Community Hospitals Seeking Partnerships: Q&A With ValleyCare's Scott Gregerson

For community hospitals, the option of partnering with larger medical centers that have access to innovative technologies and national expertise is attractive as it allows for greater access to specialized care for patients. Partnerships also allow patients to stay closer to home while giving them access to enhanced care. The Regional Cancer Center at ValleyCare in Pleasanton, Calif., recently partnered with UC San Francisco Helen Diller Family Comprehensive Cancer Center for the some of the same reasons. Scott Gregerson, Vice President Strategic Partnerships at ValleyCare Health System, discusses his thoughts on partnerships and offers advice on selecting partners and overcoming challenges.

Question: Why might a community hospital decide that it needs to partner with a larger facility?

Scott Gregerson: Normally these partnerships are driven by the belief that there are things that we can accomplish together that we simply can't do independently. In this era of medicine, it is horribly inefficient and frankly ineffective to replicate services that can be provided through a partnership. The most commonly cited drivers of an academic affiliation include access to advanced modalities and sub-specialized resources for unique diagnoses.  These are important benefits for a limited number of cases, but perhaps more importantly these relationships allow for the incorporation of best practices, access to clinical trials and expansive tumor board networks in the community setting near the patient’s home and support system.  These types of arrangements are fundamentally about designing the care system around the needs of the patient rather than having them adapt to us.

Q: What are some features of an attractive clinical partner for a community hospital?

SG: For us, there are a number of considerations. First and foremost it has to be a partner that is well-respected by both the patients and the participating physicians. We always seek the guidance of relevant physicians first as they are critical to the success of any relationship. Secondly, a partner must complement and even enhance the brand and clinical reputation of the institution. The relationship must inspire confidence in patients that they are receiving the best care possible. They should be a good "cultural" fit which for us means a maniacal focus on quality and the patient experience.

Q: What are some of the challenges of entering into a partnership with a larger facility, and how would you suggest overcoming them?

SG: The biggest issue is ensuring that the effort is constantly being evaluated and modified and doesn't simply sit on the shelf.  Particularly with a large partner, it is critical that personal relationships be developed and scheduled meetings are well attended by key players. It is a good idea to memorialize these expectations in the original agreement, as it is critical to the long-term success.  Additionally, the decisions being made must be implemented in a timely fashion. Follow-up and accountability are essential so specific individuals must be assigned to oversee the endeavor. Timelines should be closely monitored and seldom modified.

Q: How does partnering with UCSF's cancer center benefit your facility and the community it serves?

SG: The real benefit to our community is that patients are afforded access to clinical trials and sub-specialty services that otherwise wouldn't be available in a community of this size. Additionally, the right partner provides immediate access to innovations in care delivery reinforcing a culture of constant improvement.  Finally, a partner allows for a consistent care process that can be managed and refined reducing variability in the event a transfer is necessary.

Q: Are there certain specialty service lines in community hospitals that are enhanced when the hospital partners with larger facilities?

SG: I personally believe that partnerships can be appropriate for almost any service line, depending on the specifics of the institution. That said oncology services are ideal as advancements come quickly and some of the expertise and technology is prohibitively expensive. It is very difficult for any institution beyond the largest centers to offer patients all the treatment options available and thus a partnership can be very effective at extending the reach of these advanced centers with dramatic effect.

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