2. From the Beth Israel Deaconess Mission Statement
The mission of Beth Israel Deaconess
Medical Center is to serve our patients
compassionately and effectively, and to create
a healthy future for them and their families...
Service to community is at the core... and an
important part of our mission. We have a
covenant to care for the underserved and to
work to change disparities in access to care.
For more information, please call the Office of
Community Benefits at (617) 667-0598.
E-mail: community@bidmc.harvard.edu
Produced by the Office of Community Benefits,
Beth Israel Deaconess Medical Center
Stephen B. Kay, Chair, Board of Directors
Kevin Tabb, MD, President and CEO
Patricia McGovern, Senior Vice President for
Corporate and Community Affairs
Ediss Gandelman, Director, Community Benefits
Writer/Editor: Dave Demerjian
Design: Jane N. Hayward, BIDMC Media Services
Community Benefits Committee
Matt Epstein, Chair
Henry Ames
Phyllis Barajas
Joan Feinberg Berns, PhD
Kathryn R. Bloom
Jonathan Bornstein
Gary D. Buseck
Alberto Calvo
Ruth B. Fein
Peni A. Garber
Julie E. Henry
Paula Ivey Henry, PhD
Doris S. Lewis
Vivien Li
Alvaro Lima
Harvey J. Makadon, MD
Larry Mayes
Keith Motley, PhD
Jane M. Pappalardo
Helen Chin Schlichte
Leslie Bornstein-Stacks
April Tang
Clayton Turnbull
Luis A.Vidal
Tracey West
Howard L.Wolk
3. Connection. Partnership. Collaboration. These three words
are at the very core of Beth Israel Deaconess Medical Center’s commitment to the
community. They speak to the many ways we strive to provide access to equitable,
high-quality care, and they underscore our firm belief that building stronger
communities isn’t something we can do alone.
Nowhere is our commitment to partnership more visible than in our affiliation with
seven community health centers located in and around Boston and Cape Cod.
These facilities provide tens of thousands of residents with primary and specialty
care, behavioral health services and a range of community-focused programs and
resources. They are vibrant places with a public health mission to care not only for
individuals, but also to address social conditions that impact a community’s health.
We collaborate with them on innovative community-based residency programs that
train doctors to provide specialized care in a primary care context, and on important
disparities-focused clinical studies. Much of this research is conducted at the health
centers and in the communities where it has the greatest relevance and impact.
Working side-by-side with our community health center partners, we are constantly
exploring new and better ways to deliver care and achieve health equity.
But we know that these collaborations are just one part of the equation,
and we also collaborate with scores of businesses, nonprofit organizations and
government agencies. From supporting Boston’s efforts to reduce consumption
of sugar-sweetened beverages, to meeting with local ministers to promote cancer
screening, we believe in partnering at the state, city and community levels. This
approach allows us to tailor our work so that we are more effective in building
healthier communities.
In everything we do, we never lose sight of the partnerships that matter most –
those small interactions that foster understanding and build trust. Whether it’s a
patient speaking with her doctor, an intern learning from his mentor or congregants
confiding in their minister, we work tirelessly to build these one-on-one connections.
Our Bowdoin Street Health Center is transforming itself into a Patient-Centered
Medical Home, where the emphasis is on creating authentic relationships between
providers and patients while enhancing the health of all those living in the
neighborhood. For 15 years, the Advocate Education Support Project has connected
counselors to one another in a supportive, healing environment. And at the Sidney
Borum Jr. Health Center, connections are made with at-risk youth who may be afraid
to seek medical care.
This year’s report is dedicated to celebrating all of the connections, partnerships
and collaborations that help us make a difference. They are what allow us to deliver
on our mission of serving the community, ensuring equitable access to care and
improving health outcomes.
Stephen B. Kay Kevin Tabb, MD
Chair, Board of Directors President and CEO
A MESSAGE FROM LEADERSHIP
1
4. Lyndon Johnson’s War on Poverty
heralds the birth of community
health centers (CHCs).
CHCs find new funding and
providers through National
Health Service Corps.
Public Health Services
Act provides funding for
additional CHCs.
COMMUNITY HEALTH CENTERS
A history of engagement. A truly collaborative approach.
Community health centers are the largest network of primary care providers in the nation, and
a vital piece of the health care delivery system. The 2010 federal health care reform legislation
allocated $11 billion in new funding to build and expand health centers and to renovate existing
facilities. It’s an unprecedented commitment that will double national health center capacity to 44
million patients annually.
2
At Beth Israel Deaconess Medical
Center, we’ve seen first hand the
power of community health centers to
improve the lives of patients, families
and communities. We were involved in
the health center movement from the
earliest days, helping in 1969 to lead the
conversion of Roxbury’s New England
Hospital for Women and Children into
The Dimock Center. Today, BIDMC
continues its commitment to community
health through its partnership with
seven affiliated health centers. We share
clinical expertise and provide financial,
technical and IT support; education and
training; access to hospital research; and
foster relationships with providers from
across the medical center. They in turn
give us insight into health challenges
facing the patients and neighborhoods
they serve, and bring us new ideas that
impact the way we deliver care.
As the true voices of the community, our
health center partners are integral to
our work. Their energy and collaborative
spirit inspire us and help us provide
equitable, high-quality health care.
Two Cape Cod health organizations
merge to form Outer Cape Health
Services.
BI and New England Deaconess Hospital (NEDH) form clinical
relationships with CHCs to provide collaborative care including cutting-
edge initiatives for obstetrical patients and those with HIV/AIDS.
BI creates nation’s first Patient
Bill of Rights, committing to
equal care for all.
Bowdoin Street, Fenway,
South Cove and Joseph M.
Smith CHCs open.
Nation’s first CHC opens
in Boston.
Beth Israel Hospital (BI) helps launch
and staff Dimock Community Health
Center (now The Dimock Center).
CCACommunity Care Alliance (CCA) is our network of
seven affiliated community health centers.
by the numbers:
87,500patients served per year
48percent speak a primary language other than English
18languages spoken
16sites in the network
42years since BIDMC began supporting community health centers
A 40-year commitment to supporting community health
1970s 1980s1960s
5. With increased federal funding, more
CHCs open and expand.
3
Conversations:
Hsiu Chin-Chang
In 2009, South Cove Community Health Center patient Hsiu
Chin-Chang was diagnosed with breast cancer. She was
treated at BIDMC, and received support from Christina Ho,
BIDMC’s Chinese Oncology Patient Navigator.
When my doctor discovered the
lump, I wanted to return to Taiwan
for treatment, but South Cove has a relationship
with BIDMC so I went there for a biopsy. I had never been there, and
felt overwhelmed. And when I learned I’d need a mastectomy, I was
terrified. I met Christina soon after being diagnosed, and she’s been
there for me ever since. We are educated people in Taiwan, but here we
don’t know the language and feel handicapped when communicating.
Christina makes sure I understand what my doctors are saying, and
communicates with them when I have questions. But she’s much more
than an interpreter. She helps with appointments and insurance, or when
I need help finding my way around the hospital. Most of all, she provides
emotional support. Chemotherapy was tough but Christina made the
process much less scary.
Left: Hsiu Chin-Chang (center) with her
husband and BIDMC Patient Navigator
Christina Ho. Below: Ho assisting another
patient through the cancer treatment process.
BI helps CHCs address infant mortality
racial disparities in so-called “death
zone” neighborhoods.
Six CHCs affiliate with BI. BI supports South Cove’s Quincy
expansion, and new buildings for Dimock,
Fenway and Joseph M. Smith CHCs.
NEDH and Roxbury Comprehensive
Health Center build a multifaceted
relationship.
Sidney Borum Jr. Health Center opens
with BI support.
Bowdoin Street joins the BI family;
opens new building and senior
health center.
Community Care Alliance (CCA) is
formed to link BIDMC-affiliated CHCs.
1990s
6. 2 The Dimock Center
Roxbury
Since its founding in 1862 as the New England Hospital
for Women and Children, Dimock has emphasized
women’s health. Our partnership with The Dimock
Center allows us to continue this legacy, and today
we collaborate with Dimock to offer an OB/GYN
resident training program. “Whether at Dimock’s
homeless shelter educating women about pap smears,
delivering prenatal care to improve pregnancy outcomes
or researching better ways to communicate about
the importance of contraception, our residents are
committed to reducing health disparities,” says Hope
Ricciotti, MD, Residency Program Director in the Department of Obstetrics and
Gynecology at BIDMC.
3 Fenway Health
Metro Boston
Fenway Health plays an important role in providing
care to those living in and around Boston’s Fenway
neighborhood, an area that includes students, elders
and people of color. It is nationally recognized for
its expertise in LGBT health, and conducts cutting-
edge community-based research through The
Fenway Institute. Lori Panther, MD, MPH, is leading
investigations examining the efficacy of the Human
Papillomavirus (HPV) vaccine in young HIV-positive men.
“It’s something that hasn’t been well studied in the HIV population, a group Fenway
is committed to supporting,” Panther says. She believes the close relationship
between Fenway and BIDMC maximizes the work happening at both. “The Fenway
Institute brings lots of prevention research to the table,” she says, “and the medical
center is a clinical research powerhouse. It’s an extremely valuable partnership.”
1 Bowdoin Street Health Center
Dorchester
“Changes in eating and exercise habits can reap
enormous benefits,” says Bowdoin Street’s Executive
Director, Adela Margules, “but feeling safe outside and
having access to fresh food are not always givens in
this neighborhood.” Bowdoin Street, which has served
Dorchester since 1972, is responding by building a
new Wellness Center that will include physical therapy
rooms, exercise facilities and a demonstration kitchen
– safe, welcoming spaces for people to improve their health. “We want to engage
with community members while they’re healthy – not just when they’re sick,” says
Margules. “That’s the most exciting benefit our Wellness Center will offer.”
4
Hope Ricciotti, MD meets
with OB/GYN residents at
The Dimock Center.
New Wellness Center
Interior View
B
martinBattarchitects . 633 Highland Avenue . Ground Floor . Needham . MA . 02494 . USA . Telephone 781 444 2747 . Fax 781 444 0894
TREET HEALTH CENTER
aconess Medical Center
enovation Concept Study
8
A rendering of an exercise space
inside Bowdoin Street’s planned
Wellness Center
Lori Panther, MD, MPH
NEWTON
WATERTOWN
Charlestown
Hyde Park
WALTHAM
QUINCYMILTON
Jamaica Plain
Roxbury
Fenway
West Roxbury
4
2
South Boston
East Boston
Roslindale
3
Mattapan
4Allston/
Brighton
BROOKLINE
7
7
6
North Dorchester
1
South Dorchester
5
5
5
HARWICH
PROVINCETOWN
WELLFLEET
Cape Cod
Boston
Community Care Alliance
2000s
Nation sees largest ever expansion in
federal funding for health centers.
Massachusetts health insurance reform
brings CHCs thousands more patients.
BIDMC involved in South Cove building
purchase and Joseph M. Smith’s
Waltham expansion.
BIDMC supports construction of
Fenway’s new facility.
Growth in clinical, research and
teaching collaboration between BIDMC
and CCA health centers continues.
7. 4 Joseph M. Smith Community
Health Center
Allston/Brighton and Waltham
Allston/Brighton is one of Boston’s most vibrant and
diverse communities, and for nearly 40 years, the
Joseph M. Smith Community Health Center has served
as a neighborhood anchor. Staff there communicate in
15 different languages, and share with us the health
practices and needs of newly arrived immigrants. Their
perspective, understanding and expertise inform our
work, helping us provide seamless care when patients
are referred to the medical center.
5 Outer Cape Health Services
Cape Cod
Outer Cape’s three facilities – in Wellfleet, Provincetown
and Harwich – serve Cape Cod’s eight outermost
communities. It is the only CHC on the Cape to offer in-
house digital radiology, which allows for instantaneous
transmission of images. Images are taken in the
Provincetown office and read remotely by BIDMC-
affiliated radiologists, illustrating the power of our
partnership. Outer Cape has broken ground on a new
radiology suite that will provide digital radiography,
mammography, bone density and ultrasound services. “This collaboration is a great
example of how an academic medical center can partner with a rural community
health center to provide sub-specialized Radiology services at the local level,” says
Max Rosen, MD, BIDMC’s Vice Chair of Radiology.
6 Sidney Borum Jr. Health Center
Metro Boston
Located in downtown Boston, the Borum serves
at-risk youth and adolescents – including those who
are gang members, LGBTQ, HIV-positive, homeless
or uninsured. It’s a population that can be difficult to
reach. “These kids have little confidence in adults or
social institutions,” says Medical Director Ralph Vetters,
MD. To build relationships, staff go into the community,
connecting with youth in their own environments. “If
they trust us enough to come to the clinic, we can
provide more comprehensive services,” says Vetters.
“And that’s how we help them learn to utilize the
health care system.”
7 South Cove Community
Health Center
Chinatown and Quincy
South Cove is the premier Asian community health
center of Massachusetts with four locations serving
nearly 27,000 children and adults. The health center
offers primary care, OB/GYN, eye and dental services,
behavioral health programs and onsite mammography.
Targeted programs for medical conditions like hepatitis
B and tuberculosis that disproportionately affect the
Asian community are also available. These linguistically
and culturally competent health programs help South
Cove meet its mission of improving the health and well-
being of all medically underserved in Massachusetts.
5
Maura Kennedy, MD, BIDMC
Emergency Medicine physician,
reviews an X-ray of an Outer
Cape patient.
The Borum provides weekly
primary care and mental health
services to clients of Youth on
Fire and Bridge Over Troubled
Waters, drop-in centers for
homeless and street-involved
youth.
Glenn Diaz, MD, examines a
patient.
2010s
2010 federal health care reform package
provides $11 billion in CHC funding.
Prevention and Public Health Fund earmarks
nearly $250 million for 16,000 new primary
care providers by 2015.
Outer Cape Health Services receives $3.6
million through the Affordable Care Act.
Bowdoin Street Health Center plans a
4,000 square foot expansion and new
Wellness Center.
Sidney Borum becomes part of
Fenway Health.
Fenway collaborates with BIDMC on
the nation’s first HIV- and LGBT-focused
primary care residency.
The dental clinic at South Cove
provides an important health
service to its patients.
8. Engagement with the city
“Our cafeteria fountains used to offer
six sugared beverages,” says Nora Blake,
BIDMC’s Director of Food Services.
“Today, we’re replacing them with
healthier options.” That small change
is one way we’re partnering with the
Boston Public Health Commission to
address the obesity epidemic. We’re
also developing signage and education
materials, revamping refrigerator cases
and vending machines to increase
visibility of sugar-free beverages and
requiring vendors to utilize Boston’s Stop
Light Program, which promotes healthy
drinks. “The move toward less sugar is
more than a trend,” Blake says. “We’re
joining with the city in embracing
evidence-based strategies that work,
and hardwiring them into our food
services.”
Collaboration with state
agencies
“The Suffolk County District Attorney’s
office came to us concerned that its
victim witness advocates were burning
out,” says Lisa Tieszen, LICSW. “These
folks experience Secondary Traumatic
Stress (STS) in reaction to the trauma
of their clients, but their needs
weren’t being met.” With support
from the District Attorney’s Office and
the Massachusetts Office for Victim
Assistance, Tieszen and colleague
Katherine Manners, M.Ed., launched the
Advocate Education & Support Project,
which supports frontline workers and
managers working with victims of crime
and violence. Advocates come together
as peers in eight-week facilitated groups
to share challenges and develop coping
skills. “The group model normalizes the
experience of STS. It provides critical
peer support, as well as exposure
to other agencies’ approaches and
philosophies,” says Tieszen, who is
the program’s project coordinator.
Since its founding, the Project has run
more than 30 groups with participants
from over 60 different nonprofit
organizations and state agencies
throughout Massachusetts. “When we
give advocates the tools they need to
take better care of themselves,” says
Tieszen,“it allows them to better care
for the victims they’re trying to help.”
PARTNERSHIPS
Involvement at every level. Programs that make an impact.
When it comes to positively impacting the health and wellness of the people who live in our
communities, partnerships are key. Working with agencies and groups at the city, state and community
levels, we engage in programs and initiatives that foster education, collaboration and advocacy –
helping to improve health outcomes.
6
Connection with the
community
Making meaningful connections often
happens in partnership with respected
and trusted community organizations.
With a solid commitment to the youth in
our community, each year BIDMC hires
over 40 high school interns referred
through community organizations such
as the Boston Private Industry Council
(PIC); Action for Boston Community
Development (ABCD); The GOTCHA
(Get Off the Corner Hangin’ Around)
Program; Brookline Public Schools’ Work
Connections for Youth Program and
Mission Hill’s Sociedad Latina, whose
programs target the destructive cycles
of poverty, health disparities and lack of
opportunity in the Latino community.
In 2011, Sociedad recognized BIDMC
with a Champion for Education award.
“BIDMC is a key partner in our work
to promote higher education and
employment among Latino and African
American youth in our community,” says
Sociedad Executive Director, Alexandra
Oliver-Dávila.
The Stop Light Program uses signage,
color-coding and product placement to
promote healthy beverage choices.Taking
the City of Boston’s lead, we’re rolling it out
across campus to educate and motivate our
employees, patients and their families.
9. 7
Conversations:
Alphonso Brown, MD, MS
Alphonso Brown, a gastroenterologist at BIDMC, works closely with The
Faith-Based Cancer Disparities Network. BIDMC is a founding member of the
Network – a collaboration with the Dana-Farber/Harvard Cancer Center, the
Black Ministerial Alliance and the American Cancer Society – which works to
eliminate the unequal burden of cancer in communities of color.
We know that African Americans suffer significantly
higher rates of colorectal cancer than other racial and
ethnic groups, and when they do get screened and
lesions are found they tend to be at a more advanced
stage. Since early detection is the best bet to beating colon cancer, that’s an
incredibly important message to get out there, but it’s also challenging. The
Faith-Based Cancer Disparities Network opens up new and trusted lines of
communication and helps provide targeted community education to reach
those most at risk. The Network is an invaluable partner in educating
the public, primarily the African American community, so that colorectal
cancer screening is seen as something they should absolutely take part in,
and advocate for themselves to get done early.
10. Food for thought
In the Bowdoin-Geneva section of Dorchester, tables overflow with tomatoes,
squash and cucumbers. It’s a quintessential summer farmer’s market, with one major
difference: some of this produce has been grown and harvested by area youth.
These young gardeners, ages five to 12, are part of Bowdoin Street Health Center’s
Healthy Champions program, an initiative that promotes youth development and
healthy lifestyles. “The garden illustrates the benefits of incorporating healthy,
affordable foods into daily life,” says program coordinator Jen French. “And it helps
the kids educate their peers about how these foods can reduce obesity and Type 2
diabetes.” The farmer’s market is just one component of Bowdoin Street’s Healthy
Food Equity Program, which also provides education around healthy eating and a
campaign to improve availability of healthy foods at corner stores.
As their neighborhood’s health food ambassadors, Bowdoin’s Healthy Champions
are an integral part of the program. “When you’re growing your own vegetables,
you’re thinking, ‘wow, I’m doing something good for me,’” says 12-year-old Healthy
Champion Daizy. “And, I’m doing something important for my community.”
Gameplan for fitness
“We know how important exercise is, especially in young Americans,” says Loryn
Feinberg, MD, of BIDMC’s CardioVascular Institute. “The earlier we make it a habit, the
less likely we’ll have health problems like diabetes, high blood pressure, obesity and
abnormal cholesterol levels as we get older.” One way we’re working to make physical
activity part of daily life in our communities is the BIDMC Walking Club, an interactive
program that makes exercise fun and easy. We provide schools and employers with
free kits that include workout logs, information sheets, eCards and even a smartphone
app. The kits teach fitness fundamentals and encourage people to see exercise as a
way to improve their health, and the health of their communities.
HEALTHY COMMUNITIES
Understanding the challenges. Engaging to make a difference.
What is a healthy community? It’s a neighborhood where fresh and healthy food is always available. A
place where good jobs build financial self-reliance. It’s safe, welcoming streets that encourage exercise
and invite interaction. We know that building vibrant, healthier communities only happens through
engagement and collaboration with residents and community partners. It’s a philosophy that guides our
work – each and every day.
8
With BIDMC’s free Walking Club pedometer
app, your smartphone can count steps, track
pacing and measure distance. Download it
at the iTunes Store or Android Market and
start walking!
Some of Bowdoin Street’s Healthy Champions and
the fruits of their labor.
11. Partnership for peace
Collaborating with the Louis P. Brown Peace Institute and the Massachusetts Office
of Victim Assistance, we provide bereavement services that help shocked, grieving
homicide survivors deal with a crime’s immediate aftermath and the ongoing issues
of traumatic grief. A case manager at the Peace Institute works directly with families
to offer both clinical and tactical resources like burial guidance and media assistance
to guide them toward healing and justice. “We’re also encouraging families and
loved ones to explore new ways of reacting to violence,” says Lisa Hartwick, MSW,
LICSW, Program Director for BIDMC’s Center for Violence Prevention and Recovery.
“If someone you love is killed, your response may be to retaliate. We want to create
new outcomes by offering more productive and creative means of addressing
violence while also acknowledging the hurt and anger.”
Campaign for cleaner air
From recycling and composting to supporting Mayor Menino’s bike programs,
BIDMC’s long standing commitment to sustainability helps reduce waste and
improve the health of employees, patients and the community. In 2010, BIDMC
helped lead an effort to decrease congestion and air pollution in the Longwood
Medical Area by consolidating shuttle bus service, a move that reduces CO2
emissions by almost 200,000 pounds annually. “Programs like this are essential
in lowering the incidence of stroke, asthma and other health problems,” says Bill
Ravanesi, Healthcare without Harm.
Training for tomorrow
More than 500 employees each year participate in BIDMC’s workforce development
programs, which include English classes for non-native speakers and free college
courses on-site. Workforce development also runs Pipeline programs that train our
employees into higher-skilled, better paying jobs.
The Medical Laboratory Technician (MLT) Pipeline is a three-year program developed
in partnership with Children’s Hospital Boston, New England Baptist Hospital and
Bunker Hill Community College. Employees complete coursework and weekend labs
while working full time, followed by five months of hands-on training in BIDMC’s
labs to attain their Associate Degree in Clinical Lab Sciences.
The MLT Pipeline participants bring new energy to the labs where they train,” says
Gina McCormack, Operations Manager of Pathology. “In the end, the students help
us see our own possibilities, and make us better at what we do.”
Conversations: Dominic Taabazuing
Dominic Taabazuing, 24, worked in BIDMC’s Food and Nutrition Department
for five years before beginning the Medical Laboratory Technician (MLT)
Pipeline Program. He completed the program in 2011, and today is a
technician in the medical center’s microbiology lab.
This program made it easy for me to get a degree
because many of the financial aspects were taken
care of. They even supplied us with books, which
was a big help. I started with basic math and science courses, then harder
classes like anatomy and physiology, and after that clinical lab science
work in the microbiology lab, then hematology, chemistry, and blood
bank. I can’t believe how much I’ve learned, but all the hard work was
worth it because now I’m a lab technician. I love coming into work. It’s
very rewarding to be able to look under a microscope and get a general
idea of what’s wrong with a patient. Hopefully, after some years of work,
I’ll go back to school and I’ll keep going up the ladder. I can’t wait to
become a technologist and continue to work for this hospital.
9
12. Employee voices inspire us
Our Lesbian Gay Bisexual Transgender
(LGBT) Advisory Committee – one of
the nation’s first hospital committees
of its kind – ensures that the voices of
our LGBT community are heard. The
Committee has informed policies and
practices that ensure equal treatment
and a welcoming environment for our
LGBT patients and employees, including
sponsoring educational seminars for
providers and modifying our registration
process and visitor policy. “It’s incredibly
important for me to work in a place
that honors and celebrates diversity,”
says Stacey Adamson, physical therapist
and member of the LGBT Advisory
Committee. “As a clinician, I want
patients to know that this is a safe place
to talk about any aspect of their lives,
because that is so connected to their
health and wellbeing.” Thanks in part
to the Committee’s work, the Human
Rights Campaign recognized BIDMC
as a national leader in its 2011 LGBT
Healthcare Equality Index.
Patient perspectives
inform us
The cultural shift toward patient
and family-centered care is nothing
new at BIDMC, thanks in part to our
Patient and Family Advisory Councils
(PFACs). From quality and safety to
communication and hospital processes,
these groups bring patients into the
decision-making fold, giving them a
real say on how care is delivered. This
past year, our Intensive Care Unit (ICU),
Neonatal ICU, Universal Access and
Hospital-Wide Councils took up a range
of issues, including addressing parking
and shuttle issues facing the physically
challenged, reviewing patient education
materials and weighing in on the
medical center’s CEO search.
Community needs guide us
As many as one million Americans live
with Parkinson’s disease, and 60,000
new cases are diagnosed annually.
In response to needs identified by
our patients from Cape Cod, BIDMC
collaborated with others to establish
The Parkinson Support Network of Cape
Cod – an alliance of consumers, health
and human service providers and other
organizations. The Network creates
new opportunities for people living
with Parkinson’s, and leverages existing
treatment, support and education
resources. From a retreat that supports
caregivers, to an annual gala dinner that
celebrates those living with Parkinson’s
and their families, to a provider alliance
that shares tools and expertise, the
Network gives voice to a community
that needs to be heard.
VOICES
Dialogues with the community. Insights that shape our work.
Open, respectful dialogue with employees, patients and community members is what guides us. It helps
us understand challenges and explore opportunities, to build on what works and find solutions for what
doesn’t. Whether it’s patients inspiring new ideas, employees embracing diversity or community groups
sharing challenges, listening to the voices of our community shapes the way we do our work.
10
Our LGBT Advisory Committee contributed
to the powerful It Gets Better anti-bullying
movement with a video that celebrates
the medical center’s culture of inclusion
and optimism.View it online at bidmc.org/
makingitbetter, or snap the QR code below
with your smartphone.
13. 11
Conversations:
Erica Dente
Since 2010, Erica has served as a member of our ICU Patient and Family
Advisory Council (PFAC).
I’ve been a BIDMC patient for many years, and
my mom has stayed in the ICU, so I’m quite
familiar with the medical center. I’m also a Nurse
Practitioner, so I’m able to see the hospital experience from many
different perspectives. One of the things we (the ICU PFAC) have focused
on is examining ways to improve communication between patients,
families and providers. Today, for example, in certain circumstances,
providers invite patients and family members to join them on medical
rounds for their loved ones. This is when the medical team comes together
to discuss each case. That never used to happen, and it’s opening new
channels of communication in the ICU. I was cautiously optimistic when
I joined the Council, because I know that change can sometimes be a very
gradual process, but things are moving very quickly. Our providers are
committed to humanizing the patient experience, and we’re committed to
helping them do it.
PFACThe number of advisors participating in councils, on committees,
focus groups and LEAN events as part of our Patient and Family
Advisory Council (PFAC) program.
by the numbers:
2006: 18 2007: 18 2008: 34 2009: 43 2010: 54 2011: 106
Erica Dente with architectural plans to renovate a waiting room in one of the intensive care units (ICUs).
14. Interpreter services:
ensuring access
Russian. Spanish. Chinese. American
Sign Language. These are four of
the more than 60 languages our
interpreters use to ensure that patients
with limited English proficiency both
understand – and are understood –
when communicating with medical
center staff. Last year our interpreters
had more than 93,000 in-person
patient interactions, an increase of
nearly 160 percent from 2001. Those
numbers illustrate the importance
of these services, and underscore
our commitment to access, equity
and speaking the languages of our
community.
Research: understanding
disparities
“Being an ethnic minority, I have
experienced racial bias first hand and
understand the challenges that many
EQUITABLE CARE
A core value. A multifaceted strategy.
You have the right to receive medical care that meets the highest standards of BIDMC, regardless
of your race, religion, national origin, any disability or handicap, gender, sexual orientation,
gender identity or expression, age, military service or the source of payment for your care.
That’s BIDMC’s Patient Bill of Rights, and it informs everything we do. Equitable care is an essential part
of improving health outcomes and creating healthy communities, but it requires big picture perspective,
problem-solving strategies, and a focused, long-term commitment. By taking full advantage of technology,
research and clinical services, we work to ensure that everyone has access to high-quality health care.
12
ASL
2%
Cape Verdean
11%
Chinese
24%
Haitian Creole
3%Russian
18%
Spanish
30%
Thai/Laotian
2%
Vietnamese
2%
Other
8%
The number of face-to-face interpreter
encounters reached 93,461 in FY 2011.
Above, face-to-face encounters by language.
minority and underserved populations
face in accessing quality health care,”
says Christina Wee, MD, MPH. “To
improve health care for all Americans,
we need to include the voices of those
who are often under-represented in
research.” Wee, who is Co-Director
of Research in the Division of General
Medicine and Primary Care at BIDMC,
conducts research on obesity and
health disparities, including work
that examines health disparities in
underserved communities. Much of
Wee’s obesity research focuses on racial
and ethnic differences in costs and
outcomes, the relationship between
stigma and disparities in care and the
role of primary care practitioners in
obesity management. Her commitment
to community health can also be seen
in her mentoring work: she has worked
with fellows researching women
and immigrant health issues, cancer
screening and medical decision making.
Wee received the A. Clifford Barger
Award from Harvard Medical School for
Excellence in Mentoring in 2010 and
the 2011 Society of General Internal
Medicine Midcareer Research and
Mentorship Award.
Christina Wee, MD, MPH, examines a patient at
BIDMC’s Healthcare Associates.
15. Technology: improving communication
“Sharing electronic medical records enables better coordination of care among
providers,” says John Halamka, BIDMC’s Chief Information Officer. “This type of
instant access to a patient’s health information can help prevent errors and allows
doctors to make better decisions about the best course of treatment.”
We have long been leaders in using technology to enhance and streamline
communication between providers. In 2011, the medical center was named the
nation’s top-ranked health care information company by InformationWeek 500,
a list of the top technology innovators in the United States. Our expertise is tapped
often by public health departments to harness emerging technologies that enhance
the exchange of vital health information among multiple providers who are caring
for the same patient. The Massachusetts Immunization Information System (MIIS),
piloted at BIDMC, is a new registry that establishes a complete, accurate, secure,
real-time immunization record for residents of Massachusetts. It allows providers
to view a patient’s entire immunization history, thereby preventing duplicate
vaccinations or identifying unimmunized and under-immunized individuals.
James Woods with BIDMC Interpreter Michael Sullivan.
Conversations: James Woods
Long time medical center patient James Woods, who is deaf, works with
BIDMC’s American Sign Language/English interpreter team.
I began coming here over 20 years ago. Back then
they didn’t have ASL interpreters, and that made
things difficult. I remember once waiting and waiting
to see my doctor because the nurse forgot that I wouldn’t be able to hear
her when she called for me. At a lot of my appointments, doctors would
have to write or type so that I could understand what they were saying.
They meant well, but it made the appointments much longer than they
needed to be.
The interpreters here are a huge help. They come with me to my doctors’
visits, and sometimes they’ll send a text message reminding me that I have
an appointment coming up. I feel like I would be lost without them… I
remember once coming to the emergency room and trying to explain to the
nurse what was happening. She couldn’t understand me and was getting
frustrated. That made me frustrated. But then Bob (interpreter) showed
up. Just like that we were all able to communicate, and everything became
so much easier. It reminded me how important the interpreters here at the
medical center are, not just for me, but for the people who work here, too.
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16. MEDICAL EDUCATION
Learning from our partners. Working in the community.
With community health playing an ever more prominent role in health care delivery, there’s an increased
focus on community-based residency programs. BIDMC interns and residents who choose these programs
gain all the skills and experience offered by academic medical center residencies, including exposure to
cutting-edge research and mentoring by Harvard Medical School faculty. They also learn and work in
caring, intimate environments, and benefit from curriculum tailored to providing culturally responsive
care. These programs are pipelines that encourage a new generation of residents to pursue careers in
community-based primary care.
Realizing the potential of
primary care
“There are a million people in the
United States with HIV, and 50,000
new cases diagnosed every year,” says
Alex Gonzalez, MD, Medical Director at
Fenway Health. “Thanks to advances in
treatment these people are living longer,
but as a result are facing other diseases.
We need to train primary care providers
who understand how to manage and
treat HIV as a chronic condition, so that
those with the disease can lead more
productive lives.”
Fenway, which is at the forefront of
HIV and LGBT health education, has
enjoyed a close relationship with
BIDMC’s internal medicine residency
for more than a decade. In 2010, this
collaboration resulted in a grant from
the Health Resources and Services
Administration to create a primary care
residency training track focused on
preparing physicians for careers in HIV
and LGBT health. The first program of its
kind in the United States, it welcomed
its first four interns this past year. They
spend one afternoon a week at the
health center, caring for Fenway patients
and building their practices. “These
residents will become primary care
providers with a unique understanding
of LGBT and HIV health issues,”
Gonzalez says. “They’ll understand
what it means to work in a community
setting.”
Conversations:
Rebecca Glassman, MD
BIDMC Resident Rebecca Glassman trains at Fenway Health, where she is
part of the recently launched HIV/LGBT primary care track.
I believe HIV is becoming a chronic disease that
should be handled by primary care physicians rather
than just infectious disease specialists. There’s so
much that primary care doctors can do for patients
with HIV, but only if they’re fluent in treating the
disease and its complications... Every group has
unique issues, and even within my HIV patient
panel there is so much variation. Some have lived
with the disease for years without complications,
others are struggling with horrible health problems
as a result of HIV. No two patients are alike…
Treating a patient at BIDMC and then at Fenway as
an outpatient has helped me see the importance of
continuity of care, and how the partnership between
the hospital and health center makes it possible.
Fenway Health’s Lauren Scott, MD, precepting
resident Rebecca Glassman, MD14
17. TRANSLATIONAL RESEARCH
Cutting-edge clinical research. Impact at the community level.
BIDMC is the third-largest recipient of NIH funding among independent hospitals in the United States,
conducting significant research around reducing health disparities and improving care for underserved
populations. Much of this work is done in collaboration with community researchers, whose experience
and perspective inform both its design and implementation. These partnerships between the medical
center and the community yield more relevant, valuable research that impacts policy, clinical practice
and ultimately, health outcomes.
Breaking new ground in
kidney research
Approximately one out of every three
people in the U.S. with kidney failure
is African American, a disparity that
has baffled researchers for decades.
In 2010, Martin Pollak, MD, BIDMC’s
Chief of Nephrology, discovered that a
common genetic variant might make
African Americans more susceptible to
Finding new ways to reach
the community
How do you increase the local impact
of medical research, especially research
related to achieving health equity?
Finding the answer is one of the
reasons BIDMC and our community
health center partners participate in the
Harvard Catalyst’s Community Health
Innovation and Research Program
(HC-CHIRP). This multifaceted initiative
engages community-based providers
in research partnerships focused on
health disparities. The goal is to fast-
track translation of results that can
influence public policy and improve
health outcomes. HC-CHIRP provides
training and facilitates coordination
between researchers and community
health leaders. It also supports the
Community-Based Participatory
Research model, which says clinical
research should involve, engage and
benefit communities every step of
the way.
Data points
At BIDMC, we’re conducting
community-level research to learn
more about the illnesses and
conditions that disproportionately
impact underserved communities:
• HIV infection is the third leading cause
of death among black women aged
35 – 44.
• Nearly 50% of Hispanic children born
in the year 2000 are likely to develop
diabetes during their lifetimes.
• African Americans are about 40%
more likely to die of colon cancer
than whites.
• Asian and Pacific Islanders make up
less than 5% of the total population
but account for more than 50% of
Americans living with chronic
Hepatitis B.
• Hispanic adults report persistent
symptoms of depression lasting longer
than two weeks 63% more frequently
than non-Hispanic white adults.
• African Americans make up 12% of
the population but represent 32% of
dialysis patients and 35% of those
waiting for a kidney transplant.
kidney disease. It’s a groundbreaking
finding that will help scientists develop
more effective treatments. The Dimock
Center and BIDMC are partnering
resources, which allow Dimock primary
care physicians access to BIDMC renal
specialists. Working at the community
level, Pollak and his colleagues can
interact with those most impacted by
kidney disease, and the health center
has new resources to deliver more
specialized renal care.
Martin Pollak, MD, consults with Victoria
Charoonratana, research assistant.
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18. MOVING FORWARD
Preparing for tomorrow. Shaping new models today.
“New models of delivering care to patients are not only a vital part of national health care
reform but are also fundamental to BIDMC’s vision and strategic plans for our future.”
– Kevin Tabb, MD, BIDMC President and CEO
We’re proud of the work we do every day to create stronger, healthier communities and we continue
to set our sights on the future. We know that building on our success requires us to transform how and
where we deliver care, and to embrace new ideas from across the health care spectrum.
Clinical transformation:
Patient-Centered
Medical Home
What is a Patient-Centered Medical
Home (PCMH)? Think of it as a practice
within a practice. Providers from across
a primary care practice – doctors,
nurses, social workers and community
resource specialists among them – form
a team built around the needs of an
individual patient. By creating a true
partnership between patients and their
team of providers, this emerging model
has the potential to decrease health care
disparities and improve access while
containing health care costs. Bowdoin
Street Health Center embraces the PCMH
model, and is nationally recognized by
the National Committee for Quality
Assurance as a Level 3 PCMH, the
highest accreditation level. Bowdoin
Street also engages with community
organizations and public agencies to
improve access to jobs, recreational
activities and affordable food.
Payment reform:
Accountable Care
Organizations
In December 2011, The Beth Israel
Deaconess Physician Organization
(BIDPO) became part of the Pioneer
Accountable Care Organization (ACO)
Model, an initiative sponsored by
the Centers for Medicare & Medicaid
Services Innovation Center. ACOs are
transformative payment and delivery
models that tie reimbursements to
care quality and cost containment, and
BIDPO was one of only 32 provider
organizations nationally chosen to
participate in the program. While
the Pioneer ACO Model focuses
on improving service delivery and
containing costs for patients covered
by Medicare, the program will expose
BIDMC physicians to financial and care
delivery system models that have the
potential to improve care for all of the
patients we serve.
Care delivery evolution:
an integrated network
approach
The transformation of our health care
delivery system includes a trend towards
global contracting, away from the
traditional fee-for-service payments.
We recognize that this new model will
be best achieved through integrated
care delivery networks with health care
delivered closer to where the patient
lives, by community providers who
are knowledgeable about, and have
relationships with, local health and
social services resources. This provides
the opportunity to deliver high-quality
care with significant savings to patients
and the health care delivery system.
Toward this approach, BIDMC is building
its integrated network through strategic
alliances with community hospitals,
health centers, and primary care and
specialist practices – all local to patients’
homes.
Bowdoin Street Health Center is a leader in the
Patient-Centered Medical Home movement.
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