Northfield Hospital Board Meeting: Nov 2019


  1. Steve O’Neill called the meeting to order at 6:30 p.m. The Agenda and Consent Agenda were approved. The Consent Agenda included Minutes for the October Board Meeting and Minutes for a Governance and Planning Committee Meeting.



  1. Hospital Chief of Staff—Dr. Tom Holt. No report. Holt presented the applications for Medical Staff Membership/Privileges. Applications approved.



  1. Customer-facing Technology Update—Emily Nelson & Vern Lougheed. NH&C is searching for a technology platform that provides a) convenience (patients can easily access services), and b) clinical interaction (patients take control of personal health data and can directly access physicians). Most of the vendors are “new”, in business for 5 years or less, and the technology is still rapidly changing.  Three vendors have been identified that offer platforms that are compatible with EHRs from both Epic and MedTech: Luma Health, Jellyfish Health, and Relatient.  Staff will continue to evaluate the 3 vendors and generate cost comparisons.  Given that the 3 vendors each offer different features and different interfacing with the 2 Electronic Health Record vendors cost comparisons are complex.  Staff hopes to have a recommendation by year’s end, and a proposal could come to the Board in early 2020.  It was noted that Google, Microsoft, and Amazon have recently expressed an interest in developing EHR systems.
  2. Nursing Services Update—Tammy Hayes. NH&C opened a Lactation Clinic in April 2019 that supports both inpatients and outpatients.The Clinic is located in the Birth Center and is staffed by Jennifer Kleine.  The Clinic supports local breastfeeding groups, teaches breastfeeding classes, and provides educational materials.   A Partners in Healing program was initiated in June of 2019.  “The program provides opportunities for family members to help with basic care for their loved ones and helps prepare them for taking over care responsibilities when the patient goes home.”   Among the many benefits cited for the program are boosting family confidence for discharge, reducing the rate of readmission, and increasing patient and family satisfaction.  Currently the program is available to patients undergoing total joint replacement, and it will be expanded to patients with Congestive Heart Failure and Chronic Obstructive Pulmonary Disease.


Executive and Committee Reports

  1. CEO Report—Steve Underdahl. a) EHR—negotiations with Stanford Medical regarding EHRs are ongoing. b) Building—projects are on schedule in spite of some obstacles.  c) Strategic –A draft plan for Social Determinants of Health is under review and many useful comments have been received.   Topics for the next strategic planning session should include “accommodating consistent, chaotic change” and “building organizational resilience.”  d) Operations—Nov. appears to be a better month than Oct. The “law of small numbers” caught up with NH&C, and a couple extra readmissions will result in a loss of “a couple hundred thousand dollars” from Federal programs.  NH&C suffered a cyber attack that was successful in breaching Microsoft Office 365, a cloud based software program.  Staff is evaluating the extent of the breach and what confidential data, if any, was compromised.  e) Policy—hospitals are promoting pharmacies, rather than hospital EDs, as the pickup point for emergency insulin in the proposed legislation under discussion in MN.  The MN Hospital Association is urging legislation that would require “Prior Authorization” rules imposed by insurers to be rational and transparent.  Congresswomen, Angie Craig, visited NH&C on a low-key fact finding mission.
  2. Financial Report—Steve Underdahl. Net Operating Revenues were $237K under budget but a favorable payer mix (more commercial insurers) resulted in a Net Operating Income of +$301K for Oct. Cumulative Income from Operations is still slightly negative for the year.  Net Income remains positive for the year due to over $4 million of Non-operating Income thus far.   It was noted that Bad Debt deductions are increasing, possibly due to high deductible insurance polices.  The use of historical data in the budget forecasting process is becoming less reliable.  Have we entered a period of “new normals?”
  3. Community Relations Committee Report—CC Linstroth—The Committee has received $117,000 of grant requests from the community, in addition to the request from Northfield Area Fire and Rescue Squad regarding a new vehicle.



A Board member urged the administration to think about providing an access point in Northfield for immediate physician care but without the high cost of the hospital ED.   It was pointed out that a complicated diagnosis may require hours of a physician’s time and multiple tests.  Or the patient’s condition may require quick access to hospital services such as surgery.  A hospital emergency department meets these needs.  Reducing the number of patients entering the ED won’t reduce the department’s costs proportionately.

Meeting adjourned at 8:05 p.m.

Next meeting: Dec. 19, 2019

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