“We try to look at community needs and try to build centers of excellence around them,” says Dr. Julie Tome, vice president of medical operations and clinical integration at ProMedica Health System, Toledo, Ohio.
ProMedica's 591-bed Toledo Hospital and the adjacent Toledo Children's Hospital are its tertiary-care base. But the Hickman Cancer Center, its oncology hub, is at the suburban Flower Hospital in suburban Sylvania.
“We did that by design,” says Kevin Webb, president of the system's acute-care division. “We spent a lot of capital on the Flower campus. It's got a pastoral setting. It's a nice setting for people going through a terrible disease.”
Likewise, the system's Wildwood Orthopaedic and Spine Hospital, while still in Toledo, is closer to the suburbs than Center City. The hospital is also home to the Wildwood Athletic Club, a 40,000-square-foot fitness center that's open to anyone who wants to join. “One of the appeals of a boutique hospital is an aura of expertise,” Webb says.
While that draws patients, it also attracts physicians, who lead a number of ProMedica's specialty divisions. It also allows systems to invest more strategically in technology. A treatment such as radiation therapy, for instance, can be expensive to provide at multiple sites, Webb notes.
“I think systems are being forced to do that more and more because of the costs of duplication,” he says about the interest in specialty hospitals. “More systems are doing that just to rationalize costs.”
But even as service offerings have become more specialized, ProMedica is increasingly focused on population health management, Tome says.
“A lot of work on population health is done not in bricks and mortar, but in virtual (settings),” she says, noting that Wildwood was the system's first all-digital hospital, using electronic health records and other IT, when it opened in 2011. “A lot of this work is done by webinars, electronically and by conference calling. We also use a lot of telemedicine.”
While many of the service lines boutique hospitals offer are high-volume, high-margin specialties, women's health has also been a standout. DiIorio of Coordinated Health notes that women make the vast majority of decisions on healthcare spending, which means that investing in women's health can pay big dividends.
Nebraska Methodist Health System, Omaha, started thinking about service-line planning when it began to run out of room at its 460-bed acute-care campus. Physicians identified the women's services department—which was taking up three floors—as one of the easiest to relocate. Methodist Women's Hospital, Omaha, opened in 2010. Although the new facility is only 10 miles away from the flagship campus, it's closer to the suburban ZIP codes that represent most of the babies it delivers.
Thanks to recommendations from local women community leaders as well as physicians, Methodist Women's is designed to invoke a weekend getaway more than a hospital stay. Each room has a refrigerator, a safe, a hair-dryer, a vanity and a suitcase rack. Bathrooms have alcoves for toiletries and peri bottles. Medical equipment is hidden behind cupboards.
In addition, six rooms for high-risk pregnancies are designed to provide all the comforts of a studio apartment, since stays for women at risk of preterm birth can often stretch into months.
Even though women's health is the hospital's primary service line, the facility also offers many other services that are in demand in the surrounding communities outside of the urban core, including an emergency room, imaging services for men and women, and general surgery procedures. An adjacent office building not only offers adolescent gynecology and midwifery care, but also behavioral health and skin renewal services.
“Our goal patient-wise is to be a one-stop shop,” says Sue Korth, Methodist Women's vice president and chief operating officer. “We built the hospital for our future growth.”
Methodist Women's also works closely with Nebraska Methodist Hospital to facilitate patient transfers. Women's Hospital, for instance, prides itself on being able to transport cardiac catheterization patients to the tertiary-care campus within the crucial 60-minute time frame.
“We were hoping the emergency department would be a feeder to the hospital and not cannibalize them,” Korth says. “We collaborate very well.”
Follow Beth Kutscher on Twitter: @MHbkutscher