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NH Society of Healthcare Engineers and Vermont Healthcare Engineers Society Twin State Seminar July 28, 2011

Dec 28, 2015

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Proposed FY10 Operating and Capital Budgets

NH Society of Healthcare Engineers and Vermont Healthcare Engineers Society

Twin State Seminar

July 28, 2011Welcome to DHMC and the Third Annual Twin State Seminar

Some Perspective on the Challenges Facing Our Nation and Our IndustryBut Firsta Test2000 to 2010 Growth - DHMC Discharges 35% - DHMC OR Cases 60%%34 Years10Years5Years2000 to 2010 Growth - DHMC Discharges 35% - DHMC OR Cases 60%%34 Years10Years5YearsWhen Does the Aging of America Begin?2000 to 2010 Growth - DHMC Discharges 35% - DHMC OR Cases 60%%34 Years10Years5Years5YearsThe Medicare population as a % of the U.S. population will increase by approximately the same amount over the next 10 years as it has since inception. 45% of that increase will occur in the next five years.

Access will be a challenge even without reformFacility Requirements Will Be SignificantPer capital health care spending for the 65 and older population is more than five times higher than spending per child and three times spending per working-age person

- U.S. Health Care ExpendituresWe are on a pathway as a nation that is unsustainable$200 Billion in 1960; $4.4 Trillion in 2018!

9Health Care Reform OversimplifiedAt the highest level, the health care system in the U.S. is too costly and doesnt produce outcomes commensurate with the investment we are making (currently 16% of GDP) Health care reform in its most simplistic form is about impacting cost and quality/outcome and creating valueAs health care providers we need to be laser focused on:

This focus is very consistent with the fundamentals of health care reform and is what society is expecting of us.

Value = QualityTimeCostImperatives_SA10TakeawayCombining the rapid change which will occur in the Medicare population with the fact that the majority of the health care dollar is spent in the latter years of life will put significant pressure on the U.S. health care system and capacity (beginning in the next five years)

11As Facilities Managers and Engineers you will need to be at the top of your game:- Access- Quality- Cost- Contributing to the financial sustainability of your organizationsThe Impact of Engineering and Facilities Management on DHMC

We Have a Rich History

Dartmouth-Hitchcock ClinicFounded 1927(over 80 years ago)Mary Hitchcock Memorial Hospital, founded 1893 (almost 120 years ago)Since Nathan Smiths appeal to Dartmouth College to found a medical school here in 1797, caring for the people of this region has been our mission. We are stewards of the health of our forefathers, and our future generations. We intend to be here a very long time. You are contributing to a legacy that few have (DMS is the 4th oldest in the nation.)

Weve Come A Long Way(DHMC 20 Years Ago)

Who We Are Today Has Been Largely Influenced by Our Facility

Where Will We Be in 2030??

Project Description: 102,750 Square Feet $38 million project including equipment

Strategic Investment:Facilitating project to provide Inpatient capacity (at a controlled cost)Outpatient capacity (50,000 sq. ft. for Medical Homes)Flexible and Cost Effective

Ramifications if not built:Capped inpatient capacityFamily Medicine stays in adequate spaceConstrained outpatient volumeLoss of current investmentD-H Heater Road

17Project Description:Two ORs, Intra-Op MRI and CT12,000 Square Feet, Total Project cost: $19.4 millionD-H Share: $6.2 million with balance from NIHand Dartmouth CollegeStrategic Investment:Only research facility of its type in the country.Design of new integrated imaging and surgical systems (only intra-op in the country with both MRI and CT)Excellent opportunity to improve outcomes/reduce cost nationallyKey differentiating serviceRamifications if not built:Loss of NIH grant funding ($10 million)Missed opportunity for advanced imaging excellence

Advanced Surgery Center for Translational Research

18Mission Vision

We advance health through research, education, clinical practice and community partnerships, providing each person the best care, in the right place, at the right time, every time. Achieve the healthiest population possible, leading the transformation of health care in our region and setting the standard for our nation. 19Mission Vision

We advance health through research, education, clinical practice and community partnerships, providing each person the best care, in the right place, at the right time, every time. Achieve the healthiest population possible, leading the transformation of health care in our region and setting the standard for our nation. People20Thank You for Coming and Thank You for All That You Do for the Patients and Staff of the Organizations You Support and Care For!