Cutting Edge While Cutting Costs

Thomas Jefferson University’s Digestive Disease Institute’s administrator prepares for a new era of medicine while managing a growing, nationally renowned gastrointestinal service

Barbara Clancy-Sweeney takes pride in her accomplishments, but devotes more time to the future she envisions. That takes dedication, considering the list of her accomplishments in healthcare administration.

Clancy-Sweeney helped build one of the largest and most highly regarded gastrointestinal programs in the country at Philadelphia’s Thomas Jefferson University Hospital. Today, she not only manages that program, but she oversees all of Jefferson’s Division of Gastroenterology and Hepatology satellite offices and its Gastrointestinal Endoscopy units.

The construction of a surgi-care center and development of a telehealth program are just two of the hospital’s current projects that Clancy-Sweeney says keeps her invested—and ensures the hospital’s focus on the future.

“We have to be committed to provide clinical excellence and great service because patients can easily go elsewhere, and we can’t afford to lose any.”

Both projects address one of the hospital’s key challenges: staying cost-competitive despite its higher-cost status as a teaching hospital. Insurers are directing more patients to lower-cost ambulatory surgi-centers, Clancy-Sweeney notes, and she believes Jefferson must step into this space or lose business.

Clancy-Sweeney cites the vision of CEO Steven Klasko—that Jefferson will be a healthcare provider available anywhere—as the foundation of her work. The new telehealth program promises to allow the hospital’s renowned specialists to consult electronically with patients and other physicians from any location, and it will make Jefferson a more consumer-centric provider, saving patients both travel time and cost.

Cost containment has always been a concern for the healthcare system, but the current environment stresses reimbursements linked to outcomes, which makes it even more urgent. The hospital’s success depends more than ever upon well-orchestrated coordination between clinical and financial decision makers, and Clancy-Sweeney is the key between the medical and business functions of the hospital’s gastrointestinal services.

“All of our financial strategy is dependent upon clinical information, understanding our risks, and mitigating them,” says Clancy-Sweeney, who collaborates closely with physicians to understand how she and her staff of 165 can best support them. She especially values partnerships with vendors who are committed to the practice, improving patient care, and Jefferson’s positive community impact.

The gastrointestinal-infusion service provides relief to patients suffering from inflammatory bowel diseases, including ulcerative colitis and Crohn’s disease, along with other digestive disorders. When spearheading the launch of the program in 2005, Clancy-Sweeney and her staff worked with the drug suppliers to implement assistance programs for the patients and decrease out-of-pocket payments.

Patient comfort was a key goal from the start. Comfortable chairs and TVs give the space a relaxed, boutique feel, and treatment schedules are limited to provide a calm atmosphere. Before the service’s launch, Clancy-Sweeney confirmed that it completely aligned with the hospital’s existing drug-infusion protocols, found a suitable space, and purchased equipment.

“Some people like to commiserate with others about their ailments,” Clancy-Sweeney says. “Others prefer to be more private.” But she asserts that both patient types must be accommodated.

As a tertiary care provider, the program quickly grew to over 300 patients. “A lot of practices decided not to offer this treatment because of the expense of the drug,” Clancy-Sweeney says. “As one of the top gastrointestinal practices in the region, and a national leader, our physicians felt that they needed to offer treatments that could [transform the] patients’ quality of life.”

Clancy-Sweeney also had to synchronize the payment cycle to suppliers with the revenue cycle—a vital administrative task necessary to keep the gastrointestinal infusion program, and all gastrointestinal services, financially strong.

Jefferson’s leading status means Clancy-Sweeney must ensure that the gastrointestinal services maintain the highest quality on all fronts. “We’re monitoring and tracking metrics all the time,” she says, adding that not only do new healthcare regulations require scrupulous quality control, but market fundamentals require that control too.

“Consumers are smarter and have a lot of information at their fingertips,” Clancy-Sweeney adds. “We have to be committed to provide clinical excellence and great service because patients can easily go elsewhere, and we can’t afford to lose any.”

Today’s fast-paced healthcare environment forces providers to react quickly to new rules and care-delivery models. Thus, Clancy-Sweeney’s role demands high energy and an entrepreneurial mindset. She doesn’t have to be expert in all areas,  but she does need a working knowledge to manage her position in this venture—and so does her team.

Providing telehealth services, for instance, requires the clinical, regulatory, and IT capability to reach its highest potential for boosting customer satisfaction. “It’s a new line of business for us, but it will also revolutionize the future of healthcare,” she says; in the not-too-distant future, many patients won’t even visit the doctor’s office for follow-up appointments. “Newer generations want quick, efficient service.”

The vision is to provide just that. Digital apps will take a patient’s pulse and monitor other vital signs. Physicians will transfer images and confer on cases electronically. And patients will be able to be examined—at least some of the time—from the comfort of their homes via digital video.

But above all, Clancy-Sweeney is driven by the thank-you letters and success stories from grateful patients like the young woman who thought she had fertility issues, only to learn she had celiac disease. Once it was addressed, she became pregnant. “We are always committed to improving care for our patients,” Clancy-Sweeney says. “That’s where I get my satisfaction.”