Healthcare Leaders Embrace Reform

17th Annual Scottsdale Institute Spring Conference April 14-16, 2010

Camelback InnScottsdale, AZ

Largest System In Illinois More than 200 sites of care 9 acute care hospitals

- 4 level I trauma centers - 3 major teaching hospitals

1 specialty hospital 2 children’s hospitals Outpatient services

- 50+ outpatient clinics- 11 occupational health centers- 8 imaging centers- 6 immediate care centers- 5 ambulatory surgery centers

Home health/hospice services 3 owned / managed physician groups Lab joint venture

Leading Market Position

145,000 total admissions (14% share) 10,300 pediatric admissions (11.4% share) 1,575,000 outpatient visits 1,300,000 medical group visits 325,000 emergency department visits 78,000 surgeries 18,000 annual deliveries 13,500 home care admissions

Strong Financial Position

$3.4 billion net revenue 4.9% operating margin 7.9% net margin 24.3% debt to capitalization 234 days cash on hand $296 million in community benefit AA/AA- bond rating 24,500 associates

Continued CPOE Adoption

Page 5

System Health Outcomes Dashboard

Page 6

BASELINE TARGETPREVIOUS RESULT

CURRENT RESULT

HEALTH OUTCOMES PERFORMANCE

Complication Index 0.77 ≤ 0.84 0.77 0.76

Mortality Index 0.57 ≤ 0.53 0.59 0.60

LOS Index 0.93 ≤ 0.91 0.95 0.94Acute Care Readmission Percent < 30 days 12.5% ≤ 10.5% 12.3% 12.4%

HQA All-or-None Bundle 95% ≥ 93% 94% 94%

AHRQ Post-Op PE/DVT Rate per 1,000 7.2 ≤ 6.5 7.2 7.8

Overall NDNQI Fall with Injury Rate (per 1,000 inpatient days) 0.62 ≤ 0.31 0.62 0.51

Average Number of CPOE Orders (Rolling 3 Months) 659,393 ≥ 592,978 629,061

Sepsis Mortality Index 0.88 ≤ 0.80 0.88 0.88

ICU Mortality 0.97 ≤ 0.88 0.97 0.97

Central Line Infections per 1,000 Catheter Days 0.8 ≤ 0.80 0.7 0.8

Med Grp Clinical Integration Score

HH Hospitalization 12% ≤ 24% 20% 20%

HH Oral Medication 64% ≥ 53% 61% 61%

HH Ambulation 49% ≥ 58% 52% 52%

ACL: Corrected Reports (Defects per Million) 294 ≤ 289 294 283

ACL: Redraws (Defects per Million) 1290 ≤ 1199 1,174 1,233

Eureka Health Outcomes Index 49 100 49 49Bethany Health Outcomes Index 83 100 86 88

HEALTH OUTCOMES INDEX 100 (0-150) 89

February 2010SYSTEM HEALTH OUTCOMES DASHBOARD

Result worse than baseline

Result better than baseline, but worse

than target

Result meets or exceeds target

Meaningful Use Assessment-Hospital

Score Description Status % Concern

Criteria Met & Monitored 10 43

Criteria Not Met (process established - not monitored)

5 22 2

Criteria Not Met 7 30 2

Continuing to Evaluate 1 5

23 100

Page 7

Improving Healthcare Through Technology

Critical values reporting and tracking Dose range checking for high alert medications Falls risk assessment and interventions Universal protocol requirements Medication reconciliation (codified home med list) Restraint use assessments Rules to prevent the use of do not use abbreviations Suicide prevention assessments

Alerts for:- Allergies- Anticoagulation- Drug-drug interactions- Drug-food interactions- Height/weight for peds population- Lactation drug interactions- Pregnancy

Daily State of the Unit Report identifying in-house pts with deficiencies in vaccinations, HF discharge instructions and smoking cessation (HQA bundle compliance)

Death report which prints a report at each site of all pts who have expired in the past 8 hours, screen for restraint use and report to CMS within 48 hours

Rules that allow only one record at a time to be open - helps with patient identification

Improving Healthcare Through Technology (continued)

CHF bundle elements including discharge instructions

Stroke patient education

MRSA screening and reporting

Pneumonia and influenza vaccine automated orders

Targeted surveillance for central line infections, VAPS, UTIs and isolation reports

Decision Support Rules:- ICU protocol measures- VTE assessment and prophylaxis- Identifying HF discharges for HQA abstraction and

verification of bundle elements in chart - Drug selection and dosing

Improving Healthcare Through Technology (continued)