By JIMMY LAWTON

CANTON – The major Canton-Potsdam Hospital construction project now underway on Route 11 -- expected to house 20 medical offices and four outpatient surgical facilities -- is designed to respond to rapid changes in the health care industry.

CEO David Acker said the $20 million facility will allow CPH to meet the needs of a changing health care environment in which primary care, specialized care and preventative care will now generate the lion’s share of revenues for the hospital. Traditionally, the majority of revenue stemmed from inpatient care.

“We need to find a way to better health and that means keeping people out of hospitals,” he said.

The new facility will also address space issues at CPH and at the same time establish a central location for people throughout the county to seek specialized treatment. The expansion will allow the hospital to continue its rapid growth, including the addition of medical specialties for which residents now must travel to Burlington, Vt. or Syracuse.

St. Lawrence Health Systems, the parent organization of CPH and Gouverneur Hospital, is the county’s largest job provider. In August, the organization reported having 1,235 employees, with 874 full-time positions.

Acker says the medical staff has doubled since 2008 and the hospital has added 350 employees in that same time period. CPH is now averaging 65 new employees per year and that requires more space, he added.

The new 30,000 square-foot medical office is being built on a 270-acre parcel on Route 11 just east of the railroad overpass east of the village. Preliminary groundwork has already begun and construction of the medical offices is expected to begin and in the spring and finish about a year later.

The second phase of the capitol project involves building an outpatient ambulatory surgery center, which he says is desperately needed because the five CPH surgery rooms are often full.

Acker said construction on the surgical facilities will begin in the fall and finish approximately one year later.

Sea Change

Acker said there will always be a need for hospitals and he doesn’t expect them to disappear. But the future of care at hospitals will likely move toward the chronically ill and emergency care, while primary and preventative care will grow outside of the traditional hospital, he said.

The industry is experiencing a “sea change” in how reimbursements from Medicaid and insurance companies are paid out, he said. Traditionally, hospitals received set amounts for particular procedures, but those amounts are being reduced, he noted.

Acker said higher payments are also being tied to outcomes. He said hospitals that are able to increase outpatient care and increase the volume of people they serve are going to be successful. To further that point, Acker says the hospital is undergoing a three-year trial that tracks patients from when they walk into the door until they are completely recovered.

He said this is not easy to do as people do not always finish treatments, or may receive care from alternative providers, but he says the data will help the hospital learn the effects of a variety of treatments and improve treatments based on that information.

He said funding is also being tied to technological improvements for things like electronic record-keeping.

Challenge Accepted

But Acker said he isn’t frustrated by the changes and believes investment in the right areas will allow CPH to meet the future head.

He said he sees his organization’s expansion as an answer to the call for change.

“We need to overcome our isolation,” he said. “By offering care that wasn’t offered before, we can build up our reputation over time and become a place people come to for specialized care.”

Acker said CPH is already seeing tremendous growth in outpatient surgeries, but its current space to perform them is inadequate to meet the demand. Although surgeries once meant overnight stays in the hospital, Acker says the future is tied to outpatient procedures.

Because all CPH surgery suites are often in use, Acker said “decompressing the surgical facility” by building the new outpatient surgical suites in Canton will allow for better scheduling times and less shifting due to emergency procedures.

Acker said that will also mean more surgeons and more specialization. Rather than having a general orthopedic surgeon, the hospital could also have a hand specialist, heart specialist and so on, he said.

As the hospital nears its Level III Trauma Center designation, this could mean patients who were previously sent to Syracuse or Vermont could be treated locally.

Acker said emergency surgeries can’t be planned for, but the hospital must ensure there is adequate space to provide quick treatment when they arise.

He predicts that hospitals will continue to become more involved in shared services in the near future. He said the new facility could allow St. Lawrence Health System to establish a shared storage facility and combine other services as well.

He said it is likely there will be fewer players in the game as time goes on but expects local hospitals to become more specialized in particular areas. “I think there will be fewer and fewer small stand-alone inpatient hospitals,” he said.

He said cutting inefficiencies and improving strengths will help St. Lawrence County’s health care providers remain successful.

Addresses Shortages

The new facility will help address the shortage of healthcare specialists in the area and Acker envisions the offices providing a variety of care that people currently have to travel out of the county to find. Among the specialists Aker expects at the new office would be an allergist, endocrinologist and a gastroenterologist, with others likely to follow.

“I think that these new specialists bring different skills to the area and expand the core of what we can do here,” he said.

He said the idea will be to provide services that St. Lawrence County residents must currently drive more than hour to receive. Acker says Canton is the perfect location as it is in the center of the county, which makes travel times feasible for most county residents.

He said that with more people insured through the Affordable Care Act, that mean more people seeking care, but they must be able to access it as well. For some people, driving long distances is not feasible.

“If the mission is to elevate care and improve the health of the population then we have to make sure there is access to professionals,” he said.