For Altru Health System, distant ally brings local benefits

The 400 miles between Grand Forks and Rochester, Minn., is a long drive, but the route is traveled frequently by area patients facing the most serious medical diagnoses as they seek care at the Mayo Clinic.

For the past year, technology and collaboration have brought Mayo's famous quality of care closer to Grand Forks through the Mayo Clinic Care Network.

In May 2011, Altru Health System became the first health care system to join the network. The arrangement gives Altru physicians a way to increase consultation with Mayo experts.

Altru leaders say the network allows more of their patients to continue treatment in Grand Forks instead of making the journey to Rochester.

"Both of us want patients to stay in Grand Forks," said Altru Chief Planning Executive Dennis Reisnour.

The agreement between Altru and Mayo was the first time the prestigious Minnesota clinic entered into a partnership with another hospital that did not involve Mayo acquiring the other hospital.

"It's not just a larger organization. It's the premier health care organization in the world," Altru President Casey Ryan said.

Growing network

Since starting the Clinic Care Network a year ago, Mayo has expanded it, along with the number hospitals it has acquired.

This month, the Sparrow Health System in Lansing, Mich., announced it was joining the network. Heartland Health in St. Joseph, Mo., joined in May, as did Arizona State University Health Services. The network also includes the Kingman (Ariz.) Regional Medical Center.

In March, Mayo and the Coborn Cancer Center in St. Cloud, Minn., started the Mayo Clinic Cancer Care Network, a similar arrangement specializing in cancer care.

But Mayo's new approach to collaboration began with Altru.

The two health care systems share a similar culture, particularly with their leadership by physicians, said Ryan, who is a physician. "I think they wanted someone who they could test these ideas with."

While other hospitals are consolidating with larger health care chains, the network gives Altru the advantage of an association with a bigger system while retaining local control.

Asked if Mayo's network is a response to growth by regional chains such as Sanford Health, Ryan did not speculate on Mayo's motivation, but said competition could be a factor.

"Do they need to pay attention to the presence of Sanford in the region? I would certainly think so," he said.

Sanford, based in Sioux Falls, S.D., has hospitals and clinics in North and South Dakota, Minnesota, Iowa and Nebraska, and has been deepening its presence in those markets.

Mayo officials did not respond in time for this story.

Consulting more

Within the Clinic Care Network, Altru physicians have access to counterparts at Mayo through e-consults, a system through which doctors share medical records on patients and other information, such as medical imaging.

"You just kind of want some confirmation from another physician," said surgeon Scott Charette.

While Altru doctors had relationships with Mayo in the past, the system is a more formalized and efficient way to match Mayo doctors with cases at Altru.

"You were playing phone tag for a few days, sometimes a week," said Charette about trying to consult with Mayo in the past.

He said he has used the e-consult system every two or three months.

Altru leaders said its doctors have used 71 e-consults in the last quarter.

"I think they were thinking about three a month," Reisnour said.

Filtering cases

Ryan said Altru and Mayo have a desire to "get the person to the right place at the right time."

For Altru, that means keeping patients they can treat in Grand Forks in Grand Forks, while identifying the more difficult cases that are better off being treated in Rochester.

"Really, we act as a filter, to filter what we can manage here," Ryan said.

That filter benefits Mayo by allowing it to keep more routine cases with other hospitals and concentrating on more complicated medical cases that better matched with its advanced capabilities.

The network does not prevent patients who believe they would be better off going elsewhere from doing so. According to Reisnour, 11 percent of patients in Altru's primary market go to Rochester or the Twin Cities for treatment.

Retaining patients in Grand Forks benefits Altru, which does not lose patients to other hospitals. Altru leaders say many patients are better off staying close to home instead of having the disruption of traveling hundreds of miles for treatment.

"We do know there are patients where, anecdotally, doctors tell us they would have sent them to Mayo," Reisnour said.

For the complicated medical puzzles, the access to Mayo's expertise provides a backup for Altru's physicians.

"It's a type of insurance," Ryan said. "It's there, and most of us will never need it."

Sharing ideas

Altru and Mayo are beginning to share best practices and patient care models, and Altru will also explore ways in which Altru can adopt more of Mayo's culture in its care.

"We know we have a ways to go in some areas for that, but it's happening and that's where we're headed," Reisnour said.

Mayo's approach to medical care is reflected by its motto, "The needs of the patient come first," and the ability of its doctors to work as a team on patients' treatment.

In the year since Mayo and Altru launched the network, the relationship has exceeded Altru's expectations.

"Without question, it's pulled us to a higher level," Ryan said. "From whatever I thought it would be, it's better than that."

Reach Bjorke at (701) 780-1117; (800) 477-6572, ext. 117; or send e-mail to cbjorke@gfherald.com .