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Little more than half of Californias hospitalemployees received influenza vaccinationsduring the 2008-2009 flu season, withmany public facilities falling far short of

that rate, according to the first study of itskind by the California Department ofPublic Health.

The report confirmed many findings ofa Consumers Union report issued lastmonth that many of Californias hospitalworkers were eschewing flu vaccinations.CDPH officials had initially disputed theveracity of that study, calling itinaccurate in published reports, eventhough it was based on the agencys owndata.

However, a CDPH spokesman agreedlate Wednesday that the data was similar to

the Consumers Union study, which hadconcluded that about 52% of hospitalworkers received a flu shot in 2009. TheCDPH study concluded that 55% ofemployees statewide were vaccinatedduring the 2008-2009 flu season.

CDPH did not publicly announce theSept. 30 release of its report, whichsurveyed more than 400,000 hospitalemployees. It has said it would publish2009-2010 data by the end of the year.

The CDPHs findings come in the wakeof last flu seasons emergence of the H1N1flu strain. Concerns about a flu pandemic

prompted the Society for Healthcare

Epidemiology and the Infectious DiseasesSociety of America to recommend inAugust that all hospital workers receiveflu vaccinations as a condition of their

employment.Influenza causes about 36,000 deaths

and more than 226,000 hospitalizationsannually, according to nationalepidemiology data.

In 2006, California law beganrequiring hospitals to offer fluvaccinations free of charge to theiremployees. In 2008, another lawmandated that 381 hospitals report theirvaccination rates and flu shot refusal ratesto CDPH.

The statewide vaccination rate isseveral percentage points short of a 60%

goal advocated by CDPH and manynational healthcare organizations.

Of the 297 hospitals that submittedreports to the CDPH, 121, or 40.7%, metthe 60% vaccination rate. There was littlevariation among smaller and largerhospitals in the average vaccination rates.Altogether, 26.6% of hospital employeesdeclined flu shots.

There was significant regionalvariation. Hospitals in the Sierra Mountainregion had the highest compliance rate,

Hospitals Fall Short On Flu SafeguardsPublic Facilities Lag On Employee Vaccinations

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Payers & Providers Page 2

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In Brief

OSHPD Signs Off OnPalmdale Regional

The Office of Statewide HealthPlanning and Development hasissued a certificate of occupancyfor Palmdale Regional Medical

Center, ending months of delaysover hospital construction issues.

OSHPD had held up thecertification over leaky windows(more than 100 had to be replaced),ventilation issues and otherglitches. Sources inside the agencysay the project had more issuesthan is typical for new hospitalconstruction.

The 127-bed hospital was thefirst built in California by itsoperator, Pennsylvania-basedUniversal Health Services. Thehospital was originally slated for anopening in early 2009.

A statement issued by hospital

officials said the facility is expectedto be licensed by the Los AngelesCounty Department of PublicHealth to operate before the end ofthe year.

Hinsdale Named CMAPresident

San Jose trauma surgeon JamesHinsdale, M.D., was namedpresident of the California MedicalAssociation on Sunday during its139th annual delegates meeting inSacramento.

The 61-year-old Hinsdale is the

director of trauma at MarinGeneral Hospital and executivedirector of trauma at RegionalMedical Center in San Jose. Healso sits on the faculty of theStanford University School ofMedicine.

Departing CMA PresidentBrennan Cassidy, M.D., was amongsix delegates named to the CMAsexecutive committee.

Continued on Page 3

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Flu (Continued from Page One)

69.6%, closely followed by San Diego at65.2%. However, the South Coast region,which covered Los Angeles and OrangeCounties, averaged only 49.7%. In theInland Empire, more than 36% ofemployees declined vaccinations.

The lowest compliance rate statewidewas SanGabriel Valley Medical Center,at 14.4%, followed by Alameda Hospitalat 18.2%.

The five hospitals operated by the LosAngeles County Department of HealthServices stuck out: Los Angeles County-USC Medical Center reported avaccination rate of only 19%, the third-lowest in the state, and appeared to havesubmitted no data on its number ofdeclines. Harbor-UCLA Medical Centerand Rancho Los Amigos Medical Center reported rates of 38.5% and 44.8%,respectively. Olive View Medical Centerdid not submit a report at all.

A County DHS spokesman expressedsurprise at the data, but was stillanalyzing it as of presstime and did notimmediately comment.

Any hospital that is as large andtreats as many people as (County-USC)that does not get decent penetration andvolumes of employees vaccinated, should

concern anyone, said Jim Lott, executivevice president of the Hospital Associationof Southern California. Healthcareworkers are vectors of disease.

Although hospitals are required toprovide the vaccinations, employees arenot required by law to accept them. TheCalifornia Hospital Association hassuggested that obtaining the vaccinationwas a personal rather than an institutionalresponsibility.

While hospitals highly recommendinfluenza vaccination of hospitalemployees and other healthcare workers,

being vaccinated is strictly voluntary and

cannot be mandated, the CHA said in aposting on its website. We believe it isthe responsibility of individual healthprofessionals, as well as hospitals, toensure the safe delivery of care in theirfacilities.

Lott suggested that because thenursing workforce in Southern Californiais on average several years older than inNorthern California, they may be morewary of receiving a flu shot, being morecognizant of tainted flu vaccines that wereaccidentally distributed in the 1970s.

However, Lott noted that somehospitals have pushed hard to increasevaccination compliance among its

employees. Last year the Memorial CareHealth System in Long Beach convened ainfluenza task force. It required allemployees and physicians at its fivehospitals to receive flu shots.

We stated that any individual whodeclined vaccinations would have to weara surgical mask during work because theycarried a significant risk of spreading thevirus, said Jim Leo, M.D., the associatechief medical officer ofLong BeachMemorial Medical Center. Employees whodeclined to wear masks were sent home,Leo added.

Long Beach Memorial reported a 58%compliance rate among its employeesduring the 2008-2009 flu season. Itreached 90% compliance during the mostrecent flu season, Leo said.

Only one hospital reported 100%compliance: Rancho Specialty Hospital inRancho Cucamonga. Marin GeneralHospital in Greenbrae was second, at92.1%.

The CDPH spokesman concluded thatalthough the statewide vaccination rate isabove the nationwide average of 45%,hospitals needed to make a concerted

effort to increase vaccination rates.

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Payers & Providers Page

The late, great football coach George Allenwas apt to say, The future i s now. So, too,it could be said of the hospital industrysgrowing acceptance of automated deliveryrobots as a smart and sensible way toenhance productivity, save money andenrich patient care.

In an increasing number of hospitalsaround the country, robots are freeing upclinical staff to do what they do best focus on the patient. In doing so, thesehospitals are seeing noticeable cost savingsand increased efficiencies in every area that

robots touch. Robots areparticularly attractive tohospitals that are openingnew patient towers,increasing square footageand distances betweencritical areas, and looking forthe most sensible way tosupport the additional space.

What these hospitals arediscovering is that automatedrobots can deliver, track andretrieve goods and supplies morereliably and more cost

effectively than other solutions.They operate 24/7, dont get sickor injured, dont take breaks or vacations,dont require benefits, and dont complain.On average, one robot can provide theproductivity of 2.8 employees yet costs lessthan a single FTE.

Robots provide value hospital-wide. Forpharmacies, robots ensure timely andreliable delivery of medication to nursesstations throughout the hospital, eitherscheduled or on demand. The best onesalso have tracking capabilities, whichbroaden the value proposition beyond just

labor savings to aid in regulatorycompliance, error reduction and chain-of-custody concerns. In food service, robotsdeliver meals to patient floors and returndirty trays back to the kitchen. Robotssupport environmental services byretrieving soiled linens, regulated wasteand trash, ensuring a sanitary environment,and improving infection control. All thesefunctions and more come without the costof additional personnel while freeing upexisting staff to focus on high-value tasks.

At El Camino Hospital in the Silicon

Valley, 19 robots are helping the hospital more efficiently and cutting costs by$650,000 a year. Moving unassisted arounthe hospital without the need for any specinfrastructure, these robots carry medicalsupplies and patient meals, laboratoryspecimens and prescription drugs, linens, equipment as well as trash and waste safethrough the hospital. They travel the hallwand elevators announcing what they areabout to do, such as crossing hallway anturning around. They even reply thankyou after completing a delivery.

Kaiser Permanente Los AngelesMedical Center installed a fleet ofstate-of-the-art robots to transportlinens and remove trash fromthroughout the facility. These robodeliver clean sheets and gowns topatient floors, remove and transposoiled linens and transport trash fodisposal. As in other facilities, therobots are viewed as a sensibleapproach to providing basic suppl

and transportation needs, covering a of ground, performing a function thatmay be invisible to patients but critic

hospital operations.At the University of CaliforniaSanFrancisco Medical Center, the laboratory loads its robots with blood products, selecpreprogrammed destination on a computetouch screen, and presses the robots gobutton. The robot is then on its way to amedical wing of the hospital, transportingblood for transfusions. When it reaches itsdestination, point personnel enter anelectronic code to unlock the cart cabinetand access the contents. Staffers sign toconfirm the blood products were receivedthe robot then returns the signed documen

to the laboratory.The future is indeed now, and now is time for hospitals to embrace this latestwonder.

OPINION

Robots Are The Wave Of The FutureThey Cut Hospital Costs And Improve Patient Care

By Aldo

Zini

Aldo Zini is chief executive officer of Aetho

the nations largest provider of self-directed

hospital robots.

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Op-ed submissions of up to 600 words are

welcomed. Please e-mail proposals to

editor@payersandproviders.com,

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MARKETPLACE/EMPLOYMENTPayers & Providers Page 5

CONGRESS THEMESDay I: Understanding Accountable Care Organizations

Day II: Implementing Accountable Care Organizations

Day III: Innovations in Accountable Care Organizations

FEATURING THEFOLLOWING PRE-CONFERENCESI: The Premier Healthcare Alliance Collaboratives: FromReadiness to Implementation

II: The Role of the Patient Centered Medical Home inAccountable Care Organizations

III: Measuring Accountable Care

AccountableCare OrganizationCongress

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V: A Community Model Case StudyVI: Infrastructure for the Administration of the ACO

VII: Building the Information TechnologyInfrastructure for ACOs

VIII: ACO Payment Models

IX: Federal and State Regulation of ACOs

X: Legislative Perspectives on the ACO

XI: ACO Models: 1204(a) and 1206(d) Clinics

XII: The ACO Legal Environment:Antitrust, Kickbacks,and other Pitfalls to Avoid

XIII: Leveraging ACOs to improve Access and Quality whileBending Cost Trends

XIV: Facing Antitrust Hurdles in Forming andOperating an ACO

XV: Medical Foundations State, Regional, and Local

XVI: Performance Measurement in the ACOs

XVII: Infrastructure for Medical Management of the ACO

XVIII:ACO Return on Investment (ROI)

XIX: Are You Ready for Accountable Care and How toMake it Work?!

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SENIOR MEDICARE COMPLIANCE ADVISOR - Along with the Compliance Ofcer and Privacy & Information Security Ofceserves as the focal point for all Medicare Advantage compliance activities. Coordinates and communicates all assigned MedicaAdvantage compliance activities internally and with L.A. Care's contracted provider network. Along with the Compliance Ofcer, L.A. Care's liaison with Centers for Medicare & Medicaid Services (CMS) and other federal agencies concerning L.A. Care's MedicaAdvantage product(s). Ensures that L.A. Care and its subcontracted provider network is compliant with all CMS federal regulatorequirements. This is achieved by working with internal and external staff to correct performance deciencies, ensuring staff are awaof CMS reporting requirements and reports are submitted to CMS identifying internal areas for improvement. Responsible fperforming internal audits, monitors implementation of corrective measures, and interpretation of CMS requirements. Workinknowledge of federal and state requirements is required, as well as highly developed analytical skills and excellent written and verb

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