It is hard to believe that six months have gone by since I joined the leadership team and board of Porter Medical Center as the new president and CEO.
As I began this journey, my first impressions were and continue to be that Porter Hospital, our network of practices, and Helen Porter Healthcare and Rehabilitation Center are vitally important and valued community resources. More important, our mission to serve the healthcare needs of this community continues to guide our decisions and is as essential today as it was in 1925 when William Porter created a local vision of healthcare services. 
The past few months have also been a time of serious assessment of our current operations (clinical, financial, technology and customer service), and a period of thoughtful reflection and planning for our future.
Our board is actively engaged in developing both a strategic plan and a facilities master plan, which will culminate in more specific detail later this spring. Several members of our leadership team are also involved with work at the state level as Vermont moves forward with ambitious and complex plans to introduce a dramatically different payment model for healthcare services within the next 12 months.
This is a healthcare environment unlike anything we have experienced previously in our country. The amount of change, adaptability and flexibility that will be required cannot be understated. We will need the help and support of our leadership team, our employees, and the community in order to navigate the very challenging conditions ahead.
The Porter Medical Center Board of Directors, a dedicated group of community leaders who devote countless hours in support of our mission to serve the people of this region, clearly recognizes the urgency of charting a strategic course for Porter. This plan must address our current/immediate financial situation, which was termed “fragile” by the Green Mountain Care Board, as well as determining a solid path for strengthening and sustaining our services in this community for the longer term.
This will be hard work. Yet, it is essential and urgent work that will require difficult decisions in the months and years ahead; decisions that must be rooted in our mission and what is best for our community.
The recent modifications to our employee benefit program is an example of the type of change that is both painful and necessary if we are to respond to the very real financial challenges we are facing at Porter Medical Center. Additional changes in the short term, as well as those emerging from the development of our strategic plan, include closing a gap of $3-$4 million between our current financial operating performance and where we need to be in order to simply “sustain and invest” in essential services and equipment. As a small system, this amount of change does not happen without difficult decisions. 
As a small, rural community hospital, Porter is not alone in terms of the strong headwinds at both the federal and state levels as illustrated by the following statistics:
• Nationwide, 58 rural hospitals have closed since 2010, according to the North Carolina Rural Health Research Program at the University of North Carolina at Chapel Hill. The number of annual closures has increased each year during that period, with 16 rural hospitals shutting down last year.
• The National Rural Health Association has identified 283 more rural hospitals across the country that are in danger of going under — more than 10 percent of all such facilities. The group found that the financial conditions of the hospitals just hanging on are similar to facilities that already have closed. More than a third of rural hospitals operated at a deficit in 2013, according to the association.
But we must do more than just looking for ways to cut expenses. We are working hard to identify new, appropriate patient care services that we can introduce in order to provide additional appropriate care in Addison County, while also contributing to Porter’s financial well-being. Our new Infusion Center is one great example of a program that is already positively affecting our local patients and simultaneously supporting our financial position. 
Infusion (IV) therapy involves the administration of medication through a needle or a catheter. This therapy is prescribed when a patient’s condition cannot be treated effectively by oral medication. Although Porter has been providing this type of care in a limited fashion in the past, many patients who needed this important care methodology had to travel outside of Addison County to receive treatment.  Our new infusion center provides essential and local patient care and great customer service in a comprehensive manner, and is a win-win for our community and Porter Medical Center.
As we move forward to improve the health of Porter Medical Center through focused financial stewardship, as well as adapting to healthcare reform measures at the state and federal levels, the road ahead will be incredibly challenging and complex, and sometimes difficult to clearly communicate. However, remaining viable and relevant in fulfillment of our mission to your healthcare needs is extremely important work, and we will do our best to keep you informed. Please feel free to contact us through our public relations number, 388-4744, if you have a question or need information. 
Finally, as we anticipate the changing landscape ahead, we do so with the knowledge that we have many talented and dedicated staff members who care deeply about their work and our mission to serve our patients and residents. We commit to keeping those patients and residents at the center of our conversations and decisions as we chart the future course of this organization and the delivery of outstanding health care services to the people of this region.