Memorial Health

Information technologymemorial Health (mh) continues to expand its digital infrastructure by implementing technology solutions that improve patient experience, clinical effectiveness, and business processes. In february of fy23 Memorial Health went live with the cerner millenium electronic Health record at decatur Memorial hospital (dmh), decatur Memorial medical group (dmmg) and jacksonville Memorial hospital (jmh). This implementation standardized clinical applications and processes across the largest affiliates. In september of fy23 Memorial completed an upgrade to cerner millenium which met the requirements for promoting interoperability and cures act. During this project, the cerner millenium hardware and operating System were upgraded to allow for high availability technology which minimizes application downtimes and System interruptions. Additionally, Memorial Health initiated a project to migrate the enterprise resource planning (erp) software, infor lawson, to the cloud-based solution infor cloudsuite. This migration includes all components of the erp including hr, finance, and supply chain. Memorial Health continues to invest in the technology infrastructure including upgrading the wireless network and standardizing telephony (avaya) at jmh; completing multiple sites of care modernization; and upgrading network and workstation hardware at Memorial physician services (mps) and urgent care sites. Cybersecurity preparedness continues to be a priority for the Health System. In fy23, mh completed cybersecurity tabletop (mock) exercises and completed several security enhancement projects including implementing identity services engine (ise) for pacs imaging devices, conditional access enhancements and geo-blocking. A complex password roll-out with self-service password management functionality is currently being deployed across the Health system.throughout fy23, Memorial Health continued hosting and upgrading the community touchworks ambulatory electronic Health record for the springfield clinic, siu Health, orthopedic centers of central Illinois and Memorial medical group (mmg) while aiding springfield clinic in their transition to a new electronic Health record.

Guided by the values of Memorial Health, senior leadership is responsible for strategic planning, prioritizing among competing issues and engaging in dialogue and decision-making that will enable Memorial Health to achieve its mission (to improve lives and build stronger communities through better Health), its vision (to be the Health partner of choice), realize its' strategic goals, and execute its' strategic priorities to better serve central Illinois and confront the many challenges facing the healthcare industry. In fy21, mhs senior leadership constructed a new strategic plan termed "destination 2025" that was made effective fy22, three-year goals and measures of success to reflect emerging priorities related to Health reform, quality improvement, population Health, care coordination and the results of our comprehensive community Health needs assessment. This updated strategic plan considered learnings from the covid-19 pandemic and emerging trends as a result of the pandemic. Both its previous and current strategic plan served Memorial Health well during the covid-19 pandemic and was a catalyst for managing and responding to the pandemic in a coordinated, systemized fashion. This updated plan is also the foundation for the organization to successfully prevail thru the challenges the healthcare industry is facing nationally. Leadership was able to respond efficiently and effectively in a dynamic, ever- changing environment as the covid-19 pandemic evolved. While many priorities and initiatives had to be put on pause due to the covid-19 pandemic, Memorial Health made great progress in integrating a recently new affiliate hospital, decatur Memorial hospital, and new physician group, decatur medical group, in fy22. Work began in fy21 to implement a common electronic Health record (ehr) across all Memorial Health hospitals, which at the time, had 4 distinct separate ehrs in its five hospitals. Decatur Memorial hospital and jacksonville Memorial, the two largest hospitals in Memorial Health outside of springfield Memorial hospital, implemented the cerner ehr in fy23, resulting in the three largest hospitals in Memorial Health being on a common ehr. Plans are being finalized for the remaining two hospitals in Memorial without the cerner ehr to transition to the platform in fy25. In addition, the leadership team has made great strides in accomplishing Health System strategic realization plans and reported results to its board accordingly.while covid-19 was still circulating, Memorial Health's fy23 was characterized more by recovery from the economic and cultural impacts of the pandemic as the clinical severity of the disease waned. The ongoing national healthcare labor shortage, wage rate pressures, and inflation provided significant cost increases while continued shifts in payer mix towards more governmental payers put downward pressure on reimbursement rate. In response, Memorial Health successfully met a $184.6 million savings target through reduction of costs, improved processes, and enhanced revenues through a program called "strengthen our future." A few specific initiatives in fy23 of the "strengthen our future" plan included successfully renegotiating nearly all major commercial payer contracts projected to improve reimbursement by over $60 million a year into the future, reducing the average length of stay at inpatient prospective payment System hospitals by 0.44 days removing 8,500 days of unnecessary care, implementing a targeted reduction in force of 20% of all Memorial Health leadership and 4% of all colleagues that will lead to $40 million in savings in fy24, and reducing contract labor spend by $40.4 million.in fy22, the historic reliance and cost-inflation associated with agency labor contributed to Memorial's financial challenges. In fy23, significant progress was made in reducing reliance on costly agency labor. During the fiscal year, agency headcount was reduced by 46% and domestic contract labor spend declined by $40 million. Despite the progress on various cost-savings measures, Memorial still had to make the difficult decision to reduce its workforce by 5% which included 20% of leadership positions across the organization. Given the rise in inflation, Memorial Health was active in fy22 renegotiating higher rate increases with all payers and we continued to be aggressive in this space in fy23. During fy23, Memorial Health's five hospitals completed the second year of their community Health needs assessment implementation strategies to address priorities identified in each hospital's 2021 needs assessments. Priorities identified to be addressed during fy22-24 are - springfield Memorial hospital/sangamon county: access to Health, mental/behavioral Health, and economic disparities; jacksonville Memorial hospital/morgan county: mental Health, obesity, and cancers; taylorville Memorial hospital/christian county: mental Health, obesity, and lung Health; and lincoln Memorial hospital/logan county: obesity, youth mental Health, and substance use. Decatur Memorial hospital/macon county: access to Health, economic disparities, and mental/behavioral Health. Additionally, mental Health was named as a System priority and three major contributing factors were identified within each of these priorities: access to Health, social determinants of Health, and racial inequity and inequality. Memorial Health's community Health work seeks to build collaborations between county Health departments, other local hospitals, direct-service organizations, and trusted community leaders who are already doing the work, in order to meet the needs of our communities and promote equity, diversity, and inclusion. Senior leadership, ceos at each hospital, and the mh board's community benefit committee help oversee the community benefit elements of the community Health program. Memorial Health provides patient-centered care through an ambulatory organizational structure that was developed in fy19 to ensure strategic alignment for providing care outside of an acute care setting. This structure pushes coordination of care between our mental Health, home services, hospice, primary care, specialty care, urgent care, wellness, population Health and durable medical equipment affiliates. In total, the ambulatory group provided 635,410 provider office visits, 43,704 behavioral Health services, 30,658 home Health visits, and 27,219 home hospice days in fy23. Memorial medical group and decatur Memorial medical group employed a total of 333 providers during fy23, including physicians, hospitalists, advanced practice providers, and licensed therapists. The bulk of the physicians and advanced practice providers practice in the primary care setting serving a panel of over 135,000 patients. This large primary care infrastructure is a key part of Memorial Health's strategy for navigating the dynamic and ever-changing payer market and shift from fee-for-service Health care to fee-for-value. From a bond rating perspective, moody's has affirmed Memorial Health's long-term rating of a1 rating and revised its outlook from negative to stable. S&p has also affirmed Memorial Health's rating of a+ with a stable outlook. Memorial Health paused the annual engagement survey in 2023 to allow for research and assessment to identify a new survey vendor. While the formal survey was not administered, listening was still conducted in other ways, including establishing listening communities with leader and colleague groups. A new vendor partnership was established with plans to roll out a new survey in fy24. With the effects of covid-19 pandemic waning in some respects, patient experience leaders across Memorial Health centered their efforts around a return to standard operations throughout fy23 through a "back to basics" campaign. The campaign stressed the importance of connected care and retaught tactics such as providing second-level introductions, greeting, and guiding patients, walking shoulder to shoulder and asking patient permission to provide care before doing so when appropriate. In addition, per the recommendation of industry leaders in patient experience, Memorial Health moved to evaluate patient experience through top box scores rather than percentile rank. The change in reporting provides colleagues with a more direct understanding of patients' perceptions of their care. Memorial Health closed the fiscal year with 17 out of 26 patient satisfaction surveys across the Health System score at or above the 75th percent in top box scores.

Memorial Health's mission is to improve the Health of the people and communities we serve. Safe, functional facilities are the foundation of the healthcare services we provide. Clinical projects that began in fy 2023:- linear accelerator replacements and renovations - due to aging equipment we are replacing both smh 1e linear accelerators, during this time we will also upgrade finishes and bring any mep infrastructure up to date.- siu baylis 2nd floor renovations - siu and smh have agreed to a lease and siu occupying the 2nd floor of the baylis building to expand some of their service lines. Around 50% will be gutted and rebuilt to be more efficient and more patient care rooms. - 1e oncology renovations - due to the condition of the 1e oncology spaces - especially the exam room spaces (finishes, size, efficiencies, etc.) This unit needs gutted. New design includes 11 new appropriately sized exam rooms with two rooms being inpatient focused. New nurse station, reception, additional private dressing area for patients, new break room for colleagues and support spaces for physicians, nm, physicist, and nps. New is room.- artis biplane ir and room renovations - due to the age and condition of smh a137 biplane equipment it needs to be replaced as soon as possible to continue services for patients and bring additional services. Considering the size of the new equipment we need to create additional space for the equipment and for colleagues around it. This will involve moving mechanicals out of that room across the hall and removing part of the control room space to gain it back for patient care.- isu nursing at 200 north grande - we lease space at the old north grand shop n save from medics first that we will then turn around and sublease to isu nursing for educational space. This includes the build-out of a vacant part of the building separate from the medics first garage. It includes all new meps and finishes for several classrooms, conference and work spaces, and collaboration spaces.- sterile processing and central supply integration - due to cvor workload moving down into main sp additional space is needed to accommodate. Moving cvor down is not only an infection prevention initiative but also an efficiency improvement. The scope of work involves taking down the wall between cs and sp, expanding storage but also allowing those services to share resources and become more efficient. New vestibule on the cs will be provided as well as some new clean items (lights) to be installed.other projects completed for Health System include:- phase i baylis parking ramp repairs - the baylis parking ramp continues to see heavy deterioration to the point we need to invest money over the next 4 years to prolong the life of the structure. We are looking at sealing and coating all decks, repairs to any structural damage, repairs to concrete stair and pans failing, utilities that are a life safety concern due to rusting and exposure to weather.- Health System imaging equipment replacements (cath lab 1, cath lab 2) - completed the replacement of imaging equipment at smh cath lab 1 and 2. While equipment was replaced, room renovations were completed. - dmh linear accelerator replacement - replacement of linear accelerator and finishes upgrade. - jacksonville urgent care - scope of work included complete gut and build-out of an existing space in the strip mall across from springfield clinic. Exterior faade design, build-out of exam rooms and all clinic supporting spaces.- new child care - built new child care building to allow for the child care program to grow. Includes updated kitchen and more admin space for staff.- jmh booms & lights - replaced lights and booms for 7 ors.- chiller 3 rebuild - rebuilt chiller 3 due to manufacturer's recommendations of 40,000 hours. As part of the build, the chiller carries a new seven-year parts and labor warranty.- service tunnel repairs - replaced lid of a 30 foot section of the tunnel involving excavating around the tunnel exterior, supporting all meps in tunnel, removing existing lid, waterproofing and new structural support set into place, and pouring back the lid. Including lot 2 work.

Through Memorial Health partners (mhp), Memorial Health has entered into risk-based contracts to provide in-network medical services via springfield Memorial hospital (smh). Under these arrangements, mhp receives capitation payments based on the demographic characteristics of covered members in exchange for providing certain medical services to those members. During fy2023, mhp had more than 8,300 member lives covered in its network and recognized both capitation revenues for that coverage as well as purchased medical service expesnse paid to members' providers, including smh.