The Tribune Democrat, Johnstown, PA

Vision 2013

April 28, 2013

Conemaugh turns to tech

JOHNSTOWN — There was little in bricks and mortar added to Conemaugh Health System’s vast two-county network of facilities, but that doesn’t mean the region’s largest single employer has scaled back investment.

The introduction of digital mammography corresponded to an overall upgrade in radiology equipment. A new cardiac electrophysiology lab opened  and the system’s electronic medical records system continued to advance, leaders said.

“We replaced our previous technology with the newest technology available,” said John M. Moryken, Conemaugh vice president for business development and government affairs.

The new technology does more than improve efficiency, it also helps doctors react more quickly. At Conemaugh’s Level 1 trauma center in Memorial Medical Center, a few minutes can mean life and death.

Improved technology also helps improve care, Chief Medical Officer Dr. David Carlson said.

The introduction of a second interventional radiology procedure room allows radiologists to perform more procedures. Typically, the interventional radiologists use imaging to guide tiny surgical tools.

“We can do so many things now that used to take an operating room and big incision,” Carlson said.

Minimally invasive procedures are the growing trend, he said. Although the equipment and technology cost more, patients spend less time in the hospital, saving money.

Robotic assisted surgery is expanding at Memorial, representing the next generation of minimally invasive operations. The tiny robotic device is fed through a catheter tube to the affected part of the body. Because it is so small and can be designed with versatile maneuvering capabilities, the robotic tool can reach areas without damaging surrounding tissue like a traditional incision, Carlson said.

“It is miniaturizing our hands,” Carlson said. “A robot has more joints than we have. It can get into more places with less trauma.”

The electrophysiology lab and Memorial’s cardiac electrophysiologist, Dr. Genevieve Brumberg, allow patients with a broad range of heart rhythm conditions to receive care in Johnstown. Brumberg’s specialty covers implantable pacemakers and defibrillators and procedures shown to help keep the heart beating normally.

Cardiac ablation, for instance, is a nonsurgical procedure in which a thin wire-like catheter is fed through a blood vessel into the heart. Then agents are sent through the catheter using either heat or freezing to selectively destroy tiny pieces of tissue and remove the electrical triggers and circuits causing abnormal rhythms.

From a larger view, several areas position Conemaugh for the future, leaders said. The first is functioning as a system, instead of separate entities.

“We are building an integrated delivery system,” Moryken said, comparing the network to Geisinger Health System of Danville and the famed Mayo Clinic of Rochester, Minn.

“We continue to push the envelope,” he said.

Secondly, Conemaugh’s strong group of employed physicians help position the system for the future, Moryken said.

“The traditional way was lots and lots of private practices and a big hospital,” he said.

“We are developing multidisciplinary group practices. We are bringing them in and letting them help us run the business.

“They are part of the hospital. We make the whole system better by working together better.”

The third leg of Conemaugh’s base for sustainability is its medical education program, Carlson said.

There are normally about 80 doctors continuing their training in Conemaugh’s emergency, surgical, pathology, family practice and pharmaceutical residency programs. Another 50 medical student rotations come through each year, and the Conemaugh School of Nursing and Allied Health turns out its own crop of health professionals.

Clinical training partnerships are in place with St. Francis University, Pitt-Johnstown and Mount Aloysius College, among others.

“We truly are an academic center,” Carlson said. “We do a tremendous amount of medical education.”

The program helps recruit and retain skilled professionals for employment in Conemaugh programs and enables the system’s staff to keep up to date with the latest information and techniques, Carlson said.

Financially, Conemaugh is operating in the black, Chief Financial Officer Edward H. DePasquale said, reporting a 3 percent total margin.

Inpatient numbers remain on the decrease because of a shift to outpatient procedures, but also because people are putting off care due to financial concerns, he said.

Conemaugh has responded to the reduced revenue stream by controlling expenses. DePasquale credited the system’s physicians for their leadership in expense control.

The systemwide employment remains stable at 4,800 to 5,000 workers.

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