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Biloxi/Keesler Joint Venture Site

Biloxi/Keesler Joint Venture Site. 2010 VA/DoD Joint Venture Conference. Brig. Gen. Kory Cornum Commander 81 Medical Group Keesler AFB. Mr. Thomas Wisnieski, MPA, FACHE Director VA Gulf Coast Veterans Health Care System.

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Biloxi/Keesler Joint Venture Site

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  1. Biloxi/Keesler Joint Venture Site 2010 VA/DoD Joint Venture Conference Brig. Gen. Kory Cornum Commander 81 Medical Group Keesler AFB Mr. Thomas Wisnieski, MPA, FACHE Director VA Gulf Coast Veterans Health Care System

  2. Overlapping Gulf Coast Multi-MarketsProvides Unique Opportunity for VA/DoD Sharing

  3. Overview • New Initiatives – Projects Closed • Joint Venture Performance Measures • Metrics • Access to Military Installation Procedures • Access to Care and Referral Management • Future Initiatives and/or Proposals • Other Joint Activities

  4. New Initiatives – Projects Closed

  5. Joint Venture Performance Measures

  6. Cost Savings(through August 31, 2010) Keesler Savings: • FY08 $145K • FY09 $374K • FY10 $616K Savings Calculated: Private Sector Market Value Less Negotiated Rate with DoD

  7. Access: VA Encounters at DoD Facilities(through August 31, 2010) • Counts Based on Paid Billed Services

  8. Access: Top 5 VA Encounters at 81 MDG (through August 31, 2010) • Counts Based on Paid Billed Services

  9. Access: Centers of Excellence Encounters (through August 31, 2010)

  10. Cost Avoidance • Cardiology and MRI: Actual combined VA/DoD savings year to date over life of JIF • Radiation Oncology: Annual projected VA savings • Sleep Lab: Annual projected VA/DoD combined savings after expansion

  11. Access to Military Installation Procedures

  12. Meeting Base Access Challenges • Coordination Between VA and DoD Facilities • Appointment Lists are Provided to Base Gate Security and/or Appointment Letters are Provided to the Patients • Shuttle Between Biloxi and Keesler Campuses • VA Facilities on DoD Property have Perimeter Fences to Separate VA Enclave • Pensacola Joint Ambulatory Care Center • Eglin CBOC • Patient Pass-Through Gates • Eglin 96 Medical Group

  13. Access to Care and Referral Management

  14. Future Initiatives and/or Proposals

  15. Additional Information as Desired • Maintaining Currency/Competency • Nurse Training/Collaboration • Residency Training Rotations • Keesler Graduate Medical Education Programs

  16. Nurse Training/Collaboration • Simulation Laboratory at Keesler • Joint Biloxi/Keesler Staff Conducted Several 6-hour Lab Sessions Between June & August 2010 • Trained 21 VA Nurses • 126 Contact Hours • Nurse Clinical Practice Committee • Meets Monthly • Has Joint Biloxi/Keesler Participation • Trauma Nurse Care Course • September 2010 at Keesler • 2.0 VA Nurses participated

  17. Residency Training Rotations Biloxi VA Medical Center • Typically, 80 Residents Participate in Residency Training Rotations Annually. Rotation Slots follow: • General Surgery: 5 (2 Keesler and 3 University of South Alabama) • Ophthalmology: 2 (Tulane) • Ear, Nose, & Throat: 2 (Tulane) • Cardiology: 1 (University of South Alabama) • Dermatology: 2 (Tulane) • Internal Medicine: 4 (University of South Alabama) • Extended Care: 1 (Keesler) • Radiology: 1 (University of South Alabama) • Psychiatry: 2 (University of South Alabama) • Active Duty (Keesler) Specialists who work part-time (on their time) at Biloxi without compensation to maintain their skills: • 2 Ophthalmologists • 1 Plastic Surgeon (Currently Deployed) • 1 Vascular Surgeon (Pending—Expected to start in October)

  18. Keesler 81 Medical Group Graduate Medical Education • General Surgery Residency • 1 Intern • 4 Post Graduate Year-2 Residents • 4 Post Graduate Year-3 Residents • 1 Research Resident • Internal Medicine Residency • 1 Intern • 8 Post Graduate Year-2 Residents • 6 Post Graduate Year-3 Residents • Dentistry • Advanced Education in General Dentistry (one-year program-2010)—6 Residents. • General Practice Residency (one-year program-2010)—2 Residents • Endodontics (two-year program—2010)—2 Residents

  19. Backup Slides

  20. Governance Structure Executive Management Team • Five co-equal partners: • VA Gulf Coast Veterans Health Care System (VAGCVHCS) • Keesler 81 Medical Group • Naval Hospital Pensacola • Eglin 96 Medical Group • Tyndall 325 Medical Group • Sets joint policy • Coordinates multi-market health care delivery • Provides strategic direction and operational oversight

  21. Sharing Initiatives Should be… • Designed to Sustain the Highest Quality • Mutually Beneficial • Constructed to Serve Complimentary Missions • Accessible to Patients • Financially Attractive

  22. Keesler 81 Medical Group & Biloxi VAMC Sharing Initiatives • Inpatient Services: Cardiology, Intensive Care, Medicine, GI, Gynecology, Orthopedics, Plastic Surgery, General Surgery, Urology, Oral Surgery, Inpatient Mental Health • Outpatient Specialty Care: Dental Services, Dermatology/Mohs, Neurology, Radiation Oncology, Women’s Health/Mammography • Other Shared Services & Functions: • Education and Training • Medical Records • Laundry • Magnetic Resonance Imaging (MRI) • Patient Transfer/Referrals • Shared RN Staff Training, Residency Training, & Quality Management • Sleep Center • Tumor Board Conference

  23. Centers of Excellence(Capitalize on Core Competencies, Eliminate Duplication, and Create Synergy) Keesler Campus - Magnetic Resonance Imaging (MRI) June 2008: Keesler Started Scheduling Veterans - Joint Cardiovascular Care November 2008: Keesler Started Scheduling Veterans - Radiation Oncology March 2010: Keesler Started Scheduling Veterans Biloxi Campus - Sleep Laboratory November 2007: Joint Clinic Established 6

  24. Access to Care/Referral Management • Access • Referral Process Outlined in Agreements • Biloxi-Keesler Process Action Team (PAT) Identifies and Resolves Access Issues • 1.0 Program Analyst – Located on Keesler AFB • Review Cost of Services • Align Demand with Capacity • Measure Effectiveness of Agreements/Services Provided • Referral Management Staff* • 1.0 Authorization Clerk – Located at Keesler • 1.0 Authorization Clerk – Located at Naval Hospital Pensacola • 1.0 Consult Mgmt/Utilization Review Nurse – Located at Eglin *Funded with JIF funds to augment existing specialty care staff

  25. Future Direction • Separate Picture Archiving and Communication Systems (PACS) (VA Radiology Workstation Installed at Keesler to View VA Images) • Implementing Standardized Business Practices (Joint Venture Business Office (JVBO) is Being Set-up at Keesler) • Requirement to Cover Costs • Capturing Workload (Set-up a process to document VA provider workload when VA providers treat VA patients at DoD facilities) • Dual Credentialing • Separate VA/DoD Electronic Patient Records • Base Access

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