ADVANCING HEALTH

5565 Sterrett Place Columbia, MD 21044 410-772-6500

MedStarHealth.org 2014 ANNUAL REPORT Dear Friends, As MedStar Health leads the important transformation of health care in and the Washington, D.C., region, we are thinking differently about everything we do. In an ever-changing healthcare environment, our processes and approaches are evolving in order to best meet the needs of our patients, our associates and the communities we serve. Our future depends on our ability to evolve a business model constructed long ago and transform it to meet the expectations and available resources of tomorrow. And while all of this change requires us to be innovative, flexible and nimble, we must also remain focused and committed to our foundational mission-driven work of providing the very highest quality, safest care to our patients. A great deal of strength is derived from being the largest, most accessible not-for-profit healthcare system in the region. We must embrace and harness this strength through the hands, hearts and minds of our 30,000 associates, physicians and nurses as we work to build a new care delivery model. With this great strength also comes great responsibility: a responsibility to our fellow healthcare providers, our patients and the communities we serve. We take this responsibility very seriously. The theme of our Fiscal Year 2014 Annual Report—Advancing Health—focuses on a key component of our vision to be the trusted leader caring for people and advancing health. In this Annual Report, you will see the many ways in which MedStar is changing lives, and is firmly committed to the evaluation of new and innovative ways to advance the health of our region. We made bold and strategic moves this year in our quest to find new, better and faster responses to the challenges facing not only , but the entire healthcare system in the . We are also tackling transparency and addressing the manner in which health systems handle errors in care, learn from mistakes and engage former patients to prevent future occurrences. We are slowly transforming the formerly perceived closed-door realm of medicine into an even more open and transparent culture, and we have engaged patient advocates to help us lead this change. On the frontline of change is our new multispecialty healthcare center, which is highlighted in this Annual Report. The opening of this center embodies health care’s continued need to expand into the community, and yet to do so as part of a seamlessly connected continuum of care that is centered on the needs of our patients. Through our medical education and clinical partnership with , we continue to bring the best and brightest together to collaborate on research efforts certain to change the future of medicine, expediting the process for translational research to reach the bedside. Thousands of MedStar patients from across the region joined one of our many studies on promising new drugs, emerging healthcare technologies or novel approaches to care. Each patient contributed another piece to the puzzle, leading our physician scientists closer to understanding and managing a variety of diseases and other serious conditions. The highlights in this Annual Report are examples of the many clinicians and associates across our healthcare system who are dedicated to changing the path of health care, serving as examples of the expertise, leadership and innovative thinking that are required to support our long-term strategy —MedStar 2020. With the full support of our system-wide governance, medical staff and management leaders, we are building a truly connected organization with a constant focus on quality and safety, service and access. We are truly advancing health. In support of our patient-focused mission, our philanthropic partnerships and investments are critically important in our ability to advance, allowing us to make significant differences in the lives of so many. We greatly appreciate the trust placed in our organization through your generous philanthropic support. We know that our MedStar 2020 strategy continues to guide us well, and that we are leading the region in many important ways. However, we also know that while strategy and operational excellence matter, they are meaningless if not grounded in the needs of the communities we serve. With the support of our Board members, volunteers and donors, we never lose sight of our top priority—our patients and their families. It is our hope that the transformation we are leading at MedStar Health will shine light on potential solutions for health care in our country and, most especially, for the communities across our region. We could not do this important work without your support, guidance and friendship. Thank you.

Kenneth A. Samet, FACHE William R. Roberts President and CEO Chairman of the Board of Directors

MedStar President & CEO Kenneth Samet and Board Chair William R. Roberts visit the MedStar Institute for Innovation, whose mission is to catalyze innovation that advances health. ADVANCING HEALTH REVOLUTIONARY IDEAS In April 2014, MedStar Health became one of only four founding partners in the technological start-up hub, 1776. The bold The odyssey began in 2009 with the launch of the MedStar Currently, the team is working with six start-ups on remote Institute for Innovation (MI2), followed by a unique relationship monitoring systems, informatics, telemedicine, and other and strategic move is the latest in our quest with Cleveland Clinic in 2011. The result is the first-of-its-kind digital health solutions that could radically change healthcare to find new, better and faster responses to Global Healthcare Innovations Alliance designed to advance delivery. In exchange, MedStar gains first access to their the challenges facing America’s hospitals … patient care through inter-institutional collaboration, technology approaches and technologies. development and commercialization. and to lead the transformation of the “By combining the tremendous creative and intellectual nation’s healthcare system. With 1776, our search for workable solutions now reaches a capital that exists at MedStar with 1776’s talented and driven new level. While the global incubator and seed fund identifies the entrepreneurs, big change can and will happen,” says Mark S. most promising start-ups in health care and related fields—and Smith, MD, director of MI2 and MedStar’s 1776 team leader. helps engineer their success—MedStar also benefits.

“We’re looking to bring fresh ideas and approaches from the outside into the system,” says Jeff Collins, MI2’s administrative director and director of External Alliances. Dr. William Krimsky, medical device inventor and director of the Center for Interventional As 1776’s sole healthcare partner, MedStar is an adviser and Pulmonology at MedStar Franklin Square sounding board for the incubator’s new health-related companies, Medical Center, confers with a patient. helping refine prototypes into practical, real-life applications. Covering the full spectrum of patient demographics, clinical specialties and care settings, the system is a microcosm of America’s healthcare industry and an ideal testbed for fledgling products.

From Concept to Completion

To transform great ideas into successful products, MI2’s MedStar Inventor Services and the Global Healthcare Innovations Alliance navigate the daunting process of market analysis, intellectual property protection, product development, licensing, and more, in partnership with MedStar associates.

The InVent Diaphragm Assist Device (DAD)—brainchild of William Krimsky, MD, director of the Center for Interventional Pulmonology at MedStar Franklin Square Medical Center—is the latest beneficiary of their combined support. Basically an implantable ventilator, the novel device could free patients with pulmonary failure to live independently, unleashed from stationary devices. Through a licensing agreement with InnoVital Systems, the alliance’s first, Dr. Krimsky’s concept is now moving closer to reality.

“If DAD reaches the market,” he says of the simple and elegant solution, “there is potential to revolutionize care for patients with advanced lung and neuromuscular disease.”

It’s a meeting of the minds every time 1776 cofounders and entrepreneurs Evan Burfield (at left) and Donna Harris (seated) get together with MedStar experts Jeff Collins (center) and Mark Smith, MD. ADVANCING HEALTH

3 4 ACE OF HEARTS Reducing Cardiac Readmissions

Can personalized support after a discharge help heart attack and heart failure patients follow self-care instructions, avoid re-hospitalization and heal safely at home? Recently, MedStar Visiting Nurse Association and MedStar Heart & Vascular Institute became one of the first 11 partners nationwide to be awarded a grant from the American College of Cardiology to find out, enrolling more than 300 patients to date. The answer, expected in 2016, could change the future of cardiac care.

Now recovered, Sharon can enjoy more quality time with her family—keeping up with her five daughters.

Doctors did what they could to stem the deadly progression and After undergoing a triple bypass procedure, Sharon’s heart needed prepare Sharon for immediate transfer to MedStar Heart & Vascular ECMO’s extra help for five days. Less than a week later, she was Institute at MedStar Washington Hospital Center—the region’s nationally discharged to a rehabilitation center, then home. Sharon Allen—40-year-old wife and mother recognized leader in advanced cardiac care and Sharon’s best hope. of five, including a newborn—lay in a suburban Such sophisticated technology, techniques and successful outcomes There, cardiac surgeon Jennifer Ellis, MD, was ready and waiting. for even the most critical conditions contribute to MedStar Washington emergency room, fighting for her life. Hospital Center’s consistent ranking among U.S.News & World Report’s As staff worked to save her, one by one, “Sharon’s condition, spontaneous cardiac arterial dissection, was top 50 cardiac programs—the only heart program in the Washington Sharon’s coronary arterial walls disintegrated extremely rare, severe and potentially catastrophic,” she says. “Basically region to earn this national recognition. It is also one of the nation’s oxygen-starved, some of her heart tissue was already suffering, putting highest volume centers and a hotbed of innovation in cardiac care. in front of their very eyes. her at risk for a massive heart attack.” “The newest, most cutting-edge procedures and devices—what While Sharon was still airborne, Dr. Ellis plotted out her approach: you read about as ‘coming soon’—are already available at the Get her to the OR, perform open-heart surgery and then hook her MedStar Heart & Vascular Institute,” says Sharon’s husband, Dorian. up to the Hospital Center’s ECMO, one of a very few in the area. “It’s a testament to their expertise and leadership.” Only available in top-tier heart centers, the “extracorporeal membrane oxygenation” system can take over both cardiac and respiratory So, too, is Sharon’s recovery. “The girls and I could have lost her,” functions, giving damaged organs precious weeks to rest, recuperate Dorian says. “Dr. Ellis is our hero.” and regain strength to resume their duties.

ADVANCING HEALTH

5 6 BRAINSTORM Such questions inspire the creative minds at the interdisciplinary Center for Brain Plasticity and Recovery, a joint enterprise between What mental magic empowers a 3-year-old MedStar Health and our medical education and clinical partner, Georgetown University. Here, neuroscience researchers are examining to absorb two languages at once, while adults plasticity—the young brain’s ability to successfully reassign tasks to struggle to become bilingual? After a stroke, areas unaccustomed to the responsibility—in hopes of unraveling what secret pathways lead a newborn’s brain the mechanisms behind the process. Armed with the answers, they back to normalcy but seem sealed off to can then pursue their ultimate goal: learning how to coax the adult brain to once again respond like a child’s. grownups with the same damage? “It’s the most exciting research of my career,” says Alexander Dromerick, MD, the center’s co-director and a specialist in stroke rehabilitation and brain trauma recovery techniques at MedStar National Rehabilitation Hospital. “Together, what we’re doing has the potential to change people’s lives after stroke, traumatic brain injury, and maybe even Alzheimer’s and other neurologic disorders.”

With 800,000 new cases each year, stroke is a major focus and the MEDSTAR HEALTH AND GEORGETOWN UNIVERSITY: subject of the center’s first clinical trial, the Critical Periods After PARTNERS IN KNOWLEDGE AND COMPASSION Stroke Study. Jointly designed by MedStar NRH and Georgetown University, and led by Dr. Dromerick, the protocol aims to determine Advancing health through medical education, research and innovation is if there are specific windows of opportunity when additional therapy core to MedStar Health’s vision and strategy. Serving as MedStar Health’s is particularly effective. If outcomes appear positive, the study will medical education and clinical partner, Georgetown University enhances be replicated in a multicenter trial. our “advancing health” portfolio through collaborations in teaching, scholarship and research. In a related project, a university-based team is working to identify Georgetown University medical students rotate through MedStar’s the biomarkers associated with a positive response to therapy. hospitals for their clinical education and training. In addition, approximately Results could lead to a blood test to indicate the most productive 25 percent of the university’s graduating class is matched into MedStar time to initiate rehabilitation or, better yet, a drug to boost or prolong residencies and fellowships. Most of MedStar’s teaching faculty hold the brain’s receptivity to relearn key tasks. Other current work centers academic appointments at Georgetown University, realizing the on transcranial magnetic stimulation to activate precise areas within meaningful collaborations in teaching, research and academic service. the brain and cellular/molecular studies of how new synapses—bridges between brain cells—are formed, among others. In addition, Georgetown University Medical Center and MedStar Health Research Institute have increased collaborative research activities through With the aging of the baby boomers, the timing could not be better. their NIH-funded Clinical Translational Science Award (CTSA), robust joint scientific advisory board and joint intramural funding program. “Everything we’re doing right now revolves around discovering how to stimulate the brain to recover from damage, so we can preserve and GME Profile restore neurologic function,” says the university’s Elissa Newport, PhD, Number of residents and fellows 1,070 an expert in language acquisition and the center’s co-director. “With Number of accredited programs 74 specialists in neuroscience, neurology and rehabilitation medicine—all in one area, working together—we have a remarkable opportunity to Number of specialties 54 make a difference.” Number of students rotating annually 2,000 Number of rotating residents and fellows annually 700 Number of teaching hospitals 7

Both MedStar Health and Georgetown University have devoted significant resources to the Center for Brain Plasticity and Recovery, which include the university’s functional MRI—a vital tool in under- standing the mysteries of the mind, shown here with Elissa Newport, PhD, and Alexander Dromerick, MD. ADVANCING HEALTH

7 8 KNITTING A NEW LIFE After more than a year in hospitals and rehabilitation, Debra Long finally felt well enough to rejoin her church’s knitting and crocheting group this past July.

Debra Long celebrated her birthday twice Intestinal transplants are few and far between, with only about 100 or this year: officially on Feb. 28, and again so procedures performed annually, mostly on children and young adults. Averaging about 20 each year, MedStar Georgetown Transplant Institute on July 11—the first anniversary of her new is one of the busiest and most experienced intestinal transplant centers life as a multi-organ recipient, thanks to nationwide, with the deep infrastructure and range of subspecialists MedStar Georgetown Transplant Institute. required to tackle the rare and complex operation. It’s a tradition she shares with others who Debra, however, needed not one new organ, but five, complicating feel dramatically reborn when healthy her case. organs replace the failing. Confident in Dr. Matsumoto and the transplant institute—and fearful of leaving her teenage son parentless if she didn’t get off TPN—Debra joined the organ waiting list.

Nearly 10 months later, she got the call. Dr. Matsumoto, two other surgeons, residents, and students flew to Florida for the first part of their mission: to carefully retrieve the donated organs. Meanwhile Debra picked up her yarn, knitting needles and pre-packed bag, and headed off to the transplant institute for the surgery of her life.

On July 11, 2013—after 17 hours on the operating table—Debra had Debra’s life-threatening drama began with a preventive double a new pancreas, liver, small bowel, stomach, and duodenum. mastectomy and hysterectomy to avoid the cancers that claimed her mother and aunt. But the 53-year-old developed a dangerous blood “My transplant team was simply awesome—some of the most clot in her abdomen, eventually causing the loss of most of her intestines. compassionate, caring professionals I’ve ever encountered,” she says. Six months later, she was home, tethered indefinitely to the 14-hour “Their support and encouragement helped me persevere, recover intravenous feeding regimen called total parenteral nutrition (TPN), and, for the first time in two years, feel good again.” and facing an uncertain destiny. One more surgery, a kidney transplant, awaits her, but Debra’s not Then she found MedStar Health. terribly concerned.

“While short periods of TPN can be invaluable, the therapy exacts a toll “It’s all good: It’s the MedStar Georgetown Transplant Institute.” on the body when used long term,” says Cal Matsumoto, MD, Debra’s principal surgeon with the MedStar Georgetown Transplant Institute.

“As a result of TPN, Debra’s other digestive organs were starting to fail. Basically, she needed an entirely new gastrointestinal tract—an extremely difficult procedure for patients in their 20s, let alone someone middle-aged.” ADVANCING HEALTH

9 10 Restoring Bodies That procedure—scapulothoracic fusion—can restore and and Spirits improve upper extremity function for select patients, like Lauren, with facioscapulohumeral muscular dystrophy (FSHD).

“People with FSHD experience progressive weakening of skeletal muscles,” says Leigh Ann Curl, MD, of MedStar Harbor Hospital—one of a few orthopaedic surgeons on the east coast who performs this highly specialized operation. “By melding the shoulder blade to the underlying adjacent ribs, patients with FSHD gain more mobility and have a better quality of life.”

Like others who have trekked to from as far away as New Jersey and Florida, Lauren and her parents thought nothing of driving six hours or more each way, after learning of the procedure and Dr. Curl’s reputation.

“As soon as we met her, we knew we had come to the right place,” says Lauren’s mother, Rachel, a physical therapist. “The entire experience was incredible. It means a great deal when your This past spring, Lauren Brown’s dream child is taken care of so well.” ® came true: to perform at Disney World Care for children and adolescents with musculoskeletal with fellow members of North Carolina’s conditions recently received another boost with the arrival of Lee County High School marching band. Andrew Abramowitz, MD, at MedStar Franklin Square Medical Center. One of a very few pediatric orthopaedic surgeons in the As the parade passed by, none of the region, Dr. Abramowitz has a special interest in children with spectators could have guessed that— cerebral palsy—which represent some of his most complex cases. only four months earlier—the 16-year-old In the space of two weeks this spring, for example, he spent two Lauren’s mom, Rachel, researched and found the rare, highly specialized procedure her daughter needed at MedStar Harbor Hospital, part of bass drummer had undergone a rare and 12-hour days in the operating room, basically rebuilding an adolescent boy’s lower body, from his pelvis and hips down to MedStar Orthopaedics. challenging shoulder blade surgery. his ankles and feet, so he may one day walk again.

“Children are not just small adults,” says the fellowship-trained team physicians to the Baltimore Ravens, Washington Capitals, expert who also specializes in limb-lengthening. “They’re still Washington Nationals, and , as well as coverage actively growing, so we have to consider the effect of the current for many collegiate and youth programs throughout the area. procedure on future development.” The addition of pediatric orthopaedics to the roster is MedStar’s That caliber of services and personalized care has earned latest step to fulfill community needs. MedStar Orthopaedics a national reputation for excellence. With fellowship-trained specialists in nearly all musculoskeletal “By helping young patients sit, stand and walk better,” Dr. Abramowitz conditions—and a major sports medicine program—it provides says, “we restore both body and spirit.”

The beat goes on for drummer Lauren and the rest of the Lee County High School marching band, thanks to the orthopaedic experts at MedStar Harbor Hospital, ADVANCING HEALTH part of MedStar Orthopaedics. 11 12 Patient-Powered With a decade of work in safety, quality and patient-centered care, “It takes significant institutional courage and commitment to follow MedStar began our formal evolution into a high reliability organization this route, and MedStar has both,” says Dr. Smith, principal investigator (HRO) in 2013. Perfected by the aviation and nuclear power industries, for MedStar’s project. “With rollout scheduled to begin in early 2015 at the HRO model helps high-risk, complex fields successfully avoid eight of our hospitals, we are CANDOR’s largest site.” catastrophes. Now, the nation’s most enlightened and forward-thinking hospitals are adopting this approach. Consumer engagement, another important piece in our HRO journey, continues through our Patient and Family Advisory Councils for Quality “Seeking to become an HRO is an all-inclusive, top-to-bottom process,” and Safety (PFACQS). These committees comprise patients, family says David Mayer, MD, vice president of Quality and Safety. “It’s the members, hospital staff, and community residents, all interested in “No one goes into health care to harm biggest, system-wide initiative we’ve tackled in memory, and it won’t sharing their experiences and perspectives to improve patient care and patients,” says Kelly M. Smith, PhD, be fully implemented for another three to four years.” satisfaction. First introduced at the system level in 2012, the concept is scientific director for Quality and Safety now up and running at five MedStar hospitals, with the remainder in So far, Dr. Mayer and his team have introduced 2,200 executives, managers varying stages of implementation. Research at MedStar Health. Yet and others to the model’s essential leadership principles. At each of our unintentional harm happens—physically, 10 hospitals, hundreds of other HRO-prepared “champions” are walking HRO, CANDOR, PFACQS. Each component brings us one step closer financially, psychologically. The manner in frontline associates through the training necessary to achieve system-wide to our ultimate goal: to provide the highest quality, safest care possible resilience and accountability, the hallmarks of HROs. Fewer than 25 percent for our community and our associates. which hospitals handle errors in care, learn of America’s hospitals have attempted the transition. from mistakes and engage former patients As part of HRO’s second phase, MedStar is leading 14 hospitals from to prevent future occurrences is slowly three healthcare systems nationwide in a 24-month project for the changing the formerly closed-door Health Research and Educational Trust, funded by the Agency for realm of medicine into an open, Healthcare Research and Quality. Called CANDOR—short for transparent culture. Communication and Optimal Resolution—it involves developing Pictured are some of the many MedStar associates, national advocates and testing an educational toolkit to help hospitals respond to, and community members lending their time and healthcare experiences defuse and quickly resolve potential patient harm situations. to help move MedStar Health from good to great.

MedStar Health’s David Mayer, MD—a nationally recognized expert, educator and lecturer on patient safety and quality—discusses how patient advocates are helping change the healthcare environment, here and elsewhere. ADVANCING HEALTH

13 14 MILES AHEAD And within months, Miles returned to the active lifestyle he loves, thanks to his determination—and the equal determination of MedStar National Rehabilitation Hospital—to get him there.

“I had done a segment about prosthetic arms and rehab a few years ago,” says Miles, who has covered science, technology and aerospace for such media giants as CNN and PBS. “So when I started looking at possible places for rehabilitation, Chicago, Baltimore and New York made the list.”

But then a friend introduced him to MedStar NRH, and the deal was sealed.

Consistently ranked among America’s “Best Hospitals” for rehabilitation by U.S.News & World Report, MedStar NRH offers an innovative arm amputee program—a rare program for a rare problem. Part research, part rehab, it is the only comprehensive interdisciplinary clinic of its type in the mid-Atlantic region.

Together, a team of physicians, occupational therapists, prostheticists, and others are evaluating whether systematic training can teach patients to master their arm replacements, maximizing function and independence.

“Typically, patients receive an upper arm prosthetic, practice using it a few times in the maker’s office and are sent on their way,” explains Jessica Barth, MS, occupational therapist and researcher. “Out of frustration, many either abandon the device or develop Five-time Emmy winner Miles O’Brien clasps his latest award, awkward movements that can cause problems later.” presented this fall for “Manhunt—Boston Bombers,” his documentary In contrast, MedStar NRH specialists determine which activities for PBS’s NOVA. The hour-long special aired at the end of May 2013, patients would like to resume, then devise a plan to strengthen a mere six weeks after the attacks that killed three and injured hundreds. specific muscles, maintain flexibility and improve range of motion for the task at hand. When a freak, on-location accident in the And on July 13, 2014—nearly five months to the day after losing his Philippines separated Miles O’Brien from his That “can-do” attitude appealed to Miles, who most wanted to ride arm—Miles finished the entire 300-mile ride. He’s also running again left arm, the 55-year-old broadcast journalist in a 300-mile bike trip for cancer in memory of his sister. and hopes next to return to scuba diving. faced a tough decision: follow his feelings on Soon he was outfitted with a custom-designed arm expressly for “How to deal with this type of loss is a very personal decision,” he says. their downward spiral or summon the strength biking—one of many devices MedStar NRH’s specialists can craft for “But the experts at MedStar will work to get you back to the activities tumbling, kayaking, flying, and other high-performance athletics. to rise to a new, unknown challenge. that add meaning to your life. They are amazing.”

He chose the latter.

ADVANCING HEALTH

15 16 CONTRIBUTING FACTORS Dedicated donors Emily and Neil Kishter believe, “A lot of work needs to be done at our medical institutions. That can’t happen without the support of private donors.” Adds Neil, “You can’t take it with you.”

Neil has remained deeply appreciative of the quality of care and compassion Dana received from Lombardi—the area’s only NCI-designated comprehensive cancer center and one of only 41 nationwide—and the special concern and expertise of Craig Kessler, MD, her hematologist/oncologist.

Not long afterward, the 54-year-old philanthropist asked Dr. Kessler what he could do to help.

“I realized I couldn’t change Dana’s outcome,” Neil says, “but I could try to make things a little better for others.”

In the refurbished Infusion Center, each patient spends up to five hours a day receiving proven and promising therapies with the potential to change future cancer care. To comply with stringent research protocols, staff is specially trained in the intricacies of administering experimental drugs, including cancer cell-targeted antibodies and more standard chemotherapy- based treatment. Thanks to the Kishters, more comfortable surroundings, enhanced work stations, and a welcoming and healing environment now make life in the Infusion Center better and more efficient for patients and professionals alike. From breaking ground for a new building to Neil and Emily Kishter are prime examples. “Whether it’s a bricks-and-mortar project or a specific groundbreaking research … and from investing in “All contributions are important and valued,” Neil says, “but a large research study that could lead to promising therapies,” says the most advanced lifesaving technology to testing gift helps get things done. Otherwise, it can take years for a worthwhile Dr. Kessler, “philanthropy provides so many opportunities a fresh approach to manage chronic conditions, project to finally make it through budget approval.” to benefit patients, directly and indirectly.” philanthropy powers progress. MedStar Health’s So in 2013, the couple fulfilled a significant pledge toward improvements For Neil and Emily, the new Infusion Center was a rewarding donors—often grateful patients or family members to the Infusion Center at MedStar Georgetown University Hospital’s venture, with an immediate return on investment. Lombardi Comprehensive Cancer Center, a place Neil knows all too well. seeking a meaningful way to thank us for care His first wife, Dana, fought a losing battle there with three different acute “I firmly believe in giving during your lifetime, especially while received—provide the critical financial margin leukemias over a decade, spending countless hours in the outpatient facility. you’re young,” he says. “I want to be around to see the results.” needed to move from good to great and make a difference for the people we serve.

ADVANCING HEALTH

17 18 Conquering Cancer The first news Bruce Raaka heard was bad enough: He had colorectal cancer. But the more refined diagnosis, delivered a few weeks later, devastated the 61-year-old and his wife, Liz. The malignancy, already advanced, had metastasized to his liver. That change in status rendered surgery—the best line of attack—fruitless, unless chemotherapy could first halt his cancer’s progression.

At that point, the federal research scientist—a man accustomed to digging for facts and figures—didn’t want to know any more, including statistical outcomes. “Whatever the prognosis, I vowed then and there that I would beat the odds,” he says.

So Bruce threw himself into a year-long battle, led by the medical triumvirate of MedStar Georgetown University Hospital’s Michael Pishvaian, MD, PhD, oncologist, and Thomas Fishbein, MD, director of the Center for Liver and Pancreas Surgery; and Thomas Stahl, MD, interim chairman of the Department of Surgery at MedStar Washington Hospital Center and regional director of The avid golfer, bagpiper and research scientist—with his wife and fellow Colorectal Surgery, MedStar Health. scientist, Liz—now has one more distinction to add to his list: cancer survivor.

“Both Liz and I had worked previously at medical schools in New York,” he says. “Knowing that the MedStar system included an academic medical at MedStar Georgetown University Hospital, the affected portions of center was important to us.” his liver were also removed. The intensive and successful treatment Thanks to MedStar’s commitment to become a Distributed Care Delivery came full circle with a final round of chemotherapy back at MedStar Network, Bruce received much of his advanced medical care at MedStar Montgomery Medical Center, with professionals from MedStar VNA Montgomery Medical Center, closer to his Rockville home. Because assisting at his home. MedStar Montgomery Medical Center is part of the MedStar Georgetown “More and more colorectal cancers like Bruce’s can now be controlled Cancer Network, patients can consult with and receive certain standard —and even cured—thanks to the combination of surgery and today’s therapies from some of the network’s most highly trained cancer and advanced chemotherapies,” says Dr. Pishvaian, who will continue to To buoy his spirits during chemotherapy, colorectal specialists right on site. When patients need more complex monitor Bruce in the future. Bruce MacLachlan Raaka summoned his procedures and services, those same experts can treat them at MedStar inner Scot, frequently piping “Scotland the Georgetown University Hospital and MedStar Washington Hospital Center. That’s music to Bruce’s ears. Brave” at home. The self-taught player hopes Bruce’s treatment, for instance, began with aggressive chemotherapy at to join a bagpipe band following retirement. “There were so many moving parts, so many opportunities for error, MedStar Montgomery Medical Center, the site of his original diagnosis, every step along the way,” he says, likening his personal experience to to contain and shrink his primary and secondary tumors. Once down to a biomedical research experiment. “But the whole process was flawless. an operable size, the tumors and neighboring sections of Bruce’s colon I’ve been around medical institutions my entire life and am incredibly were removed at MedStar Washington Hospital Center; 10 weeks later, impressed by MedStar Health.”

ADVANCING HEALTH

19 20 HANDIWORK For 24-year-old Andrew Guthrie, the future “Andrew’s surgery was incredibly complex: an approach available at only a few centers in the world,” says James Higgins, MD, chief of looks bright. After a triple major in college, The Curtis National Hand Center, a key contributor in planning and he’s pursuing a PhD in computer science, executing Andrew’s surgery, and co-leader on the multi-institutional he’s a skillful woodworker, and he loves lifting team that—in 2013—performed one of the very few double arm weights whenever he can. But in March 2013, transplants ever attempted. “From the most drastic cases to more common elective procedures, we work diligently to achieve the best a brutal injury to his right hand cast a shadow possible outcome for each individual.” The results speak for themselves. over the years ahead. “I had no idea I could ever make a recovery like I’ve done,” Andrew concludes.

While Andrew was milling lumber for a prized piece of furniture, the planer blade sliced through the palm side of his little, ring and middle fingers.

Paramedics rushed Andrew to The Curtis National Hand Center With the help of the experts at The Curtis National Hand Center, at MedStar Union Memorial Hospital—one of the most advanced Andrew Guthrie has returned to the hobby he loves. hand trauma centers in the world, and right in Andrew’s backyard. Acutely aware of the gravity of his situation, Andrew prepared himself for the worst: a future without three fingers.

But the center’s surgeons—experts in treating the most serious and complex hand, arm and shoulder disorders—had other plans.

“While we receive trauma patients and those needing either reattachment or toe-to-hand transfers somewhat regularly, Andrew’s case was unique,” says Ryan Katz, MD, lead surgeon. “His injury, though devastating, spared some bone and all the tissue on the back of the fingers. We felt we had enough to work with to rebuild a new, and useful, hand.”

So Andrew willingly relinquished the second toe from each foot as the first stage in a highly specialized procedure. Instead of just transferring the toes onto Andrew’s hands, however, Dr. Katz and team carefully deconstructed the digits, using specific parts to fashion new fingers and advanced microscopic techniques to reconnect delicate blood vessels and nerves. Five days later, Andrew was home.

Since then, he’s undergone several more surgeries to refine the appearance of his fingers, culminating in the removal of plates and pins this July. But 18 months after this harrowing accident, Andrew can type on a computer keyboard—crucial to completing a doctoral candidate’s rigorous demands—and resume the activities he enjoys.

ADVANCING HEALTH

21 22 RECIPE FOR RECOVERY Mary Kelly loves to cook. So much so, she made a career out of it, spending 47 years in the kitchens of the Naval Air Station Patuxent River. But leg pain from diabetes forced her off her feet and into retirement. Then she developed a common yet serious complication: non-healing wounds, the bane of a diabetic patient.

Fortunately, nearby MedStar St. Mary’s Hospital had just opened its Wound Healing Center, the only one of its kind within a 40-mile radius. The state-of-the-art facility features the most advanced treatments available, including bioengineered tissue substitutes, negative pressure wound therapy, growth factor therapies, and the highly effective but time-consuming treatment Mary needed: hyperbaric oxygen therapy (HBOT).

“HBOT is the pinnacle for treating difficult wounds,” says Olivia N. Sartain, RN, MSN, and the center’s program director. “But the full course of care can be intense—two hours, Monday through Friday, for up to six weeks. So proximity to an HBOT facility is key for the best outcomes: It makes it easier and more convenient for patients to follow through with their complete treatment.”

Demand for the therapy is high. In the year since the Wound Healing Center opened, its two HBOT units regularly treat four to John Harvey, MD, Mary’s vascular surgeon, is a huge proponent of eight patients a day, the center’s capacity. In addition to MedStar both the limb-saving treatment and the hospital’s new center. St. Mary’s Hospital, HBOT is also available at MedStar Georgetown University Hospital and MedStar Good Samaritan Hospital. “It’s quite comprehensive and advanced, with the latest technology and specially trained, dedicated staff,” he says. “With this service, While HBOT is prescribed for chronic bone infections, burns, MedStar has filled a big void in this community.” side effects from radiation oncology treatment, and other difficult-to-heal conditions, diabetic wounds comprise the bulk HBOT certainly provided the missing ingredient Mary needed. of cases. Poor circulation is the culprit, reducing the flow of oxygen-rich blood to the lower extremities, resulting in foot and “I miss cooking for my work family,” she says. “But thanks to God, leg ulcers. During HBOT, patients breathe pure oxygen inside MedStar St. Mary’s Hospital and the support of my family and friends, a highly pressurized chamber, which mobilizes infection-fighting I’m once again back on my feet and at my stove.” white blood cells, promotes new collagen growth to close open Sporting her cook’s coat, Mary demonstrates wounds and stimulates the body’s other natural healing abilities. the culinary skills she used during her long career. Thanks to MedStar St. Mary’s Hospital, she can still pursue her passion.

ADVANCING HEALTH

23 24 GRADE “A” RESEARCH Overseeing it all is MedStar Health Research Institute, among the top 15 percent of centers nationwide in terms of NIH and other federal funding, and a force for advancing health.

The research institute complements the key clinical services of Last year, thousands of MedStar Health MedStar’s 10 hospitals with work that spans basic bench studies patients and others across the region joined to community-wide initiatives. In 2013, institute staff managed more than 850 grants system-wide, generating more than 500 one of our many studies on promising new peer-reviewed publications. Our current portfolio shows $30 million drugs, emerging healthcare technologies or in basic, clinical and translational research, including major trials novel approaches to care. Each contributed on a long-standing MedStar interest: diabetes.

another piece to the puzzle, leading our In the NIH-sponsored GRADE study, for instance, the research physician scientists closer to understanding institute’s team, led by principal investigator Vanita Aroda, MD, and managing cardiovascular disease, cancer compares the effectiveness of four commonly prescribed, glucose- and other serious conditions. lowering medications when taken with the front-line drug, metformin. Results from the seven-year study could change the lives of patients with type 2 diabetes.

Francisco Estrada of Virginia welcomed the chance to participate.

“I tried diet, exercise and metformin. Nothing worked,” says the retired senior manager for the Federal Aviation Administration. “But within three months of enrolling, my assigned drug—plus the extra follow-up, support and education MedStar provided—helped me lose 30 pounds, finally bringing my diabetes under control.” Dr. Stuart Levine championed GRADE’s expansion to MedStar Good

Samaritan Hospital, which cares for a significant diabetic population. One of the first of 45 sites to initiate the nationwide study, MedStar is also among the most successful study recruiters. That distinction earned us an additional $3 million to expand the GRADE study to Baltimore resident Jimmy Kelly immediately answered the call for Baltimore, beyond the original $4 million award. volunteers and was soon accepted into the hospital’s GRADE study.

“Diabetes is a significant problem among our patient population,” “My numbers have been slipping a little recently, and I felt like it was says Stuart M. Levine, MD, vice chairman, Strategic Growth and an opportunity to manage my condition better,” he says. Research at MedStar Good Samaritan Hospital, GRADE’s second MedStar site. “With a strong program and an equally strong For Francisco, joining the trial had a twofold benefit.

bond with the community, we’re an ideal real-world lab to test “I am forever grateful to MedStar Health and GRADE for the chance academic concepts.” to restore my health, while advancing knowledge about diabetes,” he concludes. “I hope study results will one day help diabetic patients everywhere.”

Leaner, healthier and happier, diabetes study participant Francisco Estrada attributes his newfound success to MedStar Health Research Institute. ADVANCING HEALTH

25 26 Frontline Solutions

Kenneth Veenema, MD, medical director of MedStar’s multispecialty healthcare center in Federal Hill, sees one of the many patients grateful for high quality, comprehensive and convenient health care right Baltimore’s historic Federal Hill is back on in the neighborhood. the frontlines of change. This time it’s not a battle that’s put it there but a building: the new 28,000-square-foot multispecialty healthcare center, MedStar Health at Federal Hill. Its July opening embodies health care’s continued expansion into the community and MedStar’s position as a standard-bearer for readily accessible, convenient care.

“Organizing care around patients’ needs, with respect to their busy work services in cardiology, orthopaedics, sports medicine, surgery, rehabilitation, Then misfortune struck again. “Scott is a good example of how we fast track patients so and life schedules, makes it a lot less likely that someone will put off seeing podiatry, and women’s health. The space’s design promotes quick and easy they can get a rapid and accurate diagnosis from a specialist, a doctor or ignore symptoms,” says Bob Gilbert, president of MedStar collaboration for the best, most thorough treatment plans, while an integrated “I sprained my knee playing tennis and immediately went back to the and start early, definitive treatment,” says Dr. Veenema. Ambulatory Services. electronic health record makes patient medical information readily available Federal Hill site,” says Scott. “Once again, Dr. Veenema examined me on “By concentrating care in one place with fewer appointments throughout the system. Free or low-cost health screenings, injury clinics, the spot, and I received the orthopaedic care I needed right upstairs.” and eliminating long waits, we’re literally changing the So in 2012, the system began introducing MedStar PromptCare—urgent and health promotion and support programs are planned for the future. way people experience health care.” care centers—followed by multispecialty care centers with a range of The population served by MedStar Health at Federal Hill is a mix services. Ten urgent care and three multispecialty care centers later, the Its opening came just in time for Federal Hill resident Scott Schaefer. of longtime residents who can’t or won’t travel far for health care, network is still growing. After being rear-ended by a texting teenager, excruciating back pain sent commuters working in the area and young transplants like Scott Scott to the site’s MedStar PromptCare center, where he was seen by looking for quick, convenient service. MedStar Health at Federal Hill is the largest and most comprehensive to Kenneth Veenema, MD, medical director and sports medicine specialist. date and the first integrated, multispecialty care center to serve the south In one visit, Scott was examined, X-rayed and diagnosed, without leaving Baltimore community. Under one roof, patients can receive urgent, primary the building. After a few weeks of on-site physical therapy, he returned to and preventive care; radiology and laboratory studies; and specialty his active routine. ADVANCING HEALTH

27 28 LEADERSHIP

BOARD OF DIRECTORS CORPORATE EXECUTIVES ENTITY PRESIDENTS CORPORATE AND OPERATIONAL LEADERSHIP William R. Roberts (Chair) Mark T. Jensen Kenneth A. Samet, FACHE Traci K. Anderson Gregory J. Argyros, MD Jennie P. McConagha President and Chief Executive Officer Co-Founder, Bowie & Jensen, LLC President and Chief Executive Officer President, MedStar Visiting Nurse Association Senior Vice President, Medical Affairs and Chief of Staff and Vice President WR Roberts Company Chief Medical Officer Operational Communications Christopher G. Kalhorn, MD Michael J. Curran Bradley S. Chambers MedStar Washington Hospital Center Rosie Allen-Herring Associate Professor of Neurosurgery Executive Vice President President, MedStar Union Memorial Hospital Stephen T. Michaels, MD President and Chief Executive Officer Director of Epilepsy Surgery, Functional Chief Administrative and Financial Officer Senior Vice President, MedStar Health Bruce A. Bartoo Vice President, Medical Affairs United Way of the National Capital Area Neurosurgery and Pediatric Neurosurgery Senior Vice President and MedStar Hospital Center and MedStar Georgetown University Hospital M. Joy Drass, MD Robert J. Gilbert Chief Philanthropy Officer Chief Operating Officer and Chief Medical Officer Chandralekha Banerjee, MD Executive Vice President President, MedStar Ambulatory Services MedStar St. Mary’s Hospital Chief of Infection Control Roberta M. Loker Operations – Washington Region Stuart B. Bell, MD MedStar Good Samaritan Hospital Loan Officer, Primary Residential Mortgage, Inc. Richard L. Goldberg, MD Vice President, Medical Affairs Susan K. Nelson Stephen R. T. Evans, MD President, MedStar Georgetown University Hospital MedStar Union Memorial Hospital Vice President, Finance and Andrew J. Berry Vincent J. Martorana, DPM Executive Vice President Senior Vice President, MedStar Health Accounting Operations President, Drew Berry & Associates Section Chief, Podiatric Surgery Medical Affairs and Chief Medical Officer Martin L. Binstock, MD MedStar Franklin Square Medical Center Jeffrey A. Matton Vice President, Medical Affairs David P. Noe Anthony J. Buzzelli Oliver M. Johnson, II President, MedStar Good Samaritan Hospital MedStar Good Samaritan Hospital Vice President, Human Resources Vice Chairman, Deloitte (Retired) Catherine A. Meloy Executive Vice President and General Counsel Senior Vice President, MedStar Health President and Chief Executive Officer Lisa M. Boyle, MD Edward W. Robinson William Couper Goodwill of Greater Washington Maureen P. McCausland, DNSc Peter W. Monge, FACHE Vice President, Medical Affairs Vice President, Performance Improvement and Retired President Senior Vice President and Chief Nursing Officer President, MedStar Montgomery Medical Center MedStar Georgetown University Hospital Operational Support MidAtlantic – Bank of America William J. Oetgen, Jr., MD, MBA (Vice Chair) Senior Vice President, MedStar Health Senior Vice President, Science and Quality Carl J. Schindelar, FACHE Joel N. Bryan Anthony O. Sclama, MD John J. DeGioia, PhD American College of Cardiology Executive Vice President Samuel E. Moskowitz, FACHE Vice President, Treasurer Vice President, Medical Affairs President, Georgetown University Operations – Baltimore Region President, MedStar Franklin Square Medical Center MedStar Franklin Square Medical Center Kenneth A. Samet, FACHE Senior Vice President, MedStar Health Diane L. Caslow Donovan Dietrick, MD President and Chief Executive Officer Christine M. Swearingen Vice President, Strategic and Larry L. Smith Director of Obstetrics and MedStar Health Executive Vice President Dennis W. Pullin, FACHE Business Planning Vice President, Risk Management Gynecology Residency Program Planning, Marketing and Community Relations President, MedStar Harbor Hospital MedStar Franklin Square Medical Center Allen J. Taylor, MD Senior Vice President, MedStar Health James Farley Mark S. Smith, MD Chief of Cardiology Eric R. Wagner Senior Vice President, MedStar Medical Group Director, MedStar Institute for Innovation Marc N. Duber MedStar Heart & Vascular Institute Executive Vice President John D. Rockwood Executive Vice President and MedStar Georgetown University Hospital and External Affairs and Diversified Operations President, MedStar National Rehabilitation Network Frederick Finelli, MD Pegeen A. Townsend Chief Operating Officer MedStar Washington Hospital Center Senior Vice President, MedStar Health Vice President, Medical Affairs Vice President, Government Affairs The Bernstein Companies MedStar Montgomery Medical Center Sara E. Watkins John Sullivan Michael R. Yochelson, MD Barbara R. Heller, EdD, RN, FAAN Senior Vice President, Capacity Partners President, MedStar Washington Hospital Center Debora J. Kuchka-Craig Vice President, Medical Affairs Vice President, Strategic Initiatives, Senior Vice President, MedStar Health Vice President, Managed Care MedStar National Rehabilitation Network Nursing and Health Sciences The Honorable Togo D. West, Jr. Laureate Education, Inc. Chair, TLI Leadership Group Neil J. Weissman, MD, FACC Stuart M. Levine, MD President, MedStar Health Research Institute Vice President, Medical Affairs MedStar Harbor Hospital (effective Dec. 1, 2014) Christine R. Wray, FACHE President, MedStar Southern Maryland Hospital David B. Mayer, MD Center and MedStar St. Mary’s Hospital Vice President, Quality and Safety Senior Vice President, MedStar Health

ADVANCING HEALTH

29 30 OVERVIEW MedStar Southern Maryland Hospital Center MedStar Health Related Organizations Located in Prince George’s County, MedStar Southern Maryland Hospital Center is a MedStar Health Research Institute 255-bed, full-service community hospital. MedStar Health Research Institute is the research arm MedStar Health combines the best aspects of academic medicine, research and innovation with a complete spectrum of clinical services to Its specialty areas include asthma and allergy of MedStar Health. It provides scientific, administrative advance patient care. As the largest healthcare provider in Maryland and the Washington, D.C., region, MedStar’s 10 hospitals, the MedStar Health care, behavioral health, cancer, cardiac care, and regulatory support for research that complements Research Institute and a comprehensive scope of health-related organizations are recognized regionally and nationally for excellence in medical care. emergency and critical care, orthopaedics, MedStar’s clinical services and teaching programs. MedStar has one of the largest graduate medical education programs in the country, training more than 1,000 medical residents annually, and is the radiology, rehabilitation, sleep disorders, stroke MedStar Health Research Institute conducts clinical, medical education and clinical partner of Georgetown University. MedStar Health is a $4.6 billion not-for-profit, regional healthcare system based in care, and women’s and newborn services. healthcare delivery and outcomes research in hospital and Columbia, Md., and one of the largest employers in the region. Our 30,000 associates and 6,000 affiliated physicians all support MedStar Health’s MedStarSouthernMaryland.org ambulatory settings, and its expertise includes translational patient-first philosophy that combines care, compassion and clinical excellence with an emphasis on customer service. Visit us at MedStarHealth.org research into disease prevention, diagnosis and treatment. MedStar St. Mary’s Hospital MedStar Health Hospitals MedStar St. Mary’s Hospital, located in St. Mary’s MedStar Ambulatory Services County, is a full-service hospital committed to MedStar Ambulatory Services is rapidly developing MedStar Franklin Square Medical Center MedStar Harbor Hospital delivering state-of-the-art emergency, acute convenient and accessible care centers, making quality Located in northeast Baltimore County, Since its founding in 1903, Baltimore’s MedStar inpatient and outpatient care to residents of health care available by bringing primary, urgent and MedStar Franklin Square Medical Center is Harbor Hospital has grown alongside the southern Maryland. The only hospital in this specialty medical care close to where people live and the largest community in community it serves. MedStar Harbor Hospital growing area, it offers advanced technologies and work. MedStar Ambulatory Services will continue to Maryland, and offers a full range of services offers a full range of healthcare services for a highly trained staff with excellence in behavioral develop innovative ways to ensure the community can for children and adults. MedStar Franklin patients—from infancy through the senior health, diabetes management, emergency and urgent easily access the quality health services and programs Square Medical Center’s Emergency years. The hospital’s specialty areas include care, hospice, oncology, orthopaedics, radiology, they need, when they need it. orthopaedics, women’s services, cancer care, Department sees more patients annually wellness, and women’s services. MedStarStMarys.org MedStar Visiting Nurse Association diabetes care, fetal assessment, cardiopulmonary than any other hospital in Maryland. MedStar Visiting Nurse Association, a non-profit, in-home rehabilitation, and the treatment of chronic MedStarFranklin.org MedStar Union Memorial Hospital healthcare provider, offers skilled nursing, rehabilitation lung conditions. MedStarHarbor.org Located in northeast Baltimore City, MedStar and infusion therapy for homebound, disabled and chronically MedStar Georgetown University Hospital Union Memorial Hospital is a regional specialty ill patients in Maryland, Washington, D.C., and the northern MedStar Georgetown University Hospital MedStar Montgomery Medical Center and teaching hospital. It is known nationally Virginia region. Personal care services are also available is an acute care teaching and research hospital MedStar Montgomery Medical Center, a for The Curtis National Hand Center, cardiac through its residential services agency. To support good health located in northwest Washington, D.C. community hospital located in Olney, Md., care and orthopaedics, and developed the first in the community, MedStar VNA offers traveling vaccination Its centers of excellence include neurosciences, remains true to its roots by offering sophisticated, hospital-based sports medicine program in the and wellness programs across the region. transplantation, cancer, and gastroenterology. high quality medicine in an atmosphere of nation. The hospital offers a comprehensive range Advanced research and cutting-edge personal, individualized care. With the addition of inpatient and outpatient services, including a MedStar Family Choice technologies have given the hospital a of specialists from MedStar Georgetown diabetes and endocrine center, general surgery, MedStar Family Choice is a licensed HMO serving more than national reputation for medical excellence University Hospital and MedStar Washington oncology, thoracic surgery, and vascular surgery. 100,000 Medicaid beneficiaries in Maryland and Washington, and leadership. MedStarGeorgetown.org Hospital Center, the hospital brings specialty care MedStarUnionMemorial.org D.C. The Maryland plan is a top-ranked Medicaid managed closer to its patients. MedStarMontgomery.org care plan by the Department of Health and Mental Hygiene, and is ranked 17th nationally among Medicaid Plan Providers MedStar Good Samaritan Hospital MedStar Washington Hospital Center by the National Committee for Quality Assurance’s Health MedStar Good Samaritan Hospital is a MedStar National Rehabilitation Hospital MedStar Washington Hospital Center is a 926-bed, Insurance Plan Rankings 2014 - 2015. MedStar Family Choice comprehensive community hospital located Located in northwest Washington, D.C., acute care teaching and research hospital located also operates MedStar Medicare Choice, a Medicare Advantage in northeast Baltimore City. Known for MedStar NRH is a specialty hospital offering in northwest Washington, D.C. The largest private Plan, in the District, with expansion across seven counties in excellence in orthopaedics and rehabilitation, inpatient, day treatment and outpatient programs hospital in the nation’s capital and one of the 50 Maryland beginning Jan. 1, 2015. it also excels in rheumatology, nephrology, specifically designed to aid in the rehabilitation of largest hospitals in the country, MedStar Washington wound care, and burn reconstruction. individuals with disabling injuries and illnesses. Hospital Center is a national leader in the research, Additionally, the campus includes the Good Centers of excellence include brain injury and diagnosis and treatment of cardiovascular disease Samaritan Nursing Center and two senior disease, spinal cord injury and disease, stroke and cancer. The hospital operates the area’s only housing complexes. MedStarGoodSam.org recovery, cardiac rehabilitation, orthopaedics, adult burn center, surgical critical care center and and pediatric rehabilitation. MedStarNRH.org the region’s premiere shock . MedStarWashington.org ADVANCING HEALTH

31 32 NUMBERS

Fiscal Year 2014 Community Benefit 2013 - $309.7 M Partnering With MedStar Health Through Philanthropy Total number of inpatient admissions / observation stays 207,731 Number of inpatient admissions 148,685 Research Throughout the region, the associates of MedStar Health lead with As a not-for-profit organization, MedStar Health is proud to reinvest $7.0 M knowledge and compassion. The growing philanthropic support income to fund our mission of caring. Philanthropic support matters Number of observation stays 59,046 received from grateful patients, families, community members, and in everything we do. We encourage you to engage us in a conversation Community others serves as a powerful validation of the value that MedStar brings to explore how we might work together to fulfill our mission and Total number of outpatient visits 3,965,578 † Services to the health and well-being of the region. advance health across our region. Your return on such an investment Number of home health visits 293,063 $54.2 M promises to be real, meaningful and life-changing for thousands of You are invited to partner with MedStar Health by making a philanthropic Number of visits 549,258 patients and families, including those closest to you. Medical investment in the way that matters most to you. Your investment may Number of physician office visits 1,444,043 Education be motivated by gratitude for the excellent care and service a loved one To explore philanthropic investment opportunities at MedStar Health, $139.3 M received, or from a desire to improve the health of others. No matter please contact Bruce A. Bartoo, CFRE, senior vice president and Number of ambulatory visits and surgeries 1,679,214 Charity Care/ the reason, philanthropic support enhances care delivery, innovation, Bad Debt* chief philanthropy officer, at 410-772-6517, or visit us online at $109.2 M research, and quality and safety programs that enable clinicians to MedStarHealth.org/Philanthropy. Net operating revenue $4.62 B provide world-class care right here in the community. Money spent caring for patients $4.49 B Earnings from operations that were reinvested $136 M Investments in information technology $60 M

Philanthropy $38 M * Includes unfunded government-sponsored programs; D.C. hospitals only.

Number of associates, residents and fellows 30,000 † Includes subsidies, community health improvement services, community building activities, financial Nurses 8,400 contributions, and community benefit operations. Residents and fellows 1,070

Number of affiliated physicians 6,000 Employed physicians 1,700

ADVANCING HEALTH

33 34