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FORM 990, SCHEDULE H, PART V, SECTION C:
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SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS-COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSBETH ISRAEL DEACONESS MEDICAL CENTER AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC). BILH IS A PURPOSE-DRIVEN, VALUES-BASED ORGANIZATION THAT UNITES 38,000 PEOPLE WHO PROVIDE EXCEPTIONAL HEALTH CARE TO EVERYONE WE SERVE. THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND PARTS OF SOUTHERN NEW HAMPSHIRE AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS AND ADDICTION TREATMENT PROGRAMS. THE BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,800 PHYSICIANS AND 38,000 EMPLOYEES. AT THE HEART OF BILH IS THE BELIEF THAT EVERYONE DESERVES HIGH-QUALITY, AFFORDABLE HEALTH CARE AND THIS BELIEF IS WHAT DRIVES EACH AFFILIATE TO WORK WITH COMMUNITY PARTNERS ACROSS THE REGION TO PROMOTE HEALTH, EXPAND ACCESS AND DELIVER THE BEST CARE IN THE COMMUNITIES BILH SERVES. BILH'S COMMUNITY BENEFITS STAFF ARE COMMITTED TO WORKING COLLABORATIVELY WITH BILH'S COMMUNITIES TO ADDRESS THE LEADING HEALTH ISSUES AND CREATE A HEALTHY FUTURE FOR INDIVIDUALS, FAMILIES AND COMMUNITIES.BILH'S PURPOSE STATEMENT ARTICULATES THE IMPACT BILH AND EACH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. BILH'S SHARED VALUES GUIDE DAILY EFFORTS, KEEP BILH AND EACH AFFILIATE ALIGNED IN THE PURSUIT OF PURPOSE AND SHOW HOW BILH CARES FOR PATIENTS, EACH OTHER AND OUR COMMUNITIES.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES - ONE PERSON AT A TIME - THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.BETH ISRAEL DEACONESS MEDICAL CENTER COMMUNITY BENEFITS MISSION STATEMENT THE MISSION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS TO SERVE OUR PATIENTS COMPASSIONATELY AND EFFECTIVELY, AND TO CREATE A HEALTHY FUTURE FOR THEM AND THEIR FAMILIES. OUR MISSION IS SUPPORTED BY OUR COMMITMENT TO PERSONALIZED, EXCELLENT PATIENT CARE FOR PATIENTS; A WORKFORCE COMMITTED TO INDIVIDUAL ACCOUNTABILITY, MUTUAL RESPECT AND COLLABORATION; AND A COMMITMENT TO MAINTAINING OUR FINANCIAL HEALTH. THE MEDICAL CENTER IS ALSO COMMITTED TO BEING ACTIVE IN THE COMMUNITY AS WELL. SERVICE TO THE COMMUNITY IS AT THE CORE AND AN IMPORTANT PART OF OUR MISSION. WE HAVE A COVENANT TO CARE FOR THE UNDERSERVED AND TO WORK TO CHANGE DISPARITIES IN ACCESS TO CARE. WE KNOW TO BE SUCCESSFUL WE NEED TO LEARN FROM THOSE WE SERVE. BIDMC'S COMMUNITY BENEFITS MISSION IS FULFILLED BY: - INVOLVING BIDMC STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE THREE-YEAR IMPLEMENTATION STRATEGY; - ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT THE HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA) IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, WITH SPECIAL ATTENTION FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES; - ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO UNDERSTAND UNMET HEALTH-RELATED AND IDENTIFY COMMUNITIES AND POPULATIONS SEGMENTS DISPROPORTIONATELY IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL, ECONOMIC AND SYSTEMIC FACTORS; - IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN BIDMC'S CBSA THAT ADDRESS THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO ACCESSING CARE, AS WELL AS PROMOTE HEALTH EQUITY TO IMPROVE THE HEALTH STATUS OF THOSE WHO ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, EXPERIENCE POVERTY, AND HAVE BEEN HISTORICALLY UNDERSERVED; - PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND - FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTHCARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, BIDMC PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $18,807,753 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMBIDMC'S BOARD OF TRUSTEES ALONG WITH ITS CLINICAL AND ADMINISTRATIVE STAFF IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS THROUGHOUT ITS CBSA AND BEYOND. WORLD-CLASS CLINICAL EXPERTISE, EDUCATION AND RESEARCH ALONG WITH AN UNDERLYING COMMITMENT TO HEALTH EQUITY ARE THE PRIMARY TENETS OF ITS MISSION. BIDMC'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF BIDMC'S BOARD OF TRUSTEES, IS DEDICATED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS AND WILL CONTINUE TO DO SO IN ORDER TO MEET ITS COMMUNITY BENEFITS OBLIGATIONS. HOSPITAL SENIOR LEADERSHIP IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF BIDMC'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. THE BIDMC COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY A TEAM OF COMMUNITY BENEFITS SENIOR LEADERS INCLUDING THE VICE PRESIDENT AND DIRECTOR OF COMMUNITY BENEFITS. THE VICE PRESIDENT OF COMMUNITY BENEFITS HAS DIRECT ACCESS TO AND IS ACCOUNTABLE TO THE BIDMC PRESIDENT AND ALSO REPORTS DIRECTLY TO THE BILH CHIEF DIVERSITY, EQUITY AND INCLUSION OFFICER. IT IS THE RESPONSIBILITY OF THESE LEADERS TO ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF COHORTS WHO HAVE BEEN HISTORICALLY UNDERSERVED ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. THE BIDMC COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH BIDMC'S HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT BIDMC'S COMMUNITY BENEFITS MISSION TO SERVE ITS PATIENTS COMPASSIONATELY AND EFFECTIVELY, AND TO CREATE A HEALTHY FUTURE FOR THEM, THEIR FAMILIES, AND BIDMC'S COMMUNITY. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF BIDMC'S COMMUNITY BENEFITS PROGRAMS IN FURTHERANCE OF BIDMC'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF BIDMC'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY BIDMC'S PROGRAMMATIC ENDEAVORS, INCLUDING THOSE FROM DIVERSE RACIAL AND ETHNIC BACKGROUNDS, AGE, GENDER, SEXUAL ORIENTATION AND GENDER IDENTITY, AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS.
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BIDMC'S CBAC MEMBERS INCLUDE:
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- FLOR AMAYA, DIRECTOR OF PUBLIC HEALTH, CITY OF CHELSEA - ELIZABETH BROWNE, CHIEF EXECUTIVE OFFICER, CHARLES RIVER COMMUNITY HEALTH - ALEXANDRA CHRY DORRELUS, CO-EXECUTIVE DIRECTOR, LOUIS D. BROWN PEACE INSTITUTE - LYNNE COURTNEY, PROGRAM ADMINISTRATOR, BILH WORKFORCE DEVELOPMENT - SHONDELL DAVIS, COMMUNITY TRAUMA HEALING SPECIALIST, CORY JOHNSON CENTER FOR POST-TRAUMATIC HEALING (COMMUNITY RESIDENT REPRESENTATIVE) - PAMELA EVERHART, SENIOR VICE PRESIDENT, REGIONAL PUBLIC AFFAIRS AND COMMUNITY RELATIONS, FIDELITY INVESTMENTS (BILH BOARD OF TRUSTEES DESIGNEE) - PAT FOLCARELLI, RN, MA, PHD BIDMC, NURSING AND PATIENT CARE SERVICES (BIDMC PRESIDENT DESIGNEE) - LAUREN GABOVITCH, COMMUNITY RESOURCE SPECIALIST, BIDMC - RICHARD GIORDANO, DIRECTOR OF POLICY AND COMMUNITY PLANNING, FENWAY COMMUNITY DEVELOPMENT CORPORATION - SHANTEL GOODEN, SENIOR DIRECTOR OF BEHAVIORAL HEALTH ADMINISTRATION AND OPERATIONS, THE DIMOCK CENTER - NANCY KASEN, VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS, BILH - BARRY KEPPARD, DIRECTOR OF PUBLIC HEALTH, METROPOLITAN AREA PLANNING COUNCIL - ANGIE LIOU, EXECUTIVE DIRECTOR, ASIAN COMMUNITY DEVELOPMENT CORPORATION - SANDY NOVACK, SOCIAL WORKER, UNIVERSAL ACCESS COUNCIL - ALEX OLIVER-DVILA, EXECUTIVE DIRECTOR, SOCIEDAD LATINA - KELINA (KELLY) ORLANDO, EXECUTIVE DIRECTOR, AMBULATORY OPERATIONS, BIDMC - TRINIESE POLK, DIRECTOR OF RACIAL EQUITY AND COMMUNITY ENGAGEMENT, BOSTON PUBLIC HEALTH COMMISSION - JANE POWERS, CHIEF OF STAFF AND EXECUTIVE VICE PRESIDENT OF STRATEGIC INITIATIVES, FENWAY HEALTH - RICHARD ROUSE, ADVISORY BOARD MEMBER, MISSION HILL MAIN STREETS - SAMANTHA TAYLOR, EXECUTIVE DIRECTOR, BOWDOIN STREET HEALTH CENTER - ROBERT TORRES, DIRECTOR OF COMMUNITY BENEFITS, BIDMC - LASHONDA WALKER-ROBINSON, COMMUNITY RESOURCE SPECIALIST, BIDMC - FRED WANG, TRUSTEE ADVISOR EMERITUS, BIDMCCOMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT-INTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY (IS OR CHIP) PURSUANT TO FEDERAL GUIDELINES, IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. BIDMC COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2022. THAT CHNA WAS APPROVED BY THE BIDMC BOARD OF TRUSTEES ON SEPTEMBER 21, 2022. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO ADOPTED BY THE BOARD ON SEPTEMBER 21, 2022, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R).THE CHNA AND THE ASSOCIATED IS REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF BIDMC'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA (CBSA) WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT BIDMC ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW BIDMC, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.COMMUNITY HEALTH NEEDS ASSESSMENT-PRIORITY GEOGRAPHY AND COHORTSAS NOTED ABOVE, BIDMC COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF BIDMC'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ENCOMPASSES THE BOSTON NEIGHBORHOODS OF ALLSTON/BRIGHTON, BOWDOIN/GENEVA, CHINATOWN, FENWAY/KENMORE, MISSION HILL AND ROXBURY, THE CITY OF CHELSEA, AND THE MUNICIPALITIES OF BROOKLINE, BURLINGTON, LEXINGTON, NEEDHAM, NEWTON (CHESTNUT HILL) AND PEABODY. THE CHNA SHOWS THAT LOW-INCOME AND RACIALLY/ETHNICALLY DIVERSE POPULATIONS LIVING IN BOSTON'S NEIGHBORHOODS OF ALLSTON/BRIGHTON, BOWDOIN/GENEVA, CHINATOWN, FENWAY/KENMORE, MISSION HILL AND ROXBURY, AS WELL AS THE ADJACENT CITY OF CHELSEA, FACE THE GREATEST HEALTH DISPARITIES AND ARE MOST AT RISK. AS A RESULT, THESE BOSTON NEIGHBORHOODS AND THE CITY OF CHELSEA HAVE BEEN IDENTIFIED AND PRIORITIZED AS THE FOCUS FOR BIDMC'S COMMUNITY HEALTH EFFORTS.COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR BIDMC'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS FROM A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).BIDMC'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCED POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN THE CITY OF CHELSEA AND THE CITY OF BOSTON NEIGHBORHOODS OF ALLSTON/BRIGHTON, BOWDOIN/GENEVA, CHINATOWN, FENWAY/KENMORE, MISSION HILL, AND ROXBURY, AS FOLLOWS: - YOUTH - LOW-RESOURCED POPULATIONS - LGBTQIA+ - OLDER ADULTS - RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS - FAMILIES AFFECTED BY VIOLENCE AND/OR INCARCERATION
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COMMUNITY HEALTH NEEDS ASSESSMENT - SUMMARY OF APPROACH AND METHODS
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BIDMC'S CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING BIDMC'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. BIDMC'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL, STATE AND NATIONAL LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, COLLABORATION, ENGAGEMENT, CAPACITY BUILDING, AND INTENTIONALITY.2022 COMMUNITY HEALTH NEEDS ASSESSMENT-SUMMARY OF APPROACH AND METHODSBIDMC'S 2022 CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING BIDMC'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. BIDMC'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL, STATE AND NATIONAL LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, COLLABORATION, ENGAGEMENT, CAPACITY BUILDING, AND INTENTIONALITY.BETWEEN OCTOBER 2021 AND FEBRUARY 2022, BIDMC, IN COLLABORATION WITH THREE OTHER REGIONAL ASSESSMENT EFFORTS, CONDUCTED 85 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, FACILITATED 22 FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, AND COMMUNITY LISTENING SESSIONS THAT ENGAGED 226 PARTICIPANTS. IN ADDITION, BIDMC'S BILH PARTNERS, BID NEEDHAM AND LAHEY HOSPITAL & MEDICAL CENTER (LHMC), CONDUCTED A COMMUNITY HEALTH SURVEY, WHICH GATHERED INFORMATION FROM MORE THAN 1,400 COMMUNITY RESIDENTS FROM BID NEEDHAM'S AND LHMC'S CBSAS, INCLUDING 346 RESIDENTS FROM NEEDHAM, 155 RESIDENTS OF BURLINGTON, AND 180 RESIDENTS OF PEABODY. BID NEEDHAM AND LHMC SHARED THIS INFORMATION WITH BIDMC. THE BOSTON PUBLIC HEALTH COMMISSION FIELDED A COVID-19 HEALTH EQUITY SURVEY IN DECEMBER 2020/JANUARY 2021; AS SUCH, BIDMC, BASED ON RECOMMENDATIONS FROM THE BOSTON CHNA- COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) COLLABORATIVE STEERING COMMITTEE, OPTED NOT TO FIELD THE BILH COMMUNITY HEALTH SURVEY IN BOSTON. THE BOSTON PUBLIC HEALTH COMMISSION COVID-19 HEALTH EQUITY SURVEY INCLUDED A RANDOM SAMPLE OF OVER 1,650 RESIDENTS IN MULTIPLE LANGUAGES AND EXAMINED ISSUES RELATED TO JOB LOSS, FOOD INSECURITY, ACCESS TO SERVICES, MENTAL HEALTH, VACCINATION, AND PERCEPTIONS OF RISK AROUND COVID-19. THE NORTH SUFFOLK PUBLIC HEALTH COLLABORATIVE ALSO FIELDED A COMMUNITY HEALTH SURVEY. THE SURVEY COLLECTED DATA FROM 1,401 RESPONDENTS FROM CHELSEA, REVERE, AND WINTHROP. RESULTS WERE STRATIFIED BY COMMUNITY, AGE GROUP, GENDER, RACE, ETHNICITY, AND LANGUAGE. IN ADDITION, BIDMC'S BILH PARTNERS, BID NEEDHAM AND LHMC, CONDUCTED A COMMUNITY HEALTH SURVEY, WHICH GATHERED INFORMATION FROM MORE THAN 1,400 COMMUNITY RESIDENTS FROM BID NEEDHAM'S AND LHMC'S CBSAS, INCLUDING 346 RESIDENTS FROM NEEDHAM, 155 RESIDENTS OF BURLINGTON, AND 180 RESIDENTS OF PEABODY. BID NEEDHAM AND LHMC SHARED THIS INFORMATION WITH BIDMC. COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-DETAIL OF APPROACH AND METHODSBIDMC RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT ITS CBSA. BIDMC COLLECTED DATA FROM SEVERAL SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AND SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT BIDMC LEVERAGED INCLUDED: - U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2016-2020) - U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2010-2020) - U.S. CENSUS BUREAU, COVID-19 HOUSEHOLD PULSE SURVEY (2021) - BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (2019) - MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021) - FBI UNIFORM CRIME REPORTS (2019) - MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021) - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2019) - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2015-2017) - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 DASHBOARD (2021) - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 COMMUNITY IMPACT SURVEY (2021) - MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019) - MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2019) - MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2020) - MASSACHUSETTS INSTITUTE OF TECHNOLOGY, EVICTION LAB (2018) - ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2019, 2020, 2021)2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-KEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN OCTOBER 2021 AND FEBRUARY 2022, BIDMC WORKED WITH COLLABORATORS TO CONDUCT 85 KEY INFORMANT INTERVIEWS THAT ENGAGED COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, ELECTED/APPOINTED OFFICIALS AND OTHER KEY COLLABORATORS THROUGHOUT BIDMC'S CBSA. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX A OF THE CHNA REPORT THAT IS POSTED ON BIDMC'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN BIDMC'S CBSA. INTERVIEWS WERE CONDUCTED VIRTUALLY USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS.
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COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-
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FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)ACROSS ALL FOUR COMPONENTS OF THE CHNA, BIDMC CONDUCTED 22 COMMUNITY FOCUS GROUPS AND HELD COMMUNITY LISTENING SESSIONS THAT ENGAGED 226 RESIDENTS IN BIDMC'S COMMUNITY BENEFITS SERVICE AREA (CBSA) TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE FOCUS GROUPS AND LISTENING SESSIONS WERE ORGANIZED IN COLLABORATION WITH THE BOSTON CHNA-CHIP COLLABORATIVE, NORTH SUFFOLK INTEGRATED CHNA AND OTHER BILH HOSPITALS.BIDMC WAS INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF BIDMC'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN TWELVE LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE NETWORKS, PUBLIC LIBRARIES, COMMUNITY EVENTS AND LARGE APARTMENT BUILDINGS TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. THE BIDMC COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE CBAC MET FIVE TIMES DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE, CONDUCTING OUTREACH TO COMMUNITY VOICES THAT HAVE HISTORICALLY BEEN LEFT OUT OF SIMILAR PROCESSES. COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-REVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSAS NOTED ABOVE, THE CHNA PROCESS WAS DIVIDED INTO THREE PHASES. THE FINAL PHASE, PHASE III, INCLUDED THE FOLLOWING STEPS: - REVIEW OF THE ASSESSMENT'S MAJOR FINDINGS WITH THE BIDMC COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS. - IDENTIFY BIDMC'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES. - ANALYZE BIDMC'S EXISTING COMMUNITY BENEFITS ACTIVITIES INFORMED BY THE 2019 CHNA AND SUBSEQUENT 2020 2022 IMPLEMENTATION STRATEGY COMPLETED BY BIDMC DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). - DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021).COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-KEY FINDINGSTHE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDING SEPTEMBER 30, 2022, WERE: - YOUTH - LOW-RESOURCED POPULATIONS - LGBTQIA+ - OLDER ADULTS - RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS - FAMILIES AFFECTED BY VIOLENCE AND/OR INCARCERATIONBIDMC'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: - EQUITABLE ACCESS TO CARE: INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTHCARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THE ISSUES STEM FROM HOW THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY. - SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO ECONOMIC INSECURITY, EDUCATION, FOOD INSECURITY, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA ON SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEY, AND LISTENING SESSIONS SUGGESTED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD SECURITY/NUTRITION, AND ECONOMIC STABILITY. - HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING TO COMMUNITY HEALTH CONCERNS. THE ASSESSMENT IDENTIFIED SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, THE MENTAL HEALTH IMPACTS OF RACISM, DISCRIMINATION, AND TRAUMA, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS). - HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN THE COMMONWEALTH AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM BIDMC'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2023, SEPTEMBER 30, 2024, AND SEPTEMBER 30, 2025.
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COMMUNITY HEALTH NEEDS ASSESSMENT
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MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLEBIDMC STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, BIDMC COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE BIDMC WEBSITE AT:HTTPS://WWW.BIDMC.ORG/-/MEDIA/FILES/BETH-ISRAEL-ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS/BIDMC-2022-COMMUNITY-HEALTH-NEEDS-ASSSESSMENT-093022.PDFIN ADDITION TO THE CHNA, BIDMC COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE BIDMC WEBSITE AT:HTTPS://WWW.BIDMC.ORG/-/MEDIA/FILES/BETH-ISRAEL-ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS/BIDMC-2023-2025-IMPLEMENTATION-STRATEGY-101122.PDFBIDMC COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THAT CHNA IS AVAILABLE ON THE BIDMC WEBSITE AT: HTTPS://WWW.BIDMC.ORG/-/MEDIA/FILES/BETH-ISRAEL-ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS/CHNA-REPORT93019FINAL.PDFFINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING BIDMC'S FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018) IS AVAILABLE ON THE BIDMC WEBSITE AT:HTTPS://WWW.BIDMC.ORG/-/MEDIA/FILES/BETH-ISRAEL-ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS/IMPLEMENTATION-STRATEGY-2020-2022.PDFEACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).
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COMMUNITY HEALTH NEEDS ASSESSMENT
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ADDRESSING COMMUNITY HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, BIDMC'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 AND A SUMMARY OF BIDMC'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THAT CHNA AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY ARE PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, BIDMC HAS BEEN STRATEGIC IN IDENTIFYING ITS COMMUNITY HEALTH PRIORITIES TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GOALS FOR EACH PRIORITY AREA ARE LISTED BELOW.PRIORITY AREA 1: SOCIAL DETERMINANTS OF HEALTH - ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENT WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES.PRIORITY AREA 2: CHRONIC AND COMPLEX CONDITIONS - IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES.PRIORITY AREA 3: ACCESS TO CARE - PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AS WELL AS URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC AND ECONOMIC BARRIERS. PRIORITY AREA 4: MENTAL HEALTH AND SUBSTANCE USE - PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE ISSUES AND CONDITIONS.COMMUNITY HEALTH NEEDS ASSESSMENT - APPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)BIDMC HAS TAKEN A HOLISTIC AND STRATEGIC APPROACH IN ADDRESSING THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY BY CREATING, SUPPORTING AND INVESTING IN HEALTH PROGRAMMING AND INITIATIVES THROUGHOUT ITS CBSA. BELOW IS A SUMMARY OF SOME OF THE COMMUNITY BENEFITS PROGRAMS AND INITIATIVES BIDMC OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES AMONG ITS FOCUS COHORTS THROUGHOUT ITS PRIORITY NEIGHBORHOODS.BIDMC HAS BEEN A LEADER IN CREATING A MYRIAD OF COMMUNITY BENEFITS PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE THE BIDMC CENTER FOR VIOLENCE PREVENTION AND RECOVERY (CVPR), JOB CREATION AND CAREER ADVANCEMENT OPPORTUNITIES THROUGH BILH'S OFFICE OF WORKFORCE DEVELOPMENT, DEVELOPMENT OF INSTITUTIONAL METRICS TO MEASURE BIDMC'S SHRINKING CARBON FOOTPRINT, AND TRANSPORTATION RESOURCES TO IMPROVE ACCESS TO HEALTHCARE. THROUGH CVPR, BIDMC HAS LED THE WAY IN DEVELOPING A CONTINUUM OF EDUCATION, OUTREACH, AND TREATMENT INTERVENTIONS TO RESPOND TO VICTIMS OF INTERPERSONAL, SEXUAL, COMMUNITY VIOLENCE, AND HOMICIDE BEREAVEMENT. IT IS ALSO ONE OF THE LEADERS IN DEVELOPING PROGRAMMING TO ADDRESS SECONDARY TRAUMATIC STRESS AMONG DOMESTIC VIOLENCE AND MEDICAL SERVICE PROVIDERS. IN FY23, BIDMC PROVIDED SERVICES TO 702 SURVIVORS OF DOMESTIC, SEXUAL AND COMMUNITY VIOLENCE. TO FURTHER ADDRESS THE SOCIAL DETERMINANTS OF HEALTH, BIDMC IS COMMITTED TO MAKING EMPLOYMENT OPPORTUNITIES AVAILABLE TO COMMUNITY RESIDENTS AND CREATING CAREER ADVANCEMENT OPPORTUNITIES FOR BIDMC EMPLOYEES WHO ARE SEEKING ADDITIONAL SKILLS AND HIGHER INCOMES. IN FY23 BILH'S OFFICE OF WORKFORCE DEVELOPMENT OFFERED 10 DIFFERENT CAREER PIPELINE PROGRAMS THAT SERVED 101 PEOPLE. ADDITIONALLY, 26 YOUTH WERE EMPLOYED IN PAID SUMMER JOBS AT BIDMC AND AN ADDITIONAL EIGHT YOUTH RECEIVED STIPENDS THROUGH A SCHOOL-YEAR PROGRAM RUN IN PARTNERSHIP WITH THE YMCA. OTHER EXAMPLES OF SUCCESS ARE LISTED IN THE SUBSEQUENT SCHEDULE H IMPLEMENTATION STRATEGY UPDATE. BIDMC IS ROOTED IN PROVIDING HEALTHCARE TO POPULATIONS WHO HAVE HISTORICALLY NOT HAD ADEQUATE ACCESS TO CARE. BIDMC CONTINUES TO EXPAND ACCESS THROUGHOUT ITS CBSA BY SUPPORTING AND LEADING THE COMMUNITY CARE ALLIANCE (CCA), ENSURING THAT RESIDENTS HAVE ACCESS TO QUALITY COMMUNITY HEALTH CENTERS (CHCS) SERVING THE NEEDS OF THE MOST VULNERABLE IN WAYS THAT ARE CULTURALLY RESPONSIVE AND ACCESSIBLE. BIDMC IS COMMITTED TO STRENGTHENING ITS FIVE AFFILIATED AND/OR LICENSED CHCS' CAPACITY INCLUDING BOWDOIN STREET HEALTH CENTER (BSHC), THE DIMOCK HEALTH CENTER, FENWAY HEALTH, CHARLES RIVER COMMUNITY HEALTH, AND SOUTH COVE COMMUNITY HEALTH CENTER. THE PARTNERSHIP TAKES MANY FORMS: RECRUITMENT, RETENTION, FINANCIAL SUPPORT AND CREDENTIALING OF PHYSICIANS AND MID-LEVEL PROVIDERS, BIDMC ADMITTING PRIVILEGES AND ACCESS TO MANAGED CARE CONTRACTS, HARVARD MEDICAL SCHOOL APPOINTMENTS AND TEACHING OPPORTUNITIES, BIDMC-SPONSORED EDUCATIONAL PROGRAMS, AND ACCESS TO UP-TO-DATE (A CLINICAL SUPPORT RESOURCE). WHILE OUTER CAPE HEALTH SERVICES REMAINS A CLINICAL AFFILIATE AND BIDMC COLLABORATOR AND COMMUNITY PARTNER, THE HEALTH CENTER IS LONGER A MEMBER OF CCA. BIDMC HAS FOCUSED ITS EFFORTS ON CREATING TARGETED PROGRAMS THAT ADDRESS CHRONIC DISEASES SUCH AS CANCER, DIABETES, AND HIV. THESE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO BIDMC'S CANCER PATIENT NAVIGATORS AND BSHC'S HEALTHY IN THE CITY. TO SUPPORT CANCER PATIENTS WHEN SPECIALTY CARE OR INPATIENT HOSPITALIZATIONS ARE NECESSARY, BIDMC OFFERS THE SERVICES OF BILINGUAL AND BICULTURAL CANCER PATIENT NAVIGATORS WHO BRIDGE THE GULF BETWEEN COMMUNITY PROVIDERS AND THE MEDICAL CENTER. ONE PATIENT NAVIGATOR SPECIALIZES IN SERVING THE LATINO COMMUNITY AND THE OTHER SPECIALIZES IN SERVING THE CHINESE COMMUNITY, THOUGH THEY ALSO SERVE PATIENTS FROM OTHER ETHNIC GROUPS. DETAILS OF OTHER BIDMC PROGRAMS, SUCH AS BSHC'S HEALTHY IN THE CITY THAT ADDRESSES CHRONIC DISEASE MANAGEMENT ARE INCLUDED IN THE IMPLEMENTATION STRATEGY UPDATE BELOW.AMONG THE MANY WAYS BIDMC AND ITS PARTNERS ADDRESS BEHAVIORAL HEALTH NEEDS IS BY EXPANDING BEHAVIORAL HEALTH INTEGRATION AT ITS AFFILIATED HEALTH CENTERS, SCREENING PATIENTS AT BIDMC AND CONNECTING THEM TO APPROPRIATE SERVICES. FOR EXAMPLE, BSHC CONTINUES TO INTEGRATE BEHAVIORAL HEALTH SERVICES INTO ITS PRIMARY CARE CLINIC. A BEHAVIORAL HEALTH CARE MANAGER IS ON-SITE TO PROVIDE MENTAL HEALTH ASSESSMENT, INTERVENTION, AND CONSULTATION TO PATIENTS AND PROVIDERS DURING PRIMARY CARE VISITS. RESULTS OF THE BEHAVIORAL HEALTH INTEGRATION SHOW THAT MORE HIGH-RISK PATIENTS ARE ACCESSING MENTAL HEALTH SERVICES, AN INCREASE IN APPOINTMENTS KEPT BY PATIENTS WHO RECEIVE A "WARM-HAND OFF" BY THEIR PROVIDER TO THERAPISTS, AND REDUCED WAIT TIME FOR MENTAL HEALTH APPOINTMENTS. BIDMC ALSO CONTINUED TO DEDICATE TIME AND RESOURCES TO RESPOND TO NEEDS RELATED TO COVID-19 AND OTHER EMERGING ISSUES, SUCH AS FOOD INSECURITY, HOUSING INSTABILITY, AND ACCESS TO CARE. BOWDOIN STREET HEALTH CENTER DISTRIBUTED BAGS OF FRESH FOOD TO HEALTH CENTER PATIENTS AND COMMUNITY MEMBERS WHO IDENTIFIED AS FOOD INSECURE. A FULL UPDATE ON BIDMC'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.FY23 SCHEDULE H-IMPLEMENTATION STRATEGY UPDATEKEY: BASELINE-2023, YEAR 1-2024, YEAR 2-2025PRIORITY AREA 1: SOCIAL DETERMINANTS OF HEALTH SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE DOMINANT THEME FROM BIDMC'S KEY INFORMANT INTERVIEWS AND COMMUNITY FORUMS WAS THE CONTINUED IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH ARE HAVING ON THE CBSA'S LOW-INCOME, UNDERSERVED, DIVERSE POPULATION COHORTS. MORE SPECIFICALLY, DETERMINANTS SUCH AS POVERTY, EMPLOYMENT OPPORTUNITIES, VIOLENCE, TRANSPORTATION, RACIAL SEGREGATION, LITERACY, PROVIDER LINGUISTIC/CULTURAL COMPETENCY, SOCIAL SUPPORT AND COMMUNITY INTEGRATION LIMIT MANY PEOPLE'S ABILITY TO CARE FOR THEIR OWN AND/OR THEIR FAMILIES' HEALTH. THE IMPACT OF RACISM, BARRIERS TO CARE, AND DISPARITIES IN HEALTH OUTCOMES THAT THESE POPULATIONS FACE ARE WIDELY DOCUMENTED. THERE ARE A MULTITUDE OF INDIVIDUAL, COMMUNITY AND SOCIETAL FACTORS THAT WORK TOGETHER TO CREATE THESE INEQUITIES. THE UNDERLYING ISSUE IS NOT ONLY RACE/ETHNICITY, FOREIGN-BORN STATUS, OR LANGUAGE BUT RATHER A BROAD ARRAY OF INTERRELATED ISSUES INCLUDING ECONOMIC OPPORTUNITY, EDUCATION, CRIME, AND COMMUNITY COHESION.
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GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS
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WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES.STRATEGIES 1.1 SUPPORT EVIDENCE-BASED PROGRAMS AND STRATEGIES TO REDUCE HOMELESSNESS, REDUCE DISPLACEMENT, AND INCREASE HOME OWNERSHIP BY LOW-INCOME INDIVIDUALS AND FAMILIES. 1.2 SUPPORT EVIDENCE-BASED PROGRAMS, STRATEGIES, AND PARTNERSHIPS TO INCREASE EMPLOYMENT AND EARNINGS AND INCREASE FINANCIAL SECURITY. 1.3 PROMOTE THRIVING NEIGHBORHOODS AND ENHANCE COMMUNITY COHESION AND RESILIENCE. 1.4 INCREASE MENTORSHIP, LEADERSHIP, TRAINING, AND EMPLOYMENT OPPORTUNITIES FOR YOUTH AND YOUNG ADULTS RESIDING IN THE COMMUNITIES BIDMC SERVES. 1.5 ADVOCATE FOR AND SUPPORT POLICIES AND PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. 1.6 CONSERVE NATURAL RESOURCES, REDUCE CARBON EMISSIONS, AND FOSTER A CULTURE OF SUSTAINABILITY TO CREATE A HEALTHY ENVIRONMENT FOR RESIDENTS. 1.7 BUILD COMMUNITY AWARENESS, ADVOCATE FOR POLICY CHANGE, AND PROVIDE SUPPORTIVE CARE FOR VICTIMS OF VIOLENCE AND TRAUMA. 1.8 PROMOTE HEALTHY EATING AND ACTIVE LIVING BY INCREASING OPPORTUNITIES FOR PHYSICAL ACTIVITY AND PROVIDING HEALTHY FOOD RESOURCES TO PATIENTS AND COMMUNITY RESIDENTS.INITIATIVES TO ADDRESS THE PRIORITY - INVESTMENTS IN HOUSING PROGRAMS TO STABILIZE OR CREATE ACCESS TO AFFORDABLE HOUSING - INVESTMENTS IN JOBS AND FINANCIAL SECURITY PROGRAMS TO STRENGTHEN THE LOCAL WORKFORCE AND ADDRESS UNDEREMPLOYMENT - COMMUNITY HIRING - HEALTHY NEIGHBORHOODS INITIATIVE - THE WELLNESS CENTER AT BOWDOIN STREET HEALTH CENTER - VILLAGE IN PROGRESS (VIP) - NEIGHBORHOOD TRAUMA TEAM - PLACEMAKING ACTIVITIES AND NEIGHBORHOOD IMPROVEMENT - YOUTH SUMMER JOBS PROGRAM - BIDMC YOUTH ADVISORS - ENVIRONMENTAL SUSTAINABILITY - THE CENTER FOR VIOLENCE PREVENTION AND RECOVERY (CVPR) - THE WELLNESS CENTER AT BOWDOIN STREET HEALTH CENTER - GROCERY STORE GIFT CARD DISTRIBUTION PROGRAM - FITNESS IN THE CITY (NOW KNOWN AS HEALTHY IN THE CITY) - EXPLORE INSTALLATION OF FREIGHT FARMSMETRICS AND STATUS UPDATE:* BASED ON DATA COLLECTED BETWEEN JULY 1, 2021 AND SEPT 30, 2023 - *HOUSING: - HOUSING SATISFACTION: (FY23: ON AVERAGE, PARTICIPANTS REPORTED HIGHER LEVELS OF SATISFACTION WITH THEIR HOUSING SITUATION AT ENDPOINT COMPARED TO WHEN THEY ENROLLED; THIS RESULT WAS STATISTICALLY SIGNIFICANT. THE OVERALL AVERAGE LEVEL OF HOUSING SATISFACTION INCREASED SIGNIFICANTLY FROM 2.9 AT BASELINE TO 3.2 AT ENDPOINT.) - HOUSING CONTROL: (FY23: ON AVERAGE, PARTICIPANTS REPORTED A HIGHER LEVEL OF CONTROL OF THEIR HOUSING SITUATION AT ENDPOINT COMPARED TO WHEN THEY ENROLLED; THIS RESULT WAS STATISTICALLY SIGNIFICANT. THE AVERAGE LEVEL OF HOUSING CONTROL INCREASED FROM 2.8 AT BASELINE TO 3.1 AT ENDPOINT.) - HOUSING SITUATION: (FY23: THE MAJORITY OF PARTICIPANTS (85.0%) DID NOT HAVE ANY CHANGE IN THEIR HOUSING SITUATION BETWEEN BASELINE AND ENDPOINT). NOTE: GIVEN THAT THE BOSTON HOUSING MARKET IS ONE OF THE MOST EXPENSIVE IN THE US, THIS STABILITY IN DESCRIPTION OF HOUSING SITUATION CAN BE INTERPRETED AS A POSITIVE RESULT. - ADVOCACY: (FY23: 2,689 ADVOCACY EFFORTS AMONG FOUR GRANTEES FOR POLICY CHANGE RELATED TO HOUSING AFFORDABILITY) - # OF YOUTHS HOUSED: (FY23: 24) - *FINANCIAL CAPABILITY AND HOPE: - FY23: 334 PARTICIPANTS FROM SIX GRANTEES ACHIEVED A POSITIVE INCREASE IN FINANCIAL HABITS AND SIGNIFICANT IMPROVEMENTS IN FINANCIAL CAPABILITY. - MORE THAN HALF IDENTIFIED AS HISPANIC, LATINX, OR OF SPANISH DESCENT (53.6%); A THIRD IDENTIFIED AS BLACK OR AFRICAN AMERICAN (33.2%); THREE OUT OF 5 PARTICIPANTS WERE FEMALE (60.4%) AND OVER A THIRD WERE MALE (36.6%). - FY23: (1.7% INCREASE IN THE PROPORTION OF PARTICIPANTS REPORTING THEY HAD A PERSONAL BUDGET, SPENDING PLAN, OR FINANCIAL PLAN, FROM 39.9% AT BASELINE TO 51.6% AT ENDPOINT. (ADULT HOPE SCALE)) - COLLECTIVE RELATIONSHIPS AND COHESION (FY23: DATA NOT YET AVAILABLE) - VILLAGE IN PROGRESS AND NEIGHBORHOOD TRAUMA TEAM - # OF NEIGHBORHOOD INCIDENTS RESPONDED TO (FY23: 12 INCIDENTS THAT WERE LEVEL 4 OR 5) - # OF THERAPEUTIC SESSIONS PROVIDED (FY23: 534) - YOUTH SUMMER JOBS PROGRAM AND BIDMC YOUTH ADVISORS - # OF YOUTH INVOLVED (FY23: 34) - # OF POLICIES REVIEWED AND SUPPORTED (FY23: BILH CONDUCTED DIRECT ADVOCACY FOR TWO POLICIES: AN ACT PROVIDING AFFORDABLE AND ACCESSIBLE HIGH-QUALITY EARLY EDUCATION AND CARE TO PROMOTE CHILD DEVELOPMENT AND WELL-BEING AND SUPPORT THE ECONOMY IN THE COMMONWEALTH AND AN ACT TO ADVANCE HEALTH EQUITY) - ENVIRONMENTAL SUSTAINABILITY - GREENHOUSE GAS EMISSIONS (FY23: BIDMC REDUCED ORGANIZATIONAL EMISSIONS BY 11.9% IN FY23 FROM A BASELINE OF 2016) - % LOCAL FOOD AND BEVERAGE SPEND (FY23: PURCHASED 17.3% SUSTAINABLE AND LOCAL FOOD & BEVERAGE IN FY23, AN INCREASE OF 0.2% FROM FY22) - WASTE DIVERSION (FY23: ACHIEVED 56.8% DIVERSION, AN INCREASE OF 6.7% FROM FY22) - THE CENTER FOR VIOLENCE PREVENTION AND RECOVERY (CVPR) - # SEXUAL ASSAULT VICTIMS RECEIVING SERVICES (FY23: 702) - # OF SERVICES PROVIDED TO SEXUAL ASSAULT VICTIMS IN THE EMERGENCY DEPARTMENT (ED) (FY23: 66) - # OF EDUCATION AND OUTREACH SERVICES - FY23: CVPR PROVIDED 27 TRAININGS TO 662 EMPLOYEES IN HEALTH CENTERS, COLLEGES AND UNIVERSITIES, AND OTHER COMMUNITY GROUPS AROUND SEXUAL ASSAULT, INTERPERSONAL VIOLENCE, COMMUNITY VIOLENCE, SECONDARY TRAUMATIC STRESS, AND HUMAN TRAFFICKING - FY23: CVPR PROVIDED TWO GROUPS WITH 8 SESSIONS OF SERVICE TO COMMUNITY GROUPS AROUND SECONDARY TRAUMATIC STRESS. - # OF SAFE BED OVERNIGHT STAYS (FY23: 6) - # OF HEALING CIRCLES (FY23: 32, AND 390 TOTAL ATTENDEES) - HEALTHY EATING AND ACTIVE LIVING - # OF PARTICIPANTS IN HEALTHY IN THE CITY (FY23: 43) - # OF UNITS OF FOOD DISTRIBUTED (FY23: 1590 BAGS THROUGH FAIR FOODS WERE DISTRIBUTED FOR FREE TO PATIENTS AND COMMUNITY MEMBERS AND 276 MEALS WERE DONATED TO FOOD FOR FREE) - # OF FARMER'S MARKET COUPONS, BPHC PROVIDED THAT COULD BE USED AT ANY CITY OF BOSTON FARMER'S MARKET TO PATIENTS AND COMMUNITY MEMBERS (FY23: 609)PRIORITY AREA 2: CHRONIC AND COMPLEX CONDITIONSHIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN THE COMMONWEALTH AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.GOAL: IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES.STRATEGIES 2.1 PROVIDE PREVENTIVE HEALTH INFORMATION, SERVICES, AND SUPPORT FOR THOSE AT RISK FOR COMPLEX AND/ OR CHRONIC CONDITIONS AND SUPPORT EVIDENCE-BASED CHRONIC DISEASE TREATMENT AND SELF-MANAGEMENT PROGRAMS. 2.2 ADDRESS THE HEALTH-RELATED SOCIAL NEEDS (HRSN) OF PATIENTS IN ORDER TO SUPPORT ACCESS TO CARE. 2.3 PROVIDE AND PROMOTE CAREER SUPPORT SERVICES AND CAREER MOBILITY PROGRAMS TO HOSPITAL EMPLOYEES. 2.4 PROMOTE ACCESS TO HEALTH INSURANCE, PATIENT FINANCIAL COUNSELORS, AND NEEDED MEDICATIONS FOR PATIENTS WHO ARE UNINSURED OR UNDERINSURED. 2.5 ADVOCATE FOR AND SUPPORT POLICIES AND PROGRAMS THAT ADDRESS HEALTHCARE ACCESS. 2.6 SUPPORT RESEARCH AIMED AT PROVIDING MORE EQUITABLE CARE FOR PATIENTS AND COMMUNITY MEMBERS. 2.7 PROVIDE AND SUPPORT RESIDENTS WITH TRANSPORTATION ACCESS, PUBLIC SAFETY, EMERGENCY CARE, PUBLIC HEALTH AND EMERGENCY PREPAREDNESS.INITIATIVES TO ADDRESS THE PRIORITY - COMMUNITY CARE ALLIANCE (CCA) AND SUPPORT FOR COMMUNITY-BASED PRIMARY AND SPECIALTY CARE - NETWORK/IT INTEGRATION AND ACCESS FOR CCA HEALTH CENTERS - CARE CONNECTION - BOSTON HEALTHY START INITIATIVE - RESIDENCY TRAINING PROGRAM - COMMUNITY HEALTH WORKER PROGRAM - BIDMC SOCIAL WORK DEPARTMENT SERVICES - PIPELINE PROGRAMS - CAREER AND ACADEMIC ADVISING - HOSPITAL-SPONSORED COMMUNITY COLLEGE COURSES - HOSPITAL-SPONSORED ENGLISH SPEAKERS OF OTHER LANGUAGES (ESOL) CLASSES - DIVERSE TALENT PROMOTION AND ACQUISITION - FINANCIAL COUNSELING - PHARMACY PROGRAMS - CENTER FOR DIVERSITY, EQUITY, AND INCLUSION - MEDICAL AND CRITICAL CARE TRANSPORTATION - TRAUMA, EMERGENCY MANAGEMENT, AND PUBLIC HEALTH SURVEILLANCE - PUBLIC SAFETY
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METRICS AND STATUS UPDATES:
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- # OF PATIENTS SERVED AT CCA HEALTH CENTERS, AFFILIATED FQHC'S AND OUTER CAPE HEALTH SERVICES (FY23: 122,800) - # OF MEDICAL CARE SERVICE VISITS (INCLUDING VIRTUAL) PROVIDED AT CCA HEALTH CENTERS AND OUTER CAPE HEALTH SERVICES (FY23: 386,100) - PERCENTAGE OF CCA FEDERALLY QUALIFIED HEALTH CENTER (FQHC) AND OUTER CAPE HEALTH SERVICES PATIENTS WITH DIABETES WITH HBA1C < 9 CONTROLLED (FY23: 75%). - PERCENTAGE OF CCA FQHC AND OUTER CAPE HEALTH SERVICES PATIENTS WITH HYPERTENSION WHO HAD A BLOOD PRESSURE < 140/90 CONTROLLED (FY23: 65%) - # OF SUPPORT GROUPS (FY23: 9 SUPPORT GROUPS MET REGULARLY AND A TOTAL OF 252 MEETINGS WERE HELD) - # OF PATIENTS ATTENDING SUPPORT GROUPS (FY23: AVERAGE OF 6 PATIENTS ATTENDED EACH SUPPORT GROUP MEETING) - # OF PATIENTS RECEIVING EARLY DETECTION LUNG CANCER SCREENING (FY23: 1,250 PATIENTS) - # OF POLICIES REVIEWED AND SUPPORTED (FY23: BILH CONDUCTED DIRECT ADVOCACY FOR ONE POLICY: AN ACT RELATIVE TO BREAST CANCER EQUITY AND EARLY DETECTION)PRIORITY AREA 3: EQUITABLE ACCESS TO CARE INDIVIDUALS IDENTIFIED SEVERAL BARRIERS TO ACCESSING AND NAVIGATING THE HEALTHCARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THE ISSUES STEM FROM HOW THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY.GOAL: PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AND URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC AND ECONOMIC BARRIERS.STRATEGIES 3.1 PROMOTE EQUITABLE CARE, HEALTH EQUITY, HEALTH LITERACY, AND CULTURAL HUMILITY FOR PATIENTS ACROSS BIDMC AND BILH'S LICENSED AND/OR AFFILIATED HEALTH CENTERS, ESPECIALLY THOSE WHO FACE CULTURAL AND LINGUISTIC BARRIERS. 3.2 INCREASE ACCESS TO PRIMARY CARE AND SPECIALTY CARE SERVICES, INCLUDING OB/GYN AND MATERNAL CHILD HEALTH SERVICES.INITIATIVES TO ADDRESS THE PRIORITY - # OF BIDMC STAFF COMPLETING SOGI TRAINING (FY23: 2,135) - # OF UNDERREPRESENTED IN MEDICINE (URIM) CLINICIANS RECRUITED; % CHANGE OVER TIME (FY23: 38 URIM TRAINEES (RESIDENTS AND FELLOWS) MATCHED TO BIDMC AND 21 URIM FACULTY WERE RECRUITED) - # OF PATIENTS ASSISTED WITH INTERPRETER SERVICES (FY23: 53,442) - # OF INTERPRETER SERVICES PROVIDED (FY23: 298,022) - # OF LANGUAGES PROVIDED (FY23: 72) - # OF DEI TRAININGS (FY23: 8) - # OF SPECIALISTS AT CCA HEALTH CENTERS (FY23: 36) - # OF PATIENTS SEEN AT AFFILIATED FQHCS (FY23: 95,934) - # OF VISITS PROVIDED AT AFFILIATED FQHCS (FY23: 305,353) - # OF PATIENTS WITHOUT INSURANCE SERVED AT FQHC CCA HEALTH CENTERS (FY23: 5,977). - # OF PATIENTS ASSISTED WITH HEALTH-RELATED SOCIAL NEED (HRSN) - # OF PATIENTS PROVIDED WITH HOUSING SUPPORT (FY23: DATA NOT AVAILABLE) - # OF PATIENTS PROVIDED EMERGENCY FOOD OR GIFT CARDS (FY23: DATA NOT AVAILABLE) - # OF PATIENTS PROVIDED CLOTHING (FY23: DATA NOT AVAILABLE) - # OF EMPLOYEES WHO PARTICIPATED IN CAREER SUPPORT AND CAREER MOBILITY PROGRAMS: (FY23: 111) - # OF EMPLOYEES WHO WERE PROMOTED (FY23: DATA NOT AVAILABLE) - # OF PATIENTS SCREENED FOR ELIGIBILITY (FY23: 315,578) - # OF PATIENTS ENROLLED INTO ENTITLEMENT PROGRAMS (FY23: 31,251) - # OF PATIENTS ENROLLED IN MASSHEALTH (FY23: 15,703) - # OF PATIENTS ENROLLED IN HEALTH SAFETY NET (HSN): (FY23: 6,639) - # OF POLICIES REVIEWED AND SUPPORTED (FY23: BILH CONDUCTED DIRECT ADVOCACY FOR SIX POLICIES: AN ACT RELATIVE TO EMERGENCY RESPONSE AND PREPAREDNESS IN THE EVENT OF A SURGE IN PEDIATRIC OR ADULT HOSPITALIZATIONS, AN ACT EXPANDING COVERAGE OF DENTAL PROCEDURES, AN ACT ESTABLISHING A TASK FORCE TO STUDY THE SUSTAINABILITY OF EMERGENCY MEDICAL SERVICES, AN ACT RELATIVE TO PHARMACEUTICAL ACCESS, COSTS AND TRANSPARENCY, AN ACT RELATIVE TO REDUCING ADMINISTRATIVE BURDEN, AND AN ACT IMPROVING HEALTHCARE DELIVERY FOR UNDERSERVED RESIDENTS OF THE COMMONWEALTH) -AMOUNT OF FUNDING DEDICATED TO DISPARITIES RESEARCH (FY23: $4,860,470) - # OF PATIENTS ASSISTED WITH TRANSPORTATION (DATA NOT AVAILABLE) - # TAXI OR RIDE-SHARING VOUCHERS PROVIDED (FY23: 5,660)PRIORITY AREA 4: MENTAL HEALTH AND SUBSTANCE USE HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING TO COMMUNITY HEALTH CONCERNS. THE ASSESSMENT IDENTIFIED SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, THE MENTAL HEALTH IMPACTS OF RACISM, DISCRIMINATION, AND TRAUMA, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS).GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE ISSUES AND CONDITIONS.STRATEGIES 1.1 SUPPORT AND IMPLEMENT EVIDENCE-BASED PROGRAMS THAT INCREASE ACCESS TO HIGH-QUALITY AND CULTURALLY AND LINGUISTICALLY APPROPRIATE MENTAL HEALTH AND SUBSTANCE USE SERVICES. 1.2 ADVOCATE FOR AND SUPPORT POLICIES AND PROGRAMS THAT ADDRESS MENTAL HEALTH AND SUBSTANCE USE. 1.3 IMPLEMENT TRAUMA-INFORMED CARE (TIC) PRINCIPLES AND OTHER PREVENTION STRATEGIES TO IMPROVE CARE FOR ALL, ESPECIALLY THOSE WITH A HISTORY OF ADVERSITY.INITIATIVES TO ADDRESS THE PRIORITY - INVESTMENTS IN COMMUNITY BEHAVIORAL HEALTH SERVICES THROUGH SCREENING, MONITORING, COUNSELING, NAVIGATION, AND TREATMENT - COMMUNITY-BASED PRIMARY AND SPECIALTY CARE (SUPPORT FOR LICENSED AND/OR AFFILIATED COMMUNITY HEALTH CENTERS) - SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT - INTEGRATIVE CARE MODEL - COLLABORATIVE CARE MODEL - OPIOID CARE COMMITTEE - THE DIMOCK CENTER SUBSTANCE USE CLINICAL STABILIZATION - EXPANSION OF TRAUMA-INFORMED CARE (TIC)- TRAINING ACROSS HOSPITAL METRICS AND STATUS UPDATES* BASED ON DATA COLLECTED BETWEEN JULY 1, 2021 AND SEPT 30, 2023 - *# OF BEHAVIORAL HEALTH PATIENTS REACHED (FY23: 748) - *# OF BEHAVIORAL HEALTH COUNSELING SESSIONS (FY23: 1,603) - *MENTAL HEALTH SYMPTOMS: (FY23: MORE THAN 3 OF EVERY 5 PARTICIPANTS EXPERIENCED IMPROVEMENT IN THEIR MENTAL HEALTH SYMPTOMS BETWEEN BASELINE AND ENDPOINT (61.9%).) USING PHQ-8; PHQ-9; PSYCHLOPS SCALE - *STIGMA (RECOVERY ASSESSMENT SCALE (RAS-DS): (FY23: ON AVERAGE, THERE WAS A STATISTICALLY SIGNIFICANT INCREASE IN PARTICIPANT CONFIDENCE AND SELF-EFFICACY RELATED TO MANAGING LIFE STRESSORS AND MENTAL HEALTH FROM BASELINE TO ENDPOINT. THE AVERAGE RAS-DS SCORE INCREASED FROM 2.9 AT BASELINE TO 3.2 AT ENDPOINT). - *GENERAL HELP-SEEKING QUESTIONNAIRE (GHSQ): (FY23: ON AVERAGE, PARTICIPANTS REPORTED A STATISTICALLY SIGNIFICANT INCREASE IN LIKELIHOOD OF SEEKING HELP AT ENDPOINT COMPARED TO BASELINE. THESE INCREASED LIKELIHOODS WERE STATISTICALLY SIGNIFICANT FOR EACH OF THE LISTED INDIVIDUALS, WITH THE EXCEPTION OF AN INTIMATE PARTNER). - *NEARLY HALF OF PARTICIPANTS IN A BEHAVIORAL HEALTH PROGRAM IDENTIFIED AS BLACK OR AFRICAN AMERICAN (45.7%) - ONE THIRD IDENTIFIED AS ASIAN (33.2%) - A SMALLER GROUP IDENTIFIED AS HISPANIC, LATINX, OR OF SPANISH DESCENT (13.3%). - MOST PARTICIPANTS IN THIS PRIORITY AREA SPOKE ENGLISH AS THEIR PRIMARY LANGUAGE (59.6%); ALMOST ONE THIRD NOTED THEIR PRIMARY LANGUAGE AS CHINESE (31.8%). - MOST BEHAVIORAL HEALTH PARTICIPANTS WERE MALE (61.6%) AND A THIRD WERE FEMALE (35.3%). - # OF INTEGRATED BEHAVIORAL HEALTH CONSULTATIONS PROVIDED IN BSHC PRIMARY CARE CLINIC (FY23: 399) - # OF PRACTICES USING THE COLLABORATIVE CARE/INTEGRATIVE CARE MODEL (FY23: 5)
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COMMUNITY PARTNERS
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BIDMC IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE: - A BETTER CITY - ABOUT FRESH - ACEDONE - ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD) - ADCARE TREATMENT CENTER - AFRICAN BRIDGE NETWORK - AIDS ACTION COMMITTEE - AIDS SUPPORT GROUP OF CAPE COD - ALZHEIMER'S ASSOCIATION OF MA (WALTHAM) - AMERICA CANCER SOCIETY - AMERICAN CHINESE CHRISTIAN EDUCATION & SOCIAL SERVICES, INC. - ASIAN AMERICAN CIVIC ASSOCIATION - ASIAN COMMUNITY DEVELOPMENT CORPORATION - ATRIUS HEALTH - AUDUBON CIRCLE NEIGHBORHOOD - BAGLY, INC. - BAMSI, INC. - BETH ISRAEL DEACONESS HEALTHCARE - BLUE CROSS BLUE SHIELD OF MASSACHUSETTS - BOSTON AREA RAPE CRISIS CENTER (BARCC) - BOSTON CENTER FOR INDEPENDENT LIVING - BOSTON CHILDREN'S HOSPITAL - BOSTON COMPREHENSIVE TREATMENT CENTER - BOSTON CHINATOWN NEIGHBORHOOD CENTER - BOSTON COMPREHENSIVE TREATMENT CENTER - BOSTON ELDER SERVICES - BOSTON EMERGENCY MEDICAL SERVICES - BOSTON FIRE DEPARTMENT - BOSTON GREEN ACADEMY - BOSTON HEALTH CARE FOR THE HOMELESS PROGRAM - BOSTON HOUSING AUTHORITY - BOSTON LIVING CENTER - BOSTON MEDICAL CENTER - BOSTON MEDFLIGHT - BOSTON POLICE DEPARTMENT - BOSTON PUBLIC HEALTH COMMISSION - BOSTON PUBLIC SCHOOLS - BOSTON UNIVERSITY LAW CLINIC - BOSTON UNIVERSITY SCHOOL OF PUBLIC HEALTH - BOWDOIN GENEVA MAIN STREETS - BOWDOIN STREET HEALTH CENTER - BOYS AND GIRLS CLUB OF BOSTON - BRIDGE OVER TROUBLED WATERS - BRIGHAM AND WOMEN'S HOSPITAL - BRIGID'S HOUSE OF HOPE - BUNKER HILL COMMUNITY COLLEGE - CAMBRIDGE COMMUNITY LEARNING CENTER - CAMBRIDGE HEALTH ALLIANCE - CAPE VERDEAN ASSOCIATION OF BOSTON - CAPIC, INC. - CASA MYRNA - CATHOLIC CHARITIES BOSTON - CHARLES RIVER COMMUNITY HEALTH - CHELSEA BLACK COMMUNITY - CHELSEA COMMUNITY CONNECTIONS - CHINATOWN MAIN STREET - CHINATOWN RESIDENT ASSOCIATION - CIRCLE OF HOPE - CITY LIFE/VIDA URBANA - CITY OF BOSTON EMERGENCY MANAGEMENT OFFICE - CITY OF BOSTON'S GREEN RIBBON COMMISSION - COMMUNITY PARTNERS REFERENCE - CONFERENCE OF BOSTON TEACHING HOSPITALS (COBTH) - COMMUNITY RESEARCH INITIATIVE - COMMUNITY SERVINGS - COMMUNITY WORK SERVICES - CRADLES TO CRAYONS - DANA FARBER CANCER INSTITUTE - DEPARTMENT OF TRANSITIONAL ASSISTANCE - DIMOCK HEALTH CENTER - DORCHESTER CATHOLIC PARISHES - DORCHESTER FOOD CO-OP - ELLIE FUND - ENGLISH FOR NEW BOSTONIANS - EVERSOURCE - FAIR FOODS (BOSTON) - FAMILY NURTURING CENTER - FATHER BILL'S AND MAINSPRING - FATHERS' UPLIFT - FENWAY ALLIANCE - FENWAY CIVIC ASSOCIATION - FENWAY COMMUNITY CENTER - FENWAY COMMUNITY DEVELOPMENT CORPORATION - FENWAY HEALTH - FIRST SOURCE - FOOD FOR FREE - FOUND IN TRANSLATION - FRIENDS OF GENEVA CLIFFS - FRIENDS OF RONAN PARK - GLAAD - GREATER BOSTON CHINESE GOLDEN AGE CENTER - GREATER BOSTON EMPLOYMENT COLLABORATIVE - GREATER BOSTON FOOD BANK - GREATER BOSTON YMCA - GREATER BOWDOIN GENEVA NEIGHBORHOOD ASSOCIATION - GREATER FOUR CORNERS ACTION COALITION - GREENROOTS - HACK DIVERSITY - HARVARD MEDICAL SCHOOL - HEALTH CARE FOR ALL - HEALTH IMPERATIVES - HEALTH LAW ADVOCATES - HEALTHCARE WITHOUT HARM - HOSPITALITY HOMES - INTERNATIONAL INSTITUTE OF NEW ENGLAND - JANE DOE INC. - JASMINE GRACE OUTREACH - JEWISH COMMUNITY CENTER (JCC) OF GREATER BOSTON - JEWISH FAMILY AND CHILDREN'S SERVICES - JEWISH VOCATIONAL SERVICES - JOE ANDRUZZI CANCER FUND - JOSIAH QUINCY ELEMENTARY SCHOOL - JOSLIN DIABETES CENTER - JUST A START - JUSTICE RESOURCE INSTITUTE (JRI) IN BOSTON - LAALIANZAHISPANA - LA COLABORATIVA - LEUKEMIA & LYMPHOMA SOCIETY - LOUIS D. BROWN PEACE INSTITUTE - MADISON PARK TECHNICAL HIGH SCHOOL MA PROGRAM - MASS COLLEGE OF ART AND DESIGN (MASSART) - MASSACHUSETTS COMMISSION FOR THE DEAF AND HARD OF HEARING - MASSACHUSETTS DEPARTMENT OF CHILDREN AND FAMILIES - MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION (MASSDEP) - MASSACHUSETTS DEPARTMENT OF MENTAL HEALTH - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH - MASSACHUSETTS DEPARTMENT OF TRANSITIONAL ASSISTANCE - MASSACHUSETTS DEPARTMENT OF TRANSPORTATION (MASSDOT) - MASSACHUSETTS GENERAL HOSPITAL - MASS HIRE BOSTON - MASS HIRE DOWNTOWN - MASSACHUSETTS HEALTH INFORMATION HIGHWAY - MASSACHUSETTS HIV DRUG ASSISTANCE PROGRAM - MASSACHUSETTS IMMIGRANT AND REFUGEE ADVOCACY COALITION(MIRA) - MASSACHUSETTS INSTITUTE OF TECHNOLOGY - MASSACHUSETTS INSURANCE COMMISSION - MASSACHUSETTS REHABILITATION COMMISSION - MASSACHUSETTS STATE POLICE - MEDICAL ACADEMIC AND SCIENTIFIC COMMUNITY ORGANIZATION (MASCO) - MEETINGHOUSE HILL CIVIC ASSOCIATION - METRO HOUSING|BOSTON - MILLENNIUM TRAINING INSTITUTE - MOUNT AUBURN HOSPITAL - NEW ENGLAND AIDS EDUCATION AND TRAINING CENTER - NEW ENGLAND LIFE FLIGHT INC. (DBA BOSTON MEDFLIGHT) - NORTHEASTERN UNIVERSITY - NORTH SHORE COMMUNITY COLLEGE - NUESTRA COMMUNIDAD DEVELOPMENT CORPORATION - OPERATION ABLE OF GREATER BOSTON - OPERATION P.E.A.C.E. - OPPORTUNITY COMMUNITIES - OUTER CAPE HEALTH SERVICES - PARTNERS FOR WORLD HEALTH - PEER HEALTH EXCHANGE (PHE) - PINE STREET INN - PINK REVOLUTION - POLITICAL ASYLUM AND IMMIGRANT'S RIGHTS (PAIR) PROJECT - PRACTICE GREEN HEALTH - PRIVATE INDUSTRY COUNCIL - PROJECT HOME AGAIN - RIA, INC. - RIVERSIDE COMMUNITY CARE - ROOM TO GROW - ROSE KENNEDY GREENWAY CONSERVANCY - ROXBURY COMMUNITY COLLEGE - ROXBURY TENANTS OF HARVARD - RYAN WHITE DENTAL PROGRAM - SCALE (SOMERVILLE PUBLIC SCHOOLS) - SEXUAL ASSAULT NURSE EXAMINER (SANE) PROGRAM - SEXUAL ASSAULT UNIT OF DISABLED PERSONS PROTECTION COMMISSION - SOCIEDAD LATINA - SOUTH COVE COMMUNITY HEALTH CENTER - SPORTSMEN TENNIS AND ENRICHMENT CENTER - STEPS TO SUCCESS - ST. PETER'S TEEN CENTER - THE FAMILY VAN - THE LATINO MEDICAL STUDENT ASSOCIATION - THE NEIGHBORHOOD DEVELOPERS - THE NETWORK/LA RED - THE PARTNERSHIP, INC. - THE STUDENT NATIONAL MEDICAL ASSOCIATION, NATIONAL AND NE CHAPTER - TRUSTEES OF RESERVATIONS - TUFTS MEDICAL CENTER - UNITED CEREBRAL PALSY - UP ACADEMY DORCHESTER SCHOOL - U.S. ENVIRONMENTAL PROTECTION AGENCY (EPA) - UNITED CEREBRAL PALSY OF METROBOSTON - VICTIM RIGHTS LAW CENTER - VICTORY PROGRAMS - VINFEN CORPORATION - VIRIDIAN APARTMENTS - WENTWORTH INSTITUTE OF TECHNOLOGY - WILMERHALELEGAL SERVICES (ALSO KNOWN AS THE LEGAL SERVICE CENTER) - WONDERFUND OF MASSACHUSETTS - WORK OPPORTUNITIES UNLIMITED - YMCA OF GREATER BOSTON - YMCA TRAINING, INC.
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AS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE
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H, BIDMC IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, IN RESPONSE TO SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE MOST RECENT CHNA THAT ARE NOT INCLUDED IN THE IS FISCAL PERIODS ENDING SEPTEMBER 30, 2023, SEPTEMBER 30, 2024 AND SEPTEMBER 30, 2025. EXAMPLES OF IDENTIFIED NEEDS THAT WILL NOT BE MET IN THESE YEARS ARE ADDRESSING THE DIGITAL DIVIDE (I.E., PROMOTING EQUITABLE ACCESS TO THE INTERNET) AND SUPPORTING EDUCATION ACROSS THE LIFESPAN. IN ADDITION, THERE WERE SOME NEEDS IDENTIFIED IN THE 2019 CHNA. IN THE FY 2023 - 2025 IS, WHICH WILL GUIDE THE BIDMC'S COMMUNITY BENEFITS ACTIVITIES THAT ARE NOT INCLUDED IN THE 2019 IS AND WHICH HAVE GUIDED THE BIDMC'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIOD COVERED BY THIS FILING. WHILE THESE ISSUES ARE IMPORTANT, BIDMC'S CBAC AND SENIOR LEADERSHIP TEAM DECIDED THAT THESE ISSUES WERE OUTSIDE OF THE MEDICAL CENTER'S SPHERE OF INFLUENCE AND INVESTMENTS IN OTHER AREAS WERE BOTH MORE FEASIBLE AND LIKELY TO HAVE GREATER IMPACT. AS A RESULT, BIDMC RECOGNIZED THAT OTHER PUBLIC AND PRIVATE ORGANIZATIONS IN ITS CBSA, BOSTON, AND THE COMMONWEALTH WERE BETTER POSITIONED TO FOCUS ON THESE ISSUES. BIDMC REMAINS OPEN AND WILLING TO WORK WITH COMMUNITY RESIDENTS, OTHER HOSPITALS, AND OTHER PUBLIC AND PRIVATE PARTNERS TO ADDRESS THESE ISSUES, PARTICULARLY AS PART OF A BROAD, STRONG COLLABORATIVE. AS NOTED IN DETAIL ABOVE, THE BIDMC'S PRIMARY TOOL FOR ASSESSING THE HEALTHCARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IS (SCHEDULE H PART VI QUESTION 2).
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW BIDMC CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 10.33% OF BIDMC'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITS - ANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, BIDMC'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT HTTPS://WWW.BIDMC.ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS. THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT BIDMC FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, BIDMC IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, RESEARCH HOSPITAL AND TEACHING HOSPITAL, PROVIDING 24-HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY.
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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS
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CHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEBIDMC'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $23,848,613 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.AS PREVIOUSLY NOTED IN THIS FORM 990, BIDMC IS ONE OF ELEVEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $73,152,852 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, FOR THE PERIOD COVERED BY THIS FILING, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE AND 400% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CARE-MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, BIDMC ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BIDMC GENERATED $75,119,938 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY BIDMC FOR SUCH SERVICES BY $19,329,502 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 12.9 % OR 121,854 OF BIDMC'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION. 46.5% OR 439,241 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND BIDMC PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BIDMC GENERATED $535,288,657 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $28,527,447. OF THESE AMOUNTS, REVENUE OF $6,281,625 IS RELATED TO THE PROVISION OF PSYCHIATRY INPATIENT CARE, CARE AT THE BOWDOIN STREET COMMUNITY HEALTH CENTER AND THE PROVISION OF URGENT CARE IN URGENT CARE CENTERS AND IS INCLUDED ON THIS SCHEDULE H, PART I, LINE 7G, AS PART OF SUBSIDIZED HEALTH SERVICES BECAUSE THE COST OF THOSE SERVICES EXCEEDED REVENUES BY $7,714,819. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH BIDMC CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, BIDMC HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. HOWEVER, IF THE MEDICARE SHORTFALL WERE INCLUDED IN THE SCHEDULE H PART I LINE 7 CALCULATION, IT WOULD INCREASE 11.4%.BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, BIDMC ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. COSTS FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $10,435,175 ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH) AND AFFILIATES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023 INCLUDE THE ACCOUNTS OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH), BETH ISRAEL LAHEY HEALTH PHARMACY, JOSLIN DIABETES CENTER AND THEIR AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP). FINALLY, EFFECTIVE JULY 1, 2023, BILH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES, INC. (EHRI) AND THREE MONTHS OF EHRI'S ACTIVITY AS WELL AS THREE MONTHS OF EHRI'S AFFILIATES' ACTIVITY, INCLUDING EXETER HOSPITAL, ARE INCLUDED IN THE AUDITED FINANCIAL STATEMENTS OF BILH AND AFFILIATES.
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PATIENT ACCOUNTS RECEIVABLE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTS
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THE SYSTEM'S PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE SYSTEM EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING MANAGED CARE PAYERS AND GOVERNMENT PROGRAMS), AND OTHERS AND INCLUDE AN ESTIMATE OF VARIABLE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS, REVIEWS, AND INVESTIGATIONS. GENERALLY, THE SYSTEM BILLS THE PATIENTS AND THIRD-PARTY PAYORS SEVERAL DAYS AFTER THE SERVICES ARE PERFORMED AND/OR THE PATIENT IS DISCHARGED FROM THE SYSTEM'S FACILITY.EMERGENCY CARE ACCESSBETH ISRAEL DEACONESS MEDICAL CENTER IS A TERTIARY CARE LICENSED ACADEMIC MEDICAL CENTER, PROVIDING MEDICAL AND SURGICAL CARE, TEACHING AND RESEARCH AND AS NOTED ELSEWHERE IN THIS RETURN, PROVIDES 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. THE ED'S MISSION, ALIGNED WITH BIDMC'S MISSION, IS TO DISTINGUISH ITSELF FROM OTHER PROVIDERS THROUGH EXCELLENCE IN PATIENT CARE, EDUCATION, RESEARCH AND THROUGH IMPROVED HEALTH IN THE COMMUNITIES SERVED. BIDMC'S DEPARTMENT OF EMERGENCY MEDICINE, PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR (SCHEDULE H, PART V, SECTION A AND SECTION B QUESTION 21).THE BIDMC DEPARTMENT OF EMERGENCY MEDICINE PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, 7 DAYS A WEEK, AND 365 DAYS A YEAR. FINANCIAL ASSISTANCE POLICY-INTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE BIDMC IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTHCARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THIS FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE FROM BIDMC AS WELL AS PROVIDERS WHO FOLLOW BIDMC'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN BIDMC AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW BIDMC'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. BIDMC DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY AN AUTHORIZED BODY AS REQUIRED PURSUANT TO THE IRC SECTION 501(R) TREASURY REGULATIONS EFFECTIVE ON OR ABOUT AUGUST 15, 2020FINANCIAL ASSISTANCE POLICY-APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY-ELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE-PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.
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FINANCIAL ASSISTANCE POLICY-TRANSLATIONS
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THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: SPANISH, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, RUSSIAN, PORTUGUESE, VIETNAMESE, FRENCH, HAITIAN CREOLE, HINDI, ITALIAN, JAPANESE, CAPE VERDEAN, AND ARABIC. (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICY-WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT HTTPS://WWW.BIDMC.ORG/PATIENT-AND-VISITOR-INFORMATION/PATIENT-INFORMATION/YOUR-HOSPITAL-BILL/FINANCIAL-ASSISTANCE. IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE OR DISCHARGE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICY-PLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY.
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LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTS
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THE LINK TO THE BIDMC FINANCIAL ASSISTANCE POLICY (FAP) AND THE FOLLOWING RELATED DOCUMENTS CAN BE FOUND ON THE HOSPITAL'S WEBSITE. - CREDIT AND COLLECTION POLICY - APPLICATION FOR FINANCIAL ASSISTANCE - MEDICAL HARDSHIP APPLICATION - FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ALL IN ENGLISH, SPANISH, FRENCH, HAITIAN CREOLE, HINDI, ITALIAN, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, RUSSIAN, PORTUGUESE, VIETNAMESE, JAPANESE, ARABIC, CAPE VERDEAN, CAN BE FOUND ON THE BIDMC WEBSITE AT: HTTPS://WWW.BIDMC.ORG/PATIENT-AND-VISITOR-INFORMATION/PATIENT-INFORMATION/YOUR-HOSPITAL-BILL/FINANCIAL-ASSISTANCE
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LIMITATION ON CHARGES - INTERNAL REVENUE CODE SECTION 501(R)(5)
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LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLED - LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS-501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCHAS PREVIOUSLY NOTED IN THIS FORM 990, PART III, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS AND TREATMENTS THAT IMPROVE THE QUALITY OF LIFE.THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING. THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,220 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,500 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 280 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, VACCINE DEVELOPMENT AND VIROLOGY, INFECTION CONTROL AND INFECTIOUS DISEASES AND CARDIOLOGY/CARDIAC SURGERY. AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN, HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS. THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION. THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES:-ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE -EMERGENCY MEDICINE -MEDICINE O ALLERGY AND INFLAMMATION O CARDIOVASCULAR MEDICINE O CENTER FOR VASCULAR BIOLOGY RESEARCH O CENTER FOR VIROLOGY AND VACCINE RESEARCH O CLINICAL INFORMATICS O CLINICAL NUTRITION O ENDOCRINOLOGY O EXPERIMENTAL MEDICINE O GASTROENTEROLOGY O GENERAL MEDICINE AND PRIMARY CARE O GENETICS O GERONTOLOGY O HEMATOLOGY AND ONCOLOGY O HEMOSTASIS AND THROMBOSIS O IMMUNOLOGY O INFECTIOUS DISEASE O INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGY O MOLECULAR AND VASCULAR MEDICINE O NEPHROLOGY O PULMONOLOGY O RHEUMATOLOGY O SIGNAL TRANSDUCTION O TRANSLATIONAL RESEARCH O TRANSPLANT IMMUNOLOGY - NEONATOLOGY - NEUROLOGY - OBSTETRICS AND GYNECOLOGY - ORTHOPAEDIC SURGERY - PATHOLOGY - PSYCHIATRY - RADIOLOGY - SURGERY O CARDIAC SURGERYO CENTER FOR MINIMALLY INVASIVE SURGERYO NEUROSURGERYO PLASTIC AND RECONSTRUCTIVE SURGERYO VASCULAR SURGERY-TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER REPORTED $82,645,170 OF NET INTERNALLY FUNDED RESEARCH ON THIS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE, WHICH REPRESENTED 3.19% OF THE MEDICAL CENTER'S TOTAL EXPENSES. ADDITIONALLY, THE MEDICAL CENTER REPORTED $ 237,364,019 OF RESEARCH EXPENSES FUNDED BY GOVERNMENTS AND OTHER TAX-EXEMPT ENTITIES INCLUDING OTHER HOSPITALS, UNIVERSITIES AND FOUNDATIONS ON SCHEDULE H, PART I LINE 7H COLUMN D.RESEARCH ENGAGED IN AT THE MEDICAL CENTERTHE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION. BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW ARE INCLUDED IN FORM 990 SCHEDULE H, PART I LINE 7H COLUMN C AND MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H, PART I, LINE 7H COLUMN E, DEPENDING ON FUNDING SOURCE. DETAIL ON RESEARCH EFFORTS WHICH WERE UNDERTAKEN AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. 1. A POTENTIAL NEW WEAPON IN THE WAR AGAINST SUPERBUGS"THE END OF MODERN MEDICINE AS WE KNOW IT." THAT'S HOW THE THEN-DIRECTOR GENERAL OF THE WORLD HEALTH ORGANIZATION CHARACTERIZED THE CREEPING PROBLEM OF ANTIMICROBIAL RESISTANCE IN 2012. WITHOUT ANTIBIOTICS TO MANAGE COMMON BACTERIAL INFECTIONS, SMALL INJURIES AND MINOR INFECTIONS BECOME POTENTIALLY FATAL ENCOUNTERS. IN 2019, MORE THAN 2.8 MILLION ANTIMICROBIAL-RESISTANT INFECTIONS OCCURRED IN THE UNITED STATES, AND MORE THAN 35,000 PEOPLE DIED AS A RESULT, ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC). A REPORT FROM THE UNITED NATIONS ISSUED EARLIER THIS YEAR WARNED THAT NUMBER COULD RISE TO TEN MILLION GLOBAL DEATHS ANNUALLY IF NOTHING IS DONE TO COMBAT ANTIMICROBIAL RESISTANCE.
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FOR NEARLY 25 YEARS, JAMES KIRBY, MD, DIRECTOR OF
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THE CLINICAL MICROBIOLOGY LABORATORY AT BIDMC, HAS WORKED TO ADVANCE THE FIGHT AGAINST INFECTIOUS DISEASES BY FINDING AND DEVELOPING NEW, POTENT ANTIMICROBIALS, AND BY BETTER UNDERSTANDING HOW DISEASE-CAUSING BACTERIA MAKE US SICK. IN A RECENT PAPER PUBLISHED IN PLOS BIOLOGY, KIRBY AND COLLEAGUES INVESTIGATED A NATURALLY OCCURRING ANTIMICROBIAL AGENT DISCOVERED MORE THAN 80 YEARS AGO. USING LEADING-EDGE TECHNOLOGY, KIRBY'S TEAM DEMONSTRATED THAT CHEMICAL VARIANTS OF THE ANTIBIOTIC, CALLED STREPTOTHRICINS, SHOWED POTENCY AGAINST SEVERAL CONTEMPORARY DRUG-RESISTANT STRAINS OF BACTERIA. WHAT'S MORE, THEY SHOWED THE ANTIBIOTIC HAD A THERAPEUTIC EFFECT IN AN ANIMAL MODEL AT NON-TOXIC CONCENTRATIONS."A SINGLE DOSE CLEARED THIS ORGANISM FROM AN INFECTED ANIMAL MODEL WHILE AVOIDING ANY TOXICITY," KIRBY SAID. "IT WAS REALLY REMARKABLE." THE RESEARCHERS ALSO REVEALED THE UNIQUE MECHANISM BY WHICH STREPTOTHRICIN FIGHTS OFF BACTERIAL INFECTIONS. "WE SHOWED THAT NOURSEOTHRICIN ACTS IN A COMPLETELY NEW WAY COMPARED TO ANY OTHER TYPE OF ANTIBIOTIC, BY INHIBITING THE ABILITY OF THE ORGANISM TO PRODUCE PROTEINS IN A VERY SNEAKY WAY," KIRBY EXPLAINED. "WHEN A CELL MAKES PROTEINS, IT MAKES THEM OFF A BLUEPRINT THAT TELLS THE CELL WHAT AMINO ACIDS TO LINK TOGETHER TO BUILD THE PROTEIN. OUR STUDY HELPS EXPLAIN HOW THIS ANTIBIOTIC CONFUSES THE MACHINERY SO THAT THE MESSAGE IS READ INCORRECTLY, AND IT STARTS TO PUT TOGETHER GIBBERISH. ESSENTIALLY THE BACTERIAL CELL GETS POISONED BECAUSE IT'S PRODUCING JUNK."STREPTOTHRICIN'S UNIQUE ACTION IS VERY POWERFUL BECAUSE IT MEANS BACTERIA ARE CURRENTLY HELPLESS AGAINST IT; THAT IS, THERE'S NO ENVIRONMENTAL RESERVOIR OF POTENTIAL RESISTANCE MECHANISMS, KIRBY SAID. THAT GIVES HUMANITY MORE TIME BEFORE PATHOGENS EVOLVE DEFENSE MECHANISMS AGAINST THIS BRAND-NEW CLASS OF ANTIBIOTIC."WE'RE STILL IN THE VERY EARLY STAGES OF DEVELOPMENT, BUT I THINK WE'VE VALIDATED THAT THIS IS A COMPOUND THAT'S WORTH INVESTING IN FURTHER STUDIES TO FIND EVEN BETTER VARIANTS THAT EVENTUALLY WILL MEET THE PROPERTIES OF A HUMAN THERAPEUTIC," KIRBY SAID. JANUARY 20, 20202. SEVERE COVID-19 LINKED WITH MOLECULAR SIGNATURES OF BRAIN AGING, RESEARCHERS FINDSCIENTISTS AT BIDMC FOUND THAT GENE USAGE IN THE BRAINS OF PATIENTS WITH COVID-19 IS SIMILAR TO THOSE OBSERVED IN AGING BRAINS. USING A MOLECULAR PROFILING TECHNIQUE CALLED RNA SEQUENCING TO MEASURE THE LEVELS OF EVERY GENE EXPRESSED IN A PARTICULAR TISSUE SAMPLE, THE SCIENTISTS ASSESSED CHANGES IN GENE EXPRESSION PROFILES IN THE BRAINS OF COVID-19 PATIENTS AND COMPARED THEM TO THOSE CHANGES OBSERVED IN THE BRAINS OF UNINFECTED INDIVIDUALS. THE TEAM'S ANALYSIS, PUBLISHED IN NATURE AGING, SUGGESTED THAT MANY BIOLOGICAL PATHWAYS THAT CHANGE WITH NATURAL AGING IN THE BRAIN ALSO CHANGED IN PATIENTS WITH SEVERE COVID-19.CO-FIRST AND CO-CORRESPONDING AUTHOR MARIA MAVRIKAKI, PHD, AN INSTRUCTOR OF PATHOLOGY AT BIDMC, AND COLLEAGUES ANALYZED A TOTAL OF 54 POSTMORTEM HUMAN FRONTAL CORTEX TISSUE SAMPLES FROM ADULTS 22 TO 85 YEARS OLD. "WE OBSERVED THAT GENE EXPRESSION IN THE BRAIN TISSUE OF PATIENTS WHO DIED OF COVID-19 CLOSELY RESEMBLED THAT OF UNINFECTED INDIVIDUALS 71 YEARS OLD OR OLDER," SAID CO-FIRST AUTHOR JONATHAN LEE, PHD, A POSTDOCTORAL RESEARCH FELLOW AT BIDMC."GIVEN THESE FINDINGS, WE ADVOCATE FOR NEUROLOGICAL FOLLOW-UP OF RECOVERED COVID-19 PATIENTS," SAID SENIOR AND CO-CORRESPONDING AUTHOR FRANK SLACK, PHD, DIRECTOR OF THE INSTITUTE FOR RNA MEDICINE AT BIDMC AND THE SHIELDS WARREN MALLINCKRODT PROFESSOR OF MEDICAL RESEARCH AT HARVARD MEDICAL SCHOOL. "WE ALSO EMPHASIZE THE POTENTIAL CLINICAL VALUE IN MODIFYING THE FACTORS ASSOCIATED WITH THE RISK OF DEMENTIA - SUCH AS CONTROLLING WEIGHT AND REDUCING EXCESSIVE ALCOHOL CONSUMPTION - TO REDUCE THE RISK OR DELAY THE DEVELOPMENT OF AGING-RELATED NEUROLOGICAL PATHOLOGIES AND COGNITIVE DECLINE."BETTER UNDERSTANDING OF THE MOLECULAR MECHANISMS UNDERLYING BRAIN AGING AND COGNITIVE DECLINE IN COVID-19 COULD LEAD TO THE DEVELOPMENT OF NOVEL THERAPEUTICS TO ADDRESS COGNITIVE DECLINE OBSERVED IN COVID-19 PATIENTS. THE TEAM IS NOW TRYING TO UNDERSTAND WHAT DRIVES THE AGING-LIKE EFFECTS IN THE BRAINS OF COVID-19 PATIENTS.3.. RESEARCH SUGGESTS POLITICAL EVENTS IMPACT SLEEP: STUDY FINDS ASSOCIATION BETWEEN ELECTIONS AND SLEEP, ALCOHOL CONSUMPTION AND OVERALL PUBLIC MOODIN A PAPER PUBLISHED IN THE NATIONAL SLEEP FOUNDATION'S JOURNAL SLEEP HEALTH, RESEARCHERS AT BIDMC SHOWED THAT MAJOR SOCIOPOLITICAL EVENTS CAN HAVE GLOBAL IMPACTS ON SLEEP THAT ARE ASSOCIATED WITH SIGNIFICANT FLUCTUATIONS IN THE PUBLIC'S COLLECTIVE MOOD, WELL-BEING, AND ALCOHOL CONSUMPTION. AS PART OF A LARGER STUDY EXPLORING THE SLEEP AND PSYCHOLOGICAL REPERCUSSIONS OF THE COVID-19 PANDEMIC, THE TEAM SURVEYED 437 PARTICIPANTS IN THE UNITED STATES AND 106 INTERNATIONAL PARTICIPANTS DAILY BETWEEN OCTOBER 113, 2020 (BEFORE THE ELECTION) AND OCTOBER 30NOVEMBER 12, 2020 (DAYS SURROUNDING THE NOVEMBER 3 U.S. ELECTION). WITH REGARD TO SLEEP, BOTH U.S. AND NON-U.S. PARTICIPANTS REPORTED LOSING SLEEP IN THE RUN-UP TO THE ELECTION; HOWEVER, U.S. RESPONDENTS HAD SIGNIFICANTLY LESS TIME IN BED IN THE DAYS AROUND THE ELECTION. ON ELECTION NIGHT ITSELF, U.S. PARTICIPANTS REPORTED WAKING UP FREQUENTLY DURING THE NIGHT AND EXPERIENCING POORER SLEEP EFFICIENCY.U.S. PARTICIPANTS WHO EVER REPORTED DRINKING ALCOHOL SIGNIFICANTLY INCREASED CONSUMPTION ON THREE DAYS DURING THE ASSESSMENT PERIOD: HALLOWEEN, ELECTION DAY AND THE DAY THE ELECTION WAS CALLED BY MORE MEDIA OUTLETS, SATURDAY, NOVEMBER 7. AMONG NON-U.S. PARTICIPANTS, THERE WAS NO CHANGE IN ALCOHOL CONSUMPTION OVER THE NOVEMBER ASSESSMENT PERIOD.WHEN THE SCIENTISTS LOOKED AT HOW THESE CHANGES IN BEHAVIOR MAY HAVE AFFECTED MOOD AND WELL-BEING OF U.S PARTICIPANTS, THEY FOUND SIGNIFICANT LINKS BETWEEN SLEEP AND DRINKING, STRESS, NEGATIVE MOOD, AND DEPRESSION."THIS IS THE FIRST STUDY TO FIND THAT THERE IS A RELATIONSHIP BETWEEN THE PREVIOUSLY REPORTED CHANGES IN ELECTION DAY PUBLIC MOOD AND SLEEP THE NIGHT OF THE ELECTION," SAID CORRESPONDING AUTHOR TONY CUNNINGHAM, PHD, DIRECTOR OF THE CENTER FOR SLEEP AND COGNITION AT BIDMC. "MOREOVER, IT IS NOT JUST THAT ELECTIONS MAY INFLUENCE SLEEP, BUT EVIDENCE SUGGESTS THAT SLEEP MAY INFLUENCE CIVIC ENGAGEMENT AND PARTICIPATION IN ELECTIONS AS WELL. THUS, IF THE RELATIONSHIP BETWEEN SLEEP AND ELECTIONS IS ALSO BIDIRECTIONAL, IT WILL BE IMPORTANT FOR FUTURE RESEARCH TO DETERMINE HOW PUBLIC MOOD AND STRESS EFFECTS ON SLEEP LEADING UP TO AN ELECTION MAY EFFECT OR EVEN ALTER ITS OUTCOME."4. TARGETED CARE REVERSES RACIAL/ETHNIC HEALTH DISPARITIES IN COLON CANCER SCREENING, RESEARCHERS FINDIN A RETROSPECTIVE REVIEW OF PATIENTS WHO HAD A RECENT PRIMARY CARE VISIT IN A WELL-RESOURCED SAFETY-NET HEALTH SYSTEM SERVING A DIVERSE POPULATION, A TEAM LED BY RESEARCHERS AT BIDMC AIMED TO BETTER DEFINE THE LINKS BETWEEN PATIENTS' SOCIO-DEMOGRAPHIC CHARACTERISTICS AND COLORECTAL SCREENING. EVALUATING SELF-REPORTED FACTORS INCLUDING RACE, ETHNICITY, PREFERRED LANGUAGE, MENTAL HEALTH AND SUBSTANCE USE STATUS, THE TEAM'S MORE GRANULAR ASSESSMENT PROVIDED FINDINGS THAT CONTRADICT TRADITIONAL U.S. HEALTHCARE DISPARITIES, WITH HISPANIC AND SPANISH-SPEAKING PATIENTS SCREENING AT SIGNIFICANTLY HIGHER RATES THAN WHITE AND ENGLISH-SPEAKING PATIENTS. THE COUNTERINTUITIVE FINDINGS, PUBLISHED IN PREVENTIVE MEDICINE, DEMONSTRATE THAT A HEALTHCARE SYSTEM DESIGNED TO PROVIDE EQUAL ACCESS TO SCREENING FOR UNDERSERVED PATIENTS CAN ADDRESS THE DISPARITIES COMMONLY SEEN IN CANCER SCREENING."INVESTMENT INTO A MULTICULTURAL WORKFORCE AND OUTREACH EFFORTS TO UNDERSERVED PATIENTS MAY COUNTERACT SOME OF THE IMPLICIT OR EXPLICIT BIASES SEEN ON HEALTH SYSTEMS THAT HAVE LED TO TRADITIONAL RACIAL/ETHNIC DISPARITIES," SAID SENIOR AUTHOR HEIDI J. RAYALA, MD, PHD, UROLOGIST AT BIDMC. "OUR STUDY SHOWED DIFFERENCES IN ODDS OF SUCCESSFUL SCREENING BASED ON SUB-SECTIONS OF TRADITIONALLY DEFINED ETHNICITIES SUCH AS BREAKING DOWN "HISPANIC" INTO MORE SPECIFIC CULTURES AND BACKGROUNDS AND THAT SUGGESTS THAT FUTURE RESEARCH SHOULD FOCUS ON BETTER UNDERSTANDING INDIVIDUAL CULTURES AND COMMUNITIES, RATHER THAN LUMPING PATIENTS INTO OVERLY LARGE GROUPS."RAYALA AND COLLEAGUES LOOKED AT DE-IDENTIFIED RECORDS OF MORE THAN 22,000 PATIENTS BETWEEN 50- AND 75-YEARS OLD WHO SAW A PRIMARY CARE PHYSICIAN AT CAMBRIDGE HEALTH ALLIANCE (CHA) IN 2018 TO 2019. OF THE 22,000 PATIENTS INCLUDED IN THE STUDY, 16,065 UNDERWENT COLORECTAL SCREENING, AN OVERALL SCREENING RATE OF 73 PERCENT--ON PAR WITH MASSACHUSETTS' OVERALL COLORECTAL SCREENING RATES. HOWEVER, MASSACHUSETTS' NUMBERS REFLECT NATIONAL RACIAL AND ETHNIC DISPARITIES, IN WHICH PEOPLE OF COLOR DO NOT GET SCREENED AS OFTEN AS WHITE PEOPLE, SHOWING A SCREENING RATE OF 56 PERCENT OF HISPANIC INDIVIDUALS AND 68 PERCENT OF BLACK INDIVIDUALS COMPARED TO 76 PERCENT FOR WHITE INDIVIDUALS.
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IN CONTRAST, AT CHA, HISPANICS HAD THE HIGHEST SCREENING RATES
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OF 78 PERCENT. RAYALA AND COLLEAGUES FURTHER BROKE OUT PARTICIPANTS BY MORE GRANULAR DEMOGRAPHIC FACTORS, FINDING THE ETHNICITY OF PORTUGUESE/AZOREAN RECEIVED SCREENING AT 79 PERCENT. SPANISH SPEAKERS IN GENERAL HAD THE HIGHEST SCREENING RATE OF NEARLY 80 PERCENT.5. PATIENTS OVERWHELMINGLY PREFER IMMEDIATE ACCESS TO TEST RESULTS, EVEN WHEN THE NEWS MAY NOT BE GOODIN APRIL 2021, NEW FEDERAL RULES WENT INTO EFFECT MANDATING THAT HEALTHCARE PROVIDERS MAKE NEARLY ALL TEST RESULTS AND CLINICAL NOTES IMMEDIATELY AVAILABLE TO PATIENTS. EVIDENCE SUGGESTS THAT PATIENTS MAY GAIN IMPORTANT CLINICAL BENEFITS BY REVIEWING THEIR MEDICAL RECORDS, AND ACCESS THROUGH ELECTRONIC PATIENT PORTALS HAS BEEN ADVOCATED AS A STRATEGY FOR EMPOWERING PATIENTS TO MANAGE THEIR HEALTH CARE AND FOR STRENGTHENING PATIENT-CLINICIAN RELATIONSHIPS. HOWEVER, CONCERNS REMAIN ABOUT THE EFFECTS OF RELEASING TEST RESULTS TO PATIENTS BEFORE CLINICIANS OFFER COUNSEL OR INTERPRETATION.IN A FIRST-OF-ITS-KIND MULTISITE SURVEY OF MORE THAN 8,000 PATIENTS WHO ACCESSED THEIR TEST RESULTS VIA AN ONLINE PATIENT PORTAL ACCOUNT, RESEARCHERS AT BIDMC AND COLLEAGUES FOUND THAT USERS OVERWHELMINGLY SUPPORTED RECEIVING THE RESULTS IMMEDIATELY, EVEN IF THEIR PROVIDER HAD NOT YET REVIEWED THEM. THE FINDINGS, PUBLISHED IN JAMA NETWORK OPEN, SHOWED ONLY A SMALL SUBSET OF PATIENTS REPORTED EXPERIENCING ADDITIONAL WORRY AFTER RECEIVING ABNORMAL TEST RESULTS. IN ADDITION, PRE-COUNSELING BY THE HEALTH CARE TEAM BEFORE TESTS WERE ORDERED WAS LINKED TO REDUCED WORRY AMONG PATIENTS WITH ABNORMAL RESULTS."ONLINE PATIENT PORTALS HAVE EMERGED AS IMPORTANT TOOLS FOR INCREASING PATIENT ENGAGEMENT," SAID CO-SENIOR AUTHOR CATHERINE M. DESROCHES, DRPH, EXECUTIVE DIRECTOR OF OPENNOTES, THE INTERNATIONAL MOVEMENT BASED AT BIDMC FOCUSED ON INCREASING INFORMATION TRANSPARENCY IN HEALTHCARE. "THEY ENABLE PATIENTS TO ACCESS INFORMATION, PARTICIPATE IN MEDICAL DECISION-MAKING AND TO COMMUNICATE WITH CLINICIANS. PRIOR STUDIES PERFORMED BY OPENNOTES INVESTIGATORS ESTABLISHED IMMEDIATE RELEASE OF CLINICAL NOTES AS A RECOMMENDED BEST PRACTICE. HOWEVER, RELEASING TEST RESULTS TO PATIENTS IMMEDIATELY, OFTEN BEFORE A CLINICIAN CAN PROVIDE COUNSELLING AND CONTEXT, WAS YET TO BE STUDIED WIDELY."TO ASSESS PATIENT AND CAREGIVER ATTITUDES AND PREFERENCES RELATED TO RECEIVING TEST RESULTS THROUGH THE PATIENT PORTAL, DESROCHES AND COLLEAGUES DELIVERED SURVEYS TO MORE THAN 43,000 PATIENTS AND CARE PARTNERS WHO ACCESSED THEIR TEST RESULTS VIA AN ONLINE PATIENT PORTAL ACCOUNT BETWEEN APRIL 2021 AND APRIL 2022. WHEN ASKED ABOUT THEIR PREFERENCES FOR CONTACTS ABOUT FUTURE TEST RESULTS, 90 PERCENT OF RESPONDENTS WITH NORMAL RESULTS INDICATED THEY WOULD PREFER RECEIVING THEIR RESULT VIA THE PATIENT PORTAL. THE SURVEY RESULTS SUGGEST THAT PATIENTS RECEIVING NOT NORMAL RESULTS ARE INDEED AT INCREASED RISK FOR WORRY. NEVERTHELESS, MORE THAN 95 PERCENT OF PARTICIPANTS WHO RECEIVED ABNORMAL TEST RESULTS REPORTED PREFERRING TO CONTINUE TO RECEIVE IMMEDIATELY RELEASED RESULTS THROUGH THE PORTAL."RESPONDENTS OVERWHELMINGLY PREFERRED TO RECEIVE TEST RESULTS THROUGH THE PATIENT PORTAL, EVEN IF IT MEANT VIEWING RESULTS PRIOR TO DISCUSSING THEM WITH A HEALTHCARE PROFESSIONAL," SAID CO-AUTHOR LIZ SALMI, COMMUNICATIONS AND PATIENT INITIATIVES DIRECTOR OF OPENNOTES AT BIDMC. "AS HEALTHCARE SYSTEMS CONTINUE TO NAVIGATE THIS NEW ERA OF HEALTH INFORMATION TRANSPARENCY, BALANCING PATIENTS' EXPECTATION OF IMMEDIATE ACCESS TO THEIR INFORMATION WITH THE NEED TO MANAGE INCREASED WORRY IS IMPORTANT."6. SHARP RISE IN CARDIOVASCULAR RISK FACTORS AMONG YOUNG ADULTS FORESHADOWS PUBLIC HEALTH CRISISIN A STUDY PUBLISHED IN JAMA AND PRESENTED AT THE AMERICAN COLLEGE OF CARDIOLOGY SCIENTIFIC SESSIONS, RESEARCHERS AT BIDMC ANALYZED MORE THAN A DECADE'S WORTH OF DATA TO EXAMINE RATES OF CARDIOVASCULAR RISK FACTORS - SUCH AS HIGH BLOOD PRESSURE, DIABETES, OBESITY AND SMOKING - AMONG US ADULTS FROM 2009 TO MARCH 2020. THE RESEARCHERS OBSERVED A RISE IN HYPERTENSION AND SIGNIFICANT INCREASES IN DIABETES AND OBESITY RATES AMONG YOUNG ADULTS, WITH NO SIGNIFICANT IMPROVEMENT IN CONTROL OF BLOOD PRESSURE OR BLOOD SUGAR. THE SCIENTISTS ALSO OBSERVED SUBSTANTIAL VARIATION IN THESE TRENDS BY RACE AND ETHNICITY."THE ONSET OF CARDIOVASCULAR RISK FACTORS EARLY IN LIFE IS ASSOCIATED WITH A HIGHER RISK OF HEART DISEASE AND ACUTE EVENTS, SUCH AS HEART ATTACK AND STROKE, RESULTING IN THE SUBSTANTIAL LOSS OF QUALITY OF LIFE AND YEARS OF LIFE," SAID CORRESPONDING AUTHOR RISHI K. WADHERA, MD, MPP, MPHIL, SECTION HEAD OF HEALTH POLICY AND EQUITY AT THE SMITH CENTER FOR OUTCOMES RESEARCH IN CARDIOLOGY AT BIDMC. "THEREFORE, THE SUBSTANTIAL RISE IN THE BURDEN OF CARDIOVASCULAR RISK FACTORS AMONG YOUNG ADULTS WILL HAVE MAJOR PUBLIC HEALTH IMPLICATIONS AS THE POPULATION AGES."WADHERA AND COLLEAGUES OBSERVED THAT THE PREVALENCE OF HYPERTENSION INCREASED AND SAW STATISTICALLY SIGNIFICANT INCREASES IN RATES OF DIABETES AND OBESITY DURING THE STUDY PERIOD. THE PERCENTAGE OF YOUNG ADULTS WITH A SMOKING HISTORY WAS HIGH AND DID NOT CHANGE. IN CONTRAST, RATES OF HIGH CHOLESTEROL DECLINED, A DECREASE THE SCIENTISTS SUGGEST REFLECTS GOVERNMENT REGULATION OF THE USE OF TRANS FATTY ACIDS AND OTHER PARTIALLY HYDROGENATED OILS IN PACKAGED CONVENIENCE FOODS AND FAST-FOOD RESTAURANTS.THE RESEARCHERS FOUND SUBSTANTIAL VARIATION IN PREVALENCE OF RISK FACTORS BY RACE AND ETHNICITY. OBESITY SIGNIFICANTLY INCREASED ACROSS ALL RACIAL AND ETHNIC GROUPS EXCEPT BLACK ADULTS. WHILE RATES OF HYPERTENSION INCREASED AMONG MEXICAN AMERICANS AND OTHER HISPANIC ADULTS, BLACK ADULTS EXPERIENCED THE HIGHEST RATES OF HYPERTENSION.THE RESEARCHERS ALSO EXAMINED CARDIOVASCULAR RISK FACTOR TREATMENT AND CONTROL RATES AMONG YOUNG ADULTS. ONLY ABOUT 55 PERCENT OF YOUNG ADULTS WITH HIGH BLOOD PRESSURE RECEIVE TREATMENT FOR THE CONDITION. RATES OF DIABETES TREATMENT WERE ALSO LOW, WITH ONE OUT OF TWO YOUNG ADULTS ON THERAPY FOR THEIR DIABETES. NEARLY HALF OF YOUNG ADULTS ON TREATMENT FOR DIABETES HAD POOR BLOOD SUGAR CONTROL."THE SUBOPTIMAL TREATMENT RATES FOR HIGH BLOOD PRESSURE AND DIABETES ARE CONCERNING AND MAY BE BECAUSE MANY YOUNG ADULTS AREN'T AWARE OF THEIR DIAGNOSIS," SAID WADHERA. "THE RISE IN CARDIOVASCULAR RISK FACTORS THAT WE OBSERVED SHOULD BE A CALL-TO-ACTION TO INTENSIFY PUBLIC HEALTH AND CLINICAL INTERVENTIONS FOCUSED ON THE PREVENTION AND TREATMENT OF CARDIOVASCULAR RISK FACTORS IN YOUNG ADULTS."7. COSTS OF NATURAL DISASTERS SET TO SPIRAL WITH CONTINUED RISE IN CO2 AND GLOBAL TEMPERATURE, STUDY SHOWSIN A PAPER PUBLISHED IN THE JOURNAL OF CLIMATE CHANGE AND HEALTH, MEMBERS OF THE BIDMC FELLOWSHIP IN DISASTER MEDICINE ESTIMATED THAT CLIMATE CHANGE-RELATED NATURAL DISASTERS HAVE INCREASED SINCE 1980 AND HAVE ALREADY COST THE UNITED STATES MORE THAN $2 TRILLION IN RECOVERY COSTS. THEIR ANALYSIS ALSO SUGGESTS THAT AS ATMOSPHERIC CARBON DIOXIDE LEVELS AND THE GLOBAL TEMPERATURE CONTINUE TO RISE, THE FREQUENCY AND SEVERITY OF DISASTERS WILL INCREASE, WITH RECOVERY COSTS POTENTIALLY RISING EXPONENTIALLY."THE UNITED STATES SPENDS A STAGGERING AMOUNT ON COSTS SECONDARY TO NATURAL DISASTERS," SAID SENIOR AUTHOR GREGORY CIOTTONE, MD, DIRECTOR OF THE DISASTER MEDICINE FELLOWSHIP AT BIDMC. "CARBON DIOXIDE LEVELS AND TEMPERATURES HAVE INCREASED OVER THE PAST FOUR DECADES AND ARE STRONGLY POSITIVELY CORRELATED WITH THE NUMBER AND COST OF BILLION-DOLLAR DISASTERS, SUGGESTING THE ANNUAL NUMBER OF EVENTS WILL CONTINUE TO INCREASE ALONG WITH THEIR ECONOMIC BURDEN. MEASURES ARE NEEDED TO MITIGATE THOSE COSTS."TO ASSESS THE RELATIONSHIP BETWEEN RISING CARBON DIOXIDE LEVELS, TEMPERATURES AND THE NUMBER OF DISASTERS COSTING A BILLION DOLLARS OR MORE IN THE UNITED STATES, CIOTTONE AND COLLEAGUES ANALYZED DATA BETWEEN 1980-2021 FROM THE NATIONAL CENTER FOR ENVIRONMENTAL INFORMATION (NCEI). THE TEAM FOUND THAT THE INCREASES IN ATMOSPHERIC CARBON DIOXIDE LEVELS AND TEMPERATURE - TIGHTLY LINKED TO EACH OTHER - WERE ASSOCIATED WITH INCREASING NUMBERS OF EVENTS PER YEAR, AS WELL AS FATALITIES. AFTER ADJUSTING DOLLAR VALUES FOR INFLATION, THEIR ANALYSIS SHOWED THAT MORE FREQUENT AND MORE SEVERE DISASTERS ARE INCURRING RISING COSTS.AMONG THEIR FINDINGS: FROM 1980-1989, THERE WERE 3 BILLION-DOLLAR EVENTS PER YEAR AND 297 DEATHS PER YEAR, COSTING A TOTAL OF $19.5 BILLION. BY 2010-2019, THE RISE IN CARBON DIOXIDE LEVELS AND TEMPERATURE WERE LINKED WITH 13 ANNUAL EVENTS, 523 ANNUAL DEATHS, AND $89.2 BILLION IN RECOVERY COSTS, A FOURFOLD INCREASE.
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"FRAMING DISASTERS IN THIS ECONOMIC LIGHT CAN BRING
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MORE ATTENTION AND MOTIVATION FOR CHANGE TO ALTER POLICYMAKERS' DECISIONS," SAID CORRESPONDING AUTHOR VIJAI BHOLA, MD, A GRADUATE OF THE DISASTER MEDICINE FELLOWSHIP AT BIDMC, WHO NOTES THE CURRENT ANALYSIS CAPTURES JUST A FRACTION OF THE COSTS INCURRED BY CLIMATE CHANGE. "THESE COSTS REPRESENT A COMBINATION OF IMMEDIATE AND LONGER-TERM RESTORATION ESTIMATES. WHAT THEY DO NOT REFLECT, HOWEVER, ARE FACTORS SUCH AS DESTRUCTION OF NATURAL RESOURCES OR LOSS OF LIFE, AND THEREFORE THESE NUMBERS SIGNIFICANTLY UNDERESTIMATE THE TRUE COST OF CLIMATE-RELATED DISASTERS."8. RESEARCHERS TEST AI POWERED CHATBOTS MEDICAL DIAGNOSTIC ABILITYIN A RECENT EXPERIMENT PUBLISHED IN JAMA, PHYSICIAN-RESEARCHERS AT BIDMC TESTED ONE WELL-KNOWN PUBLICLY AVAILABLE CHATBOT'S ABILITY TO MAKE ACCURATE DIAGNOSES IN CHALLENGING MEDICAL CASES. THE TEAM FOUND THAT THE GENERATIVE AI, CHAT-GPT 4, SELECTED THE CORRECT DIAGNOSIS AS ITS TOP DIAGNOSIS NEARLY 40 PERCENT OF THE TIME AND PROVIDED THE CORRECT DIAGNOSIS IN ITS LIST OF POTENTIAL DIAGNOSES IN TWO-THIRDS OF CHALLENGING CASES.GENERATIVE AI CHATBOTS ARE POWERFUL TOOLS POISED TO REVOLUTIONIZE CREATIVE INDUSTRIES, EDUCATION, CUSTOMER SERVICE AND MORE. HOWEVER, LITTLE IS KNOWN ABOUT THEIR POTENTIAL PERFORMANCE IN THE CLINICAL SETTING, SUCH AS COMPLEX DIAGNOSTIC REASONING."RECENT ADVANCES IN ARTIFICIAL INTELLIGENCE HAVE LED TO GENERATIVE AI MODELS THAT ARE CAPABLE OF DETAILED TEXT-BASED RESPONSES THAT SCORE HIGHLY IN STANDARDIZED MEDICAL EXAMINATIONS," SAID ADAM RODMAN, MD, MPH, CO-DIRECTOR OF THE INNOVATIONS IN MEDIA AND EDUCATION DELIVERY (IMED) INITIATIVE AT BIDMC. "WE WANTED TO KNOW IF SUCH A GENERATIVE MODEL COULD 'THINK LIKE A DOCTOR, SO WE ASKED ONE TO SOLVE STANDARDIZED COMPLEX DIAGNOSTIC CASES USED FOR EDUCATIONAL PURPOSES. IT DID REALLY, REALLY WELL."TO ASSESS THE CHATBOT'S DIAGNOSTIC SKILLS, RODMAN AND COLLEAGUES USED CLINICOPATHOLOGICAL CASE CONFERENCES (CPCS), A SERIES OF COMPLEX AND CHALLENGING PATIENT CASES INCLUDING RELEVANT CLINICAL AND LABORATORY DATA, IMAGING STUDIES, AND HISTOPATHOLOGICAL FINDINGS PUBLISHED IN THE NEW ENGLAND JOURNAL OF MEDICINE FOR EDUCATIONAL PURPOSES.EVALUATING 70 CPC CASES, THE ARTIFICIAL INTELLIGENCE EXACTLY MATCHED THE FINAL CPC DIAGNOSIS IN 27 (39 PERCENT) OF CASES. IN 64 PERCENT OF THE CASES, THE FINAL CPC DIAGNOSIS WAS INCLUDED IN THE AI'S DIFFERENTIAL A LIST OF POSSIBLE CONDITIONS THAT COULD ACCOUNT FOR A PATIENT'S SYMPTOMS, MEDICAL HISTORY, CLINICAL FINDINGS AND LABORATORY OR IMAGING RESULTS."WHILE CHATBOTS CANNOT REPLACE THE EXPERTISE AND KNOWLEDGE OF A TRAINED MEDICAL PROFESSIONAL, GENERATIVE AI IS A PROMISING POTENTIAL ADJUNCT TO HUMAN COGNITION IN DIAGNOSIS," SAID FIRST AUTHOR ZAHIR KANJEE, MD, MPH, A HOSPITALIST AT BIDMC. "IT HAS THE POTENTIAL TO HELP PHYSICIANS MAKE SENSE OF COMPLEX MEDICAL DATA AND BROADEN OR REFINE OUR DIAGNOSTIC THINKING. WE NEED MORE RESEARCH ON THE OPTIMAL USES, BENEFITS AND LIMITS OF THIS TECHNOLOGY, AND A LOT OF PRIVACY ISSUES NEED SORTING OUT, BUT THESE ARE EXCITING FINDINGS FOR THE FUTURE OF DIAGNOSIS AND PATIENT CARE.""OUR STUDY ADDS TO A GROWING BODY OF LITERATURE DEMONSTRATING THE PROMISING CAPABILITIES OF AI TECHNOLOGY," SAID CO-AUTHOR BYRON CROWE, MD, AN INTERNAL MEDICINE PHYSICIAN AT BIDMC. "FURTHER INVESTIGATION WILL HELP US BETTER UNDERSTAND HOW THESE NEW AI MODELS MIGHT TRANSFORM HEALTH CARE DELIVERY."9. INTEGRATING TECHNOLOGY TO BETTER SUPPORT MENTAL HEALTH CAREOVER THE PAST DECADE, DEMAND FOR MENTAL HEALTH SERVICES HAS RISEN SIGNIFICANTLY, WITH THE NUMBER OF ADULTS RECEIVING PSYCHIATRIC CARE INCREASING BY MORE THAN 12 PERCENT SINCE 2011, ACCORDING TO THE NATIONAL ALLIANCE FOR MENTAL ILLNESS. HOWEVER, A SHORTAGE OF MENTAL HEALTH CLINICIANS MEANS MANY PEOPLE ARE STILL NOT ABLE TO ACCESS THE CARE THEY NEED. IN A CASE STUDY PUBLISHED IN NEJM CATALYST, CLINICIAN-INVESTIGATORS IN THE DIVISION OF DIGITAL PSYCHIATRY AT BIDMC HIGHLIGHT A MODEL THEY DEVELOPED FOR INTEGRATING DIGITAL TECHNOLOGIES AND BRIEF EVIDENCE-BASED TREATMENT INTO IN-PERSON PSYCHIATRY. KNOWN AS THE DIGITAL CLINIC, THE TEAM'S INNOVATIVE HYBRID CARE MODEL EXPANDS PATIENTS' ACCESS TO HIGHLY EFFECTIVE MENTAL HEALTH CARE WHILE SIGNIFICANTLY DECREASING PATIENT WAIT TIMES AND LENGTH OF TREATMENT. ADDITIONALLY, THE TEAM'S RECENT PILOT STUDY SUGGESTS THAT THIS MODEL MAY YIELD POST-TREATMENT IMPROVEMENTS IN PATIENTS' SYMPTOMS OF DEPRESSION AND ANXIETY THAT ARE COMPARABLE TO, IF NOT BETTER THAN, TRADITIONAL MODELS OF CARE."AS THE SEVERITY OF MENTAL HEALTH CRISES INCREASES, EVIDENCED BY RISING RATES OF DEPRESSION AND ANXIETY ESPECIALLY IN YOUNG PEOPLE, IT'S CRITICAL THAT INNOVATIVE SOLUTIONS ARE DEVELOPED TO INCREASE ACCESS TO HIGH-QUALITY PSYCHIATRIC CARE," SAID SENIOR AUTHOR JOHN TOROUS, MD, MBI, DIRECTOR OF THE DIVISION OF DIGITAL PSYCHIATRY AT BIDMC. "OUR ENCOURAGING FINDINGS SUGGEST THAT WHEN WE TARGET DEPRESSION AND ANXIETY WITH BRIEF, TECHNOLOGY-ENHANCED, EVIDENCE-BASED TREATMENT, OUR PATIENTS CAN OBTAIN MEANINGFUL GAINS."IN A RECENT PILOT STUDY OF 40 ADULT PATIENTS WHO RECEIVED EIGHT WEEKS OF TREATMENT FOR DEPRESSION AND/OR ANXIETY IN THE DIGITAL CLINIC BETWEEN OCTOBER 2022 AND JANUARY 2023, 67 PERCENT OF PATIENTS' MENTAL HEALTH OUTCOMES THAT WERE TARGETED IN TREATMENT REFLECTED CLINICALLY SIGNIFICANT IMPROVEMENT. NOTABLY, 64 PERCENT OF THOSE PATIENT OUTCOMES REFLECTED REMISSION, DEFINED AS HAVING "MILD, MINIMAL OR NO SYMPTOMS" BY THE END OF TREATMENT."THESE OUTCOMES MEET AND EXCEED OUTCOMES FROM LONGER-TERM TREATMENT," SAID TOROUS, WHO ADDED THAT RECENT META-ANALYSES OF MAINLY MAINSTREAM, EVIDENCE-BASED TREATMENTS FOUND REMISSION RATES OF JUST OVER HALF FOR ANXIETY DISORDERS AND ROUGHLY ONE THIRD FOR DEPRESSION. LIKEWISE, STUDIES HAVE SHOWN THAT DIGITAL APPROACHES TO MENTAL HEALTH CAN YIELD IMPRESSIVE RESULTS WHEN PATIENTS CONSISTENTLY ENGAGE WITH THEM, BUT DECADES OF USER-CENTERED DESIGN AND GAMIFICATION HAVE NOT SOLVED THE PROBLEM OF KEEPING PEOPLE REGULARLY INTERACTING WITH THE TECHNOLOGY LONG TERM."WE DESIGNED THE DIGITAL CLINIC TO HARNESS THE STRENGTHS OF BOTH TRADITIONAL AND DIGITAL MENTAL HEALTH CARE," SAID FIRST AUTHOR NATALIA MACRYNIKOLA, PHD, A POSTDOCTORAL RESEARCH FELLOW AT BIDMC. "THE BENEFITS OF HUMAN RAPPORT, THE THERAPEUTIC ALLIANCE, AND A THERAPIST'S ABILITY TO TAILOR EVIDENCED-BASED THERAPEUTIC INTERVENTIONS TO THE NEEDS OF EACH CLIENT ARE TANGIBLE ADVANTAGES OF TRADITIONAL CARE, WHEREAS THE SCALABILITY AND ACCESSIBILITY OF DIGITAL APPROACHES CONFER CLEAR ADVANTAGES THAT SHOULD NOT BE OVERLOOKED."10. NEW NATIONAL STANDARDS FOR NEONATAL INTENSIVE CARE AIM TO ACHIEVE HEALTH EQUITY FOR US NEWBORNSLED BY BIDMC NEONATOLOGIST ANN R. STARK, MD, IN HER CAPACITY AS MEDICAL DIRECTOR OF THE NICU VERIFICATION PROGRAM FOR THE AMERICAN ACADEMY OF PEDIATRICS (AAP), A TEAM OF NEONATAL LEADERS AND EXPERIENCED CLINICIANS HAVE ESTABLISHED NEW STANDARDS FOR LEVELS OF NEONATAL CARE THAT SPECIFY THE PERSONNEL, EQUIPMENT AND SERVICES HOSPITALS NEED TO PROVIDE FOR NEWBORNS AND FAMILIES. BASED ON AAP POLICY, EVIDENCE-BASED LITERATURE AND STANDARDS OF PROFESSIONAL PRACTICE, STANDARDS FOR LEVELS OF NEONATAL CARE: II, III, & IV, APPEARED IN THE AAP'S JOURNAL PEDIATRICS."WE HAVE CREATED THESE STANDARDS WITH A GOAL TO IMPROVE OUTCOMES, INCREASE ACCESS TO CARE, IMPROVE STANDARDIZATION ACROSS ALL LEVELS OF NEONATAL CARE AND ACHIEVE HEALTH EQUITY FOR BABIES ACROSS THE COUNTRY," SAID STARK, "WE WERE CONCERNED THAT FIRST, ALL BABIES SHOULD BE TREATED IN A PLACE WITH APPROPRIATE CARE AND SECOND, THAT THE FACILITY HAS THE PEOPLE AND THE EQUIPMENT THAT ARE APPROPRIATE FOR THEIR DEGREE OF ILLNESS OR IMMATURITY." THE UNITED STATES RANKS 35TH IN NEONATAL MORTALITY AMONG DEVELOPED NATIONS; MORE THAN THREE BABIES OUT OF EVERY 1,000 BABIES DIE WITHIN THEIR FIRST MONTH OF LIFE. MANY FACTORS CONTRIBUTE TO THESE SHOCKING NUMBERS, HOWEVER, EXPERTS AGREE ONE REASON IS THE LACK OF NATIONAL STANDARDS FOR NEONATAL INTENSIVE CARE UNITS (NICUS). WITH PUBLICATION OF THE NEW STANDARDS, AND WHEN PROCESSES ARE IN PLACE, THE AAP PROGRAM WILL BE ABLE TO VERIFY A NEONATAL FACILITY'S COMPLIANCE AND DESIGNATE THAT IT PROVIDES A SPECIFIC LEVEL OF NEONATAL CARE (II, III OR IV). HOSPITALS WILL SUBMIT DATA AND UNDERGO A SURVEY OF THEIR FACILITY. THOSE THAT MEET REQUIREMENTS WILL BE ABLE TO STATE THAT THEY ARE AAP-VERIFIED AT A PARTICULAR LEVEL OF NEONATAL CARE. THE DESIGNATION THEN WILL BE TRANSPARENT TO PHYSICIANS AND FAMILIES DECIDING WHERE TO DELIVER AND/OR SEEK CARE FOR THEIR BABY."PARENTS SHOULD UNDERSTAND THE LEVEL OF NEONATAL CARE AVAILABLE WHERE THEY ARE DELIVERING," SAID STARK. "WHETHER THEY ARE BORN IN URBAN ACADEMIC MEDICAL CENTERS OR RURAL COMMUNITY HOSPITALS, ALL BABIES DESERVE OPTIMAL CARE. ADOPTION OF THE AAP NEONATAL STANDARDS IS A VITAL STEP TOWARD HIGH-QUALITY AND EQUITABLE CARE."
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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS
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GRADUATE MEDICAL EDUCATION THE MEDICAL CENTER'S DEVOTION TO TEACHING, RESPECT FOR STUDENTS/TRAINEES AND WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE THE MEDICAL CENTER A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. THE MEDICAL CENTER TRAINS HUNDREDS OF MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS, AS WELL AS PROFESSIONALS IN NURSING, SOCIAL WORK AND THE ALLIED HEALTH SCIENCES. THE MEDICAL CENTER HAS 63 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 731 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 44 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 53 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES. CORE CLINICAL TRAINING PROGRAMSTHE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS: - ANESTHESIOLOGY - EMERGENCY MEDICINE - EAR, NOSE AND THROAT (OTOLARYNGOLOGY) - INTERNAL MEDICINE - NEUROLOGY - NEUROSURGERY - OBSTETRICS AND GYNECOLOGY - PATHOLOGY - PLASTIC SURGERY - PSYCHIATRY - RADIOLOGY - SURGERY - TRANSITIONAL YEAR - UROLOGYDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER HAD NET EXPENDITURES OF $87,407,34 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO THE MEDICAL CENTER'S TEACHING FUNCTION WHICH REPRESENTED 3.38% OF THE MEDICAL CENTER'S TOTAL EXPENSES.RESIDENCY PROGRAMSTHE MEDICAL CENTER SPONSORS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED RESIDENCY PROGRAMS IN EACH OF THE CORE CLINICAL TRAINING PROGRAMS LISTED ABOVE. FELLOWSHIP PROGRAMSIN ADDITION TO THE RESIDENT TRAINING PROGRAMS LISTED ABOVE, THE MEDICAL CENTER SPONSORS A WIDE VARIETY OF FELLOWSHIP TRAINING PROGRAMS FOR ELIGIBLE DOCTORS WHO HAVE COMPLETED THEIR RESIDENCY AND WANT TO ENGAGE IN MORE SPECIALIZED STUDY. MORE THAN HALF OF THESE PROGRAMS (47 OF 91) ARE ACGME APPROVED OR APPROVED BY A COMPARABLE BODY RELATED TO THE PARTICULAR SUBSPECIALTY. THE MEDICAL CENTER SPONSORS THE FOLLOWING FELLOWSHIP PROGRAMS:- ANESTHESIA: ADULT CARDIOTHORACIC ANESTHESIOLOGY, ADVANCED CLINICAL ANESTHESIA, ANESTHESIA FOR OUTPATIENT SURGERY, CRITICAL CARE MEDICINE, NEUROANESTHESIA, NEURO CRITICAL CARE, OBSTETRIC ANESTHESIOLOGY, PAIN MEDICINE, REGIONAL ANESTHESIA, VASCULAR ANESTHESIA, PATIENT SAFETY AND QUALITY IMPROVEMENT IN ANESTHESIA, ANESTHESIA MEDICAL EDUCATION- DERMATOLOGY: CUTANEOUS ONCOLOGY, DERMATOLOGY RESEARCH FELLOWSHIP IN CLINICAL TRIALS AND OUTCOMES RESEARCH (CLEARS)- EMERGENCY MEDICINE: EMERGENCY MEDICAL SERVICES, EMERGENCY ULTRASOUND, DISASTER MEDICINE, ACADEMIC EMERGENCY MEDICINE- INTERNAL MEDICINE: ADVANCED CARDIAC NON-INVASIVE IMAGING, ADVANCED ENDOCRINE, DIABETES AND METABOLISM, ADVANCED ENDOSCOPY, ADVANCED INFECTIOUS DISEASE, ADVANCED NEPHROLOGY, CARDIAC MAGNETIC RESONANCE IMAGING, CARDIOVASCULAR DISEASE, CELIAC DISEASE, CLINICAL CARDIAC ELECTROPHYSIOLOGY, CLINICAL INFORMATICS, ENDOCRINOLOGY, DIABETES, AND METABOLISM, GASTROENTEROLOGY, GENERAL MEDICINE, GERIATRIC MEDICINE, GERIATRIC AND DIABETES, GI MOTILITY/FUNCTIONAL BOWEL DISORDERS, GLOBAL HEALTH, HEMATOLOGY AND MEDICAL ONCOLOGY, HEPATOLOGY, HOSPICE AND PALLIATIVE CARE, INFECTIOUS DISEASE, INFLAMMATORY BOWEL DISEASE, INTERVENTIONAL CARDIOLOGY, INTERVENTIONAL PULMONOLOGY, NEPHROLOGY, PULMONARY CRITICAL CARE, RHEUMATOLOGY, SLEEP MEDICINE, SLEEP RESPIRATION, STRUCTURAL HEART DISEASE, TRANSPLANT HEPATOLOGY, TRANSPLANT NEPHROLOGY, LGBTQIA+ HEALTH- NEUROLOGY: AUTONOMIC DISORDERS, COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY, NEURO CRITICAL CARE- OBSTETRICS AND GYNECOLOGY: FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY, GYNECOLOGIC ONCOLOGY, MATERNAL FETAL MEDICINE, REPRODUCTIVE ENDOCRINOLOGY- PATHOLOGY: BLOOD BANKING/TRANSFUSION MEDICINE, CYTOPATHOLOGY, DERMATOPATHOLOGY, HEMATOPATHOLOGY, MEDICAL MICROBIOLOGY, MEDICAL MICROBIOLOGY CPEP, NEUROPATHOLOGY, SELECTIVE PATHOLOGY - PSYCHIATRY: EARLY PSYCHOSIS- RADIOLOGY: DIAGNOSTIC, ABDOMINAL RADIOLOGY, BREAST IMAGING RADIOLOGY, INTERVENTIONAL RADIOLOGY-INDEPENDENT, INTERVENTIONAL RADIOLOGY-INTEGRATED, MRI, MUSCULOSKELETAL IMAGING (MSK), NEURORADIOLOGY, THORACIC IMAGING RADIOLOGY, - RADIATION ONCOLOGY: BRACHYTHERAPY, STEREOTATIC- SURGERY: ABDOMINAL TRANSPLANT SURGERY/KIDNEY, ACUTE CARE SURGERY, ANTERIOR SEGMENT OPHTHALMOLOGY, COLON AND RECTAL SURGERY, CORNEA AND REFRACTIVE SURGERY, CEREBROVASCULAR AND ENDOVASCULAR NEUROSURGERY, HEAD & NECK SURGICAL ONCOLOGY & RECONSTRUCTION, INTERDISCIPLINARY BREAST SURGERY, LYMPHATIC SURGERY, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGERY/ORTHO SPINE, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, OTOLARYNGOLOGY FELLOWSHIP, PLASTIC SURGERY, PLASTIC SURGERY/AESTHETIC RECONSTRUCTION, PLASTIC SURGERY/BREAST RECONSTRUCTION, PODIATRY, SURGICAL CRITICAL CARE, THORACIC SURGERY, UROLOGY, UROLOGY MALE INFERTILITY/SEXUAL DYSFUNCTION, VASCULAR SURGERY, VASCULAR SURGERY-INTEGRATED, JOINTS FELLOWSHIPADDITIONAL INFORMATION ON CLINICAL RESIDENCY AND FELLOWSHIPS -- EXAMPLESBELOW IS MORE DETAIL ON JUST A FEW OF THE SPECIFIC GRADUATE MEDICAL EDUCATION PROGRAMS OFFERED AT THE MEDICAL CENTER:HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY AT BIDMCTHE BETH ISRAEL DEACONESS MEDICAL CENTER HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY IS A THREE-YEAR PROGRAM (PGY-1 TO PGY-3) AFFILIATED WITH HARVARD MEDICAL SCHOOL AND IS BASED AT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A 57,000 VISIT PER YEAR LEVEL I TRAUMA CENTER. RESIDENTS ROTATE AT CHILDREN'S HOSPITAL BOSTON, BROCKTON HOSPITAL, CAMBRIDGE HEALTH ALLIANCE, TUFTS MEDICAL CENTER, ST. LUKE'S HOSPITAL, MOUNT AUBURN HOSPITAL, SOUTH SHORE HOSPITAL AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM.THE EDUCATIONAL GOALS OF THE RESIDENCY ARE TO PROMOTE EXCELLENCE IN THE CLINICAL, ACADEMIC, AND ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE. RESIDENTS ARE TAUGHT HOW TO BE OUTSTANDING CLINICIANS. THIS IS ACCOMPLISHED THROUGH CLINICAL EXPERIENCE IN SEVERAL BUSY EMERGENCY DEPARTMENTS AS WELL AS THROUGH A HIGH QUALITY DIDACTIC PROGRAM. DURING THE CLINICAL EXPERIENCE, THE RESIDENTS ARE CLOSELY SUPERVISED AND GIVEN GRADED RESPONSIBILITY FOR PATIENT CARE AND ULTIMATELY FOR PATIENT FLOW IN THE EMERGENCY DEPARTMENT. ADDITIONALLY, RESIDENTS ARE TAUGHT HOW TO SUPERVISE MEDICAL STUDENTS AND OTHER RESIDENTS AND HOW TO TEACH THE PRACTICE OF EMERGENCY MEDICINE. RESIDENTS TEACH MEDICAL STUDENTS AND PREHOSPITAL PERSONNEL AND CONTRIBUTE TO THE DIDACTIC PROGRAM. SENIOR RESIDENTS TAKE ON THE RESPONSIBILITY OF SUPERVISING JUNIOR RESIDENTS IN THE CLINICAL ARENA. THE FOCUS OF THE RESIDENCY PROGRAM IS ON TEACHING THE LEADERSHIP SKILLS NECESSARY TO DIRECT A BUSY EMERGENCY DEPARTMENT IN ANY SETTING.THE OTHER MAJOR EDUCATIONAL GOAL OF THE RESIDENCY IS TO DEVELOP THE RESEARCH AND ACADEMIC SKILLS REQUIRED FOR A CAREER IN ACADEMIC EMERGENCY MEDICINE. PARTICIPATION IN RESEARCH IS PROMOTED THROUGH A SYSTEM OF MENTORSHIP, JOURNAL CLUB PARTICIPATION, AND A DIDACTIC PROGRAM THAT TEACHES RESEARCH DESIGN AND STATISTICAL METHODS. RESIDENTS ARE REQUIRED TO COMPLETE A RESEARCH OR ACADEMIC PROJECT THAT RESULTS IN A PAPER SUITABLE FOR PUBLICATION. FUNDING IS AVAILABLE WITHIN THE DIVISION OF EMERGENCY MEDICINE AT HARVARD MEDICAL SCHOOL AND THE DEPARTMENT OF EMERGENCY MEDICINE AT BIDMC. PROMOTING THE ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE IS ANOTHER GOAL OF THE BIDMC HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY. THROUGH AN EMS/ADMINISTRATIVE ROTATION AND A LONGITUDINAL EXPERIENCE IN PREHOSPITAL ADMINISTRATION, RESIDENTS GAIN EXPERIENCE IN RUNNING A LOCAL PREHOSPITAL SYSTEM.THIS PROGRAM TAKES ADVANTAGE OF THE UNIQUE ACADEMIC OPPORTUNITIES AT HARVARD MEDICAL SCHOOL, THE HARVARD TEACHING HOSPITALS, AND THE HARVARD SCHOOL OF PUBLIC HEALTH. THESE OPPORTUNITIES INCLUDE THE OUTSTANDING EXPERIENCE AVAILABLE THROUGH BOSTON CHILDREN'S HOSPITAL AND THE DEPARTMENTS OF MEDICINE, SURGERY, OBSTETRICS AND GYNECOLOGY, AND ANESTHESIA AT BETH ISRAEL DEACONESS MEDICAL CENTER.
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INTERNAL MEDICINE EDUCATION AT BIDMC
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THE GOAL OF THIS PROGRAM IS TO DEVELOP EACH RESIDENT'S JUDGMENT AND SKILLS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE. THE MEDICAL CENTER TRAINS RESIDENTS AS ACADEMIC INTERNISTS AND PROVIDES THE FOUNDATION FOR THE PRACTICE OF INTERNAL MEDICINE OR FOR SUBSEQUENT CLINICAL AND RESEARCH TRAINING IN MEDICAL SUBSPECIALTIES. RESIDENTS ARE EXPOSED TO A WIDE ARRAY OF PATIENTS IN VARIOUS INPATIENT AND OUTPATIENT SETTINGS, INCLUDING DIFFERENT UNITS WITHIN BIDMC, DANA FARBER CANCER INSTITUTE, AND WEST ROXBURY VETERANS AFFAIRS MEDICAL CENTER. CLINICAL TEACHING IS A FOCUS AT BIDMC AND IS COMPRISED OF FORMAL AND INFORMAL DAILY ROUNDS AND NOONTIME CONFERENCES. THIS TEACHING PROVIDES THE BASIS OF AN ORGANIZED CURRICULUM FOR ALL MEDICAL INTERNS AND RESIDENTS AT BIDMC.INTERNSHIPTHE INTERNSHIP YEAR EMPHASIZES THE CARE OF PATIENTS IN GENERAL INPATIENT MEDICINE, INTENSIVE CARE MEDICINE, ONCOLOGY, CARDIOLOGY, EMERGENCY MEDICINE AND AMBULATORY CARE UTILIZING BOTH CAMPUSES AND SELECTED OUTSIDE SITES. WORKING AS PART OF A 2-4 PHYSICIAN TEAM WHICH INCLUDES AN OVERSEEING RESIDENT, ATTENDING STAFF AND OFTEN MEDICAL STUDENTS, INTERNS GAIN EXPERIENCE IN THE MANAGEMENT OF PATIENTS WITH A BROAD RANGE OF MEDICAL DISEASES. INTERNS HAVE PRIMARY RESPONSIBILITY FOR THE CARE OF ALL PATIENTS ADMITTED TO THE MEDICAL WARD SERVICE AND ARE CONSIDERED THEIR PATIENT'S PRIMARY INPATIENT DOCTOR FOR THE DURATION OF THE HOSPITALIZATION. THROUGHOUT INTERN YEAR, INTERNS MAINTAIN A LONGITUDINAL CONTINUITY CLINIC EXPERIENCE WHERE THEY DEVELOP A PANEL OF THEIR OWN PRIMARY CARE PATIENTS. DURING MOST OF THE YEAR, WITH THE EXCEPTION OF INTENSIVE CARE ROTATIONS, AN INTERN WILL HAVE CLINIC ONE HALF-DAY PER WEEK. DISTRIBUTED THROUGHOUT THE YEAR ARE FOUR "AMBULATORY BLOCKS" OF TWO WEEKS DURATION. DURING THIS TIME THE INTERN IS IN THEIR CONTINUITY CLINIC EVERY AFTERNOON AND ATTENDS OUTPATIENT SPECIFIC DIDACTIC LECTURES DURING THE MORNING HOURS. AS MEMBERS OF THE HARVARD FACULTY, INTERNS PLAY AN IMPORTANT ROLE IN TEACHING, BOTH OF THEIR PEERS AND OF ROTATING MEDICAL STUDENTS. WHILE ON THE MEDICAL WARDS, INTERNS PROVIDE DAILY CLINICAL GUIDANCE AND TEACHING TO THIRD AND FOURTH YEAR MEDICAL STUDENTS. AS PART OF THE AMBULATORY CARE CURRICULUM, INTERNS WILL ALSO HAVE THE OPPORTUNITY TO LEAD PRE-CLINIC CONFERENCES. DURING THE YEAR, THERE ARE SPECIAL INTERN-ONLY EDUCATIONAL ACTIVITIES INCLUDING THE TWICE-WEEKLY INTERN REPORT, MONTHLY INTERN FORUM SESSIONS AND BI-ANNUAL 24-HOUR INTERN RETREATS.JUNIOR AND SENIOR RESIDENCYRESIDENCY SOLIDIFIES CLINICAL AND TEACHING SKILLS AND ALLOWS TRAINEES TO EXPERIENCE LEADERSHIP OF A MEDICAL TEAM. JUNIOR RESIDENCY PROVIDES THE FIRST OPPORTUNITY FOR RESIDENTS TO SUPERVISE HOUSESTAFF TEAMS ON GENERAL MEDICAL SERVICES AND IN THE MEDICAL AND CARDIAC INTENSIVE CARE UNITS. SENIOR RESIDENCY PROMOTES CONSOLIDATION AND REFINEMENT OF THESE SKILLS, WITH ATTENDINGS ALLOWING INCREASING AUTONOMY. THE RESIDENT ON THE SERVICE IS LOOKED ON AS THE TEAM LEADER AND ASSUMES PRIMARY RESPONSIBILITY FOR TEACHING OF THE TEAM. RESIDENCY ALSO PROVIDES OPPORTUNITIES FOR INCREASED ELECTIVE TIME TO SAMPLE SUBSPECIALTY ROTATIONS. THIS PROVIDES ADDITIONAL SPECIALTY TRAINING IN AREAS OF INTEREST. THE ELECTIVE OPPORTUNITIES ARE DIVERSE, RANGING FROM ELECTROPHYSIOLOGY TO MUSCULOSKELETAL MEDICINE TO HEALTH POLICY. RESIDENTS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN ONE OF SEVERAL "TRACKS" WITHIN THE RESIDENCY PROGRAM IF INTERESTED IN ADDITIONAL SPECIFIC TRAINING RESOURCES AND EXPERIENCES.TEACHING AS A RESIDENTAS MENTIONED ABOVE, RESIDENTS ARE VIEWED AS SOME OF THE PRIMARY TEACHERS WITHIN THE DEPARTMENT OF MEDICINE. SOME OF THESE TEACHING OPPORTUNITIES WILL ALSO BE OBSERVED BY DEPARTMENT FACULTY TO HELP THE RESIDENT REFINE THE STYLE AND EFFECTIVENESS OF THEIR TEACHING. TEACHING OPPORTUNITIES WILL INCLUDE:LEADING INPATIENT MEDICINE ROUNDS: - RESIDENTS ARE IN CHARGE OF RUNNING WARD ROUNDS. MEDICAL STUDENTS AND INTERNS PRESENT TO THE RESIDENT DURING ROUNDS. THE ATTENDING HOSPITALIST IS CONSIDERED THE RESIDENT'S CONSULTANT, WITH THE RESIDENT RETAINING THE PRIMARY DECISION-MAKING ROLE FOR THE PATIENTS ON THEIR SERVICE.- DURING THE MONTHS ON MEDICAL WARDS, THE CHIEF RESIDENTS AND FIRM CHIEFS ARE ASSIGNED TO DO WALK ROUND ONCE EACH WEEK WITH ONE OF THE RESIDENTS ON THEIR FIRM. THEY WILL OBSERVE THE RESIDENT RUNNING THE WARD ROUNDS AND PROVIDE FEEDBACK ON THE TEACHING SKILLS OBSERVED DURING ROUNDS.LEADING TEACHING ATTENDING ROUNDS: - DURING EVERY ROTATION ON THE MEDICAL WARDS, EACH RESIDENT WILL LEAD ONE TO THREE ATTENDING ROUNDS SESSIONS. THE TWO TEACHING ATTENDINGS HELP PROVIDE FEEDBACK ON THE RESIDENT'S SMALL GROUP DISCUSSION AND TEACHING SKILLS. SMALL GROUP PRESENTATIONS: - DURING AMBULATORY WEEKS, RESIDENTS WILL LEAD A MAJORITY OF THE PRE-CLINIC CONFERENCES, TYPICALLY PRESENTING EITHER A CHALLENGING AMBULATORY CASE OR AMBULATORY-BASED TOPIC.- ONCE DURING RESIDENCY, EACH JUNIOR RESIDENT WILL ALSO PRESENT A JOURNAL ARTICLE OF AMBULATORY CARE SIGNIFICANCE AT AMBULATORY JOURNAL CLUB TO A SMALL GROUP OF THEIR PEERS. INTERNAL MEDICINE GLOBAL HEALTH PROGRAMOUR MISSION IS TO TRAIN LEADERS IN GLOBAL HEALTH TO BE EFFECTIVE PRACTITIONERS IN UNDERSERVED, RESOURCE-LIMITED SETTINGS AND TO DESIGN, MANAGE, IMPROVE AND EVALUATE GLOBAL PUBLIC HEALTH PROGRAMS THAT ADDRESS THE HEALTH PROBLEMS OF THE WORLD'S NEEDIEST POPULATIONS.PROGRAM OBJECTIVES - INTRODUCE GLOBAL HEALTH ISSUES TO BIDMC MEDICAL RESIDENTS - CONTRIBUTE TO THE HEALTH AND WELL-BEING OF UNDERSERVED POPULATIONS IN BOSTON AND AROUND THE WORLD - ENRICH THE MEDICAL KNOWLEDGE AND ENHANCE THE CLINICAL SKILLS OF RESIDENTS BY PRACTICING IN UNIQUE SETTINGS WITH LIMITED RESOURCES - EXPAND RESEARCH OPPORTUNITIES - ADVANCE THE CAREERS OF BIDMC RESIDENTS IN THE FIELDS OF INTERNATIONAL HEALTH, PUBLIC POLICY AND RESEARCH SITE LOCATIONS - BOTSWANA: THE DEPARTMENT HAS A PERMANENT PRESENCE IN BOTSWANA WITH A MEMBER OF OUR DEPARTMENT FULL-TIME AT SCOTTISH LIVINGSTONE HOSPITAL IN MOLEPOLOLE, BOTSWANA. - VIETNAM: THE MEDICAL CENTER HAS A PERMANENT PRESENCE IN VIETNAM. PHYSICIAN AND NURSE TRAINING ON HIV/AIDS CARE IN VIETNAM TAKES PLACE THROUGH FUNDING FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION. - ADDITIONAL LOCATIONS: THE DEPARTMENT OFFERS ROTATIONS AT THE ALBERT SCHWEITZER HOSPITAL IN GABON AND OTHER INTERNATIONAL SITES. RESIDENTS CAN ALSO DO ROTATIONS THROUGH THE INDIAN HEALTH SERVICE OR AT BIDMC-AFFILIATED COMMUNITY HEALTH CENTERS. GLOBAL HEALTH TRACK LEARNING HOW TO WORK EFFECTIVELY IN RESOURCE-LIMITED SETTINGS REQUIRES BOTH TRAINING AND EXPERIENCE. PARTICIPANTS IN THE GLOBAL HEALTH TRACK WILL PARTICIPATE WITH LEARNERS FROM AROUND THE WORLD IN THE GLOBAL HEALTH EFFECTIVENESS PROGRAM AT THE HARVARD SCHOOL OF PUBLIC HEALTH; THEY WILL ENGAGE IN OUR HOSPITAL-WIDE, YEAR-LONG GLOBAL HEALTH CURRICULUM AND JOURNAL CLUB, AND THEY WILL BE GIVEN THE OPPORTUNITY FOR TWO FIELD EXPERIENCES DURING RESIDENCY. HOSPITAL-WIDE GLOBAL HEALTH PROGRAM THE BIDMC GLOBAL HEALTH PROGRAM IS A HOSPITAL-WIDE PROGRAM AVAILABLE TO ALL BIDMC RESIDENTS. WHILE REQUIREMENTS AND TIMELINES MAY DIFFER BETWEEN DEPARTMENTS AND SPECIALTIES, THE OVERARCHING GOAL IS TO PROVIDE RESIDENTS WITH FURTHER TRAINING AND EDUCATION IN THE DISCIPLINE OF GLOBAL HEALTH.
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NEUROLOGY EDUCATION AT BIDMC
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THE HARVARD MEDICAL SCHOOL NEUROLOGY PROGRAM AT BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL IN BOSTON, MASSACHUSETTS WAS FOUNDED IN 1996 AS THE SUCCESSOR TO THE HARVARD-LONGWOOD NEUROLOGY PROGRAM. THE PROGRAM CONCENTRATES ON THE TRAINING AND RESEARCH OPPORTUNITIES AVAILABLE ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS, BY COMBINING THE RESOURCES OF TWO MAJOR HARVARD TEACHING HOSPITALS, BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL. THESE COMBINED HOSPITALS, WITH OVER 800 INPATIENT BEDS AND EXTENSIVE OUTPATIENT CLINICS, PROVIDE THE SETTING FOR TRAINING PHYSICIANS IN THE ART AND SCIENCE OF CLINICAL NEUROLOGY.THE COMBINED FACULTY CONSISTS OF MORE THAN 80 NEUROLOGISTS AT THE TWO PARTICIPATING HOSPITALS, AND PROVIDES CORE EXPERIENCES IN INPATIENT AND OUTPATIENT NEUROLOGY, AS WELL AS TRAINING IN ELECTROPHYSIOLOGY (INCLUDING EEG, EMG, AND SLEEP POLYSOMNOGRAPHY) AND NEUROPATHOLOGY. THE KEY DISTINGUISHING FEATURE OF THE PROGRAM IS THE CLOSE RELATIONSHIP BETWEEN THE CLINICAL FACULTY, NEARLY ALL OF WHOM ARE FULL-TIME ACADEMIC NEUROLOGISTS ENGAGED IN SUBSTANTIVE RESEARCH AND TEACHING EFFORTS, AND A SELECT GROUP OF RESIDENTS WHO ARE KEENLY INTERESTED IN FORGING ACADEMIC CAREERS IN NEUROLOGY. VIRTUALLY ALL OF THE CLINICAL TRAINING TAKES PLACE WITHIN A 2 BLOCK RADIUS ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS. A CRITICAL COMPONENT OF THE PROGRAM IS THE OPPORTUNITY FOR RESIDENTS TO HAVE A MENTORED TEACHING EXPERIENCE AS WELL AS THE OPPORTUNITY TO UNDERTAKE A MENTORED PROJECT, WHICH MAY ENTAIL EITHER CLINICAL OR LABORATORY BASED INVESTIGATION OR PREPARATION OF INNOVATIVE TEACHING MATERIALS OR METHODS.
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PATHOLOGY EDUCATION AT BIDMC
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THE DEPARTMENT OF PATHOLOGY AT BETH ISRAEL DEACONESS MEDICAL CENTER IS COMMITTED TO PROVIDING STATE-OF-THE-ART TRAINING TO PREPARE PHYSICIANS FOR LEADERSHIP ROLES IN PATHOLOGY AND ACADEMIC MEDICINE. THE PROGRAM OFFERS THREE RESIDENT TRAINING PATHWAYS: FIRST, A COMBINED ANATOMIC PATHOLOGY/CLINICAL PATHOLOGY (AP/CP) PATHWAY PROVIDES COMPREHENSIVE TRAINING IN ALL AREAS OF TISSUE DIAGNOSTICS AND LABORATORY MEDICINE. SECOND, THE AP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS ACADEMIC SURGICAL PATHOLOGISTS. THIRD, THE CP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS FUTURE LEADERS IN LABORATORY MEDICINE. ALL PATHWAYS INCLUDE EXTENSIVE OPPORTUNITIES TO PARTICIPATE IN RESEARCH PROJECTS WITH WORLD-RENOWNED EXPERTS IN PATHOLOGY OR RELATED DISCIPLINES. KNOWLEDGE COMES THROUGH EXPERIENCE AND EXTENSIVE INTERACTION WITH FACULTY. IN ANATOMIC PATHOLOGY SIGN OUT, RESIDENTS PREPARE THEIR OWN DIAGNOSES AND ARE THEN IN A POSITION TO TAKE FULL ADVANTAGE OF SIGN OUT WITH STAFF MEMBERS. IN CLINICAL PATHOLOGY, RESIDENTS GAIN EXPERIENCE DURING DAILY ROUNDS WITH ATTENDINGS, SOCRATIC TUTORIALS, AND THROUGH POSITIONING OF RESIDENTS AS AN INTERMEDIARY BETWEEN CLINICIAN AND LABORATORY. THERE ARE DAILY TEACHING AND CASE MANAGEMENT CONFERENCES COVERING THE DIFFERENT PATHOLOGY SPECIALTIES. GIVEN THE IMPORTANT ROLE PATHOLOGISTS PLAY IN TEACHING MEDICAL STUDENTS AND COLLEAGUES IN OTHER SPECIALTIES, THE PROGRAM PROVIDES GUIDANCE FOR RESIDENTS AS THEY HONE THEIR TEACHING SKILLS. SUCH "RESIDENT-AS-TEACHER" PROGRAMS ARE COMMON IN OTHER SPECIALTIES BUT NOT AS WELL-DEVELOPED IN PATHOLOGY. THE CURRICULUM INCLUDES SESSIONS DESIGNED TO IMPROVE SKILLS RELATED TO GIVING FEEDBACK AND SMALL GROUP TEACHING. THERE IS A SESSION ON DEVELOPING PRESENTATION SKILLS WITH CLOSE MENTORING OF FIRST YEAR RESIDENTS, BY SPECIFIC FACULTY WHO HAVE ALSO BEEN THROUGH THE CURRICULUM, AS THEY PREPARE FOR THEIR FIRST PRESENTATION. THERE ARE ALSO OPPORTUNITIES FOR RESIDENTS TO TEACH MEDICAL STUDENTS BOTH WITHIN OUR DEPARTMENT AND AT HARVARD MEDICAL SCHOOL, AS WELL AS TO RECEIVE FEEDBACK ON THEIR TEACHING SKILLS. RECOGNIZING THE NEED TO INTEGRATE TECHNOLOGY INTO RESIDENCY TRAINING, ALL FIRST YEAR RESIDENTS ARE PROVIDED WITH IPADS. THESE TABLETS ALLOW RESIDENTS TO MORE EASILY PREVIEW THE SLIDES THAT ARE ROUTINELY SCANNED FOR OUR SURGICAL SLIDE CONFERENCE. GENOMIC TECHNOLOGY WILL AFFECT THE PRACTICE OF ALL MEDICAL PRACTITIONERS. AS THE PHYSICIANS WHO MANAGE THE HOSPITAL LABORATORIES, PATHOLOGISTS MUST UNDERSTAND NEXT-GENERATION SEQUENCING TECHNOLOGY AND ITS APPLICATION TO PATIENT CARE. IN 2009, THE PROGRAM CREATED, TO OUR KNOWLEDGE, THE FIRST GENOMIC PATHOLOGY CURRICULUM IN THE COUNTRY. THE CURRICULUM HAS BEEN PUBLISHED AND HAS SERVED AS THE BASIS FOR A COLLABORATIVE EFFORT TO DEVELOP A NATIONAL GENOMICS CURRICULUM (WWW.ASCP.ORG/TRIG).TRAINING IN EVIDENCE-BASED MEDICINE IS CRITICAL. A FIRST-YEAR RESIDENT JOURNAL CLUB ALLOWS AN INTRODUCTION TO CRITICAL REVIEW OF THE MEDICAL LITERATURE. IN LATER YEARS, RESIDENTS LEAD SMALL-GROUP DISCUSSIONS IN MONTHLY JOURNAL CLUBS. THERE IS ALSO AN EVIDENCE-BASED TRANSFUSION MEDICINE CURRICULUM TO HONE THESE SKILLS DURING CP TRAINING.
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RADIOLOGY EDUCATION AT BIDMC
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THE RADIOLOGY RESIDENCY PROVIDES FOUR YEARS OF TRAINING IN DIAGNOSTIC IMAGING. APPOINTMENTS ARE HELD JOINTLY AS A RESIDENT AT THE MEDICAL CENTER AND AS A CLINICAL FELLOW AT HARVARD MEDICAL SCHOOL. WITH A CENTRAL ROLE IN CLINICAL SERVICE, TEACHING, AND RESEARCH, THE RADIOLOGY DEPARTMENT PERFORMS OVER 400,000 RADIOLOGIC EXAMINATIONS EACH YEAR. THE DEPARTMENT PROVIDES RADIOGRAPHY, CT, ULTRASOUND, MRI, NUCLEAR MEDICINE, MAMMOGRAPHY, ANGIOGRAPHY, AND INTERVENTIONAL RADIOLOGY SERVICES TO BOTH THE MEDICAL CENTER AS WELL AS OUR AFFILIATED HEALTH CARE FACILITIES. A RADIOLOGY RESEARCH AND ANIMAL LABORATORY IS HOUSED ADJACENT TO THE RADIOLOGY DEPARTMENT. ALL RESIDENTS, FELLOWS, AND FACULTY HAVE APPOINTMENTS AT HARVARD MEDICAL SCHOOL. ALL RADIOLOGIC STUDIES ARE INTERPRETED UNDER THE SUPERVISION OF STAFF RADIOLOGISTS. THE NUCLEAR MEDICINE PROGRAM IS A PART OF THE JOINT PROGRAM IN NUCLEAR MEDICINE AT HARVARD MEDICAL SCHOOL. THE DEPARTMENT PLACES STRONG EMPHASIS ON THE QUALITY OF TEACHING-BOTH IN DIDACTIC LECTURES AND IN INDIVIDUAL CASE-BASED TEACHING.WITH THE ADVENT OF RECENT CHANGES IN RESIDENCY TRAINING, THE CURRICULUM HAS RECENTLY BEEN REVISED SO THAT RESIDENTS UNDERTAKE A COURSE OF STUDY WHICH WILL PERMIT THEM TO OBTAIN EXPERTISE NOT JUST IN CLINICAL SUBSPECIALTIES BUT ALSO IN OTHER KEY AREAS SUCH AS RESEARCH, EDUCATION, GLOBAL HEALTH, QUALITY IMPROVEMENT, AND HEALTH POLICY. RADIOLOGIC PHYSICS HAS BEEN INTEGRATED INTO DAILY DIDACTIC SESSIONS. IN ADDITION, MANY DIDACTIC SESSIONS UTILIZE AUDIENCE RESPONSE TECHNOLOGY, VIDEO-RECORDING, AND IPAD2 TECHNOLOGY.THERE ARE NINE FORMAL SECTIONS IN THE DEPARTMENT: ABDOMINAL IMAGING, BREAST IMAGING, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY (CVIR), MRI, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, ULTRASOUND, AND THORACIC IMAGING. MOST NON-ANGIOGRAPHIC INTERVENTIONAL PROCEDURES ARE PERFORMED BY THE RESPECTIVE SERVICES. RESIDENTS ROTATING THROUGH THESE SECTIONS ARE PROVIDED WITH READING SUGGESTIONS AND MATERIAL. ACADEMIC ROTATIONS ARE MADE UP OF THIRTEEN 4-WEEK BLOCKS ANNUALLY. AT THE END OF EACH ROTATION RESIDENTS RECEIVE WRITTEN EVALUATIONS AND HAVE THE OPPORTUNITY TO EVALUATE THE STAFF.FIRST YEAR ROTATIONS EMPHASIZE FUNDAMENTALS AND COMMON RADIOLOGIC EXAMINATIONS IN PREPARATION FOR INPATIENT AND EMERGENCY DEPARTMENT RESPONSIBILITIES. PRIOR TO TAKING CALL, ALL FIRST YEAR RESIDENTS ROTATE THROUGH ABDOMINAL IMAGING, BREAST IMAGING, EMERGENCY RADIOLOGY, FLUOROSCOPY, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, THORACIC IMAGING, AND ULTRASOUND.DURING THE SECOND YEAR, RESIDENTS CONTINUE TO GAIN EXPERIENCE IN THESE SECTIONS, PERFORMING AND INTERPRETING MORE ADVANCED EXAMINATIONS AND INTERVENTIONS AS THEIR LEVELS OF EXPERTISE INCREASE. ADDITIONAL ROTATIONS IN MORE SPECIALIZED TOPICS OCCUR THROUGHOUT THE SECOND THROUGH FOURTH YEARS, INCLUDING INTERVENTIONAL RADIOLOGY, MRI, HEAD AND NECK IMAGING, AND PEDIATRIC RADIOLOGY. IN ADDITION, ALL RESIDENTS PARTICIPATE IN A TWO-WEEK ROTATION IN QUALITY ASSURANCE WHICH PROVIDES THEM WITH ESSENTIAL SKILLS FOR EVENTUAL BOARD RE-CERTIFICATION.ROTATIONS AT OTHER TRAINING LOCATIONS DURING THE SECOND AND THIRD YEARS OF TRAINING INCLUDE:- THREE MONTHS OF TRAINING IN PEDIATRIC RADIOLOGY AT THE BOSTON CHILDREN'S HOSPITAL DURING THE SECOND YEAR.- FOUR WEEK PROGRAM IN RADIOLOGIC-PATHOLOGIC CORRELATION AT THE ARMED FORCES INSTITUTE OF PATHOLOGY (AIRP) SPONSORED BY THE AMERICAN COLLEGE OF RADIOLOGY IN SILVER SPRINGS, MARYLAND DURING THE THIRD YEAR.- ONE MONTH ROTATION AT THE MASSACHUSETTS EYE AND EAR INFIRMARY IN HEAD-AND-NECK RADIOLOGY DURING THE THIRD YEAR.UPON COMPLETION OF THE SECOND YEAR OF RESIDENCY TRAINING, RESIDENTS SELECT AN AREA OF ACADEMIC FOCUS FOR THEIR FOURTH YEAR WHICH WILL GUIDE CHOICES FOR THE 3-MONTH MINI-FELLOWSHIPS AND THE OTHER TWO MONTHS OF ELECTIVE TIME.OUR UNIQUE EDUCATIONAL TRACKSCURRENTLY, SIX TRACKS ARE OFFERED:- CLINICAL- EDUCATION- RESEARCH- GLOBAL HEALTH- QUALITY IMPROVEMENT- HEALTH POLICY/HEALTH ECONOMICSEACH OF THESE TRACKS HAS SPECIFIC CURRICULAR OFFERINGS AND EDUCATIONAL GOALS. MOST OF THE TRACKS ARE LINKED TO SPECIFIC EDUCATIONAL ENDEAVORS. FOR EXAMPLE, A RESIDENT SELECTING THE GLOBAL HEALTH TRACK WILL ENROLL IN THE GLOBAL EFFECTIVENESS CURRICULUM OFFERED BY THE HARVARD SCHOOL OF PUBLIC HEALTH AND WILL SPEND TIME ABROAD PROVIDING CLINICAL RADIOLOGY SERVICES AND UNDERTAKING A GLOBAL HEALTH PROJECT. A RESIDENT SELECTING THE EDUCATION TRACK WILL PURSUE ADVANCED TRAINING IN EDUCATIONAL THEORY AND ADULT LEARNING BY PARTICIPATING IN THE HARVARD MACY PROGRAM FOR PHYSICIAN EDUCATORS AND UNDERTAKE AN EDUCATIONAL PROJECT BASED AT BIDMC OR HARVARD MEDICAL SCHOOL. A RESIDENT CHOOSING THE RESEARCH TRACK WILL PARTICIPATE IN GRANT WRITING WORKSHOPS AND DELVE DEEPLY INTO A RESEARCH PROJECT OF THEIR CHOICE.NO MATTER WHICH TRAINING TRACK, THE EXPECTATION IS THAT EVERY RESIDENT WILL HAVE THE OPPORTUNITY TO UNDERTAKE A SUBSTANTIAL PROJECT DURING RESIDENCY THAT WILL CULMINATE IN PRESENTATION AT A NATIONAL MEETING AND/OR PUBLICATION.
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SURGERY EDUCATION AT BIDMC
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THE ROBERTA AND STEPHEN R. WEINER DEPARTMENT OF SURGERY OFFERS EDUCATION OPPORTUNITIES FOR RESIDENTS, FELLOWS AND MEDICAL STUDENTS IN CARDIAC SURGERY, GENERAL SURGERY, NEUROSURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, PODIATRY, TRAUMA SURGERY, MINIMALLY INVASIVE SURGERY, UROLOGY, AND VASCULAR SURGERY. RESIDENTS AND FELLOWS LEARN THE MOST ADVANCED TECHNIQUES IN A STATE-OF-THE-FACILITY. RESIDENTS AND FELLOWS ALSO HAVE THE OPPORTUNITY TO LEARN MINIMALLY INVASIVE TECHNIQUES AT THE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER, THE FIRST OF ITS KIND TO BE ACCREDITED IN THE COUNTRY AND LOCATED WITHIN THE MEDICAL CENTER.THE MEDICAL CENTER'S DEPARTMENT OF SURGERY IS ONE OF THREE MAJOR TEACHING AND RESEARCH UNITS OF HARVARD MEDICAL SCHOOL'S DEPARTMENT OF SURGERY. AT ALL LEVELS, THE HOUSE STAFF GAIN TRAINING AND PRACTICAL EXPERIENCE IN THE PREOPERATIVE, OPERATIVE, AND POST-OPERATIVE CARE OF PATIENTS. THE PROGRAM EMPHASIZES RESIDENT-FACULTY INTERACTION FOR EDUCATIONAL PURPOSES. TEACHING CONFERENCES AND SEMINARS FOR THE HOUSE STAFF CAPITALIZE ON WORKING RELATIONSHIPS DEVELOPED WITH THE ATTENDING STAFF. UPON COMPLETION OF FIVE YEARS OF SURGICAL TRAINING, RESIDENTS ARE ELIGIBLE FOR THE AMERICAN BOARD OF SURGERY EXAMINATION. DIDACTIC TEACHINGTHE PROGRAM HAS DEDICATED EDUCATION TIME, INCLUDING A STRONG DIDACTIC CONFERENCE SCHEDULE, TO PROVIDE A BASIC FOUNDATION OF SURGICAL KNOWLEDGE AND SKILLS. REQUIRED WEEKLY CONFERENCES INCLUDE:- RESIDENT CURRICULUM CONFERENCE / MIS SKILLS LAB - SURGICAL SERVICE MORBIDITY/MORTALITY & SURGICAL GRAND ROUNDS - COMBINED GI CONFERENCETHROUGHOUT TRAINING, A PRIMARY RESPONSIBILITY OF SENIOR RESIDENTS IS TEACHING MORE JUNIOR RESIDENTS AND THE STUDENTS ON THEIR SERVICE. THEY ARE ALSO RESPONSIBLE FOR THE ASSIGNMENT OF CASES, CLINICAL SUPERVISION OF MEDICAL STUDENTS AND RESIDENTS, AND PREPARING MATERIAL FOR SERVICE AND TEACHING CONFERENCES.BIDMC-ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)COMMUNITY BOARDAS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. AFFILIATED HEALTH CARE SYSTEMAS NOTED BELOW AND THROUGHOUT THIS FILING, BIDMC IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. AS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BETH ISRAEL LAHEY HEALTH'S (BILH) MISSION IS TO SUPPORT ITS AFFILIATES AND THOSE AFFILIATES' MISSIONS TO IMPROVE THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY PROVIDING SERVICES TO ITS AFFILIATES WHICH SUPPORT THE DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO ACCESS SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE.BETH ISRAEL LAHEY HEALTH (BILH) IS THE PARENT AND A SUPPORT ORGANIZATION OF THE BILH NETWORK OF AFFILIATES. THE NETWORK COMPRISES AN INTEGRATED HEALTH CARE DELIVERY SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM INCLUDES ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,800 PHYSICIANS AND 39,000 EMPLOYEES.THE BILH PURPOSE STATEMENT ARTICULATES THE IMPACT THAT EACH BILH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. THESE SHARED VALUES GUIDE EACH ENTITY'S DAILY EFFORTS AND KEEP EACH AFFILIATE ALIGNED IN THE PURSUIT OF THE BILH PURPOSE, SHOWING HOW "WE CARE" FOR PATIENTS, EACH OTHER AND THE COMMUNITIES SERVED.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES - ONE PERSON AT A TIME - THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.BILH WE CARE VALUES:WELLBEING. WE PROVIDE A HEALTH-FOCUSED WORKPLACE AND SUPPORT A HEALTHY WORK-LIFE BALANCE.EMPATHY. WE DO OUR BEST TO UNDERSTAND OTHERS' FEELINGS, NEEDS AND PERSPECTIVES.COLLABORATION. WE WORK TOGETHER TO ACHIEVE EXTRAORDINARY RESULTS.ACCOUNTABILITY. WE HOLD OURSELVES AND EACH OTHER TO BEHAVIORS NECESSARY TO ACHIEVE OUR COLLECTIVE GOALS.RESPECT. WE VALUE DIVERSITY AND TREAT ALL MEMBERS OF OUR COMMUNITY WITH DIGNITY AND INCLUSIVENESS.EQUITY. EVERYONE HAS THE OPPORTUNITY TO ATTAIN THEIR FULL POTENTIAL IN OUR WORKPLACE AND THROUGH THE CARE WE PROVIDE.DURING THE FISCAL PERIOD COVERED BY THIS FILING, BILH SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL -- MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL -- NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC), ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), JOSLIN DIABETES CENTER AND THE BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER (LHMC). THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES. EFFECTIVE JULY 1, 2023, BILH ALSO BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES, INC. (EHRI) AND ITS AFFILIATES INCLUDING EXETER HOSPITAL.
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THE QUANTIFICATION IN THIS SCHEDULE H PART 1 QUESTION 7 IN THIS FILING
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REFLECTS ONLY THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST OF BIDMC AND AS NOTED THROUGHOUT THIS FILING, BIDMC IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH NETWORK. BELOW IS ADDITIONAL INFORMATION ON THE FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS ACTIVITIES ACROSS ALL OF THE BILH HOSPITALS. DURING THE FISCAL YEAR COVERED BY THIS FILING BILH HOSPITALS PROVIDED MORE THAN $48 MILLION IN NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST.IN ADDITION TO THE CHARITY CARE REPORTED ABOVE, EACH OF THE BILH HOSPITALS ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, THE COST OF PROVIDING CARE TO MEDICAID PATIENTS ACROSS BILH EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE RESULTING IN A COMBINED SHORTFALL EXCEEDING $61 MILLION RELATED TO TREATING MEDICAID PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS. PAYMENTS FROM MEDICARE DO NOT COVER THE COST OF SERVICES PROVIDED. ALL BILH HOSPITALS PROVIDE CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, THE COST OF PROVIDING CARE TO MEDICARE PATIENTS ACROSS BILH EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE, RESULTING IN A COMBINED SHORTFALL EXCEEDING $144 MILLION RELATED TO TREATING MEDICARE PATIENTS. DURING THE FISCAL YEAR COVERED BY THIS FILING BILH HOSPITALS PROVIDED COMBINED COMMUNITY BENEFITS, COMMUNITY HEALTH IMPROVEMENT SERVICES, CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS AS WELL AS COSTS INCURRED RELATED TO SUBSIDIES FOR PRIMARY CARE, BEHAVIORAL HEALTH CARE AND OTHER CARE PROVIDED AT A LOSS TOTALING OVER $88 MILLION. ACROSS BILH HOSPITALS, COSTS FOR TRAINING MEDICAL PROFESSIONALS EXCEEDED $202 MILLION. REIMBURSEMENT FROM MEDICARE FOR THESE ACTIVITIES WAS APPROXIMATELY $68 MILLION WHICH LEFT A COMBINED SHORTFALL RELATED TO THESE ACTIVITIES ACROSS BILH OF OVER $134 MILLION WHICH IS AN INVESTMENT IN THE HEALTH SYSTEM OF TOMORROW. RESEARCH ACTIVITIES ACROSS BILH SERVE PATIENT CARE BOTH AT BILH AND BEYOND AS PART OF THE ADVANCEMENT OF SCIENCE. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION AND TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. BIDMC HAS THE LARGEST RESEARCH OPERATIONS ACROSS BILH AND DURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $320 MILLION IN RESEARCH EXPENSES, MORE THAN $82 MILLION OF WHICH WERE INTERNALLY FUNDED.FOR ADDITIONAL INFORMATION ON THESE ACTIVITIES AS WELL AS EACH HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY, PLEASE SEE FORM 990 SCHEDULE H FOR EACH OF THE BILH HOSPITALS. ADDITIONAL BILH NETWORK ACTIVITIES -- EXPANDING ACCESS AND SERVICES, INCLUDING TO UNDERSERVED PATIENT POPULATIONS IN ORDER TO REDUCE HEALTH INEQUITIES; CONTINUING TO PROVIDE HIGH QUALITY CARE AT A LOWER COST; BEHAVIORAL HEALTH; COMMUNITY INVESTMENTS FISCAL YEAR ENDED SEPTEMBER 30, 2023IN ADDITION, AS NOTED FURTHER BELOW, BETH ISRAEL LAHEY HEALTH ("BILH") AND ITS AFFILIATES FOCUSED ON EXPANDING ACCESS AND SERVICES, INCLUDING TO UNDERSERVED PATIENT POPULATIONS IN ORDER TO REDUCE HEALTH INEQUITIES. IN ADDITION, THERE WAS A STRONG FOCUS ON CONTINUING TO PROVIDE HIGH QUALITY CARE AT A LOWER COST, WHEN APPROPRIATE, AS DEMONSTRATED BY BILH'S EFFORTS TO LEVERAGE COMMUNITY SETTINGS, KEEP CARE WITHIN THE BILH PERFORMANCE NETWORK ("BILHPN"), AND ALLOW PATIENTS TO RECEIVE CARE IN THEIR HOMES. THE FOLLOWING HIGHLIGHTS SPECIFIC EFFORTS DURING THE PERIOD COVERED BY THIS FILING:ACCESS & EXPANSION TO PHARMACY SERVICES - BILH PHARMACY HAS CONTINUED TO EXPAND ITS CONTRACTUAL RELATIONSHIPS, ALLOWING MORE PATIENTS TO UTILIZE ITS PHARMACY FOR THEIR PRESCRIPTIONS. IN FY 2023, BILH PHARMACY SUCCESSFULLY NEGOTIATED ACCESS TO THE POINT32HEALTH SPECIALTY PHARMACY NETWORK AS WELL AS THE WELLSENSE MEDICAID ACCOUNTABLE CARE ORGANIZATION ("ACO") PLAN. EXAMPLES OF BILH PHARMACY'S OTHER EFFORTS TO EXPAND PATIENT ACCESS TO MEDICATIONS INCLUDE: - ENHANCED MEDICATION AUTHORIZATION AND ACCESS SERVICES TO HELP PATIENTS OBTAIN NECESSARY INSURANCE AUTHORIZATIONS AND FIND CO-PAY ASSISTANCE, - EXPANDED THE MEDICATION REFILL CENTER TO ASSIST PATIENTS AND PROVIDERS IN EXPEDITING MEDICATION RENEWALS AND ENSURING PRESCRIBED MEDICATION AND DOSAGE ARE STILL APPROPRIATE, - EXTENDED PATIENT CO-PAY ASSISTANCE PROGRAMS TO THE JOSLIN ADULT DIABETES CLINIC AND NORTHEAST HOSPITAL CORPORATION PATIENTS, AND - EXPANDED CLINICAL PHARMACY SERVICES IN AMBULATORY CLINICS TO HELP MANAGE AND OPTIMIZE PATIENTS' COMPLEX MEDICATION THERAPIES. - BILH PHARMACY ALSO EXPANDED ITS CLINICAL PHARMACY PRESENCE IN CLINICS TO REDUCE THE HEALTH EQUITY GAP IN THE USE OF HIGHLY IMPACTFUL MEDICATIONS TO TREAT PATIENTS WITH DIABETES AND ATHEROSCLEROTIC CARDIOVASCULAR DISEASES BY IMPROVING THEIR BLOOD PRESSURE AND HEMOGLOBIN A1C. INTERVENTIONS CENTERED AROUND PRESCRIBING EVIDENCE-BASED MEDICATIONS, EDUCATING PATIENTS ABOUT THEIR CONDITIONS, AND ENSURING ACCESS TO MEDICATION. INITIAL RESULTS HAVE DEMONSTRATED AN INCREASE IN THE USE OF GLP-1 AGONISTS AND SGLT-2 INHIBITORS BY 32% IN BLACK AND HISPANIC POPULATIONS, AN AVERAGE REDUCTION IN HEMOGLOBIN A1C OF 0.8, AND A DECREASE OF SYSTOLIC AND DIASTOLIC BLOOD PRESSURES OF 7MMHG AND 2MMHG RESPECTIVELY.IMPROVEMENT IN LAB SERVICES - BILH OPTIMIZED THE TRANSPORTATION ROUTES OF COLLECTED LABORATORY SPECIMENS TO TESTING LABORATORIES, ENSURING HIGH STANDARDS FOR TURNAROUND TIMES AND MAXIMUM EFFICIENCY. THIS IS FOUNDATIONAL TO THE SYSTEM'S ABILITY TO CONSOLIDATE TESTING, EXPAND ACCESS TO IN-NETWORK LABORATORY SERVICES WHICH IN TURN GENERALLY REDUCES COST, AND SUPPORT THE PROVISION OF HIGH-QUALITY CARE AND THE CLINICIAN AND PATIENT EXPERIENCE. - FOCUS REMAINED STRONG IN DEVELOPING PHYSICIAN PRACTICE DELIVERY MODELS AND RE-OPENING PATIENT SERVICE CENTERS. THESE EFFORTS ENHANCE COMMUNITY PROVIDERS' ABILITY TO USE BILH LABS AND INCREASE PATIENT ACCESS TO BILH LABS.LEVERAGING IN-NETWORK CARE - BILH OPERATES A TRANSFER CENTER THAT FACILITATES PATIENT ACCESS TO THE APPROPRIATE PLACEMENT OF PATIENT TRANSFERS. WITH THE CREATION OF THE TRANSFER CENTER, BILH HAS BEEN ABLE TO RETAIN PATIENTS WHO MIGHT OTHERWISE HAVE GONE OUTSIDE OF THE SYSTEM. BY EXPANDING ITS FOCUS TO COMMUNITY HOSPITALS, BILH HAS ENHANCED ITS ABILITY TO PLACE PATIENTS, INCLUDING AT LOCATIONS POTENTIALLY CLOSER TO THE PATIENTS' HOMES. - BILHPN OPERATES A CENTRALIZED REFERRAL MANAGEMENT PROGRAM THAT FOCUSES ON PATIENTS SEEKING OUT-OF-NETWORK SPECIALTY CARE AND REDIRECTING THEM TO IN-NETWORK SPECIALTY CARE, WHEN CLINICALLY APPROPRIATE. THROUGHOUT FY 2023, BILHPN REDIRECTED WELL OVER ONE THOUSAND PATIENT VISITS. IN MOST CASES, CARE RETAINED WITHIN BILH RESULTED IN ENHANCED CARE COORDINATION AT A LOWER COST OF CARE.ENABLING PATIENTS TO RECEIVE CARE AT HOME - BILH LAUNCHED ITS HOSPITAL AT HOME PROGRAM IN FY 2023, STARTING WITH LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER. THIS HAS ALLOWED ELIGIBLE PATIENTS TO BE OFFERED CARE IN THE SETTING MOST COMFORTABLE FOR THEM THEIR HOMES WHILE ALSO CUSTOMIZING CARE PLANS AND IMPROVING PATIENTS' MOBILITY EVEN WHILE THEY ARE ACUTELY ILL. - IN FY 2023, BILHPN PUT PROGRAMS IN PLACE TO MANAGE LENGTH OF STAY AT SKILLED NURSING FACILITIES ("SNFS"), REDUCE READMISSIONS, AND DISCHARGE MEDICALLY APPROPRIATE PATIENTS DIRECTLY TO THEIR HOMES WITH HOMECARE SERVICES INSTEAD OF TO A SNF, PROVIDED PATIENTS ARE MEDICALLY STABLE TO RETURN HOME AFTER AN ACUTE CARE STAY AND WILL LIKELY HAVE BETTER OUTCOMES AND LOWER COST OF CARE.
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BEHAVIORAL HEALTH
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- IN FY 2023, BILH BEHAVIORAL SERVICES LAUNCHED ITS COMMUNITY BEHAVIORAL HEALTH CENTER ("CBHC") IN LAWRENCE, MASSACHUSETTS, CONSOLIDATING OUTPATIENT, MOBILE CRISIS INTERVENTION, AND ADULT COMMUNITY CRISIS STABILIZATION SERVICES. THE ESTABLISHMENT OF THE CBHC IS A PART OF THE COMMONWEALTH'S EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES ROADMAP FOR BEHAVIORAL HEALTH REFORM. - IN ADDITION, AS PART OF THE ROADMAP FOR BEHAVIORAL HEALTH REFORM, BILH LAUNCHED AN EMERGENCY SERVICES REDESIGN THAT SHIFTS EMERGENCY EVALUATIONS OUT OF THE EMERGENCY DEPARTMENT ("ED"). BILH BEHAVIORAL SERVICES ALSO EXPANDED ITS ED INTEGRATION EFFORTS TO A TOTAL OF SIX EDS, INCLUDING ADDISON GILBERT HOSPITAL, ANNA JAQUES HOSPITAL, BEVERLY HOSPITAL, LAHEY MEDICAL CENTER-PEABODY, BETH ISRAEL DEACONESS HOSPITAL-MILTON, AND WINCHESTER HOSPITAL.HEALTH EQUITY - BILH AND LAWYERS FOR CIVIL RIGHTS LAUNCHED A MEDICAL-LEGAL PARTNERSHIP TO PROVIDE FREE LEGAL SUPPORT TO LOW-INCOME PATIENTS, BEGINNING AT BETH ISRAEL DEACONESS MEDICAL CENTER. THE COLLABORATION WILL EXPAND BILH'S ABILITY TO ADDRESS HEALTH EQUITY AND EXPAND ACCESS TO HEALTH CARE FOR PATIENTS LIVING IN UNDER-RESOURCED COMMUNITIES. - BILHPN FOCUSED ON REDUCING HEALTH EQUITY DISPARITIES IN DIABETES AND HYPERTENSION MANAGEMENT BY STRATIFYING HEALTH OUTCOMES BY RACE, ETHNICITY AND LANGUAGE; SHARING PERFORMANCE DATA WITH PRIMARY CARE GROUPS; AND IMPLEMENTING CLINICAL INITIATIVES SUCH AS OFF-HOUR CLINICS, HOME BLOOD PRESSURE MONITOR DISTRIBUTION, CONTINUOUS GLUCOSE MONITORING, AND OUTREACH TO PATIENTS WITH HIGHER NEEDS.ONGOING INITIATIVES:ENHANCED ACCESS FOR MASSHEALTH PATIENTS - TO MITIGATE BARRIERS IN ACCESS TO CARE AND INCREASE THE NUMBER OF MASSHEALTH PATIENTS THAT BILH SERVES, THE SYSTEM COMMITTED TO UNIVERSAL NETWORK-WIDE PROVIDER PARTICIPATION IN MASSHEALTH. ALL BILH HOSPITALS AND PROVIDERS EMPLOYED BY BILH OR ON WHOSE BEHALF BILH JOINTLY CONTRACTS PARTICIPATE IN AND/OR HAVE APPLIED TO PARTICIPATE IN SOME FORM OF MASSHEALTH. IN FY 2022, BILH SIGNED A NEW MASSHEALTH ACO CONTRACT WITH BMC HEALTHNET PLAN / WELLSENSE HEALTH PLAN THAT WENT INTO EFFECT IN APRIL 2023. AS PART OF THIS CONTRACT, BILHPN EXTENDED PARTICIPATION TO ALL ELIGIBLE PRIMARY CARE PROVIDERS ("PCPS") WHO WERE NOT OTHERWISE PARTICIPATING IN A MASSHEALTH ACO. PRIOR TO THAT TIME, WHILE ALL ELIGIBLE BILHPN PCPS WERE PARTICIPANTS IN A FORM OF MASSHEALTH, SOME PCPS WERE NOT PREVIOUSLY PARTICIPATING IN A MASSHEALTH ACO. - BILH HAS DEVELOPED, REFINED AND IMPLEMENTED A MULTICULTURAL MARKETING, ADVERTISING, AND OUTREACH PLAN WITH THE PURPOSE OF EXPANDING ACCESS FOR UNDERSERVED POPULATIONS, INCLUDING MASSHEALTH PATIENTS, IN TARGETED BILH SERVICE AREAS. INVESTMENTS IN UNDERSERVED COMMUNITIES - BILH HOSPITALS HAVE CREATED AND MAINTAIN STRONG CONNECTIONS TO A NETWORK OF AFFILIATED HOSPITALS AND HEALTH CENTERS THAT PROVIDE COMMUNITY-BASED CARE TO HISTORICALLY UNDERSERVED POPULATIONS. IN THE REGIONS THAT THEY SERVE, THE SAFETY NET AFFILIATES ("SNAS") AND COMMUNITY CARE ALLIANCE ("CCA") COMMUNITY HEALTH CENTERS ("CHCS") ARE THE CORNERSTONE OF BILH'S DELIVERY SYSTEM REGARDING COMMUNITY-BASED CARE FOR MASSHEALTH AND HISTORICALLY UNDERSERVED PATIENTS. O CCA CHCS INCLUDE BOWDOIN STREET HEALTH CENTER, CHARLES RIVER COMMUNITY HEALTH, THE DIMOCK CENTER, FENWAY HEALTH, AND SOUTH COVE COMMUNITY HEALTH CENTER. O SNAS INCLUDE CAMBRIDGE HEALTH ALLIANCE AND SIGNATURE HEALTHCARE BROCKTON HOSPITAL. - BILH CONTINUES TO INVEST IN THE CCA CHCS AND SNAS, ENABLING THEM TO EXPAND THEIR CAPABILITIES AND CARE FOR MORE HISTORICALLY UNDERSERVED PATIENTS. IN FY 2022, BILH INVESTED OVER $8 MILLION IN ITS CHCS AND SNAS, IN ADDITION TO ENGAGING IN REGIONAL PLANNING AND COLLABORATIVE PROGRAM DEVELOPMENT. THESE INVESTMENTS REPRESENT ONLY A PORTION OF A MUCH LARGER COMMUNITY BENEFITS INVESTMENT PORTFOLIO THAT IS DESCRIBED IN GREATER DETAIL IN THIS AND OTHER BILH NETWORK TAX FILINGS. - BILH CONTINUES TO EXPLORE ADDITIONAL OPPORTUNITIES WITH CHCS IN ESSEX AND MIDDLESEX COUNTIES. FOR EXAMPLE, BILH HAS ESTABLISHED A TELEHEALTH PILOT PROGRAM BETWEEN PHYSICIANS AT ADDISON GILBERT AND BEVERLY HOSPITALS AND PATIENTS AT NORTH SHORE COMMUNITY HEALTH CENTER. BILH BEHAVIORAL HEALTH SERVICESTHE BETH ISRAEL LAHEY HEALTH NETWORK (BILH) IS COMMITTED TO THE BEHAVIORAL HEALTH NEEDS OF THE PATIENTS AND COMMUNITIES SERVICED. BELOW ARE SOME OF ACTIVITIES THAT BILH BEHAVIORAL SERVICES (BILHBS) HAS PROVIDED TO THE PATIENTS AND COMMUNITIES SERVED BY BILH AND ITS AFFILIATED ENTITIES. ADDICTION SERVICES NORTHEAST BEHAVIORAL HEALTH CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH BEHAVIORAL SERVICES (NBHC OR BILH BS) IS THE LARGEST NETWORK OF MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES IN EASTERN MASSACHUSETTS, PROVIDING HIGH-QUALITY MENTAL HEALTH AND ADDICTION TREATMENT. THIS INCLUDES A FULL CONTINUUM OF CARE FOR CHILDREN AND ADULTS RANGING FROM INPATIENT TO COMMUNITY-BASED SERVICES. TREATMENT OFFERINGS INCLUDE MOBILE CRISIS TEAMS FOR BEHAVIORAL AND SUBSTANCE-RELATED EMERGENCIES; INPATIENT PSYCHIATRIC AND DETOXIFICATION TREATMENT; RESIDENTIAL PROGRAMS; OUTPATIENT MENTAL HEALTH AND ADDICTION CLINICS; AND MEDICATION-ASSISTED TREATMENT PROGRAMS FOR PERSONS WITH OPIOID USE DISORDERS. NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) HAS OVER 250 BEDS IN 9 FACILITIES FOR PATIENTS REQUIRING ACUTE PSYCHIATRIC, DETOXIFICATION AND POST-ACUTE DIVERSIONARY SERVICES. OTHER OFFERINGS INCLUDE MANY COMMUNITY-BASED SERVICES SUCH AS MOBILE EMERGENCY SERVICES TEAMS, SCHOOL AND HOME-BASED COUNSELING FOR YOUTH AND THEIR FAMILIES. BILHBS SERVES APPROXIMATELY 17,000 INDIVIDUALS ANNUALLY, PROVIDING OVER 380,000 UNITS OF SERVICE, IN A VAST ARRAY OF SETTINGS BASED ON THEIR NEEDS. BECAUSE OF THE COVID-19 EMERGENCY, NBHC WAS FORCED TO RECONFIGURE ITS DELIVERY MODEL FOR MANY SERVICES. WITH MULTIPLE "BRICK AND MORTAR" SITES TEMPORARILY CLOSED DURING THE HEIGHT OF THE PANDEMIC, NBHC OUTFITTED CLINICIANS WITH THE TOOLS NEEDED TO OFFER TELEHEALTH SERVICES. BY THE END OF THE FISCAL YEAR, OF THE TOTAL UNITS OF SERVICE LISTED ABOVE, ALMOST 61,000 WERE DELIVERED VIA TELEHEALTH. IN ADDITION, AS OUTLINED BELOW, NBHC SUPPORTED BILH'S SYSTEM-WIDE RESPONSE TO THE PANDEMIC BY QUICKLY STANDING UP A SHORT-TERM STAY COMMUNITY CRISIS STABILIZATION UNIT ON THE CAMPUS OF AN AFFILIATED ENTITY. BILH BS CONTINUES TO LEVERAGE TELEHEALTH SERVICES TO CONNECT TO COMMUNITIES SERVED ACROSS BILH.
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NBHC PROVIDED ADDICTION TREATMENT SERVICES
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WITH MORE THAN 200 INPATIENT AND RESIDENTIAL BEDS, OPERATING 24/7 FOR ADDICTION TREATMENT. ADDICTION TREATMENT INCLUDES BOTH OUTPATIENT AND INPATIENT TREATMENT AND PREVENTION. SUBSTANCE ABUSE COUNSELING AND GROUP THERAPY IS OFFERED FOR BOTH ADULTS AND TEENS, AS ARE A RANGE OF COURT-ORDERED PROGRAMS INCLUDING OPERATING UNDER THE INFLUENCE (OUI) EDUCATION AND EVALUATIONS. MEDICATION-ASSISTED TREATMENT FOR MEN AND WOMEN ADDICTED TO HEROIN OR PRESCRIPTION OPIOIDS IS PROVIDED AT LOCATIONS IN GLOUCESTER AND DANVERS. ACUTE TREATMENT PROGRAMS PROVIDING INPATIENT DETOXIFICATION SERVICES FROM DRUGS AND/OR ALCOHOL IN MEDICAL SETTINGS ARE AVAILABLE AT TREATMENT CENTERS IN DANVERS AND TEWKSBURY. IN FY23 THESE CENTERS SERVED APPROXIMATELY 2,600 PATIENTS. NBHC ALSO PROVIDED POST-DETOXIFICATION RESIDENTIAL SETTINGS AT MULTIPLE LOCATIONS SERVING BOTH MEN AND WOMEN, INCLUDING HART HOUSE IN TEWKSBURY WHICH EXCLUSIVELY SERVES MOTHERS WITH CHILDREN. IN FY23, NBHC'S OUTPATIENT ADDICTION PROGRAMS PROVIDED 196,350 UNITS OF SERVICE, INCLUDING 5,600 VIA TELEHEALTH, WHILE INPATIENT AND RESIDENTIAL PROGRAMS RECORDED 60,327 BED DAYS. AMBULATORY SERVICES BILH BS' AMBULATORY DIVISION SERVES NEARLY 4,300 PATIENTS EVERY YEAR, DELIVERING MORE THAN 108,000 UNITS OF SERVICES IN VARIOUS SETTINGS. MORE THAN 43,000 WERE DELIVERED BY TELEHEALTH AMBULATORY PROGRAMS AND SERVICES OFFERED UNDER THE CHILDREN'S BEHAVIORAL HEALTH INITIATIVE (CBHI) INCLUDING A BROAD RANGE OF COUNSELING AND THERAPY AS WELL AS MORE INTENSIVE TREATMENT MODALITIES. OUTPATIENT MENTAL HEALTH CLINICS IN SALEM, LAWRENCE, GLOUCESTER AND BEVERLY, AND AN OUTREACH CLINIC IN HAVERHILL, ASSIST INDIVIDUALS AND FAMILIES THROUGH PERIODS OF STRESS AND ADJUSTMENT, PROVIDING THERAPY FOR DEPRESSION, ANXIETY, TRAUMA, BIPOLAR DISEASE, AND CHRONIC MENTAL ILLNESS. OUTREACH COUNSELORS OFFER SHORT AND LONG-TERM THERAPY IN HOMES, SCHOOLS, AND OTHER APPROPRIATE COMMUNITY SETTINGS. ALL THERAPY PROGRAMS ARE SUPPORTED BY MEDICATION CLINICS IF THAT IS DETERMINED TO BE AN APPROPRIATE ADJUNCT TO TREATMENT. IN FY23, NBHC DELIVERED 99,419 UNITS OF AMBULATORY SERVICES, SUPPORTED BY 8,432 PSYCHOPHARMACOLOGY VISITS. EMERGENCY SERVICES THE EMERGENCY SERVICES DIVISION OFFERS EMERGENCY PSYCHIATRIC SERVICES AND INCLUDES THE EMERGENCY SERVICES PROGRAM (ESP) AND COMMUNITY CRISIS STABILIZATION (CCS) INPATIENT PROGRAM. ESP PROVIDES EMERGENCY PSYCHIATRIC ASSESSMENTS AND SUPPORTIVE SERVICES 24/7 IN A VARIETY OF SETTINGS, INCLUDING HOMES, SCHOOLS, OUTPATIENT CLINICS AND HOSPITALS. ESP SERVICES ARE PROVIDED WITHIN THE COMMUNITY AND WITHIN 10 HOSPITALS EMERGENCY DEPARTMENTS (ED) THROUGHOUT THE NORTH SHORE, CAPE ANN AND MERRIMACK VALLEY, INCLUDING 6 NON-BILH EMERGENCY DEPARTMENTS. BILH BS' EMERGENCY PSYCHIATRIC AND MOBILE RESPONSE TEAMS IN LAWRENCE, SALEM AND LOWELL ARE AVAILABLE AROUND THE CLOCK, PROVIDING PSYCHIATRIC ASSESSMENTS AND SUPPORTIVE SERVICES IN VARIOUS SETTINGS. NBHC PROVIDES THESE SERVICES IN CONJUNCTION WITH A LARGE NUMBER OF AREA HOSPITALS, INCLUDING FACILITIES OUTSIDE OF THE BILH UMBRELLA. MOBILE CRISIS CLINICIANS ALSO RESPOND TO SCHOOLS, HOMES AND OUTPATIENT CLINICS, AND NBHC ALSO PROVIDES WALK-IN SERVICES AT THE THREE TEAM LOCATIONS. IN ADDITION TO EMERGENCY EVALUATION, TEAM MEMBERS PROVIDE ONGOING CRISIS COUNSELING UNTIL THE PATIENT IS STABLE AND RELATIONSHIPS ARE ESTABLISHED WITH LONGER-TERM CARE PROVIDERS. THE LAWRENCE AND SALEM LOCATIONS ALSO HOUSE 8-BED COMMUNITY CRISIS STABILIZATION UNITS, WHICH OFFER SHORT-TERM (3-5 DAY) CRISIS BEDS IN LIEU OF HOSPITALIZATION FOR MASSHEALTH, MEDICARE, AND UNINSURED CLIENTS. IN JANUARY 2023, THE STATE OF MASSACHUSETTS IMPLEMENTED BEHAVIORAL HEALTH REDESIGN, WHICH SIGNIFICANTLY IMPACTED OUR EMERGENCY SERVICES TEAMS. BILH BS WAS AWARDED ONE COMMUNITY BEHAVIORAL HEALTH CENTER (CBHC), LOCATED IN LAWRENCE. THE SERVICE AREAS FOR SALEM AND LOWELL WERE TRANSITIONED TO A DIFFERENT VENDOR. HOWEVER, THIS ALLOWED OUR SALEM AND LOWELL TEAMS TO PIVOT INWARD TO SERVICE THE BILH SYSTEM NEEDS. DURING THE FISCAL PERIOD COVERED BY THIS FILING, EMERGENCY SERVICE PROGRAMS HAD 13,502 ENCOUNTERS, 1,895 OF WHICH WERE DONE REMOTELY, AND THE CCS PROGRAMS RECORDED 2,546 BED DAYS. NBHC IS ALSO ON THE FOREFRONT OF EXPANDING TREATMENT FOR OPIOID USE DISORDER (OUD). SEVERAL BILH ORGANIZATIONS HAVE TAKEN STEPS TO ENHANCE CARE FOR PATIENTS WITH OPIOID USE DISORDER (OUD) WHO PRESENT IN EMERGENCY DEPARTMENTS, PARTICULARLY AS THESE PATIENTS TRANSITION FROM THE HOSPITAL TO A LONG-TERM TREATMENT PROGRAM. THE NBHC BRIDGE CLINIC IN GLOUCESTER ACCEPTS PATIENTS REFERRED FROM THE NORTHEAST HOSPITAL CORP (NHC) EMERGENCY DEPARTMENTS AT BOTH BEVERLY HOSPITAL AND ADDISON GILBERT HOSPITAL AND OFFERS CONTINUATION OF MEDICATION ASSISTED TREATMENT AND SUPPORT FROM RECOVERY COACHES. BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH (BID-PLYMOUTH) TREATS PATIENTS WITH OUD THROUGH MEDICATION-ASSISTED TREATMENT IN THE EMERGENCY DEPARTMENT, AND THE HOSPITAL WORKS CLOSELY WITH COMMUNITY PARTNERS TO PROVIDE ONGOING SUPPORT TO PATIENTS. THESE PROGRAMS ARE SIMILAR TO SERVICES AT MOUNT AUBURN HOSPITAL WHICH ALSO OFFERS MEDICATION-ASSISTED TREATMENT IN ITS EMERGENCY DEPARTMENT. PATIENTS CAN THEN BE REFERRED TO THE BRIDGE CLINIC AT MOUNT AUBURN HOSPITAL OR BID-PLYMOUTH FOR CONTINUED OR ADDITIONAL TREATMENT. NORTHEAST HOSPITAL CORPORATION, BID-PLYMOUTH AND MOUNT AUBURN HOSPITALS ARE ALL PART OF THE BETH ISRAEL LAHEY HEALTH NETWORK AND SISTER ENTITIES TO NBHC.
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.