BY ADAM ATKINSON
North Country This Week

POTSDAM — With the ink only a few months dry on St. Lawrence Health’s affiliation with Rochester Regional Health, SLH is already moving forward on implementing key advantages of the new relationship.

Design work is underway for a modern bed tower at Canton-Potsdam Hospital. Rochester Regional is funding the construction. And, the local healthcare network is also in the process of integrating and implementing RRH’s electronic health record system.

The affiliation this past January — part of the overall SLH strategy to enhance access and depth of available healthcare in St. Lawrence County — will also provide access to specialists, better technology and eventually allow SLH to start its own family practice residency program, said SLH Pres. David Acker.

Rochester Regional Health is “a huge operation and it’s a huge event in the healthcare history of this county,” said Acker.

Bed tower build

The most visible change from SLH’s joinery with Rochester Regional will be the construction of a modern bed tower at the Canton-Potsdam Hospital campus.

Acker said the affiliation is providing the entire funding for the project, which will include parking and access.

Several of the neighboring houses owned by SLH will be removed to allow for the work, but the bulk of the tower will be built near the emergency department wing. Part of the older hospital building there will be razed to make room for the new structure.

The extra space will allow for more intensive care and obstetrics area on the campus and increase the size of single-occupancy rooms to meet code throughout the hospital.

“This will give us more ED (emergency department) space. This will give us decent space to do more advanced imaging. People won’t have to walk down a ramp. We’ll actually have a lobby that’s not like a sardine can,” said Acker.

SLH anticipated a meeting with architects last month to begin honing down plans for the tower. Acker said he expected the new tower to be three or four stories tall. While he favors a four-story tower, the height of the new wing is going to be a product of budget, the president said.

Acker said SLH has to submit a certificate of need for the new building to the state and that will take six or so months to work its way through the process.

Once that is complete he anticipates a ground-breaking for the new building sometime next year. Construction will take about 2 years with the displacement of existing offices and space which will be razed to make way for the new tower. 

Medical records

One of the more immediate benefits of the affiliation with Rochester Regional is that the various campuses of the SLH network — in Canton, Gouverneur, Massena and Potsdam — will be able to install and use EPIC, an ultra-modern, integrated medical records system, instead of 26 different programs.

The new medical records program will allow seamless transition and communication between campuses for patients and practitioners.

“We began the implementation of the EPIC system before the merger even went through, so by April of next year that implementation will be complete,” Acker said. “It will allow for better coordination of care and the support of care.”

The president pointed out that the benefit of implementation of the new medical records system through Rochester Regional isn’t so much one of cost.

“We could have afforded it but could we have implemented it well?” Acker said. “And once it’s implemented well, can you support it well? And update as well? And modify it? That’s a bandwidth that’s beyond us.” 

Rochester Regional, with a staff of over 20,000 can provide not only a full bench of IT professionals to assist with the system but all of the other support needed to bring the system online for SLH.

Residency program

The merger should also allow SLH to start its own family practice residency program next year, Acker said. The first family practice residency class made possible by the merger would ideally start with three or four practitioners and then grow to host 12 to 13 medical students per year.

The revolving talent pool could potentially not only draw medical professionals to the area, but inspire some to stay on to set up shop in the region providing a source for new doctors for SLH.

“It’s a real game changer,” Acker said.

Long-term goal

Affiliating with the Rochester network locks in a major goal of St. Lawrence Health.

“For a decade we have had a goal of being part of a larger system that had resources that we just don’t have. Rochester has just been a really, really terrific event for us.”

The affiliation is a natural progression in the long-term strategy of SLH to provide a network of facilities, diverse practitioners and access to care to patients in St. Lawrence County.

Acker said when he first arrived in St. Lawrence County in 2007 to take over Canton-Potsdam Hospital, the thing he found so striking about the region was the geography.

In many cases, due to the size of the county and the prevalence of small local hospitals, the time to get to tertiary care made St. Lawrence County the second-most isolated east of the Mississippi in terms of access. Acker said in some cases the distances were tantamount almost to a denial to access to care.

Acker said the state Department of Health’s perspective was that with all of the smaller fragile hospitals in the county, patients would just go to the east to Plattsburgh or Burlington, or to the west to Watertown for care.

However, Acker said the “boots on the ground” reality of the situation reveals that the 2- to 3-hour travel time to larger hospitals out of the area just wasn’t sustainable for the population, especially to seniors living on their own.

“So we were really focused on the degradation of the economies in the towns and in turn with the degradation of the hospitals.”

Hospital sizes, built around the number of beds, were largely established by economics of an earlier time, and didn’t really account for changes in population size, needed specialists and the cost of running a healthcare facility. Individually, the small town-based facilities were fragile economically and would not have been sustainable on their own long term.

The more regional network approach of the St. Lawrence Health system was formed when Canton-Potsdam Hospital took over management of economically ailing Gouverneur Hospital.

SLH set up several clinics and facilities, built the new specialist facility just outside of Canton on Route 11, and took over management of the Massena Hospital in subsequent years.

SLH’s more regional approach to providing a healthcare network allows them to generate revenue to be sustainable and provide various specialists that smaller individual hospitals might not be able to on their own, Acker said.

Negotiating since 2018

Acker said both SLH and Rochester Regional had mutually agreed in 2018 to work towards an affiliation. However the merger was stalled after SLH was tasked with taking over management of Massena Hospital and bringing that facility back from the brink of closure.

“So we parked Rochester, agreeing that come 2020 we would reopen it (the affiliation),” Acker said. But once the Massena acquisition was finished, the pandemic began, causing the merger to pause again. “But we didn’t pause it very long,” Acker said.

Healthcare mergers require entities involved to file a Certificate Of Need with the state. The CON is then reviewed and considered for approval.

The state had shut down that process due to the pandemic, but Acker said he and the CEO of Rochester Regional agreed in April 2020 to lay all of the groundwork for the merger.

“We said if we really put our attention to this, we can get this affiliation agreement completed, all the multiple exhibits completed and get a Certificate Of Need prepared. We can maybe be the first major merger and acquisition that goes through the state CON process when they open back up for business.

So on July 10 they signed that. Then on Jan. 1, 2021 “we became part of the Rochester family,” Acker said.