COMMUNITY CONNECTIONS • 2012A legacy of engagement • A commitment to the community

From the Beth Israel Deaconess Mission Statement

The mission of Beth Israel Deaconess

Medical Center is to serve our patients

compassionately and effectively, and to create

a healthy future for them and their families ...

Service to community is at the core ... and an

important part of our mission. We have a

covenant to care for the underserved and to

work to change disparities in access to care.

For more information, please call the Office of Community Benefits at (617) 667-0598.

E-mail: community@bidmc.harvard.edu

Produced by the Office of Community Benefits, Beth Israel Deaconess Medical Center

Stephen B. Kay, Chair, Board of Directors

Kevin Tabb, MD, President and CEO

Patricia McGovern, Senior Vice President for Corporate and Community Affairs

Ediss Gandelman, Director, Community Benefits

Writer/Editor: Dave Demerjian

Design: Jane N. Hayward, BIDMC Media Services

Community Benefits Committee

Matt Epstein, ChairHenry AmesPhyllis BarajasJoan Feinberg Berns, PhDKathryn R. BloomJonathan BornsteinGary D. BuseckAlberto CalvoRuth B. FeinPeni A. GarberJulie E. HenryPaula Ivey Henry, PhDDoris S. Lewis

Vivien LiAlvaro LimaHarvey J. Makadon, MDLarry MayesKeith Motley, PhDJane M. PappalardoHelen Chin SchlichteLeslie Bornstein-StacksApril TangClayton Turnbull Luis A. VidalTracey WestHoward L. Wolk

Connection. Partnership. Collaboration. These three words are at the very core of Beth Israel Deaconess Medical Center’s commitment to the community. They speak to the many ways we strive to provide access to equitable, high-quality care, and they underscore our firm belief that building stronger communities isn’t something we can do alone.

Nowhere is our commitment to partnership more visible than in our affiliation with seven community health centers located in and around Boston and Cape Cod. These facilities provide tens of thousands of residents with primary and specialty care, behavioral health services and a range of community-focused programs and resources. They are vibrant places with a public health mission to care not only for individuals, but also to address social conditions that impact a community’s health.

We collaborate with them on innovative community-based residency programs that train doctors to provide specialized care in a primary care context, and on important disparities-focused clinical studies. Much of this research is conducted at the health centers and in the communities where it has the greatest relevance and impact. Working side-by-side with our community health center partners, we are constantly exploring new and better ways to deliver care and achieve health equity.

But we know that these collaborations are just one part of the equation, and we also collaborate with scores of businesses, nonprofit organizations and government agencies. From supporting Boston’s efforts to reduce consumption of sugar-sweetened beverages, to meeting with local ministers to promote cancer screening, we believe in partnering at the state, city and community levels. This approach allows us to tailor our work so that we are more effective in building healthier communities.

In everything we do, we never lose sight of the partnerships that matter most – those small interactions that foster understanding and build trust. Whether it’s a patient speaking with her doctor, an intern learning from his mentor or congregants confiding in their minister, we work tirelessly to build these one-on-one connections.

Our Bowdoin Street Health Center is transforming itself into a Patient-Centered Medical Home, where the emphasis is on creating authentic relationships between providers and patients while enhancing the health of all those living in the neighborhood. For 15 years, the Advocate Education Support Project has connected counselors to one another in a supportive, healing environment. And at the Sidney Borum Jr. Health Center, connections are made with at-risk youth who may be afraid to seek medical care.

This year’s report is dedicated to celebrating all of the connections, partnerships and collaborations that help us make a difference. They are what allow us to deliver on our mission of serving the community, ensuring equitable access to care and improving health outcomes.

Stephen B. Kay Kevin Tabb, MD Chair, Board of Directors President and CEO

A MESSAGE FROM LEADERSHIP

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Lyndon Johnson’s War on Poverty heralds the birth of community health centers (CHCs).

CHCs find new funding and providers through National Health Service Corps.

Public Health Services Act provides funding for additional CHCs.

COMMUNITY HEALTH CENTERSA history of engagement. A truly collaborative approach.Community health centers are the largest network of primary care providers in the nation, and a vital piece of the health care delivery system. The 2010 federal health care reform legislation allocated $11 billion in new funding to build and expand health centers and to renovate existing facilities. It’s an unprecedented commitment that will double national health center capacity to 44 million patients annually.

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At Beth Israel Deaconess Medical Center, we’ve seen first hand the power of community health centers to improve the lives of patients, families and communities. We were involved in the health center movement from the earliest days, helping in 1969 to lead the conversion of Roxbury’s New England Hospital for Women and Children into The Dimock Center. Today, BIDMC continues its commitment to community health through its partnership with seven affiliated health centers. We share clinical expertise and provide financial, technical and IT support; education and training; access to hospital research; and

foster relationships with providers from across the medical center. They in turn give us insight into health challenges facing the patients and neighborhoods they serve, and bring us new ideas that impact the way we deliver care.

As the true voices of the community, our health center partners are integral to our work. Their energy and collaborative spirit inspire us and help us provide equitable, high-quality health care.

Two Cape Cod health organizations merge to form Outer Cape Health Services.

BI and New England Deaconess Hospital (NEDH) form clinical relationships with CHCs to provide collaborative care including cutting-edge initiatives for obstetrical patients and those with HIV/AIDS.

BI creates nation’s first Patient Bill of Rights, committing to equal care for all.

Bowdoin Street, Fenway, South Cove and Joseph M. Smith CHCs open.

Nation’s first CHC opens in Boston.

Beth Israel Hospital (BI) helps launch and staff Dimock Community Health Center (now The Dimock Center).

CCACommunity Care Alliance (CCA) is our network of seven affiliated community health centers.

by the numbers:

87,500 patients served per year

48 percent speak a primary language other than English

18 languages spoken

16 sites in the network

42 years since BIDMC began supporting community health centers

A 40-year commitment to supporting community health

1970s 1980s1960s

With increased federal funding, more CHCs open and expand.

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Conversations:

Hsiu Chin-Chang In 2009, South Cove Community Health Center patient Hsiu Chin-Chang was diagnosed with breast cancer. She was treated at BIDMC, and received support from Christina Ho, BIDMC’s Chinese Oncology Patient Navigator.

When my doctor discovered the

lump, I wanted to return to Taiwan

for treatment, but South Cove has a relationship

with BIDMC so I went there for a biopsy. I had never been there, and

felt overwhelmed. And when I learned I’d need a mastectomy, I was

terrified. I met Christina soon after being diagnosed, and she’s been

there for me ever since. We are educated people in Taiwan, but here we

don’t know the language and feel handicapped when communicating.

Christina makes sure I understand what my doctors are saying, and

communicates with them when I have questions. But she’s much more

than an interpreter. She helps with appointments and insurance, or when

I need help finding my way around the hospital. Most of all, she provides

emotional support. Chemotherapy was tough but Christina made the

process much less scary.

Left: Hsiu Chin-Chang (center) with her husband and BIDMC Patient Navigator Christina Ho. Below: Ho assisting another patient through the cancer treatment process.

BI helps CHCs address infant mortality racial disparities in so-called “death zone” neighborhoods.

Six CHCs affiliate with BI. BI supports South Cove’s Quincy expansion, and new buildings for Dimock, Fenway and Joseph M. Smith CHCs.

NEDH and Roxbury Comprehensive Health Center build a multifaceted relationship.

Sidney Borum Jr. Health Center opens with BI support.

Bowdoin Street joins the BI family; opens new building and senior health center.

Community Care Alliance (CCA) is formed to link BIDMC-affiliated CHCs.

1990s

2 The Dimock Center RoxburySince its founding in 1862 as the New England Hospital for Women and Children, Dimock has emphasized women’s health. Our partnership with The Dimock Center allows us to continue this legacy, and today we collaborate with Dimock to offer an OB/GYN resident training program. “Whether at Dimock’s homeless shelter educating women about pap smears, delivering prenatal care to improve pregnancy outcomes or researching better ways to communicate about the importance of contraception, our residents are committed to reducing health disparities,” says Hope

Ricciotti, MD, Residency Program Director in the Department of Obstetrics and Gynecology at BIDMC.

3 Fenway Health Metro BostonFenway Health plays an important role in providing care to those living in and around Boston’s Fenway neighborhood, an area that includes students, elders and people of color. It is nationally recognized for its expertise in LGBT health, and conducts cutting-edge community-based research through The Fenway Institute. Lori Panther, MD, MPH, is leading investigations examining the efficacy of the Human Papillomavirus (HPV) vaccine in young HIV-positive men.

“It’s something that hasn’t been well studied in the HIV population, a group Fenway is committed to supporting,” Panther says. She believes the close relationship between Fenway and BIDMC maximizes the work happening at both. “The Fenway Institute brings lots of prevention research to the table,” she says, “and the medical center is a clinical research powerhouse. It’s an extremely valuable partnership.”

1 Bowdoin Street Health Center Dorchester“Changes in eating and exercise habits can reap enormous benefits,” says Bowdoin Street’s Executive Director, Adela Margules, “but feeling safe outside and having access to fresh food are not always givens in this neighborhood.” Bowdoin Street, which has served Dorchester since 1972, is responding by building a new Wellness Center that will include physical therapy rooms, exercise facilities and a demonstration kitchen

– safe, welcoming spaces for people to improve their health. “We want to engage with community members while they’re healthy – not just when they’re sick,” says Margules. “That’s the most exciting benefit our Wellness Center will offer.”

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Hope Ricciotti, MD meets with OB/GYN residents at The Dimock Center.

New Wellness CenterInterior View

B

martinBattarchitects . 633 Highland Avenue . Ground Floor . Needham . MA . 02494 . USA . Telephone 781 444 2747 . Fax 781 444 0894

BOWDOIN STREET HEALTH CENTERBeth Israel Deaconess Medical CenterExpansion + Renovation Concept Study

December 18, 2008

A rendering of an exercise space inside Bowdoin Street’s planned Wellness Center

Lori Panther, MD, MPH

NEWTON

WATERTOWNCharlestown

Hyde Park

WALTHAM

QUINCYMILTON

Jamaica Plain

Roxbury

Fenway

West Roxbury

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2 South Boston

East Boston

Roslindale

3

Mattapan

4Allston/Brighton

BROOKLINE

7

76

North Dorchester

1

South Dorchester

55

5HARWICH

PROVINCETOWN

WELLFLEET

Cape CodBoston

Community Care Alliance

2000s

Nation sees largest ever expansion in federal funding for health centers.

Massachusetts health insurance reform brings CHCs thousands more patients.

BIDMC involved in South Cove building purchase and Joseph M. Smith’s Waltham expansion.

BIDMC supports construction of Fenway’s new facility.

Growth in clinical, research and teaching collaboration between BIDMC and CCA health centers continues.

4 Joseph M. Smith Community Health Center Allston/Brighton and WalthamAllston/Brighton is one of Boston’s most vibrant and diverse communities, and for nearly 40 years, the Joseph M. Smith Community Health Center has served as a neighborhood anchor. Staff there communicate in 15 different languages, and share with us the health practices and needs of newly arrived immigrants. Their perspective, understanding and expertise inform our work, helping us provide seamless care when patients are referred to the medical center.

5 Outer Cape Health Services Cape CodOuter Cape’s three facilities – in Wellfleet, Provincetown and Harwich – serve Cape Cod’s eight outermost communities. It is the only CHC on the Cape to offer in-house digital radiology, which allows for instantaneous transmission of images. Images are taken in the Provincetown office and read remotely by BIDMC-affiliated radiologists, illustrating the power of our partnership. Outer Cape has broken ground on a new radiology suite that will provide digital radiography,

mammography, bone density and ultrasound services. “This collaboration is a great example of how an academic medical center can partner with a rural community health center to provide sub-specialized Radiology services at the local level,” says Max Rosen, MD, BIDMC’s Vice Chair of Radiology.

6 Sidney Borum Jr. Health Center Metro BostonLocated in downtown Boston, the Borum serves at-risk youth and adolescents – including those who are gang members, LGBTQ, HIV-positive, homeless or uninsured. It’s a population that can be difficult to reach. “These kids have little confidence in adults or social institutions,” says Medical Director Ralph Vetters, MD. To build relationships, staff go into the community, connecting with youth in their own environments. “If they trust us enough to come to the clinic, we can provide more comprehensive services,” says Vetters. “And that’s how we help them learn to utilize the health care system.”

7 South Cove Community Health Center Chinatown and QuincySouth Cove is the premier Asian community health center of Massachusetts with four locations serving nearly 27,000 children and adults. The health center offers primary care, OB/GYN, eye and dental services, behavioral health programs and onsite mammography. Targeted programs for medical conditions like hepatitis B and tuberculosis that disproportionately affect the Asian community are also available. These linguistically and culturally competent health programs help South Cove meet its mission of improving the health and well-being of all medically underserved in Massachusetts.

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Maura Kennedy, MD, BIDMC Emergency Medicine physician, reviews an X-ray of an Outer Cape patient.

The Borum provides weekly primary care and mental health services to clients of Youth on Fire and Bridge Over Troubled Waters, drop-in centers for homeless and street-involved youth.

Glenn Diaz, MD, examines a patient.

2010s

2010 federal health care reform package provides $11 billion in CHC funding.

Prevention and Public Health Fund earmarks nearly $250 million for 16,000 new primary care providers by 2015.

Outer Cape Health Services receives $3.6 million through the Affordable Care Act.

Bowdoin Street Health Center plans a 4,000 square foot expansion and new Wellness Center.

Sidney Borum becomes part of Fenway Health.

Fenway collaborates with BIDMC on the nation’s first HIV- and LGBT-focused primary care residency.

The dental clinic at South Cove provides an important health service to its patients.

Engagement with the city

“Our cafeteria fountains used to offer six sugared beverages,” says Nora Blake, BIDMC’s Director of Food Services. “Today, we’re replacing them with healthier options.” That small change is one way we’re partnering with the Boston Public Health Commission to address the obesity epidemic. We’re also developing signage and education materials, revamping refrigerator cases and vending machines to increase visibility of sugar-free beverages and requiring vendors to utilize Boston’s Stop Light Program, which promotes healthy drinks. “The move toward less sugar is more than a trend,” Blake says. “We’re joining with the city in embracing evidence-based strategies that work, and hardwiring them into our food services.”

Collaboration with state agencies

“The Suffolk County District Attorney’s office came to us concerned that its victim witness advocates were burning

out,” says Lisa Tieszen, LICSW. “These folks experience Secondary Traumatic Stress (STS) in reaction to the trauma of their clients, but their needs weren’t being met.” With support from the District Attorney’s Office and the Massachusetts Office for Victim Assistance, Tieszen and colleague Katherine Manners, M.Ed., launched the Advocate Education & Support Project, which supports frontline workers and managers working with victims of crime and violence. Advocates come together as peers in eight-week facilitated groups to share challenges and develop coping skills. “The group model normalizes the experience of STS. It provides critical peer support, as well as exposure to other agencies’ approaches and philosophies,” says Tieszen, who is the program’s project coordinator. Since its founding, the Project has run more than 30 groups with participants from over 60 different nonprofit organizations and state agencies throughout Massachusetts. “When we give advocates the tools they need to take better care of themselves,” says Tieszen,“it allows them to better care for the victims they’re trying to help.”

PARTNERSHIPSInvolvement at every level. Programs that make an impact.When it comes to positively impacting the health and wellness of the people who live in our communities, partnerships are key. Working with agencies and groups at the city, state and community levels, we engage in programs and initiatives that foster education, collaboration and advocacy – helping to improve health outcomes.

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Connection with the community

Making meaningful connections often happens in partnership with respected and trusted community organizations. With a solid commitment to the youth in our community, each year BIDMC hires over 40 high school interns referred through community organizations such as the Boston Private Industry Council (PIC); Action for Boston Community Development (ABCD); The GOTCHA (Get Off the Corner Hangin’ Around) Program; Brookline Public Schools’ Work Connections for Youth Program and Mission Hill’s Sociedad Latina, whose programs target the destructive cycles of poverty, health disparities and lack of opportunity in the Latino community. In 2011, Sociedad recognized BIDMC with a Champion for Education award. “BIDMC is a key partner in our work to promote higher education and employment among Latino and African American youth in our community,” says Sociedad Executive Director, Alexandra Oliver-Dávila.

The Stop Light Program uses signage, color-coding and product placement to promote healthy beverage choices. Taking the City of Boston’s lead, we’re rolling it out across campus to educate and motivate our employees, patients and their families.

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Conversations:

Alphonso Brown, MD, MS Alphonso Brown, a gastroenterologist at BIDMC, works closely with The Faith-Based Cancer Disparities Network. BIDMC is a founding member of the Network – a collaboration with the Dana-Farber/Harvard Cancer Center, the Black Ministerial Alliance and the American Cancer Society – which works to eliminate the unequal burden of cancer in communities of color.

We know that African Americans suffer significantly

higher rates of colorectal cancer than other racial and

ethnic groups, and when they do get screened and

lesions are found they tend to be at a more advanced

stage. Since early detection is the best bet to beating colon cancer, that’s an

incredibly important message to get out there, but it’s also challenging. The

Faith-Based Cancer Disparities Network opens up new and trusted lines of

communication and helps provide targeted community education to reach

those most at risk. The Network is an invaluable partner in educating

the public, primarily the African American community, so that colorectal

cancer screening is seen as something they should absolutely take part in,

and advocate for themselves to get done early.

Food for thought

In the Bowdoin-Geneva section of Dorchester, tables overflow with tomatoes, squash and cucumbers. It’s a quintessential summer farmer’s market, with one major difference: some of this produce has been grown and harvested by area youth.

These young gardeners, ages five to 12, are part of Bowdoin Street Health Center’s Healthy Champions program, an initiative that promotes youth development and healthy lifestyles. “The garden illustrates the benefits of incorporating healthy, affordable foods into daily life,” says program coordinator Jen French. “And it helps the kids educate their peers about how these foods can reduce obesity and Type 2 diabetes.” The farmer’s market is just one component of Bowdoin Street’s Healthy Food Equity Program, which also provides education around healthy eating and a campaign to improve availability of healthy foods at corner stores.

As their neighborhood’s health food ambassadors, Bowdoin’s Healthy Champions are an integral part of the program. “When you’re growing your own vegetables, you’re thinking, ‘wow, I’m doing something good for me,’” says 12-year-old Healthy Champion Daizy. “And, I’m doing something important for my community.”

Gameplan for fitness

“We know how important exercise is, especially in young Americans,” says Loryn Feinberg, MD, of BIDMC’s CardioVascular Institute. “The earlier we make it a habit, the less likely we’ll have health problems like diabetes, high blood pressure, obesity and abnormal cholesterol levels as we get older.” One way we’re working to make physical activity part of daily life in our communities is the BIDMC Walking Club, an interactive program that makes exercise fun and easy. We provide schools and employers with free kits that include workout logs, information sheets, eCards and even a smartphone app. The kits teach fitness fundamentals and encourage people to see exercise as a way to improve their health, and the health of their communities.

HEALTHY COMMUNITIESUnderstanding the challenges. Engaging to make a difference.What is a healthy community? It’s a neighborhood where fresh and healthy food is always available. A place where good jobs build financial self-reliance. It’s safe, welcoming streets that encourage exercise and invite interaction. We know that building vibrant, healthier communities only happens through engagement and collaboration with residents and community partners. It’s a philosophy that guides our work – each and every day.

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With BIDMC’s free Walking Club pedometer app, your smartphone can count steps, track pacing and measure distance. Download it at the iTunes Store or Android Market and start walking!

Some of Bowdoin Street’s Healthy Champions and the fruits of their labor.

Partnership for peace

Collaborating with the Louis P. Brown Peace Institute and the Massachusetts Office of Victim Assistance, we provide bereavement services that help shocked, grieving homicide survivors deal with a crime’s immediate aftermath and the ongoing issues of traumatic grief. A case manager at the Peace Institute works directly with families to offer both clinical and tactical resources like burial guidance and media assistance to guide them toward healing and justice. “We’re also encouraging families and loved ones to explore new ways of reacting to violence,” says Lisa Hartwick, MSW, LICSW, Program Director for BIDMC’s Center for Violence Prevention and Recovery. “If someone you love is killed, your response may be to retaliate. We want to create new outcomes by offering more productive and creative means of addressing violence while also acknowledging the hurt and anger.”

Campaign for cleaner air

From recycling and composting to supporting Mayor Menino’s bike programs, BIDMC’s long standing commitment to sustainability helps reduce waste and improve the health of employees, patients and the community. In 2010, BIDMC helped lead an effort to decrease congestion and air pollution in the Longwood Medical Area by consolidating shuttle bus service, a move that reduces CO2 emissions by almost 200,000 pounds annually. “Programs like this are essential in lowering the incidence of stroke, asthma and other health problems,” says Bill Ravanesi, Healthcare without Harm.

Training for tomorrow

More than 500 employees each year participate in BIDMC’s workforce development programs, which include English classes for non-native speakers and free college courses on-site. Workforce development also runs Pipeline programs that train our employees into higher-skilled, better paying jobs.

The Medical Laboratory Technician (MLT) Pipeline is a three-year program developed in partnership with Children’s Hospital Boston, New England Baptist Hospital and Bunker Hill Community College. Employees complete coursework and weekend labs while working full time, followed by five months of hands-on training in BIDMC’s labs to attain their Associate Degree in Clinical Lab Sciences.

The MLT Pipeline participants bring new energy to the labs where they train,” says Gina McCormack, Operations Manager of Pathology. “In the end, the students help us see our own possibilities, and make us better at what we do.”

Conversations: Dominic TaabazuingDominic Taabazuing, 24, worked in BIDMC’s Food and Nutrition Department for five years before beginning the Medical Laboratory Technician (MLT) Pipeline Program. He completed the program in 2011, and today is a technician in the medical center’s microbiology lab.

This program made it easy for me to get a degree

because many of the financial aspects were taken

care of. They even supplied us with books, which

was a big help. I started with basic math and science courses, then harder

classes like anatomy and physiology, and after that clinical lab science

work in the microbiology lab, then hematology, chemistry, and blood

bank. I can’t believe how much I’ve learned, but all the hard work was

worth it because now I’m a lab technician. I love coming into work. It’s

very rewarding to be able to look under a microscope and get a general

idea of what’s wrong with a patient. Hopefully, after some years of work,

I’ll go back to school and I’ll keep going up the ladder. I can’t wait to

become a technologist and continue to work for this hospital.

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Employee voices inspire us

Our Lesbian Gay Bisexual Transgender (LGBT) Advisory Committee – one of the nation’s first hospital committees of its kind – ensures that the voices of our LGBT community are heard. The Committee has informed policies and practices that ensure equal treatment and a welcoming environment for our LGBT patients and employees, including sponsoring educational seminars for providers and modifying our registration process and visitor policy. “It’s incredibly important for me to work in a place that honors and celebrates diversity,” says Stacey Adamson, physical therapist and member of the LGBT Advisory Committee. “As a clinician, I want patients to know that this is a safe place to talk about any aspect of their lives, because that is so connected to their health and wellbeing.” Thanks in part to the Committee’s work, the Human Rights Campaign recognized BIDMC as a national leader in its 2011 LGBT Healthcare Equality Index.

Patient perspectives inform us

The cultural shift toward patient and family-centered care is nothing new at BIDMC, thanks in part to our Patient and Family Advisory Councils (PFACs). From quality and safety to communication and hospital processes, these groups bring patients into the decision-making fold, giving them a real say on how care is delivered. This past year, our Intensive Care Unit (ICU), Neonatal ICU, Universal Access and Hospital-Wide Councils took up a range of issues, including addressing parking and shuttle issues facing the physically challenged, reviewing patient education materials and weighing in on the medical center’s CEO search.

Community needs guide us

As many as one million Americans live with Parkinson’s disease, and 60,000 new cases are diagnosed annually. In response to needs identified by our patients from Cape Cod, BIDMC collaborated with others to establish The Parkinson Support Network of Cape Cod – an alliance of consumers, health and human service providers and other organizations. The Network creates new opportunities for people living with Parkinson’s, and leverages existing treatment, support and education resources. From a retreat that supports caregivers, to an annual gala dinner that celebrates those living with Parkinson’s and their families, to a provider alliance that shares tools and expertise, the Network gives voice to a community that needs to be heard.

VOICESDialogues with the community. Insights that shape our work. Open, respectful dialogue with employees, patients and community members is what guides us. It helps us understand challenges and explore opportunities, to build on what works and find solutions for what doesn’t. Whether it’s patients inspiring new ideas, employees embracing diversity or community groups sharing challenges, listening to the voices of our community shapes the way we do our work.

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Our LGBT Advisory Committee contributed to the powerful It Gets Better anti-bullying movement with a video that celebrates the medical center’s culture of inclusion and optimism. View it online at bidmc.org/makingitbetter, or snap the QR code below with your smartphone.

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Conversations: Erica DenteSince 2010, Erica has served as a member of our ICU Patient and Family Advisory Council (PFAC).

I’ve been a BIDMC patient for many years, and

my mom has stayed in the ICU, so I’m quite

familiar with the medical center. I’m also a Nurse

Practitioner, so I’m able to see the hospital experience from many

different perspectives. One of the things we (the ICU PFAC) have focused

on is examining ways to improve communication between patients,

families and providers. Today, for example, in certain circumstances,

providers invite patients and family members to join them on medical

rounds for their loved ones. This is when the medical team comes together

to discuss each case. That never used to happen, and it’s opening new

channels of communication in the ICU. I was cautiously optimistic when

I joined the Council, because I know that change can sometimes be a very

gradual process, but things are moving very quickly. Our providers are

committed to humanizing the patient experience, and we’re committed to

helping them do it.

PFACThe number of advisors participating in councils, on committees, focus groups and LEAN events as part of our Patient and Family Advisory Council (PFAC) program. by the numbers:

2006: 18 2007: 18 2008: 34 2009: 43 2010: 54 2011: 106

Erica Dente with architectural plans to renovate a waiting room in one of the intensive care units (ICUs).

Interpreter services: ensuring access

Russian. Spanish. Chinese. American Sign Language. These are four of the more than 60 languages our interpreters use to ensure that patients with limited English proficiency both understand – and are understood – when communicating with medical center staff. Last year our interpreters had more than 93,000 in-person patient interactions, an increase of nearly 160 percent from 2001. Those numbers illustrate the importance of these services, and underscore our commitment to access, equity and speaking the languages of our community.

Research: understanding disparities

“Being an ethnic minority, I have experienced racial bias first hand and understand the challenges that many

EQUITABLE CAREA core value. A multifaceted strategy.

You have the right to receive medical care that meets the highest standards of BIDMC, regardless of your race, religion, national origin, any disability or handicap, gender, sexual orientation, gender identity or expression, age, military service or the source of payment for your care.

That’s BIDMC’s Patient Bill of Rights, and it informs everything we do. Equitable care is an essential part of improving health outcomes and creating healthy communities, but it requires big picture perspective, problem-solving strategies, and a focused, long-term commitment. By taking full advantage of technology, research and clinical services, we work to ensure that everyone has access to high-quality health care.

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ASL2% Cape Verdean

11%

Chinese24%

Haitian Creole3%Russian

18%

Spanish30%

Thai/Laotian2%

Vietnamese2%

Other8%

The number of face-to-face interpreter encounters reached 93,461 in FY 2011. Above, face-to-face encounters by language.

minority and underserved populations face in accessing quality health care,” says Christina Wee, MD, MPH. “To improve health care for all Americans, we need to include the voices of those who are often under-represented in research.” Wee, who is Co-Director of Research in the Division of General Medicine and Primary Care at BIDMC, conducts research on obesity and health disparities, including work that examines health disparities in underserved communities. Much of Wee’s obesity research focuses on racial and ethnic differences in costs and outcomes, the relationship between stigma and disparities in care and the role of primary care practitioners in obesity management. Her commitment to community health can also be seen in her mentoring work: she has worked with fellows researching women and immigrant health issues, cancer screening and medical decision making. Wee received the A. Clifford Barger Award from Harvard Medical School for

Excellence in Mentoring in 2010 and the 2011 Society of General Internal Medicine Midcareer Research and Mentorship Award.

Christina Wee, MD, MPH, examines a patient at BIDMC’s Healthcare Associates.

Technology: improving communication

“Sharing electronic medical records enables better coordination of care among providers,” says John Halamka, BIDMC’s Chief Information Officer. “This type of instant access to a patient’s health information can help prevent errors and allows doctors to make better decisions about the best course of treatment.”

We have long been leaders in using technology to enhance and streamline communication between providers. In 2011, the medical center was named the nation’s top-ranked health care information company by InformationWeek 500,

a list of the top technology innovators in the United States. Our expertise is tapped often by public health departments to harness emerging technologies that enhance the exchange of vital health information among multiple providers who are caring for the same patient. The Massachusetts Immunization Information System (MIIS), piloted at BIDMC, is a new registry that establishes a complete, accurate, secure, real-time immunization record for residents of Massachusetts. It allows providers to view a patient’s entire immunization history, thereby preventing duplicate vaccinations or identifying unimmunized and under-immunized individuals.

James Woods with BIDMC Interpreter Michael Sullivan.

Conversations: James WoodsLong time medical center patient James Woods, who is deaf, works with BIDMC’s American Sign Language/English interpreter team.

I began coming here over 20 years ago. Back then

they didn’t have ASL interpreters, and that made

things difficult. I remember once waiting and waiting

to see my doctor because the nurse forgot that I wouldn’t be able to hear

her when she called for me. At a lot of my appointments, doctors would

have to write or type so that I could understand what they were saying.

They meant well, but it made the appointments much longer than they

needed to be.

The interpreters here are a huge help. They come with me to my doctors’

visits, and sometimes they’ll send a text message reminding me that I have

an appointment coming up. I feel like I would be lost without them… I

remember once coming to the emergency room and trying to explain to the

nurse what was happening. She couldn’t understand me and was getting

frustrated. That made me frustrated. But then Bob (interpreter) showed

up. Just like that we were all able to communicate, and everything became

so much easier. It reminded me how important the interpreters here at the

medical center are, not just for me, but for the people who work here, too.

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MEDICAL EDUCATIONLearning from our partners. Working in the community. With community health playing an ever more prominent role in health care delivery, there’s an increased focus on community-based residency programs. BIDMC interns and residents who choose these programs gain all the skills and experience offered by academic medical center residencies, including exposure to cutting-edge research and mentoring by Harvard Medical School faculty. They also learn and work in caring, intimate environments, and benefit from curriculum tailored to providing culturally responsive care. These programs are pipelines that encourage a new generation of residents to pursue careers in community-based primary care.

Realizing the potential of primary care

“There are a million people in the United States with HIV, and 50,000 new cases diagnosed every year,” says Alex Gonzalez, MD, Medical Director at Fenway Health. “Thanks to advances in treatment these people are living longer, but as a result are facing other diseases. We need to train primary care providers who understand how to manage and treat HIV as a chronic condition, so that those with the disease can lead more productive lives.”

Fenway, which is at the forefront of HIV and LGBT health education, has enjoyed a close relationship with BIDMC’s internal medicine residency for more than a decade. In 2010, this collaboration resulted in a grant from the Health Resources and Services Administration to create a primary care residency training track focused on preparing physicians for careers in HIV and LGBT health. The first program of its kind in the United States, it welcomed

its first four interns this past year. They spend one afternoon a week at the health center, caring for Fenway patients and building their practices. “These residents will become primary care providers with a unique understanding of LGBT and HIV health issues,” Gonzalez says. “They’ll understand what it means to work in a community setting.”

Conversations: Rebecca Glassman, MDBIDMC Resident Rebecca Glassman trains at Fenway Health, where she is part of the recently launched HIV/LGBT primary care track.

I believe HIV is becoming a chronic disease that

should be handled by primary care physicians rather

than just infectious disease specialists. There’s so

much that primary care doctors can do for patients

with HIV, but only if they’re fluent in treating the

disease and its complications... Every group has

unique issues, and even within my HIV patient

panel there is so much variation. Some have lived

with the disease for years without complications,

others are struggling with horrible health problems

as a result of HIV. No two patients are alike…

Treating a patient at BIDMC and then at Fenway as

an outpatient has helped me see the importance of

continuity of care, and how the partnership between

the hospital and health center makes it possible.Fenway Health’s Lauren Scott, MD, precepting resident Rebecca Glassman, MD14

TRANSLATIONAL RESEARCHCutting-edge clinical research. Impact at the community level. BIDMC is the third-largest recipient of NIH funding among independent hospitals in the United States, conducting significant research around reducing health disparities and improving care for underserved populations. Much of this work is done in collaboration with community researchers, whose experience and perspective inform both its design and implementation. These partnerships between the medical center and the community yield more relevant, valuable research that impacts policy, clinical practice and ultimately, health outcomes.

Breaking new ground in kidney research

Approximately one out of every three people in the U.S. with kidney failure is African American, a disparity that has baffled researchers for decades. In 2010, Martin Pollak, MD, BIDMC’s Chief of Nephrology, discovered that a common genetic variant might make African Americans more susceptible to

Finding new ways to reach the community

How do you increase the local impact of medical research, especially research related to achieving health equity? Finding the answer is one of the reasons BIDMC and our community health center partners participate in the Harvard Catalyst’s Community Health Innovation and Research Program (HC-CHIRP). This multifaceted initiative engages community-based providers in research partnerships focused on health disparities. The goal is to fast-track translation of results that can influence public policy and improve health outcomes. HC-CHIRP provides training and facilitates coordination between researchers and community health leaders. It also supports the Community-Based Participatory Research model, which says clinical research should involve, engage and benefit communities every step of the way.

Data points

At BIDMC, we’re conducting community-level research to learn more about the illnesses and conditions that disproportionately impact underserved communities:

• HIV infection is the third leading cause of death among black women aged 35 – 44.

• Nearly 50% of Hispanic children born in the year 2000 are likely to develop diabetes during their lifetimes.

• African Americans are about 40% more likely to die of colon cancer than whites.

• Asian and Pacific Islanders make up less than 5% of the total population but account for more than 50% of Americans living with chronic Hepatitis B.

• Hispanic adults report persistent symptoms of depression lasting longer than two weeks 63% more frequently than non-Hispanic white adults.

• African Americans make up 12% of the population but represent 32% of dialysis patients and 35% of those waiting for a kidney transplant.

kidney disease. It’s a groundbreaking finding that will help scientists develop more effective treatments. The Dimock Center and BIDMC are partnering resources, which allow Dimock primary care physicians access to BIDMC renal specialists. Working at the community level, Pollak and his colleagues can interact with those most impacted by kidney disease, and the health center has new resources to deliver more specialized renal care.

Martin Pollak, MD, consults with Victoria Charoonratana, research assistant.

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MOVING FORWARDPreparing for tomorrow. Shaping new models today.

“New models of delivering care to patients are not only a vital part of national health care reform but are also fundamental to BIDMC’s vision and strategic plans for our future.” – Kevin Tabb, MD, BIDMC President and CEO

We’re proud of the work we do every day to create stronger, healthier communities and we continue to set our sights on the future. We know that building on our success requires us to transform how and where we deliver care, and to embrace new ideas from across the health care spectrum.

Clinical transformation: Patient-Centered Medical Home

What is a Patient-Centered Medical Home (PCMH)? Think of it as a practice within a practice. Providers from across a primary care practice – doctors, nurses, social workers and community resource specialists among them – form a team built around the needs of an individual patient. By creating a true partnership between patients and their team of providers, this emerging model has the potential to decrease health care disparities and improve access while containing health care costs. Bowdoin Street Health Center embraces the PCMH model, and is nationally recognized by the National Committee for Quality Assurance as a Level 3 PCMH, the highest accreditation level. Bowdoin Street also engages with community organizations and public agencies to improve access to jobs, recreational activities and affordable food.

Payment reform: Accountable Care Organizations

In December 2011, The Beth Israel Deaconess Physician Organization (BIDPO) became part of the Pioneer Accountable Care Organization (ACO) Model, an initiative sponsored by the Centers for Medicare & Medicaid Services Innovation Center. ACOs are transformative payment and delivery models that tie reimbursements to care quality and cost containment, and BIDPO was one of only 32 provider organizations nationally chosen to participate in the program. While the Pioneer ACO Model focuses on improving service delivery and containing costs for patients covered by Medicare, the program will expose BIDMC physicians to financial and care delivery system models that have the potential to improve care for all of the patients we serve.

Care delivery evolution: an integrated network approach

The transformation of our health care delivery system includes a trend towards global contracting, away from the traditional fee-for-service payments. We recognize that this new model will be best achieved through integrated care delivery networks with health care delivered closer to where the patient lives, by community providers who are knowledgeable about, and have relationships with, local health and social services resources. This provides the opportunity to deliver high-quality care with significant savings to patients and the health care delivery system. Toward this approach, BIDMC is building its integrated network through strategic alliances with community hospitals, health centers, and primary care and specialist practices – all local to patients’ homes.

Bowdoin Street Health Center is a leader in the Patient-Centered Medical Home movement.

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Community Collaborations and Partnerships

ABCD Parker Hill/Fenway Neighborhood Service Center

ABCD Health ServicesAIDS Action CommitteeAlbert Schweitzer Fellowship ProgramAmerican Cancer SocietyAmerican Heart AssociationAmerican Parkinson Disease Association, MA

chapterAmerican Red CrossAmerican Stroke AssociationAtrius/Harvard VanguardBay Cove Human ServicesBird Street Community CenterBlueCross BlueShield of MA FoundationBody by BrandyBoston Alliance for Community HealthBoston Area Rape Crisis CenterBoston Center for Youth and Families-

Streetworkers ProgramBoston Collaborative for Food and FitnessBoston Emergency Medical ServiceBoston Green Ribbon Commission/

Healthcare sectorBoston Healthcare Careers ConsortiumBoston Inspectional ServicesBoston Natural Areas Network/

Youth Conservation CorpsBoston Police DepartmentBoston Private Industry CouncilBoston Public Health CommissionBoston Public SchoolsBoston Red Sox FoundationBoston Regional Domestic Violence ProvidersBoston R.O.C.K.S Out City ProgramBoston Senior Home CareBoston Urban Asthma CoalitionBoston Visiting Nurses AssociationBowdoin Geneva Planning GroupBowdoin Street Geneva Avenue

Main Streets ProgramBowdoin Street Health CenterBrookline Health DepartmentBrookline Public SchoolsBrookline Senior CenterBuckle Up BostonBunker Hill Community CollegeCambridge CollegeCape Verdean Adult Day Health Program

Center for Community Health Education and Research (CCHER)

Child Witness to Violence ProjectChildren’s Hospital BostonCollege BoundCombined Jewish PhilanthropiesCommonwealth CorporationCommunity Care AllianceCompass SchoolCradles to CrayonsCVC Unido Conference of Boston Teaching HospitalsDana-Farber Cancer InstituteDana-Farber/Harvard Cancer CenterDeaf, Inc.Dorchester Bay Economic Development

CorporationDorchester CARESDorchester Environmental Health CoalitionDorchester Housing Action TeamDorchester Lead-Safe Yard ProjectDorchester Youth CollaborativeDream Big!Ecumenical Social Action CommitteeEPA New EnglandEvercareEthosFamily Nurturing ProgramFenway HealthFenway Community Development CorporationFenway High School Federated Dorchester Neighborhood HouseFitness in the CityFriends of Geneva CliffsFriendship WorksGay Men’s Domestic Violence ProgramGeneva Avenue Head StartGOTCHA (Get Off The Corner Hanging Around)

Youth Summer ProgramGLBT Domestic Violence CoalitionGreater Boston Environmental Justice NetworkGreater Bowdoin/Geneva Neighborhood

AssociationGreater Four Corners Action CollaborativeHarvard CATALYSTHarvard Cooperative Program on AgingHarvard Medical SchoolHarvard School of Public HealthHealth Care for All

Healthcare Without HarmHealth Resources in ActionHealthy Homes PartnershipHealthy Weight InitiativeHebrew Senior LifeHospitality HomesHyde Square Task ForceJane Doe, Inc.Jewish Children’s and Family ServicesJewish Community Housing for the ElderlyJewish Community Relations CouncilJewish Domestic Violence CoalitionJewish Vocational ServicesJohn D. O’Bryant School of Math and ScienceJoseph M. Smith Community Health CenterJoslin Diabetes CenterKit Clark Senior ServicesLead Action CollaborativeLeventhal Sidman Jewish Community CenterLouis D. Brown Peace InstituteMassachusetts Attorney General’s OfficeMassachusetts Bay Community CollegeMassachusetts Comprehensive Cancer Control

CoalitionMassachusetts Commission for the Deaf and

Hard of HearingMassachusetts Department of Children and

FamiliesMassachusetts Department of Health and

Human ServicesMassachusetts Department of Public HealthMassachusetts Department of Transitional

AssistanceMassachusetts Division of Medical AssistanceMassachusetts Executive Office of Health and

Human ServicesMassachusetts Hospital AssociationMassachusetts Immigration and Refugee

Advocacy CoalitionMassachusetts League of Community Health

CentersMassachusetts Prostate Cancer CoalitionMassachusetts Workforce Investment BoardMassCONECTMatch-Up Interfaith VolunteersMattapan Collaborative for Food and FitnessMayhim HayyimMedical Academic and Scientific Community

Organization, Inc. (MASCO)Mission Hill Main Streets Elder Friendly Business

Initiative

Multicultural Coalition on AgingNational Parkinson FoundationNeighborhood Diabetes ProgramNeighborhood Health PlanNewton Senior CenterNew England Baptist HospitalNortheastern UniversityOperation ABLEOuter Cape Health ServicesPeterborough Senior CenterProject H.O.P.E.Reach Out and ReadRock, Roll & Ride/BCYF Recreation CommissionRoxbury Community Alliance for HealthSafe Neighborhoods Initiative, Office of the

Attorney GeneralSAGE-Boston (Stop Abuse Gain Empowerment)Second StepSexual Assault Nurse Examiner ProgramSidney Borum Jr. Health CenterSilent Spring InstituteSociedad Latina, Inc. South Cove Community Health CenterSt. Peter’s ChurchSt. Peter’s Teen Center/Catholic CharitiesSportsman’s Tennis ClubSquashbustersSt. Mary’s Center for Women and ChildrenSteps to SuccessStreet Safe BostonSuffolk Law School Battered Women’s Advocacy

ClinicSuffolk County District Attorney’s OfficeTeen EmpowermentThe Boston FoundationThe City School The Dimock CenterThe Food ProjectThe Network/La RedThe Partnership, Inc.The Work PlaceUniversity of Massachusetts, BostonUphams Corner WICVictims Rights Law CenterVietnamese American Civic AssociationYMCA Black Achiever’s ProgramYMCA Training, Inc.

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