medical school and/or teaching facility. An enhanced medical education system, a healthcare provider consortium, a graduate medical education program or an accredited academic medical center are all solutions that will be examined. Katz Sapper & Miller (KSM) analyzed data from various sources throughout the project. The primary source of data was from the Indiana and Illinois Hospital Associations. This data enabled us to capture and measure the trauma volume in Northwest Indiana (NWI), determine the amount of patients seeking care in Illinois and assess the overall healthcare needs of NWI. These feasibility studies aim to validate and answer the research questions regarding trauma, medical education and the quality of healthcare for NWI residents. 5 v The limited access to a designated trauma care within a reasonable time frame within Lake and Porter counties significantly impacts the lives of Indiana residents as well as those traveling to, from and through the state. a) Injury, not cancer or any disease, is the leading cause of death for Indiana citizens ranging from age 1 to 34. b) More than 86,000 Hoosiers are hospitalized, and 5,000 die due to trauma injuries, each year. c) Motor vehicle collisions are the leading cause of unintentional injury/death and the second leading cause of unintentional injury overall. d) The total cost to Hoosiers of traumatic injuries is estimated to be in excess of $10 billion. Until March 2006, Indiana was among eleven states with no laws or regulations granting oversight authority for trauma care. Public Law 155, enacted in 2006, designated the Indiana State Department of Health (ISDH) as the lead agency for a state trauma care system with goals of preventing injuries, saving lives, and improving the care and outcome of individuals injured in Indiana. In November 2009, Governor Mitch Daniels enacted Executive Order 09-08 establishing the Indiana State Trauma Care Committee (ISTCC) and the Indiana State Trauma Care Fund. On January 14, 2013, Governor Mike Pence enacted Executive Order 13-11 for continuing the work of the ISTCC. The Indiana Trauma Care Fund was also reestablished and continued by Executive Order 13-11, to accept gifts, grants and donations to go toward the development of a comprehensive statewide trauma system. This Fund is administered by the ISDH. Overview – Trauma Background (continued) 6 After being engaged by the RDA, Katz, Sapper & Miller held a meeting with the RDA in February of 2014 to initiate the project. A four-phase process workplan was presented as well as the detailed steps within each phase. Data was supplied by the Indiana Hospital Association and the Illinois Hospital Association upon the receipt of a formal data request. The four phases of the workplan were: I. Due Diligence II. Financial & Market Implications III. Partnership Possibilities & Healthcare Reform Impact IV. Recommendations & Conclusions Process Description 7 High-level Progress Dashboard This High-level Progress Dashboard served as a 30,000 ft roadmap for the project’s progression. Client Service Team (CST) The CST was carefully selected to provide the RDA with subject matter expertise in multiple areas of the healthcare industry: legal, facility, project management, hospital reimbursement, strategic alliances and operational performance. Process Description cont’d 8 Recommendations and Key Findings 9 Trauma Services: Utilize existing facilities in Lake and Porter Counties for trauma services. ▪ Establishing a Level I or II trauma program at an existing facility is more economically feasible for the region. ▪ Building a new facility for the purpose of serving as a designated Level I or II trauma program is not recommended. ▪ Four of the largest hospitals are already moving toward some level of trauma designation ▪ It is recommended that 2 or more Level III designated trauma programs should be established at existing facilities within the next 18 months, with the goal of at least one Level I trauma center being established within the next 5 years. ▪ Preferential placement of graduate medical education resources should be given to hospitals that are on the path to trauma designation or officially “in the process.” Academic Medical Center: With current bed capacity in Lake and Porter counties, it is recommended to utilize existing facilities as opposed to building a new Academic Medical Center for teaching and research. ▪ It is recommended that a new Academic Medical Center (AMC) NOT be created in Lake and Porter counties. However, a Graduate Medical Education (GME) program should be pursued using existing facilities. ▪ A similar model is being pursued by the IU School of Medicine Southwest in Evansville. ▪ A GME program providing up to 36 residency positions should be developed and established in Lake and Porter counties using existing facilities in a coordinated approach. Recommendations – Trauma and AMC 10 v Building a new acute care facility is an expensive proposition. v Utilizing existing facilities, even with extensive renovation, is the most cost efficient option. v Additional beds in Northwest Indiana are not required given the current level of capacity at facilities. v A new acute care facility competing for the existing level of activity would likely economically damage the existing providers. v There is a relatively low level of trauma outmigration to Illinois. v