2018 MEDICAL DIRECTORSHIPS AT THE WILLIAM W.
BACKUS HOSPITAL
John Foley, MD.
Chief of Cardiology, the William W. Backus and Windham Community Hospitals
Director of Cardiology, Hartford HealthCare Medical Group
One thing is for certain in life and also true in healthcare: change,
often unexpected. I finished my cardiology fellowship in 1999 and
moved to Norwich, Connecticut and served as an invasive, non-
interventional, private practice cardiologist. For several years, in
addition to my practice in Norwich, I worked part time as a Clinical
Instructor of Medicine at Yale in the Advanced Heart Failure and
Transplant program. I became involved in medical society leadership
from my early days in CT. I held numerous leadership positions,
including President in both the New London County and the CT
State Medical Societies. I also served four terms on my town’s
Representative Town Meeting.
These leadership positions allowed me to work closely with various
federal and state legislators, including the Governor’s Office, to help
shape healthcare policy. It was during these days working on the
politics of healthcare and my community, that I became interested
in healthcare policy and the system of care delivery. Because of this
I enrolled in the American Association for Physician Leadership’s
Certified Physician Executive program and hope to complete the
certification in 2019.
It is estimated that nearly half of our population will have a cardiac
or vascular problem in the next 20 years. 5-year growth trends show
a decline for inpatient cardiac and vascular care with an increase
for both in the outpatient setting. Hospitals’ traditional focus on
inpatient care, which was driven by the current profitability of
traditional fee-for-service programs like cardiology, is out of step
with an emerging focus on value-based healthcare and population
health. While technology and scientific advances are vital, it is
wellness and health maintenance that are the ultimate objectives.
Our “patients” no longer accept that role of passive consulter.
Instead, they consider themselves to be consumers of care. Medical
providers, most notably in primary care fields, are also consumers of
services. In reality, the consumer, whether a “patient” or a provider,
expects convenient access to care, low cost, high quality, and an
exceptional patient experience. Hartford HealthCare maintains
these four tenets as drivers to excellence in care delivery.
In 2014, I was hired to develop a cardiovascular program in the
Hartford HealthCare East Region. At that time there was a single
cardiology office in Windham, Connecticut with 3 cardiologists.
Today the East Region has grown to 6 offices staffed by 13
physicians and 2 APRNs. In 2014, we offered general cardiology
alone. Since those early days, we have expanded and now provide
the following services:
• Both Outpatient and Inpatient Vascular Surgery programs with
a fully accredited outpatient vascular lab. We plan to continue
significant growth in vascular procedures and surgery in the
coming year.
• Our Electrophysiology program involves in-office consultation
with device implantation and follow-up. We are expanding to
include bi-ventricular devices and in-patient services.
• Working with Connecticut Children’s Medical Center we have
both pediatric and adult congenital clinics in our Norwich office.
This has led to training programs for our echo sonographers,
which have in turn improved the proficiency and excellence of
our diagnostic studies.
The Heart and Vascular Institute (HVI) is a vital part of the growth
strategy for cardiac and vascular care. The HVI helps to integrate
the multiple sites and programs throughout the Hartford HealthCare
network into a cohesive system of highly efficient and coordinated
care. Our expectation is that regardless of what office or facility a
person goes to receive care, the same high standard of quality will
be assured.
The growth of our primary care network is essential. The challenge
is for the system to develop personalized care that meets the
needs of the individual, not the healthcare system. One size fits all
no longer applies. For instance, we continue to develop our home
service and telemedicine programs to expand access and enhance
service delivery. Smart phone and online technology has been
primarily limited to making appointments. Patients should also
be able to track any delays with the provider’s schedule, retrieve
results of testing, do virtual follow-up visits, and generate a patient
satisfaction survey while still in the doctor’s office. Imagine our
office and hospital patients being able to generate, in real time,
scores for the care they receive. This data would allow us to better
tailor our programs and make rapid change expeditiously rather than
waiting months for survey data.
Continued on page 8
FALL 2018 7
 2018 MEDICAL DIRECTORSHIPS AT THE WILLIAM W. BACKUS HOSPITAL
In October 2018, we will be joined by our new EP physician, Paras
Bhatt MD. This will expand the diagnostic and treatment options
for arrhythmia at the William W. Backus Hospital. Members of
the Hartford Heart Failure and Transplant team have begun seeing
patients twice a month in Norwich. Over the next year, as the
volume grows, our hope is to expand access both in our office and
at the hospital. Vascular surgery, as mentioned previously, continues
to increase the number of cases done at Backus, both interventional
and surgical.
We intend to launch a Cardio-Oncology program this year. A
physician working group has been meeting for several months
to brainstorm this project. Through this group both oncologists
and cardiologists learn from each other and partner to develop
standards of care for oncology patients with cardiovascular issues.
Backus and Windham Hospital have 3D echocardiography and strain
imaging which will be invaluable in the care of cardio-oncology
patients.
We are developing standards of care and standard workflows
that will improve the patient and referring provider experience.
Most importantly, we know that our patients prefer the clinic to
the hospital bed. Infusion centers are a clear example of how one
program can dramatically improve access to care, raise quality,
and lower costs through prevention of admissions. This has been
observed in the infusion clinics now up and running in Windham,
Norwich, and Plainfield.
8 THE OPEN JOURNAL
While many healthcare systems look to an employment model as
the means to integrate providers within the community, Hartford
HealthCare continues to embrace a variety of ways to bring
independent and private practice providers into the system. I look
forward to continuing to foster the relationships between these
independent providers and Hartford HealthCare in the coming years.
As long as access, quality, cost, and excellence are aligned, we can
move forward together.
I have outlined the many changes we envision in the coming years.
It is the work being done behind the scenes on population health
that will identify the metrics leading to chronically ill patients
achieving wellness and health stability. The focus on wellness
and population health is a federal mandate guiding the future of
healthcare in this country. How we evaluate its success or failure
and how to determine compensation to those who provide the care
are technological and economic challenges.
It is an exciting time to be in healthcare. Change is much more than
a buzzword; it’s a way of life. In the end, as long as we maintain our
focus on access, cost, quality, and patient satisfaction we will not
go wrong. n