New hospital promising; leaders now must avoid another two-tier system

Welcome, Austin’s newest hospital, Dell Seton Medical Center at the University of Texas.

The hospital, which opens today, is the result of years of planning, generous donations and a 2012 proposition approved by voters that steered $54 million in property taxes to health care projects, including $35 million for a medical school. That proposition was delivered on a promise that Central Health, the county’s health care district, and Seton Healthcare, the hospital’s owner, would join forces to deliver a teaching hospital and affiliated facilities to improve health services for the poor and provide innovative health care for the region.

The new hospital replaces University Medical Center Brackenridge, or Brack as it is known to many, Austin’s long-standing safety-net provider to uninsured and low-income residents. Central Health, too, was set up to serve uninsured, low-income and indigent Travis County residents who used Brackenridge Hospital for services.

Dell Seton Medical officials must be vigilant in ensuring that Dell Seton, an upscale, model hospital with some of the region’s best doctors, maintains its focus on that mission and does not create a two-tier health system that pushes out the poor from the new facility.

For now, Dell Seton delivers on the promise of a state-of-the-art hospital. A bright and airy 517,000-square-foot facility, Dell Seton will serve as a teaching hospital for UT’s Dell Medical School as part of a safety net for low-income patients and as a Level 1 trauma center for the region. It has 42 trauma beds, 13 operating rooms and 211 patient rooms. It also includes 15 emergency medical vehicles in the event of a mass casualty, and trauma rooms that can convert into operating rooms to avoid having to transfer patients.

Meticulous detail went into the design of patient rooms. The placement of just about every object in the room was taken into consideration with the goal to better focus on the patient. Each room is equipped with identity tag sensors that announce a caregiver entering the room, as well as flat screen monitors and spacious seating for visiting family members. It’s an impressive facility.

We are encouraged most by the mission to keep people out of the hospital as more care is delivered in clinics and physicians’ offices. It’s a model that could benefit everyone, especially Austin’s economically disadvantaged residents.

Studies show that residents in low-income neighborhoods suffer more from disease and early death than people in more affluent neighborhoods. On average, African-Americans and Hispanics received worse medical care than whites, according to a 2014 report from the Robert Wood Johnson Foundation.

African-Americans, who make up 7 percent of Austin’s population, have the highest mortality for cancer, heart disease, stroke and diabetes. Although Hispanics, 36.5 percent of the city’s population, have lower death rates from serious diseases than blacks or whites, American-born children of Hispanic immigrants often have poorer health than their parents, including high rates of obesity and diabetes, the American-Statesman has reported.

Limited access to good health care has been a long-standing issue for Austin’s people of color and low-income communities. The collaboration of the medical school, Dell Seton and Central Health’s affiliated CommUnityCare clinics promises to change that. Medical school students and doctors in training will treat low-income patients at the clinics.

Hospital officials also plan to put more clinics in new places, including in H-E-B grocery stores, where patients can go for simple procedures like blood work. One H-E-B by Bee Cave Road and Loop 360 already allows patients to talk with a specialist by video screen. The model is intended to entice people to identify health issues before they end up in the hospital.

Other aspects of the hospital’s innovative health care approach are also promising. In moving endocrinology services out of Brackenridge and into local community clinics, officials hope that more patients will keep their appointments, citing less travel and no parking fees.

Orthopedic patients are also benefitting from the hospital’s new system of care delivery. Instead of patients having to make numerous phone calls to coordinate visits with a variety of health professionals, UT medical school’s new orthopedic clinic streamlines the process. There, an eight-person team monitors a patient’s care. Patients learn about and are expected to address underlying issues. Surgery is performed only after other options have been explored.

While it is too early to measure the community’s returns on the investment in the medical school, these are good signs.

Success will also depend on whether hospital officials keep their promise to continue to be Austin’s safety-net hospital. While the hospital is obligated to treat all who walk through its doors, it’s important that every person – regardless of income – feel just as welcome as they were at Brackenridge.

It’s not difficult to imagine that — as more low-income patients receive health care closer to their homes and a more affluent population moves in closer to the hospital — the new shiny, modern Dell Seton hospital loses the identity it inherits from Brack of existing for those with less.

Brackenridge was known as the hospital of Austin’s poor. It wasn’t always a good reputation to have, but it is why low-income residents could seek the medical attention they needed there. Though the Brackenridge name is gone, Dell Seton Medical should make it clear that, in that regard, nothing has changed.

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