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Partners HealthCare Annual Report 2010 Imagine you wake up in the middle of the night and as you walk to the bathroom, your right arm goes numb and you can’t remember your name. FOUNDING MEMBERS: Brigham and Women’s Hospital • Massachusetts General Hospital MEMBERS: Faulkner Hospital • Martha’s Vineyard Hospital • McLean Hospital Nantucket Cottage Hospital • Newton-Wellesley Hospital • North Shore Medical Center Partners HealthCare at Home • Partners Community HealthCare, Inc. • Spaulding Rehabilitation Network The people of Partners HealthCare know what to do. 800 Boylston Street, Boston, MA 02199-8001 (617) 278-1000 www.partners.org “Our mission will be our guide as we provide the highest quality care that is affordable to our patients and to society.” Gary L. Gottlieb, MD, MBA President and CEO, Partners HealthCare Our vision To dedicate ourselves to the delivery of superior care that is patient- and family-centered, accessible, and equitable. To provide a coordinated, cost-efficient, and transparent care model that will benefit patients across the continuum from prevention to long-term. To touch the communities we serve, local or global, with sustainable improvements in the care we provide with a keen focus on underserved populations. To lead in research that fosters collaboration, bringing discovery to the patient’s bedside, and sharing those successes with the world so future generations may benefit. To invest in education and training to nurture the next generation of leaders who can carry forward the lessons learned. To promote the development of our workforce by creating opportunities for achievement and advancement. To seek ways to deliver the highest quality health care to all. As we reflect on the past year and look to the future, we do with a sense of hope. We know each day we will improve the care that we provide to our patients and their families. And we believe that care must be affordable for society. Our mission will be our compass as we accept a leading role in helping to create solutions with political and business leaders, insurers, and the public. The ideas for our solutions, some of which we share in this annual report, come from a strategic vision that Partners leadership developed in collaboration with teams from our remarkable institutions. We are dedicating ourselves to the delivery of safe, effective, and coordinated patient- and family-centered care that will be efficient, accessible, and transparent. As a health system blessed with many of the brightest minds in medicine, we will design a roadmap for success. Jack Connors, Jr. Chair, Board of Directors Partners HealthCare With health care a popular topic in public conversations, we also see this as a time to tell the story of the Partners mission. We have been relatively quiet in the past, but we believe our voice needs to be heard. We cannot shy away from sharing our research breakthroughs that are changing lives, voicing our commitment to medical education that will support a new generation of health care providers, and defining our steadfast dedication to the communities we serve. As always, our values will guide us. Our constellation of talent, our depth, and diversity will help us to carve a path that will forge our position as leaders in health care today, tomorrow and for generations to come. To find out more about Partners’ new Strategic Initiative, go to: Partners.org/newnoteworthy/StrategicInitiative.html 1 Not all hospitals provide you with the same quality of care. When you arrive at the Massachusetts General Hospital Emergency Department with symptoms of a stroke, you are moved through triage in minutes and a nurse immediately alerts the stroke team that you need attention. You quickly are taken to a radiology center located in the same area, where you are given a brain CAT scan. As soon as a stroke is confirmed, you are given tissue plasminogen activator, tPA. Your wife calls 911. You’ve had a stroke and you arrive at a Partners hospital that is ready and able to help you. The tPA dissolves the clot and prevents you from being left with a lifetime of disability. To be most effective, it must be administered within three hours from the beginning of a stroke. Neurologists say that the longer the wait, the more likely irreversible brain damage will occur. The four Partners hospitals that routinely handle stroke cases have achieved 96–100 percent performance in prompt administration of tPA. The statewide average was 61.7 percent. In June 2010, the Massachusetts Department of Public Health found “wide variation among hospitals in the use of [this] powerful stroke drug.” Emergency care is continually improving throughout our system. The Emergency Department at Brigham and Women’s Hospital (BWH) is committed to improving the patient and family experience while decreasing the door to doctor time. Patients are greeted, examined by a physician, and then a team – doctor, nurse, and support staff – is responsible for the patient, and decides whether to admit him or her to either BWH or Faulkner Hospital, a community teaching affiliate of the Brigham. Newton-Wellesley Hospital leaders studied emergency visits to determine how to improve the patient experience. Dividing visits into discrete segments, they found ways to move patients smoothly through the emergency process. Improvements include eliminating the need for patients to provide information multiple times, gathering detailed information at the bedside, and posting wait times on the hospital’s web site and via smart phone applications. Emergency patients on the North Shore with stroke symptoms receive immediate and exceptional care from North Shore Medical Center at its community hospitals in Salem and Lynn. Last year, both hospitals were recognized for superior compliance with nationally accepted standards of rapid diagnosis and treatment of stroke patients in their emergency departments. 3 Care redesign: focusing on people with common but expensive diseases. Partners clinical teams are currently focused on working to find better, more cost-effective ways to treat four common diseases: diabetes, cardiovascular disease, colon cancer, and your condition: stroke. This new work builds on nearly a decade of quality improvement at Partners and will further advance the implementation of evidence-based, patient-centered care. You are cared for by a Partners team of doctors and nurses who provide high-quality, coordinated care. High costs are driven by a small fraction of patients. Medicare patients can be sicker and have multiple conditions, which explains why 10 percent of Medicare patients in the U.S. are responsible for 70 percent of costs. Focusing on the four diseases mentioned above can help control costs. A breakthrough against runaway Medicare costs. Chronically ill, medically complex Medicare patients often need more care and support than can be given during a routine office visit. Massachusetts General Hospital (MGH) was selected by the federal Centers for Medicare and Medicaid to find a way to deliver a higher quality of care that would also reduce costs for Medicare patients in the study. By using nurse case-managers to coordinate patient care during all phases of treatment, MGH saw a seven percent reduction in costs over three years, while admissions were reduced and deaths decreased measurably. As part of a care network, Partners member hospitals and doctors can effectively adopt successful, cost-saving strategies. In February of last year, Brigham and Women’s Hospital joined MGH in its collaboration with Medicare and enrolled more than 3,000 Medicare patients under the care of their primary care physician practices, including several at Brigham’s community teaching affiliate Faulkner Hospital. A nurse care coordinator works with the patient’s primary care team to identify and overcome any gaps in care. North Shore Medical Center has also adopted the type of case management program that showed success at MGH. In 2010, North Shore Physicians Group, the medical center’s network of primary and specialty care physicians, enrolled 1,500 patients who are being followed by nurse case-managers. 5 Shorter stays benefit knee replacement patients and save money. A team of Brigham and Women’s orthopedic surgeons has improved knee replacements for patients and produced significant cost savings for the hospital. By working with patients and caregivers, changing medications, and altering post-operative activity, the team found that patients reported less pain, had better outcomes, and spent less time in the hospital. Stays went from an average of 3.2 days to 2.4 days. While you’re in our hospital, we’re focused on getting you the care you need to get you home quickly and safely. Serving more patients, reducing the cost per patient. Newton-Wellesley Hospital (NWH) is responding to the growing needs of its community without adding personnel or space by making better use of existing resources. Changes include starting surgeries 10 minutes earlier in the day and moving patients expeditiously from post-anesthesia to either a hospital bed or a coordinated discharge. By serving more patients without adding staff or space, NWH is noticeably reducing its cost per patient. Using technology to promote patient safety. At Partners, 90 percent of prescriptions written by our doctors are done at a computer, which dramatically improves medication safety and saves money by encouraging use of generic drugs. According to Reuters, only 57 percent of Massachusetts doctors e-prescribe; The New York Times reported that only 17 percent of hospitals nationwide prescribe this way. Partners hospitals also use smart intravenous infusion pumps, the electronic medication administration record (eMAR), and bar code technology to help ensure that the right patient gets the right drug at the right dose at the right time. A Journal of the A merican Medical A ssociation study by Brigham and Women’s Hospital researchers showed that prescribing by computer reduced serious inpatient medication-related errors by 55 percent, and a New England Journal of Medicine study showed that bar coding/eMAR lowered serious medication errors by 51 percent. 7 Reducing 30-day readmissions. You’re back home, but your care continues. Once you leave the hospital, the last thing you want is to be readmitted. A survey of Massachusetts hospitals showed more than 10 percent of patients were readmitted for the same or unrelated complaints within 30 days. For the hospital, this is also expensive. A congressional study found that three-quarters of readmissions are likely avoidable, often traced to transitions from caregiver to caregiver, and from inpatient to outpatient care. Partners is working to reduce preventable readmissions by improving training; focusing on communication with patients and their family members; identifying patients at higher risk of readmission and working closely with them, and improving hand-offs to sites where discharged patients will receive the next round of care. Find your strength at Spaulding or at home. If you are recovering from stroke, rehabilitation can be the longest stretch on your road to recovery. Spaulding Rehabilitation Network, ranked fourth nationally by U.S.News & World Report, operates six inpatient facilities and 23 outpatient clinics in eastern Massachusetts, allowing patients to receive expert therapy without having to travel long distances. The caregivers at Partners HealthCare at Home use advanced medical tools and technologies to provide in-home care through highly trained nurses, therapists, home health aides, and other professionals. They work closely with one another and with you and your family to make sure that you regain your strength as soon as possible. Following patients home. Patients enrolled in North Shore Medical Center’s Heart Failure Program benefit from very personal, intensive disease management and are less likely to be readmitted to the hospital. The program is an example of a wellness approach that makes caregivers responsible for the health of certain high-cost patients outside the walls of the hospital, in a way that can help reduce costs. 9 Your house is not your only home. Your care may be delivered or coordinated through a “medical home,” an innovative model for ensuring efficient, comprehensive care. Your primary care physician leads a medical team that takes responsibility for all of your care, and helps you navigate the health care system. For a stroke patient, your medical home physician assesses you, provides care, coordinates with specialists such as neurologists and rehabilitation experts, and also arranges mental health services for emotional issues that can arise after stroke. As you return to your routine, you have new ways to stay in touch with your primary care team to assure your continued recovery. Creative ways to improve the doctor-patient relationship. The Massachusetts General Hospital Ambulatory Practice of the Future, a primary care practice for MGH employees and their spouses that brings new technology to medicine, opened its doors in July 2010. In this new approach, patients are more involved in their care and are followed by a highly collaborative, interdisciplinary team. The physical spaces of the medical office and exam rooms have been altered to benefit both patient and caregiver. The goal is to keep patients healthy by delivering customized, continuous care to patients, with better outcomes at lower costs. Stay in closer touch by computer. Through online portals like Patient Gateway, you have an efficient way to stay in touch with your physician or care team. Partners is using technology to connect you to your doctor through the internet so you can ask questions, access your medical records, check lab results, and make appointments. This will allow doctors and nurses to handle routine matters quickly, leaving time to focus on patients with more complicated conditions. The portal virtually pays for itself in efficiency. 11 Some of the many ways Partners makes a difference. We are the single biggest private employer in the state, providing 54,000 jobs. We bring millions in NIH dollars to the state. Massachusetts General and Brigham and Women’s Hospitals are the top two independent hospitals receiving National Institutes of Health research funds; much of this supports work in life sciences, genetics, and personalized medicine. We provide and support mental health and substance abuse services, despite losses of nearly $60 million; we have added capacity while many others have closed beds for financial reasons. We support 21 community health centers with capital investments of $83 million since 1994; they care for 325,000 low-income patients. We’ve committed $40 million to the state to reduce health premiums for small businesses. We deliver free and reduced-rate care for 120,000 patients without the means to pay; the value of this care is more than $330 million annually. The Kraft family gift of $20 million will improve access to and quality of care for the neediest people in Massachusetts, across New England, and throughout the U.S. The Kraft Family National Center for Leadership and Training in Community Health will create a fellowship program to train a new generation of community-based physician leaders. The funds, given by Robert and Myra Kraft and their family, will also support community cancer treatment programs. Well over a century after MGH harnessed the power of ether, shown in this landmark painting of the hospital’s Ether Dome operating theatre, today’s faculty continues to unlock the mechanisms of anesthesia, and trains leading anesthesiologists, medical students, and practicing clinicians. Emery Brown, M.D., Ph.D. (inset), of the MGH Department of A nesthesia, Critical Care, and Pain Medicine, was interviewed recently by The New York Times on his research into how anesthesia works and how to administer it safely. Massachusetts General Hospital this year celebrates its bicentennial, marking a storied tradition of compassionate caregiving, groundbreaking research, educational excellence, and improvements to the health of local communities. The third-oldest general hospital in the country and the oldest teaching hospital of Harvard Medical School, the MGH was chartered in 1811 as a general hospital that would care for the city’s sick and poor while providing a place for physicians to learn the art of medicine. Today, the MGH continues to uphold and fulfill this important mission. McLean Hospital is also commemorating its 200th anniversary, founded at the same time as MGH in 1811; it is today the top-rated independent psychiatric hospital in the nation. Nantucket Cottage Hospital is celebrating its 100th birthday in 2011, honoring its past while looking forward to its future as a member of the Partners HealthCare family. It is the island’s only year-round hospital serving a resident population of 10,000, which swells to 50,000 in the summer. Martha’s Vineyard Hospital welcomed over 2,300 supporters and community members to their new hospital at an opening ceremony on April 11, 2010. In a remarkable five-year grassroots campaign to rebuild the hospital, every dollar was generously donated by the island community. Eleven Nobel Laureates are numbered among our nationally-respected physicians, as well as 87 members of the prestigious Institute of Medicine, and three winners of the Lasker Prize, called “the American Nobel Prize.” In 1954, Joseph Murray, M.D., a Brigham surgeon, won a Nobel Prize for leading a team that performed the world’s first successful human organ transplant (inset). In 2011, a Brigham team of 30 specialists led by Bohdan Pomahac, M.D., built on the tradition of Dr. Murray and performed the first successful full face transplant in the U.S., continuing the hospital’s national leadership in transplantation. 13 Partners HealthCare Leadership Partners HealthCare is an integrated health FOUNDING MEMBERS: MEMBERS: system founded in 1994 by Brigham and Brigham and Women’s Hospital Brigham and Women’s Physicians Organization Women’s Hospital and Massachusetts Massachusetts General Hospital Faulkner Hospital General Hospital. In addition to its two academic medical centers, the Partners system also includes community and Partners Trustees Partners Officers Jack Connors, Jr. Chair James J. Mongan, M.D. (through December, 2009) Anne M. Finucane G. Marshall Moriarty, Esq. Charles K. Gifford Gary A. Spiess, Esq. Gary L. Gottlieb, M.D., M.B.A. Henri A. Termeer Albert A. Holman, III Dorothy A. Terrell Professor Jay O. Light David A. Thomas Maury E. McGough, M.D. Andrew L. Warshaw, M.D. Carol C. McMullen Beverly Woo, M.D. Martha’s Vineyard Hospital Massachusetts General Physicians Organization McLean Hospital Gary L. Gottlieb, M.D., M.B.A. President Chief Executive Officer Albert A. Holman, III Treasurer MGH Institute of Health Professions specialty hospitals, community health Nantucket Cottage Hospital centers, a physician network, home health Newton-Wellesley Hospital and long-term care services, and other North Shore Health System health-related entities. Partners is one of North Shore Medical Center: Patricia M. Salamone Secretary the nation’s leading biomedical research Salem Hospital Union Hospital organizations and a principal teaching MassGeneral for Children at North Shore Medical Center affiliate of Harvard Medical School. Partners North Shore Physicians Group HealthCare is a non-profit organization. Partners Community HealthCare, Inc. Cathy E. Minehan Partners Community Health Centers: BWH Health Centers: Brookside Community Health Center Southern Jamaica Plain Health Center MGH Health Centers: Charlestown HealthCare Center Chelsea HealthCare Center Revere HealthCare Center Independently Licensed Health Center: (relationship with MGH)* North End Community Health Center In addition, Partners is affiliated with 15 community health centers which are operated independently or under license from other hospitals. Partners Continuing Care: Spaulding Rehabilitation Network Spaulding Rehabilitation Hospital Spaulding Hospital Cambridge Spaulding Hospital North Shore Spaulding Rehabilitation Hospital Cape Cod Spaulding Nursing & Therapy Center North End Spaulding Nursing & Therapy Center West Roxbury Clark House Partners HealthCare at Home MAJOR TEACHING AFFILIATE OF: Harvard Medical School *The NECHC has a unique governance structure and affiliation arrangement with MGH (most recently revised in 2007) reflecting the health center’s historic independence. 21 Partners HealthCare Leadership Board Chairs Leadership Chief Medical Officers G. Marshall Moriarty, Esq. Brigham and Women’s Hospital Carol McMullen Newton-Wellesley Hospital Elizabeth G. Nabel, M.D. Brigham and Women’s Hospital Michael S. Jellinek, M.D. Newton-Wellesley Hospital Anthony D. Whittemore, M.D. Brigham and Women’s Hospital Robert A. Barbieri, M.D. Brigham and Women’s Physicians Organization Maury E. McGough, M.D. North Shore Health System Allen L. Smith, M.D., M.S. Brigham and Women’s Physicians Organization Robert G. Norton North Shore Medical Center Jessica C. Dudley, M.D. Brigham and Women’s Physicians Organization David J. Trull Faulkner Hospital Thomas H. Lee, M.D. Partners Community HealthCare, Inc. Stephen C. Wright, M.D. Faulkner Hospital Mary Ann Tynan Faulkner Hospital Timothy D. Sweet Martha’s Vineyard Hospital Cathy E. Minehan Massachusetts General Hospital David F. Torchiana, M.D. Massachusetts General Physicians Organization David S. Barlow McLean Hospital George E. Thibault, M.D. MGH Institute of Health Professions Stephen C. Anderson Nantucket Cottage Hospital Gary A. Spiess, Esq. North Shore Medical Center (through January, 2010) Richard E. Holbrook North Shore Medical Center (from January, 2010) Sharon L. Smith Partners Community HealthCare, Inc. Stanley J. Lukowski Partners Continuing Care Spaulding Rehabilitation Network Partners HealthCare at Home Hamilton N. Shepley Spaulding Rehabilitation Hospital Cape Cod (through November, 2010) Timothy J. Walsh Martha’s Vineyard Hospital Peter L. Slavin, M.D. Massachusetts General Hospital David F. Torchiana, M.D. Massachusetts General Physicians Organization Scott L. Rauch, M.D. McLean Hospital Janis P. Bellack, Ph.D., R.N., F.A.A.N. MGH Institute of Health Professions Sylvia Getman Nantucket Cottage Hospital (through June, 2010) Margot Hartmann, M.D. Nantucket Cottage Hospital (from October, 2010) David E. Storto Partners Continuing Care Spaulding Rehabilitation Network Partners HealthCare at Home Maureen Banks, R.N., M.S., M.B.A., C.H.E. Spaulding Rehabilitation Hospital Cape Cod Spaulding Hospital Cambridge Spaulding Hospital North Shore Christopher Attaya, M.B.A., F.H.F.M.A. Partners HealthCare at Home (through October, 2010) Carol W. Sim, R.N., M.P.H. Spaulding Rehabilitation Hospital Cape Cod (through September, 2010) Pieter Pil, M.D. Martha’s Vineyard Hospital Britain W. Nicholson, M.D. Massachusetts General Hospital Timothy D. Ferris, M.D. Massachusetts General Physicians Organization Joseph Gold, M.D. McLean Hospital George P. Butterworth, M.D. Nantucket Cottage Hospital Leslie G. Selbovitz, M.D. Newton-Wellesley Hospital Jennifer Daley, M.D., F.A.C.P. Partners Community HealthCare, Inc. (through March, 2010) Joanne Nowak, M.D. Partners Hospice (through July, 2010) David Lowell, M.D. Spaulding Rehabilitation Hospital Cape Cod Maurice Greenbaum, M.D. Spaulding Hospital North Shore (through April, 2010) Charles Pu, M.D. Spaulding Hospital North Shore (from April, 2010) Jonathon Schwartz, M.D. Spaulding Hospital Cambridge Ross D. Zafonte, D.O. Chief of Physical Medicine and Rehabilitation, Vice President of Medical Affairs, Research, and Education Spaulding Rehabilitation Network Mitchell S. Rein, M.D. North Shore Medical Center 23 Partners HealthCare Leadership Chiefs of Service Founding Hospitals Robert L. Barbieri, M.D. Chairman, Dept. of Obstetrics and Gynecology Brigham and Women’s Hospital Michael Gimbrone, M.D. Chairman, Dept. of Pathology Brigham and Women’s Hospital Jay R. Harris, M.D. Chairman, Dept. of Radiation Oncology Brigham and Women’s Hospital Thomas S. Kupper, M.D. Chairman, Dept. of Dermatology Brigham and Women’s Hospital Joseph Loscalzo, M.D., Ph.D. Physician-in-Chief and Chairman, Dept. of Medicine Brigham and Women’s Hospital A. John Popp, M.D., F.A.C.S. Chairman, Dept. of Neurosurgery Brigham and Women’s Hospital Martin A. Samuels, M.D. Chairman, Dept. of Neurology Brigham and Women’s Hospital Steven E. Seltzer, M.D. Chairman, Dept. of Radiology Brigham and Women’s Hospital David A. Silbersweig, M.D. Chairman, Dept. of Psychiatry and Institute for the Neurosciences Brigham and Women’s Hospital Thomas S. Thornhill, M.D. Chairman, Dept. of Orthopedic Surgery Brigham and Women’s Hospital Charles A. Vacanti, M.D. Chairman, Dept. of Anesthesiology, Perioperative and Pain Medicine Brigham and Women’s Hospital Ron M. Walls, M.D. Chairman, Dept. of Emergency Medicine Brigham and Women’s Hospital Michael J. Zinner, M.D. Surgeon-in-Chief and Chairman, Dept. of Surgery Brigham and Women’s Hospital Jay S. Loeffler, M.D. Chief of Radiation Oncology Massachusetts General Hospital David N. Louis, M.D. Chief of Pathology Massachusetts General Hospital Robert L. Martuza, M.D. Chief of Neurosurgery Massachusetts General Hospital W. Scott McDougal, M.D. Chief of Urology Massachusetts General Hospital Dennis A. Ausiello, M.D. Physician in Chief and Chief of Medical Services Massachusetts General Hospital Joan W. Miller, M.D. Chief of Ophthalmology Massachusetts General Hospital Alasdair K. Conn, M.D. Chief of Emergency Services Massachusetts General Hospital Joseph B. Nadol Jr., M.D. Chief of Otolaryngology Massachusetts General Hospital David E. Fisher, M.D., Ph.D. Chief of Dermatology Massachusetts General Hospital Jerrold F. Rosenbaum, M.D. Chief of Psychiatry Massachusetts General Hospital Daniel A. Haber, M.D., Ph.D. Director, MGH Cancer Center Massachusetts General Hospital Harry E. Rubash, M.D. Chief of Orthopaedic Surgery Massachusetts General Hospital Leonard B. Kaban, D.M.D., M.D. Chief of Oral and Maxillofacial Surgery Massachusetts General Hospital Isaac Schiff, M.D. Chief of the Vincent Obstetrics & Gynecology Service Massachusetts General Hospital Robert E. Kingston, Ph.D. Chief of Molecular Biology Massachusetts General Hospital Ronald Kleinman, M.D. Chief of the Pediatric Service MassGeneral Hospital for Children Keith D. Lillemoe, M.D. Surgeon in Chief and Chief of Surgical Services Massachusetts General Hospital (from May, 2011) James H. Thrall, M.D. Chief of Radiology Massachusetts General Hospital Joseph P. Vacanti, M.D. Chief of Pediatric Surgery and Surgeon in Chief MassGeneral Hospital for Children Andrew L. Warshaw, M.D. Surgeon in Chief and Chief of Surgical Services Massachusetts General Hospital (through May, 2011) Jeanine Wiener-Kronish, M.D. Chief of Anesthesia Massachusetts General Hospital Anne B. Young, M.D., Ph.D. Chief of Neurology Massachusetts General Hospital Ross D. Zafonte, D.O. Chief of Physical Medicine and Rehabilitation Massachusetts General Hospital Partners Ronald Kleinman, M.D. Chair, Partners Pediatrics Scott L. Rauch, M.D. Chair, Partners Psychiatry And Mental Health Harry E. Rubash, M.D. Co-Leader, Partners Orthopedics Thomas S. Thornhill, M.D. Co-Leader, Partners Orthopedics Community Hospitals Hilary A. Aroke, M.D. Chief of Infectious Disease North Shore Medical Center Edward N. Bailey, M.D. Chair of Pediatrics MassGeneral for Children at North Shore Medical Center Bruce A. Beckwith, M.D. Chair of Pathology North Shore Medical Center (from April, 2010) Bart Blaeser, D.M.D., M.D. Chief of Oral Surgery North Shore Medical Center Bimal P. Jain, M.D. Director of Pulmonary/Intensive Care NSMC Union Hospital Alain A. Chaoui, M.D. Chair of Family Practice North Shore Medical Center William V. Kastrinakis, M.D. Chief of General Surgery North Shore Medical Center Paul M. Copeland, M.D. Chief of Endocrinology North Shore Medical Center Barrett T. Kitch, M.D. Chief of Critical Care Medicine North Shore Medical Center (from December, 2009) Noel P. DeFelippo, M.D. Chief of Urology North Shore Medical Center Dean M. Donahue, M.D. Chief of Thoracic Surgery North Shore Medical Center Robert Freedman, M.D. Chief of Opthalmology North Shore Medical Center Terry J. Garfinkle, M.D. Chief of Otolaryngology North Shore Medical Center Richard D. Goodenough, M.D. Chief of Vascular Surgery North Shore Medical Center Anthony J. Guidi, M.D. Chair of Pathology North Shore Medical Center (through March, 2010) Joseph O. Jacobson, M.D. Chair of Medicine North Shore Medical Center (through March, 2011) Mitchell S. Jacobson, M.D. Chief of Nephrology North Shore Medical Center (from January, 2011) Kevin M. Koshy, M.D. Chief of Nephrology North Shore Medical Center (through January, 2011) Andrew H. Leader-Cramer, M.D. Chief of Neurology North Shore Medical Center Mark A. Lewis, M.D. Chief of Dermatology North Shore Medical Center William Lloyd, M.D. Chief of Rheumatology North Shore Medical Center (through January, 2011) Everett Tyronnie Lyn, M.D. Chair of Emergency Medicine North Shore Medical Center James A. MacLean, M.D. Chief of Allergy/Immunology North Shore Medical Center Maury E. McGough, M.D. Chief of Primary Care North Shore Medical Center Michael M. Medlock, M.D. Chief of Neurosurgery North Shore Medical Center 25 Partners HealthCare Leadership Chiefs of Service Community Hospitals (continued) James F. McIntyre, M.D. Chair of Radiation Oncology North Shore Medical Center Joseph Miaskiewicz, M.D. Chief of Hospitalist Medicine North Shore Medical Center William J. Murzic, M.D. Chief of Orthopedic Surgery North Shore Medical Center Albert Namias, M.D. Chief of Gastroenterology North Shore Medical Center Paul S. Peicott, D.P.M. Chief of Podiatry North Shore Medical Center Prodyut Poddar, M.D. Chief of Thoracic Surgery NSMC Union Hospital Allyson L. Preston, M.D. Chair of Obstetrics and Gynecology North Shore Medical Center Keith W. Rae, D.M.D., M.D. Chief of Plastic Surgery North Shore Medical Center David J. Roberts, M.D. Chief of Cardiology North Shore Medical Center Marc S. Rubin, M.D. Chair of Surgery North Shore Medical Center Mark A. Schechter, M.D. Chair of Psychiatry and Mental Health North Shore Medical Center M. Christian Semine, M.D. Chair of Radiology North Shore Medical Center Neil S. Shore, M.D. Director of Pulmonary/Intensive Care NSMC Salem Hospital Glynne D. Stanley, M.D. Chief of Anesthesia North Shore Medical Center Khalid Syed, M.D. Chief of Rheumatology North Shore Medical Center (from January, 2011) Thomas J. VanderSalm, M.D. Chief of Cardiac Surgery North Shore Medical Center James Gessner, M.D. Chief of Anesthesiology Faulkner Hospital Pardon R. Kenney, M.D. Chief of Surgery Faulkner Hospital Richard E. Larson, M.D. Chief of Emergency Medicine Faulkner Hospital Stephen Pochebit, M.D Chief of Pathology Faulkner Hospital Bethany Richman, M.D. Interim Chief of Radiology Faulkner Hospital Martin A. Samuels, M.D. Chief of Neurology Brigham and Women’s/ Faulkner Hospitals David A. Silbersweig, M.D. Chief of Psychiatry Brigham and Women’s/ Faulkner Hospitals Michael Wilson, M.D. Chief of Orthopedics Faulkner Hospital Stephen C. Wright, M.D. Chief of Medicine Faulkner Hospital Avraham Almozlino, M.D. Chief of Neurology Newton-Wellesley Hospital Mary Chris Bailey, M.D. Chief, Pediatric Emergency Medicine (from April, 2010) Joel Bass, M.D. Chair of Pediatrics Newton-Wellesley Hospital Thomas L. Beatty, M.D. Chair of Obstetrics and Gynecology Newton-Wellesley Hospital Dennis J. Beer, M.D. Chief of Pulmonary Medicine Newton-Wellesley Hospital Mark R. Belsky, M.D. Acting Chair, Department of Orthopaedics Newton-Wellesley Hospital (from January, 2011) Joanne Borg-Stein, M.D. Chief of Physical Medicine & Rehabilitation Newton-Wellesley Hospital John A. Buehler, D.M.D. Chief of Oral Surgery Newton-Wellesley Hospital Herbert Cares, M.D. Acting Chief of Neurosurgery Newton-Wellesley Hospital Jacob Joffe, M.D. Chair of Anesthesiology Newton-Wellesley Hospital Mark F. Rounds, M.D. Chief of Otolaryngology Newton-Wellesley Hospital Thomas Cunningham, M.D. Chief of General Internal Medicine Newton-Wellesley Hospital Arthur Kennedy, M.D. Chief of Geriatrics Newton-Wellesley Hospital Joel J. Rubenstein, M.D. Chief of Cardiology Newton-Wellesley Hospital Richard L. Curtis, M.D. Chief of Gastroenterology Newton-Wellesley Hospital Christopher Kwolek, M.D. Chief of Vascular Surgery Newton-Wellesley Hospital Daniel P. Ryan, M.D. Chief of Pediatric Surgery Newton-Wellesley Hospital Henry D’Angelo, M.D. Chair of Family Medicine Newton-Wellesley Hospital Jeffrey Lamont, M.D. Chief of Urology Newton-Wellesley Hospital David Slovik, M.D. Chief of Endocrinology/Diabetes Newton-Wellesley Hospital Sandra M. Fitzgerald, M.D. Chair of Psychiatry Newton-Wellesley Hospital Mark Lemons, M.D. Chair of Emergency Medicine Newton-Wellesley Hospital Jill Smith, M.D. Acting Chief of Ophthalmology Newton-Wellesley Hospital Lawrence S. Friedman, M.D. Chair of Medicine Newton-Wellesley Hospital Michael A. Lew, M.D. Chief of Infectious Diseases Newton-Wellesley Hospital Richard E. Wilker, M.D. Chief of Neonatology Newton-Wellesley Hospital Henning Gaissert, M.D. Chief of Thoracic Surgery Newton-Wellesley Hospital William LoVerme, M.D. Chief of Plastic Surgery Newton-Wellesley Hospital Henry M. Yager, M.D. Chief of Nephrology Newton-Wellesley Hospital Don L. Goldenberg, M.D. Chief of Rheumatology Newton-Wellesley Hospital Steven Miller, M.D. Chair of Radiology Newton-Wellesley Hospital Specialty Hospitals Anthony J. Guidi, M.D. Chair of Pathology Newton-Wellesley Hospital Frederick Millham, M.D. Chair of Surgery Newton-Wellesley Hospital Eric Hazen, M.D. Chief of Child and Adolescent Psychiatry Newton-Wellesley Hospital (from February, 2011) Timothy O’Connor, M.D. Chief of Hematology/Oncology Newton-Wellesley Hospital Esther J. Israel, M.D. Chief of Pediatric Gastroenterology Newton-Wellesley Hospital Steven Pestka, M.D. Chief, Hospitalist Service Newton-Wellesley Hospital Scott L. Rauch, M.D. Psychiatrist in Chief McLean Hospital Ross D. Zafonte, D.O. Chief of Physical Medicine and Rehabilitation, Vice President of Medical Affairs, Research, and Education Spaulding Rehabilitation Network Richard L. Zaniewski, D.O. Chief of Rehabilitation Medicine Spaulding Hospital North Shore Francis Renna, M.D. Chief of Dermatology Newton-Wellesley Hospital Joel H. Schwartz, M.D. Chief of Hematology/Oncology North Shore Medical Center 27 Partners HealthCare Leadership Chief Nursing Officers Partners Senior Management Jacqueline G. Somerville, R.N., Ph.D. Senior Vice President, Patient Care Services and Chief Nursing Officer Brigham and Women’s Hospital (from January, 2011) Joseph D. Alviani, Esq. Vice President, Government Affairs (from November, 2010) Mairead Hickey, Ph.D., R.N., F.A.H.A. Chief Nursing Officer and Senior Vice President, Patient Care Services (through August, 2010) Executive Vice President and Chief Operating Officer (from September, 2010) Brigham and Women’s Hospital Judy Hayes, R.N., M.S.N. Vice President of Nursing, Chief Nursing Officer Faulkner Hospital Dennis A. Ausiello, M.D. Chief Scientific Officer Sheridan L. Kassirer Vice President, Quality Management and Clinical Programs Peter R. Brown Chief of Staff Peter K. Markell Vice President, Finance Lee A. Chelminiak Vice President, Public Affairs David McGuire Vice President, Managed Care Contracting and Finance Christopher H. Colecchi Vice President, Research Ventures and Licensing Dennis D. Colling Vice President, Human Resources Carol Bardwell, R.N., B.S.N., M.S.N. Chief Nurse Executive Martha’s Vineyard Hospital Lynne J. Eickholt Vice President, Business Planning and Market Development Jeanette Ives Erickson, R.N., M.S. Senior Vice President for Patient Care Services and Chief Nurse Massachusetts General Hospital Matthew E. Fishman Vice President, Community Health Linda M. Flaherty, R.N., P.C. Senior Vice President for Patient Care Services McLean Hospital Jane Bonvini, R.N., B.S.N. Patient Care Services Officer Nantucket Cottage Hospital Elaine Bridge, R.N., M.B.A. Senior Vice President for Patient Services and Chief Nurse Newton-Wellesley Hospital Beatrice Thibedeau, R.N. Senior Vice President, Patient Care Services and Chief Nursing Officer North Shore Medical Center Joanne Fucile, M.S.N., C.R.R.N., O.C.N. Vice President, Patient Care Services Chief Nursing Officer Spaulding Rehabilitation Network Brent L. Henry, Esq. Vice President and General Counsel Michael Gimbrone, M.D. Harvard Medical School Dean for Academic Programs at Partners John P. Glaser, Ph.D. Vice President and Chief Information Officer (through July, 2010) Thomas P. Glynn, Ph.D. Chief Operating Officer Maureen Goggin Director, Government Relations James Noga Interim Chief Information Officer (from July, 2011) Allen Peckham Chief Development Officer Jay B. Pieper Vice President, Corporate Development and Treasury Affairs David E. Storto Vice President, Non-Acute Care Services Debra F. Weinstein, M.D. Vice President, Graduate Medical Education Kathryn E. West Vice President, Real Estate and Facilities Partners HealthCare Annual Report 2010 Imagine you wake up in the middle of the night and as you walk to the bathroom, your right arm goes numb and you can’t remember your name. FOUNDING MEMBERS: Brigham and Women’s Hospital • Massachusetts General Hospital MEMBERS: Faulkner Hospital • Martha’s Vineyard Hospital • McLean Hospital Nantucket Cottage Hospital • Newton-Wellesley Hospital • North Shore Medical Center Partners HealthCare at Home • Partners Community HealthCare, Inc. • Spaulding Rehabilitation Network The people of Partners HealthCare know what to do. 800 Boylston Street, Boston, MA 02199-8001 (617) 278-1000 www.partners.org

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