Ten years ago Norman Regional Hospital Authority trustees envisioned a second hospital. Five years later, in the fall of 2009, the HealthPlex opened on the west side of Interstate 35 at Tecumseh Road.
Now, hospital leadership is looking at reducing redundancy and consolidating services at the two Norman campus locations to better serve patients through more efficient care.
It will also cost of heck of a lot less to operate.
The HealthPlex is a 152-bed, specialty hospital with three main areas of service: cardiology and cardiovascular services, orthopedic and spine services and women’s and children’s services, but its location on the interstate makes it a prime target to ultimately provide the majority of Norman's acute care inpatient services.
The HealthPlex opened in 2009 as a $130 million facility on the 92-acre campus. Since that time there have been improvements and expansions at the HealthPlex, and the Heart Plaza opened next door to serve outpatient heart and vascular care.
“We built the HealthPlex at a time when inpatient admissions were going up every year,” said NRHS sr. vice president and COO Greg Terrel.
That trend has changed. Outpatient is the largest area of growth in the hospital industry while inpatient stays are declining. That pattern is driven by technological advances in types of services and even more by insurance, Medicare and Medicaid payment guidelines.
Consolidating the intensive care units — critical care is the most expensive care NRHS offers — is a top priority for patient safety and for saving money.
“Getting on I-35 is pretty simple math,” said Dr. Aaron Boyd during a campus consolidation master plan vision meeting on Thursday. “I think it's a mistake to not think regionally.”
Other changes may facilitate improved outpatient service.
“We focus completely on the inpatient,” Terrell said. “I think one thing the new facility has to do is be more efficient in serving the outpatient.”
Health care providers are now more proactive in treating people out front in a less expensive environment, said Josh Theodore of Page Southerland Page Inc., the team which is leading the visioning process.
NRHS includes three campus locations as well as several clinics. A third location in Moore was acquired in 2006 when the former owners of Moore Medical Center filed for bankruptcy. Norman Regional purchased the small hospital and promised to continue healthcare for the Moore community. In 2013 when a tornado damaged Moore Medical beyond repair, the old hospital was demolished and plans for a new facility grew out of a series of community and stakeholder meetings.
A temporary emergency department and outpatient services are serving Moore while the new facility is being built, but the new Moore Medical will have a smaller footprint, a more vertical structure, and will focus on providing outpatient services.
While the future possibility for expansion is there, the new Moore Medical Center currently under construction will not offer hospital-based, acute inpatient care. Already, the HealthPlex is serving Moore's inpatient needs.
Norman Regional's original Porter campus facility is an aging structure which has become expensive to maintain. Changing demographics and changes in reimbursements from insurance, Medicare and Medicaid have left smaller hospitals scrambling to survive. The Affordable Care Act and changes in technology create a complex set of challenges for health care providers.
While the loss of Moore Medical by the tornado was tragic, some good has come from that loss. Hospitals as small as Moore are failing across the nation. Because Moore Medical was a complete loss, the community was able to visualize what medical services are needed and a more economically viable, a state-of-the-art facility is going in its place.
Additionally, insurance proceeds are paying for the new facility.
In the case of Norman Regional and the HealthPlex campuses, there are no blank slates or insurance payouts to foot the bill.
One of the challenges in Norman Regional's visioning process is to get as many services in one place as possible while still serving the east side of Norman. It simply makes more sense to expand the HealthPlex and eventually put the majority of acute inpatient care at that campus.
But the HealthPlex is not currently large enough to be the primary hospital in town.
The biggest challenge is not in creating a vision that will make everyone on both sides of town happy — engaging the community in public meetings and surveys can help create picture of how best to serve Norman and surrounding areas at all three campus locations.
The real challenge will be paying for it.
The Norman Regional Health System does not have the bonding capacity at this time to move forward with a major, multimillion dollar project. And it needs to upgrade facilities to stop leakage — the loss of services to other markets such as hospitals in Oklahoma City — and to bring in a stronger regional market.
Currently, there is a lot of duplication of services and shared staff between the Porter and the HealthPlex campuses. If some of those can be consolidated without building new structures, some progress could be made.
Whatever the ultimate vision, it will have to unfold in stages and implementation could take years.
Other possible trends in the future could include remote access and virtual health systems.
“I don't think we're as far away from that as even 10 years,” said Dr. Darrin Smith.
“Really the driving force is going to be wellness and quality,” said hospital board member Doug Cubberly.
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