Minutes Meeting of the Academic Medical Centers and Hospitals Committee of the Board of Trustees of the State University of New York January 23, 2012 The Academic Medical Centers and Hospitals Committee of the Board of Trustees of the State University of New York held a meeting on January 23, 2012. Committee Members Present: Hon. H. Carl McCall, Chairman Mr. John Murad (Chair) Mr. Stephen Hunt Ms. Eunice A. Lewin Dr. Marshall Lichtman Mr. Cary Staller Committee Liaison Present: Ms. Kathy Preston Others Present: Dr. David Smith Dr. John McCabe Mr. Stuart Wright Mr. William Howard Dr. John LaRosa Mr. Ivan Lisnitzer Ms. Debra Carey Mr. Gerry Dantis Ms. Susan Blum Mr. Fred Matthews Mr. Brian Hutzley Mr. Simeon Banister Committee Members Not Present: Ms. Linda Sanford The Academic Medical Centers and Hospitals Committee meeting was called to order by Trustee John Murad at 2:00 p.m. on Monday, January 23, 2011, at the College of Optometry. . * Mr. Murad asked for approval of the minutes from the November 21, 2011, Committee meeting. The minutes were approved. * Ms. Preston provided a brief overview of the 2012-13 budget request. Specifically, Ms. Preston noted that the budget request for the hospitals was $115 million, however, the Executive budget included support at $60 million. This is the same level as the previous year. * Ms. Preston stated that we are extremely grateful that we were held harmless in this year’s budget. However, this does not reflect the formula we put forth to the Division of Budget. * Mr. Lisnitzer stated that we are thankful for the $60 million; however, last year we did a few things to get hospital support up to $100 million. Mr. Lisnitzer stated that it is important to get the support up to the $115 million or as close as we can get to that level. * Mr. Murad noted that the Committee would continue with its quality of care agenda, and would have regular discussions on quality. * Ms. Preston presented a quarterly report of quality and patient safety indicators. Ms. Preston noted that this is same report format that was used last year, and, because we have many of the same Committee members, we would present the report quarterly and have an in depth discussion once per year. Ms. Preston noted that instead of reviewing the detailed reports, we will be focusing on the actual programs, projects and structures in place to improve quality care and patient satisfaction. * Ms. Preston presented a proposed schedule for quality presentations, which lists all topics that will be discussed. * Mr. Staller stated that he likes to see all three hospitals on one slide. Mr. Staller further stated how well the Hospitals did on the patient satisfaction metrics. * Ms. Carey stated that they have been involved in various activities that supply improved patient satisfaction indicators. * Dr. McCabe noted that overall quality in the metrics is good, but there are things that they can all pick up. These metrics help them to focus. * Dr. Lichtman noted that it is such a statistical problem because there are thousands of patients and thousands of providers involved, and it is difficult to have so many individuals behave exactly the way they should all the time. * Dr. Smith stated this is an area Dr. LaRosa has been talking about for some time - and is probably a topic for discussion later - are we measuring real quality outcomes, why are we measuring, and are the measures and behaviors really predictable? It appears that some of the things external agencies track are not really predictive of quality and/or outcomes. And this is Dr. LaRosa’s point about developing a SUNY scale which would be based on level 1 evidence -- which is different from many other current measures -- and that by truly doing focusing on such evidence-based measures we will in fact improve morbidity and mortality. * Ms. Preston then started presentation of the next topic, the integrated delivery network. Ms. Preston stated that there have been many conversations about shared services, and that this is a big area of potential savings. Ms Preston presented background on what the hospitals have been working on together for the past several years, through their existing GPOs and a possible new direction. A Group Purchasing Organization or a GPO is a consortia purchasing organization which aggregates purchasing to enable their members to obtain better buying prices with favorable firms. GPO’s themselves do not buy or sell anything but act as the purchasing intermediaries primarily between vendors and hospitals. In the absence of flexibility, the hospital may go through a GPO who does all of this and gets the best price, but then the Comptroller’s office makes the hospitals justify each purchase on a transactional basis. The process can become a repetitive, slow and duplicative system. * All three hospitals are currently members of more than one GPO. Ms. Preston stated that an internal Integrated Delivery Network has been formed by SUNY’s three hospitals to coordinate and concentrate the purchase of their medical supplies and services. This group effort will focus its attention initially on the purchase of medical supplies, and then may later address some services. * Ms. Preston stated that they are talking to the Comptroller’s Office currently. There is a section in the Education Law that allows the Trustees to negotiate with the Comptroller for the exemption of certain types of purchases. Ms. Preston noted that what she has asked OSC to do was allow the hospitals to buy through GPOs without having the usual per transaction based review of purchases. Ms. Preston noted that it took us two years to get to that point and approval was limited to medical/surgical supplies and only some equipment. * Ms. Preston noted the IDN structure has been set up, and it is currently going by the informal internal name of “the SUNY Healthcare System.” Ms. Preston noted that it has been in active development for six months or so. The process is being guided by the IDN Steering Group, whose members are the CFOs at the three hospitals and some staff from SUNY System Administration who try to problem solve and help give direction to the folks in the collaborative and give some strategic direction to the overall effort. * Ms. Preston stated that as part of the hospitals’ membership in Greater New York Hospitals Association, they are provided access to Seagate, and a project manager has been provided to us by Greater New York and Seagate to help get us through this process. Ms. Preston further noted that Greater New York and Seagate are coordinating the analysis of data for using their data analysis tools. Ms. Preston noted that each hospital sends in data to look for opportunities for saving. Ms. Preston noted that it is difficult to put a projected number on the savings from the IDN; however, it is anticipated to be in the millions. * After completion of discussion of the above items, Mr. Murad made a motion to enter executive session at 2:40 pm. Trustee Staller motioned, seconded by Trustee Lichtman and was passed unanimously. * The Committee returned from Executive session at 5:50 p.m., whereupon Mr. Murad made a motion to adjourn the meeting, Trustee Hunt motioned, seconded by Trustee Staller, and passed unanimously.