In defense of Inland State commission should not seek hospital's closure

Monday, November 22, 2004

In recent weeks, many people have inquired with concern about Inland Hospital's "closure," as was reported Oct. 20 in this newspaper. Inland Hospital's trustees and management want the people of central Maine to know that we are committed to the future of our community hospital. We have no intention of closing Inland.

The Waterville hospital is clinically and financially sound, and surveys of patients show a very high level of satisfaction with our services. In fact, members of the community might have heard recently about our five-star rating. In a nationwide comparison of hospitals, Inland received the highest rating possible for patient satisfaction. We are proud of our hospital and the people who make it unique.

Despite this positive picture, the chairman of the Commission to Study Maine Hospitals, William E. Haggett, recently issued a draft recommendation to lay off hospital staff and close some hospitals, including Inland. Haggett also suggested bringing all hospitals in Maine under a regionalized, state-dominated system.

The commission was created by Gov. John E. Baldacci to study the ways Maine could lower health care costs and improve access. These are two important goals; however, Haggett's proposal to close hospitals -- a proposal he put forth by himself -- has created deep concern and confusion in the communities named in his recommendations.

While we agree that discussion of the future of health care in Maine is essential, we believe strongly that it was irresponsible to release a draft report without the support of the full commission, without consideration for the services a hospital delivers, without careful analysis of hospitals' financial and clinical data, and without evidence that such proposals would actually lower costs or preserve access.

Has this approach been successful in meeting these objectives anywhere in the United States? Have the unintended consequences proven to be dangerous to a community?

If Haggett had done his homework, he would have learned that Inland Hospital already is part of a successful regional system. As a member of Eastern Maine Healthcare Systems, Inland has evolved into what we believe is Maine's hospital model of the future for small communities. It represents a primary and acute-care facility tightly integrated, both clinically and operationally, with an advanced medical center -- Eastern Maine Medical Center in Bangor. This relationship derives through a common corporate parent and gives every person using Inland Hospital direct access to the clinical excellence at our sister hospital in Bangor.

Today, our unique sharing of clinical and business resources allows us to provide a level of clinical sophistication that a smaller, stand-alone hospital would not be able to implement. This sophistication includes shared technology that plays an immediate role in the treatment of patients at Inland Hospital. Technology links allow rapid consultations between Inland physicians and specialists at Eastern Maine Medical Center. These linkages are happening today and more opportunities are on the way thanks to our affiliation with Eastern Maine Healthcare Systems. Here are some examples:

l We are working toward one clinical and information/documentation system between Inland and Eastern Maine Medical Center. This computerized record-keeping system puts the power of information at one's fingertips in real time. It will allow doctors to have current and historical information about patients immediately so they can make the most informed decisions about care. Whether it is the operating room, the laboratory, the emergency room or an Inland Hospital doctor's office, every department will be connected to one computerized system both at Inland and at Eastern Maine Medical Center. Research shows that patient safety, quality of care and operational efficiencies are enhanced when you link documentation, diagnostic equipment and the physician. This is what patient-focused care is all about.

l We just installed a picture archiving and communication system. This is a highly sophisticated digital X-ray computer system that allows doctors to view images simultaneously with physicians at Eastern Maine Medical Center, or anywhere in the world, for immediate consultation.

l Tele-trauma will be implemented shortly. Through an interactive communication system, Eastern Maine Medical Center doctors will be able to see the Inland patient and our emergency department doctor. Vital clinical information is shared via pictures, sound and data. This will allow for a collaborative approach to assessment and treatment.

l Critical care tele-units are coming soon. They will link Inland's intensive care unit directly -- and 24 hours a day -- to the intensive care doctors at Eastern Maine Medical Center. It will be as if they are assisting Inland's attending physicians at patients' bedsides in Waterville.

Inland's relationship with Eastern Maine Healthcare Systems works so well because it was entered into voluntarily by willing partners. Although it has required hard work by trustees, doctors and members of the hospital staff, it is successful today and holds great promise.

Another critical factor in our success is that the hospital's local board of trustees continues to make all key decisions that allow Inland to fulfill its mission, which is "to care for and serve the people of our community." Trustees and the medical staff have done an excellent job leading Inland to its current level of success.

It would be a tragedy to undo this exemplary model for the sake of a narrowly conceived vision that would result in the loss of service and doctors, and cause damage to the economy of central Maine. Closing hospitals that are clinically and financially sound is not the solution to the problems in Maine's health care system. Making proposals based on faulty assumptions is no way for the commission to conduct business.

Maine deserves a respectful, reflective and factual study into the complexity of health care costs and hospitals. In our eyes, the Commission to Study Maine Hospitals has earned a failing grade thus far.

Wilfred J. Addison is president and chief executive officer of Inland Hospital, a 48-bed hospital on Kennedy Memorial Drive in Waterville. Inland has been a member of Eastern Maine Healthcare Systems since 1996.