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Behind a Pine Grove in Lebanon

DHMC’s New Heater Road Facility to Test Model Care Programs

  • Dr. Shane Chapman, a dermatologist at Dartmouth-Hitchcock Medical Center, looks out the window of the new building built by DHMC on Heater Road in Lebanon.<br/>(Valley News - Jennifer Hauck)

    Dr. Shane Chapman, a dermatologist at Dartmouth-Hitchcock Medical Center, looks out the window of the new building built by DHMC on Heater Road in Lebanon.
    (Valley News - Jennifer Hauck) Purchase photo reprints »

  • DHMC's new building on Heater Road in Lebanon. (Valley News - Jennifer Hauck)

    DHMC's new building on Heater Road in Lebanon. (Valley News - Jennifer Hauck) Purchase photo reprints »

  • Physical therapist Alison Trow works with Danielle Sampson, of Lebanon, in the new rehab facilites at DHMC's Heater Road complex in Lebanon.<br/>(Valley News - Jennifer Hauck)

    Physical therapist Alison Trow works with Danielle Sampson, of Lebanon, in the new rehab facilites at DHMC's Heater Road complex in Lebanon.
    (Valley News - Jennifer Hauck) Purchase photo reprints »

  • Dr. Shane Chapman, a dermatologist at Dartmouth-Hitchcock Medical Center, looks out the window of the new building built by DHMC on Heater Road in Lebanon.<br/>(Valley News - Jennifer Hauck)
  • DHMC's new building on Heater Road in Lebanon. (Valley News - Jennifer Hauck)
  • Physical therapist Alison Trow works with Danielle Sampson, of Lebanon, in the new rehab facilites at DHMC's Heater Road complex in Lebanon.<br/>(Valley News - Jennifer Hauck)

Lebanon — A 102,000-square-foot medical complex that will be a testing ground, of sorts, for new models of care at Dartmouth-Hitchcock Medical Center has opened just off Heater Road.

Hidden from Route 120 by a grove of pines, the three-level facility has been offering since Monday some primary care services that were previously housed near the main campus a mile up the road. Dermatology and physical therapy have moved there as well, and it soon will be home to the Dartmouth-Hitchcock Sleep Disorders Center.

The estimated $38 million project is the most significant expansion effort in at least five years for Dartmouth-Hitchcock, but it is more than just a shiny new building for the state’s largest health care provider, said Ethan Berke, director of primary care for Dartmouth-Hitchcock in Lebanon.

It offers a chance to develop new ways of coordinating care for patients as Dartmouth-Hitchcock positions itself as a leader for reforming the nation’s health care system.

“This building is an opportunity to push the transformation of care further,” Berke said in his office yesterday.

Those transformations will be worked through in the weeks and months ahead. Only four days after it opened, staff were wheeling file cabinets through the hallways, unpacking offices and arranging exam rooms. Some cosmetic work remains to be done, as exposed sheetrock with penciled markings could be seen in the lobby and lower levels.

It is a functional space, however, and set-up to be rearranged easily as physicians, nurses and administrative staff figure out the most efficient ways to work, according to Charlie Welch, director of operational services for Dartmouth-Hitchcock.

A guiding principal behind the design was to have a space that helps physicians, nurses, medical assistants, secretaries and behavioral health specialists better coordinate the ways in which patients are cared for.

“Team rooms” where all these health professionals can come together and work in the same space are dispersed throughout the building, with the idea that it will make it easier to coordinate with each other.

There are similar team spaces at Dartmouth-Hitchcock Medical Center’s main campus, too. But the Heater Road building has given Dartmouth-Hitchcock the chance to design everything from the bottom up, where details down to the placement of the check-out desk are being studied for how they affect efficiency and treating patients.

In the past, providers were working in ways that didn’t always put their skills to best use, Berke said. Doctors might be performing tasks a nurse could handle, and nurses were doing things, such as taking patient histories or giving immunizations, that a nursing assistant could do, he said. Having a set-up that allows for better coordination would, hopefully, refocus everyone around putting their skills to the best use.

“We want everyone to practice to the top of their license, at the top of their training,” Berke said. “We don’t have that.”

The Heater Road facility has done more than bring teams of physicians and nurses together. It has also brought entire disciplines closer.

General internal medicine is now working alongside family medicine.

Both provide primary care and there are ways in which they overlap, particularly in treating patients with chronic conditions, such as diabetes, said Courtney Farrell, a physician in general internal medicine.

“I think you can gain a lot of ground by combining the clinics,” she said.

Moving farther from the main campus will mean Farrell and her colleagues will sacrifice easy access to resources they previously had available to them, such as being able to reach out to other specialists on-site. But Farrell said the long-range benefits of the move would be worthwhile.

“I don’t think losing that (access to resources) outweighs the benefits of moving here,” she said.

Exactly what those benefits will be, and what efficiencies they’ll be able to achieve, remains to be seen. In this, the first week inside the building, many people were still trying to get the printers to work.

Patients shouldn’t notice too much of a difference, Farrell said, except perhaps in where they were driving to see their doctor.

The change of venue was enough to excite Daniell Sampson.

The 27-year-old Lebanon resident has been getting physical therapy at Dartmouth-Hitchcock for about three weeks, and yesterday was her first time in the Heater Road building.

Beyond the aesthetic advantages (e.g. better light, bigger windows), Sampson enjoyed pulling into a parking lot with ample spaces available, and which was closer to Interstate 89.

“You can just walk right in,” she said while working out on a NuStep machine. “You don’t have to walk through the whole hospital. It’s quick, simple, there’s no parking issues.”

Her physical therapist, Alison Trow, said such conveniences were no small matter. Many patients come to physical therapy soon after surgery, making any long walk through a parking lot or up some steps a challenge.

“There were people who had to stop three or four times before they made it to our clinic door,” Trow said.

For all the improvements, however, the Heater Road building is still very much a work in progress, Berke said. Offices could get moved around, the ways people work with each other could change, and it will all be a kind of laboratory for Dartmouth-Hitchcock as it puts into practice some of the theories its researchers have developed in seeking to transform health care.

“We are learning as we go,” he said.

Chris Fleisher can be reached at 603-727-3229 or cfleisher@vnews.com.