University of Pittsburgh Medical Center

UPMC (University of Pittsburgh Medical Center)
Type Private (not-for-profit)
Industry Health care
Founded 1893
Headquarters Pittsburgh, Pennsylvania
Area served Western Pennsylvania, Italy, Ireland, Cyprus, United Kingdom, Qatar, Japan, China
Key people Jeffrey Romoff - President
Services tertiary level clinical care
rehabilitation
cancer centers
community medical facilities
retirement & long-term care
health insurance
health care management
medical information technology
Revenue $9.0 billion USD (FY 2010)[1]
Employees 54,147 (2009)[2]
Divisions Provider Services
Insurance Services
International & Commercial Services
Website http://www.upmc.com/

The University of Pittsburgh Medical Center (UPMC) is an $9 billion integrated global nonprofit health enterprise that has 54,000 employees, 20 hospitals, 4,200 licensed beds, 400 outpatient sites and doctors’ offices, a 1.5 million-member health insurance division, as well as commercial and international ventures.[3] UPMC is closely affiliated with its academic partner, the University of Pittsburgh.[4] It is considered a leading American health care provider, as it has been consistently ranked in US News & World Report "Honor Roll" of the approximately 15 to 20 best hospitals in America over the last decade.[5][6] As of 2011, UPMC ranked 12th among the best hospitals in US News & World Report and ranked in 15 of 16 specialty areas, including 9 specialties for which UPMC is in the top 10. This does not include the Children's Hospital of Pittsburgh of UPMC which ranked in the top 8 pediatric centers in a separate US News ranking.[6]

Contents

History

Origins

UPMC has its roots in the 1893 establishment of Presbyterian Hospital,[7][8] which serves as the medical center's flagship facility, and the 1886 founding of the Western Pennsylvania Medical College. Soon after its founding, the medical college became affiliated with the Western University of Pennsylvania in 1892, and in 1908, was fully integrated into the university which that same year was renamed to the University of Pittsburgh.[9][10] Already having worked out informal agreements for teaching and staffing privileges with a number of local hospitals,[11] Pitt and its School of Medicine desired to establish an academic medical center, and by the mid-1920s had formed a plan with a coalition of city hospitals to have them relocate to the Oakland neighborhood of the city that the university had itself moved to in 1909.[12] The University provided Presbyterian Hospital, then located on the North Side, with a tract of land on its campus for construction of a new hospital which broke ground in 1930 and was subsequently opened in 1938.[8] By the end of the 1930s, the University of Pittsburgh had helped to form the "University Medical Center" which included Falk Clinic, Children's, Eye and Ear, Libby Steele Magee, Presbyterian General, and Women's Hospital, as well as the planned Municipal Hospital.[13][14][15][16] In 1949, a new affiliation agreement between the University and Presbyterian Hospital established a new three-tiered mission of patient care, research, and education and by 1951, the hospital name changed to Presbyterian University Hospital in order to reflect its close ties with the University of Pittsburgh.[8] Through the years, the University and the hospitals moved toward an ever-tightening alliance. In 1965, the University, Western Psychiatric Institute and Clinic which was managed by the School of Medicine, Presbyterian-University, Magee and Women's, Eye and Ear, and Children's Hospitals incorporated the University Health Center of Pittsburgh (UHCP). In 1969, Montefiore Hospital joined UHCP.[11] In the 1970s, a new model of administration, in which clinical revenues were invested into research, was implemented at Western Psychiatric under the leadership of Thomas Detre. After guiding the psychiatric institute to become one of the largest recipients of National Institute of Health funding, Detre assumed leadership overseeing all six of the University's schools of health sciences in the early 1980s. Implementing the same administrative model in those units, the collective schools of the health sciences and medical center were ultimately transformed into one of the largest centers for biomedical research in the nation.[17]

Merger and expansion

Beginning in 1986, members of the University Health Center including Presbyterian University Hospital, Falk Clinic, the Pittsburgh Cancer Institute and Eye & Ear Hospital began to consolidate. The consolidated group, re-termed the Medical and Health Care Division (MHCD) and led by Detre, became closely linked administratively, although Presbyterian University Hospital remained a separate entity.[18] In 1990, MHCD acquired neighboring Montefiore Hospital which it merged with Presbyterian University Hospital to form the entity that was then renamed as the "University of Pittsburgh Medical Center" (shortened to UPMC), which was the first time the current name of the medical center was officially used.[18] UPMC then began to form a network of affiliated specialty and community hospitals in 1994 termed the Tri-State Health System and established a for-profit health insurance division, UPMC Health Plan, which contracted with these hospitals.[19] In 1996, UPMC had moved to acquire South Side, Aliquippa and Braddock hospitals. Meanwhile, UPMC began to merge with several of the already affiliated Tri-State hospitals including St. Margaret Memorial, Shadyside, and Passavant hospitals in 1997 and Magee-Womens Hospital in 1998.[19] The acquisition and mergers of hospitals morphed the Tri-State Health System into a consolidation of hospitals that currently makes up a significant portion of the UPMC health system. Due to its immense growth of the medical center, as well as the University's concerns regarding the financial risks associated with its faculty practice plans in the face of national changes in health care reimbursements, the University of Pittsburgh and UPMC restructured their relationship and legally separated in 1998 thus launching UPMC as an independent nonprofit corporation.[20] The University consolidated its physicians' practice plans and transferred them, along with the university's hospital management functions, to UPMC, with UPMC providing ongoing financial support to the University and its academic missions in return. The result was a mutually exclusive partnership of close affiliation formalized by a series of interrelated agreements and mutual executive oversights, which includes the sharing of numerous board members.[20] This created a collaborative and coordinated decision-making model in which UPMC oversees all clinical activity, while the University of Pittsburgh remains the guardian of all academic priorities, particularly faculty-based research.[19]

Expansion of UPMC continued in 2001 as Children's Hospital of Pittsburgh began merging with UPMC.[7] Since then, UPMC's growth has continued, including a merger with Mercy Hospital in 2008, the opening of new Children's Hospital facilities in 2009, the integration of Hamot Medical Center in Erie, Pennsylvania in 2011,[21] and the continued expansion of overseas operations and for-profit business ventures. UPMC now operates approximately 20 academic, community, and specialty hospitals in Western Pennsylvania, as well as 400 outpatient sites, more than 50 facilities for physical, occupational, speech and specialty therapies, and 14 retirement and long-term care site, along with its international and for-profit ventures.[22]

Among the more renown individuals who have worked with the University of Pittsburgh's medical center through its history are Jonas Salk who developed the polio vaccine while at the university, and Thomas Starzl who perfected transplant surgeries there. It has also provided care to many celebrities, including Pennsylvania two-term governor and 1996 Presidential candidate Robert P. Casey for cancer, 10,000 Maniacs guitarist and founder Robert Buck for liver disease and Pittsburgh Mayor Bob O'Connor for lymphoma.

Operations

Administratively headquartered in the top five floors of the U.S. Steel Tower in Pittsburgh's Central Business District, UPMC operates as a complete and integrated health provider system that, although is legally separate from the University of Pittsburgh, remains closely affiliated with the university and its Schools of the Health Sciences including the existence of mutual board memberships and subsidization of the university's academic programs.[4] Under a collaborative and coordinated decision-making model, UPMC oversees all clinical activity, including a consolidated physicians' practice plan consisting of university faculty, while the University of Pittsburgh remains the guardian of all academic priorities, particularly faculty-based research.[20] UPMC is composed of three major operating components: Provider Services, Insurance Services, and International and Commercial Services.[23] The later two divisions include the for-profit health insurance company (UPMC Health Plan) and a for-profit International and Commercial Services Division that seeks to bring health care, management, and technologies to market throughout the world. UPMC is Western Pennsylvania's largest employer, and second in the state only to Wal-Mart.[7]

Provider Services Division

UPMC's Provider Services consists of an array of clinical capabilities that includes hospitals, specialty service lines (including transplantation, behavioral health, cancer care, children's health, women's health, and rehabilitation services among other centers, institutes, and services), contract services (emergency medicine, pharmacy, and laboratory), supporting foundations, captive insurance programs, and more than 2,700 employed physicians with associated practices. Hospital activity is categorized in four distinct groups: 1. academic hospitals that provide comprehensive clinical services and specialty services and that are the primary academic and teaching centers; 2. community hospitals that provide core clinical services to suburban populations; 3. regional hospitals that provide clinical core services to broader areas of the Western Pennsylvania region; and 4. pre- and post-acute care capabilities that include a network of home health services (UPMC HomeCare) and a network of senior living facilities (UPMC Senior Communities).[23][24]

Insurance Services Division

UPMC Insurance Services, operating under the umbrella UPMC Health Plan brand, was founded in 1998 and includes various for-profit and non-profit health care financing initiatives.[25] The integrated products of the UPMC Insurance Services Division include UPMC Health Plan (HMO), UPMC Health Network (PPO), UPMC Work Partners (workers' compensation and disability for employers), UPMC for Life (Medicare products), UPMC for You (HMO for Medical Assistance beneficiaries), and Community Care Behavioral Health Organization (a non-profit behavioral health PPO for Medical Assistance beneficiaries).[23][26] These products combine to offer a full range of HMOs, PPOs, and EPOs for group health insurance, Medicare, CHIP, Medical Assistance, behavioral health, employee assistance, and workers' compensation products and services. UPMC also offers offers consumer-directed health plans like health savings accounts and health reimbursement arrangements.[25] UPMC's provider networks total more than 80 hospitals and more than 7,500 physicians in a 29-county region,and has over 1.46 million members making it the second-largest insurer in Western Pennsylvania.[27] It is also ranked as one of the top commercial health plans in the United States according to U.S. News & World Report.[28] Also included in the Health Services Division are LifeSolutions, an employee assistance program; EBenefits Solutions, a web-based human resources consulting and benefits administration services; and Askesis Development Group, a software development group for behavioral health care.[27]

International and Commercial Services Division

UPMC's International and Commercial Services Division (ICSD) actively manages UPMC's for-profit companies that seek to commercialize its expertise in health care, advanced technologies, and management skills to global markets. Its stated goal is "to advance UPMC’s mission of positively transforming the way health care is provided in the U.S. and abroad, while revitalizing the economy of western Pennsylvania."[29] ICSD comprises operations in five areas: clinical services management, infrastructure consultation (with collaborations with companies such as dbMotion), strategic and commercial product development partnerships with companies such as IBM and Alcatel-Lucent, translational services, and national security and public health which includes UPMC's Center for Biosecurity that is dedicated to improving the country’s resilience to major biological threats.[30][31]

Facilities

UPMC currently operates approximately 20 academic, community, and specialty hospitals, as well as 400 outpatient sites, more than 50 facilities for physical, occupational, speech and specialty therapies, and 14 retirement and long-term care site.[22]

Tertiary hospitals

These following tertiary facilities represent the core of UPMC's academic, teaching, trauma, specialty and research-related hospitals.

UPMC Presbyterian Shadyside

UPMC's flagship medical entity is UPMC Presbyterian Shadyside which includes UPMC Presbyterian and the physically conjoined UPMC Ear & Eye and UPMC Montefiore hospitals located in the midst of the University of Pittsburgh's campus in the Oakland neighborhood of Pittsburgh. It also encompasses UPMC Shadyside, which includes the University of Pittsburgh Cancer Institute in the UPMC Hillman Cancer Center. These facilities are located approximately 1.5 miles (2.4 km) from the Oakland-based hospitals in the adjacent neighborhood of Shadyside. Also part of UPMC Presbyterian Shadyside is the UPMC Sports Performance Complex, located less than 2 miles (3.2 km) from the Oakland-based facilities on Pittsburgh's South Side.

UPMC Presbyterian

UPMC Presbyterian is the historical and academic center of UPMC and is physically attached to primary facility of the University of Pittsburgh School of Medicine, Scaife Hall. Located in Oakland, the hospital has 1,602 beds and includes a Level I Trauma Center. Listed among Becker's Hospital Review 50 Best Hospitals in America,[32] UPMC Presbyterian's specialties include organ transplantation, cardiology, trauma, gastroenterology, and neurosurgery. The School of Medicine uses UPMC Presbyterian for research and graduate programs.[33][34]

UPMC Shadyside

UPMC Shadyside is part of UPMC's flagship medical entity and is located in Pittsburgh's Shadyside neighborhood, with 517 beds and nearly 1,000 primary care physicians.[35] Founded in as the Pittsburgh Homeopathic Hospital, it changed it's name to that of the neighborhood of Shadyside on May 12, 1938. Shadyside agreed to be bought by UPMC on June 5, 1996. UPMC Shadyside is home to the Hillman Cancer Center, home of the University of Pittsburgh Cancer Institute.

UPMC Eye & Ear Institute

UPMC Eye & Ear Institute is located in the Oakland neighborhood of Pittsburgh and is conjoined with the medical complex housing UPMC Presbyterian, UPMC Montefiore, the University of Pittsburgh School of Medicine, and associated medical research towers. UPMC Ear & Eye Institute is one of a few centers in the nation dedicated entirely to the management of problems related to otolaryngology and ophthalmology

UPMC Montefiore

UPMC Montefiore, part of UPMC Presbyterian, was founded as Montefiore Hospital in 1908 by the Ladies Hospital Aid Society as a hospital for Jewish physicians and patients. Montefiore Hospital affiliated with the University of Pittsburgh School of Medicine in 1957 and joined UPMC in 1990. It is the home to the clinical transplantation facilities originally headed by transplant pioneer Thomas Starzl and is physically connected to UPMC Presbyterian and UPMC Eye and Ear by a series of pedestrian bridges.

UPMC Mercy

Main article: UPMC Mercy

UPMC Mercy is a teaching and Level 1 trauma hospital located in the Bluff neighborhood adjacent to downtown and less than two miles (3 km) from UPMC Presbyterian in Oakland. Mercy was the first chartered hospital in the city of Pittsburgh and was first hospital in the world to have been established by the Sisters of Mercy. Mercy has retained its affiliation with the Catholic Church following its merger with UPMC in January 2008.

UPMC Hamot

Main article: UPMC Hamot

UPMC Hamot is 404-bed, tertiary care teaching medical center with a Level 2 trauma center located in Erie, Pennsylvania. Hamot offers primary medical care and a range of specialties, including its stand alone Women's Hospital providing obstetrics and gynecological services.

Children's Hospital of Pittsburgh of UPMC

Main article: Children's Hospital of Pittsburgh of UPMC

Children's Hospital of Pittsburgh of UPMC is a specialty hospital of UPMC, specializing in pediatrics and is located two and a half miles from UPMC Presbyterian in the Lawrenceville neighborhood of Pittsburgh. Originally located adjacent to UPMC Presbyterian in Oakland, it is one of four children's hospitals in the state, and its emergency department is one of only two Level I Pediatric Trauma Centers. More than 500,000 infants, children, and adolescents make trips to the hospital every year.[36]

Children's Hospital of Pittsburgh of UPMC boasts 1,500,000 square feet (140,000 m2) and has 296 beds, with a 41-bed emergency department and a 36-bed pediatric intensive care unit.[37] A ten-story research center was constructed, with seven out of the ten floors dedicated to pediatric medical research.[38][39]

Magee-Womens Hospital of UPMC

Magee-Womens Hospital of UPMC is a UPMC specialty hospital, opened mainly for women on January 19, 1911; it has offered some services for men since the 1960s. The hospital is located in the Oakland neighborhood of Pittsburgh near UPMC Presbyterian, a location it has been at since its fourth year in 1915. It currently is equipped with 318 beds, an emergency room and ambulatory facilities on four floors. Since merging with UPMC in 1999 it has prided itself on being able to offer all possible services under one roof including family medicine physicians, gastroenterologists, dermatologists, rheumatologists, pulmonary specialists, orthopedists, urologists and neurologists. It boasts a staff of 2,500 of which 1,500 are medically licensed and operates a satellite hospital in the city's northern suburbs as part as the UPMC Passavant facility as well as 9 metro area imaging clinics. Plans for the facility's expansion to six floors and an increase to 360 beds (including 14 additional intensive care rooms) with a expansion in surgical and ambulatory facilities is slated to be under construction by March 2011 [1]. 10,000 births are performed at Magee each year, which accounts for 45 percent of all births in Allegheny County.[40]

Western Psychiatric Institute & Clinic

Western Psychiatric Institute & Clinic (WPIC) is Western Pennsylvania's largest psychiatric facility. Also serving as a clinical research center and home to the University of Pittsburgh School of Medicine's Department of Psychiatry, it is located in Thomas Detre Hall in the Oakland section of Pittsburgh and is connected to UPMC Presbyterian by an underground tunnel.

Community hospitals

UPMC operates the following community hospitals dedicated to specific missions within their particular communities.

International hospitals and facilities

Internationally, UPMC operates a transplant hospital in Italy (ISMETT), two cancer centers and Beacon Hospital in Ireland, and an emergency medical system in Qatar. UPMC is also implementing information technology solutions and assisting with the development of cancer centers in the United Kingdom, will manage a newly created health care center in Cyprus, is providing consultation services in China,[42] and, with the University of Pittsburgh School of Medicine, is implementing a U.S.-style resident training program in Japan.[43][44] In addition, UPMC announced a partnership with GE Healthcare in November 2008 to open 25 additional cancer treatment centers across Europe and the Middle East over the next ten years.[45][46]

UPMC Beacon Hospital

UPMC Beacon Hospital is privately owned full-service hospital located in the Sandyford suburb of Dublin, Ireland. Beacon's nine-story, 238,000-square-foot (22,100 m2) facility includes 183-beds.[47] UPMC began managing the hospital in 2008 and took majority ownership in 2009.[48][49]

ISMETT

Main article: ISMETT

The Mediterranean Institute for Transplantation and Advanced Specialized Therapies (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, or ISMETT) is located in Palermo, Italy, and serves the region of Sicily and the Mediterranean as a hospital designed exclusively transplants and treatment of end-stage organ failure. ISMETT is a joint public-private partnership between the Region of Sicily, through Civico and Cervello hospitals in Palermo, and UPMC, which manages and operates the facility.[50] It is also a center for research in regenerative medicine and various international collaborations including the University of Pittsburgh's and UPMC's McGowan Institute for Regenerative Medicine.[51]

Other major facilities

Hillman Cancer Center

The Hillman Cancer Center is the home of the University of Pittsburgh Cancer Institute, a National Cancer Institute designated cancer center and UPMC Cancer Centers. Hillman Cancer Center serves as the flagship treatment and research facility of the UPMC Cancer Centers network. The center is located in the Shadyside neighborhood of Pittsburgh and is connected to UPMC Shadyside via a pedestrian bridge.

UPMC Sports Performance Complex

Main article: UPMC Sports Performance Complex

The UPMC Sports Performance Complex is a multipurpose, multisport training, sports science, and sports medical complex located along the shore of the Monongahela River in Pittsburgh and is unique in that it combines training facilities for the University of Pittsburgh football team and the Pittsburgh Steelers NFL team in one location with an academically based sports science and medicine program.[52] The complex consists of four centers which include the Center for Sports Medicine, Sports Training Center, Indoor Training Center, and the Fitness and Conditioning Center.[53]

UPMC Mercy South Side Outpatient Center

Main article: UPMC Mercy South Side Outpatient Center

The UPMC Mercy South Side Outpatient Center, formerly UPMC South Side hospital, is a 209,000-square-foot (19,400 m2) urgent care and outpatient facility serving the South Side neighborhood of Pittsburgh. It is one of several UPMC outpatient medical facilities serving various communities throughout the region.

Community engagement

UPMC has committed to several community projects, most notably pledging $100 million to the Pittsburgh Promise, a scholarship program to help students graduating from the Pittsburgh Public Schools pursue post-secondary education,[54] and $525 million for construction of a new Children's Hospital.[55] In 2009, UPMC donated $195 million for charity care and unreimbursed health care, $101 in community health programs and charitable donations, and $247 million in support for research and education.[56]

Criticism and controversies

UPMC has been criticized for excessive profits,[57] monopolistic practices,[58] excessive advertising budgets,[59] and focusing on overseas operations at the expense of domestic ones.[60] In addition, various controversies have received significant local and national attention in recent years.

In 2008, the administration and reporting of UPMC's living donor living transplantation program received national attention when internal studies, spearheaded by transplant pioneer Thomas Starzl, questioned the safety of the procedure and ultimately resulted in the forced resignation of liver transplant program head, Amadeo Marcos.[61][62]

In April 2009, rival West Penn Allegheny Health System filed an antitrust lawsuit against the UPMC and health insurer Highmark, claiming a conspiracy to create a monopoly.[63] The lawsuit was later dismissed with prejudice.[64] West Penn Allegheny has filed an appeal of this judgment.[65]

In October of 2009, UPMC's administration decision to close UPMC Braddock hospital[66] resulted in multiple protest and lawsuits[67] by community groups who disputed UPMC's claims that the hospital was losing money and was underutilized.[68] The facility, now partially demolished in preparation for redevelopment, closed in January, 2010.[69]

In popular culture

The television medical dramas Heartland (2007) and Three Rivers (2009) were largely based on UPMC and the University of Pittsburgh's Thomas E. Starzl Transplantation Institute.[70][71] In both cases the hospitals are fictionalized, but in the later series UPMC is also specifically referred to as another Pittsburgh-area hospital.

Gallery

See also: List of UPMC buildings in Pittsburgh

References

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