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Clinical Programs Timothy J. Laing, MD Vice Chair Observation Cases If one could use just two words to describe the department’s clinical activities in the year 2006, those words would be “growth” and “planning.” Admissions Growth came in many forms: in the numbers of patients our faculty saw in outpatient clinics and inpatient hospital units, in the numbers of specialized clinics that gave our patients access to multiple specialized faculty at once, and in the number of square feet needed to accommodate all our patients, clinical trials, faculty and staff. But also, growth came in the form of donated funds to create programs that wouldn’t otherwise exist—and in our need for further such support to innovate for the future. The entire U-M Health System continues to experience an everburgeoning demand for patient care services of all kinds, a demand that at times has placed strain on our people and facilities. Through creative teamwork with the hospital administration, we have introduced new ways of handling the constant surge, including the expansion of our hospitalist service (see page 24). The hiring of new faculty for this service and in other divisions has helped us meet demand. And while the launch of several new multidisciplinary clinics, such as those for scleroderma and hypertrophic cardiomyopathy (see page 16), has placed increased demands on physical space, they also ultimately increase efficiency by allowing patients to be assessed by several specialists in one visit. The other hallmark of this year, planning, has positioned us well for success in 2007 and beyond. One of the largest planning efforts has been for the opening of the Cardiovascular Center in midyear, which will give our patients access to much of their outpatient and inpatient care in one state-of-the-art building—while also freeing up clinic and hospital space for other services. Likewise, we’re planning for the move of much of our Allergy outpatient activity to new leased space at Domino’s Farms in 2007, again giving much-needed “breathing room” to our clinics in the Taubman Center. Two other major planning efforts this year have involved the use of technology to share information with other clinicians at U-M and in the community. The Carelink system, which will allow our faculty to order tests, procedures and medications entirely online, has begun to be implemented in other areas of the Health System and is coming to Internal Medicine-run inpatient units and other venues. At the same time, our faculty have been instrumental in designing a regional health-information network for laboratory test results, allowing physicians outside U-M to see the results for their patients’ tests from U-M visits and admissions, and allowing our specialists access to results from other labs. As we plan for a future that will undoubtedly feature more growth in all of our clinical activities, these kinds of technologyaided initiatives will be crucial to our continued success. 4 Off-Site Primary Care Off-Site Specialty Care On-Site Primary Care On-Site Specialty Care Department of Internal Medicine University Hospital Admissions 17,000 13,496 14,128 14,800 15,200 16,000 1,039 15,000 575 Admissions 14,000 13,000 16,347 741 683 585 12,000 11,000 10,000 9,000 8,000 7,000 6,000 12,911 2001/02 Fiscal Year 13,445 14,225 14,459 15,308 2002/03 2003/04 2004/05 2005/06 Department of Internal Medicine Outpatient Office Visits 360,000 303,191 306,786 324,352 332,856 353,067 142,455 134,615 146,910 143,780 159,386 30,654 36,636 43,658 48,903 55,803 24,001 25,135 22,188 23,560 23,008 320,000 280,000 Visits 240,000 200,000 160,000 120,000 80,000 40,000 106,081 0 2001/02 Fiscal Year 110,400 111,596 116,663 114,870 2002/03 2003/04 2004/05 2005/06 Department of Internal Medicine Gross Professional Charges 200,000 116,552 128,219 148,016 161,491 175,884 2002/03 2003/04 2004/05 2005/06 180,000 In $ Thousands 160,000 140,000 120,000 100,000 80,000 60,000 40,000 20,000 0 2001/02 Fiscal Year INTERNAL MEDICINE ANNUAL REPORT 2006 • 5