2021 Service Profile - Spectrum Healthcare Partners
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2021 Service Profile
2 CEO LETTER: A REFLECTION ON 25 YEARS CMO MESSAGE: DR. HERBERT CUSHING 3
This past year has been a notable one for Spectrum Healthcare Spectrum entered 2021 with high hopes that COVID-19 would soon 25 YEARS OF INNOVATION 4
Partners. On September 30, 2021, Spectrum celebrated its 25th anniversary. subside. However, the year brought multiple variants and many more infections,
with Maine recording more than 1,000 daily cases by the end of the year. 2021 IN NUMBERS 5
Over the years, we have grown from a relatively small medical practice to one of the
largest healthcare organizations in the state of Maine. I am proud and appreciative In the face of the continued pandemic, Spectrum remained nimble and resilient.
HIGHLIGHTS BY SPECIALTY 6
of the work our physicians, advanced practice providers, other clinical staff, and our Vaccinations for physicians and staff started in late 2020 and continued until
administrative team have accomplished last year – and the past 25 years – to advance everyone was protected. We are proud to have a 100% vaccination rate across the
EVOLUTION OF RADIOLOGY 8
our efforts to provide high-quality medical services to patients across Spectrum enterprise. As
northern New England. a result of our efforts,
JOINT REPLACEMENT 10
interruptions have been
While this past year has remained a unique experience for all of us
progressively fewer
while dealing with the impacts of the COVID-19 pandemic, those REGIONAL BLOCK PROGRAM 11
and patient care has
challenges have allowed our dedication, commitment, and resiliency
continued.
to shine. It is during the hardest times that true leaders emerge,
PRECISION MEDICINE 12
and Spectrum Healthcare Partners continues to be a champion for In 2021, the Spectrum
independent medical practices. As we welcome a new year, we will board renewed its focus
TRANSFORMING PATIENT CARE 14
continue our focus on high-quality, cost-effective care, and we will and commitment to
continue to foster the collaborative relationships we share with our delivering high-quality,
TARGETED CANCER CARE 16
hospital, provider practice, health insurer, employer, government, and cost-effective care
other partners. in every community we serve. We have made many exciting changes to improve
REFINING ANESTHESIOLOGY 18
patient experience, including implementing a new electronic health record (EHR) in
The vision and dedication of our founding physicians established the foundation It is during the our orthopaedic and interventional radiology divisions (see story on page 14).
that we have built upon over the past 25 years. I invite you to watch our 25th TRAINING & EDUCATION 19
anniversary video, which features several of our early physician leaders and founders hardest times that true We’re privileged to serve our patients and look forward to more success in 2022.
of Spectrum including Drs. Christopher Pope, Roger Pezzuti, Michael Pancoe,
leaders emerge, and QUALITY 20
Robert Isler, Katherine Pope, Stuart Gilbert, and Michael Jones. You will also hear
from SHCP’s current physician leaders including our president, Dr. Michael Quinn, Spectrum Healthcare SMSC: PRACTICE MANAGEMENT 21
–Herbert E. Cushing, MD
as well as one of our community board members, Dr. Eric Lister. These physicians
share their perspectives on the formation of the organization and its most notable Partners continues PHYSICIAN WELLBEING 22
successes over the past quarter century. You can view the video at spectrumhcp.
to be a champion for
com/25thanniversary or by scanning the QR code below. WOMEN IN LEADERSHIP 23
As a result of our efforts, interruptions have been
We look forward to continuing our work providing leadership and support to our
independent medical
progressively fewer and patient care has continued.” SITES OF SERVICE 24
communities, and we wish you all well. practices.”
CHARITABLE GIVING 25
–David Landry, CEO
BOARD & LEADERSHIP 26
Scan to watch our 25th
anniversary video!
4 25 YEARS OF INNOVATION AND INDEPENDENCE 5
2021
On September 30, 2021, insurance companies and then with platform to bring subspecialty medical vascular and interventional radiololgy and the management infrastructure that
Spectrum Healthcare Partners the hospital systems. In 1995, there care to more communities throughout services. Spectrum continues to be led to the establishment of Spectrum
celebrated its 25th anniversary. were 40 independent hospitals in Maine. This approach allowed Spectrum strong, resilient and a beacon for Management Services Company.
Spectrum was formed as the result Maine, nearly 12 commercial health to increase their relevancy and influence independent-minded physicians.
insurance companies, and over 90% of in healthcare policy and financing.
Spectrum Management Services We are proud to have
of a merger of five practices: two Spectrum has always been a champion Company was founded in 2019
anesthesiology groups, two radiology the physicians were in private practice. Over the years, Spectrum grew from a for independent physician practices, through a partnership between delivered 1,643,610
groups, and one pathology group. Since Today, there are three health systems in relatively small medical practice to one which has fueled our growth and Spectrum Healthcare Partners and
then, Spectrum has integrated more Maine, four commercial health insurance of the largest healthcare organizations allowed us to remain nimble in the MBMS, a leading national provider of
services, served
than 10 other practices, developed companies, and over 70% of the
physicians are employed by hospitals.
in the state of Maine, with over 200 face of an ever-changing healthcare medical billing services. Together, the 648,173 patients,
multiple hospital relationships, and physicians practicing in the areas of landscape. Spectrum’s unique business organizations offer a comprehensive
expanded into other communities. The vision of Spectrum’s founding anesthesiology, orthopaedics, pain model has provided a durable and suite of practice management and offered $1,701,962 in
In 1996, the physicians who founded the members was to create a large and management, physiatry, pathology, scalable framework, as evidenced by the financial services to improve its clients’
diversified organization that would radiation oncology, radiology, and substantial growth across each division business and operational performance.
free patient care, and
organization created a healthcare model
that was largely unheard of at the time: a be able to sit at the same tables 25 years ago, Spectrum’s $1,018,776 in local and
multispecialty medical practice that was as the emerging health systems, founding physicians built a
both physician-owned and physician– regional and national health foundation that has supported
statewide charitable
directed. This model, which was the plans, government, business,
and other key stakeholders.
the organization’s growth contributions.
vision from day one, set the stage and resiliency over the years.
for Spectrum to influence healthcare Spectrum continues to be Spectrum has meaningful
policy and delivery, and has uniquely relevant because size really partnerships with healthcare systems,
positioned the organization to provide does matter. Diversity – both employers, insurers, managed care 1,643,610
high-value medical services throughout geographically and from a organizations, and policy makers. services provided
Maine and other parts of northern New specialty perspective – is When decisions get made
England. The evolving healthcare model important, and Spectrum’s about healthcare delivery,
and changes in both the delivery and growth has allowed us to the physician perspective
648,173
financing of medical services was key to have influence with the key stakeholders is represented, which patients served
both the formation and goals in the region. ensures our ability to
of Spectrum. At the time of Spectrum’s formation, deliver high-quality,
$1,701,962
Historically, healthcare and medical there were roughly 55 physicians cost-effective care
services were delivered in a very making up the organization, in every community free care provided
decentralized and fragmented manner primarily centered at Maine we serve.
dominated by small, independent Medical Center in Portland $1,018,776
physician practices, community and Eastern Maine Medical
hospitals, and state-based health Center in Bangor. The goal charitable
Pictured, from L to R: Robert Isler,
insurance companies. In the 1990s then was to find ways to MD; Michael Quinn, MD; Katherine
Pope, MD; Michael Pancoe, MD; Roger
contributions
the industry experienced tremendous expand outreach and Pezzuti, MD; Eric Lister, MD; Stuart
Gilbert, MD; Michael Jones, MD; David
consolidation – first amongst the accessibility and create a Landry; Christopher Pope, MD
Spectrum includes 65 physicians across
1996 Spectrum Medical Group is formed
through the merger of 5 practices. 1997 three specialties: anesthesiology, pathology,
and radiology.
1998 David Landry joins Spectrum as COO, a role
he holds until becoming CEO in 2007.
M E ANWH I LE . . . Dolly the Sheep is cloned. First emojis are developed. Google.com is founded.
6 HIGHLIGHTS BY SPECIALTY 7
ANESTHESIOLOGY ORTHOPAEDICS PATHOLOGY RADIATION ONCOLOGY RADIOLOGY CORPORATE
Our anesthesiology division added In December of 2021, we launched Our pathology division has a high Our radiation oncology division, in Collectively, the physicians in the Spectrum launched a dyad leadership
a new pain management specialist a new orthopaedic website at standard of excellence measured by collaboration with the Maine Medical Spectrum radiology north and radiology program (Leading As Partners) in 2021
in August of 2021. Syena Sarrafpour, OrthoSpectrum.com. We worked closely quality metrics to assure and improve Center Department of Radiation south divisions have subspecialty aimed at developing core competencies
MD, joined Isaac Chemmanam, MD, in with our patients, physicians, and other patient care best practices. Spectrum’s Oncology and the Maine Medical training in all areas of diagnostic and fostering collaboration for
providing pain management services key members of the orthopaedics major discordance rate (the rate of Center Research Institute, has expanded radiology, making Spectrum the only each division’s physician and
at our orthopaedic practice in Portland. team to gather feedback to create an inaccurate diagnoses) is .0018%, which its research trials and is currently healthcare team in the state of Maine administrative leaders. The areas of
Our pain management physicians are improved visitor experience. The newly is significantly lower than the 3% participating in 24 clinical trials. The that has the expertise to offer a full range focus include Understanding Work
uniquely qualified to prescribe and redesigned website offers visitors quick benchmark identified in the work of studies allow patients with a broad range of non-invasive diagnostic imaging exam Styles, The Art and Practice of Effective
interpretations by a radiologist with
administer pain medications beyond and easy navigation to our services, Peck, et al (1). In addition, Spectrum’s of malignancies to participate in cutting- Communication, Leading Through the
advanced subspecialty training. These
the operating room and see patients at locations, and provider information pathology division performs routine edge, practice-changing research close Unknown, and Influencing as Partners.
areas include: computed tomography
many of our sites of service. as well as improved functionality, second reviews of specimens 17.83% to home. The program is very active, and Through workshops, coaching, and
(CT), Magnetic resonance imaging (MRI),
integrated social media buttons, and of the time, which exceeds the 8% during the past year enrolled 53 patients various assessments, the program
Our anesthesiologist intensivists pediatric imaging, nuclear medicine
access to a new online patient portal. benchmark identified in the work of in these studies. The division has been supports the dyads, as well as each
continue to provide critical care services neuroradiology, musculoskeletal
The patient portal will improve patient Chantal, et al (2). In the second quarter a national accrual leader to both the individual, as they proactively plan
radiology, breast imaging, and
at several hospitals across the state care and satisfaction by integrating of 2021, Spectrum’s average turnaround Dana Farber Cancer Institute FABREC for and respond to challenges,
interventional radiology.
to help manage and provide care to patient engagement tools. time was 1.76 days, which exceeds trial (hypofractionated vs. standard support organizational culture,
patients during the COVID-19 pandemic. the College of American Pathologists’ post-mastectomy radiation therapy after and provide financial stewardship.
The radiology north division
An anesthesiology intensivist is an benchmark of 2.0 days. reconstruction) and the NRG CC007CD implemented OneConnect in March
anesthesiologist with additional training trial (investigates the role of survivorship Our Medical Staff Services team (MSS)
of 2021. OneConnect is a single source
in critical care, including pharmacology care planning in prostate cancer) with of communication consolidating a deployed a new software platform, MD-
and resuscitation. The Spectrum 11 and 19 patients, respectively, in 2021 wide variety of communications, Staff in April of 2021. The new platform
anesthesiology intensivist team, led alone. The division also added four new such as critical findings to referring has exceptional functionality and has
by William Sauer, MD, was called upon phase-three trials to its portfolio that providers. OneConnect is a best-practice allowed us to enhance credentialling
by our hospital partners to expand are particularly noteworthy: the ECOG- support system creating improved and payor enrollment services to both
Preview of our new user-friendly orthopaedic
our services during the height of the website. ACRIN’s EA8191 INDICATE (prostate patient care, enhanced customer service, SHCP providers and our external clients,
COVID-19 crisis in 2019. cancer), and EA2174 (esophagus cancer) improved radiologist satisfaction, and as well as streamline our ambulatory
Our orthopaedic division launched Michael A. Jones, MD, Spectrum pathologist, was increased productivity. surgery center (ASC) credentialing and
honored as Life Trustee by ABPath for his many trials, and NRG Oncology’s GU009
a webinar series that is dedicated contributions to their board. Dr. Jones was a trustee privileging process. Additionally, MSS
of the ABPath from 2013–2020 and served as vice
PREDICT-RT (high-risk, localized prostate
to discussing how best to address implemented physician CME activity
president in 2020 and treasurer in 2018–2019. cancer) and BN007 (glioblastoma/brain
certain injuries that may occur in the trackers, which allows physicians to
cancer) trials. The results of all of these
workplace. The series is led by Spectrum easily check on the progress of their
trials will improve outcomes for Mainers
Orthopaedics physicians who explain CME during their current license
with cancer in the future.
the physiology behind the injury, period. The physician CME activity
diagnostic processes, and potential trackers are customized based on the
treatment options. Sharon Siegel, MD, Spectrum’s radiologist, was physician specialty and accreditation
elected as chair of radiology for Maine Medical
(1) Martyn Peck 1, David Moffat 2, Bruce Latham 3, Tony Badrick 4, Review of diagnostic error in anatomical pathology and the role and value of second opinions in error prevention, Center. Dr. Siegel transitioned into this role in early requirements.
PMID: 30068638 DOI: 10.1136/jclinpath-2018-205226 January of 2022.
(2) Chantal C H J Kuijpers 1, Gerard Burger 2, Shaimaa Al-Janabi 2, Stefan M Willems 3, Paul J van Diest 3, Mehdi Jiwa, Improved quality of patient care through routine second review
of histopathology specimens prior to multidisciplinary meeting, PMID: 27030307 DOI: 10.1136/jclinpath-2015-203488
1999 Premier Health is established as Spectrum’s first related
venture focused on diagnostic imaging throughout Maine. 2000 Spectrum continues to expand in Maine and begins
offering services in NH and MA.
2001 Radiation oncology is established
as a separate division in Spectrum.
M E ANWH I LE . . . First Bluetooth device is launched. The first draft of the human genome is released. September 11 attacks occur in NY, DC, and PA.
8 THE CREATION OF PACS: EVOLUTION OF RADIOLOGY 9
In the 1980s and 1990s, Largely led by the American College of the chance to buy limited components of SPECTRUM HEALTHCARE diagnostic interpretation while meeting
medical images were stored in Radiology (ACR) and National Electrical the whole system while also storing their PARTNERS WAS A CRITICAL turnaround time expectations.
the basement of healthcare facilities Manufacturers Association (NEMA), medical images. This was an easy sell – a ELEMENT TO THE EVOLUTION In response to the global pandemic,
in what were called “film libraries.” the creation of a process that could cost-effective way to improve patient OF PACS IN MAINE. a rapid deployment of home
Radiologists were often “in-person” both transmit and store the medical care and delivery.
In Maine in the 1990s, PACS were workstations became a priority to
consultants to other physicians during images from and between hardware
There are two primary uses for the PACS. centered at Maine Medical Center. provide radiologic expertise in the
the days of film. If physicians were manufacturers began. The creation of
One, PACS replaces hard-copy images; Early Spectrum radiologists, such as event of physical distancing needs. “The
looking for patient information, they picture archive and communications
there is no longer a need to manage Roger Pezzuti, MD, championed these teleradiology model provides a wide
would come down to the film library systems (PACS) developed in a way
film archives. This not only improves efforts with the hospitals. Spectrum range of advantages,” states Michael Corey Couto, MD, managing director of Spectrum’s
and “check out” a patient’s files . . . if that allowed all medical studies to radiology north division
convenience but also eliminates the Healthcare Partners, known then as Quinn, MD, radiologist in Spectrum’s
they could find them. They would then be stored in a digital database and
need for space within a facility. Digital Spectrum Medical Group, was a critical radiology south division and Spectrum
bring the films over to the radiologists then distributed out to the medical
copy, often referred to as soft copy, collaborator in the evolution of PACS in president. “It not only has helped
in the reading room and the radiologists community electronically. These images
can be accessed instantly. Two, the Maine. As imaging matured alongside ensure the delivery of radiology services
would consult with the leading could be seen simultaneously by
capabilities of off-site viewing and CAT scanning, MRI, ultrasound, to our partners’ sites, but it has also
physician. Although a laborious process multiple providers. The creation of such a
reporting is a monumental advancement nuclear medicine, and interventional evolved into a creative solution for
by today’s standards, these interactions database allowed larger hospitals to offer
in radiology and medicine as a whole. radiology, digital images were typically improving radiologist satisfaction and
provided a unique opportunity smaller hospitals a chance to collaborate
Practitioners are able to be at different at the epicenter of diagnosis and for addressing staffing shortages in the
to collaborate and gain a greater and to improve access and technological
physical locations while having access to treatment. Integrating digital images current labor market.”
understanding about clinical cases. capability. Smaller hospitals were offered
the same information, simultaneously. with electronic health records allowed
Corey Couto, MD, radiologist and Michael Quinn, MD, radiologist and chairman of the
service lines and access to care to SHCP Board of Directors.
The PACS or, more generally, medical managing director of the radiology
expand as the overall delivery of patient
images, are integrated with health north division, also appreciates
care was improved.
information systems. These include the benefits of the teleradiology
hospital information systems (HIS), SPECTRUM RADIOLOGY IN 2021 model. “Maine has a lot of rural areas,
electronic medical records (EMR),
In 2021, Spectrum’s radiology division
particularly in the northern part of The teleradiology
practice management systems (PM), and the state,” he says. “Teleradiology is
has continued to expand with its
radiology information systems (RIS). This immensely helpful in allowing us to model provides a wide
insourced teleradiology program.
integration has led to improved patient improve patient care by providing
experience, physician satisfaction, and
The program allows for radiologists
increased access to subspecialists
range of advantages.”
to interpret studies from Maine sites
care delivery. It has also allowed for and an electronic pathway to triage
improved management of workflow
of service while based in Florida,
care to other subspecialists, such as –Michael Quinn, MD
Colorado, Michigan, Connecticut, and
and has facilitated more frequent neuroradiology, nuclear medicine, and
Massachusetts. Through this program,
collaboration and case reviews among a cardiac imaging.”
Spectrum teleradiologists receive
wide group of practitioners.
images to interpret from facilities that Spectrum radiology provides
are outside the radiologists’ geographic teleradiology solutions throughout
Digital images integrated with electronic health records expand service lines and access to care and improve the state.
the overall delivery of patient care.
vicinity. The radiologists are able
to view the images and provide a
2002 Anesthesiologist Charles Higgins, MD,
creates Spectrum’s regional block program. 2003
Spectrum creates its first fully outsourced billing
and management services partnership with 2004 Spectrum employs nearly 200 physicians.
McKesson / Per Se Technologies.
M E ANWH I LE . . . U.S. wins 34 medals in Winter Olympics in Salt Lake City. Health Savings Accounts are established. Wristbands for a Cause are introduced.
10 JOINT REPLACEMENT & PAIN MANAGEMENT 11
Since its inception, Spectrum Perioperatively, there have been a Orion Nohr, MD, Spectrum Patients undergoing joint SPECTRUM REGIONAL
has been known for number of improvements that enhance anesthesiologist, leads Spectrum’s BLOCK PROGRAM
collaboration and innovation. patient safety and outcomes. Notably, Regional Block Program. The Regional surgery 25 years ago
The Spectrum Regional Block
Over the past quarter century, these materials have evolved, which has Block Program offers services at 10
significantly improved the durability of locations throughout Maine, including
would typically be in the Program was created by Charles
tenets have manifested themselves
Higgins, MD, in 2002 to provide an
in a myriad of ways. Today, we see a replacement joints. In hip replacement, the Spectrum Ambulatory Surgery hospital for one to two effective, safe method for peri- and
high degree of collaboration between for example, ceramic or polyethylene Center (ASC), where Spectrum
post-operative pain management.
our orthopaedic surgeons and our bearings are now commonly used. In orthopaedic surgeons perform most of days, then discharged into
With regional blocks, Spectrum
anesthesiologists, as they work together the past two decades, we have also their outpatient surgeries.
seen a dramatic increase in the number
a rehabilitation facility. anesthesiologists inject a local
to provide patients with high-quality
“Regional blocks can help reduce stress anesthetic near a nerve, which
surgical care. of younger patients undergoing joint
on the body when you undergo surgery, Today, a hospital stay effectively “blocks” the nerve from
replacement. As the average age of
Joint replacement offers an excellent such as joint replacement,” says Dr. carrying pain messages to the brain.
patients shifts downward, the longevity of more than one night
example of how Spectrum physicians Nohr. “When you have a nerve block Regional blocks are often used
of the replacement joint becomes
James Kuhn, MD, orthopaedic surgeon
collaborate to deliver services. Spectrum
increasingly important. With the
you often need less anesthetic during would be unusual, and in concert with other anesthetics
Orthopaedics Surgical patients take surgery and less pain medication both and/or pain control medications.
advantage of many advances in medical
latest materials, it is not uncommon
during and after surgery. You may also many patients go home Patients who receive nerve blocks
for patients to expect a replacement
care, beginning even before they enter have a shorter recovery period and typically require less supplemental
We now have patient joint to last 20 years or more. This is a the same day. When
the surgical suite. better pain relief.” medication, thereby minimizing
significant improvement from the not-
education materials to James Kuhn, MD, an orthopaedic so-distant past when metal-on-plastic
surgeries are performed in side effects, such as nausea
or drowsiness. Patients often
help ensure that patients surgeon at Spectrum Orthopaedics, prosthetics would often require revision
When you have a an ASC, patients can avoid experience a reduced recovery
notes that the improved focus on surgery 10-15 years after implantation.
time, allowing them to begin earlier
and their support teams patient experience is among the most nerve block you often the hospital altogether.
Regional anesthetic techniques, also participation in physical therapy or
notable changes in joint replacement
are prepared for what surgery over the years. “Preparation
known as “blocks,” have also improved,
need less anesthetic other rehabilitative treatments.
both peri- and postoperatively. During “Not all patients are candidates to have
for surgery is much better than it
to expect with joint surgery, Spectrum anesthesiologists during surgery and less surgery in an outpatient setting, such
used to be. We now have patient as the Spectrum ASC, due to health
typically administer spinal anesthetics
replacement.” education materials to help ensure
or regional blocks as opposed to full pain medication both reasons or insurance coverage. But
that patients and their support teams having joint replacement surgery done
anesthesia, which offers many enhanced
–James Kuhn, MD are prepared for what to expect with
safety benefits, such as lower risk of
during and after surgery. at our ASC is a great option for many,”
joint replacement,” says Dr. Kuhn. “We says Dr. Kuhn. “Patients go home the
also frequently refer patients to ‘pre-
infections and blood clots. Peripheral You may also have a
nerve blocks are also often used post- same day and it’s much less expensive Orion Nohr, MD, anesthesiologist and director
habilitation’ to make sure they are able
surgically to control pain for up to 48 shorter recovery period for patients and insurers.” of Spectrum’s Regional Block Program
to do things such as use a walker and
hours. When used in combination with The Regional Block Program is
navigate stairs, in addition to optimizing
multi-modal analgesia (i.e., medications
and better pain relief.”
currently available in 10 locations
their physical condition before surgery.”
from different classes), this leads to throughout Maine and is led by
lower narcotics usage.
–Orion Nohr, MD
Orion Nohr, MD.
2005 Vascular & Interventional Physicians
integrates into Spectrum. 2006 Spectrum elects Robert Isler, MD, to a
three-year term as board president. 2007 The Spectrum radiation oncology division begins offering
intensity- modulated radiation therapy (IMRT).
M E ANWH I LE . . . YouTube is launched. Twitter is launched. First iPhone is released.
12 INDIVIDUALIZED CARE DRIVEN BY PRECISION MEDICINE 13
Over its 25-year history, the tremendous advances over the past 25 tumor boards will play an care, including the initial diagnosis of gynecologic oncologists and genetic process, Spectrum established a
Spectrum pathology division years, particularly in the last decade. some cancers, prognostic assessment, counselors to establish an algorithm “navigator” position who streamlines
has been at the forefront of new The evolution of molecular genetic increasingly important role prediction of response to therapy, to incorporate first-line PARP- the ordering and reporting
developments in molecular testing and testing has led to the development and long-term monitoring of disease. inhibitor therapy as part of routine processes, gathers all background
of “precision medicine,” which
in developing treatment They are also regularly used to identify cancer care. PARP – or poly (ADB- clinical information required by
has led many collaborative initiatives to
advance diagnostic medicine and cancer guides physicians and researchers in approaches that can help hereditary cases, which not only ribose) polymerase – is a protein that insurers, and assists with specimen
care. Such initiatives have included developing customized care plans benefits the patient, but also influences helps repair damaged DNA. management.
co-directing a Molecular Tumor Board, based on an individual’s genetics, improve outcomes based the healthcare of family members. Most L aunching a system for testing reating testing alogrithms used in
C
in which Spectrum pathology fully environment, and lifestyle. Molecular recently, molecular tests are under
and genetic testing of tumor tissue
on individual patient needs.” development for early detection of a
all newly diagnosed lung the diagnosis and management of
interprets comprehensive tumor testing adenocarcinomas for biomarkers cardiomyopathies with reduced cost
for patients with a wide variety of cancer has evolved from a step in the care of wide range of cancers, many of which that determine the most appropriate and turnaround time.
diagnoses. These detailed case reviews a small proportion of cancer patients currently have no other early detection first-line therapy. As part of this
The origins of precision medicine were
involve the analysis of anywhere from in the later stages of treatment to a mechanism.
based in oncology, and breast cancer
50 to 700 genes to help oncologists fundamental part of all aspects of the While molecular genetic tests have
more specifically. As molecular testing
care plan for many cancer patients. their origin and greatest clinical utility
evolved, physicians were better able Spectrum’s activities with the Precision Medicine
to stratify breast cancer diagnoses and in oncology, this aspect of precision
identify potential genetic causes or medicine is also becoming part of Council are quickly expanding to other areas of
As molecular and genetic protagonists of the cancer. An early routine care in other areas of medicine
example of this is HER2/neu, a protein such as cardiology, endocrinology, medicine,“ says Dr. Christman. “We are continuously
testing continues to infectious disease, benign hematology,
that is involved in the growth of normal exploring the clinical utility
evolve, we will have an breast cell tissues, but if overproduced pulmonology, and more.
can cause breast cells to replicate The Spectrum pathology division, of new molecular tests,
expanded ability to treat too quickly. The drug Herceptin was including pathologist Robert Christman,
Karen Rasmussen, PhD, FACMG, clinical geneticist in
developed as one of the first targeted MD, plays a central role in the newly
problem-solving around
Spectrum’s pathology division cancers using biologically
agents to block the effects of the HER2 formed MaineHealth Precision Medicine those tests, educating
choose between conventional therapies,
targeted agents based protein and was approved in the late Council and Precision Oncology
off-label molecularly targeted therapies,
1990s to treat HER2+ breast cancers. Committee, with a goal of expanding clinicians, creating efficient
and clinical trials -- both locally available on a tumor’s underlying Following the success of Herceptin, molecular testing in several areas of
and nationwide. Karen Rasmussen,
several other targeted cancer therapy medicine. In 2021, Spectrum played an
workflows, tackling
PhD, FACMG, clinical geneticist in the genetic-driver mutations,” Robert Christman, MD, pathologist
agents were approved in subsequent integral role in a variety of initiatives, reimbursement issues, and
Spectrum pathology division, runs the
says Dr. Rasmussen. “As years for breast as well as other including:
monthly sessions with local oncologists.
types of cancers, such as chronic
L aunching a multi-gene assay for
assisting our clinician colleagues in getting the right test
Based on the molecular interpretations this type of precision myeloid leukemia (CML) and lung
provided by Dr. Rasmussen, the group
adenocarcinomas.
diagnosis, prognosis, and therapeutic at the right time for their patients.”
discusses the pros and cons of various medicine becomes more guidance in some hematologic
Molecular biomarkers are now cancers.
therapeutic options.
prevalent, molecular routinely used in all phases of cancer
Molecular and genetic testing has seen Working together with MMC
Blood Management initiatives, led by Spectrum
2008 Pathology, leads to a 30% reduction in the use of
red blood cell transfusions.
2009 Spectrum radiologists overread more than 20,000 cases –
more than any other group in northern New England. 2010 First Spectrum Scholar is named, granting scholarship funds
for study at MMC–Tufts University School of Medicine.
The HITECH act calls for “meaningful
M E ANWH I LE . . . Retail DNA tests are made available to the public. The ACA is signed into law.
use” of electronic health records.
14 TRANSFORMING PATIENT CARE 15
Twenty-five years ago, The system provides advanced commitment to delivering high-quality Peter “Rob” Hubbs, MD, a Spectrum
electronic medical records functionality that encompasses the healthcare for years to come. anesthesiologist, serves on several
were largely unheard of. entire patient journey, including MaineHealth IT governance
Healthcare providers documented registration, prior authorization, check- committees and is the informatics
patient information via paper medical in, consultations with various providers, As technology evolves, medical director for MaineHealth.
records. These records were then stored physical therapy, and surgery, to He has led many quality
so does our ability to
in a medical office or a warehouse, and name a few. A large team of clinicians, improvement and regulatory
needed to be faxed, scanned, or mailed technologists, and staff collaborated in provide high-quality, compliance initiatives, analytics
in order to transfer them. Paper medical this very complex initiative. projects, and provider efficiency
records required a very cumbersome patient-centered programs for Epic, the EHR utilized
In October, the NextGen PM system
process for documenting and storing by MaineHealth.
went live for our orthopaedic and care,” says Bryce Wolf,
patient care data, which led to complex
vascular interventional radiology
workflows, challenges with sharing
divisions, and the EHR system went live
MD, orthopaedic
information with other practices, and
Melissa Wise, accounts receivable lead, conducts an EHR/PM training session with her colleague, Shana Qualey. for 25% of our orthopaedic providers. surgeon. “With the new
sometimes errors in patient treatment
or diagnoses. The new platform will help Spectrum
to schedule appointments and track the patient. EHRs are built to share
facilitate integration between clinics
functionality the EHR and
insurance and patient billing payments. information between healthcare
As early as the 1960s, medical practices
began implementing new ways to store
organizations, including laboratories and external providers and will provide PM systems bring, we are Peter “Rob” Hubbs, MD, anesthesiologist
It is important to understand the Spectrum physicians and clinicians with
and specialists. The information in the
and share medical information. This also difference between electronic medical
EHR also moves with the patient, to enhanced tools to provide excellent better able to consistently Dr. Hubbs is also the chair of
included the beginning of transitioning record (EMR) and electronic health the Spectrum Technology
patient care.
medical film to digital images, and record (EHR) systems. The two terms
specialists’ offices, the hospital, and deliver the most Committee, which assists the
nursing homes. The first phase of the implementation
hospital-based “reading rooms” are used interchangeably, but they are Board of Directors in oversight
evolving into digital libraries. required long hours and a great deal appropriate treatment
not the same, per the Office of National EHR and EMR systems significantly of technology and adoption of
of collaboration across a wide range of
Today, electronic medical record (EMR)
Coordinator for Health Information improve both clinical and business protocols practice-wide, innovative technologies. The next
Technology. EMRs are the digital version workflows, which help healthcare Spectrum team members. The effort phase of technology adoptions
systems are integral to the provision
of the paper charts used by clinicians practitioners deliver enhanced was reflective of the organization’s improve our diagnostic at Spectrum will be focused
of medical care. These systems help
until recently. They contain a patient's patient care. on innovation with the help of
facilitate integration and support capability, become
medical history, and the treatments technology, also referred to as
medical offices and centers. EMR systems HERE AT SPECTRUM . . .
allow providers and clinicians to access
the patient has undergone. EMRs were more effective, improve digital transformation. Spectrum
initially developed and implemented In keeping with the organization’s collects and stores voluminous
patient information, provider notes, and
with the intent to replace paper records, commitment to leverage technology our efficiency, and, data, not just from our encounters
clinical reporting. When paired with a
and stayed within each practice, in to improve patient care, Spectrum’s with patients, but also from the
practice management (PM) system, the most importantly,
much the same way paper records orthopaedic and vascular and activities we perform. Spectrum’s
systems have the ability to hold patients’
clinical, demographic, and insurance
did. EHRs include everything an EMR interventional radiology divisions enhance the overall ability to "curate" this data, and to
does, but have additional functionality began transitioning to a new EHR and understand it and analyze it, will
information, and include functionality
that is focused on the total health of PM earlier this year through NextGen Bryce Wolf, MD, orthopaedic surgeon, provided phy- patient experience.” enable the organization to provide
that allows the medical office team sician leadership throughout the implementation of
Healthcare. the new EHR/PM systems. better care and be more efficient.
2011 Specialty Solutions is formed by Spectrum
and three other Maine physician groups. 2012 Pathology Medical Group joins Spectrum.
2013 Spectrum co-founder, Michael Pancoe, MD, chairs fundraising
campaign to create new pediatric treatment space at EMMC.
USDA updates the food pyramid Grumpy Cat’s (real name Tardar 1.3 million (+/-) inpatient joint replacement
M E ANWH I LE . . .
emphasizing grains and vegetables. Sauce) first photo is posted. procedures were performed in the U.S.
16 TARGETED CANCER CARE 17
At the beginning of the However, with the advent of pinpoint dose delivery. In the early treatment, the delivery of “stereotactic has allowed oncologists to improve dose delivered to a tumor can be
20th century, not long after computer technology, advanced 2000s, this method was improved by radiosurgery” (SRS) or “stereotactic their delivery of care by curing or escalated much higher than what would
radiation was first used imaging, and modern-day linear varying not only the angle and shape ablative” (SRT, SBRT, or SABR) techniques palliating patients with cancer in the be possible or safe using external x-ray-
to image and diagnose cancer, accelerators, radiation oncology has of beam delivery, but also the intensity when appropriate, and minimize side most efficient, precise, and tolerable based radiation treatment.
radiologists discovered that delivering been revolutionized. These changes of radiation dose delivered, using a effects and risks by bending dose out of way possible. Spectrum’s radiation
“Gynecologic brachytherapy is an
doses of radiation to the same spot over have allowed oncologists to define technique called Intensity-modulated nearby normal tissue. oncology team treats adults and
integral component of curative-intent
several days could reduce the size the not only a tumor’s exact location and radiation therapy (IMRT). IMRT allows children with all types of cancer and
SPECTRUM’S IMPACT treatment for women with high risk
tumors and thereby treat cancer. With structure, but also the same for critical the radiation oncologist to essentially also uses radiation therapy to treat
or recurrent endometrial cancers, and
that, the field of radiation oncology structures nearby at risk for damage “paint” the radiation dose within Ian Bristol, MD, joined Spectrum 15 benign conditions. Spectrum offers
is clearly associated with improved
was born. In its infancy, the techniques from radiation exposure. Sophisticated the patient, such that high doses are years ago, and has had the opportunity a full range of today’s most advanced
overall survival in women with locally
and treatments were rudimentary, computer algorithms are now utilized delivered to tumor cells, intermediate to witness firsthand the exciting types of radiation therapy including
advanced cervical cancers,” states
to determine the exact amount of doses to at-risk tissue, and very low advances within the field of radiation VMAT, IMRT, SRS, SRT, SBRT, and
radiation the oncologist wants to doses to nearby healthy tissue. oncology and at Spectrum specifically. brachytherapy.
administer. Treatment is delivered “Here at Spectrum, we offer cutting-
Volumetric intensity modulated arc In 2020, radiation oncologist Whitney
to patients with extreme accuracy edge treatment with a community feel.
therapy (VMAT) is a technique that Beeler, MD, joined Spectrum Healthcare
and precision by utilizing intensity There is nothing we cannot do that a
improves on IMRT by delivering the Partners after recently graduating as
modulation and daily imaging of the major hospital in a metropolitan city
radiation dose continuously, from chief resident from the highly regarded
patient in the treatment position, with can do, with very few exceptions.”
multiple degrees, as the treatment University of Michigan Radiation
alignment directly to a patient’s tumor
machine rotates around the patient. Spectrum Healthcare Partners, through Oncology program. Dr. Beeler brings
or their internal anatomy. Modern day
our partnership with Maine Medical extensive experience using the latest
outcomes reflect these changes as well.
Ian Bristol, MD, served as the managing director of
Center’s Cancer Institute, offers today’s technologies, including SBRT and Whitney Beeler, MD, is a radiation oncologist with a
the radiation oncology division from 2016 to 2021.
Cancer cure rates are on the rise and Our board-certified and most advanced radiation oncology SRS, to treat cancer patients. She also clinical interest in treating gynecological cancers.
severe or life-threatening toxicities
care. Every year, our board-certified and has a particular clinical interest in
they were based on two-dimensional are rare. fellowship-trained radiation fellowship-trained oncologists deliver performing brachytherapy for patients Dr. Beeler. “Despite its importance,
imaging, hand calculations, and
alignment only to a patient’s surface
Changes to the field began in the oncologists deliver over over 30,000 treatments to adults and with gynecologic cancer and currently however, this technique is underutilized
1990s, when oncologists started using children. We are also the only radiation plays an important role in delivering this across the world and even within the
anatomy. Treatments were delivered
computer algorithms and three- 30,000 treatments to adults oncology group in the state of Maine treatment for women in Maine. U.S. due to a lack of resources, physician
exclusively with radioactive isotopes like
dimensional conformal therapies to that is a member of NRG Oncology. expertise, and socioeconomic factors.
Cobalt 60, unlike what can be achieved and children every year. NRG Oncology brings together several
Brachytherapy is the delivery of internal
improve treatment. Conformal radiation It is a privilege to be able to offer and
with modern-day linear accelerators. radiation using a radioactive source
therapy (CRT) uses CT images and leading research organizations to perform such a sensitive procedure for
Outcomes often reflected such that is guided by the implantation of
computer algorithms to reconstruct Image-guided radiotherapy (IGRT) conduct oncologic clinical research, my female patients, and I have no doubt
treatment delivery as well, and many catheters or needles directly into the
the location of a tumor, high-risk tissue has also improved with the ability to including phase II and phase III clinical that the quality of our team – from
patients developed severe and, at times, tumor or body cavity. This is often
(for example draining lymph node acquire low-dose CT scans while the trials, as well as formative studies to nursing, to therapists, dosimetrists,
life-threatening toxicities as a result. The performed under sedation within the
basins), and other nearby organs at risk patient is stabilized for treatment to shape future oncologic research. and physicists – translates into better
mantra in that era was “treat the room operating room, sometimes in close
in three dimensions. Radiation beams ensure that organs are aligned with outcomes for these women.”
and cone down to the patient.” The advent of technology has been conjunction with gynecologic oncology.
are matched to the shape of the tumor millimeter precision. Such techniques
revolutionary in the last 25 years and By delivering radiation internally, the
from a variety of different angles to allow for faster, more sophisticated
2014 Spectrum adds its orthopaedic division through a merger
with leading independent orthopaedic practices. 2015 Spectrum becomes largest the non-hospital-based
healthcare organization in Maine.
M E ANWH I LE . . . ALS Ice Bucket Challenge raises $115 million. Blue/black or white/gold? Dress meme debate ensues.
18 REFINING ANESTHESIOLOGY AMIDST THE OPIOID CRISIS TRAINING AND EDUCATING THE NEXT GENERATION OF CLINICIANS 19
Opioid usage has increased challenges for anesthesiologists, Although the majority of We are dedicated to our want exposure to everything,” says Dr. PHYSICAL THERAPY ROTATION
markedly since the mid-1990s. who are responsible for managing leadership in medical Hathaway. “Our program provides a case PROGRAM
In 2017, the U.S. Department of Health a patient’s perioperative and opioid prescriptions are for education. Clinicians from all of our diversity and complexity that is generally
To establish strong relationships with
and Human Services declared the postoperative pain. divisions are committed to teaching, only found in major urban centers. It’s a
the treatment of chronic wonderful opportunity for fellows and
the communities we serve, our physical
opioid crisis a public health emergency training, and mentoring medical
Aurora Quaye, MD, is a Spectrum therapy centers offer rotations to
and by 2019, it was estimated that more
anesthesiologist and researcher who pain, approximately 7% students and residents. Many of our for our state.”
graduate and undergraduate students.
than 10 million people had misused physicians serve as faculty at the region’s
also serves as a faculty scientist at the VASCULAR INTERVENTIONAL
prescription opioids in the prior year. of all opioid prescriptions medical schools, and several as residency The rotations are available to students
MMCRI Center for Outcomes Research RADIOLOGY RESIDENCY
The increasing number of patients with program directors at local area hospitals. who are currently enrolled in – or
and Evaluation (CORE). Dr. Quaye’s work are written by orthopaedic PROGRAM
are applying to – a physical therapy
opioid use disorder (OUD) has complex
focuses on opioid reduction strategies, ANESTHESIA DIVISION
implications for medical professionals
including studying novel approaches surgeons, so this is an CREATES ADULT
When the Maine Medical Center program. The program prepares
who treat patients with acute or chronic (MMC) Integrated Interventional students for practice in a specialty area,
for safely and effectively managing
important population to CARDIOTHORACIC Radiology (IR) Residency Program was
pain, including particularly unique such as sports medicine, and provides an
perioperative and postoperative FELLOWSHIP established, the program was among opportunity for students to gain hands-
pain for those with OUD. Dr. Quaye study,” says Dr. Quaye. To expand the delivery of high-quality the first 12 programs accredited by on experience in treating patients.
and her team are working on several
“The existing literature suggests that care in the communities we serve, the Accreditation Council for Graduate
prospective and retrospective Our graduate students complete each
patients who were taking opioids prior our anesthesiology division recently Medical Education (ACGME).
studies, while also identifying of their three rotations at one of our
to joint surgery have an increased risk expanded its teaching and education
multidisciplinary research collaboration Joseph Gerding, MD, is a Spectrum physical therapy centers and are paired
for persistent opioid use, but there is services to include fellowship training
opportunities with medical and surgical radiologist and the program director of with one of our licensed clinicians.
an evidence gap regarding risk factors in Adult Cardiothoracic Anesthesiology.
subspecialties. the IR Residency Program. The program Our undergraduate students join our
for those who were not. Our research Jessica Hathaway, MD, led the initiative
faculty consists of over 40 radiologists, clinicians for observation to prepare
Dr. Quaye is currently conducting a will focus on patients who did not use to establish the first cardiothoracic
including eight interventional them for applying to a graduate physical
retrospective study that aims to identify opioids 12 months prior to surgery to fellowship program in Maine at Maine
radiologists and one endovascular therapy program.
Aurora Quaye, MD, Spectrum risk factors for patients developing determine other potential predictors Medical Center (MMC). The program
surgical neuroradiologist.
anesthesiologist and faculty scientist at OUD following total joint replacement for persistent opioid use or OUD. The provides robust training in cardiac, We are affiliated with the University of
MMC’s Centers for Outcome Research and surgery. The study seeks to determine results will help inform best practices thoracic, and vascular anesthesiology The program allows only one resident New England, University of Connecticut,
Evaluation (CORE) focuses her research the incidence of persistent opioid use for anesthesia and perioperative pain as well as critical care medicine with per year, and permits the internship to be George Washington University, and Saint
on best practices for perioperative opioid following these surgeries, identify management, and potentially improve didactic, clinical, and project-based done with the surgical program at MMC. Joseph’s College of Maine.
reduction. Her work has been published in predictors and characteristics of patient outcomes.” learning opportunities. This allows the intern to incorporate
medical journals such as the International persistent opioid use, and evaluate themselves into the clinical team at large
Journal of Obstetrical Anesthesia, Journal Dr. Quaye will be conducting this study However, there are just five other
whether perioperative regional and improve our communication across
of Addiction Medicine, Seminars in through the Observational Health programs in New England, all of which
anesthesia or joint type influences the departments.
Cardiothoracic & Vascular Anesthesia, Data Sciences and Informatics network are Boston-based. The new program at
risk of OUD.
(OHDSI – pronounced “odyssey”). OHDSI Maine Medical Center provides a unique The diverse patient population
and the Journal of Clinical Pharmacology
includes researchers from 30 countries opportunity for fellows because of its enables the residents to perform a
(accepted 11/7/2021).
and health records for approximately significant volume of patients and range comprehensive array of IR procedures
600 million patients worldwide. of diseases in a less urban center. “As a that rivals those usually only performed
student of cardiothoracic anesthesia, you at major academic institutions.
Megan Cutter, DPT, and physical therapy manager at
Spectrum Orthopaedics Windham.
2016 Maine’s first orthopaedic walk-in care facility,
OrthoAccess, opens in Portland. 2017 Spectrum Medical Group becomes
Spectrum Healthcare Partners.
M E ANWH I LE . . . Fidget spinners are the hot Christmas toy. US DHHS declares the opioid crisis a public health emergency.20 QUALITY SMSC: COMPREHENSIVE PRACTICE MANAGEMENT SERVICES ACROSS THE U.S. 21
SPECTRUM OFFERS COVID One of the four tenets of patient data into a single platform, the Spectrum Healthcare Partners clients from Maine to Colorado and
VACCINE CLINICS the Institute for Healthcare new system includes a patient portal partnered with MBMS – a providing a diverse range of services,
Improvement’s Quadruple Aim – that will allow patients to engage with nationwide leader in RCM and medical including ambulatory surgery center
To help expand access and
and Spectrum’s quality improvement the practice more easily. billing services – in 2019 to form (ASC) management, marketing and SMSC was a tremendous
improve vaccination rates in
efforts – is improved patient experience. Spectrum Management Services communications, medical staff services,
Maine, Spectrum offered multiple Some of the features of the new portal
payor contracting, and physician
help with our payor
The quality, risk, and patient safety Company (SMSC). SMSC offers a full
COVID vaccine clinics in 2021: will include the ability to:
Moderna clinics in January/
department at Spectrum works closely suite of practice management services recruitment. contracting and negotiation
with each clinical division as well • Request or cancel appointments on either a bundled or a la carte basis.
February and April/May, and In 2021, SMSC also launched a
as other operational departments process. They performed
a Johnson & Johnson clinic in • Send and receive secure messages In the past year, SMSC has experienced new website. To learn more, visit
to help ensure that patients have
May. The clinics were staffed by with providers tremendous growth, acquiring spectrummsc.com. a comprehensive contract
a positive care experience with
Spectrum employees and local
Spectrum physicians, providers, and • View patient charts and health review of our primary
volunteers who provided vaccines
staff members. Spectrum’s efforts in records
to 386 individuals. The demand for
this regard take a variety of forms, • Request medication refills
commercial payor contracts
vaccines was very high at the time
including consistently looking for new
the clinics were offered, so they • Access a library of patient education and provided a detailed
ways to leverage technology to improve
provided a valuable service to materials
the community.
patient communication and other analysis that identified both
processes. Spectrum’s orthopaedics • View statements and billing
The vaccination rate among and interventional radiology divisions information
immediate and longer-term
Spectrum employees is 100%. recently implemented a new electronic
Over time, the functionality of the opportunities for revenue
health record (EHR) and practice
patient portal will be expanded to
management (PM) system (see story enhancement. They shared
on page 15). In addition to improving further facilitate patient engagement
clinical workflows and consolidating with the practice. specific points to use in
negotiations that I was
able to use successfully
in contract renewal
Audrey, a community member, receives her
discussions with payors.”
vaccine dose at one of Spectrum’s COVID-19
vaccine clinics in 2021.
Spectrum Management Services Company launched Learn more at SpectrumMSC.com.
–Jim Hueber, COO, Colorado
a new website in September of 2021.
Imaging Associates
2018 Spectrum employs more than 600 people, including
nearly 300 physicians and advanced practice providers. 2019 Spectrum Management Services Company is formed.
Researchers refine correlation between
M E ANWH I LE . . . The first known case of COVID-19 occurs in Wuhan, China.
specific BRCA1 mutations and breast cancer.You can also read
