70 years of quality medical care Our Main
Transcription
70 years of quality medical care Our Main
Celebrating 70 years of quality medical care Our Main Campus expansion Expanded services for our patients Greetings from the Chairman Welcome to the inaugural edition of Inside Springfield Clinic, a closer look at Springfield Clinic, its people and its progress. For the past 70 years, Springfield Clinic has been committed to the advancement of quality healthcare in Central Illinois. Dating back to its origin in 1939, the Clinic has continually introduced innovative new tools, equipment, facilities and services to better care for patients. We have recently completed a three-year, $40 million expansion and renovation of our Main Campus facility in Springfield. Both the new 4-story, 115,000 square foot West Building and the remodeled East Building are fully operational. These physical enhancements have been popular with physicians, staff and most importantly, our patients. We encourage you to visit, if you have not done so already. Springfield Clinic’s Electronic Health Record (EHR) system is fully operational in each physician office throughout our entire service network. This achievement places us among the top 4% of clinics in the nation to have successfully implemented a project of this magnitude. Our EHR is once again demonstrating that technology improves and enhances the efficiency, service and continuity of care we deliver to our patients. Of course, our commitment to excellent service and clinical quality has never been stronger. We hope that by exceeding our patients’ expectations, we will continue on the same path of growth and success our organization has experienced these past seventy years. In closing, I want to acknowledge our physicians and staff for their commitment to excellence, our business associates for their support in the delivery of high quality health care and most importantly, our patients and their families for their continued confidence and loyalty. Working together, we can improve the quality of health and life in Central Illinois. This publication is made possible through the generous support of our suppliers, contractors and vendors. We hope you enjoy the insider’s look at Springfield Clinic, as well as their contributions to this effort. Please let us know your thoughts about future issues and the topics that interest you most. Your opinion, as always, is important to us. Thank you again. Sincerely, William D. Putman, MD Chairman, Board of Directors 4 l INSIDE SPRINGFIELD CLINIC SPRINGFIELD CLINIC l 5 TABLE OF CONTENTS 70 Years of Quality Medical Care Springfield Clinic: 8 Carlinville Acorn Medical Associates 101 McCasland Avenue Carlinville, IL 62626 Decatur Family Medical Care of Decatur 1770 E. Lake Shore Drive Suite 105 Decatur, IL 62521 Hillsboro Hillsboro Medical Associates 1250 E. Tremont Hillsboro, IL 62049 Jacksonville Jacksonville Family Health Care 610 N. Westgate Jacksonville, IL 62650 Midwest Occupational Health Associates (MOHA) - Jacksonville 901 West Morton Avenue, Suite 16A Jacksonville, IL 62650 Springfield Clinic Jacksonville 1600 West Walnut Jacksonville, IL 62650 A Look Back in History Springfield Springfield Clinic Main Campus East 1025 South 6th Street Springfield, IL 62703 Springfield Clinic Main Campus West 1025 South 6th Street Springfield, IL 62703 15 Our Main Campus Expansion Springfield Clinic’s 16 Main Campus Expansion Springfield Clinic 1st 800 North 1st Street Springfield, IL 62702 Springfield Clinic Wabash 2200 Wabash Avenue Springfield, IL 62704 Midwest Occupational Health Associates (MOHA) 775 Engineering Drive Springfield, IL 62703 24 O’Shea Builders: Unique Challenges in Medical Facility Planning and Building 30 Springfield Clinic Celebrates New Expansion 34 Putting the Finishing Touch on Springfield Clinic’s Vision Expanded Services for our Patients Advance Medical Directives 38 Springfield Family Practice Center 1100 Centre West Drive Springfield, IL 62704 Springfield Pediatric & Adolescent Center 2532 Farragut Springfield, IL 62704 Springfield Clinic at St. John’s Pavilion 301 North 8th Street Springfield, IL 62701 Lincoln Lincoln Health Care Specialists 311 8th Street Lincoln, IL 62656 Springfield Clinic The Center for Plastic Surgery 2901 Greenbriar Drive Springfield, IL 62704 Sherman Sherman Family Practice 400 St. John’s Drive Sherman, IL 62684 Springfield Clinic at Memorial Medical Center / St. John’s Hospital 701 North 1st Street / 800 E. Carpenter Springfield, IL 62701 Taylorville Springfield Clinic Taylorville 600 N. Main Taylorville, IL 62568 A Personal Reflection 44 Administrative Team 47 Board of Directors 52 Solutions for Success: Overcoming Today’s Challenges in Oncology 56 The Personal Side of Clinical Research 60 Scrubbing In: A Day at the Ambulatory Surgery & Endoscopy Center 64 Better Health Care through Technology: the Electronic Health Record System 68 Leading the Way in Digital Imaging 70 Who Ya Gonna Call? Telenurse: Springfield Clinic’s 24-Hour a Day, 7-Day a Week Patient Help Line 73 Physician Directory Inside Springfield Clinic magazine is designed and published by Custom Publishers Group. To advertise or to publish your own corporate publication, please call Gary Wright: (502) 721-7599. 6 l INSIDE SPRINGFIELD CLINIC SPRINGFIELD CLINIC l 7 Springfield Clinic: A Look Back in HISTORY 8 l SPRINGFIELD CLINIC Springfield Clinic’s first office at 421 South 6th. training at Cook County Hospital in Chicago. He opened a solo practice, specializing in Obstetrics & Gynecology, in his hometown of Springfield. The year was 1935. Dr. James Graham, a Springfield native, completed medical school Dr. Richard F. Herndon, a member of the prominent at the University of Illinois College of Medicine in Chicago in department store family, completed his medical training at 1930. After studying two years in New York, he completed his Rush Medical College in Chicago. His Springfield-based residency training in Boston City Hospital and in 1934, returned solo practice had been established in the early 1930’s, but by to Springfield to establish a private surgical practice. 1937, he was contemplating the relocation and expansion of his practice. Dr. A.R. Eveloff moved to Springfield in 1935, following the completion of a residency in Pediatrics at St. Louis Children’s Convinced that the future of medicine lay in the practice Hospital, and began a solo practice in Pediatrics. He and Dr. of sub-specialties, and with a shared spirit of innovation, Graham discovered a common interest in a developing a group these five visionary physicians agreed to join forces. By practice and the two quickly became friends. spring of 1939, the partnership agreement had been written and the group had a plan to build a new, 24-room medical Dr. B. Lyman Stewart, a graduate of Northwestern University office building. On November 1, 1939, the partnership, Medical School and trained Urologist, rented office space from which would eventually become known as Springfield Clinic, an older group of physicians in Springfield. Upon hearing of a officially opened its doors at 421 South 6th Street. possible group being formed by Graham and Eveloff, Stewart expressed an interest in being part of their venture. The medical “group” employed three original staff members: a receptionist / stenographer, a nurse who had previously Dr. E. Harold Ennis, also a native of Springfield, attended worked with Dr. Ennis and a former bank teller to serve as medical school at Northwestern University and completed business manager. SPRINGFIELD CLINIC l 9 Just two years later, the partnership expanded for the first time, recruiting a local Internist to join the group practice. But the growth of the practice was temporarily suspended, as four of the five partners left to serve in World War II. Dr. Herndon, the oldest of the group, had served in WWI and stayed behind to maintain the practice. The Herndon family cancelled the rent during their service and held the lease open for the partners until their return. In the interim, Dr. Hurie, another local physician, joined the group. Dr. Herndon’s recommendation paid off. By 1951, adequate funds had been accrued to finance a new, larger facility to the south, just on the fringe of the downtown business district. Thankfully, all four servicemen returned home safely in 1945; The spacious new medical office, located at 1025 South 7th however, Dr. Stewart chose to stay in Los Angeles after the war. Street, accommodated the growing number of partners to With the team back in full force, the practice grew quickly and the organization, as well as the expanded radiology and lab the organization prospered. services offered. In 1947, a mere eight years after its start, 12 exam rooms were Attracted by Springfield Clinic’s innovative approach to medical added and more space for lab and x-ray services were created. care, numerous physicians joined the organization during this Dr. Herndon, the senior partner of the group, fostered the period. Several new sub-specialties, including Rheumatology, idea of a shared savings fund, which could be used for future Orthopaedics, Thoracic Surgery, Ophthalmology and expansion of the practice. Each partner agreed. Otorhinolaryngology (ENT), among others, were added. By the end of the decade, rapid growth prompted the acquisition of neighboring properties to accommodate additional parking and building expansion. The growing physical operation was accompanied by a re-organization of the administrative function, the creation of a more sophisticated accounting system and the development of what could be considered the forerunner of today’s HMO. New office at 1025 South 7th. 10 l INSIDE SPRINGFIELD CLINIC In 1967, Springfield Clinic completed a massive 3-story expansion. The next decade in Springfield Clinic history ushered in find itself in repeatedly as it continued to grow. Neighboring continued growth and technological advancement. Specialties, property was purchased and homes were razed to accommodate including Cardiology, Hematology & Oncology, Neurology, a 1961 expansion. and Dermatology were introduced and other specialties, like Surgery, diversified into further sub-specialties, specifically In 1963, the Clinic’s first Administrator, Francis Wenzel, Colon & Rectal Surgery. New services, including Physical retired and was succeeded by John W. Montgomery, whose Therapy, were established. pioneering spirit introduced computers into the operation and whose tenacity re-launched the Clinic’s satellite operations By the early 1960’s, Springfield Clinic’s partnership had grown network that had met with resistance twenty years prior. to approximately twenty-five physicians and it was commonly believed by doctors in the area that Springfield Clinic was In 1967, Springfield Clinic completed a massive, 3-story “going somewhere.” The unprecedented expansion of staff expansion, which today still serves as the east side of the Main resulted in cramped working space and a lack of parking for Campus East Building on 7th Street. patients; a situation Springfield Clinic would continue to SPRINGFIELD CLINIC l 11 Springfield Clinic’s success continued to attract well-trained and talented physicians and surgeons to its partnership throughout the 1970’s. New specialties, including Nephrology, were added to its clinical offerings and an official Family Practice department was finally created. As many others in the Illinois medical community did, Springfield Clinic partners recognized a decline in medical school graduates interested in pursing a general medicine practice, and an even greater migration of medical professionals to larger, more attractive urban areas. Springfield Clinic’s physicians played an integral role in the establishment of Southern Illinois University School of Medicine. Many Springfield Clinic partners assumed teaching roles and served as Associate Professors and Clinical Professors at the school. At one point, Springfield Clinic’s original building at 421 South 6th Street was used to house the medical school’s library. J. Michael Maynard, a native West Virginian, replaced the retiring John Montgomery as Springfield Clinic’s Chief Administrator in 1987. By the end of the decade, Springfield The next ten years, as many others before them, were marked Clinic managed eight satellite locations and had engaged in the with considerable growth. By the end of the 1980’s, number third major expansion of its Main Campus facility on South 7th of physicians in Springfield Clinic’s partnership surpassed fifty. Street. The $14 million dollar project added space for 20 new Many of the physicians recruited during this time period serve physicians, expanded Physical Therapy Services and state-of the as the leadership of the organization today. art CAT-scan equipment. Educational symposiums and seminars were held to support the Further refinements were made to the administrative structure continuing medical education of Springfield Clinic medical staff and management of the organization. In 1988, a uniform and referring physicians, many years before the State of Illinois dress code, id badges and time clocks were introduced to recognized the need for regular clinical updates. Springfield support the standardization of operations between, buildings, Clinic’s physicians also sponsored a popular Medical Bulletin specialties and providers. for many years. 12 l INSIDE SPRINGFIELD CLINIC In 1990, a 2-story expansion was added. Pre-expansion Illinois Region. Offices in Hillsboro, Jacksonville, Lincoln, Decatur and Taylorville were established during this time. Springfield Clinic’s leadership was quick to recognize the value of an internal referral network, particularly in light of the Advancements in technology created greater opportunity for expanding popularity of HMOs in the commercial insurance outpatient surgical procedures and in 1994, Springfield Clinic marketplace and the mounting importance of communications opened its Ambulatory Surgery Center, the first freestanding between family physician and specialist. surgical center in Central Illinois. For a decade or more, Springfield Clinic’s partnership grew Major enhancements to the Clinic’s computer and billing dramatically, as it strategically merged with well-established systems loaded the spring for the technology boom the smaller group practices throughout Springfield and the Central organization would experience. SPRINGFIELD CLINIC l 13 The first nine years of the new millennium will undoubtedly be remembered for the number of projects completed, the level of technology achieved and the speed at which they were implemented. Technology at Springfield Clinic took a giant leap forward with the full implementation of an integrated Electronic Health Record system in 2008. The project, which took years of planning and implementation, completely replaced traditional paper charts and revolutionized the delivery and quality of health care in Central Illinois. The accomplishment placed Springfield Clinic among the top 4% of multi-specialty clinics in the country to have successfully implemented a Springfield Clinic today. comprehensive electronic health record system. Medical Clinic, Taylorville Medical Associates and various Improved technology in imaging led to the addition of a 16-slice specialty outreach locations in the community. A similar project CT, the first digital fluoroscopy unit, Nuclear Medicine, PACS, in Lincoln is underway. an image management system, digital mammography, a 3.0 tesla MRI and digital x-ray at each and every Springfield Clinic Ever committed to serving the needs of its patients, Springfield location. Clinic continued its focus on the quality and service. For the In an effort to provide its patients with therapies from the accreditation possible through AAAHC, the Association for leading edge of medical science, Springfield Clinic formally Accreditation in Ambulatory Health Care. A Learning Center created a Research Department in 2003. Springfield Clinic was established and formal service training initiatives were physicians have served as investigators on more than 270 implemented for all staffing levels. 7th consecutive audit, Springfield Clinic received the highest trials to date and have been nationally recognized for their participation in ground-breaking medical research. On July 1, 2008, Randall Bryant, the Clinic’s Chief Financial Officer, assumed a new role as Springfield Clinic’s CEO, Major construction projects resulted in more than 300,000 following the retirement of J. Michael Maynard, who provided square feet of new medical office space for Springfield Clinic more than twenty years of service to Springfield Clinic as its physicians and staff. Springfield Clinic 1st, completed in the Chief Executive Officer. spring of 2006, brought specialists, particularly surgeons, under the same roof and in proximity to both Springfield’s hospitals. Through mergers, recruitment and retention of high quality health care professionals Springfield Clinic has reached A $40 million expansion and renovation of Springfield unprecedented numbers. In just 70 years, the number of Clinic’s Main Campus was completed in fall of 2008, further Springfield Clinic partners has grown from five to more than consolidating specialty groups and providing room for 130. Springfield Clinic’s mission, to provide the highest quality additional growth. The construction also included an expansion health care in Central Illinois, is today the focus of nearly 200 of the Ambulatory Surgery and Endoscopy Center which physicians and surgeons, approximately 80 mid-level providers currently consists of five full surgical suites and four endocsopy and more than 1600 employees. procedure rooms. Springfield Clinic providers offer care in nearly 40 medical 14 l A new 40,000 square foot medical office building in Taylorville, specialties and serve patients through its network of 20 medical opened in summer 2009, consolidated Christian County offices and specialty outreach locations throughout the region. INSIDE SPRINGFIELD CLINIC A Personal Reflection During a recent visit to Springfield Clinic, Elsie Hinds, considered to be the only living nurse from the founding partner’s group, shared a few of her memories from the early days at Springfield Clinic: “I graduated from St. John’s School of Nursing in 1945 and went to work at the hospital in the OB/GYN department. I stayed there for two years, but the hours were long and I really wanted a job where I could have holidays off,” she began. In May 1947, she accepted a nursing position with Dr. Harold Ennis, a handsome and successful doctor whose OB/GYN practice had grown quickly after his return from WWII. Elsie’s primary role was assisting Dr. Ennis with exams in the office. “We had quite a few patients and it was always busy,” she reflected, “but we rarely worked late. Dr. Ennis was a wonderful family man and he always wanted to get home at the end of the day.” According to Elsie, the staff worked hard, but knew how to have fun as well. “It must have been the early 1950’s,” she reflected, “and my husband and I lived on North 9th Street. I invited the other nurses over for a pot luck and gift exchange, so I guess you can say I hosted Springfield Clinic’s first staff Christmas Party in my apartment.” The camaraderie between the nurses was supported by the doctors too. Elsie added, “The doctors always respected us and treated us well. They would order in pizzas from Gabatoni’s for lunch or after a particularly long day, they would treat us to a bottle of wine. They were all great to work for.” “I left in 1952 to raise my own family,” recalled Elsie. “On my last day, Dr. Ennis brought me to the new building, gave me a tour and told me I would always be welcome here.” The “new building” was the first construction at 1025 South 7th Street, Springfield Clinic’s current Main Campus location. For the next eleven years, as Elsie’s own family grew, she continued to fill in for her fellow staff members at Springfield Clinic. “I didn’t drive, so the janitor would pick me up and bring me to work.” In 1963, Elsie returned to Springfield Clinic on a full-time basis and continued to do so through the mid 1980’s. The list of physicians she recalled was a virtual Who’s Who of Springfield Clinic history. “I remember so many of them…Dr. Power, he was from Michigan, Dr. Cunningham, Dr. Dilts and Dr. Hurie. Of course, I remember Dr. Manson and Dr. Spangler. I did Dr. Manson’s daughter’s OB check and was the first to tell him she was expecting twins. Sure enough, there were twins!” When asked what memories are most special to her, Elsie responded, “I really enjoyed my patients and the people I worked with. Some of my patients are still around and I love seeing them.” Elsie makes a point to stay connected with her former co-workers, like Carolyn Schroeder, currently a receptionist in the Internal Medicine Department at the Clinic’s Main Campus. “Carolyn and I worked together back in the 1960’s and we still stay in touch. She’s like a member of my family now.” Despite the fact Elsie has been retired for more than twenty years, she has fond memories of Springfield Clinic and remains a loyal patient. “It has completely changed since I was here, but this is still the best place to come for medical care. The doctors here are great.” SPRINGFIELD CLINIC l 15 Springfield Clinic Main Campus Expansion A major city sewer line was relocated in Fall 2006 to make way for the expansion. Main Campus, including buildings and parking, will cover nearly 9 acres. Demolition begins. 16 l INSIDE SPRINGFIELD CLINIC Representatives of Springfield Clinic’s Board of Directors and Building Committee officially break ground. Springfield Mayor Tim Davlin and J. Michael Maynard, CEO, exchange congratulations at the March 1, 2007 ceremony. By late spring, excavation was complete. Springfield Clinic Main Campus Expansion The West Building foundation was poured. Next step - lots of steel! In total, 2500 yards of concrete were poured – the equivalent of a sidewalk six miles long. ...and lots of concrete! 18 l INSIDE SPRINGFIELD CLINIC There were as many workers ON THE JOB at one time as there are members in the Illinois House of Representatives Construction over 6th created a temporary street closure in Fall 2007. With winter on the way, work shifted to the building interior. Springfield Mayor Tim Davlin and J. Michael Maynard, CEO, exchange congratulations at the March 1, 2007 ceremony 98,000 bricks were used – laid end to end, they would span 18 miles Brick and glass work continued throughout spring and summer of 2008. SPRINGFIELD CLINIC l 19 Springfield Clinic Main Campus Expansion Finishing touches included clean windows... caping ... and lands The building team celebrates at the Dedication Ceremony on November 15, 2008. 20 l INSIDE SPRINGFIELD CLINIC A patient enjoys the building’s abundant natural lighting. Final adjustments are made to the new ASC/GI recovery bays. Springfield Mayor Tim Davlin and J. Michael Maynard, CEO, exchange congratulations at the March 1, 2007 ceremony In all, $40 million dollars was invested in the Main Campus expansion and renovation project Project finished! SPRINGFIELD CLINIC l 21 Springfield Clinic Main Campus Expansion Today’s view from the original (1952) Main Campus construction site. Blue lighting washed the 6th Street arch in honor of World Diabetes Day. Sixteen trades were involved in the construction, which took about 90,000 man hours Main Campus in full bloom 22 l INSIDE SPRINGFIELD CLINIC SPRINGFIELD CLINIC l 23 Unique Challenges in Medical Facility Planning and Building Hanging a “Clinic Is Closed” sign, even for just a few hours, was never an option for Springfield, Illinois-based Harold O’Shea Builders during the 120,000-square-foot expansion project at the Springfield Clinic’s main campus. Maintaining the same open hours and patient service level seemed like lofty and perhaps unattainable goals for this complex medical facility construction plan. But it was nothing new for O’Shea Builders. A collaborative and adaptable work style along with extensive experience constructing healthcare facilities resulted in completing the project on time. “Many healthcare construction projects are renovations inside an existing facility or construction of a new building in close proximity to the original facility, often in heavily populated areas that include commercial and residential properties,” says Mike O’Shea, Project Executive of O’Shea Builders. “Springfield Clinic involved all of 24 l INSIDE SPRINGFIELD CLINIC SPRINGFIELD CLINIC l 25 these variables plus the challenges of ensuring continuous O’Shea Builders worked closely with Springfield Clinic to operations, keeping patients safe, and meeting the special develop and implement interim safety measures that would requirements of medical equipment. We had our work cut out eliminate or minimize environmental impact on patients and for us but knew we were comfortable with our experience.” staff and interference with patient care. Dust, noise, debris and fumes are among potential life-threatening problems for Keeping Springfield Clinic open and patients safe patients and employees with health vulnerabilities. O’Shea O’Shea Builders’ construction operations needed to blend with Builders and the clinic planned the exact location of dust the flurry of patient service activity and support operations, walls, set ground rules on the use of high-powered equipment, including maintenance, supply, receiving and janitorial services. and specified exactly when, where and how construction Careful planning and tactful timing helped prevent disruption crews would move about the building. “The O’Shea team to patients, employees and overall operations. spent a significant amount of time planning the renovation and expansion phases that allowed the Springfield Clinic to “Medical building projects demand a great deal of pre- continue normal operations during the construction,” says construction planning to address safety issues and logistical Randy Bryant, Chief Executive Officer of Springfield Clinic. complexities that include parking, material storage, crane 26 l location, temporary offices, tool storage and site access,” says Expanding and renovating with limited space Todd Missel, Project Manager at O’Shea Builders. “Proper Springfield Clinic’s physical location presented its own unique planning is what really made the difference in keeping the clinic challenges. The clinic is near downtown Springfield and in full operation throughout construction.” surrounded by commercial buildings. The construction plan INSIDE SPRINGFIELD CLINIC called for a new three-story section to be built over a one-way fence posts,” says Tom Fitch, O’Shea Builders’ Project Pre- northbound major arterial roadway carrying heavy traffic to Construction Director. “Between the H piling we installed the downtown area. This section would connect to a large timber lagging before we excavated to basement elevation to building on a lot bookended by that northbound street and retain the soil and foundation of the small clinic office. We used a southbound street carrying equally heavy traffic away from a similar solution at another side of the building to protect the the city. existing roadway and underground utilities during the basement excavation.” Additional challenges included efforts to avoid disrupting working businesses next door, particularly the chiropractic “O’Shea Builders offered several significant logistical solutions clinic located in a century-old home just 15 feet from the and cost-saving measures,” says Bryant. “One among several property line. Springfield Clinic’s new building was positioned examples was a creative solution to utility relocations that saved at that property line to maximize space for future parking and considerable project cost and time.” unloading. O’Shea Builders installed an earth retention system to prevent settlement and damage to the chiropractic office Medical equipment guides design and when excavating 12 feet into the natural ground water table to construction priorities build the new basement. Selection of equipment and furniture typically follows design and construction. However, in healthcare clinic or hospital “We considered several options and went with the soldier projects, the equipment takes center stage. The precise type of pile and lagging wall solution, a combination of drilled equipment, such as a magnetic resonance imaging (MRI) unit or concrete shafts with steel H piling that acted as underground computed tomography (CT) scanner, determines the physical SPRINGFIELD CLINIC l 27 28 l INSIDE SPRINGFIELD CLINIC space, the room design and layout, and the Intestinal rooms that feed from the central furniture. O’Shea Builders collaborated with mechanical room Springfield Clinic staff, equipment vendors and purchasing agents to design effective temporary and permanent rooms based on the equipment’s functioning requirements. “To the casual observer, many rooms in a medical facility seem rather simple,” Missel says. “They are square or rectangular, painted a single color and sparsely furnished. Some rooms have a lot of equipment, others have more open space. What people don’t see is the complexity behind the walls, above the ceilings and under the floors.” Each piece of medical equipment has specific installation, operational and environmental requirements that can affect the entire room, including elements not visible to the eye. Missel cited the following solutions that the O’Shea Builders’ design team developed for some of Springfield Clinic’s most challenging operational and equipment needs: • Sophisticated humidity and temperature controls in the operating room provide proper ventilation Keys to success O’Shea Builders count experience and the ability to work flexibly in the midst of exacting details and schedules as keys to their success in constructing medical facilities. The company managed more than 100 people from various trades while working feverishly over a 16-month period to meet project expectations. Much credit for the success has been attributed to the active partnership between O’Shea Builders and Springfield Clinic that enabled the clinic to maintain operations at an optimum level throughout the project. “Springfield Clinic made us feel like a true partner in the entire process,” Missel says. “Clinic staff wanted our input when making decisions and • A recessed structure on the new building’s encouraged us to work with the end users, fourth floor to accommodate the ENT such as nurses, doctors and maintenance department’s sound booths staff. This close working relationship helped • A 36-inch breaching vent for the boiler room that vents three new boilers in the basement all the way to the roof • A quenching vent for the existing MRI machine built under the second floor of the new building • Structural supports and bracing to protect us to really understand how the spaces would function at the Springfield Clinic.” “O’Shea Builders played a key role in facilitating communication among the City of Springfield, the architects, subcontractors, and the Springfield Clinic that kept the project on track and within budget,” says Bryant. the operating room boom monitors and “Considering the scale and complexity of this medical equipment project, we benefited greatly from partnering • The entire medical gas system for oxygen, with a builder that served as a construction nitrogen and air delivered to the recovery manager, general contractor, and construction rooms, operating rooms and Gastro design consultant.” SPRINGFIELD CLINIC l 29 Springfield Clinic celebrates new expansion Clinic’s dazzling gateway adds to city’s landscape In a city that is no stranger to landmark buildings, Springfield, “In a city known for its rich history and strong tourism Ill., has yet another building making an impact on the city’s industry, the new expansion provides a sense of destination,” landscape: Springfield Clinic. Spanning four busy northbound said Joe Mynhier, AIA, ACHA, executive director at BSA lanes over Sixth Street, the clinic’s new three-story bridge LifeStructures, who served as principal in charge. building acts as a gateway from the city’s southside to the heart of downtown. The glass-clad structure reflects the changing Challenges overcome colors of the sky, the hustle and bustle of the city and the Linking an existing building to a new one by way of a glass bridge growth of the physician-owned clinic. building—and doing it all in a partially landlocked setting— presented unique challenges for BSA LifeStructures, which Springfield Clinic, established in 1939, is one of the state’s provided architectural, system and civil engineering services; largest medical providers, offering the services of 195 physicians Hanson Professional Services, which provided surveying, civil in multiple specialties. This project marks the facility’s third and structural engineering services; and Maregatti Interiors, expansion since it opened its doors in 1952. which provided interior design services. BSA LifeStructures gathered input from physicians during the design process, First envisioned by Springfield Clinic CEO Mike Maynard, the which allowed the designers to more fully understand the three-story-tall bridge is suspended more than 17 feet above the physicians’ needs, the requirements posed by their equipment, four northbound lanes of Sixth Street at Scarritt Street. The and the most efficient layouts for their offices and exam rooms. bridge structure, which houses offices, conference rooms and an employee lounge, connects the new four-story medical office The design team learned that it needed to reduce noise coming tower to the existing clinic, which accommodates a wide variety from traffic, figure out how to support the bridge structure, and of medical specialties, such as radiology, oncology, prompt overcome vibrations and other factors that can interfere with care, family practice, internal medicine and its own ambulatory sensitive medical equipment, such as Lasik lasers and an MRI. surgical center. “We like to solve these types of problems,” said Michael Billig, The new 116,000-square-foot expansion accommodates 38 PE, senior project engineer at BSA LifeStructures. “To make a physicians with several different medical specialties, a retail facility better is the essence of what we do as a firm.” optical shop and a café for staff and patrons. Complete in August 2008, the expansion allows patients to receive medical BSA LifeStructures and Hanson Professional Services used a care within an integrated facility without having to step complex structural system to span 85 feet with thick concrete outdoors. The newly expanded parking lot provides even more slabs to mitigate floor vibration and absorb sound. convenience to patients. 30 l INSIDE SPRINGFIELD CLINIC Keeping the existing facility operational during the Hanson Professional Services Inc., headquartered in construction phase was a challenge for the design team Springfield, Ill., completed the structural engineering and Harold O’Shea Builders, the local construction design manager. For example, the imaging of an MRI can be overcoming many unique challenges that required affected by the movement of large pieces of metal. With considerable coordination with the architect, general that in mind, the design team designed the elevator and contractor and steel fabricator. for the Springfield Clinic expansion, stairs and coordinated construction equipment to avoid interference with the MRI during and after construction. Perhaps the most critical challenge was the aggressive In addition, the MRI facility’s original construction was construction schedule. To accommodate the clinic’s not designed to support additional floors above it. So the desired occupancy date, the structural steel for the team used an open, one-story steel truss that spans over project was ordered within the first six weeks of the MRI facility, and acts as a structural system that helps the structural design process. Building information carry the weight of the three-story bridge building. modeling software was used to model, design and draw structural systems in the allotted time frame. Interior design highlights Such a dramatic exterior deserves an equally eye-catching Another complex task was the structural design for interior. Created by Maregatti Interiors, the interior 15,000 square feet of air rights over Sixth Street, a design features natural tones and an open floor plan to major roadway in the city. The three-story office/ create a welcoming space. bridge area over Sixth Street connects the new and existing Springfield Clinic facilities. Many structural The most striking characteristic of the interior is its design factors for the office/bridge area were carefully curvilinear design. Unlike linear design, which has considered, including floor vibrations, exterior glass straight hallways and sharp corners, curvilinear design wall movement analysis, and floor framing for creates a feeling of fluid movement throughout a facility. restricted depths. A long-span, composite-steel joist This feeling of flow is especially important in a health system was selected as the best solution for the space. care setting, which should take every opportunity to put patients and their caregivers at ease. In the new The final major challenge was the structural design Springfield Clinic, curvilinear design is not only visually of the four-story tower structure added to the existing pleasing—it also helps clinic visitors and workers more Springfield Clinic facility. Tower structure design easily find their way from one area to another. The included the layout of structural steel to minimize interiors also incorporate a significant amount of natural possible electromagnetic wave interference over an light. existing MRI facility. The structural design for the tower uses a 14-foot-deep story truss over the existing “As Springfield Clinic’s partner through the design MRI and concrete walls to supplement the building’s process, we worked together to create a space that feels lateral load resisting system. welcoming and comfortable,” said Jennifer Worley, IIDA, LEED AP, senior interior designer at Maregatti By the numbers: Springfield Clinic expansion Interiors. “The design team achieved this through • $31,302,100: construction cost of expansion flowing architecture, use of materials and a variety of • 116,000: square footage of expansion color inspired by prairie landscapes.” • 280,000: total square footage of Springfield Clinic’s campus “We continue to hear people comment on how beautiful • 16,575: square footage of new bridge structure the building is and how it has exceeded expectations,” said • 1952: year Springfield Clinic was first built Mark Abbey, AIA, BSA LifeStructures senior architect on • 85: feet of bridge expanse over street this project. “That’s exciting and very rewarding.” • 38: number of physicians housed in new facility • 17’3”: feet of clearance between road and bridge • 4: lanes of traffic over which bridge hangs SPRINGFIELD CLINIC l 31 32 l INSIDE SPRINGFIELD CLINIC SPRINGFIELD CLINIC l 33 Putting the Finishing Touch on Springfield Clinic’s Vision It’s no surprise that Fritsch Custom Finishes was the learned a great deal about what to expect on a particular job and subcontractor selected to complete the interior finish work for how to prepare our crews.” Springfield Clinic’s Main Campus Expansion Project. Fritsch has been recognized as an industry leader in interior and The clinic’s expansion plan was two-fold. Phase one called for exterior finishing throughout Central Illinois and the St. Louis a complete remodel of the first and second floors of the existing area for over 75 years. building’s interior. With a great deal of effort and attention to detail, Fritsch crews removed all of the existing wallcovering “It’s a great fit,” says Wen Fritsch, president. “Springfield and prepared the substrate. According to Wen Fritsch, this can Clinic is deeply committed to this community, just as we are, be a difficult, tedious and messy process which is best managed and we are proud and honored to have been a part of this by professionals. Phase two of the project focused on the new exciting project.” construction. In the new addition, Fritsch completed the Fritsch began their portion of the project in July 2007 with vinyl wallcoverings. drywall finishing, painted all exposed wall surfaces and applied Harold O’Shea Builders serving as the general contractor. Wen Fritsch said he knew from the beginning that with the team Fritsch says that sometimes finish work can be overlooked they had assembled the project would be delivered on time and on a commercial project, but well-applied paint, trim and 100% complete by the deadline. The scheduled completion wallcoverings can make all the difference in the end result. The date was July 2008 – less than one year from start to finish – end result for Springfield Clinic? “Nothing short of amazing,” and, although Fritsch had worked with O’Shea and Springfield according to Fritsch. Clinic off-and-on for many years, he could tell that this project was going to be different. When all was said and done, with a staff of 14-15 workers on-site each day, Fritsch invested over 12,000 man hours, When working in a healthcare environment, construction finished more than 300,000 square feet of drywall, applied over crews must take special precautions, and Fritsch’s crew was 2,000 gallons of paint and covered 4,400 square feet of wall no exception. The Fritsch team is well-trained to handle space with vinyl. many different working environments and is very conscious of cleanliness, no matter who the client is. Additionally, in 34 l Fritsch says, “Because we are experts at what we do, we are a healthcare atmosphere, special attention must be paid to able to take on projects of this size, and we can bring them make sure that medical surfaces are not contaminated and that in on-time and on-budget. It’s a testament to our company’s contracted employees are aware of HIPPA laws. strong history and our commitment to excellence.” “We have a fantastic team of finishing specialists,” Fritsch says. Fritsch was founded in 1930 by Harry F. Fritsch in Springfield. “We take great pride in our quality of work and the expertise of Initially a home-based painting contractor, the company our employees. We’ve been doing this since 1930, and we’ve expanded gradually in size and its scope of work. Now Fritsch is INSIDE SPRINGFIELD CLINIC a union shop performing commercial and residential painting, What’s next for Fritsch? Phase three of the Springfield Clinic wallcovering, drywall, plaster, and exterior insulation finish project, of course. Fritsch has once again been selected to work systems throughout Central Illinois and the metropolitan St. with O’Shea to remodel the remaining third and fourth floors Louis area. of the original clinic building. This final phase of the project is scheduled to begin in the fall of 2008. And Fritsch continues to give back. On their most recent non-gratis project, Fritsch provided the materials and labor to “This has been a great experience for our entire team,” Fritsch construct a new shower facility for the Abe Lincoln Council, says. “Soon, physicians, employees and patients will fill the new Boy Scouts of America at Camp Bunn in Macoupin County. areas of the clinic, and we can all take great pride in knowing Fritsch has also restored intricate plaster and painting detail to that the work we did will benefit Springfield and Central Springfield’s Old State Capitol and has repaired and restored Illinois for years to come. numerous churches of all faiths throughout Central Illinois. Fifty percent of the work Fritsch does is residential, and they “We thank the clinic’s staff and its patients for their undying are proud to boast that they are one of the few contractors that patience as we worked to complete this important project. offer authentic Venetian plaster techniques. Fritsch also houses And we send heartfelt congratulations to the architects, a resident artist with an extensive portfolio of faux finishes and designers, workers, Harold O’Shea Builders, the City of custom artwork for both commercial and residential clients. Springfield and, most of all, to Springfield Clinic for having the foresight and fortitude to make this happen in our “We continue to grow our business as the needs of our clients community – job well done!” continue to grow,” says Fritsch. “It’s important that we stay competitive and that we maintain the quality of service our For more information about Fritsch Custom Finishes, go to: clients have come to expect from Fritsch Custom Finishes.” www.FritschCustomFinishes.com. SPRINGFIELD CLINIC l 35 36 l INSIDE SPRINGFIELD CLINIC Serving Residential, Commercial and Industrial Clients • Licensed Professional Engineering Design Firm • Capital Development Board Pre-Qualified • Offering Asbestos Support Services • Demolition and Scrap Management • Site Investigations and Corrective Action • Petroleum & Chemical Spill Response • Flow Proportional Waste Water Monitoring Courtice Grason Because Quality Costs Less 9 N. Hamilton • Sullivan, IL 61951 217-254-4988 Mobile • 217-728-4860 Office www.courticegrason.com SPRINGFIELD CLINIC l 37 Advance Medical Directives By Paul Bown and Jeffery M. Wilday Brown, Hay & Stephens, LLP, Springfield, IL Advance medical directives are important legal planning tools health care decisions in the event the person executing the that allow a competent adult to make decisions about the health document becomes incapacitated. It also addresses end-of- care treatment he or she should (or should not) receive in the life decisions, health care decisions in general, and, in some event of incapacity. The most common advance directives states, decisions regarding organ donation. In most states, include Living Wills, Health Care Powers of Attorney, and Do these documents only come into play when the individual Not Resuscitate (“DNR”) Orders. These documents should be is not capable of communicating decisions competently. In made a part of a patient’s medical record. that circumstance, a health care provider may take direction from the individual’s appointed agent. For example, if a LIVING WILL person is in an automobile accident and arrives at the hospital A Living Will is a directive as to whether death-delaying unconscious, the health care providers will perform life- procedures should be implemented in the event of a terminal saving, emergency procedures on such individual. No agent condition or permanent unconsciousness. No agent is or consent is required. However, there may be other non- nominated to make decisions in a Living Will. Rather, the emergency procedures, such as reconstructive plastic surgery, document is considered a declaration of intention. In the that would be medically optimal to perform at a time when optimal situation, a Living Will is not the only advance the victim is unable to give consent. Through a Health Care directive executed by an individual since end-of-life decisions Power of Attorney, these procedures could be authorized are not the only health care decisions an individual may need by the unconscious automobile accident victim’s designated to make. A person lacking decisional capacity still may need agent. routine medical care or placement. DNR ORDERS 38 l HEALTH CARE POWER OF ATTORNEY A DNR Order is a request not to have cardiopulmonary A Health Care Power of Attorney designates an agent to make resuscitation performed on a patient in the event his heart INSIDE SPRINGFIELD CLINIC stops or if the patient stops breathing. A DNR Order is put other words, a physician may still act as agent for his parent, in the patient’s medical chart by his physician at the patient’s as long as they are not directions providing for the parent’s request. Absent instruction to the contrary, medical personnel medical care. will take all available measures to aid a patient whose heart has stopped or who has stopped breathing. DNR Orders are ADVANCE DIRECTIVES: NOT JUST FOR THE accepted by physicians and hospitals in all states. ELDERLY OR TERMINALLY ILL A common misperception is that advance directives are only PORTABILITY appropriate for the elderly or persons who are critically ill. In While all states recognize both the Living Will and Health fact, some of the most well-known court cases have involved Care Power of Attorney, the laws in each state vary in terms younger individuals, such as Karen Ann Quinlan, Nancy of format, terminology and the scope of decision-making Cruzan, and most recently, Terri Schiavo. authority. A common question is whether an advance directive made and executed in one state will be valid in another. Most In February of 1990, Terri Schiavo collapsed at home and states do recognize out-of-state advance directives as long as the her brain was oxygen-deprived for several minutes. She was directive meets the legal requirements of the state where the left severely brain-damaged. Though she was able to breathe document was executed or in the state where treatment is being independently and maintain a heart beat and blood pressure, sought. Even if an advance directive is deficient in meeting she was not capable of eating or drinking. Her nutrition the technicalities of a given state’s law, the importance of the and hydration were provided by feeding tube. In 1998, Ms. directive should not be discounted, given that it is written Schiavo’s husband petitioned a Florida court to remove the evidence of the patient’s wishes. feeding tube. This petition was strongly opposed by Ms. Schiavo’s parents, and a legal battle spanning eight years ensued. ADVANCE DIRECTIVES AND HEALTH CARE PROVIDERS A major issue in the legal proceedings was whether Ms. If a patient has executed an advance directive, such as a Health Schiavo had ever expressed her wishes regarding end-of-life Care Power of Attorney, and the patient later becomes incapable treatment. Because there was conflicting testimony from of making decisions, a health care provider is directed to comply numerous witnesses and no written direction from Ms. Schiavo, with the decisions of the agent designated in the document. the court was left to decide this life-or-death issue. In the end, If, for whatever reason, the health care provider is unable to the most important decision of this young woman’s life was comply with the decisions made by the agent, the provider made by a Judge rather than by a friend or family member. In should immediately notify the agent so that arrangements can the absence of a clear, written statement of her wishes regarding be made to transfer the patient to another health care provider end-of-life treatment, Ms. Schiavo’s feeding tube was removed, who is able to comply. and she died in March of 2005 without ever having made her express wishes known. Any health care provider relying in good faith on an agent’s decisions will be protected as though having dealt directly with CONCLUSION the principal/patient. Similarly, an agent who acts in good faith Advance directives satisfy multiple purposes. They allow on behalf of the patient and in accordance with the health care an individual to express his preferences prior to a medical agency will not be subject to liability for his decisions. emergency. They give medical personnel direction. Finally, they may take some of the stress off of a patient’s family when In most states, the laws governing Health Care Powers of difficult decisions must be made. An accident or serious illness Attorney limit the ability of a health care provider to act as can occur at any time, but an individual’s wishes are more likely agent for an individual pursuant to such a document. This to be carried out if he or she has taken measures to put them in limitation does not apply to health care professionals who are writing, in the form of advance written directives. not providing health care services to the patient/principal. In SPRINGFIELD CLINIC l 39 Robert A. Stuart, Jr. J. Patrick Joyce, Jr. Eric L. Grenzebach Jeffery M. Wilday Paul Bown Almon A. Manson, Jr. Dwight H. O’Keefe BROWN, HAY & STEPHENS, LLP LEGAL COUNSEL Brown, Hay & Stephens, LLP has roots dating back to 1828 and is recognized as the Donald R. Tracy oldest law firm in Illinois. Over the course of its history, the firm has protected the Emmet A. Fairfield rights and interests of healthcare providers in Illinois. Physicians, medical groups, Denise M. Druhot Harvey M. Stephens James W. Bruner hospitals and professional medical associations benefit from the firm’s legal counsel and representation for transactions and litigation across a broad range of healthcare legal issues. • Medical malpractice defense Lorilea Buerkett • Risk management Amy K. Schmidt • Antitrust litigation Thomas Schanzle-Haskins • Regulatory compliance • Peer review, disciplinary hearing defense Hugh F. Drake • Licensing and certification Roland R. Cross • Medical staff issues Claire A. Manning • Insurance defense Daniel K. Wright Charles Y. Davis Erica L. Riplinger Alison K. Hayden Matthew D. Dougherty Harvey B. Stephens Edward J. Cunningham Charles A. Chapin Saul L. Morse B usiness L aw C ivil L itigation C reditors ’ R ights , B anking and F inance L aw E ducation and G overnment L aw E nergy and M ineral L aw F amily L aw and E lder L aw H ealthcare L aw L abor and E mployment L aw R eal E state and E nvironmental L aw T rusts and E states 40 l INSIDE SPRINGFIELD CLINIC 205 S. Fifth Street, Suite 700 Springfield, IL 62701 Phone: (217) 544-8491 Fax: (217) 544-9609 Springfield Clinic Administrative Team Randall A. Bryant Chief Executive Officer As Chief Executive Officer, Bryant is responsible for Springfield Clinic’s performance, compliance and operations. He leads the administrative team and reports directly to the board of directors. He joined Springfield Clinic, LLP in 1988 and served as the Clinic’s Chief Financial Officer before being appointed to his current position in July, 2008. As CFO, Bryant supervised the successful restructure of numerous financial systems and played an integral role in several Springfield Clinic building projects, including the recent expansion of the group’s Main Campus. Prior to joining Springfield Clinic, Bryant served as Director of Corporate Finance for Memorial Health System in Springfield, Illinois and before that, worked in public accounting and healthcare finance. Bryant is a native of Decatur, Illinois. He earned a Bachelor of Science degree in Accounting from Illinois State University in 1979 and obtained his Certified Public Accounting license in 1981. James Hewitt Chief Information Officer Hewitt joined Springfield Clinic as the organization’s Chief Information Officer in 2007 and immediately began preparing for the implementation of a comprehensive Electronic Health Record (EHR) system. Hewitt’s IT team successfully implemented the TouchWorks EHR application in phases at every medical office throughout Springfield Clinic’s network. Their “mini-bang” implementation strategy received national recognition and the completion of the project placed Springfield Clinic among the top 4% of multi-specialty clinics in the nation to have accomplished a comprehensive EHR implementation. Born and raised in Hillsboro, Illinois, Hewitt migrated to the Chicago area, where he helped develop healthcare and financial systems for several companies. Prior to joining Springfield Clinic, he served as Chief Information Officer at Allscripts, the leading provider of Electronic Health Record systems in the United States. His connections and influence in the software industry have fostered exciting new partnerships and possibilities for Springfield Clinic. Hewitt serves on multiple healthcare technology advisory panels and most recently co-founded Jardogs, a software development subsidiary of Springfield Clinic. 44 l INSIDE SPRINGFIELD CLINIC Mark J. Kuhn Chief Administrative Officer Kuhn joined the Administrative staff at Springfield Clinic as its Chief Managed Care Officer in 1998. In 2002, he was named Chief Administrative Officer, with additional responsibilities for Marketing, Occupational Medicine and ancillary divisions including Audiology, Laboratory, Physical Therapy and Radiology. During his tenure with Springfield Clinic, Kuhn has played an integral role in the development of key strategic business initiatives and alliances. His achievements include the successful expansion of ancillary services, the formation of the Clinic’s Occupational Medicine division and the development of favorable relationships with managed care organizations, including a partnership with Health Alliance. An Iowa native, Kuhn graduated from Loras College in Dubuque, Iowa with a Bachelor of Science degree in Biology and Minor in Business Administration. Immediately following, he attended University of Iowa, in Iowa City, where he earned his Masters degree in Health Care Administration (MHA). Prior to Springfield Clinic, Kuhn’s healthcare experience included 12 years with Lake Forest Hospital and its affiliated medical groups in Lake Forest, Illinois. Alan Nerone, CPA Chief Financial Officer Nerone joined Springfield Clinic in June, 2008 as the organization’s Chief Financial Officer. As such, he is responsible for the development and implementation of all financial procedures, policies, internal controls, strategic financial planning, purchasing and facilities management. A Pawnee, Illinois native, Nerone offers more than eighteen years experience working with and for health care organizations in Central Illinois. Most recently, he served as the Chief Financial Officer for Pekin Hospital in Pekin, Illinois. Nerone is a member of the Healthcare Financial Management Association (HFMA) and is a past Board Member and President of HFMA’s McMahon-Illini Chapter. He is a Certified Public Accountant and holds a Bachelor of Arts Degree from University of Illinois Springfield in Accountancy. Carolyn Otten, CPA Chief Human Resources Officer Otten has been a member of the Springfield Clinic team since October 2002. Her current responsibilities include Education & Learning, Recruitment and Human Resources. Her passion for and commitment to customer service excellence has led to the implementation of a comprehensive clinicwide customer service initiative. Otten is committed to the organization’s overall service philosophy to provide an experience that improves, enhances, and extends the quality of life for Springfield Clinic patients. In addition, she has been intimately involved in the planning of renovation and expansion projects represented at Springfield Clinic 1st , Main Campus, Taylorville and Lincoln operating locations. She was born and raised in Springfield, Illinois and attended University of Illinois Springfield where she earned a Bachelor of Arts degree in Accountancy. She is a licensed Certified Public Accountant, in the State of Illinois. Prior to joining Springfield Clinic she had a successful career in public accounting. Mary Stewart, RN Chief Clinical Officer Stewart has been a member of the Springfield Clinic administrative team since 2001 as the Chief Clinical Officer. She is responsible for clinical services and oversees departments that include: Research, Quality Management, Clinical Support, TeleNurse, TeleCommunications, and the Ambulatory Surgery & Endoscopy Center. Her passion is the delivery of quality healthcare to each and every patient at Springfield Clinic. She was born in Highland, Illinois, but has called Springfield her home since she was a child. She is a graduate of St. John’s College of Nursing and earned a Bachelor of Science in Nursing from St. Francis College in Joliet. She is a Registered Nurse licensed in the state of Illinois. Stewart led the successful expansion of the Clinic’s Ambulatory Surgery and Endoscopy Center, overseeing the facility’s growth from two to nine rooms and the addition of anesthesia services. Her achievements include the successful formation of the Springfield Clinic’s Research Department in 2003 and the creation of the Hospital Medicine division in early 2006. Stewart offers many years of nursing experience, having previously served as a surgical nurse at Springfield Clinic and the manager of St. John’s Hospital’s Surgical Unit prior to returning to the Clinic in 2001. J. Michael Maynard J. Michael Maynard retired on June 30, 2008, after serving more than 20 years as the Chief Executive Officer of Springfield Clinic. In addition to enjoying travel, photography and fly fishing, he currently provides strategic planning consultation to healthcare organizations throughout the country and is the author of Ushuaia: Finding the Balance. Without question, Mr. Maynard’s dedication and his ability to inspire others helped propel Springfield Clinic to its present level of achievement. In honor of his service to the organization, Springfield Clinic proudly displays the following tribute to him: Great leaders are often characterized by their vision for the future, moral character to guide the way and ability to inspire others to join the cause. No other individual exemplifies this definition of a leader more then J. Michael Maynard, Springfield Clinic’s Chief Executive Officer from 1987 to 2008. For more than 20 years, Mr. Maynard has led Springfield Clinic to its place as one of the most progressive and successful multi-specialty medical clinics in our nation. We honor Mr. Maynard, on the occasion of his retirement, for this achievement as well as for his commitment to high quality health care and his passionate pursuit of excellence. His goal, to transform the delivery of health care, for the better, has indelibly changed the medical landscape in Springfield and Central Illinois. SPRINGFIELD CLINIC l 45 David R. Hoelzer, MD – Endocrinology Chief Medical Officer For more than 10 years, Dr. David Hoelzer has served as Springfield Clinic’s medical director and, in a 2008 reorganization, was named Chief Medical Officer. He has served in many leadership roles, including Chairman of the Board of Directors. Currently he also serves as chairman of the Administrative Quality Management Committee. Dr. Hoelzer has been a specialist in Endocrinology since joining Springfield Clinic in 1985. Hailing from Manhasset, New York, he attended St. Louis University School of Medicine in St. Louis, Missouri where he also completed a residency in Internal Medicine. He received his fellowship training in Endocrinology and Metabolism at Washington University in St. Louis. He is board certified in Internal Medicine as well as Endocrinology and Metabolism. He has as special interest in the treatment of type-1 diabetes. Dr. Hoelzer is a member of the American Association of Clinical Endocrinologists, American Diabetes Association, Illinois State Medical Society and Sangamon County Medical Society. Lynne D. Barkmeier, MD – Vascular Surgery Medical Director Dr. Lynne Barkmeier, a native of Columbus, Nebraska, earned her medical degree from Creighton University in Omaha, Nebraska. At Creighton, she completed a General Surgery residency then relocated to Springfield, Illinois for a fellowship in Vascular Surgery at SIU School of Medicine. Upon completion, Dr. Barkmeier joined the staff of SIU, practicing there for nine years, before entering private practice for three. She joined Springfield Clinic in 2000. She maintains board certification in Vascular Surgery and is a Fellow in the American College of Surgeons. Dr. Barkmeier is a member of the Sangamon County Medical Society and Illinois State Medical Society. Dr. Barkmeier was recently named medical director for Springfield Clinic and as such, provides input to the Quality Management and Peer Review Committee. Robert F. Mulch, MD – Family Medicine Medical Director Robert F. Mulch, MD is a Family Medicine specialist at Hillsboro Medical Center, a division of Springfield Clinic, in Hillsboro, Illinois. He has practiced medicine in that community since 1980 and became affiliated with Springfield Clinic as the result of merger in 1989. Born in Quincy, Illinois, Dr. Mulch attended Rush Medical College in Chicago, Illinois. He successfully completed his Family Practice residency at Riverside Methodist Hospital in Columbus, Ohio. He maintains current board certification from the American Board of Family Medicine and is a Fellow in the American Academy of Family Practice. He 46 l INSIDE SPRINGFIELD CLINIC is a member of the American College of Physician Executives, Illinois State Medical Society and Montgomery County Medical Society. In addition to his role as one of the organization’s medical directors, Dr. Mulch serves as an advisor to the Quality Management and Peer Review Committee and a member on the Information Technology Committee. He championed the selection and implementation of the Clinic’s highly successful Electronic Health Record System and continues to offer leadership in the technology arena as chairman of the Clinical Informatics Committee. Springfield Clinic Board of Directors BOARD CHAIRMAN William D. Putman, MD Obstetrics & Gynecology William D. Putman, MD is a board-certified specialist in Obstetrics & Gynecology, with interest in gynecologic surgery. A native of Peoria, Illinois, he earned a medical degree from Creighton University in Omaha, Nebraska then returned to Illinois to complete his Residency in OB/GYN at SIU School of Medicine in Springfield. He joined Springfield Clinic in 1989, immediately following completion of his training at SIU. As an active partner, he has served four terms, for a total of twelve years, on Springfield Clinic’s Board of Directors and has presided as its chairman twice. For the past 20 years, Dr. Putman has worked to improve the quality of care delivered at Springfield Clinic and throughout central Illinois. He currently chairs Springfield Clinic’s Quality Management and Peer Review Committee, serves on the Board of Directors of Memorial Health System and contributes as a member of their Quality and Safety Management Committee. Dr. Putman is a member of the American College of Obstetrics and Gynecology, the American College of Physician Executives and several other specialty organizations. SPRINGFIELD CLINIC l 47 CURRENT BOARD MEMBERS Beth Ann Bergman, MD Plastic & Reconstructive Surgery Dr. Bergman, a native of Chicago, earned her medical degree from SIU School of Medicine in Springfield, Illinois, before attending University of North Carolina in Chapel Hill for a residency in General Surgery. She then returned to Springfield’s SIU School of Medicine, where she completed a fellowship in Plastic and Reconstructive Surgery including additional training in Microsurgery, Burn and Hand Surgery. She joined Springfield Clinic’s The Center for Plastic Surgery in 1993, immediately following her training. Bergman is board certified by the American Board for Plastic Surgery, performing Plastic and Reconstructive Surgery, with a special emphasis on breast surgery, including augmentation, reduction, and reconstruction, as well as facial and body cosmetic surgery. Dr. Bergman is a prominent partner at Springfield Clinic, currently serving on both the Board of Directors and the Board’s Executive Committee. In addition, she currently chairs the Information Technology Committee and serves on the Quality Management and Peer Review Committee. She is a member of the American Society of Plastic Surgeons, the American College of Surgeons, the Sangamon County Medical Society and the Illinois State Medical Society. Geoffrey A. Bland, MD Family Medicine Born in Rochford, England, Dr. Bland earned a medical degree and completed his residency at Dalhousie University School of Medicine in Halifax, Nova Scotia. He is certified in Family Medicine by The College of Family Physicians of Canada. He started a private medical practice in Springfield in 1980; over the next several years this developed into a four person group, at which time he founded the Wabash Family Practice Center. In 1985 his original group merged with Springfield Clinic. He provides comprehensive medical care for family members of all ages. Dr. Bland serves as chairman of the Business Development and Marketing Committee and is currently serving in his 5th term on Springfield Clinic’s Board of Directors. 48 l INSIDE SPRINGFIELD CLINIC Tomasz W. Borowiecki, MD Orthopaedic Surgery Dr. Borowiecki is a 13-year veteran of Springfield Clinic’s Department of Orthopaedic Surgery, located at Springfield Clinic 1st. Prior to joining Springfield Clinic in 1996, Dr. Borowiecki served as an Orthopaedic Surgeon at Tinker Air Force Base in Oklahoma City, Oklahoma for four years. Originally from the Milwaukee, Wisconsin area, Dr Borowiecki attended the Medical College of Wisconsin where he earned his medical degree. Dr. Borowiecki completed his Orthopaedic Surgery residency at SIU School of Medicine in 1992 and achieved the status of Chief Resident in Orthopaedic Surgery. He is currently board certified by the American Board of Orthopaedic Surgery. As a partner at Springfield Clinic, he has served on numerous committees and currently chairs the Operations Committee and the Ancillary Services Committees, in addition to his seat on Springfield Clinic’s Board of Directors. James K. Fullerton, MD General Surgery James K. Fullerton, MD is a board-certified general surgeon, with special interests in laparoscopic surgery, surgical endoscopy and ERCP. A native of Janesville, Wisconsin, Dr. Fullerton attended the Medical College of Wisconsin in Milwaukee, where he received his medical degree. He was named Chief Resident in 2004 during the completion of his General Surgery residency at SIU School of Medicine in Springfield. Immediately following, Dr. Fullerton joined Springfield Clinic’s Department of General Surgery and practiced briefly until his acceptance at University of Louisville in Louisville, Kentucky. During his leave of absence, Dr. Fullerton completed an Endoscopy and Interventional ERCP Fellowship, and returned to practice in the Clinic’s Department of General Surgery in 2006. Dr. Fullerton was elected to the Board of Directors in 2009 and currently serves on the Ambulatory Surgery Committee and as Department Chairman for Springfield Clinic’s Department of General Surgery. His memberships include the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), the American Hepato-Pancreato-Biliary Association (AHPBA), as well as the Sangamon County Medical Society and Illinois State Medical Society. Mark Kuhnke, MD General Surgery Dr. Kuhnke, a native of Johnston City, Illinois, attended medical school at SIU School of Medicine in Springfield, Illinois. He served his internship and residency at SIU affiliated hospitals in Springfield, serving as Chief Resident in 1985-1986. During his residency, Dr. Kuhnke was elected to Alpha Omega Alpha, the national medical honor society. He launched his surgical career in 1986, maintaining an active private surgical practice until the 2004 merger with Springfield Clinic. His special interests include laparoscopic and cancer surgery. He is a board certified general surgeon and a fellow in the American College of Surgeons. He previously served as the president of the Illinois Chapter of the American College of Surgeons. His current memberships include the American Society of Colon & Rectal Surgeons, the Midwest Surgical Society, the Illinois Surgical Society, the Illinois State Medical Society and the Sangamon County Medical Society. Dr. Kuhnke is also an Associate Clinical Professor at SIU School of Medicine’s Department of Surgery. He serves as the vicechairman of the Memorial Medical Center Department of Surgery and is a past-chairman of the St. John’s Hospital Department of Surgery. Currently, Dr. Kuhnke serves as the Chairman of Springfield Clinic’s Managed Care Committee and as a member on the Quality Management and Peer Review Committee, in addition to his role on the Board of Directors. Mark T. McKay, MD Family Medicine Mark McKay, MD was born in Dubuque, Iowa and attended medical school at the University of Iowa in Iowa City. He completed his Family Medicine residency at the Baptist Medical Center in Kansas City, Missouri. As a board certified Family Medicine specialist, Dr. McKay provides care to patients of all ages with specific interest in pediatric and newborn care. He is a member of the American Academy of Family Physicians, the Illinois Academy of Family Physicians, the Sangamon County Medical Society and the Illinois State Medical Society. Dr. McKay joined the family medicine group at Wabash Medical Center in September of 1997. In addition to service on the Board of Directors, he leads the Finance Committee as chairman and serves on both the Investment Sub-Committee and the Information Technology Committee. Kenneth R. Sagins, MD Internal Medicine / Pediatrics As an Internal Medicine / Pediatrics specialist, Kenneth R. Sagins, MD is the only current member of the Board of Directors representing Springfield Clinic’s satellite network. His office, Lincoln Health Care Specialists, is located in Lincoln, Illinois. Dr. Sagins, a native of Detroit, Michigan, came to Springfield as a student at SIU School of Medicine. There, he earned his medical degree, completed his internship and finished a residency in Internal Medicine / Pediatrics. He is certified by both the American Board of Internal Medicine and the American Board of Pediatrics. His practice includes the evaluation and treatment of illnesses in adults, as well as in pediatric and adolescent patients. Upon completion of his medical training, Dr. Sagins joined Springfield Clinic in 1997. His leadership has been demonstrated through service as both member and chair of numerous committees. He was elected to the Board of Directors in 2006 and currently also serves on the Board’s Executive Committee. Dr. Sagins is a member of the American College of Physician Executives, as well as a member in the American Academy of Pediatrics, American College of Physicians and the American Medical Association. John D. Zander, MD Colon & Rectal Surgery John D. Zander, MD is a board-certified specialist in Colon & Rectal Surgery, with emphasis on Colonoscopy and Anal-Rectal disease. A native of Boston, Massachusetts, Dr. Zander earned his medical degree from Emory University School of Medicine in Atlanta, Georgia. In 1980, he performed a General Surgery residency at the University of South Florida in Tampa which was immediately followed by the successful completion of a Colon & Rectal Surgery residency at Michigan State University / Ferguson Clinic in Grand Rapids, Michigan. He is also certified in General Surgery by the American Board of Surgery. He joined Springfield Clinic in 1981, immediately following completion of his training. He is one of the newest members elected to the Board of Directors. He currently serves as a member of the Clinic’s Building Committee and chairs the Insurance Committee. Dr. Zander is a member of the American Society of Surgery, American Society of Colon & Rectal Surgeons, Illinois State Medical Society and Sangamon County Medical Society. SPRINGFIELD CLINIC l 49 PAST TERM BOARD MEMBERS Ernest E. Ertmoed, MD Obstetrics & Gynecology For more than 20 years, Dr. Ertmoed has been a member of Springfield Clinic’s Department of Obstetrics & Gynecology. A Pekin, Illinois native, and graduate of Northwestern University School of Medicine in Chicago, Illinois, he chose Springfield to complete his internship and residency at SIU School of Medicine. After several years in private practice, he joined Springfield Clinic in 1987. He is board certified in Obstetrics & Gynecology and continues to practice both. He is a member of the Sangamon County Medical Society and the Illinois State Medical Society. Dr. Ertmoed has served two terms on the Board of Directors, most recently from 2005 to 2008. His efforts as a board member contributed significantly to Springfield Clinic’s latest expansion and technological progress. Mark D. Greatting, MD Orthopaedic Surgery Born in Belleville, Illinois, Dr. Greatting received nearly all his medical education and training at SIU School of Medicine in Springfield, Illinois, including his medical degree, internship and residency in Orthopaedic Surgery. He attended Mayo Graduate School of Medicine in Rochester, Minnesota to complete a fellowship in hand surgery. His Orthopaedic Surgery practice focuses primarily on the treatment and rehabilitation of hand and upper extremity problems. He maintains board certification in Orthopaedic Surgery and has a certificate of added qualification in Hand Surgery. Both certifications are issued through the American Board of Orthopaedic Surgery. After three years of practice at SIU School of Medicine, Dr. Greatting joined Springfield Clinic. Since that time, he has been an integral member of the physician leadership team, serving on the Clinic’s Building Committee, Operations Committee and just recently, the Board of Directors (2003 – 2008). His vision and commitment to the organization have helped propel Springfield Clinic to its current status in the medical community. 50 l INSIDE SPRINGFIELD CLINIC Barbara A. Mulch, MD Internal Medicine Barbara A. Mulch, MD is a board-certified specialist in Internal Medicine, practicing at Hillsboro Medicine Center, a division of Springfield Clinic. Dr. Mulch, a Chicago native, earned her medical degree from University of Illinois at Chicago in 1977 and completed her Internal Medicine residency at Ohio State University College of Medicine in Columbus three years later. She and her husband, Robert Mulch MD, established Hillsboro Medical Center, a private practice, immediately following her medical training in 1980. In 1989, Hillsboro Medical Center merged with Springfield Clinic. Since that time, Dr. Mulch has served on numerous committees, including her current membership on the Information Technology Committee. She served two consecutive terms on the Board of Directors between 1999 and 2004 and a single term from 2006 to 2008. She played a vital role in the selection and implementation of Springfield Clinic’s comprehensive Electronic Health Record (EHR) system. In addition, she serves as the regional medical director for Health Alliance Medical Plan. Dr. Mulch is a fellow in the American College of Physicians and is a member of the Montgomery County Medical Society and Illinois State Medical Society. SPRINGFIELD CLINIC l 51 Solutions for Success: Overcoming Today’s Challenges in Oncology In regards to all the challenges physicians face daily, from optimizing cash flow to ensuring proper patient care, managing the specialty of oncology in a practice or in a multispecialty setting has become increasingly complex. This is especially true with the shifting reimbursement rules and rapidly changing clinical environment. In recent months, oncologists across the country have felt significant market pressure resulting from the recent pharmaceutical label and reimbursement changes. The high cost of oncology drugs paired with the financial challenges that patients face poses a significant threat to oncology practices and clinics. With all the challenges involved in managing an oncology department or independent practice, what solutions are available? US Oncology works closely with physicians, manufacturers and payers to identify and deliver innovative services that enhance patient access to advanced cancer care. Special knowledge is required to address issues unique to cancer care, including drug pricing, complicated reimbursement rules and the growing number of oral chemotherapies. Through its physician services offerings, US Oncology provides highly specialized business and clinical resources to support oncologists and their practice staff and address these issues in a manner that often delivers savings and improved profitability. Oncology Pharmaceutical Services (OPS), a service of US Oncology, offers a solution to address the special needs in the market by providing powerful network drug contracting and services that extend beyond drug procurement. Through its unique business model, OPS offers the oncology-specific expertise of consultant pharmacists as a complement to its drug purchasing and distribution services. With an understanding that the oncology team determines the focus of the support provided, these business savvy consultant pharmacists work with staff to find clinical and operational areas of improvement. Benefits of the OPS solution include enhanced charge capture, inventory management, and access to billing and clinical educational resources. Oncology Expertise Complemented with Business Knowledge On average, each oncologist spends about $2 million on drugs annually to treat patients. The drug purchasing function has historically been a key driver of an oncology department’s financial performance. With decreasing profit margins in oncology therapeutics, shopping for low drug pricing can be less productive than it was in the past; especially when time can be better spent on enhancing patient care. 52 l INSIDE SPRINGFIELD CLINIC At Springfield Clinic, evidence-based medicine and compassionate patient care are enhanced by innovation and technology. The clinic has gained its leadership position by focusing on creating the greatest value for its constituents, especially the patients. OPS is committed to supporting the goals of Springfield Clinic by providing best-in-class cancer care pharmaceutical services to the oncology team. An OPS the associated financial implications. Often, difficult decisions consultant pharmacist works closely with the staff to address must be made, including turning away indigent patients due to key areas of improvement within both the clinical and business the practice’s inability to operate with additional bad debt or operations. Some of the areas in which OPS is working losing patient capacity due to increasing office responsibilities with Springfield Clinic include: helping with compliance to placed on staff as they spend an increasing amount of their time federal standards for admixture processes through training on reimbursement matters. and validation of admixture staff; providing consultation in development of admixture procedures; and assisting in navigating the complexities of the oncology reimbursement environment through educational webcasts. In addition, the OPS pharmacist has worked with clinic staff to establish The Key to Oncology Practice Reimbursement. process improvements that have resulted in modest, but not To assist community oncology practices as they face the insignificant, financial gains. challenges associated with a complex and ever-changing Like Springfield Clinic, many other multispecialty clinics and Oncology Reimbursement Services (ORS), an oncology- practices across the country have positively benefited from the focused billing and reimbursement service. reimbursement environment, US Oncology now offers OPS solution. Whether it be clinical education opportunities, marketing resources, or patient assistance support, OPS is ORS leverages the proven processes used with over 1,000 oncology able to provide every staff member with tools and resources providers in more than 325 sites of service across the nation and to address their specific needs. The oncology pharmacist is provides services to cover every aspect of the reimbursement ultimately a resource to the practice and focuses on projects – hurdle: a comprehensive revenue cycle management program, a big and small – important to the overall success of the oncology full curriculum of oncology billing and coding education, and a department or practice. One physician affiliated with OPS had resource for accessing patient assistance programs. this to say about the business relationship between his practice staff and the OPS pharmacist: “It’s been a valuable relationship, not just in the value of dollars and cents; our consultant pharmacist is one of the team.” – Physician The ORS practice management system was specifically designed to meet the complex needs of oncologists. This technology solution supports both front and back office business functions within an integrated revenue cycle model, providing a smooth integration from practice staff responsibilities to ORS staff responsibilities. Facing the Challenges of Declining Reimbursement Valuable billing and coding education is also made available to Before the MMA, the CMS ruling on Erythropoietin practice staff to help them effectively manage reimbursement Stimulating Agents (ESA), and numerous other recent issues and fully understand and comply with ever-changing regulatory and reimbursement changes, a primary concern coding and reimbursement-related guidelines. This increased of community oncology practices was treating patients. The knowledge of reimbursement regulations and policies at all costs associated with treatment were of less concern since high levels – federal, state, and payer specific – leads to improved drug margins helped cover cash flow issues associated with overall coding, billing, and operational efficiencies. claim denials and payer issues. Even bad debt resulting from patients who were unable to afford the costly drugs could quickly be written off without making a major impact in the In response to the struggles faced by both practice and patient practice’s financial stability. when the patient is under- or non-insured, the ORS Patient But things have changed. Assistance Support team experts work to obtain assistance for qualifying patients through foundation grants or free drug In today’s environment, many oncology practices are quickly replacement programs. In 2007, the ORS Patient Assistance finding that while their primary focus continues to be providing Support team secured over $14 million in funding for qualifying quality cancer care, they must now balance treatment plans with cancer patients being treated at practices affiliated with US SPRINGFIELD CLINIC l 53 Oncology. One financial counselor had this to say about the ORS Patient Assistance Support: ”What a great week this has been. You have helped with 4 patients and over $27,000 in help! UNBELIEVABLE !!!!!” – Patient Financial Counselor from an Ohio oncology practice Growth of Oral Oncology Therapies Increases Complexity of Patient Care Today oral drugs make up 35% of the oncology pharmaceutical pipeline. As oral oncology therapies become more commonplace, the number of challenges associated with orals also increases. Traditionally, patients have received oncology treatments intravenously, spending hours in an infusion chair monitored closely by oncology nurses. With the introduction of oral oncology therapies, practices have to deal with the complex insurance verification process, help patients find financial assistance for these costly drugs, and monitor patient adherence, all while the patient is now at home for weeks in between appointments. Alternatively, some practices may not realize the extra time and attention to adherence that is necessary when handing a patient a prescription to fill on their own. What happens after the patient leaves is often unknown until the next appointment when the practice staff finds out their patient may not have even started therapy due to cost or confusion. Oncology Expertise… Enhancing the Care of Cancer Patients In order to relieve the burden placed on practices, OncologyRx Care Advantage, a national oral oncology pharmacy, was developed by US Oncology. Care Advantage brings clinical oncology expertise to the delivery and management of oral therapies associated with cancer care. 54 l INSIDE SPRINGFIELD CLINIC “Thanks to you, patients don’t go without their meds.” – Financial Coordinator from a South Carolina oncology practice This innovative specialty pharmacy was designed with oncologists’ input to meet the needs of practices and their patients. As the single source for all patients’ oral oncology prescription needs, Care Advantage focuses on reducing practice workload and optimizing patient care. “I just want you to know how thankful I am for your assistance…I am sincerely grateful you are on my team.” – Recent patient receiving oral oncology prescription from Care Advantage The service provided by Care Advantage is unique in that it offers a team of cancer care experts – the Cancer Care Team. This experienced team includes oncology pharmacists, The Right Knowledge, the Right Support oncology-certified nurses, patient access coordinators, pharmacy With the rapidly changing environment in oncology, physicians technicians and customer service representatives. These will continue to encounter challenges trying to maintain professionals provide oncology expertise that is founded upon viable business while delivering the best care to their patients. years of cancer care delivery and clinical research within US Leveraging resources that offer the right expertise has become Oncology’s network of affiliated oncology practices. increasingly important. Through US Oncology, diverse Benefits of using Care Advantage include patients receiving performance in many key areas including: service offerings are available to enhance practice and clinic ongoing, proactive calls on a weekly basis from the Care Advantage nurses. These oncology-trained nurses provide patient education, confirm adherence to the prescribed therapy, • Powerful network drug contracting and the support of oncology-trained pharmacists and report patient side affects back to the prescribing office. • Comprehensive billing and revenue cycle management Another valuable aspect of the service is the expertise of Patient • Clinical oncology expertise in delivery and management of customized for the complexity of cancer care Access Coordinators (PACs) who provide insurance verification oral therapies associated with cancer care and financial assistance support when needed. With the high cost of these cancer care medications, it is common With US Oncology, physicians and their staff can access support that a patient is unable to pay co-pays or may fall into the in the areas most relevant to them, allowing them to fully focus Medicare Part D donut hole. The PACs work with a variety on providing patients with the advanced care they need. of foundations to obtain financial assistance for patients. Since 2007 Care Advantage has secured over $9 million in patient If you are interested in learning more about the services assistance for patients in need. offered by US Oncology, please contact 866-216-5053 or visit www.opspharmacist.com for more information. Both patients and practice staff provide feedback to illustrate the extended service Care Advantage provides: SPRINGFIELD CLINIC l 55 The Personal Side of Clinical Research Each year, hundreds of individuals --- cancer patients, arthritis sufferers, and others with treatable illnesses and diseases volunteer to help doctors improve prevention, detection and treatment of diseases through participation in clinical trials at Springfield Clinic. These trials rely heavily on medical data collected from the study participants; data which then becomes part of a much larger national sample. Study results, once amalgamated with data from other enrolling sites, can be nameless and faceless, but at Springfield Clinic, researchers work hard to ensure that trial participants are more than just another number… 56 l INSIDE SPRINGFIELD CLINIC and get everything done. Everyone has been so helpful through the whole process. We’ve wanted for nothing.” Mr. Wilson added, “They’ve treated me real good.” At home, the Wilson’s tend to the family’s dairy farm, where they grow corn, soy beans, canola and watermelon. “I’ve tried growing just about everything,” he adds. “The farm has been my life.” As a self-described “pretty ornery guy,” Mr. Wilson has been popular among research staffers. “I call him Mr. Kentucky. He’s one of the best story tellers I think I’ve ever met,” commented Peggy Carter from Springfield Clinic’s Research staff. “Some of them get pretty…hmm…colorful, but you can tell by the smile on his face that he really enjoys those memories.” Mr. Wilson is nearing the completion of his trial participation. After a four-year battle with cancer, he remains hopeful for a All the Way from Fancy Farm The trip from Fancy Farm, Kentucky to Springfield, Illinois takes Bernard Wilson and his family members more than four hours, but he is convinced it’s worth it. The 60-year-old farmer cure. Like other study participants, if his blood work shows improvement, he will continue to receive the drug as long as it is effective. He adds, “I’ve been through all the available therapies. I hope this one works.” from Western Kentucky travels to Springfield Clinic every three weeks to participate in a Bristol-Myers Squibb prostate cancer research study, which he hopes will eradicate, or at least slow, the spread of his cancer. Mr. Wilson was diagnosed with prostate cancer nearly four years ago, shortly after the birth of his first grandchild. “My dad always had a high PSA,” he said, “so I wasn’t concerned. I held out being tested until after the baby was born.” Following surgery to remove his prostate, a bone scan uncovered a suspicious spot. Since that time, Mr. Wilson has undergone a series of adjuvant therapies which have proven ineffective. Then, through his resources at MD Anderson in Houston, he learned about a new trial also being conducted at Springfield Clinic. “I was figuring on going to Houston, but when they told me I could come here to Springfield and get the same treatment, I was in.” He was the first applicant screened for the Springfield Clinic Phase I/II trial and was accepted into the program immediately. His support group always includes Wanda, his wife, and a team of close friends and relatives. They’re happy to make the journey. Mrs. Wilson added, “We come up here to one place SPRINGFIELD CLINIC l 57 Looking for Answers “They just amazed me.” That was Pat Sale’s impression as to .01, the lowest detectable level. While his initial response to he arrived at Springfield Clinic to participate in a Phase I/II the treatment was positive, a few months later, Pat’s PSA began clinical trial. “I’ve been to big medical centers before and they to rise and his doctors in St. Louis determined his cancer was ask your name, hand you the paperwork and shuffle you off non-hormone responsive. By August of 2008, his cancer had to your treatment. On my first day, Peggy from the Research returned in full force. Department was waiting for me at the front door and personally escorted me through the entire process. That’s what it’s all about --- taking care of patients.” “I went to the Internet first for information about the disease and any new treatments available.” Through the help of a friend, Pat eventually found hope at world-renowned cancer Mr. Sale, or Pat as he insists, is a prostate cancer patient research and treatment center, MD Anderson in Houston, currently receiving experimental cancer therapy at Springfield Texas. The same Bristol-Myers Squibb study at MD Anderson Clinic as part of a national clinical trial sponsored by Bristol- was enrolling prostate cancer patients for active treatment, but Myers Squibb (BMS). So how did this St. Louis businessman by the time Pat inquired, all openings had been filled. end up at Springfield Clinic for his cancer care? Research specialists at MD Anderson were quick to review 58 l Pat’s journey began with his first cancer diagnosis in 2007. “My the other participating sites and asked Pat if he was anywhere prostate felt a little funny and my doctor in St. Louis thought near Springfield, Illinois. Pat thought to himself, “Springfield it could be an infection,” recounted Pat. Antibiotic treatment Illinois?” He smiled and added, “When I saw names like MD had little effect on the lump, so his physician recommended a Anderson, Duke University, and University of Chicago that biopsy. It turned out to be Stage 4 prostate cancer, which had were involved in this study, I just couldn’t believe it. I didn’t metastasized to his ribcage. expect Springfield Clinic to be of this caliber.” His treatment included chemotherapy, in addition to a hormone Springfield Clinic serves as one of only five sites across the therapy being tested as part of a clinical trial. Pat’s PSA, a country enrolling patients in the BMS study. Peggy Carter, screening test which can help detect the presence of cancer, fell LPN, CCRP (Certified Clinical Research Professional), serves INSIDE SPRINGFIELD CLINIC as the lead coordinator on the trial. “Each site was allowed only five participants, so slots were at a premium. I had two excellent candidates and only one remaining slot. It was impossible to choose one over the other, so I convinced BristolMyers to allow our site another opening so both patients could receive treatment,” noted Peggy. Her extra effort left a lasting impression on Pat Sale. He stated, “Peggy’s terrific. She and so many others have gone the extra step to make my care possible.” As for his clinical care, Pat added, “The doctor had a whole different attitude. We spent a lot of time together and he was really interested in my life.” He continued, “I’ve only been here three times and the receptionists know me by name. At Springfield Clinic, I feel like they really care about me.” Pat’s current treatment protocol includes six rounds of chemotherapy in combination with Dasatinib, a daily pill already FDA approved for the treatment of Chronic Myloid Leukemia (CML). A rigorous schedule of blood work is required to monitor how the agents move through his bloodstream. Springfield Clinic’s Research team values the contribution of study participants. “Mr. Sale has invested so much personal time in this trial. We’re indebted to him and others like him, to help us discover new treatments.” With expected completion of his trial treatment soon, Pat Did You Know? remains hopeful. “I don’t expect this to be the cure-all, but if a useful treatment comes out of this, I’ll have the satisfaction of knowing I helped create more options for other prostate cancer patients. It will be really gratifying if this drug makes it to the market and can save others’ lives. As I see it, somebody had to do a trial to test the treatments we have today. It’s a no-brainer. I encourage everyone who has the opportunity, to participate in clinical trials. If Pat’s response to the experimental therapy is positive, Bristol-Myers will supply him with the drug as long as it is effective. Pat adds, “It’s been a long journey. I started by looking for an answer for myself and now think more about • Springfield Clinic Research Department was established in 2003 • The department currently manages more than 40 active studies • More than 40 Springfield Clinic physicians participate in research efforts • Springfield Clinic doctors have participated in excess of 270 trials to date • Five members of the Springfield Clinic Research team have achieved certification as a certified clinical research associate through the Society of Clinical Research Associates (SOCRA) doing it for others.” SPRINGFIELD CLINIC l 59 Scrubbing In: A Day at the Ambulatory Surgery & Endoscopy Center It’s 5:00 a.m. and Mary, the first staff member to arrive, makes her way through the dark and silent halls, switching on lights and checking patient monitors in preparation for another busy day. Within minutes, locker rooms are buzzing with activity, as staff members slip into scrubs and make their way to their work areas. The mood is light and friendly as members of this highly skilled team prepare for the imminent arrival of patients and surgeons. On this day, Dr. Beth Bergman, a specialist in Plastic & Reconstructive Surgery enters the surgery hallway and greets the team. She studies the case board and reviews her schedule for the day before scrubbing in. Her first patient, already anesthetized, has been fully prepped. Once gowned and gloved, Dr. Bergman leads the team in a “time out,” one final confirmation of the patient, the procedure and their game plan. By 6:00 a.m., the surgery is underway. 60 l INSIDE SPRINGFIELD CLINIC So starts a typical morning at Springfield Clinic’s Ambulatory Surgery and Endoscopy Center (ASC / EC). Throughout the day, a steady flow of patients make their way through admitting, the procedure area and recovery, and within just a few hours, will leave with family or friends to recuperate in the comfort and convenience of their own homes. On any given day, about 35 endoscopy procedures and 35 surgical cases are performed by Springfield Clinic physicians and surgeons here. When the Ambulatory Surgery /Endoscopy Center opened in 1994, it was the first free-standing facility of its kind in Central Illinois. Designed to accommodate procedures too complex for the physician office setting, but not requiring hospital admission, the facility offered a more convenient, private and affordable alternative to traditional surgical environments. Today, more than 1700 surgical procedures can be performed; Anterior Cruciate Ligament (ACL) Reconstruction, hernia repair, gallbladder removal and cataract surgery are just a few of the cases performed regularly. Dr. Bergman performs nearly twenty different surgical procedures, like face lifts, tummy tucks and breast reconstruction at the facility. “My patients love the ASC,” noted Dr. Bergman. “They rave about the experience --- the convenience of parking, the cleanliness of the facility and most of all, the friendliness of the staff. My practice involves a considerable amount of cosmetic surgery, and privacy is a concern for many of my patients. The ASC staff does an exceptional job of making them feel less anxious.” A 2008 expansion and remodel of the Ambulatory Surgery / Endoscopy Center made for greater physician access to surgical suites and improved accommodations for patients. Today, the Did You Know? In Ambulatory Surgery • Since its opening in April of 1994, nearly 57,000 cases have been completed • The most common procedure is cataract surgery • Last year, more than 6500 surgeries were performed In Endoscopy • Since opening in February of 2003, more than 41,000 cases have been done • Last year, more than 8300 procedures were performed • Colonoscopy is the most common procedure facility offers five fully equipped operating rooms and four endoscopy procedure rooms with the same equipment found in modern hospital settings. waiting room. A special children’s waiting area called the Kiddie In addition to the expansion of surgical areas, the Corral, completed in February 2009, signaled the end of the accommodations for attending family members and loved two year metamorphosis. “The changes have been positive for ones were dramatically improved. “It has been an amazing everyone,” said Forrest. “The staff has a great attitude, doctors transformation,” noted Ginny Forrest, RN, the director of the want to work here and our patients have a great experience.” Ambulatory Surgery and Endoscopy Center. “Our patients really like the addition of television in the admit areas and their The numbers speak for themselves. In patient satisfaction families enjoy the larger waiting area, access to our food services surveys, Springfield Clinic’s Ambulatory Surgery / Endoscopy and the freedom to move about the clinic campus.” Center has been rated “excellent” by 99% of respondents every month for the past two years. Dr. Bergman added, “The ASC Family members can also enjoy using their computer while is an awesome facility. I’m so grateful that my patients and I they wait on their loved one with the availability of WIFI in the have access to it.” SPRINGFIELD CLINIC l 61 62 l INSIDE SPRINGFIELD CLINIC SPRINGFIELD CLINIC l 63 Better Health Care through Technology: Springfield Clinic’s EHR Back in 2006, with more than 800,000 annual patient encounters, generating in excess of one million transcription notes and 500,000 prescriptions, a robust electronic health record was considered the only real solution to improve patient care, increase efficiency and position Springfield Clinic for the future. Little more than three years after the decision to implement a comprehensive Electronic Health Record system at Springfield Clinic, the paper charts are gone, medical records rooms are being repurposed and the environment has been spared the impact of millions of medical documents produced on paper each year. And, an office visit at Springfield Clinic has been forever changed. 64 l INSIDE SPRINGFIELD CLINIC Did You Know? • Springfield Clinic’s document imaging system holds more than 40 MILLION documents. Laid end to end, they would span the distance between Springfield, Illinois and Baghdad, Iraq How it happened Early in the process, Clinic physicians opted for a full-feature implementation of TouchWorks by AllScripts, the leading provider of Electronic Health Record systems in the United States. An implementation strategy was designed to convert medical offices to the new system in phases over a two-year period. These phases, coined “mini-bangs” by Springfield Clinic’s Chief Information Officer, Jim Hewitt, delivered • During the EHR rollout, 23 files rooms were cleared. That process reclaimed in excess of 145,000 square feet of space, approximately 30,000 square feet more than the entire Main Campus expansion created! • 850 shelving units were donated to local not-forprofit organizations throughout Central Illinois. a conversion “package” to each site, including infrastructure setup, equipment delivery, training and on-site support. Provider compliance initially concerned the EHR implementation team, particularly considering the documented failure of other clinics’ efforts at “big bang” implementations; however, Springfield Clinic’s strategy provided the support physicians and staff members needed throughout the conversion process. And, the anxiety of being “chartless” was quickly replaced with enthusiasm once physicians discovered the impressive functionality the system offered. The “mini-bang” strategy proved successful and clinical users embraced the EHR system. Today, medical information for all Springfield Clinic patients is stored in a single, secure, electronic repository. Physicians and staff utilize mobile tablets, modified laptop computers if you will, that contain digital records and images, which allow provider and patient to view medical information together in a more meaningful way. SPRINGFIELD CLINIC l 65 dramatically changed the availability of pertinent clinical information at the point of care.” Mulch continues, “The system gives us the tools to provide a more meaningful office visit, more thorough diagnosis, safer treatment and ultimately, a better patient experience. Our patients are excited about the technology and feel more confident in the care they receive.” Springfield Clinic’s Chief Executive Officer, Randy Bryant, added, “We’ve experienced benefits much sooner than imagined. We’re offering state-of-the-art medical services and improving standards of care. We’re enhancing the patient experience, Recent studies indicate that Springfield Clinic’s successful comprehensive implementation places the group among the top 4% of multi-specialty clinics in the nation to have reached this level of achievement. “Our EHR system has done everything we expected and more,” said Robert Mulch, MD, who practices family medicine at Springfield Clinic’s Hillsboro office and serves as Associate Medical Director and EHR Physician Champion. “We have Congratulations Springfield Clinic for your continued success. BREWER TRANSCRIPTION SERVICES Serving the Springfield Clinic for over 10 Years 416 Tecumseh Trail • Springfield, IL 62711 (217) 793-3475 • (217) 793-1344 Fax 66 l INSIDE SPRINGFIELD CLINIC providing better clinical outcomes, improving patient safety and lowering overall costs.” The EHR decision certainly didn’t hinge on environmental factors, but Hewitt admits the move to the electronic system has helped make Springfield Clinic more “green” than ever before. “In addition to the many other benefits, we’ve reduced the impact Springfield Clinic has on our environment and that not only benefits our patients, but it helps our world.” We would like to thank all the sponsors for making our educational publication possible. Please Support Our Advertisers. 360 Brewer Transcription Brown, Hays & Stephens, atty BSA Lifestructures Consolidated Communications Courtice/Grason Custom Publisher’s Group, Inc. Drinker, Biddle & Reath, LLP EL Pruitt Express Personnel Service Fritsch Custom Finishes Hanson Professional Services Harold O’Shea Builders Health Alliance Medical Plans McKesson Medical-Surgical Memorial Medical Center Merrill Lynch Midwest Office Supply Quest Diagnostics Selvaggio Steel St. Johns Hospital Three Sixty Designs, LLC US Oncology SPRINGFIELD CLINIC l 67 Leading the Way in Digital Imaging Case #1: Male patient presents with non-specific symptoms: some mild chest pain and shortness of breath. Following examination, his physician schedules a CT of the chest, clearly indicating a pulmonary embolism, a common, but potentially deadly disease. Patient is admitted to the hospital and given blood thinners. A life is saved. Case #2: Elderly patient complains of confusion and unsteady gait and shows no history of injury. An MRI of the brain shows a subdural hematoma; a bleed in the brain. Surgery is performed and patient returns to her normal state. A life is saved. Case #3: Female patient, age 42, undergoes routine screening mammogram. Suspicious mass is identified, a biopsy is performed and patient is diagnosed with Stage I infiltrating ductile carcinoma; breast cancer. Her medical team collaborates on treatment, which includes lumpectomy and adjuvant therapy. A life is saved. No, these aren’t scenes from a prime time medical drama; they are life-saving treatments made possible through the use of sophisticated digital imaging equipment at Springfield Clinic. If diagnostic imaging isn’t part of your regular vocabulary, think of it as the 21st century’s version of the x-ray. Remarkable images, many of them in full color and three dimensions, accompanied by equally impressive software tools, are now available to help doctors diagnose and treat illnesses with greater confidence and accuracy. “Our goal is to provide the best possible imaging technology to our patients,” said Frana Evans, Director of Radiology at Springfield Clinic. “Better images improve the quality of the diagnosis, the treatment and ultimately the patient’s outcome. Imaging technology is saving lives every day by helping our doctors identify problems earlier and enabling them to monitor patients more closely.” 68 l INSIDE SPRINGFIELD CLINIC Providing the best possible imaging technology is no easy job these days. According to Evans, the investment in the equipment, and the infrastructure to support it, has meant an investment of millions of dollars. “The equipment just keeps getting better. Today’s equipment produces better quality images with higher resolution and offers more image manipulation and reconstruction options.” In just the past ten years, Springfield Clinic has installed more than 20 imaging upgrades, including a 16-slice CT, Nuclear Medicine services, full field digital mammography, and digital x-ray in nearly all its facilities throughout Central Illinois. Scheduled to come online in summer of 2009 is the area’s most advanced 3.0 Tesla MRI unit at Springfield Clinic 1st. While many of these innovations improve the quality and quantity of the images produced, it is their digital acquisition that has proven most valuable to physicians and patients at Springfield Clinic. Digital images, like any other electronic file, can be securely stored, retrieved, shared and viewed in multiple places by multiple people. Couple this with a provider’s network-wide access to the images through Springfield Clinic’s state-of-the-art Electronic Health Record (EHR) system and the ability to communicate with other doctors, and more importantly, to patients, is tremendously enhanced. For instance, doctors at Hillsboro Medical Center, a division of Springfield Clinic, can see their patient’s x-rays minutes after the images are captured, often before the patient has driven back home. Providers at the Orthopaedic and Podiatry Acute Injury Clinic can order an x-ray and share images with the patient on the portable EHR tablet just minutes later. “Thankfully, the days of transporting oversized films between physician offices are gone, added Evans. “Sure, we can still produce film from the digital images, but the electronic process is much more efficient and effective.” Portability can also improve outcomes for patients requiring immediate treatment. “A patient arrived at Prompt Care complaining of abdominal pain and a quick CT determined he was suffering with appendicitis,” noted Evans. “Our system allows shared access with medical staff at area hospitals; essentially, the patient’s CT images were ready for the surgeon before the patient arrived at the OR.” Sarah Phillips, MD, a Prompt Care physician added, “Digital x-ray has allowed us to transmit images to the hospital for STAT interpretations. I can directly admit my patients from Prompt Care and save them a redundant visit to the hospital’s emergency room. That saves critical treatment time and of course, saves the patient money.” In addition to the advantages digital imaging offers patients and their physicians, it gives radiologists, the interpreters of the images, tremendous latitude to examine and compare images. “It hasn’t been that long ago that radiologists interpreted x-ray films with a magnifying glass,” commented Evans. “Imaging software not only captures and stores higher quality images it gives radiologists more tools than ever before.” Comparison is one of the key advantages for cancer patients whose images may reflect if a lesion is new or has changed. Karen Hoelzer, MD, a Springfield Clinic oncologist specializing in the treatment of breast cancer, noted, “Most of the patients in my practice have already had a diagnosis of breast cancer. So long as breast tissue remains present, all of them are at increased risk for a recurrence or a new cancer. Regular follow-up imaging is critical for early detection and ultimately, their survival.” Springfield Clinic’s Department of Radiology is rigorously inspected for compliance with health and safety regulations, is fully licensed by the state and is accredited in multiple areas by the American College of Radiology (ACR), American Institute of Ultrasound in Medicine (AIUM), and Intrasocietal Commission for the Accreditation of Vascular Laboratories (ICAVL). Radiologists and technologists, depending on their area of expertise, are all board certified by accrediting organizations, and many hold additional credentials in multiple specialty areas. Did You Know? • More than 103,000 total exams were performed at Springfield Clinic facilities in 2008. Of those, 10,723 were mammograms. • The magnet in Springfield Clinic’s new 3.0 tesla MRI unit is powerful enough to pull cars off the street! Fortunately, the magnet is self-shielded and the unit is surrounded by concrete and wire mesh, making it completely safe. • A 16-slice CT scanner creates an image of tissue approximately 0.625 mm thick, slightly thinner than a standard sheet of copy paper. • More than one-half million digital images are captured in Springfield Clinic’s PACS system each month. If each image were printed to a standard sheet of x-ray film, the combined weight of all 500,000 would be equivalent to three fully grown African elephants! SPRINGFIELD CLINIC l 69 Who Ya Gonna Call? TeleNurse: Springfield Clinic’s 24-hour a day, 7-day a week patient help line Think the emergency room has drama? Just spend a day with the staff of TeleNurse, Springfield Clinic’s 24-hour a day, 7-day a week patient help line. With peaks which can exceed 350 inbound calls daily, TeleNurse staff members never know what the next call may bring. 70 l INSIDE SPRINGFIELD CLINIC Each day, the highly trained and dedicated nursing staff manages patient concerns ranging from routine colds and fevers to crushing chest pain. They make certain that during each phone encounter the caller’s needs are identified and the patient is directed to the appropriate level of care. medical protocols, the nurses gather pertinent information, formulate a nursing assessment, and then talk patients through the recommended guidelines. The process may sound simple, but it takes experience and intuition to respond appropriately to the situation. TeleNurse has provided health consultation free of charge to Springfield Clinic patients since it was established in 1995. TeleNurse Director, Patty Anders, was one of two employees with the program since its launch. “I walked in to a picnic table and two protocol books. We started taking calls for 70 doctors and things got busy quickly.” “One day, I received a call from an elderly woman looking to establish care with a new doctor. She was vague, but eventually admitted she felt like her heart was beating irregularly. I just sensed the situation was more serious than she was letting on and I switched gears from a new patient call to triage,” recalled Patty. “I urged her to go to the hospital, but she insisted on keeping a hair appointment she had that afternoon. It took some doing, but I finally got her to agree that immediate medical attention was more important than a hairdo. Several Today, TeleNurse provides triage services for nearly 300 physicians and advanced practitioners. Utilizing computerized “... she had followed my advice and upon arrival in the ER, was taken into emergency surgery to install a pacemaker. She thanked me for saving her life.” SPRINGFIELD CLINIC l 71 weeks later, the woman called back. She had followed my advice and upon arrival in the ER, was taken into emergency surgery to install a pacemaker. She thanked me for saving her life.” TeleNurse staff members each possess at least 3-5 years experience in nursing and come from a wide range of nursing specialty backgrounds including home health, emergency room, office and hospital nursing. This experience better equips them for the unexpected nature of their calls and special training helps them draw out pertinent information from the caller and pick up on key words to identify symptoms. It takes superior listening skills, a comforting voice, and sometimes, a sense of humor. TeleNurse staff members admit that lack of closure is one of the drawbacks of their work. Concern and compassion for the patient isn’t something they easily dismiss. “I go home and rotate my patients through my head --- especially if I’ve had an emergency situation. My work is very personal to me. It’s who I am.” Of course, many patients do follow up with phone calls or notes to thank the nurses for their advice. “The letters are very special to each of us,” noted Anders. “I keep them to remind me why we’re here.” “An older man called one evening and seemed very anxious to establish care with a primary care doctor. When I told him it may be three to four weeks before I could schedule a new patient visit, he seemed a little frustrated.” The veteran TeleNurse team member continued, “I was concerned that he may have more serious health issues than he was letting on, so I kept asking questions. He eventually confided that he had a new lady friend and needed a prescription for Viagra right away. He chuckled (so did I) and in the end, he decided his new relationship was worth the wait.” Every TeleNurse will tell you its difficult not to become emotionally involved, especially with callers who have a serious illness or condition. “You’re right there with them. You can visualize their problem and feel their pain. It can be tough, but you take care of them, hang up, compose yourself and get ready for the next call, added Rita Stiltz, a TeleNurse manager.” While most calls are easily managed with the unit’s medical protocols, some situations need the quick thinking and kindness of compassionate individuals. Katie Kaufman, TeleNurse Coordinator, shared a perfect example. “It was a cold and rainy Saturday night about 6:30,” she recalled, “and I was talking to a new mother whose baby had been discharged from the hospital earlier that day. The baby’s fever spiked to 103.5° and I recommended the mom return her to the hospital immediately.” The young mother, with no car and no family or friends to drive, prepared herself and the baby to walk to the bus stop and catch the next bus. Katie continued, “I couldn’t let her take that sick baby out in the weather, so we all pitched in some money, prepaid the cab company and got the two of them to the hospital. I never told her where the money came from and we never heard from her again, but I know we did the right thing.” 72 l INSIDE SPRINGFIELD CLINIC Did You Know? • TeleNurse staff members take first line call for nearly 300 doctors and mid-level providers! • In 2008, TeleNurse handled 52,500 triage calls • The busiest time of year is flu season • The peak call time is Saturday between 10am to 4pm • Several members of the TeleNurse staff have more than 35 years experience in nursing Carlinville • Acorn Medical Associates Julie A. Fleischer, MD Pediatrics Elizabeth E. O’Brien, MD Internal Medicine Hollie A. Yoder, FNP-BC Family Medicine Decatur • Family Medical Center of Decatur John P. DiMondo, MD Family Medicine Dennis O. Heim, MD Family Medicine Helen B. Kennedy, FNP-BC Family Medicine Jennifer A. Rigdon, FNP-BC Family Medicine Kurt J. Heimbrecht, MD Family Medicine Dennis J. Rademacher, MD Family Medicine Robert F. Mulch, MD Family Medicine Melody S. Schniepp, MD Family Medicine Hillsboro • Hillsboro Medical Associates Douglas M. Byers, MD Family Medicine Barbara A. Mulch, MD Internal Medicine JACKSONVILLE • Jacksonville Family Health Care Shawn M. Fry, MD Family Medicine 74 l John L. Malcott, MD Family Medicine INSIDE SPRINGFIELD CLINIC Amber N. Drumeller, FNP-BC Family Medicine Michael W. King, PA-C Family Medicine Lynne M. Hutchison, FNP-BC Family Medicine JACKSONVILLE • Midwest Occupational Health Associates (MOHA) Robert L. Gordon, MD, MSPH Occupational Medicine Jane M. Kamp, FNP-BC Occupational Medicine JACKSONVILLE • Springfield Clinic Jacksonville Michael N. Fenner, MD General Surgery Darr W. Leutz, MD Orthopaedic Surgery & Sports Medicine LINCOLN • Lincoln Health Care Specialists Dennis M. Carroll, MD Family Medicine Melissa L. Cox, MD Med / Peds Kristen M. Green-Morrow, MD OB / GYN Jill Utley, MD Med / Peds Sharon L. Draper, FNP-BC Family Medicine Maria E. Rexroad, FNP-BC Family Medicine Kenneth R. Sagins, MD Med / Peds Don A. Sielaff, MD OB / GYN SHERMAN • Sherman Family Practice Letty Drapiza, MD Family Medicine SPRINGFIELD CLINIC l 75 TAYLORVILLE • Springfield Clinic Taylorville Rick Del Valle, MD Internal Medicine Yaser B. Freij, MD Pediatrics Pavi S. Gill, MD Internal Medicine David J. Kiel, MD Family Medicine Wayne L. Manson, MD General Surgery Roger McClintock, MD Med / Peds M.B. Prabhu, MD Internal Medicine / Pulmonary Diseases Sandra J. Brummet, FNP-BC Internal Medicine Kimberly A. Earl, FNP-BC Family Medicine Karen M. Manson, FNP-BC Internal Medicine Patricia A. Schneider, FNP-BC Med / Peds Kimberly V. Turner, FNP-BC Pediatrics Elvia A. Washington, FNP-BC Med / Peds Heidi L. Klemm-Glatz, CRNA Janet C. McChristy, CRNA SPRINGFIELD • Main Campus East • Anesthesiology T. Neil Rooke, MD Christopher D. Ryan, MD Jeff P. Thompson, MD Rebecca S. Murphy, CRNA Patricia J. Pikesh, CRNA Neil L. Thompson, CRNA SPRINGFIELD • Main Campus East • Family Medicine Stefan P. Kozak, MD 76 l Steven J. Lewis, MD INSIDE SPRINGFIELD CLINIC Jennifer Western, MD Randy L. Western, MD Dennis D. Yap, MD SPRINGFIELD • Main Campus East • Hematology & Oncology Mary E. Bretscher, MD Karen L. Hoelzer, MD Scott A. Mink, MD Diana S. Willadsen, MD Carla J. Daniels, AOCNP Stephen T. Randag, MD Gary G. Shull, MD Andrew K. Guardia, PA-C SPRINGFIELD • Main Campus East • Internal Medicine Timothy G. Drake, MD Vladimir A. Lytchakov, MD Cathy L. McAfee, MD Pramila Venigalla, MD Neville White, MD Laura J. Amidon, FNP-BC SPRINGFIELD • Main Campus East • Prompt Care (also located at Springfield Clinic Wabash) Mary K. Campbell, MD Larry H. Elkins, MD Sarah C. Phillips, MD Ragini L. Sharma, MD Kim E. Wyatt, MD Lynette Y. Zills, MD Brandon Landsverk, PA-C Marilyn S. Robins, ACNP-BC Agnes A. Wood, MD SPRINGFIELD CLINIC l 77 SPRINGFIELD • Main Campus West • Allergy, Asthma & Immunology Renu C. Govindaiah, MD Dareen D. Siri, MD SPRINGFIELD • Main Campus West • Dermatology Cassandra Claman, MD Sarah M. Dietrich, MD Colleen Langer, PA-C Linda J. Read, FNP-BC Judith P. Knox, MD A. Katherine Stealey, MD SPRINGFIELD • Main Campus West • Endocrinology 78 Kevin D. Hazard, MD David R. Hoelzer, MD Pamela S. Brodt, ACNP-BC Kathy S. Smith, FNP-BC l INSIDE SPRINGFIELD CLINIC Sufyan Said, MD Lynn M. Speck, MD Jadwiga M. Wesly, MD SPRINGFIELD • Main Campus West • Gastroenterology Alec Chan-Pong, MD Sailaja Cheruku, MD Mark A. Harrison, MD Peter J. Karras, MD, PhD Robert G. Mosley, MD William L. Peterson, MD Richard L. Smith, MD Heather C. Ey, FNP-BC Richard M. Foster, FNP-BC Paul E. Houk, PA-C SPRINGFIELD • Main Campus West • Gynecology Randolph Wm. Roller, MD SPRINGFIELD • Main Campus West • Optometry Kim B. Krager, OD Gaylan W. Moushon, OD Robin B. Valenti, OD SPRINGFIELD • Main Campus West • Ophthalmology Patrick J. Butler, MD David B. Krah, MD John E. Kwedar, MD Eric P. Lohse, MD Randal J. Peterson, MD Amish R. Purohit, MD Grant W. Su, MD Matthew J. Thompson, MD Vinita M. Solomon, OD Dale J. Swetlishnoff, OD SPRINGFIELD CLINIC l 79 SPRINGFIELD • Main Campus West • Otolaryngology (ENT) Robert E. Finch, MD Sarah S. Fowler, MD Maurya E. Hofner, PA-C Beth A. Phelps, ACNP-BC Philip Garcia, MD Xinyan Huang, MD, PhD SPRINGFIELD • Main Campus West • Audiology Behavioral Health Christine M. Bitzer, MS Barbara J. Wolfson, LCPC, MBA Michael R. Larson, MS Charles E. Swain, PhD SPRINGFIELD • Springfield Clinic 1st • Cardiology Adeeb Ahmed, MD Thomas B. Cahill, Jr., MD Donald L. Yakel, MD Tasha Schuette, PA-C Vaskar Mukerji, MD SPRINGFIELD • Springfield Clinic 1st • Chiropractic Windie C. McKay, DC 80 l Michael Davin, LMT INSIDE SPRINGFIELD CLINIC John E. Nester, MD Soliman A. Soliman, MD SPRINGFIELD • Springfield Clinic 1st • Colon & Rectal Surgery Anthony Firilas, MD Peter M.C. Hofmann, MD James W. Thiele, MD John D. Zander, MD SPRINGFIELD • Springfield Clinic 1st • General Surgery James K. Fullerton, MD Max D. Hammer, MD Orlando J. Icaza, MD Mark Kuhnke, MD Donald S. Ross, MD John R. Trost, MD Keith A. Wichterman, MD Jennifer S. Bradley, PA-C Kristofer J. Mitchell, MD SPRINGFIELD • Springfield Clinic 1st • Gynecologic Oncology John C. Shaffer, MD SPRINGFIELD • Springfield Clinic 1st • Neurological Surgery Margaret MacGregor, MD Brian K. Russell, MD Sally A. Vespa, PA-C SPRINGFIELD • Springfield Clinic 1st • Neurology Cecile E. Becker, MD Claude J. Fortin, MD David A. Gelber, MD Koteswara Narla, MD Denise K. Mears, FNP-BC SPRINGFIELD CLINIC l 81 SPRINGFIELD • Springfield Clinic 1st • Obstetrics & Gynecology Heather N. Beal, MD Cheryl L. Brown, MD Richard T. Eden, MD Ernest E. Ertmoed, MD Tammie A. Klein, MD William D. Putman, MD Toni M. Quinn, MD Pamela J. Rundle, MD Donna J. Sweetland, MD J. Michael Zinzilieta, MD Robin J. Hickman, FNP-BC Jennifer Jenkins, FNP-BC Carol S. Weidler, WHNP SPRINGFIELD • Springfield Clinic 1st • Orthopaedics & Sports Medicine 82 Daniel M. Adair, MD Tomasz W. Borowiecki, MD Mark D. Greatting, MD Diane C. Hillard-Sembell, MD William D. Payne, MD Stephen J. Pineda, MD Jeff A. Schopp, MD G. Brett Western, MD Brett W. Wolters, MD Christopher E. Wottowa, MD Erika A. Lukac, PA-C Jennifer R. Nichelson, FNP-BC David W. Purves, PA-C Robert E. Whitman, PA-C l INSIDE SPRINGFIELD CLINIC SPRINGFIELD • Springfield Clinic 1st • Podiatry R. Mitchell Parker, DPM Marten J. Sikorski, DPM SPRINGFIELD • Springfield Clinic 1st • Rheumatology Jason P. Guthrie, MD Jeffrey R. Horvath, MD Michael A. Pick, MD Mark A. Stern, MD SPRINGFIELD • Springfield Clinic 1st • Urology Thomas E. Baron, MD David C. Lieber, MD David A. Roszhart, MD William C. Severino, MD Susan E. Nelson, CUNP SPRINGFIELD • Springfield Clinic 1st • Vascular Surgery Lynne D. Barkmeier, MD Andrew D. Lambert, MD Stephen M. Ryan, MD Stacey A. Graven, ACNP-BC SPRINGFIELD • Springfield Clinic 1st • Physical Therapy Judy M. Limper, PT Tania K. McKahin, PT Jennifer K. Wilham, PT Linda A. Williams, PT Jamie F. Yording, PT SPRINGFIELD CLINIC l 83 SPRINGFIELD • Springfield Clinic Wabash • Family Medicine Bryan J. Albracht, DO Geoffrey A. Bland, MD Michael L. Brewer, MD Daniel E. Lanzotti, MD Mark T. McKay, MD Scott A. Morton, MD Larry M. Sapetti, MD James R. Stegeman, MD Marissa Cowell, PA-C Theresa M. Durbin, PA-C Carol M. Harper, PA-C Julie C. Hart, FNP-BC Mindy L. Hazard, FNP-BC Jennifer A. Hendricks, FNP-BC Brenda Merrill, FNP-BC Leanne M. Novar, FNP-BC Mindy M. Sanders, PA-C Terri Stephens, FNP-BC Connie Esslinger, FNP-BC Sandra Hudgins-Brewer, FNP-BC Melinda M. Vance, FNP-BC 84 l INSIDE SPRINGFIELD CLINIC SPRINGFIELD • Springfield Clinic Wabash • Pediatric Dermatology Joseph D. Conlon, MD SPRINGFIELD • Springfield Clinic Wabash • Pediatrics Raymond L. Castaldo, MD Terry L. Jones, MD Veronica G. Savage, MD Beth A. Steh, MD Valerie A. Klunick, CPNP Tracy A. Purseglove, CPNP SPRINGFIELD • Midwest Occupational Health Associates (MOHA) • Occupational Medicine Jeffrey A. Brower, MD Gregory E. Clem, MD Molly J. Baur, ACNP-BC Sandra K. Elliott, COHN-S Jennifer F. Frank, FNP-BC SPRINGFIELD • Springfield Family Practice Center • Family Medicine Jennifer E. Richards, MD Kim Y. Schoenburg, MD Stuart A. Yaffe, MD Debra S. Garner, FNP-BC Ann Marie Self, FNP-BC SPRINGFIELD CLINIC l 85 SPRINGFIELD • Springfield Pediatric & Adolescent Center • Pediatrics Christopher B. Ehrlich, MD Misty M. Phillips, MD Susan M. Soler, MD Stephen E. Wallace, MD Penny S. Fricke, FNP-BC SPRINGFIELD • The Pavilion • Infectious Diseases & Foreign Travel Medicine Donald R. Graham, MD Douglas R. Leigh, MD Praveen K. Mullangi, MD Steven D. O’Marro, MD SPRINGFIELD • The Pavilion • Nephrology Sabrina G. Bessette, MD Merry C. Downer, MD SPRINGFIELD • The Pavilion • Pulmonary Diseases & Sleep Medicine Jon Mann, MD 86 l Samir Patel, MD INSIDE SPRINGFIELD CLINIC Elinor Amy Berry, PA-C Charlene G. Shallow, FNP-BC Stephanie E. Wojtowicz, MD SPRINGFIELD • The Center for Plastic Surgery • Plastic & Reconstructive Surgery Beth Ann Bergman, MD Richard E. Brown, MD Raj K. Sinha, MD SPRINGFIELD • Memorial Medical Center / St. John’s Hospital • Hospital Medicine Chintan J. Amin, MD Rajesh G. Govindaiah, MD Susan M. O’Neal, DO Charity Kincade, FNP-BC Murty S. Renduchintala, MD Carlinville Lincoln Springfield Acorn Medical Associates 101 McCasland Avenue Carlinville, IL 62626 Lincoln Health Care Specialists 311 8th Street Lincoln, IL 62656 Decatur Sherman Family Medical Care of Decatur 1770 E. Lake Shore Drive - Suite 105 Decatur, IL 62521 Sherman Family Practice 400 St. John’s Drive Sherman, IL 62684 Springfield Clinic - Main Campus East 1025 South 6th Street Springfield, IL 62703 Springfield Clinic - Main Campus West 1025 South 6th Street Springfield, IL 62703 Hillsboro Taylorville Hillsboro Medical Associates 1250 E. Tremont Hillsboro, IL 62049 Jacksonville Jacksonville Family Health Care 610 N. Westgate Jacksonville, IL 62650 Midwest Occupational Health Associates (MOHA) - Jacksonville 901 West Morton Avenue, Ste 16A Jacksonville, IL 62650 Springfield Clinic Jacksonville 1600 West Walnut Jacksonville, IL 62650 VISIT US AT: www.springfieldclinic.com Springfield Clinic Taylorville 600 N. Main Taylorville, IL 62568 Springfield Clinic 1st 800 North 1st Street Springfield, IL 62702 Springfield Clinic Wabash 2200 Wabash Avenue Springfield, IL 62704 Midwest Occupational Health Associates (MOHA) 775 Engineering Drive Springfield, IL 62703 Springfield Family Practice Center 1100 Centre West Drive Springfield, IL 62704 Springfield Pediatric & Adolescent Center 2532 Farragut Springfield, IL 62704 Springfield Clinic at St. John’s Pavilion 301 North 8th Street Springfield, IL 62701 Springfield Clinic - The Center for Plastic Surgery 2901 Greenbriar Drive Springfield, IL 62704 Springfield Clinic at Memorial Medical Center / St. John’s Hospital 701 North 1st Street / 800 E. Carpenter Springfield, IL 62701 SPRINGFIELD CLINIC l 87 90 l INSIDE SPRINGFIELD CLINIC SPRINGFIELD CLINIC l 91 1025 South 6th Street PO Box 19248 Springfield, IL 62794-9248 PRSRT STD US POSTAGE PAID LOUISVILLE KY PERMIT #1477