Surrounding You with Care

Surrounding you with care

Annual Report 2014 Surrounding you with care

2 What’s inside

A letter from the Chief Executive 4-5 Officer / Circle Health Leadership

Pelham resident finds healing 6-7 at home is the best medicine

Giving teens a voice in 8-9 improving their communities

How physicians are working together 10-11 to connect patients to care resources

Our community of physicians 12-15

Patients’ experience and safety are top 16-17 priorities for Patient Family Advisory Council

Lowell General Hospital and Tufts 18-19 Medical Center join to form Wellforce

Bringing preventive, primary 20-21 and specialty care to Westford

Circle Health at a glance 22-23

Patient and healthcare provider photos by Kaskons Photography.

3 A letter from the Chief Executive O cer

I am pleased to present the Annual Report for Circle Health. As I re ect back on 2014, it is quite clear that last year represented a signi cant milestone for Circle Health and a time when the mission, vision and values are more important than ever. We saw a tremendous amount of collaboration and engagement throughout our physician community and Circle Health’s member and a liated organizations. While there has always been strong teamwork among these groups, this commitment was strengthened as we worked together to truly surround our community with care and improve the health and well-being of the individuals and families we serve.

In 2013, we established strategic imperatives for Circle Health that provide the foundation for us to deliver on our promise to provide Complete connected careSM to our community. is annual report shows how these strategic imperatives – Continuum of Care, Population Health, Physician Alignment, Value and Scale – came to life in 2014. You will see how Circle Health is shaping and improving the care experience – from a patient who was able to recover at home following hip surgery, thanks to close coordination between Lowell General Hospital and Circle Home, to teens who are receiving substance use education and prevention support at Lowell Community Health Center’s Teen BLOCK program. You will read how the leadership of the hospital’s Patient Family Advisory Council helps ensure patients and families receive the highest quality and safest care possible. In addition, we highlight how members of our physician community are working together to not only ensure that patients with chronic illnesses are receiving the attentive care and resources they need, but how healthcare professionals are keenly focused on keeping members of our community well through coordinated screening, prevention and educational activities.

ese impressive outcomes would not be possible without the commitment and support of every member of our team. I would like to thank our board members and executive teams, leaders and employees of Circle Home, Lowell Community Health Center and Lowell General Hospital, as well as the hundreds of physicians and healthcare professionals throughout our community for their incredible work last year. Working together, we are making a di erence in the lives of so many. is engagement is apparent throughout every facet of our strategic planning process, our daily operations and our direct care and services. We are also helping ensure that our Circle Health member and a liate organizations are strongly positioned for success, and that patients and families continue to entrust us with their healthcare needs.

is success has allowed us to continue to grow, and to take ambitious steps forward as we work to meet our community’s needs. is was especially apparent when we formed Wellforce with Tufts Medical Center in late 2014. We were so fortunate to have strong participation and feedback during the due diligence process as we crafted and solidi ed the agreement and ultimately announced the new organization. anks to your engagement and support, Wellforce is poised to dramatically transform healthcare in Massachusetts.

ank you for all you do to support individuals and families in the Merrimack Valley. Together, we are truly surrounding those we serve with the best care possible.

In good health,

Norm Deschene Chief Executive O cer of Circle Health and Lowell General Hospital

4 “ Last year represented a signiﬁ cant milestone for Circle Health. The tremendous amount of collaboration and engagement throughout our physician community and Circle Health’s member and afﬁ liated organizations allowed us to work together to truly surround our community with care and improve the health and well-being of the individuals and families we serve.”

Norm Deschene, Chief Executive Ofﬁ cer of Circle Health and Lowell General Hospital

Circle Health Leadership

Officers Trustee Emeritus Board of Governors Senior Leaders Chairman Clementine F. Alexis Arthur C. Anton, Jr. Normand Deschene Rick W. Hanson Arthur C. Anton, Sr. Richard E. Bolton, Jr. President and CEO, Circle Health; Vice Chairman Michael Athanasoulas, DDS John P. Chemaly CEO, Lowell General Hospital Daniel J. Mansur Robert J. Audet Mark S. Cochran Joseph White Edith W. Burger Carole A. Cowan, Ed.D. President / CEO President, Lowell General Hospital William J. Collins* Shamim A. Dahod, MD Normand E. Deschene Amy Hoey Robert A. Donovan Michael P. Dubuque Executive Vice President and Treasurer / CFO George L. Duncan Gopala K. Dwarakanath, MD Susan Green COO, Circle Health and Lowell Abdul Ghaffar, MD Karen Fortune, MD General Hospital Clerk Terry T. Howard, MD William Galvin, III, MD Raymond Anstiss, Jr. John C. Hughes, MD Mark G. Gilchrist, MD Susan Green Executive Vice President and Chief Charlotte LaPierre Eric P. Hanson Financial Offi cer, Circle Health and Circle Health Board F. Bailey Laughlin, Jr. Rick D. Hess Lowell General Hospital Raymond Anstiss, Jr. Jean R. McCaffery James B. Hogan Geraldine Vaughan Gary Campbell Lincoln N. Pinsky, MD Nancy Donahue Joncas Senior Vice President of Network John Carson Kendall M. Wallace George B. Leahey Integration, Circle Health; Jack Clancy Stuart G. Weisfeldt, MD Robert H. Leighton, Jr. Executive Director, Lowell General Normand E. Deschene Shortie McKinney Physician Hospital Organization Rick W. Hanson Martin T. Meehan Daniel J. Mansur * It is with sadness that we Carrie Meikle Sabrina Granville Jacqueline Moloney observe the passing of the James L. Milinazzo Senior Vice President and Chief Kimberly Oberhauser noted trustee in July 2014. Steven Normandin Human Resources Offi cer, Jack O’Connor Nels A. Palm Lowell General Hospital Margaret A. Palm Susan Pasanen Michelle Davis Tushar Patel, MD Ginger B. Pearson Vice President, External Affairs, Bruce Robinson John H. Pearson, Jr. Lowell General Hospital David C. Pickul, MD Andrew Treinis Cecelia Lynch David Wallace Kathleen M. Plath Vice President, Patient Care Gregory Wertheimer Naomi M. Prendergast Services and Chief Nurse Michael S. Reilly Executive, Lowell General Hospital Peter D. Roman, MD James C. Shannon, III David Pickul, MD Chief Medical Offi cer, Neelam Sihag, MD Circle Health Brian J. Stafford John C. Thibault Brian Sandager Drew Weber Chief Information Offi cer, Amy B. Werner Lowell General Hospital William Wyman Vice President, Revenue Services, Lowell General Hospital Dorcas Grigg-Saito CEO, Lowell Community Health Center Rachel Chaddock Executive Director, Circle Home, Inc.

5 Pelham resident finds healing at home is the best medicine

Circle Health Continuum of Care Imperative Develop coordinated, comprehensive and integrated programs of patient-centered care in partnership with physicians and other providers to provide patients with convenient access to the entire continuum of care. For so long, healthcare has operated in silos with each hospital and provider piece happening separately. Now, we are working to bridge those gaps and live by our promise that every patient’s care is seamless and well-coordinated. We are leveraging technology to help make those connections, and help providers across the continuum quickly access the information they need to provide the best care to their patients.

When Charlie Spanos, 80, underwent successful hip replacement surgery at Lowell General Hospital, he was able to recuperate at his Pelham, NH home – thanks to the close collaboration between his surgeon and the nurses and therapists at Circle Home.

“I was able to come right home after my This was his second hip replacement “After my care ended, I sent a letter to hospital stay,” Mr. Spanos relates. “My surgery; he’d also utilized home care Circle Home to commend her, she was so surgeon (David Prybyla, MD) told me services after his first procedure, about wonderful,” he adds. I’d get the same care as in a rehabilitation two years ago. facility.” His primary care physician, Paul Mr. Spanos’ daughter Charlene Morrissey, Harcourt, MD, agreed. “They’ve been very good to me and I’ve who lives near her father in New Hampshire, been very happy with them,” he relates. “I also used home care services when she This commitment to providing the right enjoyed their company, they’re very friendly underwent a knee replacement last September, care in the right setting at the right time and helpful, and I liked talking with them and she gives them equally high marks. is a vital component of Circle Health’s while they were here.” Continuum of Care Imperative. “I had a nurse and a physical therapist In fact, Mr. Spanos’ recovery went so well who came to the house, and they were just In Mr. Spanos’ case, care from Circle Home that he didn’t need home care services for marvelous,” she says. “I’d gone to a rehab included daily visits from a registered nurse, as long as originally expected. facility two weeks before I came home, and a physical therapist and an occupational felt they did nothing for me. I just wanted therapist for about two weeks — all for He also applauds his caregivers’ dedication. to come home, and that’s when Circle considerably less cost than an inpatient stay Home got involved. Both my father and “My occupational therapist came to my at a skilled nursing/rehabilitation facility. I appreciate what they have to offer.” house in a blizzard,” he says. “It was snowing But for Mr. Spanos, it meant he could regain so hard that a lot of places were closed. She When we spoke to Mr. Spanos, he had his strength and mobility in the comfortable called me and said ‘I’m on the road, so do just returned from a trip to visit another and familiar setting of his own home. you mind if I still come to see you?’ daughter in Texas. That he was able to travel is one measure of how he’s been “I told her that as much as I’d like to see “Someone came to my house first to check able to resume the activities that give him her, it’s so bad out, and I’m doing fine,” that everything was set up okay, and that I pleasure, thanks to his successful healing he continues. “But she insisted, saying ‘I could get in and out of bed, stand up, walk, and recovery at home following surgery. et cetera,” Mr. Spanos says. “I did physical want to take care of my patients.’ She was and occupational therapy every day, and so conscientious. “It makes a big world of difference,” he says. I still do the exercises they gave me.”

6 7 Giving teens a voice in improving their communities

Circle Health Population Health Imperative Improve the health status of the populations we serve through community outreach and education, disease management, wellness programs and the engagement and empowerment of all Circle Health patients.

Navigating the teen years has its challenges, especially for teens themselves. The Lowell Community Health Center’s Teen BLOCK Programs take a “youth as assets” approach to help them meet these challenges, carving out meaningful community involvement opportunities for thousands of Lowell youth, helping to give them a voice in addressing important issues. This engagement and sense of ownership of community needs is a vital piece of the Circle Health Population Health Imperative.

Channou Aing, 17, is one such teen. Now abuse among youth and adults within the “We’re getting the message in their faces a senior at Lowell High School, she got City of Lowell and surrounding communities. that there are consequences for buying involved with the Teen BLOCK Programs alcohol for minors,” Ms. Sou says. in her junior year. Ms. Sou serves as one of three co-chairs of the SUP Task Force’s Environmental Strategies “One of our big accomplishments was “I always wanted to give back to my Working Group (ESWG). Its goal is to advocating to the Board of Health to community, to make a difference, but inform and educate youth and adults on mandate minimum packaging and pricing I didn’t know where to start,” she says. how substance use is affecting the region’s of tobacco to help ensure that youth under “Then I found out about Teen BLOCK.” neighborhoods — and launch initiatives 18 aren’t getting access,” she points out. to reduce and prevent the problem. “We offer a positive and empowering Miss Aing has become what’s called a peer space for teens to become involved in their For example, the ESWG has a team of leader within the Teen BLOCK Programs. community and make changes around the young people who perform physical scans She’s actively engaged in the SUP Task issues that affect them,” explains Linda of certain neighborhoods. “If they see an Force work and a dance program, and Sopheap Sou, MHS, director of the Teen abandoned building next to a run-down she’s a major recruiter of her peers. BLOCK Youth Programs, referring to such park that’s not well lit, that can present issues as teen pregnancy, sexually transmitted an opportunity for using that space in a “I’ve been shy all my life,” Miss Aing infections, substance use and violence. negative way,” Ms. Sou explains. “So the admits, “but getting involved has helped youth would advocate along with the task me break out of my shyness, and make “We support them as individuals, but also force to local government about figuring out connections and friendships. It’s helped get them involved in groups, which helps a different use for the building and getting make me who I am today — a young build their skills, enhance their confidence, better lighting, so people aren’t tempted to person who can have a voice. and they find value by giving back to their use it for a drinking or drugging hangout.” community,” Ms. Sou adds. “I tell my peers that they really should get The Sticker Shock campaign is another involved,” she adds. “I say ‘Hey, you’re a One of these groups is the Substance Use and ESWG effort to make changes to the young adult and Teen BLOCK will help Prevention (SUP) Task Force of the Greater physical environment. Working with local you become a leader. All of us should try Lowell Health Alliance (GLHA), which vendors, group members are getting stickers to be leaders in life. And as youth, we do works to help reduce and prevent substance placed on cases and six-packs of beer, have a voice.’” warning consumers not to buy it for minors.

8 9 How physicians are working together to connect patients to care resources

10 Circle Health Physician Alignment Imperative Align, engage and integrate with all Circle Health physicians and allied health professionals to provide our patients with Complete connected care.

Strong physician collaboration improves care and health of area residents

Physicians’ dedication to taking care of they care about us like we are their family.” Our physicians are also continuing to their patients and improving their health Being able to get this care close to home develop strategies to best coordinate care and well-being are certainly not novel made a big difference for the family’s seven- and services, especially for those who are at concepts. But at Circle Health, we are year-old daughter who was often upset when highest risk for readmission to the hospital. tapping into this dedication and fostering her parents needed to make the trip to Boston. A key focus for the innovation council collaboration among physicians and allied groups has been around the transitions health professionals in ways that have the “In 2014, we saw great commitment from of care for patients along each step of potential to dramatically change not only physicians to collaborate and make their care experience, according to Amy how patients receive care, but also directly connections with other doctors and Hoey, Executive Vice President and Chief improve the health of our community. healthcare professionals as well as community Operating Officer for Circle Health and agencies who care for patients across each Lowell General Hospital. “As we looked This collaboration builds on Lowell General point of the care experience,” says Dr. David at our patient data, it was clear that those Hospital’s strong history of partnership Pickul, Chief Medical Officer for Circle with congestive heart failure and chronic between community-based physicians and Health and an internal medicine physician obstructive pulmonary disease were at specialists from Boston’s most respected with Mill City Medical Group in Lowell. highest risk for readmission to the hospital teaching hospitals. Partnership and “Whether the patient is receiving care in following an inpatient stay,” says Ms. Hoey. coordination made all of the difference for a primary care office, a local health center, “We have since created a registry of these a Tewksbury family who recently welcomed our community hospital, or at an academic patients and are focused on staying in close triplet girls. According to the triplets’ mom medical center in Boston, this strong touch with them, making sure they are Ally, she was referred to specialists at Floating collaboration has allowed us to gain a more receiving the best possible education before Hospital for Children at Tufts Medical diverse and comprehensive perspective. and after their discharge from the hospital, Center by obstetricians at Lowell General We now better understand where we have and helping schedule a follow-up visit with Hospital WomanHealth in Chelmsford once gaps in care or services, so we can focus our their primary care physician before they leave it was confirmed she was carrying triplets. efforts on those activities that will have the the hospital.” This follow-up appointment The babies were later born at Floating biggest impact on our community’s health with their provider is vital to a patient’s Hospital for Children at Tufts Medical and complete experience.” successful transition home and has proven to Center, and were cared for in the neonatal significantly reduce the likelihood a patient’s Through this collaboration and the work intensive care unit for five days until they condition will require a repeat hospitalization. were healthy enough to be transferred to of Circle Health’s innovation council teams, Lowell General Hospital for the remainder it quickly became clear that managing “This has truly been a collaborative and of their care. “We had a pediatrician at medications is extremely difficult, especially coordinated effort,” Dr. Pickul says. “Thanks Lowell General from Tufts who we checked for those high risk patients who have to this continued focus on alignment, our in with nearly every other day about the girls’ several chronic illnesses and are prescribed community physicians, the hospital, home progress,” said Ally. “The care was exactly medications by multiple specialists. The care, skilled nursing facilities, and all the same as we were getting at Tufts.” teams are now working to establish a ancillary services have become even more consistent approach for all physician committed to offering the highest value Ally also credits the close coordination practices to use in tracking their patients’ care possible, while also improving our locally with making any needed follow-up medications, reducing the potential for patients’ experience. We are confident that care much easier for her and her family. errors and ensuring patients are taking this collaboration will have a direct positive “When I go to see a specialist, we are not medications appropriately. impact on our community’s health, both in just a number, we are an actual patient. And the short term and in the years to come.”

11 Our community of physicians

Allergy and Critical Care Medicine Meaghan Nitka, MD Ariadne R. Mueller, MD Jonathan H. Oppenheim, MD Dan S. Nguyen, MD Marianne Barry, MD Immunology Wayne E. Pasanen, MD Kwesi A. Ntiforo, MD Rohit Budhiraja, MD Angela Ahuja, MD Marc N. Roy, MD Austin J. O’Brien, MD Haval Chweich, MD Priyal Amin, DO Brian P. Sanders, MD Frank E. Osborn, MD Ramesh Donepudi, MD Leonard W. Kaplan, MD David L. Sciacca, MD Sangita Pillai, MD Sebastian G. Kurz, MD Li Liang, MD, PhD Jansen Tiongson, MD Katherine A. Powers, MD Prerna Mota, MD Ami Mehra, MD Katja Von Tiesenhausen, MD Melinda G. Raboin, MD Julian Melamed, MD Diana Voskoboynik, MD John Ragucci, MD Curtis T. Moody, MD Dermatology Derek D. Wayman, MD Janis Samantha Tan Recto, MD Sara E. Narayan, MD Stuart J. Arbesfeld, MD Rothsovann Yong, MD Yahaida Rimola-Dejesus, DO Martin G. Ostro, MD Elizabeth C. Foley, MD Shorta Yuasa, MD Eric W. Romanowsky, MD Frank J. Twarog, MD Steven A. Franks, MD Mark B. Romanowsky, MD David Erik Geist, MD Endocrinology Tricia Scott, MD Samuel David Goos, MD Chong Sok So, DO Anesthesiology Saud Alzahrani, MD Christine M. Hayes, MD Ann Spires, MD Marcia J. Bergen, DO Miguel A. Ariza, MD Abby L. Hochberg, MD Eugenia E. Szekely, MD Vijayasimham Channamsetty, MD Rajaa H. Nahra, MD Kathleen M. Joyce, MD Stuart A. Dunbar, MD Hayward K. Zwerling, MD Seth G. Kates, MD Fouad S. Fam, MD Gastroenterology Khalilullah A. Khatri, MD Joseph P. Grajo, DO Geetanjali Akerkar, MD Katalin Kovalszki, MD Rizwan U. Haque, MD Family Medicine Doree T. Barton, MD* Michael S. Krathen, MD Shamee P. Mane, MD Lourdes Rucela Ada, MD Daniel F. Beluk, MD Jeffrey D. Mailhot, MD Vikram P. Narayan, MD Ghazala E. Alam, MD Paul R. Gilmore, MD Peter Muz, MD Jose A. Ossa Concha, MD Laurie B. Botie, MD Nitin Kumar, MD Helen A. Raynham, MD Dhirendra Pathak, MD Linda F. Brown, MD Franklin C. Marinelli, MD Michael T. Rosenbaum, MD Claudia E. Perez-Martinez, MD Eleanor A. Bueno, DO Supriya Rao, MD Anna S. Ryan, MD Sufyan A. Sheikh, MD Jeffrey M. Byrne, MD James H. Reichheld, MD A. David Simkin, MD Michael A. Spector, MD Cindy S. Cheng, MD Michael B. Roberts, MD Benjamin A. Solky, MD Wolfgang Steudel, MD Kimberly E. Clemente, MD Richard S. Tilson, MD Jennifer P. Toyohara, MD Harohalli R. Vijayakumar, MD Deirdre M. Connolly, MD Win J. Travassos, MD Christy M. Williams, MD Olga Volfson, MD Sara I. Diaz, MD Vladimir Volfson, MD Joseph M. Dulac, MD Director of Shaun P. Farraher, MD Gynecology Paulina Fernandes, MD Nonnie-Marie Estella, MD Cardiology Medical Education Damian Folch, MD George Flesh, MD Omar A. Ali, MD Byron Roseman, MD Christen Fragala, MD John C. Hughes, MD Richard G. Birkhead, MD Maria C. Gayanilo, MD Kathryn L. Olson, MD Jose M. Carrion, MD Nasim Ghaffar, MD Brian Cullingford, MD Emergency Medicine K. Opal Goff, MD Eric J. Ewald, MD Susan D. Brough, MD Sai N. Gollapudi, MD Infectious Disease Mohan Govindan, MD Paul Calner, MD John N. Grieveson, MD David G. Sidebottom, MD Christopher D. Hong, MD Christopher S. Clingan, MD Paul G. Harcourt, MD Adam L. Weston, MD Walter M. Jo, MD Francesco Corvi, MD Carolyn Haskell, DO Kirk J. MacNaught, MD Jonathan Drake, MD Jerri L. Jensen, MD Internal Medicine David A. Malins, MD Marc Dummit, MD James K. M. Kuin, MD Michael J. Abele, MD Harsh C. Sanchorawala, MD Marie Dupic-Washburn, MD Nidhi Lal, MD Zaheer Ahmed, MD Robert M. Shulman, MD Sarah Gilbert, MD Roberto Larios, MD Essam Al-Ansari, MD Benjamin R. Smith, MD Laura Hagopian, MD Amy L. Lee, MD Shideh Amirifeli, MD Arash Tabaee, MD Christopher Kareores, DO Raymond H. Lewis, Jr, MD Alexandra B. Argasinski, MD Stephen J. Travers, MD Susan Ly, MD Alice I. Lin, MD Naveed Aslam, MD James B. Waters, MD Richard G. Lyons, MD Martha Lipchitz, MD Noellemarie A. Barrera, DO Jerold M. Weiner, MD Nathan R. MacDonald, MD Silvia G. Los, MD Chandra Manuelpillai, MD Nelson Matos, DO Maria Teresa Bejarano Varas, MD Lucia Modesti, MD Zinabu Maxwell, MD Laide Bello, MD Kimberly Morton, MD Donald H. Miller, MD Michael G. Bertos, MD Sean M. Mosharo, MD Margaret D. Mills, MD Ilda Betancur Restrepo, MD Ravi Murthy, MD Emelyn Molato, MD Anum Bilal, MD

12 Circle of expertise – The power of community physicians

From primary care to advanced cancer treatments, area residents have access to some of the best medical experts in the region — right here in our community. Circle Health’s primary care physicians, including internists, pediatricians and family physicians, offer a range of options to meet the healthcare needs of the entire family.

Peter S. Bradshaw, MD Gargi Kundu, MD Cristina G. Stoica, MD Nephrology Louis J. Bresnick, MD Wen Yee Lee, MD Ingo H. Stubbe, MD Eduardo Haddad, MD Jack C. Chang, MD Wooseung Lee, MD Rekha Sundar, MD Ashish Mahajan, MD Mariana Chemaly, MD David M. Lezberg, MD Philip J. Tavano, MD Roy M. Maletz, MD Gautam P. Chhajed, MD, MPH Katayoun Lotﬁ , MD Alla V. Tibbetts, MD, DO Manish Maski, MD Poorvi S. Chordia, MD Oana Lungu, MD Pauline Tsirigotis, MD Douglas Mesler, MD Sara L. Clay, MD Mohamed Mahmoud, MD Heba Wassif, MD Joseph P. Rossacci, MD John E. Copanos, MD Bishal K. Mainali, MD Christina l. Wei, MD Raouf Sayegh, MD Shamim A. Dahod, MD Manuela D. Matei, MD Jessica Wieselquist, MD Sebastian G. Sepulveda, MD Hamid R. Danesh, MD Mythily Meda, MD Abhijeet Yadav, MD Karen Dasilva, MD George P. Meltsakos, MD Sivaram K. Yamajala, MD Richard A. DeAmicis, MD Richard V. Miron, MD Dolma T. Yarchim, DO Neurology Carlos A. Del Rio, MD Wendy L. Mitchell, MD Catherine S. Yu, MD Arya Farahmand, MD Kabilan Dharmarajan, MD Patricia A. Montaperto, MD Tanya Zouzas, DO Vladan P. Milosavljevic, MD Gagandeep Dhingra, MD Lata T. Mundkur, MD Jonathan S. Moray, MD Hung K. Do, MD Elias Z. Nabbout, MD Maternal and Jason C. Viereck, MD Milton A. Drake, MD Ajay P. Nanavati, MD Min Zhu, MD, PhD Brock Drapkin, MD Anil K. Neeli, MD Fetal Medicine Shazneen K. Eisner, MD Melvin B. Nemkov, MD Dorothy M. Beazley, DO Neurophysiology Hiba El-Qaddoumi, MD Jasper I. Ngomba, MD Michael D. House, MD Riad N. Ettunsi, MD Hiep Nguyen, MD Sujai D. Nath, MD Yanli Fan, MD Magdi Osman, MD Ziva Y. Stauber, MD Kristen Farwell, MD Sachin B. Patel, MD Neonatology Dena Susan Gewanter, MD Tushar M. Patel, MD Saima Aftab, MD Obstetrics Jorge E. Gonzalez, MD Dragan S. Petakov, MD Geoffrey G. Binney, Jr., MD Jeffrey Gorvine, MD Sothy Pheng, MD Malgorzata Bulanowski, MD and Gynecology Raj R. Gupta, MD David C. Pickul, MD Mario Cordova, MD Harold R. Bass, MD Mukund Gupta, MD Maheswaran M. Pillai, MD Jessica Davidson, MD Otilia Braescu, MD Seema Gupta, MD Ramya Prabhakar, MD Jonathan Davis, MD Michelle M. Cochran, MD Muzzamal Habib, MD Durga Rao, MD Noeet Elitsur, MD Minerva T. Domingo, MD Arthur Haffner, MD Krishnamoorthy Rao, MD Karen Harvey-Wilkes, MD Melissa M. Ethier, MD Zaffar Haque, MD Roopa M. Reddy, MD Anjali Iyengar, MD Karen K. Fortune, MD Mohammed A. Jaleel, MD Andrew M. Romanowsky, MD Hasene O. Kasaroglu, MD William J. Galvin, III, MD Ashok K. Joshi, MD Mohamed Sageer, MD Laura S. Madore, MD Terry T. Howard, MD Spyridon Kantas, MD Danka Samardzic, MD Elisabeth McGowan, MD Ibrahim Joulak, MD Mohammed R. Karim, MD Venkata G. Satyam, MD Sunita Pereira, MD Peter D. Kuhlmann, MD Smita Kherde, MD Matthew D. Savory, DO Jaclyn E. Ruggiero, MD Carlos A. Madrid, Jr., MD Jugta Khuman, MD Vadim Schaldenko, MD Francheyska Silfa-Mazara, MD David W. Merens, MD Eun Min Kim, MD Andrew M. Siedlecki, MD Alexandra M. Smith, MD Neil J. O’Regan, MD Srilatha Kodali, MD Alpana Sinha, MD Pranav Prakash, MD Rebecca L. Konkle, MD Dimitre T. Sirakov, MD Kiran C. Raju, DO Philip S. Kotsios, MD Lakshmi Sivasankar, MD Vijayalakshmi N. Swamy, MD Maria Krassilnikova, MD Janarthanan Someswarananthan, MD Katherine A. Van Savage, MD Ravi K. Kshirsagar, MD Alberto Soyano, MD Theodore P. Yurkosky, MD

13 Oncology, Clinical Mark A. Lapp, MD Lindsay Fox, MD Pediatrics, Kevin Malone, DO Melissa D. Fox, MD Robert J. Soiffer, MD David C. Morley, Jr., MD Mark J. Francis, MD Endocrinology Jeremy M. Moses, MD Sheila M. Galvin, MD Stuart J. Brink, MD Oncology, Gynecologic David J. Prybyla, MD Priya S. Garg, MD Sarah Feldman, MD, MPH Peter D. Roman, MD Mary Gealow, MD Pediatrics, Michael G. Muto, MD Manouchehr S. Shirazi, MD Mark G. Gilchrist, MD Valena J. Wright, MD Scott A. Sigman, MD Dan C. Hale, MD Gastroenterology Jason A. Silva, MD Pamela L. Harges, MD Robert D. Fusunyan, MD Kevin S. Tomany, MD Karen C. Hiltunen, MD Oncology/Hematology Joseph K. Weistroffer, MD Lauren A. Hittner, MD Murat A. Anamur, MD W. Howard Wu, MD Whitney Breckinridge Hunt, MD Pediatrics, Nephrology Nancy Andrea, MD Tina T. Isaac, DO Lawrence S. Milner, MD Blair Ardman, MD Otolaryngology Keyi Jiang, MD Kimberly Anne Brennan, DO Christine J. Johannes, MD Herbert J. Hansen, MD Samir M. Bhatt, MD Eric P. Kaplan, MD Pediatrics, Neurology Namrata Patel, MD Bjorn Bie, MD Basavaraj Kerur, MD Douglas J. Hyder, MD Arthur M. Lauretano, MD Jana C. Leary, MD Anthony C. Rodrigues, MD, PhD Andres Lopez-Albaitero, MD Laura Z. Lee, MD Ju Tang, MD Oncology, Radiation Vijay K. Nayak, MD Joanna K. Leyenaar, MD James Becht, MD Anit Patel, MD Bridget M. LoParo, MD Stephen Harris, MD Eric H. Stein, MD Melissa Mauro-Small, MD Pediatrics, Howard C. Hsu, MD Eric A. Meikle, MD Ophthalmology Klaudia U. Hunter, MD Pain Management Lorna Melo, MD Vicki M. Chen, MD Matthew Katz, MD Jessica S. Meyer, MD Brian Knab, MD Michael C. Connelly, MD Amy L. Molten, MD Arul Mahadevan, MD Gopala K. Dwarakanath, MD Sheila L. Morehouse, MD Pediatrics, Surgery Jeffrey A. Norton, MD Andrea B. McKee, MD David A. Newman, DO Walter J. Chwals, MD Su K. Metcalfe, MD Irving J. Newman, MD Carl-Christian A. Jackson, MD Asa J. Nixon, MD Pathology Adetokunbo O. Olotu, MD Howard C. Jen, MD William O’Meara, MD Sonali P. Ayar, MD Rebbecca L. Olszak, MD Etin-Osa O. Osa, MD Shashikala Dwarakanath, MD Jennifer M. O’Shea, MD Bryan P. Rowe, MD Physical Medicine Cheryl A. Ennis, MD Rina M. Patel, DO Thomas A. Sheldon, MD Jianmin Gan, MD Shira A. Pedan, MD and Rehabilitation Himanshu Singh, MD Samara H. Peters, DO Lija Joseph, MD Atul L. Bhat, MD Ping Zhou, MD Rekha Quazi, MD Walther M. Pfeifer, MD Elizardo P. Carandang, MD Kumble R. Rajesh, MD Benjamin O. Henkle, MD Berryzad E. Ramadan, MD Ophthalmology Srirangam R. Padmanabhan, MD Pediatrics Chandra Ramanathan, MD Dwayne B. Baharozian, MD Brad E. Alpert, MD Mohan B. Rayala, MD Adam P. Beck, MD Julia Aquino, MD Olga Rose, MD Plastic Surgery Glen A. Bolliger, MD Alena Ashenberg, MD Christina T. Sakai, MD John G. Capino, MD Loreen A. Ali, MD Andreas Athanasiou, MD David S. Salomon, MD John B. Constantine, MD Dina A. Eliopoulos, MD George P. Atkinson, MD, PhD Michelle S. Sanders, MD Evan B. Gold, MD Jeffrey D. Smith, MD Steven J. Bachta, MD Elisabeth G. Schainker, MD James Kim, MD, PhD Rekha Bains, MD, PC Lisa M. Sevigny, MD Stephen J. Poor, III, MD Purnima Baranwal, MD Shailesh J. Shah, MD Podiatric Surgery David M. Tracy, MD Beril Bayrak, MD James P. Sheehy, MD Teresa J. Burtoft, DPM David H. Yi, MD Jennifer Bell, MD Tomo Tarui, MD John J. Clarity, DPM Jessica Bennett-Shah, MD, MPH Tara Thurston, DO Christine Dalrymple, DPM Oral and Cathleen Bonacci, MD Kimberly M. Tresch, MD Timothy M. Downs, DPM Matthew P. Brewer, MD Jamelah Tucker, MD Caroline Gauthier, DPM Maxillofacial Surgery Lisa Capra, MD Susan Voute, MD Russell W. Hamilton, Jr., DPM Christos J. Bacos, DMD Megan Cardoso, MD Earnest Wu, MD Filza Khan, DPM Sotirios Diamantis, DMD, MD Chu J. Chen, MD Lazaros Xanthopoulos, MD Patricia J. Kim, DPM Hamid R. Esbah-Tabatabaie, DMD Russell T. Coleman, MD Kenneth B. Yoffe, MD Wayne M. McCullough, DPM Amy D. Field, DMD Anne Stacie Colwell, MD Gregory McNamara, DPM Neil S. Hornung, DMD Mary Ellen Conroy, MD Pediatrics, Cardiology Regina M. Mostone, DPM Jeffrey D. Stone, DMD, MD Stephen A. Conway, MD Kathleen O’Keefe, DPM Allen W. Tarro, DMD Arlene Curran, MD Michiel M. de Moor, MD John Pizzuto, DPM Thomas A. Trowbridge DDS, MD Snehlata V. Dave, MD David R. Fulton, MD Matthew Riordan, DPM Jennifer Delikat, MD Kwende Smith, DPM Orthopedics Daniel W. Dubner, MD Pediatrics, Dentistry Mitchell J. Wachtel, DPM Patricia A. Dykstra, MD Joseph H. Becht, DMD Steven Alter, MD Joan Eagan, MD Christopher W. Baker, MD Nilfa Collins, DMD Preventive Medicine Norah Rose Emara, MD Marcy P. Gabrilowitz, DMD Samuel D. Gerber, MD, FACS D. Gregory Felch, MD Michael Lappi, DO Eric D. Holstein, MD Michael D. Richler, DMD Meeta Nguyen, MD Jamie M. Fey, MD Aaron H. Watman, DDS Lawrence P. Johnson, MD Jaymi K. Formaggio, MD

14 Psychiatry Radiology, Teleradiology Surgery, Neurological * It is with sadness that we observe the death of Chand K. Bhan, MD John E. Alexander, MD Bruce R. Cook, MD the noted physician in Paul A. Fallon, MD John K. Chang, MD Katharine M. Cronk, MD, PhD our community. We are Charles D. Hanson, MD Ananthakrishna Chilukuri, MD Howard M. Gardner, MD honored to recognize Paul A. Menitoff, MD Bertrand L. Gallet De Saint Aurin, MD Peter J. Grillo, MD her dedication to patient Katherine Ruiz-Mellot, MD Christina S. Geatrakas, MD Kota S. Karanth, MD care. This physician Neelam Sihag, MD Amy R. Hellbusch, MD William P. McCann, MD passed away in 2015. Brian J. Holmes, MD Henry Yu Ty, MD Pulmonary and Christopher J. Hurt, MD Farhad Keliddari, MD Surgery, Oral Critical Care Medicine John D. Lewis, MD Amy K. Chi, MD Thomas F. Osborne, MD and Maxillofacial Carolyn D’Ambrosio, MD Adam D. Rulnick, MD Christos J. Bacos, DMD Sweta A. Desai, MD John P. Schreiber, MD Sotirios Diamantis, DMD, MD Geraldine A. Finlay, MD Helen H. Shi, MD Hamid R. Esbah-Tabatabaie, DMD Ana C. Garza, MD Thomas J. Spinuzza, MD Amy D. Field, DMD Maher A. Ghamloush, MD David F. Tague, MD Neil S. Hornung, DMD Beverly A. Goldberg, MD Katherine D. Tobin, MD Jeffrey D. Stone, DMD, MD Nicholas Hill, MD Monte F. Zarlingo, MD Allen W. Tarro, DMD Khalid Ismail, MD Thomas A. Trowbridge, DDS, MD Branko S. Kesler, MD Radiology, Vascular Denis Y. Lin, MD Christopher Manley, MD and Interventional Surgery, Thoracic Michael J. McBrine, MD James C. Bass, MD William A. Cook, MD Ioana Preston, MD Wei Du, MD Dean M. Donahue, MD Imrana Qawi, MD Gregg A. Franco, MD Christopher R. Morse, MD Greg L. Schumaker, MD Allan I. Hoffman, MD Ashok Muniappan, MD Maher K. Tabba, MD Alice Lee, MD Felix C. Yu, MD Michael F. Mastromatteo, MD Surgery, Vascular Miriam L. Neuman, MD Paul M. Burke, Jr., MD Pulmonary Disease Jonathan K. Gordon, MD Irwin A. Buchwald, MD Reproductive Calin Vasiliu, MD Edward F. Parsons, MD Endocrinology and Infertility Urology Radiology, Diagnostic Richard E. Altman, MD Joseph Hill, MD David J. Berman, MD Scott D. Abel, MD Danielle Vitiello, MD Lindsay S. Baron, MD Matthew A. Cohen, MD Joseph M. Barry, MD Robert A. Edelstein, MD Jonas J. Berman, MD Rheumatology Samantha J. Ganick, MD Chuen-Chieh James Chen, MD, PhD Joel H. Epstein, MD George Klauber, MD Elise J. Connell-Boudoya, MD Tina J. Horwitz, MD J. Mathieu Massicotte, MD Kristopher J. Daley, MD Daniel R. Gale, MD M. Elon Gale, MD Surgery, Colorectal Sreenivas Garla, MD David W. Lin, MD Michael Gerald Geary, MD Himanshu Gupta, MD Surgery, General Bruce P. Hall, MD Patrick Hanks, MD Abdul Ghaffar, MD Kellie A. Hemme, MD Elan Jeremitsky, MD Timothy J. Hough, MD Michael E. Jiser, MD Michael Jung, MD Wassim Mazraany, MD Aiham Korbage, MD Stacie E. Perlman, MD Dylan Kwait, MD Doris Pliskin, MD Jose T. Mora, MD Nari Sabeti, MD John P. Murray, MD Roy R. Shen, MD Erik B. Nine, MD Rebecca C. Shore, MD Veljko M. Popov, MD Nicholas Spirito, MD Zulmarie Roig, MD Kenneth K. Tanabe, MD M. Christian Semine, MD Monty S. Shah, MD Jill A. Steinkeler, MD Bruce G. Stewart, MD Samuel C. Tong, MD Sarah H. Whitehead, MD

15 Patients’ experience and safety are top priorities for Patient Family Advisory Council

Circle Health Value Imperative Deliver high value, affordable healthcare services through the provision of exceptional patient experiences, superb quality, safety and efficiency.

The concept of value in healthcare isn’t simply about providing lower-cost care. At Lowell General Hospital, it’s also about quality and the experience patients have when receiving care.

To involve patients and families in decisions be disappointed, thinking that we were Mr. Logan has leveraged that access to that affect the design and delivery of their going to be a committee in name only, advocate for a cause that’s near and dear care, Lowell General formed a Patient just because the hospital had to have one.” to his heart: awareness of and education Family Advisory Council (PFAC) in 2010. about shaken baby syndrome. He founded Currently made up of 13 former and He quickly learned otherwise. a nonprofit organization, A Child’s Light current patients and four hospital staff (childslight.org), to focus on the issue after In the past year alone, the Council has met members, the Council meets six times a his own six-month-old grandson died from with hospital representatives to discuss year to learn about hospital services and shaken baby syndrome 10 years ago. improving access to care for underserved programs, and provide feedback on ways populations, working with PFACs across to make them better for patients. “Each hospital in Massachusetts has a the state to address healthcare quality different new parent education program, The Council directly connects to Circle issues, improving the patient experience so I’m working to get Lowell General to Health’s Value Imperative and empowers in the Emergency Department, end-of- implement a proven national program that’s patients and families by giving them a distinct life care, the scope of services at the Heart used in 49 other states,” he says. “They’ve voice in improving the patient experience. and Vascular Center, critical care inpatient been very open to the idea.” It allows those we care for to make their services, and the offerings of Hospitality healthcare experience an exceptional one, and Support Services. This receptiveness is what keeps Mr. Logan from comfort to quality to safety. engaged and involved with the Council. At previous meetings, the group visited “I had my first surgery at Lowell General in a prototype new patient room to critique “I was wrong with my preconception 1970, and four out of five of my kids were its set-up and offer suggestions for about what the PFAC would be,” he admits. born there,” says Bob Logan, who’s been improvements, and developed ways to “The administrators have been nothing but a Council member since its inception. “I enhance a new diabetes program launched receptive to all our thoughts and ideas. They thought that getting involved in the PFAC at the Saints campus. always listen, and they always take action. was a good way to give back for all the Mr. Logan values the access to decision- “It’s like a breath of fresh air,” he adds. hospital had done for me and my family.” makers that the Council makes possible. “My opinion, my voice does matter, and He admits, however, that he was skeptical that’s why I’m still here.” “This has been a wonderful way for patients at first about the Council’s role. and families to get together and talk with The PFAC is recruiting new members. If you “There was a state law put into effect the leadership of the hospital,” he says, “and would like to add your voice to the design in 2009 mandating that hospitals have they’re the administrators who have the and delivery of healthcare at your community PFACs,” he says. “So I was prepared to power to make changes, the people who can get things done.” hospital, email [email protected].

16 17 Lowell General Hospital and Tufts Medical Center join forces to form Wellforce

Circle Health Scale Imperative Expand existing relationships and develop new partnerships to attain optimal size and geographic footprint and enable Circle Health to excel in the management of the healthcare needs of the populations we serve.

Wellforce will give Lowell General Hospital and Tufts Medical Center the size and scale needed to better serve a growing patient population.

Tufts Medical Center and Lowell General together two hospitals which are already Finalization of the agreement followed an Hospital joined forces in October 2014 recognized as some of the most efficient, intensive five-month due diligence process to form a health system different than high-quality, lower-cost providers in the after Tufts Medical Center and Lowell any other in Massachusetts. Approved state. As the Health Policy Commission General Hospital announced the signing by the Department of Public Health and recognized in its review of this new health of a Memorandum of Understanding in reviewed by the Health Policy Commission, system, “this transaction may actually April 2014. Wellforce represents a unique model that decrease costs” – in sharp contrast to other will improve coordination of care and affiliations in Massachusetts which have “Wellforce is aligned with the revolution enable clinicians to better serve the health raised the specter of higher healthcare costs. occurring in healthcare,” said Mr. Deschene. needs of communities while enhancing “The Affordable Care Act and trends the affordability of services. “Wellforce turns the traditional healthcare in healthcare costs in the United States model on its head,” said Mr. Deschene. demand a new vision for care delivery. This collaboration will give Lowell General “Our focus goes beyond caring for the With Wellforce we are well positioned to Hospital and Tufts Medical Center the size sick to encompass prevention, community build upon our efforts to lead on quality, and scale necessary to strongly position the health and investment in data and digital wellness and affordability.” new health system to not only compete in technologies rather than capital-intensive the challenging healthcare environment, but equipment and buildings, all in the interest of also invest in technology and share resources enabling clinicians to do what they do best − to better manage the health of a growing care for patients and their communities.” population that they serve. The organizations selected the name Under the agreement, Tufts Medical Wellforce because its unique structure Center and Lowell General Hospital allows all types of healthcare providers formed a new parent organization. This and organizations to join together and be a organization is led by CEO Normand positive force for improving the healthcare Deschene, CEO of Lowell General Hospital system and promoting health and wellness in and Circle Health. Ellen Zane, Vice Chair diverse communities.Wellforce builds on the of the Tufts Medical Center Board of values of Circle Health’s promise to provide Trustees, serves as Chair of the Wellforce Complete connected care, and Tufts Medical board. Lowell General and Tufts Medical Center’s commitment to keeping care in the Center are equally represented on the community and engaging the full continuum Wellforce board. The agreement brought of providers, not hospitals alone, in keeping patients and communities healthy.

18 19 Bringing preventive, primary and specialty care to Westford

20 Circle Health reached a significant milestone in expanding its services with the opening of Circle Health Westford on August 25, 2014 at Cornerstone Square, 198 Littleton Road. The new facility offers key services including urgent care, a Lowell General Hospital Patient Service Center, diagnostic imaging, primary care physicians, obstetrics and gynecology, as well as adult and pediatric specialty clinics.

When illness and injury can’t wait – Now available at Circle Health Westford Circle Health Urgent Care ADULT SPECIALTY CLINICS When patients need walk-in care for non-life threatening conditions Physicians from New England Neurological Associates and Lowell Surgical and other ailments that require prompt medical attention, urgent Associates bring high-quality specialty care for neurology, pain management care is a great option. Circle Health Urgent Care serves children, and surgery. adolescents, adult and senior patients with convenient, accessible care without an appointment. Unlike many other urgent care centers FAMILY MEDICINE or clinics, both locations in Westford and Lowell are staffed with Two primary care Circle Health physicians, Drs. Christen Fragala and experienced urgent care physicians from Merrimack Valley Emergency Katherine Powers, together with Nurse Practitioner Sherine Hassey provide Associates who are available onsite during operating hours. comprehensive healthcare services for patients of all ages.

“Our urgent care centers allow us to bring seamless care to patients LOWELL GENERAL HOSPITAL PATIENT SERVICE CENTER who need the right care at the right time at a lower cost than a more Patients needing blood tests, imaging services and outpatient testing now expensive emergency department setting,” says Dr. Jerry Jenson, have a Patient Service Center close, convenient and accessible to their home Medical Director of Circle Health Urgent Care. “During flu season or work. This Patient Service Center offers a full complement of testing when a primary care physician may have a full schedule or after hours, services including: we are here to assist and will communicate with the patient’s doctor to - Blood draws and specimen collection ensure that any needed follow-up care is coordinated.” - Diagnostic imaging services (X-ray and ultrasound) - Electrocardiograms (EKG) Circle Health Urgent Care treats non-life-threatening conditions and other ailments like allergies, dehydration, urinary symptoms, scrapes OBSTETRICS AND GYNECOLOGY or lacerations, sprains or possible fractures, stings and bites, minor burns, and conditions needing X-rays or laboratory tests. Lowell General Hospital WomanHealth provides a full range of healthcare to women from adolescence through maturity. With special expertise in Patients don’t need a Circle Health physician to use our urgent care gynecologic care, obstetrics, urinary incontinence, menopause and gynecologic centers and they have full access to all the diagnostic and treatment cancer, the physicians and nurse practitioners offer the most up-to-date resources at Lowell General Hospital, as well as other specialty technology for diagnosis and treatment. providers that are part of the Circle Health network. PEDIATRIC SPECIALTY CENTER Lowell General Hospital’s expanded partnership with the Floating Hospital for Children at Tufts Medical Center brings the expertise of some of Boston’s top pediatric specialists to Westford in areas including cardiology, gastroenterology, genetics, nephrology, neurology, pulmonology and rheumatology.

21 Circle Health at a glance

About Circle Health

Circle Health is a progressive collaboration of physicians, hospitals, other health providers and organizations with a shared vision for empowering people and communities to be healthier. Through innovative programs and a collaborative approach to care management – called Complete connected care – Circle Health supports communities with a comprehensive range of services and provides individuals easy access to the expertise and resources to achieve the best possible health throughout their lives. Circle Health is a not-for-profit company headquartered in Lowell, Massachusetts.

CIRCLE HEALTH STATS IN REVIEW

1,091 NURSES • 4,033 EMPLOYEES • 660 PHYSICIANS 804 VOLUNTEERS • 59,838 VOLUNTEER HOURS

22 About Lowell General Hospital

Lowell General Hospital is an independent, not-for-profit, community hospital serving the Greater Lowell area and surrounding communities. With two primary campuses located in Lowell, Massachusetts, the hospital offers the latest state-of-the-art technology and a full range of medical and surgical services for patients, from newborns to seniors.

Patient Highlights at a Glance Financials

FY14 FY13 Balance Sheet FY14 FY13

Inpatient discharges 21,750 23,086 ASSETS Observation discharges 4,146 2,329 Total patient discharges 25,896 25,415 Cash and equivalents $48,738,759 $57,510,221 Investments at market value 88,089,312 78,367,578 Patient days of care provided 82,975 86,145 Patient accounts receivable 47,684,478 50,964,338 Average length of stay (in days) 3.81 3.73 Property, plant, equipment 231,761,402 238,715,734 Births 2,323 2,269 Due from affiliates 6,337,490 7,646,773 Diagnostic imaging procedures 255,756 250,223 Other assets 50,647,087 52,256,650 Laboratory procedures 1,924,672 1,995,150 Total assets 473,258,528 485,461,294 Surgical procedures 14,597 14,349 Radiation therapy procedures 11,350 10,808 LIABILITIES AND NET ASSETS Emergency services 100,729 100,803 Outpatient clinic visits 69,715 69,055 Accounts payable and $79,064,371 $87,166,237 accrued expenses Due to third parties 3,269,408 2,710,485 Due to affiliates 4,769,498 4,904,138 Long-term debt 168,402,069 174,470,379 Other liabilities 50,645,830 46,581,908 Total net assets 167,107,352 169,628,147 Total liabilities and net assets 473,258,528 485,461,294 Awards The Joint Commission Top Performer on STATEMENT OF OPERATIONS Key Quality Measures® 2013 Operating revenues $415,630,458 $404,617,917 Operating expenses 409,224,792 402,297,471 Operating income 6,405,666 2,320,446

UNCOMPENSATED CARE COSTS ® Net charity care $11,208,733 $9,947,269

23 295 Varnum Avenue, Lowell, MA 01854 I 978.937.6000 I www.circle-health.org