Panel OKs UI health care reorganization

Panel OKs UI health care reorganization

Full board to discuss it at meeting later this month; some faculty say process too quick

URBANA — Three years after approving a reorganization of the University of Illinois health enterprise, trustees are poised to consider an organizational overhaul of its hospital, clinics and medical colleges.

A UI Board of Trustees committee on Monday advanced a reorganization plan, with a discussion by the full board expected to occur later this month. But some faculty are saying "slow down."

After several months of discussions, including bringing on consultants from the Huron Group, UI administrators have proposed eliminating the vice president for health affairs, a university-level administrative office, and instead establishing a vice chancellor for health affairs.

The move would dismantle a health-affairs structure established by former UI President Michael Hogan, whose centralization initiatives were not well-received by faculty. Hogan proposed, and trustees approved, the Office of the Vice President for Health Affairs to coordinate the hospital, clinics and faculty practice plans, while deans of the health affairs departments, such as the UIC College of Medicine and College of Nursing, remained separate.

But because of ambiguity surrounding several issues — such as reporting lines and funding, including managing revenue from clinical operations — plus changes in the health care industry, the coming implementation of the Affordable Care Act and, ultimately, Vice President for Health Affairs Skip Garcia's decision to leave the UI to accept a job in Arizona, UI President Bob Easter has in recent months made the health affairs reorganization a priority.

Considering the hospital, clinics, several different health science colleges at UIC (the medical school is the country's largest), plus the satellite campuses in Peoria, the Quad Cities and other areas of the state, "it's an enormous enterprise," said UI Trustee Tim Koritz, an anesthesiologist in Rockford.

"This is a huge responsibility for the board" he said. "It's a big part of the puzzle of the University of Illinois, a big financial concern."

On Monday, Easter's special assistant, Avijit Ghosh, outlined the plan and said further details, such as the reporting structure, will be given to trustees by their March 2014 meeting.

"The motivation for the changes is to create an integrated academic health medical center comprising the hospital, the clinics and health science colleges on the Chicago campus" — a structure that would help advance the academic and clinical missions of the UI and allow it to respond to rapid changes in the health care environment, Ghosh said.

"By aligning the clinical and educational missions of the academic health center, the university can better leverage the benefits" of its research and its clinical care to serve the health needs of Illinois residents, he said.

The current vice presidential position reports directly to the president. As proposed, the new vice chancellor for health affairs would report to the Chicago chancellor and have oversight of the hospital, clinics and medical colleges.

Deans of the various health science colleges, such as medicine, pharmacy, dentistry and nursing, would report to this new administrator. The regional medical programs and campuses have always reported to their respective college deans in Chicago, and that will continue to happen under this proposed structure, according to Ghosh.

Dimitri Azar, dean of the College of Medicine, said the deans of the health science colleges support the proposal.

However, last week, a faculty governance group on the Chicago campus forwarded to Easter a letter and report outlining numerous concerns and issues. The UIC Senate overwhelmingly supported a document that essentially asked university leaders to consult more with the faculty and provide more information before moving ahead with the plan, said UIC School of Health Professor Vicky Persky.

"We feel, in general, the university would be stronger if more faculty input was had on these things," said Persky, who chaired the committee that reviewed the proposal.

It is faculty, she said, who have a good handle on how any kind of reorganization or restructuring may play out.

Faculty want to hear more detailed information prior to any formal board action, she said. In addition to learning more about the rationale for the restructure and the data behind it, faculty have questions about how the office will be supported financially and, if the hospital runs into financial difficulty, how will that affect the medical colleges. Other lingering questions have to do with a college's autonomy and any effect on cross-campus collaborations between a health science college and one that is on the east side of the campus; the potential for duplication of services; effects on promotion and tenure; and the UIC Library, among other concerns.

"The devil is in the details. Unless we can dig deeper into the consequences of the proposed changes, we can say with a lot of certainty we will have subsequent problems," the UIC Senate Executive Committee report said. "Thus, we urge the administration that we take our time thinking about the details, and resolve the critical issues now, rather than 'on the fly.'"