UPMC picks leader in effort to streamline care methods, costs

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University of Pittsburgh Medical Center today will announce the promotion of one of its top executives and medical researchers to a newly created position designed to meld new ideas for disease treatment with the need to reduce health care costs.

Starting Oct. 1, Steven Shapiro, currently associate medical and science director for the International and Commercial Division, will fill the post of chief medical and scientific officer for the entire UPMC system.

"When you think of a chief medical officer you think of someone fixing problems and trouble-shooting," said Dr. Shapiro, 54, who came to UPMC from posts at Harvard Medical School and Brigham and Women's Hospital in 2006. "But in this position, I'll help fine-tune some of the care delivery systems we've put in place."

The fine-tuning will be the result of pilot programs aimed at everything from how to reduce readmissions, to making use of in-home monitoring, to studying which patients might react better to certain diseases.

His work will involve not only data from all of the patients who use UPMC hospitals, but also information from the UPMC Health Plan insurance company.

One example, Dr. Shapiro said, is work he has been leading looking for genetic markers for how a patient would react to four types of cancers: prostate, breast, ovarian and lung.

"We already know that 6 percent of men with prostate cancer die of it," he said. "We don't know who are the patients who are more likely to survive it, but we tend to treat all of them with that in mind" that 6 percent of them will die.

The results of studies in this area could result in how aggressive treatment should be, Dr. Shapiro said. Less aggressive treatment could result in health-care savings.

"Ultimately we do think this would cost less," he said. "It would not only be better for their health, but also this should reduce their costs."

As an example of how important those dual goals are, Dr. Shapiro will answer directly to UPMC CEO and president Jeffrey A. Romoff, who said in a statement that Dr. Shapiro "will help ensure that UPMC creates the future of health care with innovative science and technology, a global health enterprise that is flexible, evidence-based, integrated, cost-effective and always focused on that which is best for our patients."

The idea behind Dr. Shapiro's post is something every major hospital and health system is looking at now, said Dr. Gerard Anderson, director of the center for hospital finance and management at Johns Hopkins University.

"All academic health care centers are gearing up to do this," he said, noting a number of other systems that already have people leading such efforts, including the systems at Johns Hopkins and Harvard.

A big reason for that, he said, is because the new federal health care law passed this year created a system to encourage such savings. If hospitals can demonstrate cost savings by 2012 and qualify as "accountable health care organizations" they could share in federal Medicare funding incentives.

Steven Wartman, president of the Association of Academic Health Centers, of which UPMC is a member, said most hospitals are looking at this "and I would like to think this is just because they want to do the right thing, but there's no question the incentives are important."

Dr. Shapiro, whose ongoing research has included breakthroughs in understanding the genetic causes of several diseases, said some of the scientific advances might not be implemented for years to come, but there are other programs that can both improve care and help cut costs sooner than that.

"We know too many patients are coming back in after we sent them home and we have to find out how to improve that," he said.

Pilot programs going on now at UPMC's St. Margaret and Presbyterian hospitals have already shown some results in reducing readmissions, he said, "primarily because we're paying more attention to the patient. It is common sense, I agree. But it's that gap in care that we're focusing on."

Sean D. Hamill: shamill@post-gazette.com or 412-263-2579.


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