000 patient, who was afflicted with a rare spontaneous spinal cord others who speak a spectrum the attention of the federal to the Center for Neural stroke that left him a ventila- Healthcare Solutions of languages representing their clients from more than government and serve as a national model for how Repair’s Spinal Cord Regen- eration Research Program, tor-dependent quadriplegic. Now in its third year in 60 countries throughout the locally based, cost-effective which funded research into establishment, HeadNorth will group enters local market world. Marselian, who herself and highly efficient social and medical services can be spinal cord regeneration. Led by Tuszynski, the Spinal Cord continue to grow and hopes to help a greater number of SCI also speaks fluent Spanish, delivered. Regeneration Research survivors in 2009. Waste Management is The company will be the first Italian, French and English, Program conducted pre-clini- building a special services to have the infrastructure to said that while the organiza- Esterbrooks is a San cal research that aims to devel- Schober is the executive division to help health care offer a full range of services tion has grown and expand- Diego-based freelance op practical therapies that director of the HeadNorth operations manage their con- and provide health care facil- ed in the last two decades, writer. could lead to clinical trials for Foundation. sumed materials. Waste ities with greater efficiency, her main goal remains “find- Source Code: 20090130crf spinal cord injury. Source Code: 20090130crh Management has taken the reduced costs, more recycling first step toward this goal in and better environmental the San Diego market with stewardship. the purchase of Spectrum Once its operations are Services in San Diego. fully functional, Waste Waste Management’s goal Management will be able to is to offer a combination of provide services for hospitals, services to handle solid clinics, surgery centers, phar- waste, recycling, medical maceutical manufacturers waste, confidential docu- and a variety of other health ments, universal and phar- care operations in Southern maceutical waste from a sin- California. gle supplier. Through its The company also has a extensive resources and con- team of subject experts from sulting expertise, Waste hazardous waste, pharma- Management has been able ceutical waste and recycling to save complex businesses to offer state-of-the-art-knowl- more than $50 million. The edge and technology to pre- company believes it can serve the environment while bring these competencies to cost effectively treating and the U.S. health care industry, transporting these wastes. the largest industry in the Waste Management cur- country with 18 percent of rently manages waste for gross domestic product. more than 30,000 health Related to these moves, care customers, including Waste Management also 1,400 hospitals. With the recently purchased the addition of these service lines largest medical waste treat- and expertise, Waste ment facility in the Southwest. Management’s goal is to This facility, located in become the leading environ- Chambers County in south- mental experts in the U.S. east Texas, will provide serv- health care market. ices from Southern California Here’s what Waste to Louisiana beginning in Management’s Healthcare March after significant Solutions offers: upgrades are completed to 1. Cost control meet WM’s high safety and 2. Risk management environmental standards. 3. Integrated solutions Fully 70 percent of health 4. Waste reduction care-generated waste is reg- 5. Managed complexity ular solid waste. Waste 6. Increased reuse and Management is in a unique recycling position to use its existing 7. Optimal environmental infrastructure to handle this protection solid waste as the company 8. Routine progress report- adds health care waste treat- ing ment facilities. In addition, For more information on Waste Management’s Waste Management’s Health- Recycle America division is care Solutions group, visit the country’s largest recycler. www.healthcare.wm.com. Submitted by Waste Management’s Healthcare Solutions 6 FRIDAY, JANUARY 30, 2009 • San Diego Health Care • THE DAILY TRANSCRIPT OC hospital says Lean: It’s a lifestyle Medicine Continued from Page 1 physician is critical as the ment. it’s corrected director of this team. Medicare and other health change, not a ‘fad diet’ al internists or pediatricians for children. The medical home model insurance plans are seriously patient problems Americans were not happy being forced to always get has emerged to improve health care and increase its considering a major change in the financing of health care to Source: Childs Mascari Warner spearhead the process and to their care through a PCP, and efficiency by lowering costs support the growth of the The Associated Press Architects help stay focused on change. managed care declined in the while at the same time medical home model. Rather ORANGE, Calif. — Fad diets come and go, but • Start with a small proj- late 1990s as HMOs opened increasing the quality of care. than traditional fee-for-serv- University of California, the tried and true way to fit- ect, or even part of a project, up direct access to specialists. When greater resources are ice practice that only rewards Irvine Medical Center said it ness is a change in lifestyle. but just start, even if you The Preferred Provider placed into prevention and physicians for doing things, has submitted a plan to cor- The same principle stands don’t feel fully prepared to Organization (PPO) has managing chronic problems, payment would be made for rect dozens of patient care for health care design and dive in. become the most popular the overall costs of care go the coordination of care by problems that threaten to construction. Implementing • Get everyone involved insurance model, where peo- down as the rates of major the physician and team. The cost it millions of dollars in lean principles is not a during the construction ple may choose primary care problems decline. Recent evi- medical home payment would Medicare funding. quick-fix solution, but phase — this includes the or specialty physicians in an dence has shown a decline in incentivize the team to reach After an October inspec- requires first a shift in men- client, staff and contractors. organized network of physi- heart attacks in a population out and coordinate care in tion, federal regulators tality and a mindset that • Eliminate “silo” think- cians agreeing to accept dis- through a reduction in ciga- ways that do not require issued a 127-page report cit- accepts growth and change. ing. As a core group, map counted rates for their servic- rette smoking — still the most patient visits, such as over the ing dozens of examples of Just like with a fitness plan, processes to determine es. common cause of heart dis- telephone and through secure problems with patient care the key is tailoring the right value, identify potential The current decline in pri- ease and cancer. When a pop- online communication. or hospital procedures. lean plan for a project. The points of waste and develop mary care has now lasted a ulation of diabetics is better Quality outcomes of care to The U.S. Centers for key lies in figuring out where efficient ways to improve decade, and a critical short- controlled, the costs of care go populations become the new Medicare and Medicaid to start, how to keep it with the idea of enhancing age of primary care physi- down as there are fewer com- financial incentive. Services sent a letter to the going, and what “lean” really the quality of care. cians is looming. Starting plications of the disease, such Will the medical home teaching hospital last means in each setting. You • Think about planning in salaries in primary care are as kidney failure, heart model cause a resurgence in month, ordering it to submit do not have to be an expert new ways. going up, but there are not attacks, loss of vision and interest in primary care a plan for correcting the to begin integrating lean • Implement an integrat- enough physicians coming amputations of limbs. among today’s medical stu- problems or risk losing its into your processes. ed form of agreement. out of the pipeline to fill open The medical home uses a dents? It is too early to tell. patient care funding. Lean is a lifetime commit- positions. Something needs to team approach to care with But the buzz has captured The problems were fixed What is lean? ment, and is not effective happen to rescue primary information systems that help national attention, and sup- before the hospital submit- The lean process, original- unless it remains a priority, care medicine. all the professionals coordi- port for the medical home is ted its plan, said Dr. David ly championed by Toyota just like a diet or a fitness The American population is nate care with informed and likely to be a part of the Bailey, UCI’s vice chancellor Production System (TPS), program. aging, and chronic health activated patients. Electronic Obama administration’s for health affairs. has been a well-known phi- problems such as hyperten- health records (EHRs) allow health care reforms. There is “These were all things losophy in the manufactur- As co-founders of the sion, diabetes, heart disease for a flow of information a critical need to lower health that were fixable and cor- ing arena for decades. Lean Southern California chap- and even obesity eat up most where all the caregivers have care costs, and the efficiencies rectable,” Bailey said. “We thinking is based on the ters of the Lean health care costs and cause the same information to work of the medical home offer a really believe that we offer ideals of driving out waste Construction Institute, the most serious problems, from, and best practice clini- way to do this and improve outstanding health care . . . and ultimately providing Childs Mascari Warner like heart attacks and heart cal guidelines are imbedded the health of the population. and we don’t want to see one maximum value for the cus- Architects and BSD failure. Chronic health prob- in the patient information. slip-up for any patient.” tomer. While the lean con- Builders, along with lems are best treated early by With emerging personal Scherger, M.D., M.P.H., is Jack Cheevers, a cept isn’t new, its application Professor Colin. T. Milberg primary care physicians. A health records (PHRs), chair of the San Diego County spokesman for the Medicare in health care operations, with SDSU, are bringing new model of chronic illness patients are able to get Medical Society centers regional office in design and construction is lean to Southern California care has emerged based on a involved in their own care Communications Committee San Francisco, said the on the cutting edge. health care design and con- team of health professionals much like people today are and editor of San Diego agency was still reviewing struction. engaging with a population of able to get involved with their Physician magazine. the plan. Where do you start? Source Code: 20090130crn patients, but the primary care money and travel manage- Source Code: 20090130crc “Once it’s approved, The key to implementing there’ll be another inspec- lean is a solid understanding tion,” he said. Among other things, fed- of its core principles, com- bined with a company cul- Wireless Continued from Page 1 Comparable existing hospitals and emerging com- tion devices that seniors can eral inspectors found that ture that is willing to accept devices tighten on the arm panies, showing them how to use while living independent- developed a continuous moni- four patients had suffered new ideas and make changes. and take the patient’s blood integrate wireless technology ly is a huge growth area. toring, noninvasive device for bedsores; the hospital did Though many are familiar pressure every 20 to 30 min- with health care, Sobrian said. These devices include measuring blood pressure on not have enough nurses to with concepts of lean, they utes, using the same technolo- Intel has also been actively reminders to take drugs and ambulatory patients. provide one-on-one care to reach a roadblock in taking gy utilized by a doctor’s office, involved and is working on monitoring of vital signs and Angel funds helped get children in the newborn the first steps to implement according to Watlington. advancing wireless technology movements. Triage started, and the com- intensive care unit; and these ideas for a specific “It’s invasive, the cuff has to for the industry. “The challenge lies in get- pany recently concluded a sec- nurses adjusted doses of project or process. Below is a be inflated and it is not con- “Activity in this sector falls ting the seniors to adapt to ond round of Series B funding insulin or other drugs with- brief list of steps that can tinuous. Triage was conceived into two areas — medical the technology. Innovators for $20 million, led by out doctor approval or hos- begin the lean process. Qualcomm (Nasdaq: QCOM). to develop a continuous, non- devices that monitor, measure often develop a gadget with- pital protocol. • Establish an action Other investors included Intel invasive device that does not and transmit data; and cell out thinking about who will Source Code: 20090121ch group or lean committee to (Nasdaq: INTC), Sanderling require inflation and allows phones that monitor, transmit use it. In the hospital environ- Ventures and 3 Eye. patients to be ambulatory,” he data as well as advice to the ment, the challenge is in “In 2007, our attention said. patient,” said Sobrian. “It achieving accuracy, reliability switched to monitoring all of could be anything from a and economies of scale. Our The Daily Transcript presents: Qualcomm’s role refrigerator that stores blood technology summit this year the vital signs, not just BP (blood pressure), which is the Both Watlington and and transmits supply-level will focus on consumer tech- American Heart Association Holy Grail, the last vital sign Sobrian highlighted data, to a wireless bandage nology adoption and the that could not be measured Qualcomm’s involvement in that can monitor blood pres- growth of the industry,” Go Red for Women wirelessly. ViSi, our device, will be worn on the body. this emerging field. “They are very visionary sure and heart rate.” RFID is helpful for patients Sobrian said. According to Watlington, Sensors process the signs and that way,” said Watlington. with Alzheimer’s, who tend to the next generation of devices March 13, 2009 transmit them wirelessly,” said Triage has been working with wander and get lost. The will be so advanced that they Triage CEO Tom Watlington. Qualcomm in placing a tracking technology can also will not even require the tiny Triage will submit the modem inside their device so be used on hospital equip- wires now used to apply sen- device for FDA approval at the that it can transmit data ment in the area of loss pre- sors to the body. end of this year and hopes to directly. “The system can send vention, Sobrian pointed out. “We are very fortunate to be bring it to market in the first a warning to the health care in San Diego, with companies half of next year. It is initially provider, who can then ask Future trends like Qualcomm. It’s a very intended for in-hospital use the patient to come in for Sobrian said the future rich, entrepreneurial environ- by patients who are not in the tests.” holds big opportunities in the ment. There is a growing pres- ICU or CCU, but a consumer Activity in this field began pharmaceutical area. ence of medical device inno- version will be developed later ramping up in 2005, which “Right now, clinical trials vation. This is definitely a for patients to use in their spurred the need for the are conducted on paper, with growth area for the city, since homes. WLSA. Sobrian recalled that patients recording in a diary, this is a perfect place for “If a patient’s condition is about half a dozen health care and there are pitfalls to this progress to occur and will be a deteriorating, if their BP is firms, including Sharp, Kaiser system with false reporting. source of future jobs,” going down, it will monitor Permanente and Scripps, Having data transmitted wire- Watlington said. and send data to the nurse in were spending millions of dol- lessly helps identify potential charge. It will allow patients lars going digital and search- new solutions and negative Nagappan is a San Diego- to leave hospitals earlier and ing for wireless technology. effects quickly.” based freelance business still be monitored,” At the same time, In the consumer market, writer. Watlington said. Qualcomm was meeting with monitoring and communica- Source Code: 20090130crg Go Red For Women is the American Heart Association’s nationwide movement that celebrates the energy, passion and power women have to Gilbane completes Stephen Birch Healthcare Center at Sharp Memorial Hospital band together and wipe out heart disease. Thanks to the participation of Serving as construction has the most modern, patient- Services; EAR Quality Swisslog; TMAD Taylor & millions of people across the country, the color red and the red dress have manager at risk, Gilbane focused health care delivery Inspection Services; Earl Gaines; Tower Glass; Tri- become linked with the ability all women have to improve their heart Building Co. has completed system in the county and in the Composites; EDCO Disposal County Insulation; Valley Crest health and live stronger, longer lives. construction on the new country,” said Sharp Corp.; Fuller Electric; GEM Landscape Development; 315,000-square-foot, 334- Memorial Hospital CEO Mechanical; Hasson; Hill- Washington Iron Works; The Daily Transcript at SDDT.com is proud to sponsor the Go Red for bed health care facility at Daniel Gross. Rom; ISEC; JD2; Johnson West-Tech Contracting; and Women luncheon and a special spotlight on the American Heart Sharp Memorial Hospital, offi- A highlight of the Sharp Maintenance; KPFF; Lerch, Yardley Zaretsky. Association on Friday, March 13, 2009. cially named the Stephen project is the large-scale steel Bates and Associates; Letner Gilbane Building Co. is Include your company’s message in this special issue distributed at the Birch Healthcare Center. reinforcement and steel beams Roofing Co.; Martin & ranked as the No. 9 health luncheon on March 13, 2009. Don’t miss this exciting opportunity to Gilbane’s Southern California utilized to meet California Ziemniak; McDonough care builder in the nation by support heart health education. office, based in San Diego, building code and OSHPD Construction Rentals; MDI; Engineering News Record. managed the preconstruction regulations to guarantee the Mid Canada Millwork; Morley The firm provides a wide and construction efforts. structure is seismically secure. Construction Co.; National range of services and pro- Contact email@example.com or 619.232.4381 today! The new facility proudly The new tower has 612 tons of Electric Works; NBBJ; OCB grams that focus on the health houses private patient suites reinforcing rebar in the walls Reprographics; OTIS; Pacific care market, including Ad space closes: March 5, 2009 featuring a three-zoned lay- and foundation. Air Care; Pacific Coast Healthcare Cost Advisor, Artwork due: March 9, 2009 out giving caregivers, Gilbane wishes to thank all Cleaning; Pacific Coast Steel; Healthcare Center of patients and visitors personal of the firms that contributed to Poliform USA; Prime Tile; Excellence, Transition Plan- The Go Red for Women Lucheon, themed around sisterhood and space with a comfortable the successful expansion of ProSpectra Contract Flooring; ning and Management, inspiration, is a life-changing experience that focuses on three areas to sleeping area for a visiting Sharp Memorial Hospital: Rotech Consulting; Ruckle Building Information Modeling support the fight against heart disease in women: heightening family member. The new ABKJ Structural; Allstate Construction; Schuff Steel and Interdisciplinary Docu- awareness of the issue, creating a passionate call-to-action, and tower includes a surgery cen- Services Environmental; Pacific; Shadpour Consulting ment Coordination. generating funds to support education and research. ter, specialized designs for American Labor Pool; AO Engineers; Shannon & Gilbane (www.gilbaneb- This event is designed to be both social and educational; it is an orthopedics, cardiac surgery, Reed & Co.; Basile Wilson; Sharp Memorial uilding.com) provides a full opportunity to raise awareness of heart disease in women and a neurotrauma and transplan- Construction; Bergelectric Hospital; Sideplate; Siemens slate of facilities-related serv- chance to empower women to take charge of their own heart health. tation; a new main entrance Corp.; Bradshaw Engineering; Building Technologies; Sim J ices for clients in the educa- Visit goredforwomen.org for more information. and lobby as well as Brady Co.; Business Cleaning Harris; Simplex Grinnell; Site tion, health care, life sciences, enhanced admitting and Co.; California Sheet Metal Workshop; Southern convention/cultural, govern- scheduling areas. Works; Coast Environmental; California Soils & Testing; ment, sports/recreation and “Sharp Memorial Hospital Diamond Environmental Standford Sign & Awning; criminal justice markets. www.sddt.com Submitted by Gilbane Building Co.
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