From the Hospital CEO - November 2013


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    While there is uncertainty about the immediate impact of changes in the U.S. healthcare system, the longer-term trends are becoming increasingly clear.

    These changes are centered on the value proposition. This means that insurance companies, government payors (Medicare and Medicaid) and individual consumers are linking reimbursement with outcomes. They want proof that the care being provided not only works, but also is delivered efficiently, safely and at the highest quality.

    As a result, hospitals and other providers are looking to evidence-based medicine, which consistently identifies the best-proven clinical protocols and clinical pathways to patients. At Stony Brook, that has always been our goal. But now these practices are being standardized across the board, so that there is less variation from doctor to doctor and hospital to hospital on how to treat the same condition. In those instances where best practice does not exist, we will be working to establish, improve and teach beat practice in our role as an academic institution committed to research, discovery, and innovation.

    This is consistent with our current strategy at Stony Brook — aligning ourselves with other institutions and medical groups that share our values and principles to further strengthen our clinical and academic enterprise. The recent realignment of the School of Medicine, the Hospital and physician practice plans within the University has placed us in a stronger position to do so. We are working together in a fully coordinated manner to proactively form relationships with other hospitals and physician groups to develop a network of institutions with one shared mission. These efforts will lead to a time in the near future when Stony Brook will be part of a system of hospitals and physicians that spreads over a wide area of Suffolk County offering premium healthcare to the community that is second to none and providing outstanding teaching and research.

    To best use healthcare resources, Stony Brook Medicine is working toward the establishment of a regional network across Suffolk County. As we begin to forge relationships with other hospitals and physicians in the region, we will optimize care for patients, as well as the use of our facilities.

    For example, someone with a minor condition could be treated at a community hospital, rather than at a tertiary care center (a center that provides advanced specialized care) like Stony Brook, with similar outcomes. This does two things. First, it allows a patient to receive care in a facility close to home, which we know is optimum for healing. And second, it makes the best use of our county’s resources, freeing up Stony Brook to care for the most severely ill patients from across and outside the region. It’s a partnership proposal where we work with other hospitals to provide the best mix of services — a case of delivering the right care at the right time at the right place.

    Stony Brook has been laying the groundwork for a regional network well before the Affordable Care Act entered our national conversation. Over the past few years, we have systematically restructured our internal procedures, streamlined our administration, improved efficiencies of care, instituted the electronic medical record, invested in technology and research, expanded our primary care network, broadened our base of clinical care outside of the hospital and recruited a new group of physician leaders with the skills to helm this new initiative.

    In short, we are fully committed to driving healthcare change in the community — change that will provide the highest level of care for our patients.

    L. Reuven Pasternak, MD
    Chief Executive Officer, Stony Brook University Hospital
    Vice President for Health Systems, Stony Brook Medicine