January 13, 2012

After hosting a lengthy communication and feedback period, VA New England Healthcare System has requested approval from the Secretary of Veterans Affairs to officially integrate VA Boston Healthcare System and Bedford VA Medical Center. This supports a regional approach to VA health care and improving the services available to eastern Massachusetts Veterans.
 
In November, VISN 1 conducted a full analysis of the proposal.  We included it in our submission to Secretary Shinseki. A copy of it can be found by visiting http://www.newengland.va.gov/whitepaper.pdf. Our plan is to integrate the two systems with one leadership team, one medical staff and one medical record.  If the Secretary approves our proposal, all four campuses (Bedford, Brockton, Jamaica Plain and West Roxbury) would continue to operate. No facilities would close. No current inpatients would be moved to a different facility. None of the existing CBOCs would be affected.  Current staff would neither lose their employment nor see a decrease in pay.

If the proposal is approved, care to Veterans would improve in many ways. The integration of the electronic medical record systems would make all clinical information (doctor’s notes, labs and medication lists, etc.) readily available to clinicians across both sites. A single medical staff would allow specialists from Boston to add clinics at Bedford. A single system would also allow for better coordination of appointments and transportation between the sites.

VISN, Bedford and Boston leadership met on January 9. All present were unanimous in agreeing that starting the planning for a potential integration now, rather than later, is important. It allows us to be forward-thinking and to develop a plan that is both methodical and sensitive to all the affected stakeholders. As a result of this meeting, I appointed a steering committee that will include the quadrads of both facilities, and be supported by a full time project manager. Over the next three months, the steering committee will develop a comprehensive plan to guide the implementation, should it get approved. Regardless of the Secretary’s decision, more cooperation in the Greater Boston area is the right thing to do for both our staff and our patients.

As we move forward with this planning, the leadership group established four principles to guide this work:

1. Put Veterans first and employees a close second: Putting our patients first and providing safe, effective and high-quality care is our top priority. We want to make sure no patient is harmed or his/her care diminished during the integration process. Similarly we will safeguard the financial, personal and career interests of all staff.
2. Be transparent: The process, planning, decision-making and implementation for this potential integration would remain open and transparent to the Veterans, employees and other stakeholders.
3. Respect all stakeholders: Bedford and Boston employees would be included in the discussions regarding service line structures, and two-way communication with all stakeholders, including Veterans and their families, would be promoted at all times. All stakeholders would be treated with respect.
4. Be deliberate and plan carefully: The VISN has assigned a full-time project manager to support the process. The VISN will provide additional support so any costs of the integration would not come from the medical centers’ budgets for clinical care.

We will continue to update stakeholders, including staff and patients, of any changes that may result from the proposed integration. While issues related to staffing would only affect a small group of employees, and the vast majority of employees would see few or no changes, this proposal has no doubt caused anxiety for some. We want to be thoughtful in our approach in an effort to ease any concerns for all our employees.

Overall, this is an exciting opportunity to make the excellent health care we provide to Veterans even better. With the combined resources and talents of these two institutions, an integrated Greater Boston Healthcare System would be one of the flagship hospitals of the VA system, and a leader among the many fine teaching hospitals in the Boston area. I ask for your participation in this effort and thank you for helping us to make VA’s health care more accessible to a patient population that both needs and certainly deserves it. If you have any questions, you can submit a comment, or visit our frequently asked questions section.

Respectfully yours,

Michael F. Mayo-Smith, MD, MPH

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