Staff Writer
PRESQUE ISLE, Maine – Outpatient services will be offered at a new location in Presque Isle for many Aroostook County residents by 2009.
During a press conference at The Aroostook Medical Center on Monday, Dave Peterson, president and CEO, announced hospital officials had determined a change was necessary in how services were being provided to a number of communities in northern Aroostook County. The decision was made to consolidate services at a new facility in Presque Isle by 2009. In an ever-changing health care landscape, TAMC’s mission is to improve, restore and maintain the health of those in the communities it serves in a professional and compassionate environment. To do so, officials devised a Master Facilities Plan in 2007, listing several areas relevant to outpatient services, said Peterson, giving an overview.
“More outpatient procedures are the trend. We want to concentrate outpatient services in a comprehensive location not on the A.R. Gould campus,” said Peterson, noting that most outpatient clinic services can be moved to a location not attached to the hospital.
“We (TAMC officials) looked at how we deliver service, particularly outpatient services. In effect, we’re creating a second campus of TAMC,” said Peterson. “The (medical) environment is changing. We need to anticipate and respond to those changes. Changes represent opportunities as TAMC continues to grow.”
Peterson said the hospital Board of Trustees approved the master plan.
“It’s a comprehensive document to guide us through the next 10 to 20 years of service,” he said.
With more outpatient procedures now being the trend, it was decided to concentrate growth outside TAMC. When the site formerly occupied by Smythe’s IGA Plus became available on North St., hospital officials made the decision to pursue use of the space as a possible location to combine services under one roof.
“The space available is approximately 50,000 square feet and is easily adaptable. Advantages include the facility’s central location, with easy access from all directions, ample space and parking. Space disadvantages include the site’s distance from some diagnostic tools,” explained Peterson.
The new location would house a number of outpatient services under one roof, including Aroostook Pediatrics, Aroostook Family Practice and Outpatient Mental Health Service offices. Planned actions include consolidating primary care practices that are now located in various communities in Aroostook County, including: Washburn Regional Health Center, Limestone Health Center, Madawaska Health Center and Fort Fairfield Health Center/Community General Hospital. Peterson said officials met recently to discuss the hospital’s plans with officials from those communities.
“Some facilities are over 60 years old that are in use now. The buildings are tired. We’re adjusting our philosophy to fit the reality of 2008 and beyond. The grouping of providers creates a better flow of services, provides convenience,” said Peterson. “North St. would be a ‘medical mall.’ Parking has become an issue at TAMC, even though we have 650-plus spots. The new site has over 300 spots.”
While Peterson acknowledged some services might have to be duplicated, such as a lab, the site will provide a better flow of service for patients, with more consistency. Though some patients may not wish to continue service at the new location – instead seeking care closer to home, as in the case of patients currently using the Madawaska facility – officials are confident the majority of patients will follow their primary-care providers to the new location.
For those needing other diagnostic work performed at TAMC, Peterson said shuttle service is being considered.
“Establishing a medical mall provides several opportunities. Our outreach sites are losing (money) and can’t be sustained. Physicians expect to practice in groups so they can confer with one another. Solo practices don’t work for very long. With physicians in short supply, it’s important to consolidate services when possible,” said Peterson.
“This model is the wave of the future. Physicians who come out of medical school today expect to work closely with other health care practitioners. Now that we have hospitalist physicians caring for patients at A.R. Gould 24 hours a day, family practitioners can serve their patients at this new location without having to worry about being close to the hospital,” said Dr. Dan Fowler, president of TAMC’s medical staff, at the recent Board of Trustees’ meeting.
Times have changed, according to Peterson. Where once patients were limited in their ability to travel, people think nothing nowadays of going to town for a desired service, be it shopping, banking or medical care.
“The problem of travel for care takes a back seat to the continuity of care. Patients have indicated they want to stick with a provider wherever they go,” said Peterson. “People prefer to go where their provider is five days a week.”
Peterson said the moving of some services – Aroostook Pediatrics and Aroostook Family Practice – will free up space to expand other services.
“Other services will change. We’ll relocate Surgical Services, Infectious Disease and Cardiology; expand Orthopedics into Aroostook Pediatrics; relocate the Women’s Health Center; and expand Horizons Obstetrics into the Women’s Health Center,” said Peterson.
TAMC officials are in the process of working with a design engineer to plan for the new facility and what needs to be done to remodel sections at TAMC. The cost for all the renovations is substantial, estimated at over $3 million. But Peterson said the long-term savings that will come from closing several satellite facilities will far offset the amount needed for renovations in the long run.
“North St. improvements will run around $2,818,000, with A.R. Gould renovations estimated at $577,000, for a total financial impact of $3,395,000,” said Peterson.
By relocating services from several other locations, and therefore not having the expense of maintaining those facilities, Peterson said the net annual cost savings would be approximately $499,000.
“As health care continues to change, hospitals will need to become even more efficient in order to offer advanced services and the latest technology. Every hospital in Maine suffers from MaineCare shortfalls and delays in payment, and in fact, the state currently owes TAMC over $17 million. TAMC remains financially strong, but we need to regularly review ways to improve our efficiency so we can continue to offer a complete range of services in our communities, explained Bruce Sandstrom, senior vice president and chief financial officer of TAMC, at the Board of Trustees’ meeting.
A timeline has been established for when the new facility will be in operation. Planning and programming of the space will begin this month. Design of the space will take place between March and April of this year. Suite design at the North St. site will occur sometime between May and July 2008. The project will go out to bid by July 2008. Construction could begin as early as August of this year.
“We’re hoping to occupy the new space at North St. by January 2009,” said Peterson.
Peterson said he’s looking forward to the consolidation and believes patients will too.
“This is a new concept in how health care can be provided in Aroostook County,” said Peterson. “The outpatient services center in the new medical mall will provide patients with enhanced access and will free up space at A.R. Gould Memorial Hospital for future growth. The changes will result in more convenient services both at the hospital and at the North St. location, and we believe our patients will be very satisfied.”
