There's a lot more to Las Vegas and its surrounding communities beyond the bright lights of the strip, says Chris A. Vito, president and CEO, Rehabilitation Institutes of Nevada in Las Vegas. In a place where the population was increasing by 10,000 people monthly — and three years later is still going up by more than 7,000 monthly — there's no more vibrant industry to be in than health care.

In only five years, five new hospitals have been built and two more are in the works in the southern Nevada region, which includes the 1.6 million residents living in cities such as Las Vegas and Henderson.

“The health care industry here is exciting for any health-care executive or health-care provider,” Vito says. “I'm a 23-year veteran of this industry, and I've never seen anything like it.”

As new hospitals have opened and cluster industries such as pharma and medical products have gained strength around them, the area has dealt with challenges in human resources, education and legislation. Answering those concerns led to the formation of a broad coalition, says Bob Cooper, economic development manager, city of Henderson. Together with Vito he is co-founder of the Southern Nevada Medical Industry Coalition, which has brought 250 volunteers together to tackle health care access in the region, from introducing new health-care professionals to each other to recruiting health-care workers from across the country.

Southern Nevada isn't the only place creating such partnerships. Spokane, Wash., is home to Inland Northwest Health Services, or INHS. Owned by Empire Health Services and Providence Health Care, the mission of INHS is to provide collaborative health-care services for Spokane and the surrounding region. The non-profit corporation's approach to collaboration, which has included major technical innovations in patient record-keeping, is viewed as a model for other communities and has attracted the attention of the federal government for its cost-saving measures.

“Economic development officials here see the collaboration as a value-added element,” says Tom Fritz, CEO, INHS. The unique approach taken by INHS has increased efficiency and improved patient care at the 32 hospitals it contracts with, which in turn has answered labor shortfalls and increased customer satisfaction and loyalty. “The community expects us to collaborate, to do everything we can do to give patients the best clinical outcomes,” Fritz says.

Working Together

Collaboration is a recurring theme in health care, especially at universities such as the University of California-San Diego, where McCarthy Building Cos. recently completed the $104 million, 270,000-square-foot Rebecca and John Moores UCSD Cancer Center.

“The genesis of the project was to bring together the researchers, physicians and patients into one environment,” says Ron Hall, executive vice president, McCarthy. “They wanted to bring laboratory research to quicker application for the patient and consolidate services under one roof. They also wanted to take cancer care to the next level.”

Consolidation meant that the five floors of wet laboratory space made of cast-in-place concrete had to be integrated with the structural steel clinical side of the building. McCarthy was charged with evaluating the merging systems for cost and stability, Hall says.

Hall notes that health-care construction comprises 60 to 70 percent of the contracts fulfilled by McCarthy, which has regional offices nationwide. While population growth fuels expansions handled by McCarthy — in the Carolinas, Georgia and Florida, for example — California is even busier because of state law. One statute, SB 1953, passed in response to the 1994 Northridge earthquake, mandated that all inpatient facilities meet certain criteria from both structural and non-structural standpoints.

“In the event of an earthquake, the buildings can't collapse and services within them, like respirators, must be able to continue,” Hall says. “There were deadlines set, one in 2008 and another in 2030, so that's driving replacement hospitals in California.”

Among the trends Hall sees in California are an increased emphasis on outpatient care facilities, particularly as technology advances allow more procedures to be conducted on an outpatient basis. Also, because the hospital market is characterized by technology advances, construction has to be flexible to accommodate the latest innovations, Hall says. There are special requirements for imaging equipment, telephone and data transmission and materials movement systems, automated robotic systems that move goods throughout a hospital.

Of course, one consistent factor in siting new facilities or expanding old ones is the need to build cooperation between the facility and the surrounding neighborhood. “We have a big role in integrating construction without disrupting other facilities and the communities,” Hall says. “Construction relations are usually happening in an urban environment, and that requires good community relations.”

Improving Efficiency

In Spokane, INHS has focused on standardization to save costs. On the tech side, INHS works with its customers — 32 hospitals in Washington, Idaho, California, Montana and Alaska — to streamline patient information into one secure database of 2.7 million records, reducing hospitals' needs for separate, individual servers and extensive information technology staff. Among the applications, INHS has used its approach to create prescription label codes matched to patient codes, helping avoid costly and fatal medicine mistakes.

“The system integrates patient data,” says Fritz, who in addition to being CEO at INHS is also CEO of St. Luke's Rehabilitation Institute in Spokane. If a patient of one hospital is in an accident close to another INHS-affiliated hospital, doctors can have instant access to the patient's record to know allergies and blood type.

Now 10 years old, INHS has concentrated on improving efficiency. The organization can purchase bulk software and hardware to save costs. It merged two ambulance services into one. It also keeps costs down for participating hospitals that otherwise could not afford to run their own technology. For example, smaller or rural hospitals unable to afford streaming video now can through INHS.

“Everything we are doing makes sense from a patient care perspective,” Fritz says. “We're avoiding duplications in laboratory services, consolidating billing, avoiding medical errors, saving time and improving patient safety. We can recruit employees better because they know we take better care of our patients.”

An Increasing Trend

Vito sees collaboration as a national trend, evidenced by mergers and cooperative agreements in the corporate world. One way companies can stay competitive as they expand is to consolidate services, as a new facility planned for the Rehabilitation Institutes of Nevada will do, providing comprehensive post acute care for the major medical centers in the area, Vito says. He sees a need for one facility to handle all forms of post acute care, instead of requiring patients to seek long-term and short-term post acute care and rehabilitation in separate hospitals and clinics.

Just as the new facility will bring a variety of care options under one roof, the Southern Nevada Medical Industry Coalition has brought a cross-section of volunteers to tackle health-care access issues in the rapidly growing region.

Since the coalition started three years ago, alliances and collaborations between health care providers have formed to the benefit of the citizens of southern Nevada.

In terms of economic development, Bob Cooper sees the coalition as a means to tackle labor, legislation and strategic alliances in health care, an industry predicted to grow by 3.6 percent annually in southern Nevada, he says. The coalition is a regional effort between Henderson, Las Vegas, Las Vegas North and Clark County.

Cooper, who says he calls Nevada “Delaware West” because of its low taxes, has seen other collaborations spin out from the original organization. For example, to answer part of the labor challenges, the coalition set out to recruit private colleges and universities to the region. As the 12 new institutions set up shop in Henderson and Las Vegas, they have worked together with the coalition to coordinate efforts to promote their presence.

While it's difficult for a company to site on their own, it may be easier to be a part of a group or a partnership in a community, notes Vito. “The initial impression of working together is, ‘I don't want to share secrets.' But participants put their guard down and the resulting synergy turns out to be very positive.”

Jen Humphrey is a freelance writer from Lawrence, Kan. She can be reached at Jenlynnhumphrey@yahoo.com.

For more information on the organizations featured in this article, visit:

City of Henderson (Nev.) Economic Development Division, www.cityofhenderson.com

Inland Northwest Health Services, www.inhs.org

McCarthy Building Cos., www.mccarthy.com

Southern Nevada Medical Industry Coalition, www.snmic.com              

Health Services

Based on number of establishments first quarter 2003 to first quarter 2004.

New Branches

1.      California

2.      Texas

3.      Florida

4.      New York

5.      Pennsylvania

6.      Ohio

7.      Illinois

8.      Michigan

9.      Georgia

10.  North Carolina

Startups

1.      California

2.      Florida

3.      Texas

4.      New York

5.      Ohio

6.      Illinois

7.      Georgia

8.      New Jersey

9.      Michigan

10.  Washington

Data includes the following SICs:

80 Health services

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