ST. FRANCIS ANNOUNCES `ONE STOP' EXPANSION

St. Francis Medical Center plans a new "one stop" facility, combining doctors offices with medical laboratories and technology on the medical center campus.

The medical center's president, John Fidler, announced plans to employees Friday. Many of the details are still to come, including square footage and exactly what services would be housed in the proposed addition.

"We are not building a building," Fidler said. "We are building a new health care delivery system that is transparent between inpatient and outpatient."

Fidler believes the addition fits health care reform. It should also help entice new doctors to Cape Girardeau. He hopes to break ground this September and to see completion in November 1995.

Plans for expansion at St. Francis have been criticized by the Southeast Missouri Business Group on Health.

Robert Cranmer, president of the group, said the trouble is a lack of community involvement in the decision.

"I don't care if it's a medical office building or an outpatient surgery center, nobody has presented a case for the need. It's strictly St. Francis saying what they need.

"The message I've been trying to get out is what is the need for the community, who assesses that need and does the community really need it?" said Cranmer.

Fidler says the community needs a cost effective way to delivery health care. The proposed facility would combine equipment, technology with hospital-based services and programs. The net result is cost savings. And he asks why should a patient have to go two of three places for medical care when everything could be at one location -- St. Francis.

"At a medical office building you go to the office and see the doctor," Fidler said. "If they physician needs to do anything more than very basic lab or very basic X-ray, the patient is sent to the hospital. That's another day and another test and another process. In this case, physicians could send the patient down the hall for the test all on the same day and the same process.

Physicians are increasingly practicing in groups, he said.

"It's more cost efficient to have 20 to 30 physicians in one location," Fidler said. The new facility would offer support for paper work and other management duties.

"Their role will be to see patients," he said.

Fidler said part of the proposal is mobilizing the services and taking physicians and technicians into area communities.

Hospital officials are determining how big the expansion would need to be.

"We are looking at needs of expansion of our medical center," Fidler said.

For example, the gastrointestinal lab, which is used predominately for outpatient testing, might be moved to the new facility. That would free up space in the main hospital.

"We do outpatient surgery now," Fidler said. "One option would be to build surgery suites. Another options would be to bring patients to the building, prepare them and then take them to the hospital for surgery. We don't plan on duplicating anything unless it has reached maximum utilization."

"We are designing a system that support health care," Fidler said.

The medical center has been criticized for a lack of collaboration.

Cranmer said: "All this groups wants to get at is a community effort. We keep hearing all the talk but we never see the action plan.

"This (proposed building) has not discussed as community effort in a cooperative effort," he said. "It has not been reviewed by any business in this community -- yet."

St. Francis responded to critics in a letter to the Business Group on Health.

Fidler and Robert Hendrix, chairman of the St. Francis board, said in the letter, "When you understand the scope and purpose of our outpatient services project, you should agree that St. Francis is responding to the nationwide health care reform challenge by addressing and improving the fundamental way that health care is delivered."

They also said that Southeast's recently completed addition did little to improve the overall delivery process.

"If anything, that project represents a costly over construction program," the letter says.

Southeast Missouri Hospital Administrator James Wente declined comment Friday night.

In an accompanying chart, Southeast's occupancy rate for 1992 was placed at 51.7 percent. St. Francis's occupancy rate for that year was 62.3 percent.

Fidler also listed 11 examples of collaboration between St. Francis and Southeast, including physician recruitment, a community health care needs assessment study, community education programs, and a pediatric care program for low-income children in Cape Girardeau and Bollinger Counties.