A Toolkit for Redesign in Health Care: Final Report

Denver Health is a large integrated, urban, academic safety net institution. Various aspects of this system are listed below.

Components of the Integrated System

• 911 system for City and County of Denver.
• 398-bed acute care hospital with Level I trauma center.
• 8 family health centers (federally qualified health centers).
• 12 school-based clinics.
• Public health department for the City and County of Denver.
• 100-bed non-medical detoxification center.
• Correctional care facility.
• HMO for Medicaid, Child Health Plan, and commercial product.
• Call center—regional poison center, drug line for national companies, nurse advice line, translation line, centralized scheduling.

Demographics of Population Served

• Approximately 150,000 individual users.
• Approximately 70 percent of patients are members of ethnic minority populations.
• 27 percent of the patients are non-English speakers.
• 42 percent of charges are for uninsured patients.
• $285 million in care to uninsured patients in 2004.

Organizational Aspects of the System

• Is an independent government entity.
• Employs 4,100 individuals, including physicians.
• Has a formal academic affiliation with the University of Colorado School of Medicine.
• Provides a learning environment for160 interns and residents at any given time, integrated with University of Colorado School of Medicine.
• Employs physicians who have a full-time faculty appointments at University of Colorado School of Medicine.

Information Technology Structure

• $225 million investment in information technology since 1997.
• Integrated information technology across the entire system.
• Single patient identifier for the integrated system.
• Single electronic medical record across the integrated system.
• Integration of financial, clinical,radiology, pharmacy, and laboratory data.
• Computers in all clinic offices; chartless environment.
• Initial phases of roll out of computerized provider order entry.

All Denver Health community health centers, the hospital, emergency services, pharmacy, and laboratory systems use the same unique identifier for patients; thus, outpatient, inpatient, and ancillary service data can be linked to evaluate health services utilization, medication use, and provider compliance with guidelines.