June 2, 2014

New UConn facility offers blueprint for patient-centered care

Photo | Pablo Robles
Photo | Pablo Robles
UConn Medical Group Director Dr. Denis Lafreniere stands inside UConn Health Center's new $203 million ambulatory care center currently under construction in Farmington. When it opens early next year, Lafreniere said the facility will provide a better patient experience.
Photo | Pablo Robles
A bridge, shown above, connecting UConn Health Centerís new outpatient pavilion (left) to the Farmington campusí Medical Arts & Research Building (right) will make it easier for patients to access care.

As a UConn Health Center faculty member for more than two decades, Dr. Denis Lafreniere saw first-hand the medical center's Farmington facilities become outdated in recent years.

A lack of investment, the 56-year-old ear, nose, and throat doctor said, hurt the Health Center's competitiveness, particularly as other area hospitals were injecting tens of millions of dollars, or more, into their own facilities, making them more patient friendly.

But as Lafreniere, who also serves as medical director of the UConn Medical Group, walks through the Health Center's state-of-the art, $203 million outpatient pavilion currently under construction, he sees new hope and opportunity.

Within the pavilion's aqua-tinted windows, where hanging wires, saw dust, wood, concrete, and construction crews absorb most of the space right now, Lafreniere envisions a blueprint for the future of health care, where UConn medical providers will be able offer patients a more integrated, one-stop shop consumer experience.

The 300,000-square-foot facility, scheduled to be completed by December, will bring under one roof virtually all outpatient services offered by UConn, which are currently spread out across the Farmington campus, making it easier for patients to access care. The building's design and technology will also reshape the way physicians collaborate and practice medicine.

"This investment has been due for a long time," said Lafreniere, whose UConn Medical Group doctors will practice in the new facility. "This is not just about building a new building but revising the way we deliver care."

The new outpatient center is part of the state's $864 million Bioscience Connecticut initiative that also includes construction of a new patient tower at John Dempsey Hospital and renovations to 238,000 square feet of existing UConn Health Center research facilities. Additionally, 28,000 square feet of incubator space is being built for startups.

A recent walk through UConn Health Center's campus shows a transformation coming closer to fruition. A new parking garage has been built and is operational. The bones of the patient tower are being erected. Construction crews are piecing together the exterior of The Jackson Laboratory's 189,000-square-foot, $291 million genomic research center, scheduled to open this fall.

But as much as new shiny buildings excite Lafreniere and others, it's the opportunity they present UConn medical staff in improving the quality of care delivered that will be the real game changer, he said. It could also shift the region's competitive landscape.

"This allows is to catch up and potentially exceed what the competition is doing or at least put us on equal footing," Lafreniere said.

"Patient-centered" or "integrated" care are industry buzzwords; what they really mean is improving the customer experience. While customer service is a major focus in most industries, that hasn't always been the case in health care. It's not that doctors haven't provided the best care possible, but navigating the complex healthcare system, in which patients are asked to visit a dizzying array of providers and specialists, who are located in different offices and don't communicate with each other, creates inefficiencies.

At UConn Health Center, for example, outpatient services have traditionally been spread out across the Farmington campus, in the Dowling North and South buildings among others, forcing some patients to stop at two or three separate locations during a single visit. The facilities were also built in the 1980s and designed in a way that creates silos between departments — each have separate check-in locations and exam rooms.

"It's inconvenient and inefficient and gives patients a reason to potentially choose a different provider," Lafreniere said.

National and statewide efforts to curb medical costs and improve patient health outcomes are forcing medical providers to re-think the way they deliver care.

UConn Health Center, with its new ambulatory care and patient towers, has the unique opportunity to literally rebuild its infrastructure to adapt to this new model.

By consolidating almost all outpatient services, ranging from primary care, geriatrics and gastroenterology to oncology and physical therapy, in one facility, patients will now have access to a one-stop shop experience. If one of Lafreniere's ear patients, for example, is also having balance issues, they can walk, or take the elevator, to another floor to get a hearing and balance test. There is also a bridge that links the outpatient pavilion to UConn's Medical Arts & Research Building, which offers bone, joint, and connective tissue care.

The building itself, and how specialties are grouped within it, is designed so that medical providers can offer the most efficient care in the least amount of space, said Tom Trutter, UConn Health's associate vice president for campus planning, design, and construction. To eliminate silos, there are no walls between departments so a geriatrician could be practicing next to a primary care physician.

Doctors will use flexible, 120-square-foot exam rooms to be shared by different departments, depending on patient demand. That will increase exam room utilization and reduce the outpatient centers' overall space needs, creating economic efficiencies that should help improve UConn Health Center's finances, which have struggled over the years, Trutter said.

Previously, Trutter explained, doctors owned space in the hospital, including their offices and exam rooms; that will not be the case anymore. The new design means patients will move less than physicians do. UConn is also trying to lean out its processes so patients can move in and out of the hospital more efficiently.

Meantime, common work areas outside exam rooms aim to encourage doctors from different departments to collaborate on patient care. More natural light, simpler building navigation, consolidated patient check-in and check-out services, and a coffee kiosk are other amenities aimed at improving the consumer experience, Trutter said.

"We've gone through a lot of work to try to change the mindset," Trutter said.

Technology will also change the patient experience, said Frank Torti, UConn Health Center's executive vice president for health affairs and dean of the UConn School of Medicine. Electronic health records will connect all providers within the Health Center, and an app-based technology will allow medical staff to communicate and exchange photos in real time so they can collaborate instantly on a patient's care. If a primary care physician, for example, has an urgent question for a patient's cardiologist the app will allow for direct communication between the doctors, increasing the likelihood of a quick response.

"The alternative is forcing the patient to set up another appointment in a week," Torti said. "This saves time, money and improves patient satisfaction."

Of course new infrastructure alone will not cure all the ills of an inefficient healthcare system. There also needs to be a culture shift among staff and patients, Torti said. Improving doctor-patient communication and getting patients more involved in their own care is important, he said.

When someone gets out of the hospital, for example, UConn nurses will make follow-up calls to ensure proper medications are taken and appointments are scheduled. Preventative care treatments, like smoking cessation programs, will also be available to patients.

Also, adjusting to all the changes won't be easy, Torti admits. Widespread adoption of electronic medical records in recent years, for example, has slowed productivity and disrupted the workflow of many doctors.

One advantage UConn has, Torti said, is that it's an academic medical center with staff interested in cutting-edge technology.

"It is a change for doctors, but they are very open to new ideas," Torti said.

Learn more about the financial hopes UConn medical officials have for the new patient tower and pavilion.

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