SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
BETH ISRAEL DEACONESS MEDICAL CENTER
 
Employer identification number

04-2103881
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

 

No
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    25,646,015 9,708,320 15,937,695 0.810 %
b Medicaid (from Worksheet 3, column a) . . . . .     216,862,980 196,181,903 20,681,077 1.050 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     242,508,995 205,890,223 36,618,772 1.860 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     9,265,457 1,945,307 7,320,150 0.370 %
f Health professions education (from Worksheet 5) . . .     112,188,081 33,864,929 78,323,152 3.990 %
g Subsidized health services (from Worksheet 6) . . . .     37,739,170 19,530,120 18,209,050 0.930 %
h Research (from Worksheet 7) .     263,242,077 193,994,615 69,247,462 3.530 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     6,589,561   6,589,561 0.340 %
j Total. Other Benefits . .     429,024,346 249,334,971 179,689,375 9.160 %
k Total. Add lines 7d and 7j .     671,533,341 455,225,194 216,308,147 11.020 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development     383,166 81,718 301,448 0.020 %
9 Other            
10 Total     383,166 81,718 301,448 0.020 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
25,799,994
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
513,360,668
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
526,941,195
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-13,580,527
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 BETH ISRAEL DEACONESS MEDICAL CENTER
330 BROOKLINE AVENUE
BOSTON,MA02215
WWW.BIDMC.ORG
VL42 		X X   X   X X   TERTIARY CARE ACADEMIC MEDICAL CENTER  
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
BETH ISRAEL DEACONESS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART VI
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
BETH ISRAEL DEACONESS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SUPPLEMENTAL INFORMATION
b
SEE SUPPLEMENTAL INFORMATION
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
BETH ISRAEL DEACONESS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
BETH ISRAEL DEACONESS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
BETH ISRAEL DEACONESS MEDICAL CENTER PART V, SECTION B, LINE 5: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H, PART V, SECTION B PLEASE SEE SCHEDULE H, PART VI SUPPLEMENTAL INFORMATION
BETH ISRAEL DEACONESS MEDICAL CENTER PART V, SECTION B, LINE 11: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H, PART V, SECTION B PLEASE SEE SCHEDULE H, PART VI SUPPLEMENTAL INFORMATION
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?5
Name and address Type of Facility (describe)
1 1 - BETH ISRAEL DEACONESS HEALTHCARE LEXIN
482 BEDFORD STREET
LEXINGTON,MA02420 		OUTPATIENT MEDICAL CARE
2 2 - BETH ISRAEL DEACONESS HEALTHCARE CHELS
1000 BROADWAY
CHELSEA,MA02150 		OUTPATIENT MEDICAL CARE
3 3 - BOWDOIN STREET HEALTH CENTER
230 BOWDOIN STREET
DORCHESTER,MA02122 		OUTPATIENT MEDICAL CARE
4 4 - CHESTNUT HILL AMBULATORY CARE
200 BOYLSTON STREET
NEWTON,MA02467 		OUTPATIENT MEDICAL CARE
5 5 - BETH ISRAEL DEACONESS CANCER CENTER
148 CHESTNUT STREET
NEEDHAM,MA02492 		OUTPATIENT MEDICAL CARE
6
7
8
9
10
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
FORM 990 SCHEDULE H SUPPLEMENTAL INFORMATION SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSCOMMUNITY BENEFITS MISSION STATEMENT THE MISSION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS TO PROVIDE EXTRAORDINARY CARE, WHERE THE PATIENT COMES FIRST, SUPPORTED BY WORLD-CLASS EDUCATION AND RESEARCH. BIDMC'S MISSION IS SUPPORTED BY A COMMITMENT TO PERSONALIZED, EXCELLENT PATIENT CARE; A WORKFORCE COMMITTED TO INDIVIDUAL ACCOUNTABILITY, MUTUAL RESPECT AND COLLABORATION; AND A COMMITMENT TO MAINTAINING THE INSTITUTION'S FINANCIAL HEALTH. BIDMC IS COMMITTED TO BEING ACTIVE IN THE COMMUNITY AS WELL. SERVICE TO COMMUNITY IS AT THE CORE AND AN IMPORTANT PART OF OUR MISSION. BIDMC HAS A COVENANT TO CARE FOR THE UNDERSERVED AND TO WORK TO CHANGE DISPARITIES IN ACCESS TO CARE. THIS COMMUNITY BENEFITS MISSION IS FULFILLED BY:- INVOLVING BIDMC'S STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE IMPLEMENTATION STRATEGY;- ENGAGING RESIDENTS THROUGHOUT THE HOSPITAL'S SERVICE AREAS IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, INCLUDING ASSESSMENT, PLANNING, IMPLEMENTATION AND EVALUATION. SPECIAL ATTENTION IS FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES;- ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO IDENTIFY UNMET HEALTH-RELATED NEEDS AND TO CHARACTERIZE THOSE IN THE COMMUNITY WHO ARE MOST VULNERABLE AND FACE DISPARITIES IN ACCESS AND OUTCOMES;- IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES BID MILTON'S SERVICE AREA GEARED TOWARD IMPROVING CURRENT AND FUTURE HEALTH STATUS OF INDIVIDUALS, FAMILIES AND COMMUNITIES BY REMOVING BARRIERS TO CARE, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, STRENGTHENING THE HEALTHCARE SYSTEM AND WORKING TO DECREASE THE BURDEN OF THE LEADING HEALTH ISSUES;- PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND - FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, BIDMC PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $13,909,711 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMTHE BIDMC'S COMMUNITY BENEFITS TEAM IS LED BY THE DIRECTOR OF COMMUNITY BENEFITS. THE DIRECTOR IS ACCOUNTABLE TO THE BILH VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS AND THE CHIEF STRATEGY OFFICER FOR BILH, ALONG WITH BIDMC'S PRESIDENT. THESE FOUR SENIOR MANAGERS ARE RESPONSIBLE FOR ENSURING THAT COMMUNITY BENEFITS ARE ADDRESSED BY THE ENTIRE ORGANIZATION AND THE NEEDS OF BIDMC'S UNDERSERVED POPULATIONS ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES AND PROGRAM DEVELOPMENT. COMMUNITY HEALTH NEEDS ASSESSMENTMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES, IN ORDER TO MAINTAIN ITS TAX EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. BIDMC COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2019. THAT CHNA WAS APPROVED BY THE BIDMC BOARD OF DIRECTORS ON SEPTEMBER 18, 2019. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO APPROVED BY THE BOARD ON SEPTEMBER 18, 2019, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER IRC SECTION 501(R). THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED IMPLEMENTATION STRATEGY (IS) REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OUT OF BIDMC'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT BIDMC ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW BIDMC, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY2019 COMMUNITY HEALTH NEEDS ASSESSMENT TARGETED GEOGRAPHY AND POPULATIONAS NOTED ABOVE, BIDMC COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2019. THE GEOGRAPHICAL FOCUS OF BIDMC'S MOST RECENTLY COMPLETED CHNA ENCOMPASSES THE BOSTON NEIGHBORHOODS OF ALLSTON/BRIGHTON, BOWDOIN/GENEVA, CHINATOWN, FENWAY/KENMORE, MISSION HILL, AND ROXBURY, AND THE CITIES OF CHELSEA, BROOKLINE, LEXINGTON, NEEDHAM, AND NEWTON (CHESTNUT HILL). BIDMC'S FY19 CHNA, ON WHICH THIS REPORT IS BASED, SHOWS THAT LOW-INCOME AND RACIALLY/ETHNICALLY DIVERSE POPULATIONS LIVING IN BOSTON'S NEIGHBORHOODS OF ALLSTON/BRIGHTON, BOWDOIN/GENEVA, CHINATOWN, FENWAY/KENMORE, MISSION HILL, AND ROXBURY, AS WELL AS THE ADJACENT CITY OF CHELSEA, FACE THE GREATEST HEALTH DISPARITIES AND ARE MOST AT RISK. AS A RESULT, THESE BOSTON NEIGHBORHOODS AND THE CITY OF CHELSEA HAVE BEEN IDENTIFIED AND PRIORITIZED AS THE FOCUS FOR BIDMC'S COMMUNITY HEALTH EFFORTS. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT SUMMARY OF APPROACH AND METHODSTHE CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. RATHER THAN CONDUCTING A SINGLE ASSESSMENT, BIDMC'S COMMUNITY BENEFITS STAFF CONDUCTED THEIR OWN ASSESSMENT AND CO-LED AND/OR PARTICIPATED IN A SERIES OF ADDITIONAL, CONCURRENT AND COMPREHENSIVE ASSESSMENTS THAT WERE THEN AGGREGATED TO CREATE THE 2019 CHNA REPORT. THESE CONCURRENT ASSESSMENTS WERE CONDUCTED BY ORGANIZATIONS OR COLLECTIVES OF ORGANIZATIONS IN BOSTON AND CHELSEA WITH WHICH BIDMC PARTNERS ON A REGULAR BASIS (BOSTON CHNA-CHIP COLLABORATIVE, NORTH SUFFOLK INTEGRATED CHNA, BILH AND OTHER HOSPITAL CHNAS). BIDMC ALSO INTEGRATED ITS EXTENSIVE COMMUNITY ENGAGEMENT AND PLANNING WORK FROM ITS MASSACHUSETTS DETERMINATION OF NEED NEW INPATIENT BUILDING COMMUNITY-BASED HEALTH INITIATIVE. INVOLVEMENT IN THESE FOUR EFFORTS ALLOWED BIDMC TO LEVERAGE RESOURCES AND CREATE A ROBUST AND INCLUSIVE CHNA AND IS. THE COLLABORATIVE PROCESS INCLUDED SYNTHESIZING EXISTING REGIONAL DATA ON SOCIAL, ECONOMIC AND HEALTH INDICATORS AS WELL AS INFORMATION FROM 4,219 SURVEYS, 74 KEY INFORMANT INTERVIEWS, 35 FOCUS GROUPS AND 5 COMMUNITY MEETINGS. COMMUNITY DIALOGUES AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM ACROSS THE CITIES OF BOSTON, CHELSEA, REVERE AND WINTHROP THAT COMPRISE THE NORTH SUFFOLK REGION AND WITH A RANGE OF PEOPLE REPRESENTING DIFFERENT AUDIENCES, INCLUDING LEADERS IN EMERGENCY RESPONSE, EDUCATION, HEALTH CARE AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS (E.G., OLDER ADULTS) (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED APPROXIMATELY 1,085 PEOPLE.BIDMC CONDUCTS THEIR CHNAS IN THREE PHASES, WHICH ALLOWED BIDMC TO:- COMPILE AN EXTENSIVE AMOUNT OF QUANTITATIVE AND QUALITATIVE DATA;- ENGAGE AND INVOLVE KEY STAKEHOLDERS, BIDMC CLINICAL AND ADMINISTRATIVE STAFF AND THE COMMUNITY AT-LARGE;- DEVELOP A REPORT AND DETAILED STRATEGIC PLAN; AND- COMPLY WITH ALL COMMONWEALTH ATTORNEY GENERAL AND FEDERAL IRS COMMUNITY BENEFITS REQUIREMENTS.DATA SOURCES INCLUDED A BROAD ARRAY OF PUBLICLY AVAILABLE SECONDARY DATA, KEY INFORMANT INTERVIEWS, AND FOUR COMMUNITY FORUMS2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS DETAIL OF APPROACH AND METHODSBIDMC RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. BIDMC COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA.
EXAMPLES OF SECONDARY DATA SOURCES THAT BIDMC LEVERAGED INCLUDED: - U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2013-2017)- BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, 2017- MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2017 AND 2018-2019)- FBI UNIFORM CRIME REPORTS (2017)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2015)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2017)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, ANNUAL REPORTS ON BIRTHS (2016)- MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2017)- MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL PROFILES (FY13-FY17)- MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2017)- MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2018)2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS KEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BIDMC CONDUCTED 74 KEY INFORMANT INTERVIEWS THAT ENGAGED INSTITUTIONAL, ORGANIZATIONAL AND COMMUNITY LEADERS AND FRONT-LINE STAFF ACROSS SECTORS. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX H OF THE CHNA REPORT THAT IS POSTED ON BIDMC'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN BIDMC'S CBSA. INTERVIEWS WERE CONDUCTED IN PERSON AND ON THE PHONE USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING MAJOR HEALTH ISSUES, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS, AND TARGET POPULATIONS.2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)BIDMC CONDUCTED 35 COMMUNITY FOCUS GROUPS IN BIDMC'S SERVICE AREA TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE FOCUS GROUPS WERE ORGANIZED IN COLLABORATION WITH THE BOSTON CHNA-CHIP COLLABORATIVE, NORTH SUFFOLK INTEGRATED CHNA AND OTHER BILH HOSPITALS.BIDMC HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF BIDMC'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY SENT OUT AS PART OF THE BOSTON COLLABORATIVE CHNA WAS ADMINISTERED ONLINE AND VIA HARD COPY IN SEVEN LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE NETWORKS, WAITING ROOMS, BOSTON PUBLIC LIBRARY NEIGHBORHOOD BRANCHES, COMMUNITY EVENTS AND LARGE APARTMENT BUILDINGS TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. AS AN EXAMPLE OF BIDMC'S EXTENSIVE AND SUCCESSFUL COMMUNITY OUTREACH, NEARLY HALF (45%) OF FOCUS GROUP PARTICIPANTS IDENTIFIED AS BLACK OR AFRICAN-AMERICAN AND 34% IDENTIFIED AS HISPANIC/LATINO.THE BIDMC COMMUNITY BENEFITS COMMITTEE WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE COMMUNITY BENEFITS COMMITTEE MET QUARTERLY DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS REVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSAS NOTED ABOVE, THE CHNA PROCESS WAS DIVIDED INTO THREE PHASES. THE FINAL PHASE, PHASE III, INCLUDED THE FOLLOWING STEPS: - REVIEW OF THE ASSESSMENT'S MAJOR FINDINGS.- IDENTIFY BIDMC'S COMMUNITY BENEFITS PRIORITY POPULATIONS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES.- ANALYZE BIDMC'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2016 CHNA AND SUBSEQUENT IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY BIDMC DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015).- DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018).2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS KEY FINDINGSTHE KEY PRIORITY POPULATIONS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2019, WERE:- YOUTH AND ADOLESCENTS - OLDER ADULTS- LOW-RESOURCE INDIVIDUALS AND FAMILIES- LESBIAN, GAY, BISEXUAL, TRANSGENDER AND QUEER OR QUESTIONING (LGBTQ) INDIVIDUALS- RACIALLY AND ETHNICALLY DIVERSE POPULATIONS AND NON-ENGLISH SPEAKERSBETH ISRAEL DEACONESS MEDICAL CENTER'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: - SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE DOMINANT THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS, SURVEY, FOCUS GROUPS AND COMMUNITY FORUMS WAS THE CONTINUED IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH ARE HAVING ON THE CBSA'S LOW-INCOME, UNDERSERVED, DIVERSE POPULATION COHORTS. MORE SPECIFICALLY, DETERMINANTS SUCH AS POVERTY, EMPLOYMENT OPPORTUNITIES, HOUSING, VIOLENCE, TRANSPORTATION, RACIAL SEGREGATION, LITERACY, PROVIDER LINGUISTIC/CULTURAL COMPETENCY, SOCIAL SUPPORT, AND COMMUNITY INTEGRATION LIMIT MANY PEOPLE'S ABILITY TO CARE FOR THEIR OWN AND/OR THEIR FAMILIES' HEALTH. - HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). THE IMPACT OF SOCIAL DETERMINANTS WAS THE LEAD FINDING, BUT A CLOSE SECOND WAS THE PROFOUND IMPACT OF BEHAVIORAL HEALTH ISSUES (I.E., SUBSTANCE USE AND MENTAL HEALTH) ON INDIVIDUALS, FAMILIES AND COMMUNITIES IN EVERY GEOGRAPHIC REGION AND EVERY POPULATION SEGMENT IN BIDMC'S CBSA. DEPRESSION/ANXIETY, SUICIDE, ALCOHOL USE, OPIOID AND PRESCRIPTION DRUG USE AND MARIJUANA USE ARE MAJOR HEALTH ISSUES AND ARE HAVING A SIGNIFICANT IMPACT ON THE POPULATION AS WELL AS BURDENING THE SERVICE SYSTEM. THE FACT THAT PHYSICAL AND BEHAVIORAL HEALTH ARE SO INTERTWINED COMPOUNDS THE IMPACT OF THESE ISSUES. OF PARTICULAR CONCERN ARE THE INCREASING RATES OF OPIOID USE AND THE IMPACTS OF TRAUMA. - HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). THE ASSESSMENT'S QUANTITATIVE DATA CLEARLY SHOWS THAT MANY COMMUNITIES IN BIDMC'S CBSA HAVE HIGH RATES FOR MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). IN MANY COMMUNITIES, THESE RATES ARE STATISTICALLY HIGHER THAN COMMONWEALTH RATES, INDICATING A PARTICULARLY SIGNIFICANT PROBLEM. HOWEVER, EVEN FOR THOSE COMMUNITIES WHERE THE RATES ARE NOT STATISTICALLY HIGHER, THESE CONDITIONS ARE STILL THE LEADING CAUSES OF PREMATURE DEATH.- LIMITED ACCESS TO PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, BEHAVIORAL HEALTH, AND ORAL HEALTH CARE SERVICES FOR LOW-INCOME, FOREIGN BORN, THOSE COVERED BY MEDICAID, UNINSURED, AND OTHER VULNERABLE POPULATIONS VACING HEALTH CARE DISPARITIES AND BARRIERS TO CARE. DESPITE THE FACT THAT MASSACHUSETTS HAS ONE OF HIGHEST RATES OF HEALTH INSURANCE AND THE COMMUNITIES THAT MAKE UP BIDMC'S CBSA HAVE STRONG, ROBUST SAFETY NET SYSTEMS, THERE ARE STILL SUBSTANTIAL NUMBERS OF LOW-INCOME, MEDICAID COVERED, UNINSURED AND OTHERWISE VULNERABLE INDIVIDUALS WHO FACE HEALTH DISPARITIES AND ARE NOT ENGAGED IN ESSENTIAL MEDICAL, BEHAVIORAL AND ORAL HEALTH SERVICES. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE AND IMPROVE THE QUALITY OF PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, BEHAVIORAL HEALTH AND ORAL HEALTH SERVICES. THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, WILL INFORM BIDMC'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2020; SEPTEMBER 30, 2021; AND SEPTEMBER 30, 2022.
QUALITATIVE DATA: INTERVIEWS, GROUPS CONVERSATIONS, SURVEYS AND THE COMMUNIT CARE ALLIANCEJSI CONDUCTED A SERIES OF FIVE COMMUNITY AND PROVIDER FORUMS IN BIDMC'S CBSA TO GATHER CRITICAL COMMUNITY INPUT FROM SERVICE PROVIDERS, COMMUNITY LEADERS AND RESIDENTS FROM BIDMC'S CBSA. THESE FORUMS WERE ORGANIZED IN COLLABORATION WITH BIDMC'S COMMUNITY CARE ALLIANCE (CCA) HEALTH CENTERS TO LEVERAGE THEIR COMMUNITY CONNECTIONS AND ENSURE STRONG COMMUNITY PARTICIPATION. ONE OF THE FORUMS WAS CONDUCTED IN COLLABORATION WITH BID MILTON BECAUSE BIDMC AND BID MILTON BOTH SERVE THE TOWN OF QUINCY. THE COMMUNITY FORUMS WERE ALSO CONDUCTED IN PARTNERSHIP WITH THE CONFERENCE OF BOSTON TEACHING HOSPITALS (COBTH) UNDER THE AUSPICES OF COBTH'S COMMUNITY BENEFITS COMMITTEE. COBTH IS A COALITION OF 14 BOSTON-AREA TEACHING HOSPITALS THAT WORK COLLECTIVELY TO ENSURE QUALITY CARE, ADVOCATE FOR ADVANCES IN MEDICAL EDUCATION AND RESEARCH, AND FOSTER ECONOMIC DEVELOPMENT. QUALITATIVE DATA WERE COLLECTED FROM COMMUNITY MEMBERS THROUGH THE FOLLOWING METHODS:- KEY INFORMANT INTERVIEWS (22)- GROUP CONVERSATIONS/FOCUS GROUPS (13)- COMMUNITY MEETINGS (5)- COMMUNITY CARE ALLIANCE (6)THE COMMUNITY CARE ALLIANCE CONSISTS OF SIX HEALTH CENTERS LOCATED IN BIDMC'S CBSA. THEY INCLUDE:- BOWDOIN STREET HEALTH CENTER- CHARLES RIVER COMMUNITY HEALTH- THE DIMOCK CENTER- FENWAY HEALTH- OUTER CAPE HEALTH SERVICES- SOUTH COVER COMMUNITY HEALTHWRITTEN COMMENTS SOLICITED ON THE 2016 CHNA AND IMPLEMENTATION STRATEGYAS REQUIRED, THE 2016 CHNA AND CORRESPONDING IMPLEMENTATION STRATEGY WERE POSTED ON THE BIDMC WEBSITE AND MADE AVAILABLE IN HARD COPY. COMMUNITY MEMBERS WERE ENCOURAGED TO SHARE THEIR THOUGHTS, CONCERNS OR QUESTIONS2016 COMMUNITY HEALTH NEEDS ASSESSMENTMAJOR HEALTH NEEDS AND HOW PRIORITIES WERE DETERMINEDDURING THE DEVELOPMENT OF THE IMPLEMENTATION STRATEGY, BIDMC FIRST REVIEWED THE MASSACHUSETTS ATTORNEY GENERAL'S AND THE INTERNAL REVENUE SERVICE'S GUIDELINES. IN MASSACHUSETTS HOSPITALS ARE ENCOURAGED TO ADDRESS THE FOLLOWING STATEWIDE HEALTH PRIORITIES: SUPPORTING HEALTH CARE REFORM, REDUCING HEALTH DISPARITIES, IMPROVING CHRONIC DISEASE MANAGEMENT AND PROMOTING WELLNESS IN VULNERABLE POPULATIONS. THE INTERNAL REVENUE SERVICE GUIDELINES OUTLINE THE FOLLOWING FEDERAL PRIORITIES: IMPROVING ACCESS TO CARE, ADVANCING MEDICAL KNOWLEDGE, ENHANCING COMMUNITY HEALTH AND RELIEVING OR REDUCING GOVERNMENT BURDEN.NEXT, BIDMC CONSIDERED THE SAME PRINCIPLES THAT HAD GUIDED THE ASSESSMENT PROCESS:- COMPILE AN EXTENSIVE AMOUNT OF QUANTITATIVE AND QUALITATIVE DATA - ENGAGE AND INVOLVE KEY STAKEHOLDERS, BIDMC CLINICAL AND ADMINISTRATIVE STAFF, AND THE COMMUNITY AT-LARGE AND- DEVELOP A REPORT AND DETAILED STRATEGIC PLANFINALLY, BIDMC REVIEWED AND EVALUATED ALL CURRENT BIDMC COMMUNITY BENEFIT PROGRAMING, INCLUDING ANY RECOMMENDATIONS OF WHETHER OR NOT TO CONTINUE EACH PROGRAM.ONCE ALL OF THE ASSESSMENT'S FINDINGS WERE COMPILED, HOSPITAL AND COMMUNITY STAKEHOLDERS PARTICIPATED IN A STRATEGIC PLANNING PROCESS THAT INTEGRATED DATA FINDINGS FROM PHASES I AND II OF THE PROJECT, INCLUDING INFORMATION GATHERED FROM THE INTERVIEWS AND COMMUNITY FORUMS. PARTICIPANTS ENGAGED IN A DISCUSSION OF THE ASSESSMENT FINDINGS, CURRENT COMMUNITY BENEFITS PROGRAM ACTIVITIES AND EMERGING STRATEGIC IDEAS THAT COULD BE APPLIED TO REFINE THEIR COMMUNITY BENEFITS STRATEGIC RESPONSE. FROM THIS MEETING, COMMUNITY HEALTH PRIORITIES WERE IDENTIFIED, AS WERE TARGET POPULATIONS AND CORE STRATEGIES TO ACHIEVE HEALTH IMPROVEMENTS THE FOLLOWING QUESTIONS HELPED INFORM THE IMPLEMENTATION STRATEGY:- WHAT DO YOU SEE AS THE MOST PRESSING HEALTH AND WELLNESS ISSUES IN YOUR COMMUNITY TODAY? - WOULD YOU SAY THINGS HAVE GOTTEN BETTER, WORSE OR PRETTY MUCH THE SAME FROM A FEW YEARS AGO? - WHAT RESOURCES AND/OR SUPPORTS CURRENTLY EXIST IN YOUR COMMUNITY TO ADDRESS BARRIERS TO HEALTH AND WELLNESS FOR RESIDENTS?- WHAT IS WORKING WELL? - WHAT WOULD BE HELPFUL IN YOUR NEIGHBORHOOD TO ADDRESS THE MOST PRESSING HEALTH AND WELLNESS ISSUES AFFECTING YOUR COMMUNITY? - WHAT IS IMPORTANT FOR HOSPITALS TO KNOW SO WE CAN WORK COLLABORATIVELY WITH RESIDENTS AND LOCAL COMMUNITY ORGANIZATIONS? IN ADDITION TO ANSWERING THESE QUESTIONS COMMUNITY MEMBERS ARTICULATED:- A LACK OF TRUST AMONG SOME RESIDENTS DUE TO HISTORICAL REASONS AND CULTURAL NORMS- A NEED FOR YOUTH TO HAVE ACCESS TO PAID JOBS DURING THE SUMMER- A NEED FOR COMMUNICATION BETWEEN ORGANIZATIONS AND HOSPITALS DOING SIMILAR WORK INCLUDING RESOURCE SHARING- PROBLEMS WITH SUBSTANCE USE IN THE COMMUNITY2016 COMMUNITY HEALTH NEEDS ASSESSMENT KEY FINDINGSBIDMC'S CHNA RESULTED IN THE FOLLOWING KEY FINDINGS: SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A TREMENDOUS IMPACT ON MANY SEGMENTS OF THE POPULATION. THE DOMINANT THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS AND COMMUNITY FORUMS WAS THE CONTINUED IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH ARE HAVING ON THE CBSA'S LOW-INCOME, UNDERSERVED, DIVERSE POPULATION COHORTS. MORE SPECIFICALLY, DETERMINANTS SUCH AS POVERTY, EMPLOYMENT OPPORTUNITIES, VIOLENCE, TRANSPORTATION, RACIAL SEGREGATION, LITERACY, PROVIDER LINGUISTIC/CULTURAL COMPETENCY, SOCIAL SUPPORT, AND COMMUNITY INTEGRATION LIMIT MANY PEOPLE'S ABILITY TO CARE FOR THEIR OWN AND/OR THEIR FAMILIES' HEALTH. HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). THE ASSESSMENT'S QUANTITATIVE DATA CLEARLY SHOWS THAT MANY COMMUNITIES IN BIDMC'S CBSA HAVE HIGH RATES FOR MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). IN MANY COMMUNITIES THESE RATES ARE STATISTICALLY HIGHER THAN COMMONWEALTH RATES, INDICATING A PARTICULARLY SIGNIFICANT PROBLEM. HOWEVER, EVEN THOSE COMMUNITIES WHERE THE RATES ARE NOT STATISTICALLY HIGHER, THESE CONDITIONS ARE STILL THE LEADING CAUSES OF PREMATURE DEATH. HIGH RATES OF SUBSTANCE ABUSE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). IF THE IMPACT OF SOCIAL DETERMINANTS WAS THE LEADING FINDING, A CLOSE SECOND WAS THE PROFOUND IMPACT THAT BEHAVIORAL HEALTH ISSUES (I.E., SUBSTANCE ABUSE AND MENTAL HEALTH) ARE HAVING ON INDIVIDUALS, FAMILIES AND COMMUNITIES IN EVERY GEOGRAPHIC REGION AND EVERY POPULATION SEGMENT IN BIDMC'S CBSA. DEPRESSION/ANXIETY, SUICIDE, ALCOHOL ABUSE, OPIOID AND PRESCRIPTION DRUG ABUSE, AND MARIJUANA USE, PARTICULARLY IN YOUTH, ARE MAJOR HEALTH ISSUES AND ARE HAVING A TREMENDOUS IMPACT ON THE POPULATION AS WELL AS A BURDEN ON THE SERVICE SYSTEM. THE FACT THAT PHYSICAL AND BEHAVIORAL HEALTH ARE SO INTERTWINED COMPOUNDS THE IMPACT OF THESE ISSUES. OF PARTICULAR CONCERN ARE THE INCREASING RATES OF OPIOID ABUSE. LIMITED ACCESS TO PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, AND ORAL HEALTH CARE SERVICES FOR LOW-INCOME, MEDICAID INSURED, UNINSURED, AND OTHER VULNERABLE POPULATIONS FACING HEALTH CARE DISPARITIES AND BARRIERS TO CARE. DESPITE THE FACT THAT MASSACHUSETTS HAS ONE OF HIGHEST RATES OF HEALTH INSURANCE AND THE COMMUNITIES THAT MAKE UP BIDMC'S CBSA HAVE STRONG, ROBUST SAFETY NET SYSTEMS THERE ARE STILL SUBSTANTIAL NUMBERS OF LOW-INCOME, MEDICAID INSURED, UNINSURED, AND OTHERWISE VULNERABLE INDIVIDUALS WHO FACE HEALTH DISPARITIES AND ARE NOT ENGAGED IN ESSENTIAL MEDICAL AND ORAL HEALTH SERVICES. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE, AND IMPROVE THE QUALITY OF PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, AND ORAL HEALTH SERVICES.COMMUNITY HEALTH NEEDS ASSESSMENT MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLEBIDMC STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, BIDMC COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE BIDMC WEBSITE AT:HTTPS://WWW.BIDMC.ORG/-/MEDIA/FILES/BETH-ISRAEL-ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS/CHNA-REPORT93019FINAL.PDF IN ADDITION TO THE CHNA, BIDMC COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE BIDMC WEBSITE AT:HTTPS://WWW.BIDMC.ORG/-/MEDIA/FILES/BETH-ISRAEL-ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS/IMPLEMENTATION-STRATEGY-2020-2022.PDF IN ADDITION, AS NOTED ABOVE, BIDMC COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015. THAT CHNA IS AVAILABLE ON THE BIDMC WEBSITE AT:HTTPS://WWW.BIDMC.ORG/-/MEDIA/FILES/BETH-ISRAEL-ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS/BIDMC-2016-CHNA-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF
FINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING BIDMC'S FISCAL YEAR ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015) IS AVAILABLE ON THE BIDMC WEBSITE AT:HTTPS://WWW.BIDMC.ORG/-/MEDIA/FILES/BETH-ISRAEL-ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-IMPLEMENTATION-PLAN.PDF EACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).COMMUNITY HEALTH NEEDS ASSESSMENT ADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, BIDMC'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. THAT CHNA AND IMPLEMENTATION STRATEGY WILL INFORM THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF BIDMC FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2020, SEPTEMBER 30, 2021 AND SEPTEMBER 30, 2022. THIS FORM 990 COVERS BIDMC'S FISCAL YEAR ENDED SEPTEMBER 30, 2019. THE PREVIOUS CHNA AND ACCOMPANYING IMPLEMENTATION STRATEGY WERE APPROVED BY THE BIDMC BOARD BEFORE SEPTEMBER 30, 2016 AND INFORMED THE BIDMC'S COMMUNITY BENEFITS INITIATIVES FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2017; SEPTEMBER 30, 2018; AND SEPTEMBER 30, 2019. AS SUCH, THE ACCOMPLISHMENTS AND ACTIVITIES INCLUDED IN THIS FILING AND REPORTED BELOW RELATE TO THE DOCUMENTS APPROVED AS OF SEPTEMBER 30, 2016. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, BIDMC HAS BEEN STRATEGIC IN IDENTIFYING ITS PRIORITY AREAS IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GOALS FOR EACH PRIORITY AREA ARE LISTED BELOW.PRIORITY AREA 1: SOCIAL RISK FACTORS AND HEALTH EQUITY GOAL 1: INCREASE PHYSICAL ACTIVITY GOAL 2: PROMOTE HEALTHY EATING (NUTRITION AND FOOD ACCESS) GOAL 3: PROMOTE VIOLENCE PREVENTION (SAFE NEIGHBORHOODS AND COMMUNITY COHESION) GOAL 4: SUPPORT WORKFORCE DEVELOPMENT AND CREATION OF EMPLOYMENT OPPORTUNITIES GOAL 5: PROMOTE ENVIRONMENTAL SUSTAINABILITY GOAL 6: PROMOTE TRANSPORTATION EQUITYPRIORITY AREA 2: CHRONIC DISEASE MANAGEMENT GOAL 1: IMPROVE CHRONIC DISEASE MANAGEMENT GOAL 2: IMPROVE CARE TRANSITIONS FOR THOSE WITH CHRONIC HEALTH CONDITIONS GOAL 3: INCREASE CANCER SCREENING GOAL 4: SUPPORT CANCER PATIENTS AND CAREGIVERS GOAL 5: SUPPORT OLDER ADULTS TO AGE IN PLACEPRIORITY AREA 3: ACCESS TO CARE GOAL 1: INCREASE ACCESS TO QUALITY MEDICAL SERVICES (INC. PC, OB/GYN, & MEDICAL SPECIALTY CARE) GOAL 2: INCREASE ACCESS TO QUALITY ORAL HEALTH SERVICES GOAL 3: INCREASE QUALITY AND EFFICIENCY OF CLINICAL SERVICES AT CCA CLINICS GOAL 4: PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WITH LIMITED ENGLISH PROFICIENCYPRIORITY AREA 4: BEHAVIORAL HEALTH GOAL 1: PROMOTE BEHAVIORAL HEALTH/PRIMARY CARE INTEGRATION GOAL 2: REDUCE BURDEN OF OPIOID USE GOAL 3: INCREASE ACCESS TO QUALITY BEHAVIORAL HEALTH CARE SERVICES GOAL 4: IDENTIFY THOSE AT RISK FOR BEHAVIORAL HEALTH CONDITIONS AND PROVIDE ENHANCED CARE MANAGEMENTBIDMC HAS TAKEN A HOLISTIC AND STRATEGIC APPROACH IN ADDRESSING THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY BY CREATING, SUPPORTING AND INVESTING IN HEALTH PROGRAMMING AND INITIATIVES THROUGHOUT THEIR CBSA. BELOW IS A SUMMARY OF SOME OF THE COMMUNITY BENEFITS PROGRAMS AND INITIATIVES BIDMC OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES OF THEIR TARGET POPULATIONS THROUGHOUT THEIR PRIORITY NEIGHBORHOODS.BIDMC HAS BEEN A LEADER IN CREATING A MYRIAD OF COMMUNITY BENEFITS PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE THE BIDMC CENTER FOR VIOLENCE PREVENTION AND RECOVERY (CVPR), FITNESS IN THE CITY AT THE BOWDOIN STREET HEALTH CENTER (BSHC), JOB CREATION AND CAREER ADVANCEMENT OPPORTUNITIES THROUGH BIDMC'S OFFICE OF WORKFORCE DEVELOPMENT, DEVELOPMENT OF INSTITUTIONAL METRICS TO MEASURE BIDMC'S SHRINKING CARBON FOOTPRINT, AND TRANSPORTATION RESOURCES TO IMPROVE ACCESS TO HEALTHCARE. THROUGH CVPR, BIDMC HAS LED THE WAY IN DEVELOPING A CONTINUUM OF EDUCATION, OUTREACH, AND TREATMENT INTERVENTIONS TO RESPOND TO VICTIMS OF INTERPERSONAL, SEXUAL, COMMUNITY VIOLENCE, AND HOMICIDE BEREAVEMENT. IT IS ALSO ONE OF THE LEADERS IN DEVELOPING PROGRAMMING TO ADDRESS SECONDARY TRAUMATIC STRESS IN SERVICE PROVIDERS IN THE DOMESTIC VIOLENCE AND MEDICAL COMMUNITIES. IN FY19, BIDMC PROVIDED EMERGENCY MEDICAL CARE TO 62 SEXUAL ASSAULT SURVIVORS IN THE EMERGENCY DEPARTMENT. THE MEDICAL CENTER PROVIDED FOLLOW UP CARE TO 35 SURVIVORS IN THE INFECTIOUS DISEASE CLINIC AT A COST TO THE HOSPITAL OF APPROXIMATELY $25,000. TO FURTHER ADDRESS THE SOCIAL DETERMINANTS OF HEALTH, BIDMC IS COMMITTED TO MAKING EMPLOYMENT OPPORTUNITIES AVAILABLE TO COMMUNITY RESIDENTS AND CREATING CAREER ADVANCEMENT OPPORTUNITIES FOR BIDMC EMPLOYEES WHO ARE SEEKING ADDITIONAL SKILLS AND HIGHER INCOMES. IN FY19 BIDMC'S OFFICE OF WORKFORCE DEVELOPMENT OFFERED FIVE DIFFERENT CAREER PIPELINE PROGRAMS THAT SERVED 41 PEOPLE. ADDITIONALLY, 37 YOUTH WERE EMPLOYED IN PAID SUMMER JOBS AT BIDMC. OTHER EXAMPLES OF SUCCESS ARE LISTED IN THE SUBSEQUENT SCHEDULE H IMPLEMENTATION STRATEGY UPDATE. BIDMC IS ROOTED IN PROVIDING HEALTHCARE TO POPULATIONS WHO HAVE HISTORICALLY NOT HAD PROPER ACCESS TO CARE. BIDMC CONTINUES TO EXPAND ACCESS THROUGHOUT THEIR CBSA BY SUPPORTING AND LEADING THE COMMUNITY CARE ALLIANCE (CCA), ENSURING THAT RESIDENTS HAVE ACCESS TO QUALITY COMMUNITY HEALTH CENTERS (CHCS) SERVING NEEDS OF THE MOST VULNERABLE IN WAYS THAT ARE CULTURALLY RESPONSIVE AND ACCESSIBLE. BIDMC IS COMMITTED TO STRENGTHENING THE CAPACITY OF ITS SIX AFFILIATED CHCS INCLUDING: BOWDOIN STREET HEALTH CENTER (BSHC), THE DIMOCK HEALTH CENTER, FENWAY HEALTH, CHARLES RIVER COMMUNITY HEALTH), SOUTH COVE COMMUNITY HEALTH CENTER, AND OUTER CAPE HEALTH SERVICES. THE PARTNERSHIP TAKES MANY FORMS: RECRUITMENT, RETENTION, FINANCIAL SUPPORT AND CREDENTIALING OF PHYSICIANS AND MID-LEVEL PROVIDERS, BIDMC ADMITTING PRIVILEGES AND ACCESS TO MANAGED CARE CONTRACTS, HARVARD MEDICAL SCHOOL APPOINTMENTS AND TEACHING OPPORTUNITIES, BIDMC-SPONSORED EDUCATIONAL PROGRAMS, AND ACCESS TO UP-TO-DATE (A CLINICAL SUPPORT RESOURCE).BIDMC HAS FOCUSED ITS EFFORTS ON CREATING TARGETED PROGRAMS THAT ADDRESS CHRONIC DISEASES SUCH AS CANCER, DIABETES, AND HIV. THESE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO THE BOWDOIN STREET HEALTH CENTER'S (BSHC) DIABETES PROGRAMS, SUPPORT FOR PATIENTS WITH HIV AND HCV AT THE DIMOCK CENTER, AND CANCER PATIENT NAVIGATORS AT BIDMC. AT BSHC, THE PREVENT T2 PROGRAM, DEVELOPED BY THE CENTERS FOR DISEASE CONTROL (CDC), IS A HEALTH LITERACY AND LIFESTYLE MODIFICATION PROGRAM FOCUSED ON PREVENTING OR DELAYING AN INDIVIDUAL'S RISK OF DEVELOPING TYPE 2 DIABETES THROUGH DIETARY CHANGES, INCREASED PHYSICAL ACTIVITY AND STRESS REDUCTION. THE EVIDENCE-BASED CDC CURRICULUM CONSISTS OF 26 CLASSES OFFERED OVER THE COURSE OF ONE YEAR TO PARTICIPANTS WHO ARE AT RISK FOR DEVELOPING TYPE 2 DIABETES. RISK IS DETERMINED THROUGH BLOOD WORK AND/OR THE COMPLETION OF A RISK ASSESSMENT SURVEY. THE AIM OF THE PROGRAM IS TO HELP PARTICIPANTS LOSE 5-7% OF THEIR WEIGHT THROUGH DIET AND 150 MINUTES OF MODERATE PHYSICAL ACTIVITY PER WEEK. BSHC'S PREVENT T2 PROGRAM ALSO INCLUDES COOKING CLASSES AND GROUP EXERCISE CLASSES. DETAILS OF OTHER BIDMC PROGRAMS THAT ADDRESS CHRONIC DISEASE MANAGEMENT ARE INCLUDED IN THE IMPLEMENTATION STRATEGY UPDATE BELOW.AMONG THE MANY WAYS BIDMC AND THEIR PARTNERS ADDRESS BEHAVIORAL HEALTH NEEDS IS BY EXPANDING BEHAVIORAL HEALTH INTEGRATION AT THEIR AFFILIATED HEALTH CENTERS AS WELL AS SCREENING PATIENTS AT BIDMC AND CONNECTING THEM TO APPROPRIATE SERVICES. ONE EXAMPLE OF BIDMC'S SUCCESS IN EXPANDING BEHAVIORAL SERVICES TO NEIGHBORHOODS AND POPULATIONS THAT HAVE HISTORICALLY BEEN UNDERSERVED IS AT BSHC. BSHC CONTINUES TO INTEGRATE BEHAVIORAL HEALTH SERVICES INTO THEIR PRIMARY CARE CLINIC. A BEHAVIORAL HEALTH CARE MANAGER IS ON-SITE TO PROVIDE MENTAL HEALTH ASSESSMENT, INTERVENTION, AND CONSULTATION TO PATIENTS AND PROVIDERS DURING PRIMARY CARE VISITS. RESULTS OF THE BEHAVIORAL HEALTH INTEGRATION SHOW THAT MORE HIGH-RISK PATIENTS ARE ACCESSING MENTAL HEALTH SERVICES, AN INCREASE IN APPOINTMENTS KEPT BY PATIENTS WHO RECEIVE A "WARM-HAND OFF" BY THEIR PROVIDER TO THERAPISTS, AND REDUCED WAIT TIME FOR MENTAL HEALTH APPOINTMENTS. IN CONTINUATION OF BSHC'S QUALITY IMPROVEMENT AND PROGRAM EVALUATION WORK IN FY17 AND FY18, THE HEALTH CENTER APPLIED FOR AND RECEIVED GRANT FUNDING FROM THE MASSACHUSETTS LEAGUE OF COMMUNITY HEALTH CENTERS/MASSHEALTH TO PILOT AN EVIDENCE-BASED TREATMENT APPROACH ACROSS THE SOCIAL WORK TEAM. IN FY19 BSHC CONTINUED ITS SOLUTIONS-FOCUSED BRIEF THERAPY (SFBT) PILOT THAT SOUGHT TO FULFILL A NUMBER OF IDENTIFIED NEEDS FOR BSHC PATIENTS AND CLINICIANS ON THE BEHAVIORAL HEALTH TEAM. A FULL UPDATE ON BIDMC'S FOUR HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED IN THE FINAL YEAR IMPLEMENTATION STRATEGY UPDATE BELOW.
FY19 SCHEDULE H IMPLEMENTATION STRATEGY UPDATE KEY: BASELINE-2017, YEAR 1-2018, YEAR 2-2019 PRIORITY AREA 1: SOCIAL DETERMINANTS AND HEALTH RISK FACTORS SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A TREMENDOUS IMPACT ON MANY SEGMENTS OF THE POPULATION. THE DOMINANT THEME FROM BIDMC'S KEY INFORMANT INTERVIEWS AND COMMUNITY FORUMS WAS THE CONTINUED IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH ARE HAVING ON THE COMMUNITY BENEFITS SERVICE AREA'S LOW-INCOME, UNDERSERVED, DIVERSE POPULATION COHORTS. MORE SPECIFICALLY, DETERMINANTS SUCH AS POVERTY, EMPLOYMENT OPPORTUNITIES, VIOLENCE, TRANSPORTATION, RACIAL SEGREGATION, LITERACY, PROVIDER LINGUISTIC/CULTURAL COMPETENCY, SOCIAL SUPPORT AND COMMUNITY INTEGRATION LIMIT MANY PEOPLE'S ABILITY TO CARE FOR THEIR OWN AND/OR THEIR FAMILIES' HEALTH. LARGE PROPORTIONS OF INDIVIDUALS RESIDING WITHIN BOSTON AND BIDMC'S COMMUNITY BENEFITS SERVICE AREA LIVE IN POVERTY, HAVE LIMITED FORMAL EDUCATION, ARE UNEMPLOYED, AND STRUGGLE TO AFFORD FOOD AND OTHER ESSENTIAL HOUSEHOLD ITEMS. IT IS CRITICAL TO NOTE THAT THERE IS A MULTITUDE OF INDIVIDUAL, COMMUNITY AND SOCIETAL FACTORS THAT WORK TOGETHER TO CREATE THESE INEQUITIES. IT IS INSUFFICIENT TO TALK SOLELY ABOUT RACE/ETHNICITY, IMMIGRATION STATUS, OR LANGUAGE; AS THE UNDERLYING AND CORRELATIVE ISSUES RELATED TO HEALTH AND WELL-BEING INVOLVE ECONOMIC OPPORTUNITY, EDUCATION, CRIME AND COMMUNITY COHESION. KEY: BASELINE-2017, YEAR 1-2018, YEAR 2-2019GOAL: INCREASE PHYSICAL ACTIVITY AND HEALTHY EATINGTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 1.1 INCREASE THE NUMBER OF CHILDREN, YOUTH, AND ADULTS WHO ARE PHYSICALLY ACTIVE1.2 IMPLEMENT PROGRAMS AT BOWDOIN STREET WELLNESS CENTER (BSHC) TO IMPROVE PHYSICAL HEALTH1.3 INCREASE ACCESS TO HEALTHY AND AFFORDABLE FOODS IN THE COMMUNITY1.4 IMPROVE NUTRITIONAL QUALITY OF THE FOOD SUPPLY1.5 DECREASE THE NUMBER OF INDIVIDUALS AND FAMILIES WHO FACE FOOD INSECURITY COMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT AND PROMOTE THE DEVELOPMENT OF WALKING AND OTHER PHYSICAL ACTIVITY GROUPS IN SCHOOLS, COMMUNITY-BASED AND PRIMARY CARE-BASED SETTINGS (E.G., BOWDOIN STREET WELLNESS CENTER)- SUPPORT AND COLLABORATE WITH BPHC AND COMMUNITY-BASED ORGANIZATIONS (E.G., GBFB, CRCH, BSHC, ETC.) TO PROMOTE ACCESSIBLE/AFFORDABLE HEALTHY FOOD INCLUDING HEALTHY INCENTIVES PROGRAM, FARMERS MARKETS, AND COMMUNITY SUPPORTED AGRICULTURE (CSA) PROGRAM- INCREASE ACCESS TO HEALTHY FOOD CHOICES AVAILABLE AT BIDMC FOR PATIENTS AND STAFF- SUPPORT HEALTHY CHAMPIONS, A GROUP OF TEENAGERS IN HEALTHY COOKING AND EDUCATION WORKSHOPS AT BSHCMETRICS AND STATUS UPDATE:- NUMBER OF SCHOOLS, COMMUNITY GROUPS, AND PRIMARY CARE SETTINGS PARTICIPATING IN WALKING PROGRAMS AND OTHER PHYSICAL ACTIVITY GROUPS (FY17: 44 PUBLIC SCHOOLS WITH 7,175 CHILDREN AND 1,000 SCHOOL STAFF; FY18: 46 PUBLIC SCHOOLS AND 17 AFTER SCHOOL PROGRAMS WITH 4,335 CHILDREN AND 1,000 SCHOOL STAFF; FY19: 28 PUBLIC SCHOOLS AND 13 AFTER SCHOOL PROGRAMS WITH 3,545 CHILDREN AND 226 SCHOOL STAFF)- NUMBER OF FAMILIES PARTICIPATING IN CSA (FY17: 30 FAMILIES; FY18: 23 FAMILIES; FY19: 30 FAMILIES)- PERCENTAGE OF BIDMC TOTAL FOOD AND BEVERAGE SPENT ON LOCAL PRODUCTS (FY18: 4.5%; FY19: 11.2%)- PERCENTAGE OF BIDMC TOTAL BEVERAGE SPENT ON HEALTHY BEVERAGES (FY18: 43.6%; FY19: 61.9%)- NUMBER OF HOSTED HEALTHY CHAMPIONS (FY17: 15 HEALTHY CHAMPIONS; FY 18: 15 HEALTHY CHAMPIONS; FY19: 16 HEALTHY CHAMPIONS)- NUMBER OF CHILDREN SEEN AT AFFILIATED HEALTH CENTERS THAT WERE SCREENED FOR BMI (FY17: 7,650 (75%); FY18: 10,245 CHILDREN (65%); FY19: 7,102 (69%))- NUMBER OF CHILDREN ENROLLED IN FITNESS IN THE CITY (FY18: 43 CHILDREN; FY19: 100 CHILDREN)- NUMBER OF UNDUPLICATED INDIVIDUALS WHO ACCESSED THE MOBILE MARKET AT CRCH (FY18: 445; FY19: 488)COMMUNITY PARTNERS: COMMUNITY CARE ALLIANCE, BOSTON PUBLIC HEALTH COMMISSION, BOWDOIN STREET HEALTH CENTER, BOSTON PUBLIC SCHOOLS, DAILY TABLE, CHARLES RIVER COMMUNITY HEALTH, MAYOR'S OFFICE OF FOOD INITIATIVES, TUFTS UNIVERSITYGOAL: PROMOTE VIOLENCE PREVENTION (SAFE NEIGHBORHOODS AND COMMUNITY COHESION)TARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 2.1 INCREASE ACCESS TO MENTAL HEALTH SERVICES AT BSHC FOR AFFECTED VICTIMS2.2 MAINTAIN PARTICIPATION IN ADVOCATE EDUCATION AND SUPPORT PROJECT2.3 PROVIDE COUNSELING AND OTHER MEDICAL SERVICES TO SEXUAL ASSAULT VICTIMS2.4 PROVIDE GRIEVING SUPPORT ACTIVITIES2.5 CONDUCT NEIGHBORHOOD CAMPAIGNS TO ENGAGE COMMUNITY AND CREATE GREATER COMMUNITY COHESIONCOMMUNITY ACTIVITIES/STRATEGIES: - SUPPORT PROGRAMS AT BSHC THAT INTEGRATE SERVICES PROVIDED BY BEHAVIORAL HEALTH SPECIALISTS AND MONITOR, ASSESS, AND TREAT THOSE EXPERIENCING TRAUMA AS A RESULT OF VIOLENCE- HOLD HEALING SERVICES WHEN APPROPRIATE FOR COMMUNITY RESIDENTS- PARTICIPATE IN COMMUNITY INTERVENTIONS THAT RAISE AWARENESS ABOUT VIOLENCE, BY ENGAGING THE COMMUNITY, ADDRESSING FACTORS ASSOCIATED WITH VIOLENCE (E.G., BLOCK CAPTAINS PROGRAM, ETC.) AND PROMOTING A SENSE OF COMMUNITY- SUPPORT AND PROMOTE THE IMPLEMENTATION OF TRAINING PROGRAMS, SUPPORT GROUPS FOR ADVOCATES AND AFFECTED COMMUNITY MEMBERS- PROVIDE OVERNIGHT STAYS FOR DOMESTIC VIOLENCE AND/OR SEXUAL ASSAULT VICTIMS WITHOUT SAFE SHELTER- CONDUCT PUBLIC POLICY ADVOCACY FOR SAFE SHELTERS AND LONG-TERM HOUSING SUPPORT- EMPOWER YOUTH TO DEVELOP LEADERSHIP SKILLS, PREVENT VIOLENCE AND CREATE CHANGE IN THEIR COMMUNITY THROUGH THE YOUTH LEADERSHIP PROGRAM AT BSHCMETRICS AND STATUS UPDATE: - NUMBER OF SEXUAL ASSAULT VICTIMS RECEIVING SERVICES (FY17: PROVIDED SERVICES, INCLUDING COUNSELING FOR 75 SEXUAL ASSAULT VICTIMS. PROVIDED POST-HIV EXPOSURE PROPHYLAXIS MEDICATIONS TO 49 SEXUAL ASSAULT VICTIMS; FY18: PROVIDED SERVICES, INCLUDING COUNSELING FOR 64 SEXUAL ASSAULT VICTIMS. PROVIDED POST-HIV EXPOSURE PROPHYLAXIS MEDICATIONS TO 35 SEXUAL ASSAULT VICTIMS; FY19: PROVIDED SERVICES, INCLUDING COUNSELING FOR 62 SEXUAL ASSAULT VICTIMS. PROVIDED POST-HIV EXPOSURE PROPHYLAXIS MEDICATIONS TO 35 SEXUAL ASSAULT VICTIMS)- NUMBER OF SAFE BED OVERNIGHT STAYS (FY17: 59; FY18: 33; FY19: 50)- NUMBER OF HEALING CIRCLES HELD WITH WOMEN, MEN, AND CHILDREN (FY17: 57; FY18: 58; FY19: 73)- NUMBER OF BOWDOIN/GENEVA YOUTH PARTICIPATING IN THE BSHC YOUTH LEADERSHIP PROGRAM (FY17: 25; FY18: 22; FY19: 22)- PERCENTAGE OF YOUTH IN BSHC YOUTH LEADERSHIP PROGRAM WHO HAD A POSITIVE INCREASE ON A KNOWLEDGE AND ATTITUDE TEST BEFORE AND AFTER THE PROGRAM (FY18: DATA NOT AVAILABLE; FY19: 50%) COMMUNITY PARTNERS: BOWDOIN STREET HEALTH CENTER (BSHC), BOSTON AREA RAPE CRISIS CENTER, BOSTON PUBLIC HEALTH COMMISSION, LOUISE D. BROWN PEACE INSTITUTE, OTHER BOWDOIN/GENEVA NEIGHBORHOOD ORGANIZATIONSGOAL: SUPPORT WORKFORCE DEVELOPMENT AND CREATION OF EMPLOYMENT OPPORTUNITIESTARGET POPULATION: YOUTH, YOUNG ADULTS, ADULTS, BIDMC EMPLOYEESPROGRAMMATIC OBJECTIVES: 3.1 ORGANIZE AND SUPPORT PIPELINE PROGRAMS TO ENHANCE SKILLS AND CAREER ADVANCEMENT 3.2 PROVIDE OPPORTUNITIES THROUGH EMPLOYEE CAREER INITIATIVE (ECI) FOR COLLEGE-LEVEL COURSES AS WELL AS COUNSELING 3.3 OFFER ESOL CLASSES, GED CLASSES, A BASIC COMPUTER SKILLS COURSE, CITIZENSHIP CLASSES, AND A FINANCIAL LITERACY CLASS 3.4 PROVIDE JOB AND CAREER INTRODUCTORY OPPORTUNITIES FOR COMMUNITY RESIDENTS3.5 PROVIDE JOB AND CAREER INTRODUCTORY OPPORTUNITIES FOR MIDDLE AND HIGH SCHOOL STUDENTS3.6 CONTINUE TRAIN4CHANGE AT BSHC3.7 IMPLEMENT AND EXPAND LEARN AND EARN PROGRAM THROUGH BUNKER HILL COMMUNITY COLLEGECOMMUNITY ACTIVITIES/STRATEGIES: - ORGANIZE AND SUPPORT PIPELINE PROGRAMS TO ENHANCE SKILLS AND CAREER ADVANCEMENT - PROVIDE OPPORTUNITIES THROUGH EMPLOYEE CAREER INITIATIVE (ECI) FOR COLLEGE-LEVEL COURSES AS WELL AS COUNSELING - OFFER ESOL CLASSES, GED CLASSES, A BASIC COMPUTER SKILLS COURSE, CITIZENSHIP CLASSES, AND A FINANCIAL LITERACY CLASS - PROVIDE JOB AND CAREER INTRODUCTORY OPPORTUNITIES FOR COMMUNITY RESIDENTS- PROVIDE JOB AND CAREER INTRODUCTORY OPPORTUNITIES FOR MIDDLE AND HIGH SCHOOL STUDENTS- CONTINUE TRAIN4CHANGE AT BSHC- IMPLEMENT AND EXPAND LEARN AND EARN PROGRAM THROUGH BUNKER HILL COMMUNITY COLLEGEMETRICS AND STATUS UPDATE: - NUMBER OF PIPELINE PROGRAMS OFFERED (FY17: 4; FY18: 6; FY19: 5)- NUMBER OF PARTICIPANTS IN PIPELINE PROGRAM (FY17: 31; FY18: 36; FY19: 41)- NUMBER OF PARTICIPANTS GRADUATED FROM PIPELINE PROGRAMS (FY17: 21; FY18: 25; FY19: 29)- NUMBER OF EMPLOYEES RECEIVING ECI SERVICES (FY17: 707; FY18: 651; FY19: 723)
NUMBER OF EMPLOYEES ENROLLED IN ESOL CLASSES (FY17: 19; FY18: 30; FY19: 31) - NUMBER OF EMPLOYEES PARTICIPATING IN COMPUTER SKILLS, CITIZENSHIP, AND FINANCIAL LITERACY CLASSES (FY17: 107 EMPLOYEES PARTICIPATED IN A 10-WEEK COMPUTER SKILLS CLASS, 11 ATTENDED CITIZENSHIP CLASSES, AND 123 ATTENDED A FINANCIAL LITERACY CLASS; FY18: 98 EMPLOYEES PARTICIPATED IN COMPUTER SKILLS CLASSES (NOT 10 WEEKS), 12 IN CITIZENSHIP CLASSES, 20 IN FINANCIAL LITERACY PROGRAM; FY19: 136 EMPLOYEES ATTENDED COMPUTER SKILLS CLASS, 20 ATTENDED CITIZENSHIP CLASS, 18 WENT THROUGH OUR FINANCIAL FITNESS PROGRAM THAT INCLUDED 1:1 ADVISING, AND 91 ATTENDED A FINANCIAL FITNESS WORKSHOP)- NUMBER OF ADULT INTERNS PLACED (FY17: 8; FY18: 8; FY19: 13)- NUMBER OF ADULT INTERNS HIRED AFTER INTERNSHIPS (FY17: 3; FY18: 1; FY19: 5)- NUMBER OF REFERRALS/RECOMMENDATIONS BY COMMUNITY PARTNERS FOR BIDMC TO HIRE (FY17: 81; FY18: 38; FY19: 52 REFERRED)- NUMBER OF PARTICIPANTS IN BSHC'S TRAIN4CHANGE (FY17: 4; FY18: 4; FY19: 4)- NUMBER OF INTERNS HIRED FROM BUNKER HILL COMMUNITY COLLEGE'S LEARN AND EARN PROGRAM (FY17: 1; FY18: 2; FY19: 1)- NUMBER OF SUMMER JOB OPPORTUNITIES PROVIDED (FY17: 41; FY18: 43; FY19: 37)- NUMBER OF SCHOOL INTERNS HOSTED (FY17: 3; FY18: 3; FY19: 4) NUMBER OF BOSTON PUBLIC SCHOOL STUDENTS HOSTED FOR BOSTON'S PRIVATE INDUSTRY COUNCIL ANNUAL JOB SHADOW DAY (FY17: 31; FY18: 31; FY19: 23)- NUMBER OF MEDICAL CHAMPIONS MENTORED (FY17: 10; FY18: 12; FY19: 12)- NUMBER OF HIGH SCHOOL STUDENTS HOSTED IN SUMMER HEALTH CORPS PROGRAM (FY17: 41; FY18: 42; FY19: 40)COMMUNITY PARTNERS: BOSTON PUBLIC SCHOOLS, BOSTON PRIVATE INDUSTRY COUNCIL (PIC), BOWDOIN STREET HEALTH CENTER, BUNKER HILL COMMUNITY COLLEGE, JEWISH VOCATIONAL SERVICES (JVS), ONE-STOP CAREER CENTER, ST. MARY'S CENTER FOR WOMEN AND CHILDRENGOAL: PROMOTE ENVIRONMENTAL SUSTAINABILITYTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 1.1 REDUCE ENERGY AND WATER CONSUMPTIONCOMMUNITY ACTIVITIES/STRATEGIES: - IMPLEMENT ENVIRONMENTAL STRATEGIC PLAN- PROMOTE RECYCLING, COMPOSTING, AND CONSERVATION OF WATER AND ENERGY THROUGHOUT BIDMC- REDUCE GREENHOUSE GAS EMISSIONS AND INCREASE DIVERSION RATE AT BIDMCMETRICS AND STATUS UPDATE: - GREEN CHEMICAL CLEANING PRODUCT SPEND AT BIDMC (GOAL: 50% SPEND BY 2019; FY19: 34%) - GREENHOUSE GAS (GOAL: REDUCE EMISSIONS BY 25% BY 2020; FY19: REDUCED EMISSIONS BY 12% SINCE CY14)- DIVERSION RATE (FY18: 44.6%; FY19: 42.4%) COMMUNITY PARTNERS: MASCO, HEALTH CARE WITHOUT HARM, PRACTICE GREEN HEALTH, EPA, BOSTON GREEN RIBBON COMMISSION, BIDMC ENVIRONMENTAL SUSTAINABILITY COMMITTEEGOAL: PROMOTE TRANSPORTATION EQUITY TARGET POPULATION: YOUTH, ADULTS, BIDMC EMPLOYEESPROGRAMMATIC OBJECTIVES:5.1 PROMOTE TRANSPORTATION EQUITY FOR EMPLOYEES AND PATIENTS AT BIDMC COMMUNITY ACTIVITIES/STRATEGIES: - GREEN COMMUTING AT BIDMC - PARTICIPATE IN REGIONAL TRANSPORTATION PLANNING AND/OR MAINTAIN MEMBERSHIP IN TRANSPORTATION MANAGEMENT ASSOCIATION- PROVIDE BIKE RACKS, BIKE PATHS, WALKWAYS AND SHOWER FACILITIES FOR ALTERNATIVE COMMUTERS- INSTALL ELECTRIC VEHICLE CHARGING STATIONS- PROVIDE OR OUTSOURCE SHUTTLE/VANPOOL, CARPOOL OR RIDE-SHARING SERVICES- OFFER TELEWORK, COMPRESSED WORK SCHEDULES TO REDUCE EMPLOYEE COMMUTING- PROVIDE VOUCHERS OR SUBSIDIES FOR PUBLIC TRANSIT AND RIDE-AND-BIKE-SHARING SERVICES- PROVIDE PREFERRED PARKING FOR CARPOOL PARTICIPANTS AND LOW-EMISSION, FUEL-EFFICIENT VEHICLES- REDUCE TRANSPORTATION BARRIERS RELATED TO ACCESSING CARE - KIT CLARK SENIOR SERVICES- MAYOR'S CANCER RIDE PROGRAMMETRICS AND STATUS UPDATE: - NUMBER OF EMPLOYEES COMMUTING TO WORK VIA PUBLIC TRANSPORT, CAR, BIKE, WALKING, OTHER (FY18: DATA NOT AVAILABLE; FY19: 6,238 EMPLOYEES)- NUMBER OF TAXI OR CHAIR CAR VOUCHERS PROVIDED TO PATIENTS BY BIDMC (1,671 TAXI RIDES PROVIDED IN FY18; FY19: 1,951)PRIORITY AREA 2: CHRONIC DISEASE MANAGEMENTHIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). THE ASSESSMENT'S QUANTITATIVE DATA SHOWS THAT MANY COMMUNITIES IN BIDMC'S CBSA HAVE HIGH RATES FOR MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). IN MANY COMMUNITIES THESE RATES ARE STATISTICALLY HIGHER THAN COMMONWEALTH RATES, INDICATING A PARTICULARLY SIGNIFICANT PROBLEM. HOWEVER, EVEN FOR THOSE COMMUNITIES WHERE THE RATES ARE NOT STATISTICALLY HIGHER, THESE CONDITIONS ARE STILL THE LEADING CAUSES OF PREMATURE DEATH. LIMITED ACCESS TO CANCER SCREENING FOR RACIAL/ETHNIC DIVERSITY AND OTHER AT-RISK POPULATIONS. MANY OF THE COMMUNITIES THAT ARE PART OF BIDMC'S CBSA HAVE HIGH CANCER MORTALITY RATES. THIS IS PARTICULARLY TRUE FOR CERTAIN CANCERS IN SPECIFIC COMMUNITIES IN BOSTON NEIGHBORHOODS SUCH AS ROXBURY, DORCHESTER, AND SOUTH END/CHINATOWN. AT THE ROOT OF ADDRESSING HIGH MORTALITY IS SCREENING, EARLY DETECTION, AND ACCESS TO TIMELY TREATMENT. HIGH RATES OF HIV/AIDS PARTICULARLY ON THE OUTER PORTION OF CAPE COD AND IN A NUMBER OF BOSTON NEIGHBORHOODS THAT ARE PART OF BIDMC'S CBSA. GREAT STRIDES HAVE BEEN MADE IN CONTROLLING AND MANAGING HIV/AIDS, AND FOR MANY IT IS MANAGED AS A CHRONIC CONDITION WITH MEDICATIONS. RATES OF ILLNESS, DEATH, AND HIV TRANSMISSION DECLINED OVERALL IN THE PAST DECADE. HOWEVER, HIV/AIDS STILL HAS A MAJOR IMPACT ON CERTAIN SEGMENTS OF THE POPULATION, INCLUDING MEN WHO HAVE SEX WITH MEN AND INJECTION DRUG USERS. IN BIDMC'S CBSA, RATES OF HIV/AIDS ARE PARTICULARLY HIGH IN THE OUTER PORTION OF CAPE COD AND IN A NUMBER OF BOSTON'S NEIGHBORHOODS.GOAL: IMPROVE CHRONIC DISEASE MANAGEMENT TARGET POPULATION: LOW-INCOME ADULTSPROGRAMMATIC OBJECTIVES: 1.1 INCREASE THE NUMBER OF ADULTS WHO RECEIVE EDUCATION AND COUNSELING REGARDING RISK FACTORS AND HEALTHY BEHAVIORS TO INCREASE CHRONIC DISEASE HEALTH LITERACY1.2 INCREASE THE NUMBER OF ADULTS SCREENED FOR DIABETES, HYPERTENSION, HIV/AIDS, AND ASTHMA 1.3 INCREASE THE NUMBER OF ADULTS WITH DIABETES, HYPERTENSION, HIV/AIDS, AND PERSISTENT ASTHMA WHO RECEIVE EVIDENCE-BASED COUNSELING/COACHING AND TREATMENT1.4 INCREASE THE NUMBER OF ADULTS WITH DIABETES, HYPERTENSION, HIV/AIDS, AND PERSISTENT ASTHMA WHOSE CONDITIONS ARE MONITORED AND CONTROLLEDCOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT PROGRAMS IN CCA HEALTH CENTERS INCLUDING LIVE AND LEARN DIABETES AT CRCH THAT EDUCATE AND SCREEN PATIENTS FOR DIABETES, HYPERTENSION, AND PERSISTENT ASTHMA- PROVIDE EVIDENCED-BASED COUNSELING/COACHING AND TREATMENT, AS WELL AS APPROPRIATE REFERRALS FOR SPECIALTY CARE SERVICES FOR PATIENTS WHO SCREEN POSITIVE FOR DIABETES, HYPERTENSION, HIV/AIDS, AND ASTHMA- PROVIDE SCREENING, EDUCATION/COUNSELING, AND TREATMENT SERVICES HIV/AIDS AND HIV/HCV CO-INFECTION- OFFER SUPPORT GROUPS FOR MEN AND WOMEN LIVING WITH HIV/AIDS- SUPPORT PRIMARY CARE PROVIDER EDUCATION AT CRCH IN THE AREA OF DIABETES MANAGEMENTMETRICS AND STATUS UPDATE:- NUMBER OF HIV/AIDS PATIENTS EDUCATED/COUNSELED, AND TREATED FOR HIV (FY17: 2,577; FY18: 2,705; FY19: 2,811)- PERCENTAGE OF HIV POSITIVE PATIENTS SCREENED FOR HCV (FY17: 99%; FY 18: 98%: FY19: 98%)- NUMBER OF BSHC PATIENTS PARTICIPATING IN DISEASE MANAGEMENT PROGRAMS (FY17: 900; FY18: 1,015; FY19: 1,015)- PERCENTAGE OF CCA FQHC PATIENTS WITH DIABETES WITH HBA1C < 9 (FY17: 79%; FY18: 70%; FY19: 78%)- PERCENTAGE OF CCA FQHC PATIENTS WITH HYPERTENSION WHO HAD A BLOOD PRESSURE < 140/90 (FY17: 62.4%; FY18: 65.5%; FY19: 63%)- PERCENTAGE OF CCA FQHC PERSISTENT ASTHMATIC PATIENTS WITH PHARMACOLOGICAL THERAPY (FY17: 86%; FY18: 94.7%; FY19: 86%)- NUMBER OF GROUPS CONVENED FOR HIV/AIDS SUPPORT GROUPS (FY17 AND FY18: CONTINUED EXPERIENCED AND POSITIVE GROUP FOR GAY MEN WHO HAVE ADVANCED AIDS - 22 SESSIONS; 2 HOURS PER SESSION; 9 (FY17) AND 8 (FY18) PARTICIPANTS AND SUPPORT GROUP FOR HIV+ WOMEN - 22 SESSIONS; 2 HOURS PER SESSION; 8 PARTICIPANTS; FY19: 25 SESSIONS FOR MEN, 2 HOURS PER SESSION, 8 MEN PER GROUP AND 25 SESSIONS FOR WOMEN, 2 HOURS PER SESSION, 9 WOMEN PER GROUP)- IMPROVE CARE MANAGEMENT FOR BSHC PATIENTS WITH CHRONIC DISEASE- BSHC PATIENTS THAT HAD AT LEAST ONE HBA1C TEST (FY17: 87.5%; FY18: 83.9%; FY19: 83.4%)- BSHC PATIENTS THAT HAD AT LEAST ONE LDL TEST (FY17: 56%; FY18: 66%; FY19: 50.2%)- BSHC PATIENTS THAT HAD AT LEAST ONE EYE EXAM (FY17: 38.9%; FY18: 50.2%; FY19: 43.6%)COMMUNITY PARTNERS: CCA HEALTH CENTERS, JOSLIN DIABETES CENTER GOAL: IMPROVE CARE TRANSITIONS FOR THOSE WITH CHRONIC HEALTH CONDITIONSTARGET POPULATION: ELDER ADULTS, LOW-INCOME ADULTS PROGRAMMATIC OBJECTIVES: 2.1 IMPROVE CARE TRANSITIONS FROM THE INPATIENT HOSPITAL SETTING TO OTHER CARE SETTINGS, TO IMPROVE QUALITY OF CARE AND TO REDUCE READMISSIONS FOR HIGH-RISK PATIENTS COMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT PREVENTABLE ADMISSIONS CARE TEAM (PACT) PROGRAM METRICS AND STATUS UPDATE: - NUMBER OF HEALTH CENTER PATIENTS ENROLLED IN PACT PROGRAM (DATA NOT AVAILABLE)- NUMBER OF MEDICAID PATIENTS ENROLLED IN PACT PROGRAM (DATA NOT AVAILABLE)
COMMUNITY PARTNERS: CCA HEALTH CENTERS GOAL: INCREASE CANCER SCREENING AND SUPPORT CANCER PATIENTS/CAREGIVERSTARGET POPULATION: LOW-INCOME AND RACIAL/ETHNIC DIVERSE ADULTS PROGRAMMATIC OBJECTIVES: 3.1 INCREASE THE NUMBER OF LOW-INCOME AND RACIAL/ETHNIC DIVERSE ADULTS EDUCATED AND SCREENED FOR CANCER3.2 INCREASE THE NUMBER OF ADULTS WHO SCREEN POSITIVE FOR CANCER WHO ARE REFERRED FOR EDUCATION, COUNSELING AND TREATMENT3.3 INCREASE THE NUMBER OF ADULTS WHO SCREEN POSITIVE FOR CANCER WHO ARE LINKED TO A CANCER NAVIGATORCOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT ACCESS TO BREAST, PROSTATE, COLON, AND LUNG CANCER SCREENING AND TREATMENT FOR LOW-INCOME, UNINSURED ADULTS, INCLUDING MAMMOGRAMS, COLORECTAL SCREENING, AND LUNG CT SCANS - SUPPORT AND PROMOTE THE CITY-WIDE CANCER NAVIGATORS PROGRAM- LINK PATIENTS WHO SCREENED POSITIVE FOR CANCER TO CANCER PATIENT NAVIGATORS- SUPPORT SURVIVOR SELF-PORTRAIT AND TESTIMONIES ACTIVITIES TO REDUCE STIGMA IN COMMUNITIES- PROVIDE EMOTIONAL CANCER PEER SUPPORT PROGRAMS SUCH AS THE PATIENT-TO-PATIENT AND HEART-TO-HEART PROGRAM- COLLABORATE WITH THE HARVARD CATALYST TO TRANSLATE RESEARCH INTO PRACTICEMETRICS AND STATUS UPDATE: - INCREASE ACCESS TO PATIENT NAVIGATORS- NUMBER OF PATIENTS SERVED BY CHINESE PATIENT NAVIGATOR (FY17: 469; FY18: 495; FY19: 492)- NUMBER OF ENCOUNTERS PROVIDED BY CHINESE PATIENT NAVIGATOR (FY17: 2,279; FY18: 2,350; FY19: 2,579)- NUMBER OF PATIENTS SERVED BY LATINA PATIENT NAVIGATOR (FY17: 231; FY18 PROGRAM ENDED; FY19: NEW STAFF HIRED)- NUMBER OF ENCOUNTERS PROVIDED BY LATINA PATIENT NAVIGATOR (FY17: 395; FY18: PROGRAM ENDED; FY19: NEW STAFF HIRED)- NUMBER OF PATIENT NAVIGATORS PARTICIPATING IN QUARTERLY NETWORK MEETINGS (FY17: 21; FY18: 24; FY19: 25)- NUMBER OF MAMMOGRAMS PROVIDED FOR LOW-INCOME PATIENTS IN FENWAY, OUTER CAPE, AND SOUTH COVE (FY17: 6,368; FY18: 5,322; FY19: 5,904)- NUMBER OF COLON CANCER SCREENINGS PROVIDED FOR LOW-INCOME PATIENTS (FY17: 1,492; FY18: 1,896; FY19: 1,784)- NUMBER OF PATIENTS SCREENED FOR LUNG CANCER (FY17: 704; FY18: 972; FY19: 1,695)- NUMBER OF PATIENTS PARTICIPATING IN CANCER PEER SUPPORT PROGRAMS (FY17: 172; FY18: DATA NOT AVAILABLE; FY19: 56)COMMUNITY PARTNERS: CCA HEALTH CENTERS, CANCER NAVIGATOR PROGRAM, DANA FARBER HARVARD CANCER CENTER (DFHCC)GOAL: SUPPORT OLDER ADULTS TO AGE IN PLACE TARGET POPULATION: OLDER ADULTS PROGRAMMATIC OBJECTIVES: 4.1 REDUCE INAPPROPRIATE READMISSIONS FOR OLDER ADULTS4.2 REDUCE ELDERLY FALLS4.3 REDUCE SOCIAL ISOLATIONCOMMUNITY ACTIVITIES/STRATEGIES:- INCREASE STRENGTH AND REDUCE THE RISK OF FALLS- OFFER HEALTH AND WELLNESS PROGRAMMING - OTHER PROGRAMS WITH HSLMETRICS AND STATUS UPDATE: - NUMBER OF ADULTS ENROLLED IN TAI CHI CLASSES AT BSHC (FY17: 29 PARTICIPANTS; FY18: 104 TAI CHI CLASSES HELD; FY19: TAI CHI CLASSES HAVE BEEN ROLLED INTO A SUITE OF PROGRAMS AT THE BSHC WELLNESS CENTER)COMMUNITY PARTNERS: BIDMC STAFF AND CLINICIANS, KIT CLARK SENIOR SERVICES, CCA HEALTH CENTERS, OTHER COMMUNITY PROVIDERS, HEBREW SENIOR LIFEPRIORITY AREA 3: ACCESS TO CARELIMITED ACCESS TO PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, AND ORAL HEALTH CARE SERVICES FOR LOW-INCOME, MEDICAID INSURED, UNINSURED, AND OTHER VULNERABLE POPULATIONS FACING HEALTH CARE DISPARITIES AND BARRIERS TO CARE. DESPITE THE FACT THAT MASSACHUSETTS HAS ONE OF HIGHEST RATES OF HEALTH INSURANCE AND THE COMMUNITIES THAT MAKE UP BIDMC'S CBSA HAVE STRONG, ROBUST SAFETY NET SYSTEMS, THERE ARE STILL SUBSTANTIAL NUMBERS OF LOW-INCOME, MEDICAID INSURED, UNINSURED, AND OTHERWISE VULNERABLE INDIVIDUALS WHO FACE HEALTH DISPARITIES AND ARE NOT ENGAGED IN ESSENTIAL MEDICAL AND ORAL HEALTH SERVICES. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE, AND IMPROVE THE QUALITY OF PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, AND ORAL HEALTH SERVICES.BARRIERS TO ACCESS AND DISPARITIES IN HEALTH OUTCOMES CONTINUE TO CHALLENGE THREE SPECIAL POPULATIONS (INFANTS/MOTHERS/FATHERS, FRAIL OLDER ADULTS, AND LESBIAN, GAY, BI-SEXUAL, AND TRANSGENDER (LGBT) POPULATIONS. BASED ON INFORMATION GATHERED PRIMARILY FROM INTERVIEWS AND COMMUNITY FORUMS, THE ASSESSMENT IDENTIFIED A NUMBER OF SPECIAL POPULATIONS THAT FACE BARRIERS TO CARE AND DISPARITIES IN ACCESS. MORE SPECIFICALLY, INFANTS/MOTHERS/FATHERS, FRAIL OLDER ADULTS, AND THE LESBIAN, GAY, BI-SEXUAL, AND TRANSGENDER (LGBT) POPULATIONS FACE DISPARITIES IN ACCESS AND OUTCOME AND ARE PARTICULARLY AT-RISK. IF THESE DISPARITIES ARE GOING TO BE ADDRESSED, THEN CARE NEEDS TO BE TAKEN TO TAILOR IDENTIFICATION/SCREENING AND PREVENTIVE SERVICES AS WELL AS ACUTE AND CHRONIC DISEASE MANAGEMENT SERVICES FOR THESE SPECIAL POPULATIONS. GOAL: INCREASE ACCESS TO QUALITY MEDICAL SERVICES, INCLUDING PRIMARY CARE, OB/GYN, AND SPECIALTY CARE IN BOSTON'S NEIGHBORHOODS, QUINCY, AND THE OUTER PORTION OF CAPE CODTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 1.1 INCREASE THE NUMBER OF PATIENTS RECEIVING PRIMARY MEDICAL CARE SERVICES, INCLUDING OB/GYN SERVICE AT CCA HEALTH CENTERS1.2 INCREASE THE NUMBER OF PATIENTS RECEIVING SPECIALTY CARE MEDICAL SERVICES1.3 ENSURE ACCESS TO SERVICES FOR THOSE ON THE OUTER CAPE1.4 ENSURE ACCESS TO APPROPRIATE TRAUMA CARE AND EMERGENCY SERVICES1.5 MAINTAIN OR INCREASE SUPPORT FOR HSN TRUST FUND; AND ADVOCATE FOR LEGISLATION AND POLICIES SUPPORTING PUBLIC HEALTH, MENTAL HEALTH AND SUBSTANCE USE AND ANTI-POVERTY PROGRAMS1.6 SCREEN AND ENROLL THOSE WHO QUALIFY FOR HEALTH INSURANCE THROUGH ACACOMMUNITY ACTIVITIES/STRATEGIES: - SUPPORT INSTITUTIONAL AND COMMUNITY EMERGENCY PREPAREDNESS - ENSURE CONNECTION TO SPECIALTY CARE THROUGH CARE CONNECTION'S INPATIENT DISCHARGE FOLLOW UP PROGRAM- SUPPORT CARE INTEGRATION THROUGH INFORMATION SHARING VIA PARTICIPATION IN MASS HIWAY AND A HEALTH INFORMATION EXCHANGE- SUPPORT MED-FLIGHT AND COORDINATED EMS IN BOSTON- SUPPORT HSN- CONDUCT "MYSTERY SHOPPING" TO ADDRESS QUALITY IMPROVEMENT- ADMINISTER ASK DEVELOPMENT EVALUATION PROGRAM- SUPPORT RESIDENT ROTATIONS INTO CCA HEALTH CENTERS - EXPLORE SPREADING PACT PROGRAM TO MEDICAID COHORTMETRICS AND STATUS UPDATE: - NUMBER OF PATIENTS SERVED AT FQHC CCA HEALTH CENTERS (FY17: 106,463; FY18: 110,268; FY19: 112,689)- NUMBER OF VISITS PROVIDED AT FQHC CCA HEALTH CENTERS (FY17: 543,713; FY18: 551,521; FY19: 557,044)- NUMBER OF PATIENTS WITHOUT INSURANCE SERVED AT FQHC CCA HEALTH CENTERS (FY17: 11,704; FY18: 11,610; FY19: 11,495)- NUMBER OF REFERRALS MADE THROUGH CARE CONNECTION CALL CENTER (FY17: 986; FY18: 923; FY19: 933)- NUMBER OF INDIVIDUALS SCREENED FOR INSURANCE ELIGIBILITY (FY17: 9,776: FY18: 10,265; FY19: 10,784)- NUMBER OF INDIVIDUALS ENROLLED IN ENTITLEMENT PROGRAMS (FY17: 8,716: FY18 9,152; FY19: 9,560)- NUMBER OF PATIENTS SUPPORTED THROUGH HSN (FY17: 2,603: FY18: 3,025; FY 19: 2,385)- NUMBER OF MYSTERY SHOPPING SURVEYS COMPLETED (FY17: 72; FY 18: 72; FY19: 56)- NUMBER OF PRESCRIPTIONS FILLED FOR INDIGENT PATIENTS (FY18: 5,452; FY19: 4,362)COMMUNITY PARTNERS: CCA HEALTH CENTERS, BIDCOGOAL: INCREASE ACCESS TO QUALITY ORAL HEALTHTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:2.1 MAINTAIN AND INCREASE THE NUMBER OF PATIENTS RECEIVING PRIMARY DENTAL CARE SERVICES AT CCA HEALTH CENTERS2.2 CONDUCT PUBLIC POLICY ADVOCACYCOMMUNITY ACTIVITIES/STRATEGIES: - SUPPORT CCA HEALTH CENTERS- SUPPORT HSNMETRICS AND STATUS UPDATE: - NUMBER OF DENTAL PATIENTS AT FQHC CCA HEALTH CENTERS (FY17: 25,709; FY18: 26,720; FY19: 26,385)- NUMBER OF UNIQUE DENTAL VISITS AT FQHC CCA HEALTH CENTERS (FY17: 80,622; FY18: 83,450; FY19: 78,088)COMMUNITY PARTNERS: CCA HEALTH CENTERSGOAL: INCREASE QUALITY AND EFFICIENCY OF CLINICAL SERVICES AT CCA CLINICSTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 3.1 MAINTAIN AND INCREASE THE NUMBER OF PROVIDERS AT CCA HEALTH CENTERCOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT MEDICAL RESIDENTS AT CCA HEALTH CENTERS METRICS AND STATUS UPDATE:- NUMBER OF MEDICAL RESIDENTS PLACED AT CCA HEALTH CENTERS: (FY17: 34; FY18: 31; FY19: 24)COMMUNITY PARTNERS: CCA HEALTH CENTERSGOAL: PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WITH LIMITED ENGLISH PROFICIENCYTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:4.1 CONTINUE INTERPRETER SERVICES PROGRAM4.2 EDUCATE STAFF/CLINICIANS IN HEALTH EQUITY PRINCIPLES4.3 PROMOTE HEALTH EQUITY, HEALTH LITERACY, AND CULTURAL COMPETENCE ACROSS CCA HEALTH CENTERS COMMUNITY ACTIVITIES/STRATEGIES:- UNDERSTAND CULTURAL IMPACTS ON HEALTH CARE DELIVERY, HEALTH STATUS AND HEALTH OUTCOMES- EXPLORE AVAILABLE TOOLS AND RESOURCES TO FACILITATE CROSS-CULTURAL COMMUNICATION- EXPLORE OPPORTUNITIES FOR CCA HEALTH CENTERS IN THEIR EFFORTS TO BECOME HEALTH LITERATE ORGANIZATIONS- IMPROVE ACCESSIBILITY OF INTERPRETER SERVICES FOR LIMITED ENGLISH PROFICIENCY (LEP) PATIENTSMETRICS AND STATUS UPDATE: NUMBER OF LEP ENCOUNTERS AND LANGUAGES
METRICS AND STATUS UPDATE: - NUMBER OF LEP ENCOUNTERS AND LANGUAGES AT BIDMC (FY 17: 127,439 IN PERSON ENCOUNTERS, 101,314 TELEPHONIC ENCOUNTERS, 237,255 TOTAL ENCOUNTERS IN 73 LANGUAGES; FY18: 135,512 IN PERSON ENCOUNTERS, 94,033 TELEPHONIC ENCOUNTERS, 229,545 TOTAL ENCOUNTERS IN 81 LANGUAGES; FY19: 138,297 IN PERSON ENCOUNTERS, 21,169 TELEPHONIC ENCOUNTERS (TELEPHONIC DATA INCOMPLETE DUE DATA AND DATABASE DIFFICULTIES, 159,466 TOTAL ENCOUNTERS IN 81 LANGUAGES)- NUMBER OF PATIENTS BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH AT FQHC CCA HEALTH CENTERS (FY17: 43,900; FY18: 44,988; FY19: 46,058)- NUMBER OF PATIENTS OF DIVERSE RACE/ETHNICITY SERVED AT FQHC CCA HEALTH CENTERS (FY17: 68,682; FY18: 71,045; FY19: 67,622)COMMUNITY PARTNERS: CCA HEALTH CENTERSGOAL: PROMOTE GREATER HEALTH EQUITY AND REDUCE DISPARITIES IN ACCESS FOR LGBT POPULATIONSTARGET POPULATION: LGBT POPULATIONPROGRAMMATIC OBJECTIVES:5.1 REDUCE DISPARITIES5.2 PROMOTE HEALTH EQUITY COMMUNITY ACTIVITIES/STRATEGIES:- EXPLORE HOW TO BEST IMPLEMENT SEXUAL ORIENTATION/GENDER IDENTITY APPROPRIATE POLICIES AND PROCEDURES- CONTINUE JOINT RESIDENCY PROGRAM WITH FENWAY HEALTH - SUPPORT PRIDE CELEBRATION- SUPPORT EFFORTS TO ACHIEVE HEALTHCARE EQUALITY INDEX (HEI) RECOGNITION (E.G., SIGNAGE AND PATIENT SELF-IDENTIFICATION OF SEXUAL ORIENTATION)METRICS AND STATUS UPDATE:- ESTABLISH SOGI TASKFORCE; FY19: SOGI TASKFORCE FILMED, DIRECTED AND RECORDED AND LAUNCHED A REQUIRED TRAINING FOR ALL STAFF. - NUMBER OF LGBT PATIENTS SEEN AT FQHC CCA HEALTH CENTERS (FY17: PATIENTS THAT IDENTIFY AS OTHER THAN STRAIGHT: (FY17: 12,061; FY18: 13,600; FY19: 16,943); PATIENTS THAT IDENTIFY AS TRANSGENDER: (FY17: 1,549; FY18: 1,916; FY19: 1,740)COMMUNITY PARTNERS: CCA HEALTH CENTERS, GLAD LEGAL ADVOCATES & DEFENDERS FOR THE LGBTQ COMMUNITY, HARVARD MEDICAL SCHOOL, HEALTHCARE EQUALITY INDEX, HUMAN RIGHTS CAMPAIGNPRIORITY AREA 4: BEHAVIORAL HEALTH HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY, AND STRESS). IF THE IMPACT OF SOCIAL DETERMINANTS WAS THE LEADING FINDING OF THE CHNA, A CLOSE SECOND WAS THE PROFOUND IMPACT THAT BEHAVIORAL HEALTH ISSUES (I.E., SUBSTANCE USE AND MENTAL HEALTH) ARE HAVING ON INDIVIDUALS, FAMILIES AND COMMUNITIES IN EVERY GEOGRAPHIC REGION AND EVERY POPULATION SEGMENT IN BIDMC'S CBSA. DEPRESSION/ANXIETY, SUICIDE, OPIOID AND PRESCRIPTION DRUG DEPENDENCY, AND ALCOHOL AND MARIJUANA USE, PARTICULARLY IN YOUTH, ARE MAJOR HEALTH ISSUES AND ARE HAVING A TREMENDOUS IMPACT ON THE POPULATION AS WELL AS A BURDEN ON THE SERVICE SYSTEM. THE FACT THAT PHYSICAL AND BEHAVIORAL HEALTH ARE SO INTERTWINED COMPOUNDS THE IMPACT OF THESE ISSUES. OF PARTICULAR CONCERN ARE THE INCREASING RATES OF OPIOID ABUSE IN THE COMMONWEALTH.LIMITED ACCESS TO BEHAVIORAL HEALTH SERVICES, PARTICULARLY FOR LOW-INCOME, MEDICAID INSURED, UNINSURED, AND THOSE WITH COMPLEX, MULTI-FACETED ISSUES. DESPITE THE BURDEN OF MENTAL HEALTH AND SUBSTANCE USE ON ALL SEGMENTS OF THE POPULATION, THERE IS AN EXTREMELY LIMITED SERVICE SYSTEM AVAILABLE TO MEET THE NEEDS THAT EXIST FOR THOSE WITH ALL MILD TO MODERATE EPISODIC ISSUES OR THOSE WITH MORE SERIOUS AND COMPLEX, CHRONIC CONDITIONS. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE (INCLUDING STIGMA), AND IMPROVE THE QUALITY OF PRIMARY CARE AND SPECIALIZED BEHAVIORAL HEALTH SERVICES.GOAL: PROMOTE BEHAVIORAL HEALTH (BH)/PRIMARY CARE INTEGRATIONTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:1.1 INCREASE THE NUMBER OF PATIENTS RECEIVING MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES IN THE PRIMARY CARE SETTING IN CCA HEALTH CENTERS1.2 INCREASE THE NUMBER OF PATIENTS RECEIVING PRIMARY BEHAVIORAL HEALTH CARE SERVICES AT CCA HEALTH CENTERS1.3 CONDUCT PUBLIC POLICY ADVOCACYCOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT PRIMARY CAREBEHAVIORAL HEALTH INTEGRATION AT CCA HEALTH CENTERS- SUPPORT TELEPHONIC AND ONSITE PSYCHIATRIC CONSULTATION FOR PRIMARY CARE PROVIDERS SERVING THOSE WITH BH CONDITIONS- PROVIDE OB/GYN SERVICES FOR PATIENTS WITH CHRONIC SUBSTANCE ABUSE ISSUES- PROVIDE CULTURALLY APPROPRIATE MENTAL HEALTH SERVICES FOR THE LATINO COMMUNITY- SUPPORT EDUCATIONAL OPPORTUNITIES ON CULTURAL PSYCHIATRY FOR SPANISH SPEAKING MENTAL HEALTH PROVIDERS- CONTINUE SBIRT IN BIDMC'S EMERGENCY DEPARTMENTMETRICS AND STATUS UPDATE:- NUMBER OF PATIENTS ACCESSING BH SERVICES IN FQHC CCA HEALTH CENTERS: (FY17: 8,658; FY18: 9,599; FY19: 10,846)- NUMBER OF PCPS PARTICIPATING IN BH CONSULTATION PROGRAM AT CHARLES RIVER COMMUNITY HEALTH (FY17: 11; FY18: 13, COMPLETED))COMMUNITY PARTNERS: CCA HEALTH CENTERSGOAL: REDUCE BURDEN OF OPIOID USETARGET POPULATION: ADULTSPROGRAMMATIC OBJECTIVES: 2.1 INCREASE THE NUMBER OF ADULTS WITH SUBSTANCE ISSUES WHO ARE APPROPRIATELY MONITORED, ASSESSED, AND TREATED IN CCA HEALTH CENTERS2.2 INCREASE THE NUMBER OF PATIENTS RECEIVING DETOX SERVICESCOMMUNITY ACTIVITIES/STRATEGIES: - SUPPORT THE DEVELOPMENT OF SUBOXONE CLINICS IN HCA AND A "BRIDGING" CLINIC FOR NON-HCA PATIENTS (2 SESSIONS EACH)- SUPPORT THE RECRUITMENT OF AN ADDICTION PSYCHIATRIST, PSYCH-NP, LCSW, AND ADMINISTRATIVE SUPPORT PERSON TO DEVELOP A CORE ADDICTIONS COMPETENCY- SUPPORT THE DEVELOPMENT OF A BIDMC ADDICTIONS ADVISORY GROUP - SUPPORT THE EXPANSION OF THE DIMOCK INPATIENT DETOX FACILITY METRICS AND STATUS UPDATE:- OPEN/BUILD DIMOCK'S INPATIENT DETOX PROGRAM - OPENED ON APRIL 3RD, 2018- NUMBER OF ADDICTION SPECIALISTS HIREDGOAL ACHIEVED- BIDMC'S ADDICTION TREATMENT TEAM, ESTABLISHED IN FY2017, INCLUDES ADDICTION SPECIALIZED PSYCHIATRY, NURSING, AND SOCIAL WORK. THIS TEAM FOCUSES ON THE CARE OF PATIENTS WITH SUBSTANCE USE DISORDERS IN ALL SETTINGS ACROSS BIDMC. THE GOAL OF THE ADDICTION TREATMENT TEAM IS TO HELP BIDMC PHYSICIANS AND STAFF PROVIDE THE RIGHT CARE AT THE RIGHT TIME TO PATIENTS WITH SUBSTANCE USE DISORDERS.- KEVIN HILL, MD, ADDICTION SPECIALIST, PSYCHIATRY- LESLIE BOSWORTH, LICSW, SPECIALIST IN ADDICTIONS- ALLISON BORRELLI, LICSW, INPATIENT/OUTPATIENT PSYCHOTHERAPY- JOANNE DEVINE, APN, SPECIALIST IN ADDICTIONS FORM ADDICTIONS ADVISORY GROUPGOAL ACHIEVED- THE OPIOID CARE COMMITTEE (OCC) LED BY CHAIR STEPHANIE JONES, MD, VICE CHAIR FOR EDUCATION, DEPARTMENT OF ANESTHESIA, CRITICAL CARE AND PAIN MEDICINE, IS A SUBCOMMITTEE OF THE MEDICAL EXECUTIVE COMMITTEE. THIS MULTIDISCIPLINARY TEAM WAS ESTABLISHED IN 2016 AS ONE OF BIDMC'S ANNUAL OPERATING PLAN GOALS TO ENSURE A COMPREHENSIVE APPROACH WHEN CONSIDERING SAFE PRESCRIBING OF OPIOIDS, TREATMENT FOR OPIOID USE DISORDERS, AND ALTERNATIVE THERAPIES FOR PAIN MANAGEMENT. THE COMMITTEE ENSURES BIDMC PROVIDERS FOLLOW ESTABLISHED BEST PRACTICES WHEN ASSESSING, PRESCRIBING, TREATING, EDUCATING, AND PROVIDING URGENT AND CONTINUED CARE FOR THE INDIVIDUAL PATIENT WITHIN THE CONTEXT OF OPIOID USE/MISUSE. REPRESENTATIVES FROM ALL OF BIDMC'S LICENSED SITES FORM THE MEMBERSHIP OF THIS COMMITTEE. COLLABORATION WITH AFFILIATE INSTITUTIONS OCCURS AS APPROPRIATE. ESTABLISH SUBOXONE CLINICGOAL ACHIEVED- HEALTHCARE ASSOCIATES OPENED OFFICE BASED OPIOID TREATMENT (OBOT) CLINIC FOR BUPRENORPHINE IN SUMMER 2017. THIS CLINIC SERVES HCA PATIENTS ONLY. - BOWDOIN STREET HEALTH CENTER ESTABLISHED OFFICE BASED OPIOID TREATMENT (OBOT) IN SUMMER 2017.- SUPPORTED DIMOCK HEALTH CENTER ACUTE TREATMENT SERVICES (ATS) WHICH IS A 35-BED MEDICALLY MONITORED DETOX UNIT FOR ALCOHOL AND OPIOID USE DISORDERS LOCATED ON THE DIMOCK CENTER'S MAIN CAMPUS. ESTABLISH BRIDGING CLINICGOAL ACHIEVED- WITH THE OPENING OF THE NEW ADDICTION PSYCHIATRY CLINIC SPACE AND THE ADDITION OF SEVERAL STAFF MEMBERS, DR. KEVIN HILL AND HIS TEAM ARE ABLE TO OFFER EXPANDED ACCESS TO BRIDGE CLINIC SERVICES FOR PATIENTS BEGINNING TREATMENT FOR OPIOID USE DISORDER WITH MEDICATION ASSISTED THERAPY. AN ADDITIONAL BRIDGE CLINIC IS AVAILABLE WITH PROVIDERS AT HEALTH CARE ASSOCIATES. ESTABLISH DASHBOARD METRICSGOAL ACHIEVED- THE INPATIENT OPIOID PRESCRIBING DASHBOARD IS NOW LIVE. THE METRICS INCLUDED IN THE DASHBOARD WERE DERIVED BASED ON THE RECOMMENDATIONS OF THE MASSACHUSETTS HEALTH AND HOSPITAL ASSOCIATION AND THE CONSENSUS STATEMENT BY THE SOCIETY OF HOSPITAL MEDICINE ON SAFE OPIOID USE FOR ACUTE PAIN IN HOSPITALIZED PATIENTS. INDIVIDUALS WILL BE ABLE TO COMPARE THEIR PRESCRIBING TO THAT OF PEERS IN THEIR DIVISION OR DEPARTMENT, AS WELL AS SET GOALS FOR ADHERENCE TO RECOMMENDED PRACTICES. COMMUNITY PARTNERS: CCA HEALTH CENTERSGOAL: INCREASE ACCESS TO QUALITY BEHAVIORAL HEALTH CARE SERVICES TARGET POPULATION: CHILDREN, YOUTH, ADULTS PROGRAMMATIC OBJECTIVES: 3.1 INCREASE PARTICIPATION IN LGBT SUPPORT GROUPSCOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT TRANSGENDER SUPPORT GROUPS AT BIDMC METRICS AND STATUS UPDATE: NUMBER OF PARTICIPANTS IN TRANSGENDER SUPPORT GROUPS AT BIDMC (FY17: 13, COMPLETED)
COMMUNITY PARTNERS: CCA HEALTH CENTERS GOAL: IDENTIFY THOSE AT RISK FOR BH CONDITION AND PROVIDE ENHANCED CARE MANAGEMENT TARGET POPULATION: ADULTS PROGRAMMATIC OBJECTIVES: 4.1 SUPPORT ENHANCED CARE MANAGEMENT FOR THOSE AT RISK FOR BH CONDITIONS COMMUNITY ACTIVITIES/STRATEGIES: - CONTINUE TO PROVIDE CASE MANAGEMENT SUPPORT SERVICES FOR BSHC PATIENTS WITH COMPLEX PHYSICAL AND BEHAVIORAL HEALTH ISSUES METRICS AND STATUS UPDATE:- NUMBER OF BSHC PATIENTS PARTICIPATING IN BROOKLINE MENTAL HEALTH PARTNERSHIP PROGRAM (FY17:18; FY18: 11 COMPLETED PROGRAM ROLLED INTO MASSHEALTH ACO)COMMUNITY PARTNERS: CCA HEALTH CENTERS
FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW BIDMC CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 11.01% OF BIDMC'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITS - ANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, BIDMC'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE COMMUNITY BENEFITS ADVISORY COMMITTEE AND BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT:HTTPS://WWW.BIDMC.ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITSTHERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT BIDMC FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, BIDMC IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, RESEARCH HOSPITAL AND TEACHING HOSPITAL, PROVIDING 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. ADDITIONAL INFORMATION IS INCLUDED BELOW. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEBIDMC'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $15,937,695 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CARE - MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, BIDMC ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS WHICH INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BIDMC GENERATED $196,181,903 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY BIDMC FOR SUCH SERVICES BY $20,681,077 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND BIDMC PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BIDMC GENERATED $513,360,668 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $13,580,527. OF THESE AMOUNTS, REVENUE OF $19,530,120 IS RELATED TO THE PROVISION OF PSYCHIATRIC CARE AND IS INCLUDED ON THIS SCHEDULE H, PART I, LINE 7G, AS PART OF SUBSIDIZED HEALTH SERVICES BECAUSE THE COST OF THOSE SERVICES EXCEEDED REVENUES BY $18,209,050. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH BIDMC CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, BIDMC HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. HOWEVER, IF THE MEDICARE SHORTFALL WERE INCLUDED IN THE SCHEDULE H PART I LINE 7 CALCULATION, IT WOULD INCREASE TO 2.18%BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, BIDMC ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $25,799,994 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR THE FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2020 INCLUDE THE ACCOUNTS OF: BETH ISRAEL LAHEY HEALTH, INC. (BILH), AND THE ENTITIES FOR WHICH BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS SOLE MEMBER DURING THE FISCAL PERIOD COVERED BY THIS FILING, (BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES, AND WHOSE ACCOUNTS ARE INCLUDED IN THE BILH AUDITED FINANCIAL STATEMENTS. THE FINANCIAL STATEMENTS ALSO INCLUDE THE ACCOUNTS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF BETH ISRAEL DEACONESS MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES.THE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.EMERGENCY CARE ACCESSBETH ISRAEL DEACONESS MEDICAL CENTER IS A TERTIARY CARE LICENSED ACADEMIC MEDICAL CENTER, PROVIDING MEDICAL AND SURGICAL CARE, TEACHING AND RESEARCH AND AS NOTED ELSEWHERE IN THIS RETURN, PROVIDES 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. THE EMERGENCY DEPARTMENT (ED) IS ALSO A LEVEL I TRAUMA CENTER AND THE ED'S MISSION, ALIGNED WITH BIDMC'S MISSION, IS TO DISTINGUISH ITSELF FROM OTHER PROVIDERS THROUGH EXCELLENCE IN PATIENT CARE, EDUCATION, RESEARCH AND THROUGH IMPROVED HEALTH IN THE COMMUNITIES SERVED. BIDMC'S DEPARTMENT OF EMERGENCY MEDICINE, PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR (SCHEDULE H, PART V, SECTION A AND SECTION B QUESTION 21).
FINANCIAL ASSISTANCE POLICYINTERNAL REVENUE CODE SECTION 501(R)(4) FINANCIAL ASSISTANCE POLICY PURPOSE BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR HOSPITAL) IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED INELIGIBLE FOR A GOVERNMENT PROGRAM, OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THE BIDMC FINANCIAL ASSISTANCE POLICY (FAP) IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS. PATIENTS ELIGIBLE FOR BIDMC FINANCIAL ASSISTANCE WILL ALSO RECEIVE FREE AND/OR DISCOUNTED CARE FROM PARTICIPATING BIDMC PROVIDERS.THE HOSPITAL DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS, OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY AND THE AMOUNTS GENERALLY BILLED (AGB) CALCULATION IS UPDATED NOT LESS THAN ANNUALLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE MOST RECENT VERSION OF THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WAS REVISED AUGUST 2020 BY AN AUTHORIZED BODY OF THE HOSPITAL, AS DEFINED WITHIN THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R).FINANCIAL ASSISTANCE POLICY APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. THIS INFORMATION IS ALSO INCLUDED IN THE PLAIN LANGUAGE SUMMARY (PLS). IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY ELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICY TRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY, PLAIN LANGUAGE SUMMARY, APPLICATION FOR FINANCIAL ASSISTANCE AND HARDSHIP APPLICATION (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: SPANISH, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, RUSSIAN, PORTUGUESE, VIETNAMESE, FRENCH, HAITIAN CREOLE, HINDI, ITALIAN, JAPANESE, CAPE VERDEAN, AND ARABIC. (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICY WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT HTTPS://WWW.BIDMC.ORG/PATIENT-AND-VISITOR-INFORMATION/PATIENT-INFORMATION/YOUR-HOSPITAL-BILL/FINANCIAL-ASSISTANCE/ IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDES CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED.
FINANCIAL ASSISTANCE POLICYPLAIN LANGUAGE SUMMARY ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE AND/OR DISCHARGE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). AS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY. LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE FOLLOWING FINANCIAL ASSISTANCE POLICY (FAP) DOCUMENTS:- APPLICATION FOR FINANCIAL ASSISTANCE- MEDICAL HARDSHIP APPLICATION- BIDMC FINANCIAL ASSISTANCE POLICY- FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY AS WELL AS ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ARE AVAILABLE IN THE FOLLOWING LANGUAGES: ENGLISH AND SPANISH, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, RUSSIAN, PORTUGUESE, VIETNAMESE, FRENCH, HAITIAN CREOLE, HINDI, ITALIAN AND JAPANESE, CAN BE FOUND ON THE BIDMC WEBSITE AT:HTTPS://WWW.BIDMC.ORG/PATIENT-AND-VISITOR-INFORMATION/PATIENT-INFORMATION/YOUR-HOSPITAL-BILL/FINANCIAL-ASSISTANCELIMITATION ON CHARGES INTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLED LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS UPDATED NOT LESS FREQUENTLY THAN ANNUALLY AS REQUIRED PURSUANT TO THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R) AND THE AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22).PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS 501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCHAS PREVIOUSLY NOTED IN THIS FORM 990, PART III, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS AND TREATMENTS THAT IMPROVE THE QUALITY OF LIFE.
FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCH THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING. THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,220 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,500 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 280 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, VACCINE DEVELOPMENT AND VIROLOGY, INFECTION CONTROL AND INFECTIOUS DISEASES AND CARDIOLOGY/CARDIAC SURGERY. AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN, HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS. THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION. THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES:- ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE - EMERGENCY MEDICINE - MEDICINE - ALLERGY AND INFLAMMATION - CARDIOVASCULAR MEDICINE - CENTER FOR VASCULAR BIOLOGY RESEARCH - CENTER FOR VIROLOGY AND VACCINE RESEARCH - CLINICAL INFORMATICS - CLINICAL NUTRITION - ENDOCRINOLOGY - EXPERIMENTAL MEDICINE - GASTROENTEROLOGY - GENERAL MEDICINE AND PRIMARY CARE - GENETICS - GERONTOLOGY - HEMATOLOGY AND ONCOLOGY - HEMOSTASIS AND THROMBOSIS - IMMUNOLOGY - INFECTIOUS DISEASE - INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGY - MOLECULAR AND VASCULAR MEDICINE - NEPHROLOGY - PULMONOLOGY - RHEUMATOLOGY - SIGNAL TRANSDUCTION - TRANSLATIONAL RESEARCH - TRANSPLANT IMMUNOLOGY- NEONATOLOGY - NEUROLOGY - OBSTETRICS AND GYNECOLOGY - ORTHOPAEDIC SURGERY - PATHOLOGY - PSYCHIATRY - RADIOLOGY - SURGERY - CARDIAC SURGERY - CENTER FOR MINIMALLY INVASIVE SURGERY - NEUROSURGERY - PLASTIC AND RECONSTRUCTIVE SURGERY - VASCULAR SURGERY- TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER REPORTED $69,247,463 OF NET INTERNALLY FUNDED RESEARCH ON THIS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE, WHICH REPRESENTED 3.53% OF THE MEDICAL CENTER'S TOTAL EXPENSES. ADDITIONALLY, THE MEDICAL CENTER REPORTED $190,560,437 OF RESEARCH EXPENSES FUNDED BY GOVERNMENTS AND OTHER TAX-EXEMPT ENTITIES INCLUDING OTHER HOSPITALS, UNIVERSITIES AND FOUNDATIONS ON SCHEDULE H, PART I LINE 7H COLUMN D, WHICH, IF INCLUDED IN SCHEDULE H, PART I, LINE 7H COLUMN E CALCULATION, WOULD INCREASE THE NET COMMUNITY BENEFIT REPORTED FROM RESEARCH ACTIVITIES ON THIS SCHEDULE H, PART I, LINE 7H TO 15.56%.
RESEARCH ENGAGED IN AT THE MEDICAL CENTER THE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION. BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW ARE INCLUDED IN FORM 990 SCHEDULE H, PART I LINE 7H COLUMN C AND MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H, PART I, LINE 7H COLUMN E, DEPENDING ON FUNDING SOURCE. COVID-19 VACCINE RESEARCHTHE PERIOD COVERED BY THIS FILING IS THE FISCAL YEAR ENDED SEPTEMBER 30, 2020, DURING WHICH THE COVID-19 PANDEMIC CHANGED LIFE IN THE UNITED STATES AND ACROSS THE GLOBE. RESEARCH CONDUCTED AT BIDMC DURING THIS FISCAL PERIOD SET THE STAGE FOR BIDMC'S NATIONAL LEADERSHIP DURING THIS ONGOING PUBLIC HEALTH CRISIS.AS OF LATE JULY, 2021, ABOUT 48.5 PERCENT OF AMERICANS, OR ABOUT 159 MILLION PEOPLE, ARE FULLY VACCINATED AGAINST SARS-COV-2, THE VIRUS THAT CAUSES COVID-19. BIDMC IMMUNOLOGIST DAN BAROUCH, MD, PHD, PLAYED AN INSTRUMENTAL ROLE IN DESIGNING AND DEVELOPING ONE OF THE THREE COVID-19 VACCINES CURRENTLY AVAILABLE IN THE UNITED STATES. AS DIRECTOR OF BIDMC'S CENTER FOR VIROLOGY AND VACCINE RESEARCH (CVVR), DR. BAROUCH AND HIS COLLEAGUES BEGAN WORKING ON A COVID-19 VACCINE ON JANUARY 10, 2020, THE SAME NIGHT THAT CHINESE SCIENTISTS RELEASED THE SARS-COV-2 VIRUS'S GENOME. DR. BAROUCH'S TEAM QUICKLY DESIGNED A SERIES OF VACCINE CANDIDATES, EVALUATED IN CLINICAL STUDIES LED BY PRIMARY INVESTIGATOR KATHRYN E. STEPHENSON, MD, MPH, DIRECTOR OF THE CLINICAL TRIALS UNIT AT CVVR.DR. BAROUCH'S INNOVATIVE VACCINE DESIGN NOW THE BASIS OF THE JOHNSON & JOHNSON SINGLE SHOT VACCINE USES A COMMON-COLD VIRUS, CALLED THE ADENOVIRUS, TO DELIVER A SMALL BIT OF THE COVID-19 DNA INTO HOST CELLS, WHERE IT STIMULATES THE BODY TO RAISE IMMUNE RESPONSES AGAINST THE VIRUS. SHOWN TO BE SAFE AND EFFECTIVE, THE COVID-19 VACCINE WAS GRANTED EMERGENCY USE APPROVAL BY THE U.S. FDA IN FEBRUARY 2021.OVER THE LAST 20 YEARS, DR. BAROUCH HAS APPLIED THE ADENOVIRUS STRATEGY FOR USE AGAINST PATHOGENS SUCH AS HIV AND ZIKA. ONE SUCH CANDIDATE HIV VACCINE DEVELOPED BY DR. BAROUCH AND HIS COLLEAGUES IS CURRENTLY IN CLINICAL EFFICACY TRIALS AT SITES AROUND THE WORLD, THE ONLY REMAINING HIV VACCINE CURRENTLY IN LARGE-SCALE CLINICAL TRIALS. DETAIL ON ADDITIONAL COVID AND NON-COVID RESEARCH EFFORTS WHICH WERE UNDERTAKEN AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. BIDMC-LED CLINICAL TRIAL IDENTIFIES FOUR NOVEL 3D-PRINTED SWABS FOR USE IN COVID-19 TESTINGIN THE EARLY DAYS OF THE COVID-19 PANDEMIC, RAPID AND WIDESPREAD TESTING FOR THE VIRUS WAS HAMPERED BY A SHORTAGE OF SPECIALIZED NASOPHARYNGEAL (NP) SWABS USED TO COLLECT SAMPLES FROM PATIENTS' NOSES AND THROATS. A MULTI-DISCIPLINARY TEAM FROM BIDMC IDENTIFIED FOUR NOVEL PROTOTYPES OF 3D-PRINTED SWABS THAT COULD BE USED FOR COVID-19 TESTING. THE FOUR PROTOTYPES WERE DEVELOPED THROUGH A HIGHLY COLLABORATIVE EFFORT COORDINATED BY RAMY ARNAOUT, MD, DPHIL, ASSOCIATE DIRECTOR OF THE CLINICAL MICROBIOLOGY LABORATORIES AT BIDMC, AND WERE TESTED AGAINST A STANDARD NP SWAB IN 230 ADULTS WHO UNDERWENT TESTING FOR COVID-19 AT BIDMC AND VOLUNTEERED TO PARTICIPATE IN THE STUDY. SELECTED AFTER THE REVIEW OF MORE THAN 100 DESIGNS, THE FINAL FOUR DESIGNS SHOWED EXCELLENT CONCORDANCE WITH THE CONTROLS IN A CLINICAL TRIAL.THE CLINICAL TRIAL WAS THE THIRD AND FINAL STEP IN AN EFFORT THAT BEGAN MID-MARCH 2020, WHEN DR. ARNAOUT AND HIS FELLOW DIRECTORS OF BIDMC'S CLINICAL MICROBIOLOGY LABS JAMES KIRBY, MD, PHD, AND STEFAN RIEDEL, MD, PHD NOTED IMPENDING SWAB SHORTAGES COULD IMPEDE TESTING FOR COVID-19. DR. ARNAOUT AND COLLEAGUES SOON HAD MORE THAN 150 NOVEL SWAB DESIGNS MADE OF 45 DIFFERENT MATERIALS SUBMITTED BY 23 COMPANIES, LABORATORIES AND INDIVIDUALS ACROSS THE COUNTRY FOR BIDMC'S CONSIDERATION.
BIDMC-LED CLINICAL TRIAL IDENTIFIES FOUR NOVEL 3D-PRINTED SWABS FOR USE IN C "THROUGH THE WORK OF A LARGE AND SELFLESS TEAM FROM HEALTH CARE, ACADEMIA, AND THE PRIVATE SECTOR, IT TOOK JUST 22 DAYS FROM THE TIME WE IDENTIFIED THE SWAB SHORTAGE TO WHEN OUR TRIAL CLINICALLY VALIDATED THE FIRST NEW SWAB CAPABLE OF HIGH-THROUGHPUT MANUFACTURE," DR. ARNAOUT SAID. "WE HOPE OUR COLLECTIVE EXPERIENCE CAN PROVIDE A USEFUL ROADMAP TO OTHERS WORKING UNDER THE PRESSURE OF A PUBLIC HEALTH EMERGENCY."THE TEAM'S MANUSCRIPT WAS PUBLISHED IN THE JOURNAL OF CLINICAL MICROBIOLOGY.RESEARCHERS REPORT SHARP DECLINE IN PATIENT VISITS FOR HEART ATTACK, STROKE AND CANCER CARE DURING COVID-19 PANDEMICFIVE DAYS AFTER MASSACHUSETTS OFFICIALS DECLARED A STATE OF EMERGENCY IN RESPONSE TO RISING CASES OF COVID-19, THE STATE'S DEPARTMENT OF PUBLIC HEALTH DIRECTED ALL HOSPITALS TO POSTPONE OR CANCEL ALL NONESSENTIAL PROCEDURES. WHILE THE ORDER EXPLICITLY ALLOWED FOR LIFE-SUSTAINING INTERVENTIONS FOR URGENT CONDITIONS, PHYSICIANS NOTICED A PRECIPITOUS DROP IN EMERGENCY VISITS FOR HEART ATTACKS, STROKES AND OTHER AILMENTS.IN A PREPRINT RELEASE OF STUDY FINDINGS PUBLISHED IN MEDRXIV, PHYSICIAN-SCIENTISTS QUANTIFIED THE EFFECT OF THE COVID-19 PANDEMIC ON THE NUMBERS OF PATIENTS SEEKING MEDICAL ATTENTION FOR SELECT POTENTIALLY LIFE-THREATENING DIAGNOSES AT BIDMC. THE TEAM FOUND THAT PATIENT ENCOUNTERS FOR HEART ATTACK AND STROKE DROPPED BY ABOUT A THIRD AND MORE THAN HALF, RESPECTIVELY, DURING THE PANDEMIC COMPARED TO PATIENT VISITS DURING THE SAME PERIOD IN 2019. "OUR DATA SUGGEST THAT PATIENTS ARE DEFERRING LIFE-SAVING CARE DUE TO FEAR OF CONTAGION," SAID CORRESPONDING AUTHOR DHRUV S. KAZI, MD, MSC, MS, ASSISTANT DIRECTOR OF BIDMC'S SMITH CENTER FOR OUTCOMES RESEARCH IN CARDIOLOGY AND DIRECTOR OF BIDMC'S CARDIAC CRITICAL CARE UNIT. "EARLY ANNOUNCEMENT OF STAY-AT-HOME ORDERS LIKELY FLATTENED THE COVID-19 CURVE IN THE COMMONWEALTH OF MASSACHUSETTS, BUT GIVEN THE TIME-SENSITIVE NATURE OF INITIATING TREATMENT FOR HEART ATTACKS AND STROKES, WE NEED TO IMPROVE PUBLIC HEALTH MESSAGING TO ENSURE THAT PATIENTS CONTINUE TO SEEK CARE FOR ACUTE EMERGENCIES. WE NEED TO REMIND OUR PATIENTS THAT IF THEY EXPERIENCE SYMPTOMS OF A HEART ATTACK OR STROKE, THEY DESERVE THE SAME LIFE-SAVING TREATMENT WE OFFERED BEFORE THIS PANDEMIC SET IN. THEY SHOULD NOT TRY AND SIT IT OUT."HYDROXYCHLOROQUINE FOR TREATMENT OF COVID-19 LINKED TO INCREASED RISK OF CARDIAC ARRHYTHMIASIN THE EARLY MONTHS OF THE PANDEMIC, WITH NO FDA APPROVED TREATMENTS FOR PATIENTS WITH SEVERE COVID-19 AVAILABLE, THE ANTI-MALARIAL DRUG, HYDROXYCHLOROQUINE, EMERGED AS A POTENTIAL THERAPY FOR THE PNEUMONIA ASSOCIATED WITH COVID-19, WITH OR WITHOUT THE ANTIBIOTIC AZITHROMYCIN. IN A BRIEF REPORT PUBLISHED IN JAMA CARDIOLOGY, A TEAM OF PHARMACISTS AND CLINICIANS AT BIDMC FOUND EVIDENCE SUGGESTING THAT PATIENTS WHO RECEIVED HYDROXYCHLOROQUINE FOR COVID-19 WERE AT INCREASED RISK OF ELECTRICAL CHANGES TO THE HEART AND CARDIAC ARRHYTHMIAS. THE COMBINATION OF HYDROXYCHLOROQUINE WITH AZITHROMYCIN WAS LINKED TO EVEN GREATER CHANGES COMPARED TO HYDROXYCHLOROQUINE ALONE.IN THIS SINGLE-CENTER, RETROSPECTIVE, OBSERVATIONAL STUDY, SENIOR AUTHOR HOWARD S. GOLD, MD, AN INFECTIOUS DISEASE SPECIALIST AT BIDMC AND AN ASSISTANT PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL, AND COLLEAGUES, EVALUATED 90 ADULTS WITH COVID-19 WHO WERE HOSPITALIZED AT BIDMC BETWEEN MARCH 1 AND APRIL 7, 2020, AND RECEIVED AT LEAST ONE DAY OF HYDROXYCHLOROQUINE. MORE THAN HALF OF THESE PATIENTS ALSO HAD HIGH BLOOD PRESSURE, AND MORE THAN 30 PERCENT HAD DIABETES."IN OUR STUDY, PATIENTS WHO WERE HOSPITALIZED AND RECEIVING HYDROXYCHLOROQUINE FOR COVID-19 FREQUENTLY EXPERIENCED QTC PROLONGATION AND ADVERSE DRUG EVENTS," SAID CO-FIRST AUTHOR CHRISTINA F. YEN, MD, OF BIDMC'S DEPARTMENT OF MEDICINE. "ONE PARTICIPANT TAKING THE DRUG COMBINATION EXPERIENCED A POTENTIALLY LETHAL TACHYCARDIA CALLED TORSADES DE POINTES, WHICH TO OUR KNOWLEDGE HAS YET TO BE REPORTED ELSEWHERE IN THE PEER-REVIEWED COVID-19 LITERATURE."NATIONAL SURVEY ON COVID-19 PANDEMIC SHOWS SIGNIFICANT MENTAL HEALTH IMPACT A COLLABORATION AMONG RESEARCHERS AT BETH ISRAEL DEACONESS MEDICAL CENTER AND MASSACHUSETTS GENERAL HOSPITAL, LED BY THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL (UNC) SCHOOL OF MEDICINE, DEPLOYED A NATIONALLY REPRESENTATIVE INTERNET SURVEY OF 1,500 PEOPLE DURING THE SECOND HALF OF MAY 2020, A POINT IN THE PANDEMIC AT WHICH MORE THAN 20,000 PEOPLE WERE DIAGNOSED WITH COVID-19 IN THE UNITED STATES EACH DAY, AND A THOUSAND OR MORE PEOPLE WERE DYING FROM THE DISEASE. INTENDED TO GAIN INSIGHT INTO HOW INDIVIDUALS ARE RESPONDING TO THE STRESSORS OF ISOLATION AND QUARANTINE, RECORD UNEMPLOYMENT LEVELS, AND THE VIRUS' THREAT TO THEIR HEALTH, THE RESEARCHERS' 16-QUESTION SURVEY CALLED THE PANDEMIC EMOTIONAL IMPACT SCALE (PEIS) ASSESSED A BROAD RANGE OF SPECIFIC EMOTIONAL EFFECTS RELATED TO THE PANDEMIC AND FOUND THAT CERTAIN STRESSORS AFFECTED A LARGE MAJORITY OF THE POPULATION. NEARLY 80 PERCENT OF RESPONDENTS WERE FRUSTRATED ON SOME LEVEL WITH NOT BEING ABLE TO DO WHAT THEY NORMALLY ENJOY DOING. AROUND THE SAME NUMBER WERE WORRIED ABOUT THEIR OWN HEALTH, AND NEARLY 90 PERCENT OF THOSE SURVEYED WERE MORE WORRIED ABOUT THE HEALTH OF LOVED ONES THAN BEFORE THE COVID-19 PANDEMIC. THE RESEARCHERS ALSO OBSERVED THAT RACIAL AND ETHNIC MINORITIES, ESPECIALLY THOSE IDENTIFYING AS HISPANIC/LATINX, REPORTED HIGHER LEVELS OF EMOTIONAL DISTRESS DUE TO COVID-19, AND THAT ADULTS YOUNGER THAN 50 WERE MUCH MORE LIKELY TO REPORT EMOTIONAL IMPACT OF THE PANDEMIC COMPARED TO OLDER ADULTS. "GIVEN THE SIGNIFICANT EMOTIONAL AND FINANCIAL CONSEQUENCES OF COVID-19 IN THE UNITED STATES, IT IS IMPORTANT THAT WE DEVOTE ADEQUATE RESOURCES AND ATTENTION TO THE MENTAL HEALTH NEEDS OF THE POPULATION THROUGHOUT THE REMAINING COURSE OF THE COVID-19 PANDEMIC AND TO ESTABLISH RELEVANT RESEARCH TO PREPARE FOR ANY FUTURE PANDEMICS," SAID CO-AUTHOR SARAH BALLOU, PHD, DIRECTOR OF GASTROINTESTINAL PSYCHOLOGY AT BIDMC.
QUALITATIVE DATA: INTERVIEWS, GROUPS CONVERSATIONS, SURVEYS AND THE COMMUNIT THOUSANDS OF APPS FEWER THAN HALF OF THE ESTIMATED 47 MILLION U.S. ADULTS LIVING WITH MENTAL ILLNESS RECEIVE TREATMENT, COUNSELING OR MEDICATION. IN RECENT YEARS, SMARTPHONE APPS HAVE EMERGED AS POTENTIALLY COST-EFFECTIVE MEANS OF EXPANDING ACCESS TO MENTAL HEALTHCARE. BUT WITH SOME 10,000 MENTAL HEALTH APPS WHICH ARE NOT SUBJECT TO FDA OVERSIGHT AVAILABLE IN MOBILE APP STORES TODAY, THE TASK OF DETERMINING WHICH APPS ARE SAFE AND EFFECTIVE CAN SEEM OVERWHELMING TO PATIENTS AND PROVIDERS ALIKE.NOW, RESEARCHER-CLINICIANS FROM BIDMC AND LAHEY HOSPITAL AND MEDICAL CENTER, BOTH PART OF BETH ISRAEL LAHEY HEALTH, HAVE COLLABORATED TO DEVELOP AN ONLINE ASSESSMENT TOOL TO HELP PATIENTS AND PROVIDERS MAKE MORE INFORMED DECISIONS ABOUT CHOOSING AND USING A MENTAL HEALTH APP. THE 105-QUESTION INTERACTIVE TOOL DOES NOT ENDORSE OR RECOMMEND SPECIFIC APPS, BUT RATHER HELPS POTENTIAL USERS WEIGH APPS' SAFETY, EASE OF USE, AND COMMITMENT TO USER PRIVACY, THE SCIENTISTS REPORTED IN NPJ DIGITAL MEDICINE."THE ABSENCE OF REGULATORY OVERSIGHT LEAVES THE APP STORES' USER REVIEWS AND RANKINGS AS THE MAJOR SOURCES OF INFORMATION FOR CONSUMERS INTERESTED IN MENTAL HEALTH APPS," SAID CORRESPONDING AUTHOR JOHN TOROUS, MD, DIRECTOR OF DIGITAL PSYCHIATRY AT BETH ISRAEL DEACONESS MEDICAL CENTER. "TO FILL THAT VOID, WE DEVELOPED A DATABASE OF MENTAL HEALTH APPS THAT IS GROUNDED IN PRINCIPLES OF MEDICAL ETHICS. RATHER THAN FOCUSING ON WHAT IS THE 'BEST' APP WE AIM TO HELP PEOPLE FIND ONE THAT IS THE 'BEST MATCH' THROUGH GUIDING THEM THROUGH INFORMED DECISION MAKING."UNINTENDED CONSEQUENCES: STUDY FINDS 40 PERCENT MORTALITY RATE FOR PATIENTS DENIED BARIATRIC SURGERYMORE THAN 300,000 AMERICANS DIE EACH YEAR FROM CONDITIONS ASSOCIATED WITH BEING OVERWEIGHT OR OBESE, INCLUDING DIABETES, HIGH BLOOD PRESSURE, ARTHRITIS, HEART DISEASE AND SLEEP APNEA. TO DATE, METABOLIC AND BARIATRIC SURGERY (MBS)WITH METABOLIC SURGERY DEFINED AS WEIGHT LOSS SURGERY AS TARGETED TREATMENT FOR DIABETESHAS PROVEN TO BE THE MOST EFFECTIVE MEANS OF LOSING WEIGHT AND KEEPING IT OFF OVER THE LONG TERM. YET MANY PATIENTS SEEKING THE PROCEDURE ARE DENIED IT, EITHER BY INSURANCE PROVIDERS, AND/OR BECAUSE THEY FAIL TO MEET CURRENT MEDICAL CRITERIA.TO LEARN WHAT HAPPENED TO PATIENTS DENIED WEIGHT LOSS SURGERY, PHYSICIAN-SCIENTISTS AT BIDMC FOLLOWED UP WITH 107 PATIENTS WHO WERE DENIED THE PROCEDURE IN 2007. THE TEAM FOUND THAT MOST PATIENTS WHO WERE INITIALLY TURNED AWAY EVENTUALLY OBTAINED BARIATRIC SURGERY, EXPERIENCED IMPROVED OVERALL HEALTH AND WERE STILL LIVING AT 12-YEAR FOLLOW UP. HOWEVER, 40 PERCENT OF THOSE DENIED SURGERY IN 2007 WHO NEVER UNDERWENT THE PROCEDURE WERE DECEASED BY 2019. THE FINDINGS WERE PUBLISHED IN THE JOURNAL SURGERY FOR OBESITY AND RELATED DISEASES."DENYING PATIENTS SEEKING BARIATRIC SURGERY WAS A DEATH SENTENCE FOR NEARLY THE 40 PERCENT OF PATIENTS WHO NEVER OBTAINED A METABOLIC OPERATION AFTER INITIAL DENIAL," SAID SENIOR AUTHOR DANIEL B. JONES, MD, CHIEF OF MINIMALLY INVASIVE SURGICAL SERVICES AND DIRECTOR OF THE BARIATRIC PROGRAM AT BIDMC. "OUR FINDINGS SUGGEST CURRENT INSURANCE CRITERIA FOR ACCEPTING OR DENYING PATIENTS FOR WEIGHT LOSS SURGERY ARE UNNECESSARILY STRINGENT, POTENTIALLY HARMFUL TO PATIENTS AND SHOULD BE REASSESSED."STUDY EXAMINES RACIAL AND ETHNIC DISPARITIES AMONG COVID-19 CASES IN MASSACHUSETTSIN SPRING OF 2020, MASSACHUSETTS HAD ONE OF THE HIGHEST INCIDENCES OF COVID-19 IN THE UNITED STATES. EARLY REPORTS SUGGESTED THAT BLACK AND LATINX RESIDENTS WERE DISPROPORTIONATELY AFFECTED, WITH BLACK AND LATINX PEOPLE TOGETHER COMPROMISING 55 PERCENT OF COVID-19 CASES. HOWEVER, THE SPECIFIC FACTORS UNDERLYING THESE STARK DISPARITIES REMAINED UNCLEAR. IN A STUDY PUBLISHED IN HEALTH AFFAIRS, RESEARCHERS AT BIDMC AND THE HARVARD T.H. CHAN SCHOOL OF PUBLIC HEALTH EXAMINED THE ASSOCIATION BETWEEN SPECIFIC DEMOGRAPHIC, ECONOMIC, AND OCCUPATIONAL FACTORS AND COVID-19 CASE RATES ACROSS 351 MASSACHUSETTS CITIES AND TOWNS BETWEEN JANUARY 1 AND MAY 6, 2020. THE TEAM THAT FOUND A 10 PERCENT INCREASE IN THE BLACK POPULATION WAS ASSOCIATED WITH AN INCREASE OF 312 COVID-19 CASES PER 100,000 PEOPLE, WHILE A 10 PERCENT INCREASE IN THE LATINX POPULATION WAS LINKED TO AN INCREASE OF 285 CASES PER 100,000 PEOPLE."OUR STUDY DEMONSTRATES THE EXTENT TO WHICH MASSACHUSETTS' BLACK AND LATINX COMMUNITIES HAVE BEEN DISPROPORTIONATELY AFFECTED BY COVID-19," SAID CO-FIRST AUTHOR RISHI WADHERA, MD, MPP, MPHIL, AN INVESTIGATOR IN THE SMITH CENTER FOR OUTCOMES RESEARCH IN CARDIOLOGY AT BIDMC. "WE ALSO FOUND THAT A HIGHER PROPORTION OF NON-CITIZENS OR FOOD SERVICE WORKERS LIVING WITHIN A COMMUNITY, AS WELL AS LARGER HOUSEHOLD SIZES, WERE EACH INDEPENDENTLY ASSOCIATED WITH HIGHER COVID-19 CASE RATES. ALTHOUGH THESE FACTORS EXPLAINED THE HIGHER BURDEN OF COVID-19 IN LATINX COMMUNITIES, THEY DID NOT FOR BLACK COMMUNITIES, SUGGESTING THAT OTHER STRUCTURAL INEQUITIES MAY BE AT PLAY."THE RESEARCHERS CONCLUDE THAT FURTHER RESEARCH INTO THE SOCIAL AND ECONOMIC FACTORS UNDERLYING COVID-19-RELATED DISPARITIES AND NEW POLICIES TO ADDRESS RISK FACTORS AND INSTITUTIONAL RACISM WILL BE CRITICAL TO CONTROLLING THE PANDEMIC AND IMPROVING HEALTH EQUITY.BETH ISRAEL LAHEY HEALTH ("BILH") QUICKLY AND EFFECTIVELY MARSHALLED ITS RESOURCES TO MOUNT A COMPREHENSIVE RESPONSE TO THE COVID-19 PANDEMIC. PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS IN PART III FOR FURTHER DETAILS REGARDING BILH'S COVID-19 RESPONSE IN FY20.WELL-CONTROLLED STUDY OF MORE THAN 400 PARTICIPANTS SUPPORTS REDUCING SALT INTAKE AS AN IMPORTANT PUBLIC HEALTH STRATEGY TO DECREASE INCIDENCE OF HYPERTENSIONA NEW STUDY LED BY STEPHEN JURASCHEK, MD, PHD, ASSISTANT PROFESSOR OF MEDICINE AT BIDMC, FOUND THAT REDUCING SODIUM INTAKE IN ADULTS WITH ELEVATED BLOOD PRESSURE OR HYPERTENSION DECREASED THIRST, URINE VOLUME (A MARKER OF FLUID INTAKE), AND BLOOD PRESSURE, BUT DID NOT AFFECT METABOLIC ENERGY NEEDS. THESE RESULTS, PUBLISHED IN THE JOURNAL HYPERTENSION, SUPPORT THE TRADITIONAL NOTION THAT DECREASING SODIUM INTAKE IS CRITICAL TO MANAGING HYPERTENSION DISPUTING RECENT STUDIES.USING DATA FROM THE COMPLETED DIETARY APPROACHES TO STOP HYPERTENSION (DASH)-SODIUM TRIAL, A RANDOMIZED CONTROLLED-FEEDING STUDY, PUBLISHED IN 2001, THE RESEARCHERS EXAMINED THE EFFECTS OF THREE DIFFERENT LEVELS OF SODIUM INTAKE (LOW, MEDIUM, AND HIGH) ON BLOOD PRESSURE IN PARTICIPANTS FOLLOWING TWO DISTINCT DIETS A TYPICAL AMERICAN DIET (CONTROL DIET) OR A HEALTHY DIET (THE DASH DIET). IN THIS SECONDARY ANALYSIS OF THE DASH-SODIUM TRIAL, THE RESEARCHERS MEASURED THE IMPACT OF SODIUM INTAKE ON PARTICIPANTS' ENERGY INTAKE, WEIGHT, SELF-REPORTED THIRST, AND 24-HOUR URINE VOLUME.THE RESEARCHERS FOUND THAT, WHILE REDUCED SODIUM INTAKE DID NOT AFFECT THE AMOUNT OF ENERGY REQUIRED TO MAINTAIN A STABLE WEIGHT, IT DID DECREASE PARTICIPANTS' THIRST. FURTHERMORE, URINE VOLUME WAS EITHER UNCHANGED OR LOWER WITH REDUCED SODIUM INTAKE. TOGETHER THESE RESULTS SUGGEST THAT IN ADULTS WITH ELEVATED BLOOD PRESSURE OR HYPERTENSION, A LOWER SODIUM INTAKE DECREASES THIRST, URINE VOLUME (AND LIKELY FLUID INTAKE) AND BLOOD PRESSURE. THESE CHANGES OCCURRED WITHOUT ALTERING THE AMOUNT OF ENERGY REQUIRED TO KEEP BODY WEIGHT CONSTANT."OUR STUDY CONTRIBUTES MEANINGFULLY TO THIS SCIENTIFIC DEBATE AND UNDERSCORES THE IMPORTANCE OF SODIUM REDUCTION AS A MEANS TO LOWER BLOOD PRESSURE," SAID JURASCHEK. "PUBLIC HEALTH RECOMMENDATIONS AIMED AT LOWERING POPULATION-WIDE SODIUM INTAKE FOR BLOOD PRESSURE SHOULD CONTINUE WITHOUT FEAR OF CONTRIBUTING TO WEIGHT GAIN."
RESEARCHERS WORK TO BETTER MEASURE DELIRIUM SEVERITY IN OLDER PATIENTS DELIRIUM IS AN ACUTE CONFUSIONAL STATE THAT CAN PRESENT AS INATTENTION, DISORIENTATION, LETHARGY OR AGITATION, AND PERCEPTUAL DISTURBANCE. MOST COMMON AMONG OLDER HOSPITALIZED PATIENTS, DELIRIUM CAN LEAD TO POOR OUTCOMES, INCLUDING PROLONGED HOSPITAL STAYS, FUNCTIONAL DECLINE, AND DEATH. WITH IN-HOSPITAL MORTALITY RATES FOR OLDER PATIENTS WITH DELIRIUM AT 25 TO 33 PERCENT AND ANNUAL HEALTH CARE COSTS ATTRIBUTABLE TO DELIRIUM IN EXCESS OF $182 BILLION IN THE UNITED STATES ALONE, DELIRIUM HAS GARNERED INCREASING ATTENTION AS A WORLDWIDE PUBLIC HEALTH AND PATIENT SAFETY PRIORITY.IN A STUDY PUBLISHED IN THE JOURNAL DEMENTIA AND GERIATRIC COGNITIVE DISORDERS, RESEARCHERS AT BIDMC AND HEBREW SENIOR LIFE REPORTED ON THEIR EFFORT TO IMPROVE AND VALIDATE TOOLS USED TO ASSESS THE SEVERITY OF DELIRIUM. THE AIM WAS TO MORE ACCURATELY DEFINE METHODS FOR DETECTING AND MEASURING DELIRIUM SYMPTOM SEVERITY, WHICH COULD IN TURN LEAD TO IMPROVED PREVENTION AND TREATMENT FOR PATIENTS AT RISK.RESEARCHERS DEVELOPED A SET OF 17 CRITERIA THAT THEY AGREED CAPTURES THE SEVERITY OF DELIRIUM, INCLUDING BUT NOT LIMITED TO: LEVEL OF CONSCIOUSNESS, EMOTIONAL DYSREGULATION, DISORGANIZED THINKING, DISORIENTATION AND HALLUCINATION. THE STUDY INDICATES THAT HIGH-QUALITY DELIRIUM SEVERITY INSTRUMENTS SHOULD ULTIMATELY HAVE IMMEDIATE RELEVANT APPLICATION TO CLINICAL CARE AND QUALITY IMPROVEMENT EFFORTS."WHILE A VARIETY OF TOOLS FOR THE ASSESSMENT OF DELIRIUM SEVERITY CURRENTLY EXIST, MOST DELIRIUM SEVERITY INSTRUMENTS HAVE NOT BEEN DEVELOPED WITH ADVANCED MEASUREMENT METHODOLOGY OR EVALUATED WITH RIGOROUS VALIDATION STUDIES," SAID LEAD AUTHOR SARINNAPHA M. VASUNILASHORN, PHD, OF THE DIVISION OF GENERAL MEDICINE AT BIDMC AND ASSISTANT PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL (HMS) AND IN EPIDEMIOLOGY AT THE HARVARD T.H. CHAN SCHOOL OF PUBLIC HEALTH. "OUR STUDY HAS LAID THE FOUNDATION FOR A NEW, MORE FULLY CONCEPTUALIZED DELIRIUM SEVERITY MEASURE."PLATINUM-BASED AGENTS ARE NOT SUPERIOR TO STANDARD CHEMOTHERAPY FOR PATIENTS WITH BREAST CANCER WHO CARRY BRCA MUTATIONS COMMONLY KNOWN AS THE BREAST CANCER GENES, THE BRCA GENE FAMILY PLAYS A ROLE IN REPAIRING DAMAGED DNA. INHERITED MUTATIONS IN THE GENES BRCA1 OR BRCA2 RAISE THE RISK OF DEVELOPING BREAST, OVARIAN, PROSTATE AND OTHER CANCERS. LED BY CLINICIAN-RESEARCHERS AT BIDMC, A FIRST-OF-ITS-KIND STUDY PROVIDED NEW EVIDENCE ABOUT THE OPTIMAL WAY TO TREAT PATIENTS WHO CARRY BRCA MUTATIONS ALSO KNOWN AS BRCA CARRIERS WHO HAVE BEEN DIAGNOSED WITH BREAST CANCER. THE DATA CAME FROM THE INFORM TRIAL, THE RESULTS OF WHICH APPEARED IN THE JOURNAL OF CLINICAL ONCOLOGY. DESIGNED TO SETTLE A QUESTION RAISED BY PREVIOUS STUDIES, INFORM IS THE LARGEST PROSPECTIVE RANDOMIZED CLINICAL TRIAL TO COMPARE THE EFFICACY OF A PLATINUM AGENT TO A STANDARD TREATMENT REGIMEN. THE INFORM TRIAL WAS LED BY NADINE TUNG, MD, DIRECTOR OF THE CANCER RISK AND PREVENTION PROGRAM AND HEAD OF BREAST MEDICAL ONCOLOGY AT BIDMC. "PREVIOUS STUDIES REPORTED THAT THE PLATINUM-BASED THERAPY CISPLATIN WAS EFFECTIVE IN BRCA CARRIERS WITH BREAST CANCER," SAID TUNG. "THOSE FINDINGS LEFT CLINICIANS UNCERTAIN WHETHER TO USE CISPLATIN AN UNCONVENTIONAL DRUG FOR TREATING EARLY STAGE BREAST CANCER OR WHETHER TO USE THE SAME CHEMOTHERAPY REGIMEN USED FOR OTHER WOMEN WITH BREAST CANCER. PRIOR TO INFORM, NO RANDOMIZED PROSPECTIVE DATA EXISTED COMPARING PLATINUM TO STANDARD CHEMOTHERAPY IN THIS POPULATION OF PATIENTS. OUR STUDY FOUND THAT PLATINUM-BASED THERAPY WAS ACTUALLY NO MORE EFFECTIVE THAN THE STANDARD FIRST-LINE TREATMENT."SURGE PROTECTOR: NOVEL APPROACH TO SUPPRESSING THERAPY-INDUCED TUMOR GROWTHIN A PREVIOUS STUDY, A TEAM OF RESEARCHERS LED BY DIPAK PANIGRAHY, MD, A PATHOLOGIST AT BETH ISRAEL DEACONESS MEDICAL CENTER, DEMONSTRATED THAT DEAD AND DYING CANCER CELLS KILLED BY CONVENTIONAL CANCER TREATMENTS PARADOXICALLY TRIGGER THE INFLAMMATION THAT PROMOTES TUMOR GROWTH AND METASTASIS. NOW, IN A FOLLOW-UP STUDY PUBLISHED IN PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCE, PANIGRAHY AND COLLEAGUES ILLUMINATE THE MECHANISM BY WHICH DEBRIS GENERATED BY OVARIAN TUMOR CELLS TARGETED BY FIRST-LINE CHEMOTHERAPY ACCELERATES TUMOR PROGRESSION. ADDITIONALLY, THE RESEARCHERS DESCRIBE A NOVEL APPROACH TO SUPPRESSING THE CHEMOTHERAPY-INDUCED TUMOR GROWTH. DR. PANIGRAHY AND COLLEAGUE'S ANALYSIS REVEALED THAT CHEMOTHERAPY-KILLED OVARIAN CANCER CELLS INDUCE SURROUNDING IMMUNE CELLS CALLED MACROPHAGES TO RELEASE A SURGE OF IMMUNE-RELATED CHEMICAL COMPOUNDS CYTOKINES AND LIPID MEDIATORS THAT CREATE OPTIMAL CONDITIONS IN WHICH TUMORS CAN SURVIVE AND GROW. NEXT, THE TEAM SHOWED THAT A COMMON ANTI-INFLAMMATORY DRUG CALLED A DUAL COX-2 INHIBITOR BLOCKED THE SURGE OF TUMOR-FRIENDLY CYTOKINES AND LIPIDS. "THE ROLE OF THESE CHEMOTHERAPY-INDUCED CYTOKINES AND LIPIDS IS UNDERAPPRECIATED AND POORLY CHARACTERIZED, AND OVARIAN CANCER PATIENTS MAY BENEFIT FROM SUPPRESSING THEIR RELEASE," SAID DR. PANIGRAHY. "FURTHER RESEARCH IS NEEDED BUT, DUAL INHIBITION OF THE COX-2 PATHWAYS IS A NOVEL THERAPEUTIC MODALITY THAT MAY COMPLIMENT CONVENTIONAL CANCER THERAPIES BY ACTING AS A SURGE PROTECTOR AGAINST CELL DEBRIS-STIMULATED TUMOR GROWTH."
STUDY: LEVELS OF LIVER FAT BIOMARKER ASSOCIATED WITH METABOLIC HEALTH BENEFITS OF REGULAR EXERCISEWHILE GENETICS AND OTHER FACTORS LIKE AGE AND GENDER CONTRIBUTE TO EACH INDIVIDUAL'S RESPONSE TO EXERCISE, LITTLE IS KNOWN ABOUT THE BIOLOGICAL MECHANISMS BY WHICH PHYSICAL ACTIVITY BRINGS ABOUT BENEFICIAL CHANGES TO THE BODY. IN A STUDY LED BY CARDIOLOGISTS AT BETH ISRAEL DEACONESS MEDICAL CENTER, SCIENTISTS FOUND THAT INCREASING EXERCISE CAN LOWER LEVELS OF DIMETHYLGUANIDINO VALERIC ACID (DMVG), A MOLECULE IN THE BLOOD LINKED TO POOR HEALTH OUTCOMES. HOWEVER, THE RESEARCHERS WERE SURPRISED TO FIND THAT PEOPLE WITH HIGHER BASELINE LEVELS OF DMVG THOSE WITH "MORE ROOM TO IMPROVE" ACTUALLY SAW LESS BENEFIT FROM EXERCISE THAN PEOPLE WITH LOWER BASELINE LEVELS OF DMVG THOSE IN BETTER HEALTH TO BEGIN WITH.LED BY CORRESPONDING AUTHOR ROBERT GERSZTEN, MD, CHIEF OF CARDIOVASCULAR MEDICINE AT BIDMC, THE SCIENTISTS WERE INTERESTED IN STUDYING DMGV BASED ON THEIR PREVIOUS RESEARCH FINDINGS SHOWING THAT THE MOLECULE WAS A MARKER OF LIVER FAT AND THAT CIRCULATING LEVELS WERE TIED THE DEVELOPMENT OF TYPE 2 DIABETES UP TO 12 YEARS PRIOR TO DISEASE ONSET. THE STUDY WAS PUBLISHED IN JAMA CARDIOLOGY.STRUCTURE OF ENZYME THAT PRODUCES FUEL FOR THE HEART OF MUSCLE CELLS REVEALED AFTER SIXTY YEARS OF INTENSIVE INVESTIGATION BY BIOCHEMISTS AND PHYSIOLOGISTS WORLDWIDE, A TEAM OF SCIENTISTS LED BY GABRIEL BIRRANE, PHD, A STRUCTURAL BIOLOGIST AT BETH ISRAEL DEACONESS MEDICAL CENTER, PROVIDED THE FIRST DETAILED PICTURE OF THE STRUCTURE OF THE LIPOPROTEIN LIPASE (LPL) PROTEIN. THE TEAM'S FINDINGS, PUBLISHED IN THE PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES, OFFER A BETTER UNDERSTANDING OF CARDIOVASCULAR METABOLISM AND COULD OPEN THE DOOR TO TARGETED TREATMENT FOR SEVERAL RARE CARDIOVASCULAR DISORDERS. "BECAUSE LPL ALONE IS NOT VERY STABLE, PREVIOUS EXPERIMENTERS HAD DIFFICULTY PRODUCING SUFFICIENT AMOUNTS LPL FOR STRUCTURAL ANALYSIS," EXPLAINED DR. BIRRANE. "MY COLLABORATORS PROVIDED THE BREAKTHROUGH DATA, INCLUDING METHODS TO PURIFY ACTIVE LPL AND A COMPANION PROTEIN THAT WAS CRUCIAL TO STABILIZE LPL. WITH THIS KNOWLEDGE, WE CONCENTRATED OUR EFFORTS ON CRYSTALLIZING A COMPLEX OF THE TWO PROTEINS. CRYSTALS OF THE COMPLEX PRODUCED X-RAY DATA OF MUCH HIGHER QUALITY THAN WE WERE ABLE TO OBTAIN WITH LPL ALONE AND THIS ALLOWED US TO ANALYZE THE STRUCTURE AT A MOLECULAR LEVEL." NOW THAT THE TEAM HAS REVEALED THE STRUCTURE OF THE PROTEIN COMPLEX, RESEARCHERS CAN UNDERSTAND HOW MUTATIONS IN LPL OR GPIHBP1 LEAD TO ELEVATED TRIGLYCERIDE LEVELS AND CORONARY ARTERY DISEASE. OTHER MOLECULES BIND TO AND REGULATE THE FUNCTION OF LPL. IN FOLLOW UP STUDIES, DR. BIRRANE AND HIS COLLABORATORS WOULD LIKE TO DETERMINE THESE MOLECULES' MECHANISM OF ACTION, INFORMATION THAT WILL ALLOW SCIENTISTS TO BETTER UNDERSTAND THE ROLE LPL PLAYS IN CARDIOVASCULAR DISEASE AND DIABETES. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS GRADUATE MEDICAL EDUCATION THE MEDICAL CENTER'S DEVOTION TO TEACHING, RESPECT FOR STUDENTS/TRAINEES AND WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE THE MEDICAL CENTER A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. THE MEDICAL CENTER TRAINS HUNDREDS OF MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS, AS WELL AS PROFESSIONALS IN NURSING, SOCIAL WORK AND THE ALLIED HEALTH SCIENCES. THE MEDICAL CENTER HAS 59 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 683 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 52 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 60 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES. CORE CLINICAL TRAINING PROGRAMSTHE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS:- ANESTHESIOLOGY- EMERGENCY MEDICINE- INTERNAL MEDICINE- NEUROLOGY- NEUROSURGERY- OBSTETRICS AND GYNECOLOGY- PATHOLOGY- PSYCHIATRY- RADIOLOGY- SURGERY- TRANSITIONAL YEARDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER HAD NET EXPENDITURES OF $78,323,152 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO THE MEDICAL CENTER'S TEACHING FUNCTION WHICH REPRESENTED 3.99% OF THE MEDICAL CENTER'S TOTAL EXPENSES.
RESIDENCY PROGRAMS THE MEDICAL CENTER SPONSORS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED RESIDENCY PROGRAMS IN EACH OF THE CORE CLINICAL TRAINING PROGRAMS LISTED ABOVE. FELLOWSHIP PROGRAMSIN ADDITION TO THE RESIDENT TRAINING PROGRAMS LISTED ABOVE, THE MEDICAL CENTER SPONSORS A WIDE VARIETY OF FELLOWSHIP TRAINING PROGRAMS FOR ELIGIBLE DOCTORS WHO HAVE COMPLETED THEIR RESIDENCY AND WANT TO ENGAGE IN MORE SPECIALIZED STUDY. OVER HALF OF THESE PROGRAMS (59 OF 109) ARE ACGME APPROVED OR APPROVED BY A COMPARABLE BODY RELATED TO THE PARTICULAR SUBSPECIALTY. THE MEDICAL CENTER SPONSORS THE FOLLOWING FELLOWSHIP PROGRAMS:- ANESTHESIA: ADULT CARDIOTHORACIC ANESTHESIOLOGY, ADVANCED CLINICAL ANESTHESIA, ANESTHESIA FOR OUTPATIENT SURGERY, CRITICAL CARE MEDICINE, NEUROANESTHESIA, NEURO CRITICAL CARE, OBSTETRIC ANESTHESIOLOGY, PAIN MEDICINE, REGIONAL ANESTHESIA, VASCULAR ANESTHESIA, PATIENT SAFETY AND QUALITY IMPROVEMENT IN ANESTHESIA- DERMATOLOGY: CUTANEOUS ONCOLOGY, DERMATOLOGY RESEARCH FELLOWSHIP IN CLINICAL TRIALS AND OUTCOMES RESEARCH (CLEARS)- EMERGENCY MEDICINE: EMERGENCY MEDICAL SERVICES, EMERGENCY ULTRASOUND, DISASTER MEDICINE, ACADEMIC EMERGENCY MEDICINE- INTERNAL MEDICINE: ADVANCED CARDIAC NON-INVASIVE IMAGING, ADVANCED ENDOCRINE, DIABETES AND METABOLISM, ADVANCED ENDOSCOPY, ADVANCED INFECTIOUS DISEASE, ADVANCED NEPHROLOGY, CARDIAC MAGNETIC RESONANCE IMAGING, CARDIOVASCULAR DISEASE, CELIAC DISEASE, CLINICAL CARDIAC ELECTROPHYSIOLOGY, CLINICAL INFORMATICS, ENDOCRINOLOGY, DIABETES, AND METABOLISM, GASTROENTEROLOGY, GENERAL MEDICINE, GERIATRIC MEDICINE, GERIATRIC AND DIABETES, GI MOTILITY/FUNCTIONAL BOWEL DISORDERS, GLOBAL HEALTH, HEMATOLOGY AND MEDICAL ONCOLOGY, HEPATOLOGY, HOSPICE AND PALLIATIVE CARE, INFECTIOUS DISEASE, INFLAMMATORY BOWEL DISEASE, INTERVENTIONAL CARDIOLOGY, INTERVENTIONAL PULMONOLOGY, NEPHROLOGY, PULMONARY CRITICAL CARE, RHEUMATOLOGY, SLEEP MEDICINE, SLEEP RESPIRATION, STRUCTURAL HEART DISEASE, TRANSPLANT HEPATOLOGY, TRANSPLANT NEPHROLOGY- NEUROLOGY: AUTONOMIC DISORDERS, COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY- OBSTETRICS AND GYNECOLOGY: FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY, GYNECOLOGIC ONCOLOGY, MATERNAL FETAL MEDICINE, REPRODUCTIVE ENDOCRINOLOGY- PATHOLOGY: BLOOD BANKING/TRANSFUSION MEDICINE, CYTOPATHOLOGY, DERMATOPATHOLOGY, HEMATOPATHOLOGY, MEDICAL MICROBIOLOGY, MEDICAL MICROBIOLOGY CPEP, NEUROPATHOLOGY, SELECTIVE PATHOLOGY - PSYCHIATRY- RADIOLOGY-DIAGNOSTIC: ABDOMINAL RADIOLOGY, BREAST IMAGING RADIOLOGY, INTERVENTIONAL RADIOLOGY-INDEPENDENT, INTERVENTIONAL RADIOLOGY-INTEGRATED, MRI, MUSCULOSKELETAL IMAGING MSK, NEURORADIOLOGY, THORACIC IMAGING RADIOLOGY, - RADIATION ONCOLOGY: BRACHYTHERAPY, STEREOTATIC- SURGERY: ABDOMINAL TRANSPLANT SURGERY/KIDNEY, ACUTE CARE SURGERY, ANTERIOR SEGMENT OPHTHALMOLOGY, COLON AND RECTAL SURGERY, CORNEA AND REFRACTIVE SURGERY, CEREBROVASCULAR AND ENDOVASCULAR NEUROSURGERY, HEAD & NECK SURGICAL ONCOLOGY & RECONSTRUCTION, INTERDISCIPLINARY BREAST SURGERY, LYMPHATIC SURGERY, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGERY/ORTHO SPINE, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, OTOLARYNGOLOGY FELLOWSHIP, PLASTIC SURGERY, PLASTIC SURGERY/AESTHETIC RECONSTRUCTION, PLASTIC SURGERY/BREAST RECONSTRUCTION, PODIATRY, SURGICAL CRITICAL CARE, THORACIC SURGERY, UROLOGY, UROLOGY MALE INFERTILITY/SEXUAL DYSFUNCTION, VASCULAR SURGERY, VASCULAR SURGERY-INTEGRATED
ADDITIONAL INFORMATION ON CLINICAL RESIDENCY AND FELLOWSHIPS -- EXAMPLES BELOW IS MORE DETAIL ON JUST A FEW OF THE SPECIFIC GRADUATE MEDICAL EDUCATION PROGRAMS OFFERED AT THE MEDICAL CENTER:HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY AT BIDMCTHE BETH ISRAEL DEACONESS MEDICAL CENTER HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY IS A THREE-YEAR PROGRAM (PGY-1 TO PGY-3) IS AFFILIATED WITH HARVARD MEDICAL SCHOOL AND IS BASED AT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A 57,000 VISIT PER YEAR LEVEL I TRAUMA CENTER. RESIDENTS ROTATE AT CHILDREN'S HOSPITAL BOSTON, BROCKTON HOSPITAL, CAMBRIDGE HOSPITAL, TUFTS MEDICAL CENTER, ST. VINCENT HOSPITAL, ST. LUKE'S HOSPITAL, MOUNT AUBURN HOSPITAL AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM.THE EDUCATIONAL GOALS OF THE RESIDENCY ARE TO PROMOTE EXCELLENCE IN THE CLINICAL, ACADEMIC, AND ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE. RESIDENTS ARE TAUGHT HOW TO BE OUTSTANDING CLINICIANS. THIS IS ACCOMPLISHED THROUGH CLINICAL EXPERIENCE IN SEVERAL BUSY EMERGENCY DEPARTMENTS AS WELL AS THROUGH A HIGH QUALITY DIDACTIC PROGRAM. DURING THE CLINICAL EXPERIENCE, THE RESIDENTS ARE CLOSELY SUPERVISED AND GIVEN GRADED RESPONSIBILITY FOR PATIENT CARE AND ULTIMATELY FOR PATIENT FLOW IN THE EMERGENCY DEPARTMENT. ADDITIONALLY, RESIDENTS ARE TAUGHT HOW TO SUPERVISE MEDICAL STUDENTS AND OTHER RESIDENTS AND HOW TO TEACH THE PRACTICE OF EMERGENCY MEDICINE. RESIDENTS TEACH MEDICAL STUDENTS AND PREHOSPITAL PERSONNEL AND CONTRIBUTE TO THE DIDACTIC PROGRAM. SENIOR RESIDENTS TAKE ON THE RESPONSIBILITY OF SUPERVISING JUNIOR RESIDENTS IN THE CLINICAL ARENA. THE FOCUS OF THE RESIDENCY PROGRAM IS ON TEACHING THE LEADERSHIP SKILLS NECESSARY TO DIRECT A BUSY EMERGENCY DEPARTMENT IN ANY SETTING.THE OTHER MAJOR EDUCATIONAL GOAL OF THE RESIDENCY IS TO DEVELOP THE RESEARCH AND ACADEMIC SKILLS REQUIRED FOR A CAREER IN ACADEMIC EMERGENCY MEDICINE. PARTICIPATION IN RESEARCH IS PROMOTED THROUGH A SYSTEM OF MENTORSHIP, JOURNAL CLUB PARTICIPATION, AND A DIDACTIC PROGRAM THAT TEACHES RESEARCH DESIGN AND STATISTICAL METHODS. RESIDENTS ARE REQUIRED TO COMPLETE A RESEARCH OR ACADEMIC PROJECT THAT RESULTS IN A PAPER SUITABLE FOR PUBLICATION. FUNDING IS AVAILABLE WITHIN THE DIVISION OF EMERGENCY MEDICINE AT HARVARD MEDICAL SCHOOL AND THE DEPARTMENT OF EMERGENCY MEDICINE AT BIDMC. PROMOTING THE ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE IS ANOTHER GOAL OF THE BIDMC HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY. THROUGH AN EMS/ADMINISTRATIVE ROTATION AND A LONGITUDINAL EXPERIENCE IN PREHOSPITAL ADMINISTRATION, RESIDENTS GAIN EXPERIENCE IN RUNNING A LOCAL PREHOSPITAL SYSTEM.THIS PROGRAM TAKES ADVANTAGE OF THE UNIQUE ACADEMIC OPPORTUNITIES AT HARVARD MEDICAL SCHOOL, THE HARVARD TEACHING HOSPITALS, AND THE HARVARD SCHOOL OF PUBLIC HEALTH. THESE OPPORTUNITIES INCLUDE THE OUTSTANDING EXPERIENCE AVAILABLE THROUGH BOSTON CHILDREN'S HOSPITAL AND THE DEPARTMENTS OF MEDICINE, SURGERY, OBSTETRICS AND GYNECOLOGY, AND ANESTHESIA AT BETH ISRAEL DEACONESS MEDICAL CENTER. *****INTERNAL MEDICINE EDUCATION AT BIDMCTHE GOAL OF THIS PROGRAM IS TO DEVELOP EACH RESIDENT'S JUDGMENT AND SKILLS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE. THE MEDICAL CENTER TRAINS RESIDENTS AS ACADEMIC INTERNISTS AND PROVIDES THE FOUNDATION FOR THE PRACTICE OF INTERNAL MEDICINE OR FOR SUBSEQUENT CLINICAL AND RESEARCH TRAINING IN MEDICAL SUBSPECIALTIES. RESIDENTS ARE EXPOSED TO A WIDE ARRAY OF PATIENTS IN VARIOUS INPATIENT AND OUTPATIENT SETTINGS, INCLUDING DIFFERENT UNITS WITHIN BIDMC, DANA FARBER CANCER INSTITUTE, AND WEST ROXBURY VETERANS AFFAIRS MEDICAL CENTER. CLINICAL TEACHING IS A FOCUS AT BIDMC AND IS COMPRISED OF FORMAL AND INFORMAL DAILY ROUNDS AND NOONTIME CONFERENCES. THIS TEACHING PROVIDES THE BASIS OF AN ORGANIZED CURRICULUM FOR ALL MEDICAL INTERNS AND RESIDENTS AT BIDMC.INTERNSHIPTHE INTERNSHIP YEAR EMPHASIZES THE CARE OF PATIENTS IN GENERAL INPATIENT MEDICINE, INTENSIVE CARE MEDICINE, ONCOLOGY, CARDIOLOGY, EMERGENCY MEDICINE AND AMBULATORY CARE UTILIZING BOTH CAMPUSES AND SELECTED OUTSIDE SITES. WORKING AS PART OF A 2-4 PHYSICIAN TEAM WHICH INCLUDES AN OVERSEEING RESIDENT, ATTENDING STAFF AND OFTEN MEDICAL STUDENTS, INTERNS GAIN EXPERIENCE IN THE MANAGEMENT OF PATIENTS WITH A BROAD RANGE OF MEDICAL DISEASES. INTERNS HAVE PRIMARY RESPONSIBILITY FOR THE CARE OF ALL PATIENTS ADMITTED TO THE MEDICAL WARD SERVICE AND ARE CONSIDERED THEIR PATIENT'S PRIMARY INPATIENT DOCTOR FOR THE DURATION OF THE HOSPITALIZATION. THROUGHOUT INTERN YEAR, INTERNS MAINTAIN A LONGITUDINAL CONTINUITY CLINIC EXPERIENCE WHERE THEY DEVELOP A PANEL OF THEIR OWN PRIMARY CARE PATIENTS. DURING MOST OF THE YEAR, WITH THE EXCEPTION OF INTENSIVE CARE ROTATIONS, AN INTERN WILL HAVE CLINIC ONE HALF-DAY PER WEEK. DISTRIBUTED THROUGHOUT THE YEAR ARE FOUR "AMBULATORY BLOCKS" OF TWO WEEKS DURATION. DURING THIS TIME THE INTERN IS IN THEIR CONTINUITY CLINIC EVERY AFTERNOON AND ATTENDS OUTPATIENT SPECIFIC DIDACTIC LECTURES DURING THE MORNING HOURS. AS MEMBERS OF THE HARVARD FACULTY, INTERNS PLAY AN IMPORTANT ROLE IN TEACHING, BOTH OF THEIR PEERS AND OF ROTATING MEDICAL STUDENTS. WHILE ON THE MEDICAL WARDS, INTERNS PROVIDE DAILY CLINICAL GUIDANCE AND TEACHING TO THIRD AND FOURTH YEAR MEDICAL STUDENTS. AS PART OF THE AMBULATORY CARE CURRICULUM, INTERNS WILL ALSO HAVE THE OPPORTUNITY TO LEAD PRE-CLINIC CONFERENCES. DURING THE YEAR, THERE ARE SPECIAL INTERN-ONLY EDUCATIONAL ACTIVITIES INCLUDING THE TWICE-WEEKLY INTERN REPORT, MONTHLY INTERN FORUM SESSIONS AND BI-ANNUAL 24-HOUR INTERN RETREATS.JUNIOR AND SENIOR RESIDENCYRESIDENCY SOLIDIFIES CLINICAL AND TEACHING SKILLS AND ALLOWS TRAINEES TO EXPERIENCE LEADERSHIP OF A MEDICAL TEAM. JUNIOR RESIDENCY PROVIDES THE FIRST OPPORTUNITY FOR RESIDENTS TO SUPERVISE HOUSESTAFF TEAMS ON GENERAL MEDICAL SERVICES AND IN THE MEDICAL AND CARDIAC INTENSIVE CARE UNITS. SENIOR RESIDENCY PROMOTES CONSOLIDATION AND REFINEMENT OF THESE SKILLS, WITH ATTENDINGS ALLOWING INCREASING AUTONOMY. THE RESIDENT ON THE SERVICE IS LOOKED ON AS THE TEAM LEADER AND ASSUMES PRIMARY RESPONSIBILITY FOR TEACHING OF THE TEAM. RESIDENCY ALSO PROVIDES OPPORTUNITIES FOR INCREASED ELECTIVE TIME TO SAMPLE SUBSPECIALTY ROTATIONS. THIS PROVIDES ADDITIONAL SPECIALTY TRAINING IN AREAS OF INTEREST. THE ELECTIVE OPPORTUNITIES ARE DIVERSE, RANGING FROM ELECTROPHYSIOLOGY TO MUSCULOSKELETAL MEDICINE TO HEALTH POLICY. RESIDENTS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN ONE OF SEVERAL "TRACKS" WITHIN THE RESIDENCY PROGRAM IF INTERESTED IN ADDITIONAL SPECIFIC TRAINING RESOURCES AND EXPERIENCES.
TEACHING AS A RESIDENT AS MENTIONED ABOVE, RESIDENTS ARE VIEWED AS SOME OF THE PRIMARY TEACHERS WITHIN THE DEPARTMENT OF MEDICINE. SOME OF THESE TEACHING OPPORTUNITIES WILL ALSO BE OBSERVED BY DEPARTMENT FACULTY TO HELP THE RESIDENT REFINE THE STYLE AND EFFECTIVENESS OF THEIR TEACHING. TEACHING OPPORTUNITIES WILL INCLUDE:LEADING INPATIENT MEDICINE ROUNDS: - RESIDENTS ARE IN CHARGE OF RUNNING WARD ROUNDS. MEDICAL STUDENTS AND INTERNS PRESENT TO THE RESIDENT DURING ROUNDS. THE ATTENDING HOSPITALIST IS CONSIDERED THE RESIDENT'S CONSULTANT, WITH THE RESIDENT RETAINING THE PRIMARY DECISION-MAKING ROLE FOR THE PATIENTS ON THEIR SERVICE.- DURING THE MONTHS ON MEDICAL WARDS, THE CHIEF RESIDENTS AND FIRM CHIEFS ARE ASSIGNED TO DO WALK ROUND ONCE EACH WEEK WITH ONE OF THE RESIDENTS ON THEIR FIRM. THEY WILL OBSERVE THE RESIDENT RUNNING THE WARD ROUNDS AND PROVIDE FEEDBACK ON THE TEACHING SKILLS OBSERVED DURING ROUNDS.LEADING TEACHING ATTENDING ROUNDS: - DURING EVERY ROTATION ON THE MEDICAL WARDS, EACH RESIDENT WILL LEAD ONE TO THREE ATTENDING ROUNDS SESSIONS. THE TWO TEACHING ATTENDINGS HELP PROVIDE FEEDBACK ON THE RESIDENT'S SMALL GROUP DISCUSSION AND TEACHING SKILLS. SMALL GROUP PRESENTATIONS: - DURING AMBULATORY WEEKS, RESIDENTS WILL LEAD A MAJORITY OF THE PRE-CLINIC CONFERENCES, TYPICALLY PRESENTING EITHER A CHALLENGING AMBULATORY CASE OR AMBULATORY-BASED TOPIC.- ONCE DURING RESIDENCY, EACH JUNIOR RESIDENT WILL ALSO PRESENT A JOURNAL ARTICLE OF AMBULATORY CARE SIGNIFICANCE AT AMBULATORY JOURNAL CLUB TO A SMALL GROUP OF THEIR PEERS. INTERNAL MEDICINE GLOBAL HEALTH PROGRAMOUR MISSION IS TO TRAIN LEADERS IN GLOBAL HEALTH TO BE EFFECTIVE PRACTITIONERS IN UNDERSERVED, RESOURCE-LIMITED SETTINGS AND TO DESIGN, MANAGE, IMPROVE AND EVALUATE GLOBAL PUBLIC HEALTH PROGRAMS THAT ADDRESS THE HEALTH PROBLEMS OF THE WORLD'S NEEDIEST POPULATIONS.PROGRAM OBJECTIVES - INTRODUCE GLOBAL HEALTH ISSUES TO BIDMC MEDICAL RESIDENTS - CONTRIBUTE TO THE HEALTH AND WELL-BEING OF UNDERSERVED POPULATIONS IN BOSTON AND AROUND THE WORLD - ENRICH THE MEDICAL KNOWLEDGE AND ENHANCE THE CLINICAL SKILLS OF RESIDENTS BY PRACTICING IN UNIQUE SETTINGS WITH LIMITED RESOURCES - EXPAND RESEARCH OPPORTUNITIES - ADVANCE THE CAREERS OF BIDMC RESIDENTS IN THE FIELDS OF INTERNATIONAL HEALTH, PUBLIC POLICY AND RESEARCH SITE LOCATIONS - BOTSWANA: THE DEPARTMENT HAS A PERMANENT PRESENCE IN BOTSWANA WITH A MEMBER OF OUR DEPARTMENT FULL-TIME AT SCOTTISH LIVINGSTONE HOSPITAL IN MOLEPOLOLE, BOTSWANA. - VIETNAM: THE MEDICAL CENTER HAS A PERMANENT PRESENCE IN VIETNAM. PHYSICIAN AND NURSE TRAINING ON HIV/AIDS CARE IN VIETNAM TAKES PLACE THROUGH FUNDING FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION. - ADDITIONAL LOCATIONS: THE DEPARTMENT OFFERS ROTATIONS AT THE ALBERT SCHWEITZER HOSPITAL IN GABON AND OTHER INTERNATIONAL SITES. RESIDENTS CAN ALSO DO ROTATIONS THROUGH THE INDIAN HEALTH SERVICE OR AT BIDMC-AFFILIATED COMMUNITY HEALTH CENTERS. GLOBAL HEALTH TRACK LEARNING HOW TO WORK EFFECTIVELY IN RESOURCE-LIMITED SETTINGS REQUIRES BOTH TRAINING AND EXPERIENCE. PARTICIPANTS IN THE GLOBAL HEALTH TRACK WILL PARTICIPATE WITH LEARNERS FROM AROUND THE WORLD IN THE GLOBAL HEALTH EFFECTIVENESS PROGRAM AT THE HARVARD SCHOOL OF PUBLIC HEALTH; THEY WILL ENGAGE IN OUR HOSPITAL-WIDE, YEAR-LONG GLOBAL HEALTH CURRICULUM AND JOURNAL CLUB, AND THEY WILL BE GIVEN THE OPPORTUNITY FOR TWO FIELD EXPERIENCES DURING RESIDENCY. HOSPITAL-WIDE GLOBAL HEALTH PROGRAM THE BIDMC GLOBAL HEALTH PROGRAM IS A HOSPITAL-WIDE PROGRAM AVAILABLE TO ALL BIDMC RESIDENTS. WHILE REQUIREMENTS AND TIMELINES MAY DIFFER BETWEEN DEPARTMENTS AND SPECIALTIES, THE OVERARCHING GOAL IS TO PROVIDE RESIDENTS WITH FURTHER TRAINING AND EDUCATION IN THE DISCIPLINE OF GLOBAL HEALTH.
NEUROLOGY EDUCATION AT BIDMC THE HARVARD MEDICAL SCHOOL NEUROLOGY PROGRAM AT BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL IN BOSTON, MASSACHUSETTS WAS FOUNDED IN 1996 AS THE SUCCESSOR TO THE HARVARD-LONGWOOD NEUROLOGY PROGRAM. THE PROGRAM CONCENTRATES ON THE TRAINING AND RESEARCH OPPORTUNITIES AVAILABLE ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS, BY COMBINING THE RESOURCES OF TWO MAJOR HARVARD TEACHING HOSPITALS, BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL. THESE COMBINED HOSPITALS, WITH OVER 800 INPATIENT BEDS AND EXTENSIVE OUTPATIENT CLINICS, PROVIDE THE SETTING FOR TRAINING PHYSICIANS IN THE ART AND SCIENCE OF CLINICAL NEUROLOGY.THE COMBINED FACULTY CONSISTS OF MORE THAN 80 NEUROLOGISTS AT THE TWO PARTICIPATING HOSPITALS, AND PROVIDES CORE EXPERIENCES IN INPATIENT AND OUTPATIENT NEUROLOGY, AS WELL AS TRAINING IN ELECTROPHYSIOLOGY (INCLUDING EEG, EMG, AND SLEEP POLYSOMNOGRAPHY) AND NEUROPATHOLOGY. THE KEY DISTINGUISHING FEATURE OF THE PROGRAM IS THE CLOSE RELATIONSHIP BETWEEN THE CLINICAL FACULTY, NEARLY ALL OF WHOM ARE FULL-TIME ACADEMIC NEUROLOGISTS ENGAGED IN SUBSTANTIVE RESEARCH AND TEACHING EFFORTS, AND A SELECT GROUP OF RESIDENTS WHO ARE KEENLY INTERESTED IN FORGING ACADEMIC CAREERS IN NEUROLOGY. VIRTUALLY ALL OF THE CLINICAL TRAINING TAKES PLACE WITHIN A 2 BLOCK RADIUS ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS. A CRITICAL COMPONENT OF THE PROGRAM IS THE OPPORTUNITY FOR RESIDENTS TO HAVE A MENTORED TEACHING EXPERIENCE AS WELL AS THE OPPORTUNITY TO UNDERTAKE A MENTORED PROJECT, WHICH MAY ENTAIL EITHER CLINICAL OR LABORATORY BASED INVESTIGATION OR PREPARATION OF INNOVATIVE TEACHING MATERIALS OR METHODS. *****PATHOLOGY EDUCATION AT BIDMCTHE DEPARTMENT OF PATHOLOGY AT BETH ISRAEL DEACONESS MEDICAL CENTER IS COMMITTED TO PROVIDING STATE-OF-THE-ART TRAINING TO PREPARE PHYSICIANS FOR LEADERSHIP ROLES IN PATHOLOGY AND ACADEMIC MEDICINE. THE PROGRAM OFFERS THREE RESIDENT TRAINING PATHWAYS: FIRST, A COMBINED ANATOMIC PATHOLOGY/CLINICAL PATHOLOGY (AP/CP) PATHWAY PROVIDES COMPREHENSIVE TRAINING IN ALL AREAS OF TISSUE DIAGNOSTICS AND LABORATORY MEDICINE. SECOND, THE AP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS ACADEMIC SURGICAL PATHOLOGISTS. THIRD, THE CP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS FUTURE LEADERS IN LABORATORY MEDICINE. ALL PATHWAYS INCLUDE EXTENSIVE OPPORTUNITIES TO PARTICIPATE IN RESEARCH PROJECTS WITH WORLD-RENOWNED EXPERTS IN PATHOLOGY OR RELATED DISCIPLINES. KNOWLEDGE COMES THROUGH EXPERIENCE AND EXTENSIVE INTERACTION WITH FACULTY. IN ANATOMIC PATHOLOGY SIGN OUT, RESIDENTS PREPARE THEIR OWN DIAGNOSES AND ARE THEN IN A POSITION TO TAKE FULL ADVANTAGE OF SIGN OUT WITH STAFF MEMBERS. IN CLINICAL PATHOLOGY, RESIDENTS GAIN EXPERIENCE DURING DAILY ROUNDS WITH ATTENDINGS, SOCRATIC TUTORIALS, AND THROUGH POSITIONING OF RESIDENTS AS AN INTERMEDIARY BETWEEN CLINICIAN AND LABORATORY. THERE ARE DAILY TEACHING AND CASE MANAGEMENT CONFERENCES COVERING THE DIFFERENT PATHOLOGY SPECIALTIES. GIVEN THE IMPORTANT ROLE PATHOLOGISTS PLAY IN TEACHING MEDICAL STUDENTS AND COLLEAGUES IN OTHER SPECIALTIES, THE PROGRAM PROVIDES GUIDANCE FOR RESIDENTS AS THEY HONE THEIR TEACHING SKILLS. SUCH "RESIDENT-AS-TEACHER" PROGRAMS ARE COMMON IN OTHER SPECIALTIES BUT NOT AS WELL-DEVELOPED IN PATHOLOGY. THE CURRICULUM INCLUDES SESSIONS DESIGNED TO IMPROVE SKILLS RELATED TO GIVING FEEDBACK AND SMALL GROUP TEACHING. THERE IS A SESSION ON DEVELOPING PRESENTATION SKILLS WITH CLOSE MENTORING OF FIRST YEAR RESIDENTS, BY SPECIFIC FACULTY WHO HAVE ALSO BEEN THROUGH THE CURRICULUM, AS THEY PREPARE FOR THEIR FIRST PRESENTATION. THERE ARE ALSO OPPORTUNITIES FOR RESIDENTS TO TEACH MEDICAL STUDENTS BOTH WITHIN OUR DEPARTMENT AND AT HARVARD MEDICAL SCHOOL, AS WELL AS TO RECEIVE FEEDBACK ON THEIR TEACHING SKILLS. RECOGNIZING THE NEED TO INTEGRATE TECHNOLOGY INTO RESIDENCY TRAINING, ALL FIRST YEAR RESIDENTS ARE PROVIDED WITH IPADS. THESE TABLETS ALLOW RESIDENTS TO MORE EASILY PREVIEW THE SLIDES THAT ARE ROUTINELY SCANNED FOR OUR SURGICAL SLIDE CONFERENCE. GENOMIC TECHNOLOGY WILL AFFECT THE PRACTICE OF ALL MEDICAL PRACTITIONERS. AS THE PHYSICIANS WHO MANAGE THE HOSPITAL LABORATORIES, PATHOLOGISTS MUST UNDERSTAND NEXT-GENERATION SEQUENCING TECHNOLOGY AND ITS APPLICATION TO PATIENT CARE. IN 2009, THE PROGRAM CREATED, TO OUR KNOWLEDGE, THE FIRST GENOMIC PATHOLOGY CURRICULUM IN THE COUNTRY. THE CURRICULUM HAS BEEN PUBLISHED AND HAS SERVED AS THE BASIS FOR A COLLABORATIVE EFFORT TO DEVELOP A NATIONAL GENOMICS CURRICULUM (WWW.ASCP.ORG/TRIG).TRAINING IN EVIDENCE-BASED MEDICINE IS CRITICAL. A FIRST-YEAR RESIDENT JOURNAL CLUB ALLOWS AN INTRODUCTION TO CRITICAL REVIEW OF THE MEDICAL LITERATURE. IN LATER YEARS, RESIDENTS LEAD SMALL-GROUP DISCUSSIONS IN MONTHLY JOURNAL CLUBS. THERE IS ALSO AN EVIDENCE-BASED TRANSFUSION MEDICINE CURRICULUM TO HONE THESE SKILLS DURING CP TRAINING. *****RADIOLOGY EDUCATION AT BIDMCTHE RADIOLOGY RESIDENCY PROVIDES FOUR YEARS OF TRAINING IN DIAGNOSTIC IMAGING. APPOINTMENTS ARE HELD JOINTLY AS A RESIDENT AT THE MEDICAL CENTER AND AS A CLINICAL FELLOW AT HARVARD MEDICAL SCHOOL. WITH A CENTRAL ROLE IN CLINICAL SERVICE, TEACHING, AND RESEARCH, THE RADIOLOGY DEPARTMENT PERFORMS OVER 400,000 RADIOLOGIC EXAMINATIONS EACH YEAR. THE DEPARTMENT PROVIDES RADIOGRAPHY, CT, ULTRASOUND, MRI, NUCLEAR MEDICINE, MAMMOGRAPHY, ANGIOGRAPHY, AND INTERVENTIONAL RADIOLOGY SERVICES TO BOTH THE MEDICAL CENTER AS WELL AS OUR AFFILIATED HEALTH CARE FACILITIES. A RADIOLOGY RESEARCH AND ANIMAL LABORATORY IS HOUSED ADJACENT TO THE RADIOLOGY DEPARTMENT. ALL RESIDENTS, FELLOWS, AND FACULTY HAVE APPOINTMENTS AT HARVARD MEDICAL SCHOOL. ALL RADIOLOGIC STUDIES ARE INTERPRETED UNDER THE SUPERVISION OF STAFF RADIOLOGISTS. THE NUCLEAR MEDICINE PROGRAM IS A PART OF THE JOINT PROGRAM IN NUCLEAR MEDICINE AT HARVARD MEDICAL SCHOOL. THE DEPARTMENT PLACES STRONG EMPHASIS ON THE QUALITY OF TEACHING-BOTH IN DIDACTIC LECTURES AND IN INDIVIDUAL CASE-BASED TEACHING.WITH THE ADVENT OF RECENT CHANGES IN RESIDENCY TRAINING, THE CURRICULUM HAS RECENTLY BEEN REVISED SO THAT RESIDENTS UNDERTAKE A COURSE OF STUDY WHICH WILL PERMIT THEM TO OBTAIN EXPERTISE NOT JUST IN CLINICAL SUBSPECIALTIES BUT ALSO IN OTHER KEY AREAS SUCH AS RESEARCH, EDUCATION, GLOBAL HEALTH, QUALITY IMPROVEMENT, AND HEALTH POLICY. RADIOLOGIC PHYSICS HAS BEEN INTEGRATED INTO DAILY DIDACTIC SESSIONS. IN ADDITION, MANY DIDACTIC SESSIONS UTILIZE AUDIENCE RESPONSE TECHNOLOGY, VIDEO-RECORDING, AND IPAD2 TECHNOLOGY.THERE ARE NINE FORMAL SECTIONS IN THE DEPARTMENT: ABDOMINAL IMAGING, BREAST IMAGING, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY (CVIR), MRI, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, ULTRASOUND, AND THORACIC IMAGING. MOST NON-ANGIOGRAPHIC INTERVENTIONAL PROCEDURES ARE PERFORMED BY THE RESPECTIVE SERVICES. RESIDENTS ROTATING THROUGH THESE SECTIONS ARE PROVIDED WITH READING SUGGESTIONS AND MATERIAL. ACADEMIC ROTATIONS ARE MADE UP OF THIRTEEN 4-WEEK BLOCKS ANNUALLY. AT THE END OF EACH ROTATION RESIDENTS RECEIVE WRITTEN EVALUATIONS AND HAVE THE OPPORTUNITY TO EVALUATE THE STAFF.FIRST YEAR ROTATIONS EMPHASIZE FUNDAMENTALS AND COMMON RADIOLOGIC EXAMINATIONS IN PREPARATION FOR INPATIENT AND EMERGENCY DEPARTMENT RESPONSIBILITIES. PRIOR TO TAKING CALL, ALL FIRST YEAR RESIDENTS ROTATE THROUGH ABDOMINAL IMAGING, BREAST IMAGING, EMERGENCY RADIOLOGY, FLUOROSCOPY, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, THORACIC IMAGING, AND ULTRASOUND.DURING THE SECOND YEAR, RESIDENTS CONTINUE TO GAIN EXPERIENCE IN THESE SECTIONS, PERFORMING AND INTERPRETING MORE ADVANCED EXAMINATIONS AND INTERVENTIONS AS THEIR LEVELS OF EXPERTISE INCREASE. ADDITIONAL ROTATIONS IN MORE SPECIALIZED TOPICS OCCUR THROUGHOUT THE SECOND THROUGH FOURTH YEARS, INCLUDING INTERVENTIONAL RADIOLOGY, MRI, HEAD AND NECK IMAGING, AND PEDIATRIC RADIOLOGY. IN ADDITION, ALL RESIDENTS PARTICIPATE IN A TWO-WEEK ROTATION IN QUALITY ASSURANCE WHICH PROVIDES THEM WITH ESSENTIAL SKILLS FOR EVENTUAL BOARD RE-CERTIFICATION.ROTATIONS AT OTHER TRAINING LOCATIONS DURING THE SECOND AND THIRD YEARS OF TRAINING INCLUDE:- THREE MONTHS OF TRAINING IN PEDIATRIC RADIOLOGY AT THE BOSTON CHILDREN'S HOSPITAL DURING THE SECOND YEAR.- FOUR WEEK PROGRAM IN RADIOLOGIC-PATHOLOGIC CORRELATION AT THE ARMED FORCES INSTITUTE OF PATHOLOGY (AIRP) SPONSORED BY THE AMERICAN COLLEGE OF RADIOLOGY IN SILVER SPRINGS, MARYLAND DURING THE THIRD YEAR.- ONE MONTH ROTATION AT THE MASSACHUSETTS EYE AND EAR INFIRMARY IN HEAD-AND-NECK RADIOLOGY DURING THE THIRD YEAR.UPON COMPLETION OF THE SECOND YEAR OF RESIDENCY TRAINING, RESIDENTS SELECT AN AREA OF ACADEMIC FOCUS FOR THEIR FOURTH YEAR WHICH WILL GUIDE CHOICES FOR THE 3-MONTH MINI-FELLOWSHIPS AND THE OTHER TWO MONTHS OF ELECTIVE TIME.
OUR UNIQUE EDUCATIONAL TRACKS CURRENTLY, SIX TRACKS ARE OFFERED:- CLINICAL- EDUCATION- RESEARCH- GLOBAL HEALTH- QUALITY IMPROVEMENT- HEALTH POLICY/HEALTH ECONOMICSEACH OF THESE TRACKS HAS SPECIFIC CURRICULAR OFFERINGS AND EDUCATIONAL GOALS. MOST OF THE TRACKS ARE LINKED TO SPECIFIC EDUCATIONAL ENDEAVORS. FOR EXAMPLE, A RESIDENT SELECTING THE GLOBAL HEALTH TRACK WILL ENROLL IN THE GLOBAL EFFECTIVENESS CURRICULUM OFFERED BY THE HARVARD SCHOOL OF PUBLIC HEALTH AND WILL SPEND TIME ABROAD PROVIDING CLINICAL RADIOLOGY SERVICES AND UNDERTAKING A GLOBAL HEALTH PROJECT. A RESIDENT SELECTING THE EDUCATION TRACK WILL PURSUE ADVANCED TRAINING IN EDUCATIONAL THEORY AND ADULT LEARNING BY PARTICIPATING IN THE HARVARD MACY PROGRAM FOR PHYSICIAN EDUCATORS AND UNDERTAKE AN EDUCATIONAL PROJECT BASED AT BIDMC OR HARVARD MEDICAL SCHOOL. A RESIDENT CHOOSING THE RESEARCH TRACK WILL PARTICIPATE IN GRANT WRITING WORKSHOPS AND DELVE DEEPLY INTO A RESEARCH PROJECT OF THEIR CHOICE.NO MATTER WHICH TRAINING TRACK, THE EXPECTATION IS THAT EVERY RESIDENT WILL HAVE THE OPPORTUNITY TO UNDERTAKE A SUBSTANTIAL PROJECT DURING RESIDENCY THAT WILL CULMINATE IN PRESENTATION AT A NATIONAL MEETING AND/OR PUBLICATION.*****SURGERY EDUCATION AT BIDMCTHE ROBERTA AND STEPHEN R. WEINER DEPARTMENT OF SURGERY OFFERS EDUCATION OPPORTUNITIES FOR RESIDENTS, FELLOWS AND MEDICAL STUDENTS IN CARDIAC SURGERY, GENERAL SURGERY, NEUROSURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, PODIATRY, TRAUMA SURGERY, MINIMALLY INVASIVE SURGERY, UROLOGY, AND VASCULAR SURGERY. STUDENTS LEARN THE MOST ADVANCED TECHNIQUES IN A STATE-OF-THE-FACILITY. STUDENTS ALSO HAVE THE OPPORTUNITY TO LEARN MINIMALLY INVASIVE TECHNIQUES AT THE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER, THE FIRST OF ITS KIND TO BE ACCREDITED IN THE COUNTRY AND LOCATED WITHIN THE MEDICAL CENTER.THE MEDICAL CENTER'S DEPARTMENT OF SURGERY IS ONE OF THREE MAJOR TEACHING AND RESEARCH UNITS OF HARVARD MEDICAL SCHOOL'S DEPARTMENT OF SURGERY. AT ALL LEVELS, THE HOUSESTAFF GAIN TRAINING AND PRACTICAL EXPERIENCE IN THE PREOPERATIVE, OPERATIVE, AND POST-OPERATIVE CARE OF PATIENTS. THE PROGRAM EMPHASIZES RESIDENT-FACULTY INTERACTION FOR EDUCATIONAL PURPOSES. TEACHING CONFERENCES AND SEMINARS FOR THE HOUSESTAFF CAPITALIZE ON WORKING RELATIONSHIPS DEVELOPED WITH THE ATTENDING STAFF. UPON COMPLETION OF FIVE YEARS OF SURGICAL TRAINING, RESIDENTS ARE ELIGIBLE FOR THE AMERICAN BOARD OF SURGERY EXAMINATION. DIDACTIC TEACHINGTHE PROGRAM HAS DEDICATED EDUCATION TIME, INCLUDING A STRONG DIDACTIC CONFERENCE SCHEDULE, TO PROVIDE A BASIC FOUNDATION OF SURGICAL KNOWLEDGE AND SKILLS. REQUIRED WEEKLY CONFERENCES INCLUDE:- RESIDENT CURRICULUM CONFERENCE / MIS SKILLS LAB - SURGICAL SERVICE MORBIDITY/MORTALITY & SURGICAL GRAND ROUNDS - COMBINED GI CONFERENCETHROUGHOUT TRAINING, A PRIMARY RESPONSIBILITY OF SENIOR RESIDENTS IS TEACHING MORE JUNIOR RESIDENTS AND THE STUDENTS ON THEIR SERVICE. THEY ARE ALSO RESPONSIBLE FOR THE ASSIGNMENT OF CASES, CLINICAL SUPERVISION OF MEDICAL STUDENTS AND RESIDENTS, AND PREPARING MATERIAL FOR SERVICE AND TEACHING CONFERENCES.GRADUATE MEDICAL EDUCATION BIDMCADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)COMMUNITY BOARDAS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. AFFILIATED HEALTH CARE SYSTEMAS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BIDMC IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BILH OPERATES AS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. BILH SERVES AS SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). LAHEY CLINIC FOUNDATION SERVES AS THE SOLE MEMBER OF LAHEY CLINIC, INC. AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER. EACH OF THESE AFFILIATES IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES SERVED BY BILH. EACH OF THESE AFFILIATES MAY ALSO, IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES.FOR THE FISCAL YEAR 2020 THE BILH HOSPITALS NOTED ABOVE PROVIDED CARE TO MEDICAID PATIENTS AT COSTS WHICH EXCEEDED REVENUES BY OVER $86 MILLION AND PROVIDED CARE TO MEDICARE PATIENTS AT COSTS WHICH EXCEEDED REVENUES BY $117 MILLION. IN ADDITION, THE BILH HOSPITALS PROVIDED TOTAL COMMUNITY BENEFITS IN THE NATURE OF DIRECT SERVICES TO THE COMMUNITIES SERVED BY THE BILH NETWORK AS WELL AS FUNDS PROVIDED TO COMMUNITY PARTNERS IN THE AMOUNT OF $32 MILLION BILH HOSPITALS ALSO INCURRED NET COSTS FOR SUBSIDIZED HEALTH SERVICES TO ENSURE THAT CARE WAS AVAILABLE WITHIN THE COMMUNITIES SERVED ACROSS BILH IN THE AMOUNT OF $93 MILLION. FINALLY, BILH HOSPITALS ARE COMMITTED TO PROVIDING RESEARCH TO FURTHER ADVANCE CARE TO BILH PATIENTS AND TO THE GENERAL ADVANCEMENT TO HEALTHCARE TREATMENT BEYOND THE COMMUNITIES IMMEDIATELY SERVED BY BILH AND TO PROVIDING CUTTING EDGE TRAINING TO FUTURE HEALTHCARE PROVIDERS. BILH HOSPITALS INVESTED NET COSTS OF $183 MILLION TOWARD THESE MISSIONS DURING THE FISCAL YEAR COVERED BY THIS FILING.
Schedule H (Form 990) 2019
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