The Task Force on Medical Care for the MIT Community: An Update from MIT Medical

William Kettyle

For more than 100 years, MIT has been providing convenient, on-site healthcare services. Eventually, MIT Medical grew into a comprehensive, multi-specialty, group practice offering services to all members of the community, from the very young to the most senior. Through our various insurance plans, we care for the entire student population, many graduate student families, and almost half of the faculty, employees, and their families. We promote campus wellness and healthy lifestyles. We plan for campus emergencies. We advise Institute leadership on healthcare policy and matters related to the health of the campus. And we care deeply for the health of the individuals in the community and for the health of the community as a whole.

Given the complexities of our mission, our continuum-of-care model, and the impact we have on the lives of individuals, we welcome occasional opportunities to look at and learn about ourselves with the help of others, both those inside and outside our community. Our goal is to have broad input and comparative information to help us evaluate and continuously improve our services to the MIT community.

We had just such an opportunity in 2004 when MIT President Charles Vest created the Task Force on Medical Care for the MIT Community. Its charge was to examine the cost and quality of medical services and health insurance coverage provided by MIT to its students, faculty, employees, retirees, and post-doctoral affiliates and fellows. In November 2005, the Task Force recommended that “the MIT Administration express its confidence in and strong support of the basic model for medical care and medical insurance that has served the Institute so well for many decades.”

The following December, a multi-disciplinary working group was convened to assess and address the 41 recommendations included in the Task Force’s final report and to work diligently to assure implementation of the ideas and suggestions that had been generated. In March 2007, Terry Stone, MIT’s Executive Vice President and Treasurer, announced that the working group had successfully reviewed and made determinations regarding each of the recommendations and offered an update on each outcome.

The 41 recommendations fell into two broad categories: those pertaining to MIT Medical and those pertaining to MIT’s health insurance programs. For MIT Medical, the Task Force, in partnership with the working group, allowed us to take a thorough and careful look at the medical care we provide to the community. It also allowed us to look at our insurance programs, as well as our fiscal budgeting and resource allocation processes, to ensure that the fiscal foundation of MIT Medical was robust, healthy, comprehensive, and comprehensible.

At this point, many of the recommendations specific to MIT Medical have been successfully implemented while others are ongoing in nature and will require additional and continuing analysis and input.

We have introduced several new practices and processes with the goal of improving healthcare for the MIT community, emphasizing a patient-centered approach. I am pleased to offer an update on a few specific recommendations that should be of particular interest to the MIT faculty.

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Improving access to care

Even before the Task Force released its recommendations, MIT Medical was working diligently to increase clinical staffing and improve access to care and services in key clinical areas, including adult medicine, mental health, dental, eye services, and women’s health. In addition, our Center for Health Promotion and Wellness continues to advance efforts to promote wellness and healthy living.

We have also enhanced our health financial management systems to improve our resource utilization processes. These changes allow us to make important decisions with much better, more detailed information and clearer views of the cost implications for our patients and for the Institute. These enhancements allow us to partner more effectively with MIT’s Human Resources Department to optimize resource deployment. MIT’s Human Resources Department shares our goal of matching available insurance benefit packages to the needs of the community.

Update on key recommendations

Key outcomes for each of the 41 recommendations are summarized in the Medical Task Force Follow-Up Worksheet (web.mit.edu/task-force/medical/), however, it might be helpful to highlight a few of the recommendations and offer more details:

• A recommendation was made to “continue efforts to identify and take advantage of opportunities for reducing costs without reducing the quality of care.”
  As a practice providing more than 25 clinical specialties, we are constantly evaluating the balance of providing the best possible care at the right cost. For example, we are working on ways to control our expenses while improving our services in the area of “high-tech” imaging. Through advances in healthcare information technology, MIT Medical has been able to take advantage of marketplace competition within the areas of CT, MRI, and PET scanning. We have access to high-quality images, which improves patient care at a lower cost. We have also realized some efficiency through digital radiography; updated electronic laboratory systems; and implementing an electronic dental records system.

• A recommendation was made to “address issues regarding access to specialists within and outside the Medical Department.”
  We have improved access to care within MIT Medical with the addition of new clinicians in the areas of Internal Medicine, Dermatology, Neurology, and Orthopedics. We are also encouraging each of our patients to identify a primary care provider, which will improve and expedite access for both routine and urgent care issues. We have also improved our specialist-referral process to help patients more easily access medical care outside of MIT Medical. We have been especially diligent in helping our patients make appointments for colon cancer screening, breast cancer treatment, cardiac testing, and orthopedic care.

• A recommendation was made to “continue efforts to strengthen the measurement and assessment of objective measures of the quality of care provided by the Medical Department.”
  MIT Medical has developed an evidence-based decision support system to measure and report metrics of care quality and patient outcomes at the clinician and service level. The model has been successfully tested in our Internal Medicine Service and will be implemented in all major services in 2008. This system allows us to monitor such things as colon cancer screening rates, management of patients with diabetes, and patient satisfaction. This real-time quantitative and qualitative data-reporting instrument will be available to our clinicians with the goal of providing the information needed to improve care for patients across our practice.

Looking forward

The Task Force recommendations and the efforts of the working group have established a system of processes and frameworks that will continue to enhance care for our community in the years to come. Healthcare has changed dramatically over the years, with an increased focus on quality of care, wellness, preventative medicine, and patient outcomes. MIT Medical will continue to partner with key stakeholders in the Institute community including the senior administration, the Medical Management Board, the Medical Consumers’ Advisory Council, and the Student Health Advisory Council, to integrate ideas and suggestions to help improve healthcare for the community.

I very much appreciated serving on the Advisory Committee to the Task Force on Medical Care and the opportunity to be a member of the working group. I extend my thanks to all those who supported this major effort with their time, ideas, analyses, thoughtfulness, and creative approaches. In response to the careful analysis of the Task Force and the follow-up work of the working group, the Institute has invested resources in MIT Medical that will allow us to continue our mission to promote wellness and provide healthcare for the diverse needs of the Institute community.

We welcome your feedback, thoughts, and ideas. MIT Medical has created an e-mail address – MTF@med.mit.edu – for you to share your ideas related to the work of the Task Force. Please feel free to write to me and share your thoughts.

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