This Toronto institution has practiced patient-centric medicine for more than 60 years. Those services will be enhanced when it moves into its new facility in 2010
Written by Kevin Doyle & Produced by Xan Wynne Jones
Founded by four physicians who graduated from the University of Toronto and served together in the Canadian Army Medical Corps and Canadian Army Dental Corps during World War II, the Albany Medical Clinic has provided community-based healthcare to the Greater Toronto Area since 1946.
Managing Director James Higginson-Rollins articulates the clinic’s mission: “The founding principles in 1946 were to create a one-stop shop where the family physician had as much as possible in one place to deal with the patient’s issues. The founders had their first experience in field hospitals in Italy and their philosophy was built on that experience – to have as much as you need to work with at the point of care. That foundation is still our primary principle.”
From humble beginnings in the former Albany Private Hospital (a maternity hospital run by nursing sisters in the 1930’s - hence the clinic’s name), Albany Medical Clinic developed a patient-centric turnkey model that, for years, was unique in Canada. Today the staff numbers 23 family physicians, seven nurses and 35 visiting specialists. The clinic provides more than a dozen ancillary services for approximately 30,000 patients each month.
“We see as many patients as the outpatient departments of the major hospitals in Toronto,” says Higginson-Rollins. “When a patient comes to see the family doctor, everything they need is in one building. It allows us to manage [and drastically reduce] patients’ waiting time and we take care of all the administrative work for the doctors.”
CHANGE IS COMING
The clinic long ago outgrew the 21,000sf space it occupied since 1965. Higginson-Rollins, who joined the clinic in 1999, drew on the knowledge gleaned from a lengthy career in corporate real estate and consulting once the decision to move was made.
“This facility was never designed to handle the volumes we see. Once it was determined we couldn’t buy this building, we began to investigate the immediate area. We were very fortunate that a patient who is a developer had property right around the corner and we struck a deal,” Higginson-Rollins says.
The clinic will move around the corner to occupy 42,000sf of a building now under construction next February. Under a deal structured by the legal team of Aird & Berlis, the clinic will occupy the top four floors as tenants, maintaining an option to purchase.
Craft Development Corporation is overseeing construction, working in consort with architects Sweeny, Sterling, Finlayson & Co. Steel framework has been completed, exterior walls arrived on Sept. 11 and interior work on stud walls and HVAC is under way.
“It’s on the fast track. Craft had never done a medical building before but they’re doing a terrific job. They introduced us to Sweeny, Sterling and Finlayson, a firm with an excellent reputation that has done a number of high-profile projects in the city,” says Higginson-Rollins.
“They [Sweeny, Sterling, Finlayson & Co.] did the interiors for us and have been very efficient, spending a lot of time working with us on the layout of individual offices and furniture construction within the offices. Everything is custom-designed and very ergonomic. They did a lot of research for this project,” he adds.
The first floor, owned by the developer, includes a full-service Rexall pharmacy – the clinic is closing its own dispensary – a Toronto Dominion Bank and space Albany will lease for its walk-in facility. The second floor houses services such as diagnostic imaging, dentistry and laboratory; ample consultation areas for visiting specialists; and two procedure rooms built to strict hospital standards. General practitioners and the centralized nursing clinic will occupy the third and fourth floors with physiotherapy, administrative offices and Health and Wellness services outsourced through ICC HealthNet Canada, Inc. located on the fifth floor.
Higginson-Rollins is hopeful the building layout will encourage dialogue and collegiality among general practitioners, specialists and those offering homeopathic alternatives. “It should help break down some barriers and patients will get even better care. Being in the same space improves communication better than anything else. They will do what they can to assist each other because they’re all part of the same team,” he says.
GONE DIGITAL
Albany Clinic went live with the JonokeMed™ EMR system in December of 2008. The full impact won’t be felt until the move to the new building, but the system is light years beyond the clinic’s previous practices.
“When I arrived in ’99, things hadn’t changed since the ‘70s,” Higginson-Rollins recalls. “Everything was done on paper. The only thing they did electronically was provide a weekly reel-to-reel billing tape to the Ministry. So, we’ve had to evolve through a huge change.”
Implementation of JonokeMed™ was not made lightly. “We went through a very long process of about three years. We fit into a mid-sized marketplace and there aren’t a lot of technology companies that do that well. We wrote our own RFP and conducted comprehensive research. Jonoke was the winner,” Higginson-Rollins says.
Albany Clinic applied for funding via a lottery system through the OntarioMD - the agency overseeing the funding provided by the Ministry of Health. It didn’t win but pressed on with the EMR project. “Then we got a surprise call in 2008 to let us know we’d been awarded some funds that other clinics hadn’t used,” he says.
“EMR opens the doors to whole new work flows. As an example, EMR will create a new process for nurses’ orders. The nurse will annotate what she’s done, with the entire record completed in the EMR,” Higginson-Rollins says. “We’re going to expand on this in the new building, we’ll have lay persons trained by our nurses carrying out patient prep work, inputting that information directly into EMR and getting the patient into the doctor’s exam room. The doctors also work in the EMR, computerizing the entire process, start to finish.”
MOVING FORWARD
If imitation is the sincerest form of flattery, Albany Clinic can be viewed as the leader of a revolution. “We’re getting a little less unique as the government has been pushing hard for GPs to practice in group environments and to build teams around them. They’ve clued into the fact that what we do works and that’s a good thing,” Higginson-Rollins says.
A lack of doctors, however, is not. “That’s an issue we need to deal with. There are just not enough physicians. Last summer I hired three new doctors – two from the States and another from Western Canada. I have another one coming from the States this year. We’re recruiting hard but it’s still a problem,” he says.
The new building’s design anticipates potential changes to service delivery. “Our vision is that permission to perform day surgery is coming. We don’t have this here in Canada, but we’re building to that standard because we expect that will happen,” Higginson-Rollins says. Additionally, space in the nurse’s clinic has been set aside for a time when nurses will be able to counsel patients.
That progressive vision keeps doctors with the clinic for decades and second, third and fourth generations of patients returning even though they may no longer live in the GTA.
“We have patients coming from all over for their annual physicals, traveling huge distances. And every year at our Christmas Party I give out awards for 15, 20 and 25 years of service. I have physicians in their 70s who have never worked anywhere else. We must be doing something right,” Higginson-Rollins concludes.
FACTS AT A GLANCE
COMPANY NAME: Albany Medical Clinic
MANAGING DIRECTOR: James Higginson-Rollins
OPERATIONS: Community-based healthcare provider
ESTABLISHED: 1946
EMPLOYEES: 165
REVENUE: NA
www.albanyclinic.ca
View Digital Corporate Profile of AlbanyMed in Healthcare Digital October 2009