‘Computer, how is this patient doing?’ Using analytics in health care

photo of st. luke's health care analytics
St. Luke’s Health System is using data analytics to help monitor patients and alert personnel when the situation warrants. Photo courtesy of St. Luke’s Health System

Correction: This story has been updated to correct the spelling of Onur Torusoglu’s name.

St. Luke’s Health System is looking at new ways to use data analytics to help produce better patient outcomes.

“It’s not magic, it’s math,” said Onur Torusoglu, chief digital and analytics officer at the Boise-based nonprofit health organization.


With analytics employees sprinkled across St. Luke’s, the organization has recently consolidated the 80 to 90 employees who can use technologies such as SQL, R and Python to create analytic algorithms, Torusoglu said.

Altogether, St. Luke’s has 60 technology systems in a centralized repository using a cloud-based data warehouse to make the data available to people who can use it to help make business decisions, Torusoglu said.

photo of Onur Torusglu
Onur Torusoglu

Computers can constantly monitor patients in the hospital setting and alert staff if patients are developing a problem such as sepsis, Torusoglu said. Clinicians define thresholds to determine which patients are at risk, he said.

“A number of data points are updated on an almost instantaneous basis,” he said. “We capture key variables and analyze that on the fly. We can identify patients before they turn septic, which is a tremendously helpful tool for our physicians.”

While St. Luke’s has had the capacity in its electronic health records system to do this for some time, the organization has been developing this project for the past 12 to 18 months.

“We took our time to build the right teams and skill sets,” Torusoglu said. “We’re dealing with human lives. We didn’t want to just turn on this capability and see what happens.”

For example, if the thresholds weren’t set correctly, they could alert staff too often – or not soon enough.

“That fine-tuning is the tricky part today, to set those thresholds correctly so they serve patients and clinicians in the correct manner,” Torusoglu said.

Artificial intelligence

Other systems are using artificial intelligence and machine learning, Torusoglu said.

“We have an ability to utilize analytics in an oncology setting to help match patients with a given trial or other active cases we have,” he said. “Instead of sorting manually through hundreds of thousands of different oncology trials, we can directly match patients to trials on a much faster basis.”

Analytics are also beneficial after a patient is discharged, Torusoglu said.

“We have resources around case and care notification settings that would allow us to create follow-up conversations with patients, social workers or case managers” for issues such as medication adherence, he said.

Studies bear fruit

St. Luke’s isn’t alone. A number of health care organizations are looking to analytics to help create better patient outcomes. Analytics are associated with a higher chance of successful patient outcomes, according to a recent study, “How Successful Are Healthcare Organizations at Achieving ROI with Analytics?” by HIMSS Analytics, sponsored by  Dimensional Insight, a vendor in this field.

The organizations surveyed 109 senior health care executives involved with analytics and decisionmaking in clinical analytics, financial analytics and operational analytics. The survey found that organizations saw the most success with clinical analytics (77.7%) compared with financial analytics (73.5%) and operational analytics (70.3%). In particular, organizations see the highest measured success rate (75.4%) if they use clinical outcomes improvement as their primary metric, the survey found.

However, there are barriers toward implementation of analytics in health care, according to a 2018 study, “The Opportunities and Challenges of Data Analytics in Health Care,” by the Brookings Institution, a Washington, D.C.-based nonprofit public policy organization.

“These barriers include the nature of health care decisions, problematic data conventions, institutionalized practices in care delivery, and the misaligned incentives of various actors in the industry,” the study found.

Health providers struggle with electronic health records interoperability

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While electronic health records are an improvement over handwritten ones, there are still gaps, especially between providers. File photo.

Doctors’ handwriting is notoriously challenging, but it turns out electronic health records (EHR) are no panacea either, especially when trying to interoperate between two different medical providers, according to IT experts.

Many medical providers have moved to EHR, but each vendor has its own way of displaying information. And while there have been attempts to develop interoperability standards between them, they don’t always work. There are even competing interoperability standards.

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Dana Hamilton, left

When done well, EHR lets medical professionals convert data into information and look for correlations, said Dana Hamilton, health information systems specialist for Fisher’s Technology, speaking at the Boise Technology Show on May 16. But to do that, the data has to be in a form the computer system can understand, she said.

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Jon Vanderpool

In 2015, health organizations were required by the Centers for Medicare and Medicaid Services, the federal agency that administers the programs, to use a “continuity of care document” (CCD) whenever a patient is referred to another provider’s care, said Jon Vanderpool, IT program manager for St. Luke’s Health System. But there can be different terminology standards, he said.

“Part of the problem is there’s a gap from one EHR to another, especially if they’re different vendors,” he said.

The biggest problem is with unstructured data, or the sorts of notes that medical personnel write down about a patient’s condition. By its very nature, there’s no standard way of converting unstructured data from one format into another.

But even with structured data, there can be problems, especially when exchanging data with another health provider with different processes. One EHR product has 745 places a systolic blood pressure value could be entered, Hamilton said. “Which one are you using?” she asked. “Are you sure?”

Using the same fields is particularly important when doing analysis that might be comparing fields, Hamilton said. Misspellings or incorrect data can also lead to records not being grouped properly, she said. Ensuring that the records are equivalent and the data is valid – a process known as cleaning the data – took her eight months for a single dataset, she said.

In response, networks have been formed to help organizations exchange CCDs, Vanderpool said, such as Carequality and CommonWell Health Alliance.

“All the organizations that participate agree to common data use agreements,” he explained.

That said, there are still multiple networks. St. Luke’s is part of Carequality while Saint Alphonsus Health System is part of Commonwell, but the networks are working on interoperability. Since April, St. Luke’s and Saint Alphonsus have been able to share records, Vanderpool said.

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A. Patrice Burgess

Partly to improve interoperability, Saint Alphonsus is standardizing its EHR system to Epic EHR, said A. Patrice Burgess, chief medical informatics officer for Saint Alphonsus. All four of its hospitals currently use the Cerner EHR system, she said.

“Our clinics currently use a variety of systems, but will all be moving to the Epic system along with our hospitals in October,” she said. “When we are on the Epic system, that will allow better communication within our own facilities as well as with other systems that use Epic.”

In the meantime, Idaho health organizations use the Idaho Health Data Exchange, a nonprofit health information exchange formed in 2008.

“We estimated in 2015 that 54% of clinicians in Idaho had the ability to exchange data,” Vanderpool said.

While he didn’t know current figures, he said the gap is closing.

Virtual reality playing a role in health care

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Virtual reality is increasingly being used in health care, as in this demonstration at a recent event. Photo by Sharon Fisher.

This is the second story in a three-part series on virtual reality. 

We’re a ways from using it in areas such as surgery and other medical procedures, but virtual reality (VR) is playing an increasingly larger role in health care.

VR in health care is a booming market. Starting at just $525 million in 2012, the market grew to $976 by 2017, according to Markets and Markets. By 2025, the VR and Augmented Reality (AR) health care industry will be $5.1 billion, according to Grand View Research. Yet another study found that health care virtual reality is expected to grow at a CAGR of 54.5 percent through 2023, according to a report from Research and Markets, while Technavio analysts forecast growth of 28.15 percent from 2019 to 2023.

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Howard Rose

With its background in gaming, VR’s ability to gamify health care outcomes such as rehabilitation, and its immersive traits that help distract patients from pain, apprehension, or boredom, make it useful. While people’s first thought is often performing surgery remotely, that’s just the beginning, said Howard Rose, CEO of Firsthand Technology, a Seattle-based VR health care company.

“There’s more to VR than surgical simulation,” said Rose, who spoke on Nov. 16 to the Idaho Virtual Reality Council. It can also be used in areas such as mental health, lifestyle, pain relief, and wellness, he said. VR has five “super powers,” he said: It’s immersive, interactive, psychological, cognitive, and emotional.

Pain relief is a particularly promising area, because using VR for it can not only reduce the pain itself, but can also do so at a lower cost – and with less chance of addiction – than by using opioids, Rose said. A number of studies found that using VR, compared with opioids, produced better outcomes in areas such as unpleasantness reduction, time spent thinking about pain, and the amount of fun, he said. Moreover, VR often lasts longer, he said.

“VR has a profound, lasting effect,” Rose said. “It’s not just a distraction.”

In addition to pain relief, VR can also be used in conjunction with therapy for mental health care, such as simulations, phobia cures, and realigning a distorted sense of self, Rose said. “It’s not replacing the therapist, it’s enhancing the ability to provide therapy.”

The complication is finding a way to deliver VR in a clinical fashion, Rose said. “What’s the dose of a game?”

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Shelly Gorman

In Idaho, the Saint Alphonsus Health System is fundraising to expand and remodel its Boise infusion room, where patients receive chemotherapy and other supportive medications either intravenously or through a port, said Shelly Gorman, regional service line director for oncology and general surgery. Part of that renovation is expected to include support for VR, she said. “We’re using a portion of the funds raised to bring VR experiences to our patients while they’re spending hours undergoing chemotherapy and other treatment,” she said.

For example, the clinic could use VR’s immersion ability to help treat the nausea that such treatments sometimes produce, Gorman said. “Maybe they’re traveling, or maybe they’re getting away to the beach,” she said. “We plan to have a wide range of experiences available to them.” Providing VR would cost from $30,000 to $40,000, she said.

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Keri Monson

In addition, VR could help reduce pain and anxiety for such patients, said Keri Monson, nursing supervisor for cancer care infusion. “Pain creates anxiety, and a lot of our cancer patients are pain patients,” she said. Chemotherapy itself can also cause pain, she added.

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St. Luke’s Virtual Care Center doesn’t yet support virtual reality, but it may in the future. Photo courtesy of St. Luke’s.

The St. Luke’s Virtual Care Center, which opened in August, is a Boise-based “virtual hospital,” intended to provide people in remote, underserved communities with access to specialty and emergency providers without having to make a trip to Boise. While the facility doesn’t yet offer VR or AR functionality, that could happen in the future, said Krista Stadler, senior director of telehealth services. “We don’t have plans to date,” she said. “We are definitely keeping tabs on what is happening nationally with other health services.”

St. Luke’s is looking at VR to see how it might apply in Idaho, whether in the hospital, in clinics, or in patients’ homes, Stadler said. “The goal would be to find out how that application would be most effective, and for what conditions, and how to deploy it,” she said.

Last beam in place for St. Luke’s Children’s Pavilion; next up a sky bridge

Crews place a beam with hundreds of employee signatures at the top of the Idaho Elks Children’s Pavilion at St. Luke’s. Photo by Teya Vitu.

The Idaho Elks Children’s Pavilion at St. Luke’s structure is in place now, having arisen from a 36-foot deep hole since July-August 2017.

The final steel beam at the highest point was installed the week of Oct. 22, a week following the Oct. 17 ceremonial “final” beam signed by hundreds of St. Luke’s employees.

St. Luke’s Health System in the week of Nov. 7, 2016, started dismantling the Treasure Valley Pediatrics building at Jefferson Street and Avenue B as well as drilling the first column holes for the future Idaho Elks Children’s Pavilion at that site.

The tower crane that has been in place since June 9, 2017, will come down Oct. 27-29 and likely be relocated a couple blocks over to start work on the new St. Luke’s central plant, parking garage and shipping and receiving buildings – the first structures for the estimated $400 million, 680,000-square-foot expansion in downtown Boise over the next decade.

By the end of the year, a sky bridge will cross Avenue B from the St. Luke’s Children’s Hospital to the new Children’s Pavilion. Image courtesy of St. Luke’s Health System.

The next big lift will be a sky bridge that will cross over Avenue B to provide a passageway between the Children’s Pavilion and St. Luke’s Children’s Hospital. The sky bridge pieces were delivered Oct. 19-21 and will be assembled over the next two months and installed across Avenue B at the end of December, hospital spokeswoman Anita Kissée said.

The four-story, 100,000-square foot structure will now shift to masonry cladding of the exterior and mechanical installations inside with a targeted opening next summer.

“It’s going to go really fast,” said Kathryn Beattie, executive medical director of St. Luke’s Children Hospital. “The drywall is in on the first and second floors.”

The Children’s Pavilion will be an outpatient clinic enabling St. Luke’s to bring all its pediatric specialists to one location. They are now scattered in four locations, Beattie said.

The frame for the sky bridge (right) is already in place at St. Luke’s Children’s Hospital. Photo by Teya Vitu.

“The kids can now stay in one place and all the doctors come to see them,” Beattie said.

That can mean children get all their treatments in the same building or stay in the same treatment room in the multi-disciplinary clinic, she said.

The Children’s Pavilion will have more than 100 treatment rooms with 60 to 70 pediatric specialists on site covering 22 specialties, Beattie said.

Beattie said the Boise arrangement is unique with the children’s hospital and outpatient clinic across the street from each other with doctors not even having to go outdoors to get from operating room to outpatient treatment rooms.

The $42 million project included $25 million in philanthropic donations. Hummel Architects is the architect and St. Luke’s is the general contractor.

St. Luke’s builds overnight accommodations for cancer patients in Fruitland

St. Luke’s is building a respite house in Fruitland where cancer patients can stay while getting multi-day radiation treatments. Image courtesy of St. Luke’s Health System.

Backed by $1 million in donations, St. Luke’s Health System will build a 5,235-square-foot respite house in Fruitland for cancer patients traveling from hundreds of miles away for radiation treatment.

The $1.6 million respite house will have four guest rooms with bathrooms for patients and families. The house also will have a living area, two kitchens, showers, laundry facility and storage.

Patients drive to the St. Luke’s Mountain States Tumor Institute (MSTI) in Fruitland from as far away as the Oregon cities of John Day, Pendleton, Grangeville and White Bird, often making the round-trip drive on the same day to save motel bills, said Dr. Sarah Bolender, MSTI Fruitland medical director.

“There is a lot of tired,” Bolender said.

The respite house will also have parking for five RVs, Bolender said.

Radiation treatments are given five days in a row for six, seven or eight weeks.

Bolender has lobbied for a respite house for six years.

“I actually begged St. Luke’s to do this,” Bolender said. “This is specifically for cancer patients. This will be right behind our clinic.”

Construction will start July 19 with an opening in spring 2019. St. Luke’s handles architecture and general contracting in-house.

The Surviving Hearts Cancer Support Group has raised more than $40,000 for the respite house with four annual tri-tip dinner auctions. Last year’s dinner raised $17,000 from $30 dinner tickets and auctions for three-day trips to Reno, the Pendleton Rodeo and the Seven Devils Lodge in Council, said Shellie Colbard, Surviving Hearts’ founder and president.

“It’s probably going to be the biggest thing to happen for cancer patients (in eastern Oregon and west central Idaho),” Colbard said. “We also help with gas cards. This last week we gave out $500 worth.”

Other large donors are the Laura Moor Cunningham Foundations, the Bunco Babes, and the Friends Always Club, Bolender said.

Room rates will likely be around $20 to $30 a night, St. Luke’s spokesman Daniel Mediate said.

State healthcare apprenticeship program adds skilled workers in Idaho hospitals

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LaKalyn Thomas, of the St. Luke’s Health System medical assistant program, prepares for patients. Photo by Fiona Montagne.

A healthcare apprenticeship program is helping Idaho hospitals obtain some of the skilled workers they need.

Similar to the software engineering apprenticeship program, the Idaho Hospital Association, in cooperation with the Department of Labor, provides Idaho employers with tools for apprenticeships, said John Russ, IDOL apprenticeship coordinator. For now, there are two healthcare programs, one for medical assistants and one for critical care nursing, he said.

The medical assistant internship program is operated through St. Luke’s Health System, said Chris Southard, workforce registered nurse manager for St. Luke’s ambulatory clinic, in Boise. Candidates join the program either from IDOL or an internal pool, and require either six months’ prior experience as a certified nursing assistant or patient specialist, or six months of health experience, she said.

People are brought into the program as a medical-assistant-in-training, starting at about $13 an hour, Southard said. After nine to 12 months of academic and on-the-job training, they are eligible to become a certified medical assistant, at which point they earn $14.72 an hour, she said.

The program has 13 apprentices in the Treasure Valley, five in the Wood River Valley, and two in McCall, Southard said. Ideally, they would like to bring on 10 new apprentices every three months for a goal of 40 students, and they have a link on their job board for applicants to the July cohort of the program, she said.

“We did have some individuals who did not meet some of the pre-employment criteria or, post-hire, live up to our system values,” Southard said. “We had to make some tough decisions there. We want them to follow the same standard as any St. Luke’s employee.” Otherwise, the program has been going well, she said. “The candidates are really dedicated to their learning, and take on-the-job training very seriously. They come prepared to clinic, and meet the expectations of the program.” They’ve also gotten great feedback from the clinics, she added.

Saint Alphonsus Health System uses the apprenticeship program to train nurses for its Intensive Care Unit, said Claire Jones, director of critical care in Boise. “We were perpetually trying to train and onboard new, competent, and seasoned ICU nurses,” she said. “Our vacancy rate couldn’t keep up.” The organization developed its own six-month training program and then learned about the apprenticeship program at IDOL, which they used starting with cohort 3, which graduated five months ago.

Saint Alphonsus has eight residents in cohort 4, six of whom are in Boise and two of whom are on the Nampa campus, said Cindy Malinowski, nurse educator specialist for critical care. The next cohort, beginning in August, will have 12, she said.

The program has worked out well, Malinowski said. “The week after cohort 3 graduated, we had one of our graduates taking care of the sickest patient you could possibly muster in this unit,” she said. “She was only a week out of residency, and you would never have known, in terms of her level of performance, ability to manage an acute setting, and do it with confidence and skill.”

Moreover, all the apprentices who completed the program are still working for one of Saint Alphonsus’ three Boise units or on its Nampa campus, Malinowski said. The apprenticeships typically start as a graduate nurse or a registered nurse II, earning $27 to $30 an hour, Jones said. A critical care competency ladder lets graduates earn raises by pursuing specialties and documenting their competency, she said.

For the August cohort, Saint Alphonsus opened the program to external hires, and had 121 applicants, which they weeded down to 87, and then interviewed 22, Jones said. Final hires came from North Idaho, Oregon, Wyoming, the Dakotas, and the Midwest, she said.

“We had used this as an internal market development retention tool, but it was robbing Peter to pay Paul by taking acute care nurses and making them ICU nurses,” she said.

Saltzer plans its future

Saltzer Medical Group has had to retrench after a lawsuit stopped a planned merger with St. Luke’s Health System. Photo by Laura Clements.

A year after the completion of antitrust lawsuit that forced it to unwind its planned merger with St. Luke’s Health System, Saltzer Medical Group is planning for its future as an independent organization.

The Nampa-based company says it is now the largest independent multispecialty physicians group in Idaho, with 40 doctors. It plans to increase that to 100 in the next five to ten years, including adding surgical subspecialists. The organization, now with six locations, is focusing on expansion in Canyon and Western Ada counties, and could add a third Quick Care clinic in Meridian.

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Dr. John Kaiser

“That’s where the growth is,” said John Kaiser, president of the company, of Canyon County and west. Saltzer has clinics between Boise and Caldwell. “It’s helpful to be in a growing community.”

After the lawsuit (see box), it took Saltzer a year and a half to unwind it. In May 2017, the company entered into a long-term managed services agreement with Change Healthcare, based in Nashville, Tennessee. Change Healthcare assumed responsibility for all of Saltzer’s non-clinical operations, such as clinical and administrative staff management, finance, accounting, real estate, human resources, and technology hosting and support.

Once that was accomplished, it was time to look at the doctors, some of whom the organization had lost during the transition. By the time the lawsuit was over, it was down to 30 doctors. “We decided to look at how we might add specialists and primary care doctors to our group,” Kaiser said. “We started reaching out to doctors in the community as an alternative from the two major hospital systems.”

Since then, Saltzer has added three specialty areas – ear, nose, and throat, general surgery, and a partnership with a dermatologist – and is looking to expand its subspecialties beyond that, Kaiser said.

The organization is also working to expand its Quick Care facilities – drop-ins for non-emergency but unscheduled care, similar to the urgent care centers run by its two large competitors in the Boise-area market, the St. Luke’s and Saint Alphonsus health systems. Saltzer has two Quick Care locations in Nampa, one at the original Saltzer location near 12th Ave. and one next to the St. Luke’s facility near Nampa Costco.  The company is also considering opening another one in Meridian by the I-84 interchange on Eagle Road.

Unlike quick care providers such as Primary Health Medical Group, Saltzer sees its quick care locations primarily as an adjunct for its own patients, because the facilities have their medical records and can get the patients back with their primary care doctors faster than through an emergency room visit, Kaiser said. “There’s a significant cost savings to patients and to payers,” he said.

While St. Luke’s and Saint Alphonsus occupy a major role in Idaho healthcare, there is still room for providers such as Saltzer and Primary Health Medical Group, based in Garden City, the smaller providers say. The demand for fast, efficient care is increasing, said David Peterman, CEO of Primary Health, which said it had nearly 400,000 patient visits last year.

“We have two clinics opening in 2019,” Peterman said. “We will continue to expand to make sure the community has accessible primary care services.”

Clinics such as Saltzer and Primary Health, which are not aligned with a hospital system, are more flexible in responding to changes, Kaiser said. For the doctors, the smaller organization means they have more say in how the group is run and how they run their practice in a private group setting, he said. At the same time, being aligned with an organization such as Saltzer lets doctors take advantage of the administrative support Change Healthcare provides. “Because of what we set up with Change Healthcare, we can provide economies of scale by billing and collections expertise that you’re probably not going to be able to get on your own as a private doctor,” he said.

Background on the Saltzer-St. Luke’s lawsuit

Founded in 1961, Saltzer started looking in 2009 at its plans for the future, said John Kaiser, president of the company. “It was a general move throughout the county, aligning with hospital systems,” he said. “We decided to figure what might work for us.”

The company, based in Nampa, decided to align with St. Luke’s Health System. But that led to an antitrust lawsuit by Saint Alphonsus Regional Medical Center, Treasure Valley Hospital, the Federal Trade Commission (FTC), and Idaho Attorney General Lawrence Wasden in 2012, seeking to halt the acquisition.

U.S. District Judge B. Lynn Winmill ruled in January 2014 that the buyout needed to be unwound because it was likely the deal would raise health care costs by giving the hospital a dominant market position. Saltzer and St. Luke’s then appealed the decision to the Ninth Circuit Court, which upheld the lower court ruling in February 2015.

In June 2015, Wasden’s office and the FTC filed a motion claiming St. Luke’s was divesting only a fraction of Saltzer and not completely complying with Winmill’s judgment. In July 2015, Winmill ordered St. Luke’s to disclose its separation plan from Saltzer.

YMCA plus park, library and St. Luke’s equals a Meridian collaboration called The Hill

The new South Meridian Family YMCA is expected to open May 25. Photo by Teya Vitu.
The new South Meridian Family YMCA is expected to open May 25. Photo by Teya Vitu.

The YMCA, St. Luke’s Health System, Meridian Parks & Recreation, West Ada School District and Meridian Library will unveil a grand collaboration May 25 at what is being called The Hill on Meridian’s south side.

On that day, the South Meridian Family YMCA, Hillsdale Park, St. Luke’s Lifestyle Medicine center and a “tiny library” version of the Meridian Library will open off the new roundabout at Eagle and Amity roads.

The new, $18.5 million South Meridian Family YMCA is attached to Hillsdale Elementary School, which opened in September 2016.

Treasure Valley Family YMCA CEO David Duro announces the $18.5 million South Meridian Family YMCA will open debt-free. Photo by Teya Vitu.
Treasure Valley Family YMCA CEO David Duro. Duro said the $18.5 million South Meridian Family YMCA will open debt-free. Photo by Teya Vitu.

The Treasure Valley Family YMCA, under which the Meridian facility falls, built two adjacent gyms. One of the gyms includes secure access from Hillsdale Elementary for dedicated school use during the school day and will be open for public use after the school day, said David Duro, president and CEO of the Treasure Valley Family YMCA.

St. Luke’s will use an 8,000-square-foot space within the YMCA for its new Lifestyle Medical program, which will encourage and teach healthy lifelong behavior. It wll share that space with the YMCA.

The new Hillsdale Park lawn runs up to the YMCA, and the park’s playground serves as the Hillsdale Elementary playground during the school day.

Eventually, the Meridian Library also wants a branch at The Hill but for now will have a “tiny children’s library” in a 300-square-foot shipping container just outside the YMCA main entrance. The tiny library is expected to open May 25 along with the YMCA, St. Luke’s and Hillsdale Park.

“It’s a model other communities can follow on how to leverage each other’s efforts to bring something to the community that can be more than the individual parts,” Meridian Mayor Tammy de Weerd said at the April 2017 groundbreaking for the YMCA.

The Hill started with 2014 land donations of 15 acres by married couple Marti Hill and Dixie Cook and by the Brighton Corp. The 10 acres of Hillsdale park comprise about 7.5 acres from Hill and Cook and 2.5 acres from Brighton. Brighton also donated the school property and is developing the housing due south of The Hill.

Hill and Cook considered donating their farmland for use as a park for about a decade. Their ranch house remains at the west edge of the park.

Brighton’s David Turnbull quickly got to talking to YMCA and school officials and The Hill collaboration emerged.

South Meridian Family YMCA

Both levels of the new South Meridian Family YMCA will have outdoor access. Photo by Teya Vitu.
Both levels of the new South Meridian Family YMCA will have outdoor access. Photo by Teya Vitu.

The 58,491-square-foot, two-level South Meridian Family YMCA will be Meridian’s Y as well as serving Kuna, which is 2 miles to the west. Southwest Boise is about 1 mile to the east.

Duro also mentioned the South Meridian Y is within a 12-minute drive of 19 elementary schools.

Meridian has not had its own YMCA building since the Treasure Valley Family YMCA sold the Meridian Homecourt YMCA facility to the city of Meridian in 2016 for $4 million. That money all went to the building of the South Meridian Y. Treasure Valley YMCA CEO David Duro announced on March 13 that fundraising had brought in pledges for the balance of the $18.5 million project to allow the new YMCA to open debt-free.

Garage doors will give the fitness rooms a sense of the outdoors at the new South Meridian Family YMCA. Photo by Teya Vitu.
Garage doors will give the fitness rooms a sense of the outdoors at the new South Meridian Family YMCA. Photo by Teya Vitu.

The Y’s athletic facilities (gyms and fitness rooms) will be on the lower level with the upper level dedicated to activity centers for different age groups. The St. Luke’s lifestyle medicine center occupies the upper level, and both levels have access to the outdoors.

The Y’s primary 7,000-square-foot gym fits a full-size basketball court lengthwise and two smaller courts across. Basketball courts and volleyball stanchions will all be lowered from walls or ceiling, South Meridian Y Executive Director Mike Kapuscinski said.

The primary gym has doors into the 4,335-square-foot smaller elementary school gym . The smaller gym will have one smaller basketball court and will open to the public after school lets out.

The three 2,350-square-foot , 1,682-square-foot and 1,225-square-foot fitness studios have glass garage doors that can be rolled up during warmer months. The Y also has a high-ceiling 5,300-square-foot cardio room accessible by stairs from the upper level main lobby.

Steps from the lobby lead down to the cardio room at the new South Meridian Family YMCA. Photo by Teya Vitu.
Steps from the lobby lead down to the cardio room at the new South Meridian Family YMCA. Photo by Teya Vitu.

Kapuscinski is especially enthused about the four-story play structure.

A future $9 million or $10 million indoor aquatic facility could follow in the next 12 to 18 months, attached to the Y building on the Hillsdale Park side.

“Idaho leads the nation in drownings per capita,” Duro said. “We know the cure. Teach kids to swim.”

St. Luke’s Lifestyle Medicine

St. Luke’s Lifestyle Medicine program, launched last fall, will reside in the 8,000-square-foot space St. Luke’s acquired for $4 million on the upper level of the South Meridian Family YMCA. The St. Luke’s investment also included paying its share of common space at the YMCA.

It will include a 2,000-square-foot instructional kitchen that can be partitioned into four smaller spaces. St. Luke’s will also have a supervised transitional gym for patients not yet comfortable with working out in the Y’s gyms.

Lifestyle Medicine’s focus is based on the World Health Organization’s statement that 80 percent of non-communicable disease revolves around how much people move, what we eat, avoiding alcohol and smoking, and sleep patterns, said Pat Lara, St. Luke’s administrator for heart and vascular.

“We are good at treating sick people but we’re not that good at keeping people from getting sick,” Lara said. “Lifestyle medicine is our first hard effort to help people from getting sick.”

Lara said the collaboration with the YMCA is ideal as the organization’s focus is family fitness. He said the Y excels at reaching out to families, while St. Luke’s expects people to “come to us.”

St. Luke’s brought on Dr. Jennifer Shalz to be director of its department of lifestyle medicine. Lara said St. Luke’s has performed lifestyle medicine on cardio and pulmonary rehabilitation patients for eight years.

square-feet-april-story-blurbSt. Luke’s lifestyle medicine center at the South Meridian YMCA will work to make patients more fit in the weeks before surgeries and also improve lifestyles post-surgery. The center will also offer lifestyle education and counseling to women considering pregnancy, Lara said.

“We will tune you up before surgery,” he said.

Lifestyle Medicine will have an on-site full-time and half-time staff dedicated to diabetes education, diets, psychology and other subjects.

“Everybody knows they should exercise more and eat better,” Lara said. “How do we get people to change their health behavior?”

The St. Luke’s instructional kitchen includes audio-visual equipment enabling people to tune in live from St. Luke’s medical centers in  Boise, Nampa, Magic Valley, McCall and Ketchum.

“We overbuilt the audio-visual system,” Lara said. “It will look like the Food Network.”

St. Luke’s will also station a nurse practitioner at adjoining Hillsdale Elementary School who will also be a resource for nurses across West Ada School District, Lara said.

In the next year or so, St. Luke’s plans to expand at The Hill and build a 12,000- to 16,000-square-foot free-standing clinic adjacent to the YMCA.

Hillsdale Park

The new Hillsdale Park is a collaboration with Hillsdale Elementary School and the South Meridian Family YMCA. Photo by Teya Vitu.
The new Hillsdale Park is a collaboration with Hillsdale Elementary School and the South Meridian Family YMCA. Photo by Teya Vitu.

Meridian Parks & Recreation laid 3.9 acres of sod last year closest to Hillsdale School to give students a play area for the whole 2017-18 school year. The other 6.1 acres were seeded with established grass anticipated for Hillsdale Park’s May 25 opening, Meridian Parks director Steve Siddoway said.

The park pays homage to the Hill family ranch that it replaces. One playground element is in the shape of a tractor, roofs for two picnic shelters have a barn look,  the Hill cattle brand is incorporated in the eaves and park benches resemble hay bales.

The Hillsdale Park playground serves as the playground for Hillsdale Elementary School. Photo by Teya Vitu.
The Hillsdale Park playground serves as the playground for Hillsdale Elementary School. Photo by Teya Vitu.

Park construction that started in March 2017 is largely complete, though exercise stations along the loop path still need to be installed and grass is not yet in place in the area between the park and the YMCA, Siddoway said

“The most unique thing (about Hillsdale Park) is the partnership,” Siddoway said. “The park didn’t have to build any parking. The school and YMCA have parking lots we can use. At the same time, we are providing the playground for the school.”

Hillsdale Park replaces Hillsdale Farm, which is honored with its brand in the eaves of the picnic shelters. Photo by Teya Vitu.
Hillsdale Park replaces Hillsdale Farm, which is honored with its brand in the eaves of the picnic shelters. Photo by Teya Vitu.

The park land was all part of a 15-acre donation to the YMCA from married couple Marti Hill and Dixie Cook and Brighton Corp. In turn, the Y passed 10 of those acres on to Meridian Parks & Rec.

Meridian Library

The Meridian Library will get its foothold at The Hill with what director Gretchen Caserotti is calling a “tiny children’s library.”

A 300-square-foot shipping container will be set up between Hillsdale Elementary School and the South Meridian Family YMCA.

The tiny library will be a setting for early literacy and kindergarten readiness with materials to support those programs, Caserotti said.

Eventually, a full branch library is expected at The Hill.

St. Luke’s closes deal on former Morrison Knudsen HQ

File photo.
The Washington Group Plaza campus near downtown Boise. File photo.

A joint venture including St. Luke’s Health System and a number of investors closed March 8 on the $86.5 million purchase of the four-building Washington Group Plaza complex originally built by Morrison Knudsen Corp,  a corporate giant that was acquired and relocated in 2007.

The 622,000-square-foot acquisition at Broadway and Front Street substantially expands St. Luke’s 1.1 million-square-foot campus on the east end of Boise’s downtown.

St. Luke’s has been angling to acquire the former MK/Washington Group property for a couple of years and has leased one of the structures, the six-story, 125,568-square-foot Plaza I building, since June 2015.

The largest hospital group in Idaho plans to occupy 120,000 additional square feet in portions of the Plaza II, Central Plaza and Plaza IV buildings by the end of the October, said Mary Cronin, St. Luke’s  senior director of operations.

Over the next six years, as existing tenants – particularly the state of Idaho – move out, St. Luke’s will occupy the entire complex where Broadway, Myrtle Street, Front Street and Park Boulevard all converge, she said.

St. Luke’s historic downtown St. Luke’s Regional Medical Center campus is just three blocks away with plans for a 700,000-square-foot expansion. St. Luke’s departments in buildings that are slated for demolition at the regional center will relocate to Washington Group Plaza, which will eventually be renamed.

The St. Luke’s billing team, administrative team support for outpatient services and scheduling & registration will be the first tenants moving into the newly acquired space. St. Luke’s human resources and Center for Learning and Development moved into Plaza I in July 2016.

St. Luke’s has a lease-to-own deal

St. Luke’s has a 49.5 percent ownership share in Broadway Park Holdings, the limited liability corporation that bought the former Morrison Knudsen corporate headquarters from City Office REIT, Inc., a Vancouver, B.C., real estate investment trust that acquired the property in April 2014 from Second City Capital Partners, also of Vancouver.

“Since that time, we have implemented substantial operational improvements and cost savings, increased the square footage of the buildings by 23,000 square feet through re-measurement,” said Greg Tylee, chief operating officer and president of City Office in a news release.

City Office owned Washington Group Plaza through its wholly-owned SCCP Boise LP subsidiary, which it acquired from Second City.

St. Luke’s will be the master leaseholder of the property, leasing from Broadway Park Holdings, which will pay off the $86.5 million mortgage, likely over 30 years with refinancing expected after five and or 10 years, said David Wali, managing member of Broadway Park Holdings.

Wali is executive vice president at Gardner Company, developer of several high-profile Treasure Valley office and medical facilities. He is the principal investor of the 50.5 percent ownership share at Broadway Park Holdings, along with a small number of other investors. Wali has had several similar co-ownership arrangements with St. Luke’s.

Cronin said Washington Group Plaza now has about 100,000 square feet vacant with tenant improvements underway for St. Luke’s.

The state of Idaho leases 159,535 square feet for three agencies, with leases expiring in the next three years. The Idaho State Tax Commission, occupying 111,381 square feet, will depart in October to the former Hewlett-Packard campus, which the state acquired Dec. 21 for $110 million.

Idaho Fish & Game’s lease on 28,022 square feet runs to December 2019 and the Idaho Department of Finance’s lease on 20,132 square feet ends in July 2021, said Linda Miller, the statewide leasing manager at the Idaho Department of Administration.

City Office reported it anticipated a $45 million net gain on the sale.

The Ada County Assessor assessed the four-building complex at $82.1 million in 2017, but only $43.98 million in 2016 and $39.87 million in 2015.

“The value is in the eye of the beholder and sometimes not in the eye of the assessor,” Wali said. “If you take the $86.5 million and divide it by the square footage, I can’t build it for that.”

That division comes to $139 per square foot. Cronin said St. Luke’s calculated the cost of building such a campus, and came up with construction costs of $250 per square foot.

St. Luke’s has departments in 12 to 20 leased buildings around the Treasure Valley, and is considering moving those into the plaza in the next two to five years. The only buildings Cronin would identify are the former Kmart and the Shoreline Center, both at Americana Boulevard and Shoreline Drive, both under contract for sale for a potential downtown stadium and mixed-use complex.

New emergency department opens at St. Luke’s in Mountain Home

The new emergency department at St. Luke's Elmore Medical Center is more than five times bigger than the old one. Photo courtesy of St. Luke's Health System.
The new emergency department at St. Luke’s Elmore Medical Center is more than five times bigger than the old one. Photo courtesy of St. Luke’s Health System.

St. Luke’s Elmore Medical Center in Mountain Home opened a new emergency department Jan. 16 that is more than four times larger than the existing department.

The new 7,610-square-foot emergency department (9,725 square feet including the lobby) had been under construction since July 2016. The emergency department has 10 exam rooms.

The former 1,800-square-foot emergency department was a single room with four beds separated by a curtain, said Anita Kissee, a St. Luke’s spokeswoman. She said it had moved around the hospital since the structure was built in 1955.

There are 10 exam rooms in the new health department at St. Luke's Elmore Medical Center in Mountain Home. Photo courtesy of St. Luke's Health System.
There are 10 exam rooms in the new health department at St. Luke’s Elmore Medical Center in Mountain Home. Photo courtesy of St. Luke’s Health System.

Before July, the hospital used local doctors who were not certified in emergency medicine to take shifts in the emergency department. In July, St. Luke’s Elmore started using Emergency Medicine of Idaho to staff the emergency department.

Houston-Bugatsch Architects of Nampa was the architect and St. Luke’s builds its own facilities.

The new emergency department is designed to handle 14,000 patients a year. The old department was designed to handle 5,000 patients a year. St Luke’s Elmore now handles about 12,000 emergency patients a year, Kissee said.

Ortho clinic confirmed for Boise’s West End

St. Luke's Health System will build a four-story orthopedic facility at 27th Street and Fairview Avenue in Boise. Image courtesy of St. Luke's Health System.
St. Luke’s Health System will build a four-story orthopedic facility at 27th Street and Fairview Avenue in Boise. Image courtesy of St. Luke’s Health System.

St. Luke’s Health System for the first time Oct. 20 acknowledged plans to build a 230,520-square-foot orthopedic facility at 27th Street and Fairview Avenue .

St. Luke’s plans to consolidate three orthopedic surgery centers in Boise and Meridian and other orthopedic services into the four-story facility that will also house sports medicine, according to a St. Luke’s news release.

The facility will have 12 operating rooms and 30 beds for short recoveries

“For us, it’s more than a hospital so we are calling it a facility,” St. Luke’s spokeswoman Anita Kissée said.

The facility will include a fenced outdoor training and rehabilitation center for athletes at the corner of 27th and Fairview, she said.

The structure will have two wings, one for doctor visits and rehabilitation and the other for operating rooms and patient beds, according to the release.

Construction is expected to start in spring with a 2020 opening expected.

The new orthopedic facility will free up patient rooms and operating rooms at the St. Luke’s main hospitals in Boise and Meridian, said Robert Walker, division medical director for St. Luke’s Orthopedics and Neurosurgery.

“As our community expands, so will the demand for orthopedic services,” Walker said in a release. “In fact, demand is already up. By 2020 alone, analysis supports a 10-percent increase.”

St. Luke’s charts expansion in McCall

St. Luke's McCall plans to expand with a two-story addition to the current one-story hospital. Photo by Teya Vitu.
St. Luke’s McCall plans to expand with a two-story addition to the existing one-story hospital. Photo by Teya Vitu.

St. Luke’s Health System will build a new hospital in McCall, nearly doubling the size of the existing hospital.

Technically, the work is being described as a remodel and expansion of the existing 47,000-square-foot building, which was built in 1956.  The $35 million upgrade will double the number of operating rooms and emergency rooms, according to promotional materials. But all four operating rooms and eight emergency rooms will be new in the expanded space, as will all 17 in-patient beds.

“It will be a new hospital on an old site,” St. Luke’s McCall Administrator Sean McCallister said. “We want to make sure we have space for the future. This is a legacy project, once in a lifetime. Our vision is to build something that will serve the region for decades to come. ”

The two-story expansion will be built on a gravel parking lot to the north of the existing hospital. The existing 15-bed inpatient area and two operating rooms will be demolished, and much of the old hospital will be remodeled for enlarged imaging facilities, labs, cardiopulmonary, dining room and pharmacy.

Ancillary support services will also be housed in the remodeled existing hospital building.

Sean McCallister
Sean McCallister

“We are now wheeling supplies over snowy, icy parking lots,” McCallister said. “Laundry service is across the street. We are bringing that in-house.”

Planned for more than a decade, the expansion now is at the in-house design phase with an outside architect expected to join the project in the coming months. The first artistic renditions could be released in the next four to six months.

The new hospital main entrance will be reoriented to face State Street to the east. The existing hospital faces west and is virtually invisible when driving on Lake Street (State Route 55), even after turning onto State Street.

McCallister expects final approvals from St. Luke’s in the second quarter of 2018 with site work including utilities starting in summer 2018. Construction could follow in spring or summer 2019 with completion in phases over the following three years.

St. Luke's McCall (rear) plans to expand into the gravel parking lot to the north of the hospital. Photo courtesy of Laura Crawford.
St. Luke’s McCall (rear) plans to expand into the gravel parking lot to the north of the hospital. Photo courtesy of Laura Crawford.

A new or expanded hospital has been discussed for more than a decade, but the McCall Memorial Hospital District didn’t foresee  having the money to undertake the project. The district decided to join St. Luke’s in 2010 on the condition that St. Luke’s improve McCall Memorial.

St. Luke’s is paying for $30 million, and community donations will pay for the other $5 million. So far, $4 million has been raised.

“Where would this community come up with that kind of money if we didn’t have a partner like (St. Luke’s)?” said Derek Williamson, board chair of the McCall Memorial Hospital District, which still owns the hospital property that St. Luke’s leases and operates. “It would have been a hard hurdle to come over.”

St. Luke’s takes McCall hospital into the future

This public corridor at St. Luke's McCall has to be closed to the public when patients are moved between the operating room and patient room. Photo by Teya Vitu.
This public corridor at St. Luke’s McCall has to be closed to the public when patients are moved between the operating room and patient rooms. Photo by Teya Vitu.

A 14,000-square-foot McCall Memorial Hospital was built in 1956,  with 3,000 square feet added in 1962 and a 30,000-square-foot expansion and remodel in 1996.

“We have only 60 percent of the space we need,”McCallister said. “The mechanical systems are dated. It’s difficult to incorporate some new technologies and IT systems.”

He said one public corridor has to be shut down when patients are transferred to and from the operating room and in-patient rooms.

Since McCall Memorial Hospital joined St. Luke’s in 2010, the health care dynamic has shifted in the Long Valley. Previously, many Valley County residents sought health care in Boise.

Added services in recent years, such as a full-time orthopedic surgeon, wound care, the first permanent MRI machine and infusion services including oncology have drawn a large share of locals to St. Luke’s McCall. The increasing number of second residences has also spiked patient counts as some Boise residents now choose to have their health care in McCall rather than the Treasure Valley, McCallister said.

St. Luke’s McCall Medical Center reports emergency room visits have increased by 42 percent since 2010, with surgeries climbing 182 percent and lab tests up 36 percent in the same time period.

The McCall emergency room now transfers only 4 percent of patients to Boise. St. Luke’s also accepts many more insurance policies than McCall Memorial did, he said.

“We’ve become a regional health care hub,” McCallister said.

The new hospital is being designed in an era where hospitals are quickly evolving and nobody’s quite sure what hospitals will look like in the future. Recent years have seen a drastic shift to outpatient care. In 1956, the community saw a need for 12 inpatient rooms with 15 beds. Just 17 inpatient rooms are penciled into the expansion.

Three of the 17 patient rooms will be set aside for expectant mothers to stay in the same room for labor and delivery.

“What’s the future of hospitals? Is it acute care?” McCallister posed. “How do we deliver the best outcomes at the lowest cost? We believe the future of health care is not with this. It’s care in home, preventative and wellness.”

Valley County is the healthiest county in Idaho. The County Health Rankings & Roadmaps by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute say Valley County residents see the lowest level of premature death and are in the top 10 percent of healthiest U.S counties.

“We’re lucky we’re already on a very high plateau,” Williamson said.

Williamson said the new hospital will help attract and retain medical staff.

“The staff will have a professional environment they will want to work in,” he said.

St. Luke’s explores covered outdoor passages

A big, new hospital isn’t the only thing on the mind of St. Luke’s McCall Administrator Sean McCallister.

There is also the scattering of clinics across the streets and parking lot from the existing hospital and what will be the expanded hospital.

“The clinics will need to expand in the future,” McCallister said. “We’d love to connect the clinic to the hospital with an enclosed corridor. That’s our vision down the road.”

These include the Payette Lakes and McCall medical clinics as well as the orthopedic surgery, rehabilitation therapy and integrative medicine clinics.

Orthopedics in McCall has grown “by leaps and bound”

Orthopedics – the specialty involving bones, muscles and ligaments – has evolved dramatically since the St. Luke’s Health System took on health care in McCall in 2010.

Dr. Greg Irvine became McCall’s first full-time orthopedic surgeon in spring 2011. St. Luke’s McCall is recruiting to add a second orthopedic surgeon in 2018, Administrator Sean McCallister said.

This upgrade in orthopedics allowed the addition of knee and hip joint replacement surgery in 2012.

“Orthopedic service has grown by leaps and bounds,” McCallister said.

The number of orthopedic surgeries multiplied from 17 in 2010 to 377 in 2016, hospital spokeswoman Laura Crawford said.