Transforming Healthcare through Innovation

2013 System Report Transforming Healthcare through Innovation 2013 System Report

Geisinger is Transforming Healthcare

“We started our journey more than a decade ago with a single goal: Bring great value to the people in our community. Then we asked ourselves if what we learned here at Geisinger could be adapted or modified to work in other settings. The answer has become clear: Yes it can.”

– Glenn D. Steele Jr., MD, PhD

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Our Mission

Enhancing quality of life through an integrated health service organization based on a balanced program of patient care, education, research, and community service.

Our Vision

To be the health system of choice, advancing care through education and research. Our vision is focused on these strategic priorities:

Quality and Innovation driving all our patient care decisions

Market Leadership exporting Geisinger quality and innovation across the region and into new markets

The Geisinger Family empowering personal and professional well-being Contents

3 Mission and Vision

4 Leadership Message

6 The Geisinger Journey: A Study in Transformation Through Innovation An interview with Geisinger leadership

10 Transforming Quality and Innovation

18 Transforming Market Leadership

30 Transforming the Geisinger Family

36 Community Benefit

38 The Geisinger System

48 Financial Summary

50 System Statistics

52 Boards and Councils

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Abigail Geisinger’s vision in 1913 was to build the George F. Geisinger Memorial Hospital, a hospital grounded in the concepts of group practice and an interdisciplinary approach to patient care. From the very start, Mrs. Geisinger said: “Make my hospital right. Make it the best.”

Since then, countless men and women have dedicated their lives to achieving Mrs. Geisinger’s vision. In so doing, they have disseminated their knowledge, caring, and commitment to excellence across central and northeastern Pennsylvania and beyond.

Healthcare and government strategists, payers and employers, and hospital and health system leaders are looking to Geisinger because—working with our board, staff, physicians, researchers, and patients—we have assumed accountability for coordinating and organizing care in order to improve outcomes, reduce variability, align Leadership Message incentives, and decrease costs. As the Geisinger family prepares to celebrate its centennial in 2015, we must rededicate ourselves to achieving Mrs. Geisinger’s vision to “make it the best.” At the same time, we can look to the future with confidence, knowing that what we do here, today and every day, is helping to mold our country’s healthcare system for generations to come.

Glenn D. Steele Jr., MD, PhD William H. Alexander President and Chief Executive Officer Chairman of the Board

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An interview with Glenn D. Steele Jr., MD, PhD, President and CEO, Geisinger Health System; Duane E. Davis, MD, President and CEO, Geisinger Health Plan; and Thomas R. Graf, MD, Chief Medical Officer, Population Health and Longitudinal Care Service Lines

Today Geisinger Health System has a national— even international—reputation for innovation. Reducing variability and readmissions. Engaging patients in their own care. Using the electronic health record to enhance quality and value. Hospital and health system leaders, policy makers, and employers all want to know: What is going on at Geisinger? What makes this century-old health system in rural Pennsylvania special and unique? How can my hospital/ health system/company/employees benefit from the geisinger journey: Geisinger’s innovations? A Study in Transformation through Innovation The Geisinger team worked quietly, at first on a small and limited scale, according to Geisinger president and CEO Glenn D. Steele Jr., MD, PhD. They were blessed, in Steele’s words, with “the perfect laboratory.”

“We had people committed to creating a high- performing hospital and the components of a real system—physicians, hospitals, a powerful research capability, a health plan, and a defined community to serve.”

It was a journey. Clinicians, researchers, business leaders, and educators all collaborated to test ideas and protocols. Some didn’t work, said Steele, so they moved on to the next experiment. What did work was carefully tested again “Yes . . . we have come to believe throughout the Geisinger system. that we might make a difference Then came the question: Can what we learned here at Geisinger be adapted or modified to beyond our region.” work in other settings? “Yes,” Steele said, “we have come to believe that we might make a difference beyond our region.” – Glenn D. Steele Jr., MD, PhD

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The Time Is Right

Geisinger’s ground-breaking work was almost perfectly synchronized with a gradual global realization that the transformation of how healthcare is provided and financed is inevitable. As Steele said, “The old models of clinical care and a failing payment system are threatening the future of accessible healthcare in many communities.”

Geisinger’s innovations address those challenges and help pave the way for transformation. He points to ProvenCare®—the pioneering and highly praised effort to address unjustified variation by affixing evidenced-based protocols to acute and chronic care episodes to ensure the same high quality care is delivered to every patient, every time.

Premised on the well-documented RAND Study that found as much as 30 percent of care many Geisinger’s ProvenHealth Navigator® (PHN) is Thomas R. Graf, MD, chief medical officer patients receive is unnecessary and even harmful, another innovation rapidly gaining acceptance for Population Health and Longitudinal ProvenCare was designed to improve outcomes outside Geisinger. “The fact that we had our Care at Geisinger and a key leader in helping and reduce costs. own health plan gave us the information and other systems adapt, describes it as a “Johnny incentive to design and re-engineer the services Appleseed” approach. “We plant the seed and we were providing to the people we covered,” let it grow. We share a pathway to something A Road Map, Not A Rule Book Steele said. “Our health plan was vital to quality better.” improvement.” Glenn Steele believes the future of the nation’s “We heard hospitals say ProvenCare was great,” PHN is patient-centered primary care, creating healthcare may rest on two of its greatest Steele said. “But then they’d say, ‘We can’t do it. a medical home and neighborhood that not only strengths: its people and the ultimate value Our doctors would be wary. We don’t have the addresses episodes of illness, but also gives nurses of their work. “The men and women of culture. We don’t have the resources.’” How to and physicians the information and tools to Geisinger understand that the value of all they overcome those roadblocks and carve a path for manage the health of a population. That means do goes back to the people getting the care— others to use what Geisinger had learned? The treating debilitating chronic illnesses, such as that every component of our system is aimed Geisinger team has realized that sharing didn’t diabetes, that can lead to serious complications at that target,” Steele said. mean others should do what Geisinger was doing and aggressive efforts at prevention. and expect the same results. It meant that others “With that in place, you can change what had to take their own journey to excellence using Duane E. Davis, MD, president and CEO of each professional does in relation to others Geisinger as a road map. Geisinger Health Plan, adds that the role of the and they begin to agree on best practices. It’s Plan, not only as the insurer but as an engine for not cookbook medicine; it’s truly coordinated “It became a process of scaling and generalizing,” providing clinical information to providers, is a care. I think that’s what’s drawn other Steele said. “Scaling meant adjusting the scope strong confidence-building element for others hospitals and health systems to look at our of our model to fit the capabilities and resources working to emulate Geisinger’s successes. “Our journey and join us.” of others. One size never fits all.” And because experience shows them that transformation is few health systems have Geisinger’s structure or not a ‘light switch’ event. It’s different, a history, “generalizing” helped adjust for differences collaborative journey that takes time and in the culture and community. “We are learning as commitment,” he said. much from them as they are from us,” he said.

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Geisinger’s commitment to quality and innovation continues to drive all patient care decisions and influence how care is financed in Pennsylvania and beyond. The talents and energy of the Geisinger family, cutting-edge research, and the use of data and metrics are all harnessed to improve clinical outcomes, develop new models of care, and base payment on value re-engineering.

Transforming Quality and Innovation

ProvenCare

In 2006, Geisinger started transforming care by testing and rewarding how elective cardiac surgery was performed. That marked the birth of ProvenCare®, what the New York Times called “the Warranty,” one of Geisinger’s earliest tests of how its integrated model, connectivity, and demography could benefit patients and bring value to payers.

ProvenCare relies on the latest patient data to evaluate what works and what doesn’t work for various medical conditions. Based on this information, physicians develop evidence-based, reliable protocols—all aimed at reducing mortality rates, improving outcomes and reducing costly readmissions.

“While ProvenCare aims to redesign complex clinical systems, the basic model can be applied to any acute episodic or chronic disease care,” says Geisinger president and CEO Glenn D. Steele Jr., MD, PhD. “We believe any provider can consistently raise quality and reduce costs by adhering to ProvenCare best practices.” 10 11 Transforming Healthcare through Innovation 2013 System Report

ProvenCare Perinatal: The women’s health physician and leadership team has taken the core fundamentals of ProvenCare and applied them to perinatal care. John Nash, MD, chairman of the department of obstetrics and gynecology, says the physician team quickly moved to adopt procedures to avoid elective procedures prior to 39 weeks.

Hans P. Cassagnol, MD, associate chief quality officer and director of obstetrics and gynecology for Geisinger Northeast, says ProvenCare Perinatal is built around two primary tools. “We used evidence-based medicine and the electronic medical record to come up with a set of best practice measures,” he says.

In prenatal care, the best practices can sometimes be lab work, education, family history, social “We continue to track outcomes and to modify perioperative care, wound care, and the post- ProvenCare Lung Cancer: Geisinger’s The 38 elements cover everything from Early results show compliance with the 38 history, or radiology studies, Harry O. Mateer the program to understand what really matters discharge process. ProvenCare model to provide surgical treatment antibiotic administration and pain management elements rising to nearly 85 percent from below Jr., MD, director of obstetrics and gynecology at in the care of our mothers and newborns,” for patients with non-small cell lung cancer to mediastinoscopy and lymph node sampling. 40 percent when the study began. As of August Geisinger Medical Center, says. What matters is says Kerri Potsko, RN, BSN, associate vice The best practice elements were developed by continues to be implemented at hospitals across In terms of quality and efficiency, ProvenCare 2013, the study had enrolled more than 1,100 that “all of those best practices are offered at the president of women’s health. “Our results show a systemwide interdisciplinary team including the country as part of The Commission on looks to eliminate any unnecessary care steps, patients. Investigators eventually hope to apply appropriate time for each and every individual, that hospitals around the country can improve neurosurgery, orthopaedics, internal medicine, Cancer’s ProvenCare Lung Cancer Collaborative. automate as much work as possible and actively ProvenCare concepts to the total care of lung and that people don’t fall through the cracks outcomes for moms and babies by taking these pain management, GI nutrition, rheumatology, As of 2012, the pilot project has been engage patients in their own care. cancer, involving all stages of the disease. because you think somebody else did it and proven steps.” orthotics, physiatry, and pharmacology. implemented at 12 hospitals of different sizes and you don’t have a good way of documenting and models (see map). making sure it was done.” The women’s health physician and leadership “As a tertiary care, multi-hospital system, we team presented ProvenCare Perinatal for a are in a unique position to perform broad care The project—originated at Geisinger—is Published in The Journal of Nursing HealthLeaders webinar in September 2013. delivery re-engineering of all aspects of lumbar dedicated to improving outcomes and efficiency Administration (2011 May; 4 (5): 226-230), spine fusion surgery,” says Jonathan R. Slotkin, for lung resections by making sure that best ProvenCare Perinatal’s results show that the ProvenCare Lumbar Spine: One of the MD, director of spinal surgery, department of practices are followed for every patient, every rate of C-sections at Geisinger Wyoming Valley newest additions to Geisinger’s ProvenCare neurosurgery. “These process redesign efforts are time. Participating hospitals use interdisciplinary Medical Center went from 36 percent down to model is ProvenCare Lumbar Spine, which is labor intensive, but necessary to achieve reliable teams to provide treatment according to a care 19 percent. In addition, ProvenCare Perinatal designed to re-engineer care delivery for elective delivery of best practices.” Dr. Slotkin is also pathway containing 38 standardized elements, reduced the number of neonatal intensive care lumbar spine fusion surgery. Healthcare experts chairman of the operations committee of the from the preoperative to the postoperative period. unit (NICU) admissions at Geisinger Medical believe lumbar spine fusion is one of the fastest National Neurosurgery Quality and Outcomes Center by instituting key protocols such as “We’re trying to develop a culture of quality and growing inpatient procedures over the past 15 Database. smoking cessation education and intervention safety by eliminating unwarranted variation,” years, with upwards of 500,000 procedures for pregnant women, and measures to identify “As a multidisciplinary team, we’ve worked says Matthew A. Facktor, MD, FACS, Geisinger’s being performed a year. gestational diabetes for appropriate treatment as diligently to ensure every patient referred to director of thoracic surgery. “We view compliance early as possible. ProvenCare Lumbar Spine provides 38 best us for lumbar spine fusion surgery receives the as ‘all or none’ and expect that only patients, practice elements for patients undergoing one- same evidence-based standardized best practice not individual providers, should drive variation Other results show that ProvenCare Perinatal level or two-level, lumbar-instrumented fusion care protocols every time,” says Geisinger in protocols.” reduced the average NICU length of stay by 1.5 with or without interbody fusion. The protocols orthopaedic spine surgeon Michael Haak, MD, days for babies of mothers who received care after start in the outpatient setting by making sure, who also serves as president of the American the program’s implementation, allowing families for example, that patients are at a healthy weight Spinal Injury Association. to go home sooner. for surgery. The model then extends through 12 13 Transforming Healthcare through Innovation 2013 System Report

Advancing Innovation through Big Computing More Data, Better Care

The new High-Performance Medical Computing Core facility within Geisinger’s model as both a clinical enterprise education. Many departments have embraced the Geisinger Institute for Advanced Application (GIAA) is leveraging and health insurance company have long a partnership approach to research, working “We believe that a new type of genomic test report, the power of a parallel cluster computing environment to unearth enabled it to assemble and then apply data with institutions across the globe. Orthopaedics, tailored for patient as well as clinician use, promotes novel answers to basic, translational, and clinical questions. The analytics to improve outcomes while reducing for example, under the direction of Michael cluster allows researchers to complete computations in the period the cost of care in ProvenCare initiatives as well Suk, MD, JD, MPH, FACS, has been selected shared decision making and trust.” of several minutes or hours that would have taken a single computer as other programs. to participate in the Function and Outcomes one or two weeks to compute. Research for Comparative Effectiveness in Total – Marc S. Williams, MD An example of Geisinger’s use of data analytics Joint Replacement (FORCE-TJR) initiative, Director of Geisinger’s Genomic Medicine Institute The Geisinger computational cluster, housed at the Sigfried and is the creation of dashboards found in nearly a nationwide, comprehensive database of Janet Weis Center for Research, will significantly expand the scope every Geisinger clinical department that create total joint replacement and patient-reported of research that can be conducted in areas such as genome data visual representations of large amounts of data outcomes. The FORCE-TJR research effort will analysis, image analysis, and clinical outcome and risk prediction. pulled from the health system’s sophisticated collect data from 30,000 patients, develop tools “The cluster allows us to use complex mathematical and electronic health records and billing system. with which to record the patients’ assessment computational modeling strategies to provide novel answers to The goal of this data-driven approach is to of their surgery, and conduct research to guide basic, translational, and clinical questions,” says Nicholas Marko, MD, use analytics to compare patient outcomes both clinical care and healthcare policy. director of neurosurgical oncology and co-director of the to historical data, as well as to predict how high-performance medical computing core facility. Another example is the Cardiovascular Center procedures will impact care quality and cost. for Clinical Research (CCCR), which is involved For example, high-speed computing may allow scientists to compare in more than 100 ongoing studies, including the genome alignments of a patient with those of his or her parents. investigator-initiated, federally-funded studies Researchers can then determine if the patient inherited a genetic Clinical Research and industry-sponsored studies, as well as variant or if the variant is unique to the child. If the variants are new, biobanks and registries. Under the direction Clinical research is one of the foundations of they are more likely to be contributing to or causing the disease. of Peter Berger, MD, the Center’s director Geisinger’s quality improvement efforts. In and Geisinger’s chairman of cardiology, the addition to Geisinger’s two dedicated research CCCR promotes and supports clinical provider centers, clinicians throughout the health system expertise in identifying, implementing and are engaged in both investigator-initiated conducting randomized trials and other clinical research and third-party trials. Geisinger research by managing relationships with industry researchers have set their sights on improving sponsors and governmental agencies. care in areas as diverse as autism spectrum disorders and total joint replacement. In 2013, Ongoing clinical trials range from those there was a 26 percent increase in research investigating safety and effectiveness of new funding (from 2012) to $24.9 million, with coronary and aortic stent technology to drug investigators publishing 184 articles (up 10 therapy for obesity as well as new cholesterol In 2013, the Institute launched an awareness University and Virginia Polytechnic Institute percent from 2012). lowering drugs for patients at high risk of heart campaign funded by an educational grant and State University (Blacksburg, VA), is led by attack and stroke. from Weis Markets: “Do you know about your Marc S. Williams, MD, director of Geisinger’s “With state-of-the-art research tools and one of family’s health history?” The program shows Genomic Medicine Institute. the nation’s most advanced and sophisticated individuals how to collect their family health electronic health records systems, Geisinger Expanding Genomic Research history and work with their physicians to “We believe that a new type of genomic test continues to attract top investigators who are develop a prevention plan to reduce the risk report, tailored for patient as well as clinician looking for research opportunities they can’t The Genomic Medicine Institute at Geisinger’s of disease. use, promotes shared decision making and find anywhere else,” says David H. Ledbetter, Sigfried and Janet Weis Center for Research trust,” Dr. Williams says. “It also allows patients PhD, executive vice president and chief has continued to make strides toward fulfilling Similarly, Geisinger was awarded in September to be more involved in the management of their scientific officer. the promise of targeted disease prevention and 2013 a $1.4 million research award from the disorders and to make more informed decisions Patient-Centered Outcomes Research Institute about their health and healthcare in conjunction Within Geisinger’s clinical departments, treatment via genetic screening. With a stable (PCORI) to study how best to share genomic with their clinicians.” Nicholas Marko, MD physicians and their teams are advancing population and a reach of more than 2.6 million lab results with patients. The project, which patient care through translational research and residents, Geisinger is in a unique position to study how disease impacts families. includes researchers from the Pennsylvania State 14 15 Transforming Healthcare through Innovation 2013 System Report

Integrating Bioethics into Patient Care and Research Clinical Genome Project MyCode Expands and Updates

Dan Davis, PhD leads Four Geisinger Health System researchers have The ability to study families is an extremely Led by Gregory Moore, MD, PhD, director, A note contains a detailed account of the visit, Integrating Bioethics taken center stage nationally in genomics thanks powerful tool for identifying disease-related GIAA and chief, Emerging Technology and including the history, exam, relevant lab or study @ Geisinger, a to new funding from the National Institutes genes and ultimately for providing personalized Informatics, Geisinger Health System, the GIAA findings, and the clinician’s assessment and plan multifaceted initiative of Health, which recently awarded Geisinger and preventive healthcare. As a result, Geisinger will initially include three centers: the Center of care. Currently that focuses on $25 million as part of the Clinical Genome expanded its MyCode® project to include for Healthcare Re-engineering, co-directed limited to improving the ethics (ClinGen) Project. Building on genetic mapping pediatric participants. MyCode involves by Kenneth Wood, DO and Pascale Carayon, outpatient quality of patient care of human DNA completed by the Human collecting blood samples and health information PhD; the Center for Emerging Technology visits and and research. Dr. Davis Genome Project in 2003, the ClinGen Project from thousands of people for use in future and Informatics, directed by Dr. Moore; and utilized works with clinicians will harness data from hundreds of thousands research studies. the Center for Clinical Innovation, directed by by more than at the bedside and of clinical genetics tests and determine which Jonathan Darer, MD, MPH. 160,000 patients, the program is expected to with investigators, variants are most relevant to improving This expansion of MyCode allows researchers to expand to inpatient stays in 2014. especially in the field patient care. investigate the genetic basis of disease in children of genomics. He will and to follow participating children through More OpenNotes for Patients The expansion of OpenNotes® is the result of soon be working The principal investigator for these grants adolescence and into adulthood. When both the 12-month OpenNotes pilot project funded is David H. Ledbetter, PhD, executive vice parents and their children are enrolled into the by a $1.4 million grant from the Robert Wood with professionals— Dan Davis, PhD To better engage patients in taking control of clinicians and president and chief scientific officer of Geisinger program, parents can give permission to link their own care, Geisinger is granting patients Johnson Foundation. “The study showed that investigators who Health System. Other key contributors to their samples and associated data for research access to their doctors’ notes through their patients who read their notes felt more engaged,” are affiliated with the ClinGen efforts are Christa Martin, studies. All Geisinger patients are invited to secure MyGeisinger online patient portal. says Jonathan Darer, MD, MPH, Geisinger’s non-Geisinger PhD, director of the Geisinger Autism & participate in MyCode, and more than 27,000 MyGeisinger is regularly used by more than chief innovation officer for the division of organizations—who are Developmental Medicine Institute; Andy of them have given their consent. 240,000 patients to complete such tasks as clinical innovation and the Center for Clinical committed to exploring the ethical dimensions of their work and to Faucett, MS, CGC, director of policy and messaging their healthcare team, looking at Innovation. Over the past year, MyCode updated the consent reflecting that commitment in daily practice. education, Geisinger Genomic Medicine medication risks, and scheduling appointments. Institute; and Marc S. Williams, MD, director process to prepare for whole genome and exome According to Dr. Davis, ethics quality covers ideals and norms of Geisinger’s Genomic Medicine Institute. sequencing of participants. Also, after holding that clinicians and researchers should achieve in patient care and focus groups with current participants, the research. These include: Because of this grant award, Geisinger patients protocol and consent were updated to include will now be among the first in the nation to return of medically actionable results in EPIC. • Providing treatment and interventions that are appropriate and benefit from advances in personalized medicine. effective, based on sound clinical and scientific evidence, and consistent with the patient’s wishes and with the integrity of “Technological advances are quickly allowing Geisinger Institute for clinical judgment genome-wide analysis to become commonplace Advanced Application in the care of patients. However, the ability • Ensuring that patients and their families are well informed to detect DNA variants has greatly surpassed Geisinger’s unique culture of innovation about their options for the team-based multidisciplinary nature the ability to interpret their clinical impact, led to the September 2013 launch of the of contemporary healthcare which has thus far limited the benefit of these Geisinger Institute for Advanced Application • Striving to communicate effectively and developing and technologies,” says Dr. Ledbetter. “Improving (GIAA). The Institute will leverage Geisinger’s sustaining effective collaborative relationships with members genomic interpretation will require a cross-disciplinary expertise to make tangible of the healthcare team coordinated effort from both the clinical and contributions to improving healthcare quality research communities.” and value-driven outcomes for patients, • Promoting research honesty and integrity, excellence, and providers, payers and employers. accountability, along with respect for human participants In addition to providing key leadership in the ClinGen Project, Geisinger Health System will Designed to redefine conventional thinking In addition, Dr. Davis is developing a Center for Rural Bioethics, take the lead in developing a unique, patient- regarding the use of new technologies and designed to contribute, in measurable ways, to the advancement centered registry. This registry will serve not innovative approaches, GIAA will engage experts of education, research, and patient care at Geisinger. When fully only as a community resource for individuals from Geisinger and other organizations who staffed, the Center will be committed to ethics education, service- undergoing genetic testing, but as an innovative will be tasked with designing, evaluating, and related functions, and ethics research and scholarship. resource essential in the interpretation of operationalizing new models, applications, genomic variants. and technologies. 16 17 Transforming Healthcare through Innovation 2013 System Report

Whether focused on improving the health status of the residents of the Commonwealth through partnerships or telemedicine; collaborating with out-of-state health systems; or helping redesign how care is delivered and financed in Singapore, Geisinger remains dedicated to capitalizing on the “sweet spot” between its Clinical Enterprise and Health Plan to scale and generalize Geisinger innovations. Research

Geisinger Research, a component of Geisinger drives new models of healthcare service and delivery Clinic, works to transform healthcare and improve that will improve quality of care while enhancing access patient outcomes through discovery, validation, and and affordability and seeks ways to achieve personalized implementation of new knowledge to ultimately healthcare for patients while increasing their satisfaction provide better care for Geisinger’s patients. Through and engagement. And, most importantly, it leverages a broad research agenda undertaken across Geisinger Geisinger’s integrated healthcare delivery system; large, Health System, researchers work to generate new stable patient population; advanced electronic health knowledge that can be applied locally while having record; and clinical data warehouse to address the needs national and international implications. of patients in Pennsylvania and beyond.

Geisinger’s research program spans a broad range The dedicated research buildings—including the Transforming Market Leadership of topics from discovery of the underlying causes Sigfried and Janet Weis Center for Research and the and mechanisms of disease to translation of these Henry Hood Center for Health Research on the discoveries into improved patient care models. It (Continued on page 20)

From basic science research to epidemiologic research, research in our clinics systemwide, and clinical trials, Geisinger’s research programs concentrate on what can be uniquely done at Geisinger.

• The Sigfried and Janet Weis Center for • The Genomic Medicine Institute • The Geisinger Obesity Institute Research focuses on laboratory-based combines research, education and addresses the challenges of obesity research on the molecular and cellular clinical care innovation in genomic and obesity-related diseases in basis of diseases and on translational medicine to develop innovative adults and children. research, in particular genomic treatment strategies and to lead medicine. in the integration of genomics into • The Environmental Health Institute integrated healthcare systems. works to understand links between • The Geisinger Center for Health land use, ecosystem health, Research, housed in the Henry Hood • The Center for Re-engineering community health, and human Center for Health Research, advances Healthcare Delivery seeks to health, and to translate knowledge outcomes and population-based improve healthcare delivery into changes that promote research and devises new models of by applying the principles of sustainable, healthy communities. care to improve the efficiency and engineering to healthcare. The quality of care to patients. Center for Re-Engineering • Disease-focused research • The Autism and Developmental Healthcare Delivery is one of in Cardiovascular Sciences, Medicine Institute (ADMI) is dedicated three centers under the Institute Neuroscience, Orthopaedics, to clinical care, research, and education for Advanced Applications. The Oncology, Nephrology and many that will improve and expedite the other two centers are the Center other clinical departments includes diagnosis, treatment, and care of for Emerging Technology and clinical trials as well as health children with autism spectrum disorders Informatics and Center for Clinical services, outcomes, and laboratory- and other developmental disorders. Innovation. based approaches. 18 19 Transforming Healthcare through Innovation 2013 System Report

(Continued from page 19) Telemedicine

Danville campus and the Geisinger-Bucknell • Face Perception, Social Cognition and the uses the genomics of developmental disorders Geisinger’s telemedicine services provide and remote review of radiology exams to help Autism and Developmental Medicine Autism Spectrum: A Functional Magnetic for diagnosis and for developing individualized community hospitals—many of which are in physicians diagnose and treat patients with clot- Center in Lewisburg—are home to some of Resonance Imaging Study in Children treatment plans; and encourages each patient rural areas—with confidential, convenient, and busting thrombolytic medications, 24 hours a Telemedicine services and Geisinger’s research centers and institutes. In • Exploring Packaging Platforms for and his/her siblings and parents to participate cost-saving access to advanced specialty services day, seven days a week. Geisinger monitors the outpatient locations* Reducing Medication Errors so their patients can receive quality care close following facilities: addition, research takes place in numerous in research. Institute staff also work with area • Adult Psychiatry: Lycoming multidisciplinary institutes and clinical • Genetic Variation in CNTNAP2 and colleges and universities to develop new training to where they live and work. The Geisinger Correlation with Multisensory Integration • Geisinger-Community Medical Center (Montoursville) departments across the Geisinger programs and provide job opportunities for Telemedicine Program connects patients who in the Broader Autism Phenotype • Geisinger-Lewistown Hospital live in areas that do not typically have access to service area. • Methodology for Determining the students in proven behavioral treatments. • Geisinger-Shamokin Area Community • Adult Psychiatry-Bariatrics: specialists through two types of telemedicine: Scenery Park Research Partnerships: Geisinger Relationship between Surgical Drill “We believe Geisinger is the right place to Hospital Parameters and Bone Temperature • Geisinger Wyoming Valley Medical Center continues to partner with hospitals and health develop a national model for integrating early • Live, two-way audio/video consultations • Adult Psychiatry-Pain: Geisinger • Non-Environmental Health Impacts of • Evangelical Community Hospital systems, insurers—such as Highmark Blue and accurate diagnosis of developmental between patients and physicians South Wilkes-Barre, Pain Clinic Marcellus Shale Development • Store-and-forward exams in which • Schuylkill Health System Cross—academic and research disorders; medical and behavioral • Wayne Memorial Hospital (coverage centers, businesses, and communities treatments; and parent, sibling, and photographic and exam data is captured • Behavioral Psychiatry: Geisinger at the patient site and forwarded to a commencing in 2014) to share innovations, ensure access teacher training and support with a broad South Wilkes-Barre, Sleep Clinic specialist at another location for review • Windber Medical Center to care, and extend its knowledge program of research and training,” says and interpretation • Dermatology: Frackville, Geisinger In addition to stroke, many patients require and technology. The result is a vast David H. Ledbetter, PhD, executive vice Specialty Care-Shamokin, Lock neurologic care for a variety of other conditions, network of experts from organizations president and chief scientific officer. Examples of telemedicine services include: Haven, Philipsburg, Scenery Park, such as Bucknell University, Johns including headaches and seizures. Geisinger’s eMERGE: Berwick Hopkins University, Mayo Clinic, Geisinger is among nine eICU: Geisinger Health System’s eICU® eNeuro program provides telemedicine-based and Vanderbilt University connecting centers nationwide, including Mayo connects remote intensive care units (ICUs) neurology consult services for any type of • Geriatric Psychiatry: LIFE to share a wealth of knowledge, data, Clinic (Rochester, MN) and Vanderbilt to a team of critical care specialists—including neurologic evaluation. Geisinger-Kulpmont, LIFE and resources that benefit Geisinger University (Nashville, TN), participating board-certified critical care intensivists and Geisinger-Scranton Pediatric Cardiology: For every 1,000 patients and Geisinger Health Plan in the Electronic Medical Records and critical care nurses—who provide monitoring children born, nine have heart conditions • Maternal-Fetal Medicine: Gray’s members as well as families across the Genomics (eMERGE) Network. The of patients’ vital information and real-time ranging from mild heart murmurs to those Woods, Lewistown, Tunkhannock United States. network is a consortium organized clinical status. by the National Human Genome that require surgery. Geisinger’s pediatric • Pediatric Psychiatry: Pottsville Bucknell-Geisinger Research Research Institute (NHGRI) to develop, Based at Geisinger Medical Center, the eICU cardiologists provide expert interpretations Initiative (BGRI): In its disseminate, and apply approaches to connects to other hospital ICUs at: of echocardiograms, electrocardiograms, and • Pulmonology: Frackville, Gray’s second year of funding in 2013, research combining genetics and patient Holter monitoring exams for regional hospitals • Geisinger-Community Medical Center Woods, Lycoming (Montoursville), and providers. The Geisinger Pediatric TeleEcho a collaborative research program data in the electronic health record. • Geisinger-Lewistown Hospital Mount Pocono, Philipsburg Service allows remote caregivers to transmit between Geisinger and Bucknell Autism: The Autism and Developmental • Geisinger Wyoming Valley Medical Center (Moshanon Valley) Each member site is using electronic records studies to Geisinger specialists for interpretation, University (Lewisburg, PA) that focuses on Medicine Institute, a systemwide initiative linked to genetic samples for large-scale, high- Evangelical Community Hospital in Lewisburg, facilitating timely, accurate diagnosis and • Rheumatology: Frackville, research in the areas of medical devices and designed to care for patients with autism throughput genetic research. The research is PA and Schuylkill Health System in Pottsville, treatment planning. Lycoming (Montoursville), Mount processes, neuroscience, operations research, spectrum and other developmental disorders, bioinformatics and biostatistics, and community aimed at determining how genetic make-up PA also participate with Geisinger’s eICU Pocono, Philipsburg (Moshanon opened its headquarters and first location in Tele-Rheumatology: Patients can and regional health issues began publishing its gives some people a greater chance of developing program, helping remote ICU staff monitor Valley) Lewisburg, PA in 2013. The Geisinger-Bucknell undergo a rheumatology consult at a variety findings. chronic health conditions such as diabetes, performance against quarterly best-practice Autism and Developmental Medicine Center Alzheimer’s, or heart disease. reports on metrics important to critical care. of Geisinger community practice offices with • Virtual Sleep: Lake Scranton, In addition, the following second-round projects seamlessly integrates clinical services, clinical the help of a telemedicine-trained nurse using Mount Pocono, Selinsgrove- Telestroke/eNeuro: have received funding: research, training, and education through The samples are obtained, with a patient’s For patients who may audio/video technology. Using telemedicine, Susquehanna University, a multidisciplinary team of providers and consent, through past studies, biobanks, or have suffered a stroke, time is of the essence. Geisinger rheumatologists are able to perform Tunkhannock • Biomechanics of Genetic-Morphogenetic- researchers. residual blood and tissue samples. As part of Many communities do not have adequate a “virtual joint exam” to assess for joint pain, Hemodynamic Feedback Loop in Heart eMERGE, Geisinger agreed in October 2013 to neurological expertise, however. As a certified joint swelling, and range of motion; correctly In addition to offering patients multidisciplinary *All locations refer to Geisinger Community and Vascular Development develop methods to return clinically-confirmed stroke center and the only neurovascular diagnose the patient’s condition; recommend • The Development of Methods to care designed to improve how autism is treated, Practice offices unless otherwise noted. research results to research participants. intervention center in the region, Geisinger treatment; and perform follow-up exams. Improve the Operations and Performance the Institute tests and refines clinical processes; Medical Center employs board-certified stroke Measurements of the Emergency specialists who use audio/video consultation Department 20 21 Transforming Healthcare through Innovation 2013 System Report

Population Health Transitions of Care Clinical Partnerships

For more than a decade, Geisinger has been “Transitions of care” refers to the patient care about how effectively they are managing their The full merger and integration of Lewistown Hospital into focused on population health: delivering value- journey—where care shifts from one care setting condition. Patients answer the five to seven Geisinger Health System became effective November 1, 2013. “This based care across a continuum of care—from to another, such as from a hospital to a skilled questions via computer or smart phone. Patients is tremendous news for Lewistown Hospital, our patients, staff, and the healthy to the critically ill. Geisinger’s model nursing facility, to home, and sometimes back with a poor asthma control test score, indicating area residents,” says Kay A. Hamilton, Geisinger-Lewistown Hospital and its sophisticated electronic health record to the hospital. Geisinger has earned national that their asthma may not be under control, chief administrative officer. “This merger with Geisinger ensures have enabled Geisinger to use best practices, accolades for its innovative care transitions receive an intervention call from a nurse, who that a strong, not-for-profit healthcare system focused on patients predictive analytics, and electronic tools to model which leverages technology and a case will help them better manage their condition. remains in Lewistown.” manage specific patient populations. manager’s experience and skill to target high-risk “The electronic survey makes it possible to “We welcome the Lewistown Hospital team into the Geisinger patients in a patient-centered strategy that works catch problems before the patient ends up in family, and look forward to building programs, growing services, ProvenHealth Navigator® (PHN), Geisinger’s between Geisinger and non-Geisinger facilities. advanced medical home, is a collaborative effort the emergency department,” explains Jonathan improving outcomes, and demonstrating value to the people of between Geisinger Health Plan (GHP) and Geisinger’s ProvenHealth Navigator (PHN) Darer, MD, MPH, chief innovation officer, the Juniata Valley,” says Glenn D. Steele Jr., MD, PhD, Geisinger’s Geisinger Clinic. PHN is designed to drive case managers focus on these care transitions. division of clinical innovation. “With this president and CEO. sustained changes in healthcare quality and value They are notified about every admission, and, in technology we are able to check in more often Geisinger has also signed letters of intent with Holy Spirit Hospital by providing physician-directed, team-delivered turn, contact the hospital discharge planner to with the patient.” (Camp Hill, PA) and AtlantiCare Health System (Atlantic City, NJ) care. The model works to improve the quality gauge progress and anticipate home care needs. to explore new ways to improve care and serve their respective of care provided through the implementation ProvenHealth Navigator “Transitions of care was a very thoughtful and communities. The signing of the letters of intent enables each of a series of patient-centered, integrated, and Outcomes (2007—2012)* strategic approach when we started medical Care Connectivity Consortium organization to investigate in greater detail the opportunities to evidence-based clinical protocols that support home,” says Janet Tomcavage, RN, MSN, chief • 27.5% reduction in acute care affiliate. The due diligence and approval process is expected to take sustainable systems of care. At the model’s core administrative officer of Geisinger Health Plan. A network of high-performing health systems– admissions six to nine months. is the application of population management Geisinger, Intermountain Healthcare, Kaiser “All of these transitions need to be actively Permanente, and Mayo Clinic–have formed a capabilities, including moving nurse case • 34% reduction in all cause 30 Says Dr. Steele, “We are proud to partner with organizations that managed to prevent unnecessary admissions nationwide secure and reliable electronic health managers into Geisinger and non-Geisinger day readmissions share our culture of quality and innovation and are committed to or readmissions,” says Frederick Bloom, MD, information exchange. practice sites supported by near-real time enhancing population health. We are pleased to look at ways we • 72% of patients thought that chief of Geisinger’ care continuum. The most data analytics. can further our missions together.” quality of care improved important part of the transition is medication “The Care Connectivity Consortium founders “To manage outside the office, it really takes when they worked with a reconciliation. The result is improved quality, share a common mission to use the health a team,” says Frederick Bloom, MD, chief of ProvenHealth Navigator case reduced cost, and high patient and provider information exchange to support patient- Geisinger’s care continuum. According to Dr. manager satisfaction scores. centered, high-value care for the citizens of this Bloom, PHN is focused on covering all the nation. The consortium is utilizing standards- • ED visits remain flat for necessary ground in “taking care of a population Diabetes, hypertension, coronary artery disease, based health information technology to share ProvenHealth Navigator while of patients.” and cholesterol HEDIS scores are all better, data about patients electronically,” says Glenn ED visits have increased according to Duane E. Davis, MD, president D. Steele Jr., MD, PhD, Geisinger president and “The goal of ProvenHealth Navigator is to significantly for unmanaged and CEO of Geisinger Health Plan. “Our CEO. “The goal of the consortium is to provide support the directive of the Institute for patients savings more than cover the additional expense patients–no matter where they are–better and Healthcare Improvement’s Triple Aim,” • Demonstrated improvement of the nurse and it has demonstrated a positive safer care through accessible data.” says Janet Tomcavage, RN, MSN, chief in the risk of heart attack, impact. We’ve seen a more than 30 percent administrative officer of Geisinger Health Plan. reduction in readmissions.” Frank Richards, Geisinger’s chief information stroke, and retinopathy in officer, says, “Care Connectivity Consortium The Triple Aim identifies three objectives for individuals with diabetes new healthcare designs: improve population members share a clear vision that the access to health, enhance the patient experience, and Mobile Apps full medical information that exists in each of reduce per capita costs. “We wanted to improve *Outcomes represent the period 2007— the systems should be extended to all patients by quality, but there also needed to be a business 2012 and over 80,000 Geisinger Health Mobile technology is an important tool used to connecting all communities and the nation in case. The care delivery model needed to reduce Plan members in Geisinger Health help manage chronic conditions like asthma. order to improve healthcare for all Americans.” System practices. One of Geisinger’s key mobile health projects total cost of care, and it has.” This connectivity is enabled by Healtheways, is the electronic capture of patient-reported a collaboration leveraging the consortium’s data. Geisinger uses an electronic survey that advanced patient-centered care technology with gathers information from patients with asthma a robust network. 22 23 Transforming Healthcare through Innovation 2013 System Report

KeyHIE Transform Expands Keystone Accountable Care Retail/Urgent Care Clinics Keystone Beacon Community Connectivity Organization Geisinger’s community-based Careworks and Meeting or exceeding its care coordination, A new, low-cost software The Keystone Accountable Care Organization Urgent Care centers provide convenient access to communication, and connectivity goals, the tool, developed by Geisinger (ACO) is a network of regional doctors, treatment for minor illnesses and common minor three-year federally funded Keystone Beacon Health System and powered by hospitals and other healthcare providers medical problems/injuries, and preventive care and Community formally concluded in fiscal BridgeGate International called who have agreed to work together to screenings. To ensure seamless communication year 2013. The care coordination progress KeyHIE Transform™, allows provide coordinated care and chronic disease between healthcare providers, visits are documented in Keystone Beacon’s geographic footprint nursing homes and home health management for their Medicare patients. This in patients’ electronic health records. (Columbia, Montour, Northumberland, agencies—with or without an network provides patients with increased access Snyder, and Union counties), however, is electronic health record—to to the expertise, staff, and technology needed to “By eliminating serving as scaffolding for Geisinger’s next round contribute patient assessment coordinate care across all the places where service unnecessary emergency of clinical and payment initiatives. information to KeyHIE. is provided. department visits, the model has been effective Keystone Beacon was the first of the 17 This low cost, easy to implement The Keystone ACO is among a select group at improving quality, Beacon communities in the United States to innovation, which meets of ACOs nationally that have been selected patient satisfaction, translate its experiences and lessons learned national HL7 standards for to participate in the Medicare shared-savings and controlling costs,” about notifications through the electronic interoperability, is linking program. explains Kenneth health record into actionable information that providers and health exchanges Berndt, CEO of can be adapted for use by other communities. locally, regionally, and nationally Participating Keystone ACO hospitals: Careworks. These notifications improve patient transitions to better coordinate care and • Evangelical Community Hospital, and reduce unnecessary readmission rates by The two venues are: ultimately to improve care value. Lewisburg, PA using admission, discharge, and transfer-based • Geisinger-Bloomsburg Hospital, • Careworks notification through electronic health records. Bloomsburg, PA Convenient • Geisinger-Community Medical Center, Healthcare offers Keystone Health Information Scranton, PA convenient, Exchange • Geisinger Medical Center, Danville, PA affordable healthcare provided by Geisinger • Geisinger Wyoming Valley Medical Center, nurse practitioners and physician assistants. Patient Portal goes Mobile One of the nation’s largest and most advanced • Physicians with their patients’ hospital KeyHIE Connections* Wilkes-Barre, PA Services include diagnosing, treating and health information exchanges, the Geisinger- discharge summaries • Wayne Memorial Hospital, Honesdale, PA writing prescriptions for common medical Geisinger’s electronic health led Keystone Health Information Exchange • Hospitals with patient information when 22 participating hospitals problems, including cold and flu symptoms, portal—MyGeisinger—is now Participating Keystone ACO physician groups: (KeyHIE®), now links hospitals, long-term a patient is admitted or treated in an allergies, insect bites, earaches and sinus available on mobile devices, outpatient setting care facilities, community health clinics, and 175 physician practices • Evangelical Medical Services Organizations, infections. Also provided are immunizations, including smart phones. • Patients with the ability to interact with other healthcare professionals in more than Lewisburg, PA and surrounding screenings and various wellness services. all their KeyHIE-participating doctors Used by more than 240,000 53 Pennsylvania counties to ensure health communities Careworks currently operates 11 walk-in and and nurses, regardless of facility affiliation, 28 home health locations Geisinger patients, this secure information follows patients, regardless of where • Highland Physicians, Ltd., Honesdale, PA after-hours clinics, with plans to open at least and view their clinical information from web portal to the EPIC-based • Wayne Memorial Community Health 13 more clinics in 2014. they receive care. participating healthcare organizations 70 long-term care facilities electronic health record is Centers, Honesdale, PA and surrounding • Urgent Care provides more extensive services through the KeyHIE patient portal, accessible anywhere internet Access to KeyHIE provides: communities to treat acute illnesses and minor injuries, MyKeyCare 749 Bucknell University helping patients avoid unnecessary emergency is available. MyGeisinger • Emergency departments, care managers students who utilize room visits. These sites, located at Geisinger provides a secure, confidential, and home health nurses the ability to MyKeyCare also functions as a personal health South Wilkes-Barre and Geisinger Wyoming and efficient way to view MyKeyCare to access their access critical information, including record that allows nearly 3,000 active users Valley, include X-ray, EKG, IV hydration, health information, make medical histories, allergies and a variety of to upload health information from non- Student Health Center and phlebotomy. There is also a pediatric appointments, message test results, including results from ECGs, participating healthcare providers and keep track urgent care center located in Selinsgrove at healthcare providers, pay bills, (*as of 12.5.13) Holter monitoring, and stress tests of all their healthcare information in one place. Susquehanna University. and track personal health and wellness goals. In addition, Careworks provides tailored consulting to help hospitals and health systems across the country implement and operationalize convenient care clinics into their local system of care. 24 25 Transforming Healthcare through Innovation 2013 System Report

Geisinger Blood Center

To ensure that blood products are readily available HealthChoices: Individuals and families us to have an option to fit every need in the Brewer, ME) offering coverage to EMHS for Geisinger patients in central and northeastern eligible for Pennsylvania Medical Assistance community. For example, we now cover more employees and their dependents. GHP also Pennsylvania, Geisinger established its own Blood (HealthChoices) can now choose Geisinger than 9,000 children in the Children’s Health began offering pharmacy benefit services to Center in 2012. Health Plan for their medical assistance (MA) Insurance Program (CHIP). We are happy Christiana Care Health System, Wilmington, plan in 22 counties of central and northeastern to partner again with the Commonwealth of DE employees in July. Mike Quint, the center’s director, says that, as Pennsylvania. The managed care program is Pennsylvania.” a result of the acute nature of the illnesses and designed to improve access to and quality of care GHP Partnerships: Geisinger Health injuries Geisinger treats every day, the demand for for MA consumers throughout Pennsylvania. Office of Strategic Industry Plan (GHP) is partnering with a number of blood and blood products is great. “Every unit of The plan will be offered under the name Partnerships and Negotiations progressive health systems that are focused blood that’s donated in this community supports Geisinger Health Plan (GHP) Family. life in this community,” he says. on improving quality and outcomes, and The Office of Strategic Industry Partnerships GHP Family covers doctor’s office visits; fundamentally changing the way healthcare is and Negotiations is charged with identifying, Geisinger Medical Center alone uses more than emergency care; preventive services including delivered and financed. structuring, and developing key partnerships 70 units of blood a day or approximately 25,000 immunizations and cancer screenings; diabetes with top-tier global companies that, like In 2012, GHP expanded its reach outside of units of blood a year. Cancer patients, surgical care; well woman and maternity care; dental Geisinger, seek to transform the way in which Pennsylvania when it began providing coverage patients, premature infants, people being treated and vision services; and prescription drugs. In healthcare is provided and paid for nationally. to West Virginia United Health System’s for accidents and trauma, recipients of bone addition, members have access to unique GHP The primary intent of these select strategic Morgantown-based employees and their marrow and organ transplants, and patients with Family benefits including the Extra Eye Care partnerships is to leverage the aligned interests dependents. In addition, GHP is working with chronic diseases, such as hemophilia, all depend on benefit, ProvenHealth Navigator “Right from and complementary assets of Geisinger and its Meridian Health System (central and southern donated blood as part of their care. the Start” maternity program, a nurse hotline, partners in order to develop, test, and deliver New Jersey) to offer Geisinger Gold Medicare health and wellness information and reminders, innovations that increase quality and reduce Geisinger’s blood center follows transfusion Advantage plans to individuals in New Jersey’s as well as health coaches. total cost of care in the United States. medicine’s best practices to collect exactly the Ocean and Monmouth counties. In 2013, GHP amount of blood that is needed to efficiently and Dudley Gerow, GHP’s chief government began a third-party administrator relationship with EMHS (Eastern Maine Health System, effectively care for its patients in the service area. programs officer, says, “It is important for Partnering with Employers: The Geisinger Blood Center is a partnership with Destination Care the Institute for Transfusion Medicine (ITxM), an organization that specializes in transfusion and With more employers and insurers offering related services. incentives like reduced out-of-pocket costs to Walmart, the nation’s largest employer, named “Geisinger’s Destination Care program provides encourage employees to travel for their care Geisinger as one of six health systems1 nationally an array of surgical procedures for patients who to designated high-quality health systems, where its employees and dependents who need are willing to travel for care beyond their local Geisinger Health Plan Geisinger launched its Destination Care cardiac surgery can receive care with no out-of- provider markets, and for companies that are program. pocket expenses or travel costs. Covered cardiac interested in developing new benefit programs “Geisinger Health Plan has been offering quality surgeries include coronary artery bypass grafts, to include employee travel for specific, non- Employers say they can save money, in part, insurance products to Pennsylvania residents for heart valve replacement/repair, closures of heart emergent procedures,” says Joanne Wade, by working with health systems that specialize more than 25 years,” says Duane E. Davis, MD, defects, thoracic and aortic aneurysm repair, and Geisinger’s executive vice president, Strategic in high-acuity programs by negotiating a president and CEO of Geisinger Health Plan. “By other complex cardiac surgeries. Program Development. leveraging the ‘sweet spot’ between the Clinical single rate that includes the fees for surgeons, Enterprise and Geisinger Health Plan we are able anesthesiologists, and all medical care for 90 Since Walmart kicked off its Centers of to scale and generalize the innovative programs days following the procedure. By leveraging Excellence program, Geisinger’s cardiac team has that focus on improving health while containing its internationally recognized ProvenCare® cared for a number of Walmart employees who costs that have placed us in the national spotlight,” program, Geisinger is well positioned to attract have specified that Geisinger is the health system he says. “We are happy to bring our programs high-margin procedures that are reimbursed at where they wished to receive their cardiac surgery. and expertise to thousands of additional families commercial rates. through Pennsylvania’s HealthChoices program and partnerships with a variety of systems that 1 share our commitment to quality and value.” The six designated healthcare organizations include Cleveland Clinic in Cleveland, Ohio; Geisinger Medical Center in Danville, Pa.; Mayo Clinic sites in Rochester, Minn., Scottsdale/Phoenix, Ariz., and Jacksonville, Fla.; Mercy Hospital Springfield in Springfield, Mo; Scott & White Memorial Hospital in Temple, Texas; and Virginia Mason Medical Center in Seattle, Wash. 26 27 Transforming Healthcare through Innovation 2013 System Report

Greening Geisinger’s Knowledge Dissemination Footprint Healthcare strategists, government leaders, and Steinberg, MD, MPP, xG’s chief executive officer Energy conservation initiatives across the healthcare executives from around the world who also serves as executive vice president, Geisinger system have netted more than $7 look to Geisinger because the health system has Innovation & Dissemination, Geisinger Health million in annual energy savings. These measures assumed accountability for coordinating and System. “Our clinician-led management team include achieving efficiencies in water chillers, organizing care in order to reduce variability, has had multi-dimensional experience at boilers, and lighting. improve outcomes, and decrease costs. Geisinger and other leading institutions. Our Geisinger accomplishes this goal in a variety of methods have been proven to improve quality “Reducing energy consumption lowers ways, including offering a robust continuing of care while reducing cost of care not only pollution,” says Alan Neuner, vice president education program, encouraging employees at Geisinger, but also at several other health of facility operations at Geisinger, “so we track to publish outcomes and present findings at systems,” he says. energy saved and quantify the impact on the key conferences, publications, and through the health of the more than 2.6 million people launch of xG Health Solutions™. The main goal of client engagements is to help we serve.” those organizations transform to value-oriented xG Health Solutions was created in 2013 to care delivery, while improving quality, clinical Sustainability initiatives were first implemented bring Geisinger expertise in healthcare delivery outcomes, patient and provider satisfaction, and in 2006 during construction of the Henry Hood to organizations nationwide. xG Health, reducing cost. xG Health has already partnered Center for Health Research, now a Leadership in supported in part by a $40 million investment with more than a dozen organizations from West Energy & Environmental Design (LEED) Silver by Oak Investment Partners, is the primary Virginia to Maine, Georgia to Washington State. building. Today, Geisinger has eight LEED- provider of Geisinger’s Healthcare Performance certified buildings. In addition, the Laboratory Improvement Intellectual Property (IP). xG Health offers a variety of products and Medicine Building on the Geisinger Medical services, including volume-to-value roadmap, Center campus—scheduled to open in April xG Health provides experienced professionals care design and delivery, population health 2015—is also designed to be LEED-certified. to partner in developing and implementing analytics, and financial best practices. These strategies focused on improving quality and offerings are powered by Geisinger Health “Being sustainable is the right thing to do for our reducing cost of care over the long haul. “We System’s methods that have been proven to community and our health system,” says William have roots in one of America’s most innovative achieve best-in-class outcomes. J. Gladish, Geisinger’s director of construction. and successful health systems,” says Earl “We are so committed to the environment that all of our new buildings are designed to be On June 3, 2013, Geisinger- LEED-certified buildings.” Community Medical Center (G-CMC) broke ground on a Geisinger’s LEED-certified buildings include: $97.1 million expansion project. Scheduled to be completed • Buckhorn Office Building, in the summer of 2015, the Bloomsburg, PA expansion will include a 14- • Geisinger-Dallas Clinic, Dallas, PA room operating suite, a new • Geisinger-Gray’s Woods, State College, PA intensive care unit with eICU • Geisinger-Orwigsburg, Orwigsburg, PA capabilities, an enhanced lobby • Geisinger Wyoming Valley Critical Care that will extend to Mulberry Building, Wilkes-Barre, PA Street and additional clinical • Henry Cancer Center, Wilkes-Barre, PA and physician office space. The • Henry Hood Center for Health Research, G-CMC expansion is part of Danville, PA the $158.6 million investment • Hospital for Advanced Medicine, Geisinger Health System Danville, PA committed to Scranton and its • Justin Drive Office Building, Danville, PA surrounding communities.

Geisinger–Dallas features family medicine, pediatrics, women’s health, lab, radiology, and specialty outreach services. The 17,000 square-foot facility also includes a CareSite Pharmacy and Careworks After Hours clinic. 28 29 Transforming Healthcare through Innovation 2013 System Report

Geisinger’s heritage of excellence and tradition of service is grounded in and contingent upon the personal and professional well-being of the Geisinger family. Geisinger will secure its legacy by providing its people with opportunities for learning and knowledge sharing; recruiting and retaining the best and brightest professionals; and developing and sustaining world-class formal education programs that strive for academic excellence and distinction.

Employee Health and Wellness

Geisinger began cultivating a culture of wellness in 2006 with the implementation of Geisinger Geisinger was one of the first Wellness, a program designed to motivate health systems in the country to Geisinger family members to be active partners require all job applicants to be in achieving healthy lifestyles. The Geisinger nicotine-free. Wellness mission is accomplished through the identification, development, and promotion of Geisinger was one of 65 Transforming the Geisinger Family interactive educational opportunities focused companies nationwide to on healthy behaviors, as well as risk factors be named a Best Employer associated with chronic disease. The program for Healthy Lifestyles by the includes weight-loss and weight-maintenance National Business Group on challenges; resources and tips on diet, exercise, Health in 2013. stress management, tobacco cessation, and “Employers across the country—including In 2012 and 2013 Geisinger work/life balance; and tools including exercise Geisinger—are looking for ways to improve the earned the American Heart planners, food and strength logs, and step and health of their employees, decrease absenteeism, Association’s Gold Certification weight trackers. In addition, employees can and control costs,” says Janet Tomcavage, RN, as a Start! Fit-Friendly Company. use Geisinger’s internal social collaboration MSN, chief administrative officer of Geisinger website to participate in wellness discussions and Health Plan. “MyHealth Rewards is, at its core, support groups, and to share tips, ideas, a population health management program that and recipes. focuses on overall health and wellness, including Over the past five years, Geisinger has increased obesity and chronic illness, both of which are its portfolio of programs designed to improve pervasive in our society.” Bringing Farm Freshness to the Workplace the health and wellness of its employees and MyHealth Rewards 2012 results included: their families with the addition of MyHealth Rewards, an incentive-based program offered to • Approximately 15,000 pounds were lost The inaugural 2013 Get Fresh employees who are also Geisinger Health Plan by employees; on average, each participant Market was held weekly at (GHP) members. lost 10 pounds Geisinger Medical Center. • 246 employees quit smoking Featured dishes were also Launched in 2012, MyHealth Rewards is • Nearly 100 participants are being treated available at Geisinger Wyoming designed to help employees achieve and for medical conditions that they didn’t Valley Medical Center and maintain personal wellness goals through know they had Geisinger-Community Medical education, awareness, and health/wellness • 73 percent of more than 14,000 benefits- Center. In 2014, the Get Fresh coaching, while rewarding those who achieve eligible employees participated in the Market will have a presence on program their goals with a reduction in the contributions all Geisinger campuses. • More than 17,000 health screenings were they make to their healthcare premiums. provided

30 31 Transforming Healthcare through Innovation 2013 System Report

Geisinger PRIDE Educational Graduate Medical Education Programs Leadership Family Practice Residency Hundreds of Geisinger of how quality, value, patient safety, and team skills Residencies Program Director family members are are integrated into the delivery of modern medicine. Linda M. Famiglio, MD, FAAP Anesthesiology Michael Entrup, MD Geisinger expanded its GWV-based Family Practice involved in Geisinger’s At Geisinger, students and residents receive real-life Chief Academic Officer Clinical Psychology Christine Chew, PhD residency to address the massive shortage of Proven Innovation experience working in an integrated health system Dermatology Michele Maroon, MD family medicine doctors in northeast Pennsylvania. Drive for Excellence at hospitals and clinics, as well as training in how Joseph J. Stella, DO, FACOS “The Dr. David Kistler Family Medicine Residency Emergency Medicine Robert Strony, DO (PRIDE) initiative. PRIDE engages employees in to apply the advanced electronic health record, Associate Chief Academic Officer Program is charged with repopulating the area with Osteopathic Medical Education dozens of project teams dedicated to re-engineering technology, and innovative solutions directly to Family Medicine – GWV Steve Evans, DO; APD and AOA PD family medicine-trained physicians in the tradition and improving the system’s processes, workflow, and patient care. General Surgery Mohsen Shabahang, MD Douglas F. Kupas, MD, FACEP of the late Dr. Kistler, the founder of family medicine reliability; enhancing patient care; and reducing costs Internal Medicine Mary Harris, MD training in northeast Pennsylvania more than 25 Geisinger serves as the clinical campus of Temple Associate Chief Academic Officer for and increasing value. Project teams set their goals Medicine – Pediatrics Michelle Thompson, MD years ago,” says Dr. Famiglio. University School of Medicine, Philadelphia College Simulation and Medical Education according to PRIDE’s guiding principles, focusing on: Neurology Jonathan Hosey, MD of Osteopathic Medicine and The Commonwealth Michelle Thompson, MD Neurosurgery Shelly Timmons, MD, PhD • Patients and their families Medical College. Each year, more than 270 medical Associate Chief Academic Officer for • Innovation students from these and other top educational Inter-professional Education and Obstetrics/Gynecology P. Joseph Swanson, MD • Continuous improvement tracked by institutions complete their training at Geisinger. Quality Ophthalmology Vincent Baldassano, MD measurable data The system offers programs that spotlight Geisinger’s • Best practices and transparency Oral & Maxillofacial Surgery Robert Pellechia, DDS unique and visionary attributes as an integrated Advanced Practice Council • Optimum productivity, deployment, and Orthopedic Surgery Gerry Cush, MD delivery system, as well as health information Leadership cycle time Osteopathic Surgery – GWV Joseph J. Stella, DO technology, innovation, and education in medical Ronald Byerly, PA-C Otolaryngology J. Scott Greene, MD PRIDE project teams are targeting a variety of specialties and clinical electives. Allison Mowery, CRNP Pediatrics Paul Bellino, MD mission-related initiatives, including community- In addition, Geisinger trains approximately 400 Jay Thomas, CRNA based care, pain management, coding, clinical and Pediatric Dentistry Karen Uston, DDS residents and fellows at Geisinger Medical Center, non-clinical supplies, and emergency medicine. Radiology Anne Dunne, MD Geisinger Wyoming Valley (GWV) Medical Center, Urology Joel Sumfest, MD and Geisinger-Community Medical Center. Fellowships Program Director Education The health system’s patient-centered, interprofessional model focuses on evidence-based decision making Cardiovascular Medicine Terry Bauch, MD Geisinger Physician Assistant Residency Program Geisinger has a long-standing commitment to medical that helps to prepare students for the future of Clinical Cardiology Electrophysiology Pugazhendi Vijayaraman, MD Residency Program Program Director education and takes seriously its responsibility healthcare. According to Linda M. Famiglio, MD, Critical Care Medicine Karen Korzick, MD to train physicians, nurses, and other healthcare Geisinger’s chief academic officer and a pediatric Cytopathology Haiyan Liu, MD General Surgery Nevin Gorki, PA-C professionals. Embracing its legacy of patient-centered neurologist, “We have a powerful ability to train Dermatopathology Tammie Ferringer, MD Internal Medicine Esther Klinger, PA-C care and academic excellence, Geisinger’s educational physicians and keep them here. About one-third of EMS David Schoenwetter, DO Neonatology Ray Hayes, MD programs provide students with an understanding our trainees stay and practice in Pennsylvania.” Gastroenterology & Nutrition Robert Smith, MD Neuroscience Wayne Rodrigues, PA-C Interventional Cardiology Thomas Scott, DO Non-standard Fellowship Programs Program Director Maternal Fetal Medicine Michael Joseph Paglia, MD, PhD Medical Physics Andrew J. Jones, PhD Addiction Medicine David Withers, MD, PD Nephrology William Difilippo, MD Advanced Endoscopy David Diehl, MD (Fellowship) Palliative Medicine Neil Ellison, MD Minimally Invasive Surgery Anthony Petrick, MD Procedural Dermatology Michael Ramsey, MD Neuropsychology Brad Wilson, PhD Pulmonary/Critical Care Paul Simonelli, MD, PhD Obesity Medicine/Nutrition Support Christopher Still, DO (Nutrition) Rheumatology Alfred Denio, MD Orthopedic Trauma Research Daniel Horwitz, MD Sports Medicine – GWV David Ross, MD Pediatrics Hospitalist Paul Bellino, MD Vascular Surgery James Elmore, MD Psychology Fellows Christina Chew, PhD (Child Psych) Charlotte Collins, PhD (Adult Psych)

32 33 Transforming Healthcare through Innovation 2013 System Report

Magnet Redesignation for Geisinger Medical Center Nursing Education: Geisinger is the region’s The American Nurses Credentialing primary provider of nursing education, says Sue Nonclinical Internships Center (ANCC) recently announced that Hallick, RN, BSN, MHA NEA-BC, executive vice Now Available president and system chief nursing officer. Geisinger Medical Center (GMC) has earned redesignation as a Magnet Hospital. GMC “We recognize the importance of educating nursing Geisinger offers undergraduate- is one of 24 Pennsylvania hospitals and 395 students and providing continuing education for and graduate-level placements hospitals in the United States that have nursing professionals,” Hallick says. Geisinger for students in nonclinical areas. achieved Magnet status. partners with Bloomsburg University for on-site Offering both paid internships classes for those who are in pursuit of BSN, MSN, and unpaid externships for “It’s an honor to receive this redesignation,” CRNA, and nurse practitioner degree programs. credit, students benefit from says Sue Hallick, RN, BSN, MHA NEA-BC, the experience of hundreds executive vice president and system chief Geisinger also offers employees the option of of professionals in dozens of nursing officer. “This honor is a testament pursuing nursing education online with three specialties as they learn about to the hard work and dedication of GMC’s educational programs at the following universities: an occupation or career field. high-performing nursing and patient care Drexel University, American Sentinel University, Internships provide an excellent teams who make a difference in our patients’ and Ohio University. opportunity for students to apply lives each and every day.” what they have learned in the Professional Education: The health system classroom and gain real-world Hospitals earn Magnet designation for a is committed to Interprofessional Allied Health experience while sharpening four-year period, during which the ANCC programs and continuing educational opportunities their skills. conducts annual reviews requesting updated for a wide range of healthcare professionals, documentation. At the end of four years, the including pharmacy, neuropsychology, medical hospital will go through the entire Magnet physics, dentistry, and podiatry. redesignation process once again. In addition, Geisinger Health System is approved In response to increasing demands facing the Magnet hospitals are known as places where to offer continuing medical education credits by the healthcare workforce, Geisinger offers the nurses deliver excellent patient care and have following accrediting bodies: following advanced health profession programs: a high level of job satisfaction. They also • Pharmacy Residency • Pennsylvania Medical Society (PMS) encourage open communication between • Administrative Fellowship • Pennsylvania State Nurses Association (PSNA) nurses and members of the healthcare team • School of Cardiovascular Technology • American Council on Pharmaceutical and provide nurse involvement in decision • Dietetic Internship Program Education (ACPE) making about patient care. • School of Spiritual Care • The Commission on Dietetic Registration • Physician Assistant Education (CDE) “Magnet • School of Radiologic Technology • National Board for Certified Counselors redesignation (NBCC) • School of Phlebotomy continues to • American Society of Radiologic Technologists reaffirm what we Geisinger’s Center for Continued Professional (ASRT) already know— • The American Occupational Therapy Development optimizes Geisinger’s integrated and that our nurses Association (AOTA) multidisciplinary environment by facilitating for- are among • National Athletic Trainers Association Board of credit courses that are taught by Geisinger teams Certification (BOC) the best in to other Geisinger teams. These teams include • American Psychological Association (APA) the nation,” doctors, nurses, pharmacists, social workers, • American Osteopathic Association (AOA) says Hallick. “Magnet is an affirmation of imaging technologists, physician assistants, nurse • American Nurses Credentialing Center Geisinger nurses’ long-standing tradition of practitioners, dietitians, athletic trainers, counselors, (ANCC) teamwork and exceptional patient care.” psychologists, and occupational therapists. • Accreditation Council for Continuing Medical Education (ACCME)

34 35 Transforming Healthcare through Innovation 2013 System Report

For nearly a century, Geisinger Health System As part of the commitment to patient care, has focused on the health and well-being of education, and community service, Geisinger Trusted Advisor northeastern and central Pennsylvania through is proud to support and participate in regular the provision of high-quality, compassionate community health needs assessments in Geisinger’s Trusted Advisor program care to all who need it. With healthcare as its conjunction with other area organizations. These is a resource designed to help first priority, Geisinger is also deeply invested assessments obtain statistically valid information educate community members about in related community partnerships, charity, job on the health status and socioeconomic and sweeping changes associated with creation, support for local governments, and environmental factors related to the health of health reform and the Affordable helping where it can. As a community-based, area residents, and lead to the development of Care Act (ACA). not-for-profit organization, Geisinger continues action plans to better meet community need. to invest in understanding and meeting the Among the community needs identified are Through the Trusted Advisor diverse health needs of the region. improved access to healthcare for underinsured website (www.geisinger.org/ and uninsured residents, increased healthy reform) community members The health system’s $336.6 million in behaviors, and community development of are able to learn what the ACA community support during fiscal year 2013 multilingual healthcare services. is, how it will affect them and represents approximately 14.9% of Geisinger’s what they need to consider when operating expenses, nearly three times what is Geisinger’s response to these needs includes: reviewing marketplace plans. The required to meet Pennsylvania’s standards as website also provides links to other a charitable mission. Over the past 10 years, • Supporting free healthcare clinics, such as Community Benefit the Leahy Clinic for the Uninsured and useful resources, including www. Geisinger has invested more than $2 billion in Scranton Primary Health Care Center HealthCare.gov, where Pennsylvania community benefit, resulting in a significant in Scranton, the McAuley Clinic and residents shop for their new health positive impact on the health of the people Volunteers in Medicine in Wilkes-Barre, insurance. throughout the area. Columbia County Volunteers in Medicine in Mifflinville, and A Community Clinic “It is natural that people have Geisinger’s community support includes the in Sunbury questions about what the changes provision of free, uncompensated care to • Improving quality of life for seniors at mean to them and their families,” patients who could not afford to pay; care to LIFE Geisinger Centers in Kulpmont and said Geisinger president and CEO the elderly and the poor not paid by Medicare Scranton Glenn D. Steele Jr., MD, PhD. “We are or Medicaid; allied health, medical residency, • Protecting residents and the environment committed at Geisinger to sharing and fellowship educational programs to train through a Medication Disposal Project information to help everyone make • Removing language barriers for better physicians and other healthcare professionals; the ACA work to their benefit.” healthcare research; and community health, care through real time, trusted interpreter education and outreach programs. services A toll-free phone line that connects • Providing medication therapy callers with trained counselors management, health screenings, and other The largest non-government employer in central who provide real-time answers community programs and northeastern Pennsylvania, Geisinger to ACA-related questions is has an annual positive economic impact of Long ago, the health system’s founder Abigail also available. Callers can also approximately $6.1 billion throughout the Geisinger set a high standard by stating, learn about Pennsylvania health state. As a major employer of more than 20,000 “Make my hospital right. Make it the best.” insurers—including Geisinger Health people, and through the ripple effect utilization Her words continue to guide Geisinger, not Plan—that are participating in the of Pennsylvania suppliers and other businesses, only throughout the health system, but also Marketplace Exchange. the health system supports more than 30,280 throughout the community. jobs in the Commonwealth. Recognizing that employees drive everything it does, Geisinger invests nearly $1.4 billion annually in employee salaries, benefits, training, and education.

36 37 Transforming Healthcare through Innovation 2013 System Report

Serving more than 2.6 million residents in 44 counties as a not-for-profit, fully integrated health service organization, Geisinger Health System is dedicated to excellence in care, education, research, and service. The physician-led health system represents a fundamentally different way of caring for patients. Its multidisciplinary group practice with system-aligned goals is based on successful clinical programs, an advanced information technology platform, a robust research program, and an insurance partner—Geisinger Health Plan.

Geisinger-Bloomsburg Hospital (G-BH), Bloomsburg, PA, is an acute/ psychiatric care hospital (52 acute beds and 20 psychiatric beds). G-BH complements GMC by offering a wide variety of quality programs and services, including inpatient surgery and hospitalization; 24-hour hospitalist services; same day surgery; cardiology and cardiac rehabilitation; full maternity services The Geisinger System and education classes; and pediatric care, physical therapy, orthopaedics, respiratory, and psychiatric services. Geisinger-Bucknell Autism and Developmental Medicine Center opened in Lewisburg, PA in April 2013. This collaborative effort brings together neurodevelopmental pediatrics, psychiatry, radiology, and genomic medicine departments Geisinger Community Health Services Geisinger Health Plan (GHP) is the and Bucknell University’s academic programs (GCHS) is a not-for-profit organization that not-for-profit health insurance component in neuroscience, psychology, education, annually provides healthcare services to nearly of Geisinger Health System. GHP, one of the mathematics, and computer science to 60,000 individuals close to where they live and nation’s largest rural HMOs, provides high enhance the understanding of autism and work. GCMS complements and expands the care quality, affordable healthcare benefits for neurodevelopmental disorders and ensure the provided by Geisinger Health System. GCHS businesses of all sizes, individuals, families, development of more effective treatment plans programs include: and Medicare beneficiaries. Preferred Provider that are highly individualized and tailored to Organization (PPO) and high deductible plans • Careworks, which provides basic health services are sold through Geisinger Quality Options, Inc. each child’s unique needs. in retail or work site settings Self-funded plans are sold through Geisinger • Health Care Quality Unit nurses who educate Geisinger Clinic serves as a national model community members and caregivers of Indemnity Insurance Company. Based in of a successful multispecialty physician group intellectually disabled individuals Danville, PA, GHP serves 429,135 members* in medical practice and is one of the largest • LIFE Geisinger, which provides a Pennsylvania, West Virginia, Delaware, and New ambulatory care programs in Pennsylvania. As comprehensive program of health and social Jersey. of June 30, 2013, 1,055 employed physicians services to the frail elderly practiced in 78 medical group locations • Geisinger HomeCare & Hospice, which *GHP membership as of June 30, 2013 (primary care and specialty outreach) within provides 24-hour-a-day home health services the system’s service area. Members of the group to patients in central and northeastern practice admit to 15 Geisinger and non- Pennsylvania Geisinger hospitals and nursing homes within • VITALine, which provides comprehensive the Geisinger service area. high-tech infusion therapies in a home setting 38 39 Transforming Healthcare through Innovation 2013 System Report

Geisinger-Community Medical Center • The Hospital for Advanced Medicine Geisinger Medical Groups (GMG) Henry Hood Center for Health transported to a Geisinger facility. Geisinger’s on molecular and cellular mechanisms. The Weis (G-CMC), Scranton, PA, is an acute care, (HfAM) serves as an integrated “hospital bring Geisinger expertise and advanced services Research is a 63,000 square-foot facility Life Flight operates five base locations: Center also provides training in laboratory research 297-bed hospital housing Lackawanna County’s within a hospital” for the most critically ill to communities throughout central and located on the GMC campus. Hood Center Geisinger Medical Center, Danville; Wilkes- to postdoctoral and clinical fellows, residents, and only Level II Trauma Center and adult in-patient patients. Outpatient services are available northeastern Pennsylvania through a network research programs are committed to discovering Barre Scranton International Airport, Avoca; students. behavioral health unit. Accredited as a Chest Pain on- and off-campus. of 40 physician office locations. In addition and validating efficient, accessible, and effective University Park Airport, State College; • Geisinger-Knapper Clinic, an outpatient Center and a certified primary stroke care center, to providing primary and specialty care, the means of improving and protecting health, Williamsport Regional Airport, Williamsport; clinic located on the GMC campus, and Good Will Fire Department, Minersville. Geisinger Affiliated Entities G-CMC is home to an expansive range of clinical houses Geisinger’s Cancer Institute medical groups offer patients the opportunity focusing on outcomes research, rural health and surgical services, including cardiac care, to participate in clinical trials and research policy, environmental health, EHR safety, and and is also home to family medicine, Marworth orthopaedics, neurosurgery/neurology and general initiatives in collaboration with Geisinger’s genomics. Located within the Hood Center, the , Waverly, PA, is recognized as Community Medical Care, Inc. (CMCI) general pediatrics, and specialty care a national leader in alcohol and chemical surgery. in endocrinology and metabolism and research centers, creating evidence that is both Center for Health Research brings together the A 501(c)(3) not-for-profit corporation that employs and dependency treatment with highly-specialized psychology. On-site services like X-ray, timely and directly relevant to clinical care. In clinical and research capabilities of pediatrics, engages physicians and other healthcare professionals In June, 2013, G-CMC broke ground on a lab, and pharmacy make it especially conjunction with Geisinger Health Plan, the neurodevelopment, and pediatric psychiatry. addiction treatment programs that address a who provide professional services. $97.1 million expansion project. Scheduled to be convenient for patients. medical groups also offer their own unique person’s unique medical circumstances. This Lewistown Hospital completed in the summer of 2015, the expansion model of medical home, called ProvenHealth merged into Geisinger 91-bed facility offers three levels of treatment: Community Medical Center Healthcare will include a 14-room operating suite, a new, 19- Navigator®–a program that embeds nurse care Health System on November 1, 2013. Located In outpatient, intensive outpatient with partial System (CMCHS) bed intensive care/critical care unit, an enhanced Lewistown, about 60 miles southwest of Danville, hospitalization, and inpatient detoxification and managers in medical group offices with the goal A 501(c)(3) not-for-profit corporation that was the lobby and additional clinical and physician PA, the newly branded Geisinger-Lewistown rehabilitation. of advancing chronic disease prevention and former parent entity that functioned as a holding office space. The G-CMC expansion is part of Hospital provides inpatient, outpatient, wellness, care management. Sigfried and Janet Weis Center for company for the corporate affiliates of GCMC. the $158.6 million investment Geisinger Health and community services ranging from family Research System committed to enhance clinical programs, Geisinger Wyoming Valley (GWV) medicine, internal medicine, and cardiology to is a state-of-the-art basic science Geisinger Assurance Company, LTD (GAC) increase physician recruitment, expand and Medical Center, located in Plains Township infectious disease and general/cardiovascular laboratory facility on the GMC campus whose improve facilities and implement new information near Wilkes-Barre, PA (approximately 60 miles surgery. primary mission is to conduct original and A wholly owned for-profit subsidiary of the Foundation systems in Scranton and its surrounding north of Danville, PA), is an acute/tertiary innovative research focusing on laboratory domiciled in the Cayman Islands which provides Life Flight® communities. hospital and regional referral center serving the , an air ambulance medical service, research and research training and supporting reinsurance against liability arising out of System healthcare needs of northeastern Pennsylvania. provides Geisinger staff trained in advanced life the clinical staff in their research programs. Staff activities, including professional and general liability. A $20 million project to upgrade G-CMC’s GWV houses the only Level II trauma center support that supplements the trauma program and senior scientists, research scientists, and GAC provides all of the reinsurance for the System’s technology infrastructure, including integration in Luzerne County. The campus includes the and the neonatal intensive care unit (NICU). support personnel investigate a range of topics primary professional liability coverage. into Geisinger’s electronic health record system, Frank M. and Dorothea Henry Center, the During fiscal year 2013, Life Flight performed in cardiovascular biology, genomics, cancer and was completed in 2012. Richard and Marion Pearsall Heart Hospital, 2,352 flights resulting in 1,963 patients being developmental biology, with a focus mainly • Geisinger Woodbine Lane in Danville, Geisinger Medical Center (GMC), the Janet Weis Children’s Hospital Pediatric PA houses many outpatient services, Unit including the Tambur Neonatal Intensive Danville, PA, is the largest regional-referral, including same-day surgery, dermatology, tertiary/quaternary-care teaching hospital in the Care Unit, a transplant program, and the Brain and MOHS skin cancer surgery; and Spine Tumor Institute. region. Designated as a Magnet hospital, GMC an interventional pain center; and maintains the region’s only Level 1 Regional rehabilitation and sports medicine. • Geisinger South Wilkes-Barre (GSWB) Resource Trauma Center with additional • Geisinger-Shamokin Area Community is GWV’s ambulatory campus. Located qualifications in pediatrics. GMC offers an array of Hospital (G-SACH), Shamokin, PA, is in Wilkes-Barre, PA, GSWB offers a highly specialized services including neurosciences, a campus of Geisinger Medical Center. multispecialty same day surgery center, cardiovascular, transplantation, women’s health (in G-SACH provides a 55-bed medical/ pre-surgery center, a fully accredited the Women’s Pavilion), oncology and orthopaedics. surgical acute care unit serving the primary sleep disorders center, adult and pediatric and secondary needs of Northumberland Urgent Care Centers, and more. GSWB • The Janet Weis Children’s Hospital includes County and also includes a 24-hour also houses an unaffiliated non-profit 89 pediatric beds and offers more than emergency department, related diagnostic organization’s 10-bed hospice unit. 100 pediatric specialists in over 40 medical services, and outpatient surgeries. fields, including oncology, neurosurgery Additionally, a 15- bed short stay skilled neonatology, cardiology, and nursing unit is available for post-acute cardiovascular surgery. care needs.

40 41 Transforming Healthcare through Innovation 2013 System Report

Geisinger-Bloomsburg Health Care (G-SACH), a campus of Geisinger Medical Center, in HealthSouth/Geisinger Health System, Marworth Mountain View Care Center (MVCC) Center Shamokin, PA, and a separate outpatient ambulatory LLC (GHS HealthSouth) A 501(c)(3) not-for-profit corporation operating A 501(c)(3) not-for-profit corporation operating A 501(c)(3) not-for-profit corporation operating campus also in A limited liability company representing a a residential alcohol and chemical dependency a 180-bed long-term care, skilled nursing, and a 149-bed long-term care nursing home in Danville, PA. joint venture between GMC and HealthSouth treatment center in Waverly, PA, with an inpatient rehabilitation facility providing skilled nursing Bloomsburg, PA. Corporation to develop, manage, finance, and center and outpatient and family addiction care in Scranton, PA. Geisinger Medical Management operate a freestanding rehabilitation hospital on the treatment programs. Geisinger-Bloomsburg Hospital (G-BH) Corporation (GMMC) GMC campus and the development of a network to Northeast Surgery Center A 501(c)(3) not-for-profit corporation owning and GMMC is a wholly owned for-profit subsidiary provide outpatient rehabilitation centers and other Medical Dimensions, Inc. (MDI) A Pennsylvania limited liability company operating a 72-bed hospital in Bloomsburg, PA. of the Foundation. It is comprised of three main programs to the System’s patients. A 501(c)(2) not-for-profit corporation operating representing a joint venture between Geisinger- components, including (a) a portfolio of third party as a real estate holding company which holds title SCA Holdings, LLC and Dickson City Surgeons, Geisinger Clinic (Clinic) partnerships that are strategic to Geisinger and LifeSource Geisinger Blood to property. LLC, to operate an ambulatory surgery center organized under the Office of Strategic Industry Center, LLC A 501(c)(3) not-for-profit corporation operating located in Dickson City, PA. Partnerships & Negotiations (SPAN); (b) Geisinger- a multispecialty group medical practice providing A Pennsylvania non-profit limited liability Meridian Geisinger owned organizations, including MedMining, ISS, physician staff for patient care, education, and company, representing a joint venture between Health Network, LLC xG Health Solutions, Inc. Pine Barn, Caresite Specialty Pharmacy, and the clinical research, and CareSite pharmacies. GMC and the Institute for Transfusion Medicine A New Jersey limited liability company A Delaware corporation, representing a Careworks Management Services Organization; and (ITxM), a Pennsylvania not-for-profit corporation, representing a joint venture between GHP, GQO, collaboration between the Foundation and to fulfill their missions and to initiate and (c) an administrative services group that provides back Geisinger-Columbia Montour Home to engage in blood collection, manufacturing, and and Meridian Health System, Inc., to improve Oak Investment Partners, offering consulting, administer grant and philanthropic support office support services for various Geisinger programs. Health Services distribution services. healthcare analytics, and care management programs for all Geisinger entities. the quality and efficiency of healthcare through comprehensive population health management services to assist other healthcare provider and A 501(c)(3) not-for-profit corporation that Geisinger Quality activities in portions of New Jersey. insurer organizations become high-performing provides comprehensive home health services. Geisinger Health Plan (GHP) Options, Inc. (GQO) population health management systems by A 501(c)(4) not-for-profit health maintenance A wholly owned for-profit subsidiary of the Geisinger-Community Medical Center providing solutions based primarily upon organization operating health insurance Foundation providing indemnity health insurance. (G-CMC) Geisinger’s methods, experience, and innovations. product lines. A 501(c)(3) not-for-profit corporation owning Geisinger-SCA Holdings, LLC and operating a 297-bed acute care hospital in Geisinger Indemnity Insurance A Delaware limited liability company, representing Scranton, PA. Company (GIIC) a joint venture between G-CMC and SCA A wholly owned for-profit subsidiary of the Pennsylvania Holdings, LLC (a subsidiary of Surgical Geisinger Community Health Services Foundation providing indemnity health Care Affiliates, LLC), to develop, operate, and (GCHS) insurance. manage ambulatory surgery centers in central and A 501(c)(3) not-for-profit corporation designed northeastern Pennsylvania. to conduct charitable, scientific, and educational Geisinger Insurance Corporation, activities for the citizens of the communities Risk Retention Group (GIC–RRG) Geisinger System Services (GSS) served by the System including the operation of a A 501(c)(3) not-for-profit corporation domiciled A 501(c)(3) not-for-profit support service corporation Medicare-certified home health agency providing in the state of Vermont and registered by the providing financial services, human resources, healthcare services in a patient’s place of residence. Pennsylvania Insurance Department, providing information systems, internal audits, legal services, primary professional liability coverage for several strategic planning, marketing and public relations, Geisinger Health System Foundation System entities, including GMC, Clinic, GWV, and facilities services. (Foundation) G-CMC, G-BH and GCHS. A 501(c)(3) not-for-profit corporation that Geisinger Wyoming Valley Medical Center serves as corporate parent which coordinates Geisinger Medical Center (GMC) (GWV) and supervises the activities of all of the System’s A 501(c)(3) not-for-profit corporation owning A 501(c)(3) not-for-profit corporation owning and affiliated entities. The Foundation is not a licensed and operating a regional referral tertiary/ operating an acute/tertiary care, open-staff community healthcare provider, nor does it provide healthcare quaternary care medical center in Danville, PA, hospital near Wilkes-Barre, PA and an ambulatory services to patients. It serves to ensure the System’s Geisinger Shamokin Area Community Hospital campus located in south Wilkes-Barre, PA. affiliated entities have adequate financial resources

42 43 Transforming Healthcare through Innovation 2013 System Report

Designated Affiliates Accreditations and Awards

The following list sets forth the Designated Affiliates and the cities in One important indicator of quality is whether which their principal facilities or primary operations are located. a hospital and its staff are recognized by independent organizations devoted to measuring • Geisinger Health System Foundation, Danville, PA healthcare quality. Listed below are some of • Bloomsburg Physicians Services d/b/a Geisinger-Bloomsburg the honors, accreditations, and awards given to Physicians Services, Bloomsburg, PA • Columbia Montour Home Health Services/Visiting Nurses Geisinger in 2012–2013. Association, Inc. d/b/a Geisinger-Columbia Montour Home Thomson Reuters 15 Top Health Systems Health Services/Visiting Nurses Association, Inc., Bloomsburg, PA study ranks Geisinger Health System as one of • Community Medical Care, Inc., Scranton, PA • Community Medical Center d/b/a Geisinger-Community the top 15 health systems in the United States. Medical Center, Scranton, PA Geisinger Health System has been listed among • Community Medical Center Healthcare System, Scranton, PA the country’s “100 Most Wired Hospitals and • Geisinger Assurance Company, Ltd , George Town, Grand Health Systems” Cayman, BWI for the 11th time. • Geisinger-Bloomsburg Health Care Center, Bloomsburg, PA Geisinger Health System’s Genomic Medicine • Geisinger-Bloomsburg Hospital, Bloomsburg, PA Institute received Bio-IT World’s grand prize in • Geisinger Clinic, Danville, PA • Geisinger Community Health Services, Danville, PA its Best Practices Awards, 2013. • Geisinger Health Plan, Danville, PA The National Business Group on Health • Geisinger Indemnity Insurance Company, Danville, PA awarded Geisinger Health System its 2013 Gold • Geisinger Insurance Corporation, Risk Retention Group, Award Burlington, VT for ongoing commitment and dedication • Geisinger Medical Center, Danville, PA to promoting a healthy workplace. • Geisinger Medical Management Corporation, Danville, PA Sixty-three Geisinger Health System physicians Geisinger Medical Center was named to Becker’s Geisinger Medical Center earned the • Geisinger System Services, Danville, PA Hospital Review’s 2013 lists of “100 Great U.S. Environmental Protection Agency’s • Geisinger Quality Options, Inc., Danville, PA in 19 specialties were named to the national Hospitals” and “100 Hospitals with Great ENERGY STAR certification for 2013, • Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA Best Doctors list for 2012-2013. Neurosurgery and Spine Programs.” • HealthSouth/Geisinger Health System, LLC, Danville, PA for superior energy performance. Geisinger Health System was named to the • Marworth, Waverly, PA “100 Columbia Montour Home Health Services was Geisinger Medical Center and Geisinger • Medical Dimensions, Inc., Scranton, PA named to the Becker’s Hospital Review named to the Top 500 of the 2012 HomeCare Wyoming Valley Medical Center, • Mountain View Nursing Home, Inc. d/b/a Mountain View Care Great Places to Work in Healthcare” list Elite, a compilation of the top-performing home Center, Scranton, PA for 2012. accredited as American Heart Association health agencies in the United States. Mission: Lifeline ST-elevation myocardial Geisinger Health Plan and Geisinger Gold were infarction (STEMI) receiving centers. named the top-ranked Private and Medicare Geisinger Medical Center and Geisinger Health Plans in Pennsylvania by the National Wyoming Valley Medical Center were awarded Geisinger Medical Center received Committee for Quality Assurance annual Health the National Research Corporation Consumer the 2012 Thomson Reuters 100 Top Insurance Plan Rankings, and 12th and 6th Choice Award for 2012-2013. Hospitals®: National Benchmarks Award respectively in the nation. for overall organizational performance. Geisinger-Community Medical Center received Geisinger Medical Center earned Magnet the 2013 American College of Cardiology Geisinger Wyoming Valley Medical Center Redesignation from the American Nurses Foundation’s ACTION Registry-Get With received the 2013 Silver Medal of Honor Credentiaing Center. Magnet hospitals are the Guidelines Platinum Performance from the U.S. Department of Health distinguished as organizations where nurses Achievement Award. and Human Services in recognition of deliver excellent patient care and have a high outstanding care of organ donors and Geisinger Medical Center’s environmental level of job satisfaction. offering comprehensive transplant services. services team earned the Association for the Geisinger Medical Center was listed as one of Healthcare Environment of the American AARP Magazine’s “Top Hospitals for Safety” Hospital Association’s Environmental Services for 2013. Department of the Year Award for 2013. 44 45 Transforming Healthcare through Innovation 2013 System Report

Leadership Recruitments and Promotions FY13

Physician Leadership Recruitments James Handlan Thomas Graf, MD Vice President, Business Development, Associate Chief Medical Officer, Population Mark Bernardi, DO Government Programs, GHP Health Director, Cardiac Catheterization Lab, NE John Kiernan-Lewis, PhD Maria Kobylinski, MD Christine Chew, PhD Director, Research Project Management: Chairman Community Practice Service Line Director, Psych Residency Program Special Initiatives John Kravitz, MHA Kishore Harjai, MD Kevin Lanciotti Associate Chief Information Officer Director, Structural Heart Disease Chief Finance Officer, GMC Daniel Lohr, JD Ben Hohmuth, MD Christa Martin, PhD Vice President, Legal Services Director, Hospitalist Program, GMC Director, Autism& Developmental Medicine Institute Gregory J. Moore, MD, PhD N. Sertac Kip, MD Chief Emerging Technology and Informatics Director, Molecular Pathology Keith McRee Officer Director, Institute for Advanced Chief Compliance Officer, GHP Application John Mitchell, MD Director, Trauma Surgery Andrew Michael, PhD Stephen Paolucci, MD Director, Neuro-imaging Analytics Laboratory, Chief Medical Officer, Geisinger-Bloomsburg Michael Murray, MD Autism & Developmental Medicine Institute Hospital Director, Genomics Kathy Scullin Kerri Potsko, RN, BSN James Wade, MD Chief Communications Officer Vice President, Operations, Women’s Health Chair, Cancer Service Line Stephen Sellers, MAT, MA Denise Prince, MBA, MPH Robert J. Weil, MD Director, Research Project Management Vice President, Value Base Core Chief Medical Executive, Geisinger Northeast Vice President, Population Health Associate Chief Science Officer, Geisinger Health System Physician and Administrative Raymond Roth, DO, MBA Leadership Promotions Chief Medical Officer, GIO

Administrative Leadership Lori Biacchi Charles Sawyer, MD Recruitments Chief Compliance Officer, GHS Chief Health Information Officer

Michael Berger Frederick Bloom, MD Vice President, CDIS Analytics Thomas Shawyer Chief, Care Continuum Vice President, Labor & Employee Relations

David Brady Keith Boell, MD Vice President, Healthcare Reform, GHP Deborah Peitretich Templeton, R.Ph, MHA Medical Director, Medical Operations, GHP Chief, Care Support Services

Daniel Davis, PhD Lyn Boocock-Taylor Director, Bioethics Chief Advancement Officer

46 47 Transforming Healthcare through Innovation 2013 System Report

FY12 FY13 Geisinger earned: (in millions) (in millions) Customer premiums, services to patients, and general services $7,519.4 $8,744.3

Geisinger did not receive full payments from: Medicare and medical assistance 2,999.0 3,420.5 Charity to patients 106.2 139.1 Bad debt 42.5 59.1 Other patients receiving services under contractual Geisinger ended fiscal year (FY) 2013 arrangements or due to administrative allowances 1,452.7 1,770.5 (July 1, 2012 through June 30, 2013) with an operating income, excluding Total amount received 2,919.0 3,355.1 interest expense, of $163.3 million, a Financial Summary 4.9% return on revenue of $3.4 billion. Geisinger spent: The economic benefit to Pennsylvania Salaries and benefits 1,222.1 1,420.9 (from direct spending and an indirect Contracted services 891.4 1,055.9 ripple effect of spending) totaled Supplies, utilities, and other expenses 525.5 602.8 approximately $6.1 billion, as reported by The Hospital and Health System Depreciation 99.3 112.2 Association of Pennsylvania. Even with Total costs for patient treatment and reimbursement shortfalls, economic rendering care to beneficiaries 2,738.3 3,191.8 challenges, and the uncertainty of healthcare reform, Geisinger provided $336.6 million (approximately Operating income 180.7 163.3 14.9% of operating expenses) in Interest on debt, earnings on investments, and community benefits, including non-operating gains (losses) 19.0 138.6 uncompensated care and care Excess of revenue and gains over expenses and losses 199.7 301.9 provided under government programs at less than cost. Revenue grew by 14.9% over FY12, once again an Operating margin 6.2% 4.9% incredible achievement in the current Total assets 3,532.6 3,913.3 environment and the highly regulated, Total liabilities 1,829.0 1,869.6 competitive healthcare industry. In addition, Geisinger invested $182.6 Accumulation of net worth from prior earnings 1,703.6 2,043.7 million in capital projects.

48 49 Transforming Healthcare through Innovation 2013 System Report

Geisinger Health System is one of the nation’s leading fully integrated health service organizations. Founded in 1915, Geisinger serves more than 2.6 million residents throughout central and northeastern Pennsylvania. Unless otherwise noted, statistics are for fiscal year 2013 (July 1, 2012 through June 30, 2013).

Geisinger includes Life Flight® Primary care sites:...... 44 Air ambulances:...... 6 Specialty care sites:...... 34 Locations:...... Geisinger Medical Center, Danville; Service area:...... 2.6 million residents in 44 counties Wilkes-Barre Scranton International Airport, Avoca; University Park Airport, State College; Williamsport Regional Employees (systemwide, as of June 30, 2013)...... 19,504 Airport, Williamsport; and Good Will Fire Department, Minersville Clinical staff(included in total employee head count) Trips:...... 2,352 total flights Physicians:...... 1,055 (as of June 30, 2013) Residents/fellows:...... 385 Average occupancy rate (based on staffed beds)...... 74.9%

Nurses (included in total employee head count) Emergency department visits...... 158,824 System Statistics Registered nurses:...... 3,485 Geisinger Medical Center:...... 49,486 Licensed practical nurses:...... 850 Geisinger Wyoming Valley:...... 60,449 Geisinger-Community Medical Center:...... 36,213 Licensed inpatient beds*...... 1,417 Geisinger-Bloomsburg Hospital:...... 12,676 (also, 344 skilled nursing facility beds and 91 chemical dependency beds) Surgery cases (inpatient and outpatient)...... 46,708 Geisinger Medical Center:...... 560 beds Geisinger Medical Center:...... 26,247 (includes 55 inpatient beds and 15 skilled nursing beds at Geisinger Wyoming Valley Medical Center:...... 8,999 G-SACH, 60 at the Hospital for Advanced Medicine, and Geisinger-Community Medical Center:...... 6,997 89 [41 NICU] at the Janet Weis Children’s Hospital) Geisinger Bloomsburg Hospital:...... 4,465 Geisinger Wyoming Valley Medical Center:...... 274 beds Geisinger-Community Medical Center:...... 297 beds Outpatient visits (includes emergency room visits)...... 1,751,962 Geisinger-Bloomsburg Hospital:...... 72 beds Geisinger Medical Center:...... 948,862 52 acute care beds, 20 psych beds) Geisinger Wyoming Valley Medical Center:...... 672,521 Geisinger-Lewistown:...... 123 Geisinger-Community Medical Center:...... 96,955 Marworth:...... 91 beds Geisinger Bloomsburg Hospital:...... 33,624

*Licensed beds exclude nursery and rehabilitation beds and include Total deliveries...... 3,593 neonatal intensive care beds. Geisinger Medical Center:...... 1,864 Finances Geisinger Wyoming Valley Medical Center:...... 1,588 Geisinger Bloomsburg Hospital:...... 141* Revenue:...... $3.4 billion Current capital investments:...... $182.6 million *births from September to July, FY 2013

Admissions...... 56,197 Average length of stay (days)...... 4.9 Geisinger Medical Center:...... 27,717 Geisinger Health Plan membership Geisinger Wyoming Valley:...... 14,565 ....429,135 (June 30, 2013) Geisinger-Bloomsburg:...... 2,137 Commercial:...... 187,952 Geisinger-Community Medical Center:...... 11,778 TPA:...... 48,495 CHIP:...... 9,364 Medicaid:...... 115,619 Medicare:...... 67,705 50 51 Transforming Healthcare through Innovation 2013 System Report

Geisinger Health System Advisory Councils 2013

Geisinger Medical Center

Don Rosini (Chair) Nancy Rizzo (Vice-Chair) Kendra Aucker Ron Beer Stephen Benkovic, PhD Darla Bortz Albert Bothe Jr., MD James Brucker, PhD Lissa Bryan-Smith Duane Davis, MD Lisa Davis Geisinger Health System Geisinger Health Plan Andrew Deubler Foundation Board of Board of Directors Georgeann Eckstine Boards and Councils Directors (December 2013) (December 2013) Karl Girton John Gordner Richard A. Grafmyre, CFP® Heather Acker* Glenn D. Steele Jr., MD, PhD (Chair) Roger S. Haddon Jr. William H. Alexander (Chair, June ‘11) Heather Acker* Susan Hallick, RN, BSN Dorrance R. Belin, Esq.** William H. Alexander* Thomas Harlow John C. Bravman, PhD Alfred Casale, MD Chris Holcombe, PE Karen Davis, PhD Karen Davis, PhD* Corinne Klose, RN E. Allen Deaver Duane Davis, MD (ex-officio) Cheryl Latorre William J. Flood** Earl Foura David Ledbetter, PhD Richard A. Grafmyre Richard A. Grafmyre* Jay L. Lemons, PhD William R. Gruver R. Brooks Gronlund Teri MacBride Frank M. Henry Chris Holcombe, P.E. Susan Mathias Jeff Jacobson Jonathan P. Hosey, MD Susan W. McDowell Thomas H. Lee Jr., MD Thomas H. Lee Jr., MD* Frank Menapace Jr., MD Virginia McGregor Joseph J. Mowad, MD Lynn Miller Joel S. Mindel, MD, PhD** Don A. Rosini* Lee Myers Robert E. Poole Christopher B. Sullivan* Ruth Nolan Richard A. Rose Jr. Frank J. Trembulak Michael O’Keefe Don A. Rosini Stephen Paolucci, MD Gary A. Sojka, PhD** *also serve on Geisinger Health System Gayle Pollock William E. Sordoni* Foundation Board Charles M. Ross Glenn D. Steele Jr., MD, PhD (ex-officio) Kathy Scullin Christopher B. Sullivan* Graham Showalter, Esq. Robert L. Tambur Gary Sojka, PhD Gail R. Wilensky, PhD Thomas Sokola *appointed December 2013 David L. Soltz, PhD **emeritus Robert Spahr, MD

(Continued on page 54) 52 53 Transforming Healthcare through Innovation 2013 System Report

(Continued from page 53) The Centennial Campaign: Redefining Boundaries Glenn D. Steele Jr., MD, PhD Richard L. Pearsall Jeffrey A. Jacobson Christopher Sullivan Eugene Roth, Esq. Deborah A. Kolsovsky Geisinger’s legacy began with one woman’s Frank Trembulak Father Jack Ryan Eric R. Linde vision to: “Make my hospital right. Make it the Joanne Wade Conrad Schintz Bill Lynett best.” Today, nearly a century later, generations H.W. Wieder Jr. Kathy Scullin Anthony Manzione of healthcare professionals have dedicated Kenneth Wood, DO Glenn D. Steele Jr., MD, PhD Virginia D. McGregor themselves to achieving Mrs. Geisinger’s dream. Larry D. Stetler Mary Ellen Monacelli Geisinger Wyoming Valley Robert S. Tamburro Stephen F. O’Brien Medical Center Now Geisinger is preparing to celebrate its Frank Trembulak Debra A. Pellegrino 100th anniversary in September 2015 with the Eugene Roth, Esq. (Chair) Joanne Wade Maria J. Russoniello completion of a $150 million Centennial Campaign. Tom Bielecki Robert Weil, MD Pat Sheridan The campaign’s call to action is bold: invest Lyn Boocock-Taylor John Wiercinski J. Harvey Sproul Jr. in redefining patient care through innovation, Larry D. Stetler Albert Bothe, MD Geisinger-Community Medical Center research, education, and healthcare environments Kevin Brennan Thomas P. Tulaney for the 21st century. Lissa Bryan-Smith David W. Hawk (Chair) Kevin M. Wilson We invite you to invest in research and discovery James Brucker Heather M. Acker to enable the acceleration of the understanding John Buckley Dorrance R. Belin 2013 External Scientific of chronic and life-threatening diseases. Invest in Alfred Casale, MD Ellen Q. Bush Advisory Board Geisinger’s commitment to education so we can Cheryl Connolly Scott A. Byers continue to disseminate Geisinger quality and value Charles M. Davis, MD Lewis J. Critelli Huntington F. Willard, PhD (Chair) by teaching and training tomorrow’s healthcare Duane Davis, MD Charles M. Davis Atul Butte, MD, PhD professionals. Invest in the Geisinger family Dominick DeNaples Dominick DeNaples Nancy Cox, PhD through a robust, lifelong learning program. Invest Andrew Deubler Laura J. Ducceschi Abel N. Kho, MD, MS, FACP (AD HOC) in creating sustainable environments that foster Eberhard L. Faber Jeanne Genzlinger Philip Reilly, MD, JD patient engagement, partnerships, and innovation. William J. Flood Melinda C. Ghilardi Alan R. Shuldiner, MD Robert Friedman Roland Greco The vision that Mrs. Geisinger articulated is at the Tom Gibbon core of Geisinger’s success. Through philanthropic Patricia H. Graham support, Geisinger will help positively impact the Christopher Hackett lives of millions of people and help mold healthcare Susan Hallick, RN, BSN in the Commonwealth of Pennsylvania and across Marge Hennelly-Bergin the United States for years to come. Scott E. Henry Michael J. Hirthler David Jolley Patrick Judge David Ledbetter, PhD Melanie Maslow Lumia Peter Mailloux Catherine McGroarty, RSM William F. Medico Lynn Miller Marilyn D. Millington Juanita Namey Lori Nocito Steven B. Pierdon, MD Nancy Rizzo

54 55 “Make my hospital right. Make it the best.” – Abigail Geisinger, 1915

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