John R. Feussner, M.D. Affiliations and Outreach College of Medicine Clinical Affairs Affiliations and Outreach FY 14

Strategic Plan ~ Mission 2015 Vision: Vision: MUSC will be nationally recognized as a premier academic medical center Intent: Intent: Top 25 among academic medical centers for reputation, quality, service, efficiency and financial performance by 2015 MUSC Health/Medical Affairs Achieved our Strategic Intent being ranked #22 two years ahead of our 2015 goal date!

Focus – Overview Primary Care Specialty Care Hospital Alliances Telemedicine

New Patient Growth Discussing FY 15 Enterprise Growth Goal of 3%

Primary Care Expansion Capacity vs. additional locations * Working with FM to determine capacity *

Georgetown Health System Georgetown Health System – Logistics progressing well Establishing Regional Service Lines – Oncology » Finalize agreements following their February Board of Trustees meeting » Operating Agreement » Management Services Agreement Clinical Affairs – Progress in Affiliations

Georgetown Health System Georgetown Health System – Logistics progressing well Joint Recruitment – Joint Strategic Plan Administrator hired – Assists with implementation, including oversight of all Driving Strategies and Tactics Clinical Affairs – Progress in Affiliations

Georgetown Health System Georgetown Health System – Logistics progressing well Establishing Regional Service Lines – Neurosciences » Define needed services » Identify infrastructure needs » Discuss physician recruitment Clinical Affairs – Progress in Affiliations

Beaufort Memorial Hospital and MUSC Health Strategic Planning Discussion Project Team  Strategy Steering Committee  Stakeholder Briefing Sessions Completed Joint Strategic Planning in January Waiting on BMH’s Board decision

Beaufort Community Beaufort Community – Lowcountry Medical Group Clinical Affairs – Progress in Affiliations Bluffton Community Bluffton Community – Explore opportunities to establish a clinical presence Southern Coastal Region

Clinical Affairs – Progress in Affiliations Hilton Head Hospital & Hollings Cancer Center Hilton Head Hospital & Hollings Cancer Center – Renewed agreements Affiliation Clinical Trials Network

Clinical Affairs – Progress in Affiliations Orangeburg Regional Medical Center Orangeburg Regional Medical Center – Met with Orangeburg leaders Ms. Brenda Williams, VP, Strategic Planning Ms. Theresa Chandler, Director, Mabry Cancer Center Ms. Cheryl Mason, CFO – Initiating short and long term strategic planning

Clinical Affairs – Progress in Affiliations Orangeburg Regional Medical Center Orangeburg Regional Medical Center – Next Meeting in Orangeburg in March – Priority Topics include: MUHA affiliation Oncology & Hollings Cancer Center Tele-health Network, stroke & eICU Physician Network & joint recruiting Quality of care programs/expertise EMR connectivity GI Surgery

Surgical Care Affiliates (SCA) Surgical Care Affiliates (SCA) – Completed SCA and MUHA modeling utilization scenarios – Strategic Project teams established – OR optimization assessment – Case migration analysis Clinical Affairs – Progress in Affiliations

Pediatric Cardiology eConsults Pediatric Cardiology eConsults – The Emerson Rose Act Clinical Affairs – Progress in Affiliations Legislation signed by Gov. Haley Legislation requires every newborn to be screened for heart defects before hospital discharge Pediatrics currently supports East Cooper Medical Center nursery Pediatrics working with 10 additional Birthing Centers in 9 county area to respond to screening results Telemedicine expanding its reach!

Associate Dean for Clinical Affairs, Executive Medical Director, Physician Network Associate Dean for Clinical Affairs, Executive Medical Director, Physician Network – Leads development of a strategy and infrastructure to build a geographically dispersed clinical network involving employed, aligned and independent physicians – Leads the Network with a delivery structure capable of thriving under healthcare reform, pay for performance and programs based on quality and patient satisfaction Clinical Affairs – Progress in Affiliations

Statewide Focus – Strategy Patient Centered Collaborative Quality Access

IT & Health Informatics Strategy Multiple Strategies – Statewide Telehealth Network – Coordinated information systems – Telemedicine connections – Link MD networks

The difficult is what takes a little time; the impossible is what takes a little longer. Fridtjof Nansen

Statewide Focus – Strategy

Expand Access & Capacity Grow Primary and Outpatient Care Physician Network Development Recruit Executive Medical Director Develop geographically dispersed clinical network with array of employed, aligned and independent physicians

Unify & Align Primary Care Alignment Unify IM, FM, and MUSC P into one primary care PCMH Yr 1 = $250K increased reimbursement Subsequent years = additional $s based on continued performance improvement

Clinical Affairs – Progress in Affiliations East Cooper Strategic Planning East Cooper Strategic Planning – Building capacity currently supporting 34 specialties – PCMH at East Cooper received NCQA certification – Franke Home Affiliation initiated – Primary Care expansion – Coleman Road – Addition of After Hours services (adult & pediatric) and Sat. Walk – In Sports Medicine clinic well received by patients

Clinical Affairs – Progress in Affiliations North Charleston Strategic Planning North Charleston Strategic Planning – N. Charleston has favorable demographics with highest population growth in 29445; northeast of MUSC Health – North – Very few providers along the I-176/I-52 corridor (29445) – Projected strong average growth (+22%) across most service lines over next 5 years

Unify & Align Specialty Care Alignment Affiliation and Outreach Committee process ensures clinical expansion aligns with strategic plan priorities: Heart and Vascular Neurosciences Oncology Transplant Pediatric Subspecialties

Developing Hospital Alliances Principles – Enhance value by increasing quality – Achieve patient and population centric care – Technology, information and clinical – Economics, mutually beneficial – Coordinate spectrum of care – Full range of services for community – Process integration, improve efficiency, lower cost

Developing Hospital Alliances MUSC Health – Expertise & Services – Best practices, clinical guidelines – Physician expertise, program development – Quality of care, using objective metrics – Coordinated information systems – Telemedicine connections – Link physician networks

Developing Hospital Alliances MUSC Health – Expertise & Services – Consider statewide PCMH – Coordinate services, facilitate patient movement through our system – Gain economies of scale for cost reductions – Align marketing efforts to create advantages in community – Foster continuity and stability for local hospital leadership

Notes: *REACH contracts are in progress Legend Transfer Agreement REACH Clinical Presence Telemedicine Clinical Trial Joint Strategic Plan

Affiliations & Outreach Primary Care & Specialties N. Charleston Affiliations & Outreach Primary Care & Specialties N. Charleston MUSC Health – North Charleston Dermatology MOHS Cardiology Endocrinology Hematology/Oncology Nephrology Pulmonology Rheumatology Neurosciences Maternal & Prenatal Wellness Orthopedics Otolaryngology Radiology GI Plastic Surgery Surgical Oncology Vascular Surgery Urology

Affiliations in progress Georgetown Hospital System Georgetown Hospital System – Draft Joint Operating structure completed – Legal counsel drafting partnership agreement – Oncology and neurosciences initial focus – Recruit physician leader to implement joint strategic plan Establish State Wide Partnerships

Affiliations in progress Surgical Care Affiliates (SCA) Surgical Care Affiliates (SCA) – Co-Development Agreement signed – Equity partnership; MUSC 51% / SCA 49% – Ambulatory surgery center selected – External legal counsel engaged – Draft joint venture documents – Complete business planning Establish State Wide Partnerships

Affiliations in progress, cont. Beaufort Memorial Hospital Beaufort Memorial Hospital – Multiple onsite visits by Drs. Pisano, Cawley and Feussner – Meet C-Suite members & selected Board members – Discussion of joint mission and driving strategies – External consultant engaged (The Beckham Co.) – Next group meeting November 20 th in Charleston Establish State Wide Partnerships

The difficult we do right away. The impossible takes a little longer

Because a thing seems difficult for you, do not think it impossible for anyone to accomplish. ~Marcus Aurelius