MIT
Reports to the President 1994-95
Inpatient care continues to be provided in the Inpatient Unit of the Medical
Department. Although the number of CRC inpatients has declined, the intensity
of investigations performed has increased in the past year. Innovative studies
of protein metabolism have involved 24 hour intravenous and intragastric
infusions of amino acids and studying the rates of synthesis and breakdown of
proteins. Additional studies conducted have shown that melatonin, a hormone
released by the pineal gland, plays a major role in the induction of sleep.
Interchange between the CRC and the remainder of the Medical Department
continues to provide the CRC with sophisticated consultations. In addition,
Dr. Shiang, Chief of the Inpatient Unit, attends CRC staff meetings and
provides consultation and continuity during the year.
Highlights of the year have included a contract with the Whitehead Institute
for Medical Research for the provision of environmental medical services. This
new agreement has allowed the addition of another position in the Biosafety
Office. EMS participated in the oversight of the move of personnel from the
Biology Department to the new building and reviewing the older buildings for
radiation hazards, chemicals and biosafety agents. Another area was a
comprehensive review at Lincoln Laboratory regarding the use of amines in the
ventilation system. As part of the review a number of Lincoln Laboratory
personnel were evaluated in the Medical Department. A report was prepared
advising the decrease of these materials over the next several years. EMS
sponsored an international seminar on toxicology and the proceedings will be
published by "Inhalation Toxicology," a peer reviewed journal. Medichem, an
international organization that is a scientific advisory committee of the
International Commission on Occupational Health, is planning an annual congress
which will be held at MIT in September 1995. Preparations for this have
included preliminary meetings and the attraction of a number of international
scientists both as speakers and as participants in the program. An
occupational medical resident from Boston University Medical Center has
participated in EMS activities and it is hoped that these educational
activities can be expanded in the future. The Director continues to be a
member of a number of Institute committees that relate to environmental medical
services. Efforts are being made to integrate EMS activities into the
educational curriculum at MIT initiated through the Center for Environmental
Health Sciences. Finally, a regional search has identified Claudia Mickelson,
Ph.D. who was offered and has accepted the position of Chief, Biosafety Office,
following the departure of Dr. Daniel Liberman.
The HES continued to define its health promoting mission and expand programming
for students, employees and families in the MIT community. The MedLink peer
education program coordinated by health educator, Tracy Desovich, continued to
thrive and included more than 100 students representing 25 residents' units. A
variety of programs that included immunizations, AIDS and sexually transmitted
disease awareness and prevention, acquaintance rape, health promotion, KISS
(Keeping Intimacy Safe and Sensual), Safer Spring Break programs, were all well
received during the year. Special emphasis has been directed toward increasing
awareness on campus of the harmful effects of binge drinking, both on the
drinkers as well as the nondrinkers. The CORE Survey of alcohol use patterns
was distributed to a random sample of undergraduates and 40% of those surveyed
returned the confidential questionnaire, results of which will be made
available for orientation of new students and for focusing the efforts of
health education and other interests of the Department in appropriate areas.
The Health Education Advisory Group which was reconstituted this year served to
increase the awareness of health education activities within the Medical
Department. Increased visibility resulted and this led to the recruitment of
closer working relationships with Nutrition, Pediatrics, Ob/Gyn as well as with
the Athletics Department, the Deans Offices, Family Resource Center and Public
Service Center. Circulation of brochures, videos and books continues to grow
out of the Health Education Library. Under the leadership of Sally Ciampa, the
rich and extensive IAP lecture program and workshops in spring and fall was an
outstanding success. We are currently searching for a new Director of the
Health Education Service and with it an expectation of an even broader array of
health education activities directed at both students and other members of the
MIT community will ensue.
The volume of patient visits at Lincoln Laboratory increased to 3,624, up from
the 1994 figure of 3,455 and the 1993 figure of 3,587. A variety of programs
were instituted which included skin cancer screening, performance improvement
monitoring of the RN and MD, monitoring of prescription provision. A patient
satisfaction survey was completed and a FAX machine was procured to improve the
flow of clinical material between the Medical Department and the Lincoln
Laboratory Clinic.
A hepatitis B immunization campaign for students was initiated and completed
during the academic year with a significant number of students finishing the
program. We intensified our interest in alcohol abuse in students working with
the Office of the Dean for Student Affairs and a survey form was developed on
alcohol which is presently being distributed. The mailing will be focusing on
pre-matriculating freshmen who will be entering in late August 1995 and the
results of the survey should be available for use by senior administration and
members of the Department during R/O week in late August/early September. The
Student Medical Advisory Council has continued to meet and allows student
members an increased voice in the activities of the SHS. In particular, there
were important student contributions in the areas of communication, self care
and access to care. The student Blue Cross/Blue Shield hospitalization policy
had its premium for the year kept at the same cost for the individual student
and in addition plans are under way to provide a pharmacy drug benefit for
students that enroll in the student Blue Cross/Blue Shield hospitalization
policy.
In January 1995 coordination and management of primary care and specialty care
were combined in one position. The streamlining of the management of clinical
services should allow the Medical Department more flexibility and
responsiveness for the clinical needs that lie ahead. Efforts directed at
increasing the value of the services are under way and with it programs to
reduce costs while maintaining or improving patient care are in place already
in the Pharmacy and in the Laboratory and other areas are gearing up for
similar efforts. Programs are being developed for efficient use of hospital
resources, the MIT Inpatient Unit as well as acute care hospitals that we use
in the community. Active negotiations with hospital providers, medical service
organizations and health insurers are under way in an effort to maximize
patient benefit and minimize costs. More effective use of the Inpatient Unit
and coordination of inpatient care with outpatient care are goals. Clinical
care data is being generated and reviewed so that we can assure appropriate
staffing and use of our resources and exploration of different care delivery
styles is being undertaken. Work has begun on implementing the strategic plan
with an overriding goal to maintain excellence of clinical care in the face of
a changing health care environment. Medical Department staff members continue
to play and active role in the education of medical students and medical
engineering students in the HST program. In addition, many staff members
participate in activities in the MIT campus serving as premedical advisors,
mentors for MedLinks program and speakers in educational programs offered by
the health education office and other campus groups.
Twenty three years after its inception, the MIT Health Plans strives to
continue to find ways to offer broad benefits at competitive premium rate. The
Department's Strategic Plan is completed and the Health Plans remain committed
to lowering costs through improved direct hospital contracts and better rates
through our administrative services organization. Internally, the operational
processes are under scrutiny for ways to improve efficiency and doing the daily
business of claims processing, enrollment and financial analysis more
effectively. Turnaround processing time for outpatient mental health claims
has been reduced. Authorization process for outpatient mental health has been
streamlined. Projects to improve daily operation are continuing. A recently
hired utilization review nurse will help to reduce the hospital days both in
the Inpatient Unit as well as the outside hospitals and hence reduce our costs.
Cost pressures facing the MIT Health Plans are enormous compared to the larger
HMO's. Our goal is to address the difficult financial issues, remain
competitive and maintain access and care that is expected by the MIT community
staff, faculty and students.
During fiscal 1995 the Medical Department continued on its mission of
operational and strategic initiatives to remain competitive and effective.
Annette Jacobs replaced Linda Rounds as Executive Director and has brought new
perspectives to the operation. Changes in the medical administration were
noted in the Introduction with the assumption by Dr. William Kettyle of the
broad activities previously subsumed by the Associate and Assistant Medical
Directors. The resignation of several internists has presented the Internal
Medicine Section the opportunity to assess their service needs and we are in
the process of recruiting a Health Education Director to enhance communication
with the greater MIT community. As mentioned a utilization review nurse has
been hired to help us reduce hospital costs and a Medical Information Systems
Director will be hired to implement, maintain an automated information system
that will support physicians clinically and provide statistical and financial
information for managing.
The Department's Strategic Plan is completed and we have begun implementation.
Negotiations are under way with hospitals and managed care organizations and we
hope to establish new alliances intended to bring down overall cost structure
and improve continuity of care. Through renewed management focus we have
heightened awareness of and contained costs in the Laboratory and Pharmacy. A
recently completed patient satisfaction survey will provide insight and
direction as we implement strategic planning.
Several cross functional groups are working to improve operational processes
and enhance our ability to provide consistent and accurate general information
to our patients. We will install kiosks in the front lobby to improve access
to general Medical Department and health plans information. We are also
looking to improve the accuracy and completeness of encounter forms and efforts
are under way to facilitate communication between clinical and administrative
staff.
Finally we hope to broaden our marketing efforts to bring information about the
Medical Department to a broader range of the MIT community as well as through a
consolidated publication that will reach out to all of the MIT community who
use the Medical Department for primary care or as a student or member of the
health plan.
APPOINTMENTS
Marie J. Avelino Head Nurse
Esquiel E. Barrera Assistant Biosafety Officer
Janet V. Beyer Director, Nursing Service
Jayne C. Birch Inpatient Nurse
Ann B. Boppe Registered Nurse
Nancy R. Chisholm Inpatient Nurse
Barbara A. Choate Inpatient Nurse
Shabnam H. Herrera Assistant Chief Medical Technologist
Annette Jacobs Executive Director
Michael A. Kane Physician
Susan Kattlove Postdoctoral Fellow, Psychiatry
William M. Kettyle Associate Medical Director
J. Christian Kryder Physician
Meridith S. Lawrence Pharmacist
James A. Marquardt Obstetrician/Gynecologist
Barbara E. McCormack Inpatient Nurse
Lisa S. Newfield Manager, Special Projects
Nancy Sachar Sidhu Postdoctoral Fellow, Psychiatry
Claire M. Sullivan Inpatient Nurse
Katherine Ellin Tobias Postdoctoral Fellow, Psychiatry
Andrea M. Wilson Postdoctoral Fellow, Psychiatry
Lori Ann Wroble Chief, Obstetrics/Gynecology
RESIGNATIONS/RETIREMENTS
Rochelle G. Alexander Coordinator, Quality Assurance and Risk
Management
Judith A. Badner Postdoctoral Fellow, Psychiatry
Janet M. Bertolino Assistant Chief Medical Technologist
Jayne C. Birch Inpatient Nurse
Diana Smith Bowling Postdoctoral Fellow, Psychiatry
Nancy R. Chisholm Inpatient Nurse
Barbara A. Choate Inpatient Nurse
Theresa E. Connolly Inpatient Nurse
Charles F. Eades Gynecologist
Susan Kattlove Postdoctoral Fellow, Psychiatry
Julie F. Lavallee Assistant Radiation Protection Officer
Cathy J. Lore Postdoctoral Fellow, Psychiatry
Katherine M. Martien Pediatrician
Barbara E. McCormack Inpatient Nurse
Mary C. McDonald Nutritionist
Michael T. Myers Internist
Linda Salza Olson Coordinator, Claims and Members Services
Robert C. Runyon Orthopedic Surgeon
Nancy Sachar Sidhu Postdoctoral Fellow, Psychiatry
Claire M. Sullivan Inpatient Nurse
Sharron M. Thrasher Postdoctoral Fellow, Psychiatry
Andrea Wilson Postdoctoral Fellow, Psychiatry
Ann Morris Zaia Inpatient Nurse
This has been a year of changes: departures and hirings, new responsibilities,
movements to improve operations that will lower costs and strategic planning to
increase our value to our patients and MIT. During the coming year we expect
to make a number of decisions that will define hospital relationships, develop
satellite arrangements in areas convenient to family members of our health
plans, provide more seamless care of an enlarging elderly retiree population,
expand our medical information system and explore ways to enlarge the members
of MIT related people we serve. Health education and prevention will also be
high on the agenda, reaching out to both student and nonstudent populations.
At the same time that we engage in these efforts we shall also prepare the
Department for the re-accreditation process that will occur with an
October/November 1996 visit from the Joint Commission on Accreditation of
Healthcare Organizations.
Arnold N. Weinberg, M.D.
MIT
Reports to the President 1994-95