JRMC Seeks Affiliation Agreement to Work with Sanford Health

Jamestown Regional Medical Center will pursue an affiliation agreement with Sanford Health, the JRMC Operating Board decided unanimously last week at a planning retreat.

An affiliation agreement — the lowest level of relationship Sanford offers — would allow JRMC’s local board to retain all its decision-making powers, while also allowing JRMC to offer patients more cancer care options.

“It’s all about bringing services here,” said Connie Krapp, chairman of the JRMC Operating Board.

Should the affiliation agreement be finalized, JRMC will also be able to install and use Epic, an electronic health record system already in use by the Sanford and Essentia clinics in Jamestown.

“I think Sanford wants the relationship because they have a lot of investment in the community with the two clinics,” said Todd Hudspeth, CEO of the medical center. “They want to deliver care as close to the patients’ home as possible.”

Through cooperation with the Sanford Roger Maris Cancer Center, JRMC will be able to expand its chemotherapy offerings, and eventually, radiation therapy may be offered as well.

“Three to five years out, we’ll address that,” Hudspeth said, explaining that adding radiation cancer therapy would require the hospital to invest approximately $5 million in equipment. “The long-term goal is to get that out here, but we’re going to start with medical oncology.”

Currently, very little chemotherapy occurs at JRMC. It is offered in a small space in the emergency department, Hudspeth said.

Chemotherapy is rated at four different levels, based on potential complications and strength, and JRMC offers level 1, and a little bit of level 2. The idea, Hudspeth said, is that JRMC will continue that work but offer additional levels of chemotherapy as time goes on.

In addition, cancer treatment will be moved from the emergency room to a dedicated cancer center in the JRMC’s clinic building.

The medical center has long recognized a need for more local cancer treatment, Krapp said, even before the new hospital was built.

“That’s been on the wish list for several years,” Hudspeth said.

Partnering with Sanford could potentially allow JRMC patients to participate in Sanford clinical trials at JRMC, too.

For the most part, patients who aren’t being treated for cancer likely won’t notice any changes, Hudspeth said.

Utilizing the Epic record-keeping system will mean that the JRMC’s electronic records are totally compatible with those of Sanford and Essentia clinics, both of which use the same system.

While the hospital does already have an electronic records system, it doesn’t really “talk” to the clinics’ system.

Physicians feel that the new system will help improve patient care, Hudspeth said, and it also has the potential to reduce duplicate testing, as patients’ previous lab results will all be easily accessible.

“For quality and safety, it really makes a difference,” Hudspeth said.

Recent information from the hospital’s current system will be migrated into the Epic system.

“It’ll be a lot safer, more efficient for the patient,” Krapp said.

The licensing cost for the new system is extremely high, and installation is estimated to cost approximately $1 million. Much of that — probably 70 to 80 percent — will be reimbursed by the federal government, Hudspeth said.

Under the Affordable Care Act, the hospital would eventually be penalized financially if Epic or a similar system were not installed and utilized, Hudspeth explained.

However, a hospital as small as Jamestown Regional Medical Center would not be able to license itself under Epic, because it’s not big enough, he added.

Currently, Sanford is in the process of installing Epic in all its medical facilities, Hudspeth said. JRMC would likely install it sometime next winter, using its own IT staff and the back-office support of Sanford’s computer centers in Fargo.

Talks about partnering with Sanford or other larger health systems have been going on for a long time, but they intensified after the Affordable Care Act became public, Krapp said.

“We’re seeing tremendous change in healthcare with increasing focus on the cost and efficiency of care,” said Rick Giesel, president of the Sanford Health Network, Fargo. “Closer collaboration and integration lends itself to better align incentives and potentially avoid duplication of services.

“Evaluating a closer affiliation between JRMC and Sanford seeks to address our changing environment so that we can continue to offer the best patient care possible.”