Looking ahead to 2014: San Francisco Department of Public Health's Integrated Delivery System

San Francisco General Hospital and Trauma Center (SFGH) is a public hospital providing emergency, trauma, inpatient, and ambulatory services; it is part of a safety net system with networks of publicly funded primary care clinics, independent community clinics, behavioral and mental health services, long-term care and jail health. Over the past several years, the ambulatory network has been strengthened by the development of a system-wide chronic disease registry; standardized primary care metrics and reports that encompass access, productivity, clinical and patient experience measures; an electronic referral system that enhances communication between primary care providers and specialists; and investment in health information technology to enhance off-campus access to SFGH¹s EMR. These efforts have been synergistic with San Francisco¹s universal access initiative (Healthy San Francisco) and our local Medicaid managed care plan¹s efforts to improve access and quality across the safety net providers. Dr. Chen, SFGH's Chief Integration Officer, will discuss the hospital's current initiatives and challenges including a new pay-for-performance program focused on improving access and quality of care across primary care, specialty care and acute inpatient care settings at SFGH (CMS Incentive Pool); implementation of electronic health records; transitioning Medicaid fee-for-service patients to managed care; and the development and implementation of a 5 year strategic plan to transform SFGH from a provider of last resort to a provider of choice.