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A view of the Fairview-U Medical Center's Riverside campus.

The University of Minnesota Medical Center, Fairview at Riverside neighborhood near the U's West Bank.

Ten years together

University of Minnesota, Fairview Health Services and U Physicians continue partnership

By Mary Hoff

From eNews, March 8, 2007

Anywhere else, Gavin Nieters's chances would have been slim to none. Born June 9, 2005, with a major malfunction in his tiny heart, Gavin needed highly specialized surgery. And the only place in the world it could be done was the University of Minnesota Children's Hospital, Fairview. When Gavin was four days old, pediatric cardiothoracic surgeon John Foker cut into his small chest and, in a 12-hour operation, corrected the deadly defect.

Gavin's lifesaving surgery might not have been possible if it hadn't been for an innovative partnership forged 10 years ago between the University of Minnesota, Fairview Health Services, and University of Minnesota Physicians. By combining a community health system with an academic health center and its faculty physicians, the partnership created an entity specialized enough to function at--and advance--the leading edge of medicine, yet sturdy enough to survive in a highly competitive health-care environment.

"Our patients are truly the beneficiaries of the University-Fairview partnership," says Gordon Alexander, president of University of Minnesota Medical Center, Fairview, and University of Minnesota Children's Hospital, Fairview. "Over the past 10 years, our partnership has evolved. We had to get to know each other--to learn how best to work together and harness our strengths to achieve our unified vision of world-class patient care, research and education."

Setting the stage For the University, the motivation behind the merger was largely economic. In the mid-1990s, the University of Minnesota Hospital and Clinics, like many of its peers, was struggling financially as it tried to provide highly specialized health-care services in an increasingly competitive managed-care environment. Its faculty physicians--then represented by 18 separate practice groups--were in the process of creating a single practice plan, University of Minnesota Physicians, which would help them thrive in the tough health-care market.

But that was not going to solve the problem entirely. With the University's hospital $140 million in debt, administrators eyed a number of options, including closing, downsizing and partnering with an existing community health-care network.

Visionaries at Fairview Health Services saw a chance to support academic medicine while adding high-end services, such as transplants and leading-edge cancer care, to Fairview's repertoire and providing new opportunities for its Riverside medical center, located just across the Mississippi from the University. In January 1997, University Hospital and Fairview merged, bringing together the strengths of each to create what they hoped would be a new and powerful paradigm for providing exceptional teaching, research, and clinical care.

Skylie with Heather Voss and Dr. Cynthia Herrington.
Baby Skylie with Heather Voss and University surgeon Cynthia Herrington (right).

At first the road was rocky. The merger brought together very different cultures--each used to doing things in a certain way. Employees worried about jobs. Physicians on both campuses tried to figure out how they fit into the new reality.

"After high-fives and champagne corks, within six or eight months each side was saying, 'Who are these guys? These guys are crazy--we can't get along with them,'" recalls David Page, Fairview president and chief executive officer.

Gradually, however, participants began to acknowledge and appreciate their differences. What were once seen as obstacles were reframed as opportunities. Today, the medical center is financially healthy, providing innovative care to patients from the Upper Midwest and beyond--and looking forward to future growth.

A sturdy financial foundation What benefits did the merger bring? Top on the list for the University: "We're still here," says Frank Cerra, the University's senior vice president for health sciences.

"When we embarked on this, the future of University Hospital was in great jeopardy, both financially and competitively," Cerra says. "We were at risk of losing our primary teaching hospital--the hospital at which we performed most of our clinical research and the place known for high-end, technologically oriented care you can't get in most places."

Partnership in action

Watch a short video about the University of Minnesota Physicians and the group's connection to the University of Minnesota Medical Center, Fairview, or read the full story at Minnesota Medical Foundation.

Before the merger, the University's hospital was projected to lose $50-$55 million per year by 2000. Today, says James Fox, Fairview senior vice president and chief financial officer, it's on a trajectory to produce $30 million in net income for the year.

That solid fiscal foundation is not just good business. It also allows the medical enter to provide premier care to patients. Since the merger, Fairview has invested some $250 million in facilities and equipment, from creating a kid-friendly imaging and sedation center in the children's hospital to adding a sophisticated da Vinci robotic surgical system for performing minimally invasive surgeries.

Cerra notes that the U.S. News and World Report "Best Hospitals 2006" edition lists the University of Minnesota Medical Center, Fairview, among the top 50 U.S. medical centers in 11 areas: kidney disease; respiratory disorders; endocrinology; gynecology; orthopaedics; neurology and neuro-surgery; cancer; ear, nose, and throat; heart and heart surgery; urology and digestive disorders.

"That's a real sign of success," he says.

Pattern for partnership Today the University-Fairview merger is seen as a model for other academic health centers. In a 2000 report, the Association of Academic Health Centers and University HealthSystem Consortium cited the University-Fairview merger as a national model for academic-community partnerships.

The merger also has provided a pattern for other partnerships within the system. In May 2005, Fairview broke ground for a new ambulatory care clinic in Maple Grove--a collaboration with University of Minnesota Physicians that will bring the expertise of University doctors to the community.

Thompson anticipates more such agreements in the future. "Our academic mission acknowledges the growing need for us to have a larger presence in the community," he says.

With the dust finally settling after a decade, partners are now standing back to take a big-picture look at configurations for the next 20 years. A Clinical Sciences Campus Plan developed in 2004 calls for creating a new specialty medical center, consolidating clinical laboratories, and offering a more inviting, user-friendly setting for patients and their families.

Plans are also under way to construct a state-of-the-art replacement facility for University of Minnesota Children's Hospital, with groundbreaking scheduled to take place this year.

Further reading New name for hospital