Op-ed: The hospital of tomorrow in Queens

BY KENNETH L. DAVIS, MD

The new building addition to Mount Sinai Queens, the Queens campus of The Mount Sinai Hospital, now rising in Astoria, is more than just an expansion of a community hospital. The construction project is actually part of a nationwide shift toward a new model of health care delivery: the hospital of tomorrow.

The hospital of tomorrow will be measured neither by the number of new beds, nor even by the four walls of its physical plant. These are traditional, outdated metrics commonly used to describe the hospital of today, a stand-alone facility where services are provided mostly at the hospital itself. The hospital of tomorrow extends out into the community with a full network of physicians and medical offices providing comprehensive care beyond its primary facility, as part of a large, integrated health system, designed to keep patients healthy and out of the hospital and its emergency department.

Toward that goal, Mount Sinai Queens’ new building will house a fully integrated medical practice with new primary care physicians in internal medicine, OB-GYN and pediatrics, as well as specialists in cardiology, endocrinology, and gastroenterology. It will also include new operating rooms and surgeons, which means patients will no longer need to leave their community for all but the most complex surgery. A new and expanded emergency department will provide privacy and dignity for those who need it — all part of New York City’s largest private health system.

This network of doctors affiliated with the hospital of tomorrow is dedicated to maintaining the health of community members, preventing illness and managing diseases through population health management. This is a proactive approach to health care in which the hospital network handles the full medical needs of a community, such as members of a health insurance plan or Medicaid beneficiaries, through cost-effective care. In contrast, the hospital of today is a reactive institution that treats diseases and provides urgent care. This is a high-cost model, nowhere more apparent than in the emergency department, which is vastly overused, particularly by individuals who do not regularly visit physicians and instead rely upon the hospital as a substitute for primary care. Adding to costs is the hospital of today’s fee-for-service model, which incentivizes doctors to over-test and over-utilize expensive medical resources, such as advanced imaging services that may be duplicative or even unnecessary. The hospital of tomorrow is structured to recognize and address these deficiencies in today’s health system.

Where the hospital of tomorrow does increase spending is on improved coordination among practitioners through the use of fully integrated electronic medical records. This allows all doctors affiliated with the health system — from the internal medicine physician at an ambulatory care facility in Long Island City to the brain surgeon at The Mount Sinai Hospital on the Upper East Side — to easily access the exact same patient information and history, facilitating well-orchestrated care. This ends the hospital of today’s disjointed system of isolated medical silos in which primary care physicians, specialists and hospital staff may treat the same patient, but fail to communicate, creating the risk that they are uninformed of each other’s diagnosis, treatment, or even a patient’s prescription history.

The hospital of tomorrow puts in place systems and processes designed to eliminate such confusion, inefficiencies, inappropriate incentives and other causes for less effective health care. As a result, Mount Sinai Queens will encompass a well-coordinated network of health providers, committed to compassionate, proactive care that will always care for inpatients, but strives to keep patients well and out of the hospital, a good outcome for our communities’ medical and fiscal health.

Dr. Davis is CEO and president of the Mount Sinai Health System.

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