Lehigh Valley Physician Group (LVPG)

History and background:the Lehigh Valley Physician Group (lvpg) was established in 1993 as an affiliate of Lehigh Valley health network (lvhn). As a non-profit corporation which supports both lvhn and Lehigh Valley hospital (lvh), lvpg has developed Physician practices in the clinical departments of family medicine, medicine and medical subspecialties, obstetrics/gynecology, pediatrics, psychiatry, surgery, and emergency and hospital medicine. With a current size of around 1,200 physicians and more than 800 advanced practice clinicians, the medical Group operates as a single entity with services provided at over 160 locations. Importantly, lvpg plays a critical role in the Lehigh Valley community, caring for over 50% of the population. Last fiscal year, lvpg-lehigh provided more than 3.6 million visits to our patients. The following summarizes the medical specialties offered across lvpg: adolescent medicine, advanced spine, concussion, head trauma, bariatric medicine, bariatric surgery, behavioral health, burn surgery and wound care, general cardiology, cardiology electrophysiology, cardio-thoracic surgery, chiropractic medicine, ear / nose / throat medicine, concussion care, critical care medicine, emergency medicine, endocrinology/metabolism/diabetes, express care/walk in, family medicine, general and minimally invasive surgery, general internal medicine (ambulatory & hospitalists), geriatrics, gynecology, gynecologic oncology, health and wellness, hematology/oncology, infectious disease, maternal fetal medicine, neonatology, nephrology, neurology, neuropsychology, neurosurgery, obstetrics, occupational medicine, ophthalmology, optometry, orthopedic surgery, pain management, palliative medicine, general pediatrics, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric hospitalists, pediatric infectious disease, pediatric intensivists, pediatric neurology, pediatric neonatology, pediatric plastic surgery, pediatric pulmonology, pediatric surgery, pediatric urology, plastic surgery, physiatry, psychiatry - child & adolescent, general psychiatry, pulmonology, rheumatology, sleep medicine, sports medicine, surgical oncology, toxicology, trauma surgery, transplant surgery, urogynecology, urology, vascular surgery.lvpg has participated for seven years in a track 1 medicare shared savings program (mssp). Our mssp accountable care organization (aco) is comprised of over 38,000 medicare beneficiaries. We performed better than benchmark our first two years in the program, with shared savings in program year one and quality scores consistently over 90% since that time. Through this, our medical Group has demonstrated the ability to realize the triple aim as measured through a cms lens.patient care programs:lvpg offers a continuum of health care promotion, prevention, diagnosis, and treatment to the community. Extensive outpatient services are provided at locations throughout the region and are a part of a healthcare network established by lvpg to meet the medical and surgical needs of the residents of the Lehigh Valley and beyond. Lvpg serves as a multispecialty Physician Group, accepting referrals from an area populated by approximately two million residents of surrounding counties in eastern Pennsylvania. In center city allentown, our 17th street campus provides dedicated service and care delivery to our underserved population. With over 70% of the patient population un/under-insured, these practices provide the highest quality care to patients regardless of their ability to pay. The pediatric children's clinic cares for over 25,000 children, and not only provides healthcare but supportive outreach through well integrated social support services. Other 17th street practices include internal medicine, family medicine, ob/gyn, comprehensive health services and a hepatitis care center, a medical specialties practice and wellness center. Throughout fy22, five of these practices continued their transformation into a federally qualified health center that is now called Valley health partners. Their work remains tightly connected with the lvhn. The work of the Valley health partners (vhp) fqhc will serve the community even greater in years to come. Covid-19 (c19) pandemic: in response to the c19 pandemic, Lehigh Valley health network and lvpg have undertaken transformative and impactful actions. The lvpg clinical footprint was quickly expanded to include virtual care offerings, including video visits, phone visits, and e-visits. This virtual model has continued to expand and is now part of basic service offerings, allowing any appropriate encounter to be performed safely and effectively.additional c19 services have included screening c19 e-visits, on demand video screening c19 visits and a transition of care c19 virtual care clinic for patients discharged from the hospital. These types of encounters provided hundreds of thousands of visits to our community over the past few years throughout the c19 challenges. This model enabled patients to stay home, stay safe and receive care in a manner that was convenient and value-added. In addition, the lvpg workforce and practice teams worked in partnership with our hospital sites to deliver vaccines across our community. These efforts supported areas of our patient population across all regions we serve. Cancer services:lvpg provides medical care and leadership within the Lehigh Valley topper cancer institute (lvtci). Lvtci is comprised of 7 hospital-based locations with 121 infusion bays, 4 radiation therapy departments with 8 linear accelerators, and breast health services in 6 health centers and one mobile coach. A new building for the cancer center is scheduled to open in hazleton during the summer of 2023. Lvcti offers a range of cancer services in one convenient, patient-focused location. Cancer care services include prevention, detection, diagnosis, therapy, clinical trials, rehabilitation, and the evaluation of cancer-related care. Infusion therapy services are offered consistently across the region we serve, including in the newly opened hecktown oaks and carbon locations. Lvcti is a member of the memorial sloan kettering cancer alliance, which provides patients with even more lifesaving care options and access to more advanced clinical trials. In 2021, there were 148 adult accruals and 35 pediatric accruals by 30 different Physician providers, and currently in 2022, 156 adult accruals and 33 pediatric accruals by 24 different Physician providers.cancer support services at Lehigh Valley topper cancer institute are a significant part of the patient experience. Services provided by cancer support services include nurse navigation, social work, counseling, nutrition, and genetics. The nurse navigation program consists of oncology certified nurses who serve as a link between the patients and the healthcare team. The gregory & lorraine harper cancer risk and genetic assessment program is realizing year over year growth in the utilization of genetic screening resources. Cancer not only affects physical health but mental health as well and there is an extensive social work team to assist with transportation, referrals, prescription assistance, mental health/substance abuse referrals and grant funding support. When a patient requires additional coping support, there is a dedicated behavioral health therapist in the surgical oncology office for in-person or virtual consultations. Dietitians are available to work with the patient to manage dietary needs during and after treatment. Heart and vascular services:the Lehigh Valley heart and vascular institute is one of the largest and most respected cardiovascular programs in Pennsylvania. With 60 cardiologists, 6 cardiothoracic surgeons, 6 vascular surgeons, and a dedicated team of advanced practice clinicians and support staff, the heart and vascular institute offers an impressive and comprehensive array of preventative, diagnostic, acute, tertiary, and quaternary cardiovascular services. Specialized programs include, but are not limited to: cardiac arrest management, coronary intervention, structural heart, advanced heart failure & mechanical circulatory support, cardio-oncology, complex lipid management, comprehensive rhythm management, a women's heart and vascular program with a developed subspecialty heart and pregnancy program, neuro-cardiology, and sports cardiology.

Linkage to community: the community of solutions Group encompasses a partnership between Lehigh Valley practice and community based research Group, public health, and local community-based organizations with a focus on identification opportunities to improve the well-being of youth in our community. In the past year, they completed a photovoice project to engage local youth to identify those factors that have supported and detracted from their wellness, particularly since the onset of the covid-19 pandemic given increased risk of stress and isolation. The results of this project were shared with local organizations as part of a data driven approach to developing programming to support the health and wellness of youth in our community.linkage to addiction treatment & opioid stewardship: a second round of funding from Pennsylvania coordinated medication for addiction treatment (pacmat) provided support for the current network of primary care practices providing medications for opioid use disorder (moud) as well as engaging new practices from family medicine, internal medicine and ob/gyn across 7 counties. Family medicine faculty at Valley health partners expanded access to moud both at the family health center and through street medicine, serving over 150 patients in the last year, many of whom are facing intense barriers to care such as chronic homeless, past incarceration, and undertreated mental health conditions. The mobile harm reduction team, with support from Lehigh county drug and alcohol, has initiated outreach, naloxone distribution and mobile medical visits for people who use drugs in the hard-hit 7th street neighborhood. Neurosciences services:lvpg physicians provide treatment for stroke, brain tumors, aneurysms, spine disorders and other neurological disorders in the following areas: neurosurgery, pain management, neurology, neuropsychology, neuro-imaging, and neuro-oncology. Lvh launched the first mobile stroke unit in Pennsylvania, where an msu allows stroke patients to begin rapid treatment before hospital arrival, such as initiating clot busting medication or reversing coagulopathy. The availability of neuroimaging allows precise triage and routing to an appropriate level of stroke center and prevent intra-facility transports currently delaying arrival to the comprehensive stroke center.in addition to the above services, programs include a neuromuscular disease program, an als center, a neuroimmunology / multiple sclerosis program, an epilepsy program and monitoring unit, a headache center, movement disorders program, general neurology program and multiple subspecialty multidisciplinary programs including neurocardiology and neurology in pregnancy. Behavioral health services:lvpg physicians provide medical leadership for the lvh acute care inpatient mental health program for adolescents and adults in Lehigh, northampton, carbon, monroe, schuylkill, and berks counties based upon the number of admissions and provides inpatient psychiatric, psychological, substance abuse and social services in all clinical areas. Among the areas of focus were the continued expansion of the zero suicide initiative, including internal suicidal prevention pathways, mitigation of ligature risk, and suicide prevention training in the emergency departments and medical-surgical units. Partnering with Lehigh, northampton, and carbon/ monroe/pike counties, the "warm handoff" program was developed. This program follows individuals who have had suicidal thoughts and behaviors as they are discharged from lvhn inpatient and emergency departments into the community to confirm a solid connection to appropriate care. Lvpg physicians also provide ambulatory care in these settings: - partial hospitalization program oversight for adolescents and adults- outpatient mental health clinic for the chronically and severely ill- short-term, outpatient treatment services for children, adolescents, adults, and families- residential rehabilitation program teaching independent living skills to the chronically mentally ill- emergency services- mental health and home care servicestele-psychiatry: achieved up to 100% virtual care throughout fy20 and continues to run around 50% in fy21, throughout the c19 pandemic. Ongoing high levels of virtual care have been maintained since that time.surgery services:lvpg physicians, advanced practice clinicians and allied health providers perform comprehensive, coordinated surgical care and provide services in specialties such as: bariatric surgery, burn surgery, cardiac and thoracic surgery, general surgery, neurosurgery, ophthalmology, orthopedic surgery, otolaryngology, pediatric otolaryngology, pediatric surgery, pediatric urology, plastic and reconstructive surgery, surgical oncology, transplant surgery, trauma surgery, urology and vascular surgery. In addition, our surgeons serve as the program director and core faculty for the general surgery residency program. In the past year, surgical volumes at lvh and lvh-m was 46,411 cases. Over this past year there were more than 100 organ transplants, including kidney transplants and simultaneous kidney pancreas transplants. Trauma services:lvpg physicians and other practitioners provide comprehensive trauma care and services as a major regional resource covering a ten-county area and a two million patient base. Lvpg physicians are part of the accredited program for pediatric trauma. Lvpg physicians are an integral component of the Lehigh Valley hospital trauma program, which provides a continuum of care for the trauma patient with at least one of our trauma surgeon team providing 24/7/365 in house coverage. A trauma rehabilitation team completes the continuum of trauma care. Lvpg physicians also provide care in the burn center serving northeastern Pennsylvania and western new jersey. Women's services:lvpg offers programs and services designed to provide care for women in the Lehigh Valley. Lvpg offers comprehensive obstetrics and gynecology services, including general obstetric and gynecologic care, maternal-fetal (high-risk) medicine, and pelvic reconstructive surgery.clinical programs in general obstetrics and gynecology include a maternity care pathway, well woman care pathway, routine gynecologic care, gynecologic specialty programs in focus areas such as pelvic pain, menopause, weight management, and sexual health, and surgical care. These comprehensive programs are delivered by teams of healthcare providers including physicians, midwives, and advanced practice clinicians along with their related clinical staff. We also offer embedded counseling services for mental and behavioral health and clinical care management for our perinatal substance use disorder program. The maternal-fetal medicine program is one of the largest in the state, offering screening, diagnostic, and therapeutic services, and unique interdisciplinary clinical programs in our network and outside to neighboring hospitals as well. Infants/children/young adults:lvpg offers comprehensive inpatient and outpatient pediatric medical care by combining a philosophy of patient/family-centered care with diagnostic, medical and surgical techniques. Services are provided through the collaborative efforts of community and hospital-based physicians and subspecialists. Pediatric specialty services include adolescent medicine, child abuse, developmental pediatrics, gastroenterology, hematology, hospital-based care, intensivists, infectious disease, neonatology, neurology, oncology, plastic and reconstructive surgery, psychiatry, pulmonology, rheumatology, general surgery, and trauma & burn care. Lvpg physicians provide care to patients at the Lehigh Valley hospital 40 bed level iii neonatal intensive care unit, 8 bed pediatric intensive care unit, 32 bed pediatric inpatient unit, 13 bed adolescent psychiatry unit and a recently opened 12 bed pediatric emergency department. Ambulatory services provided by lvpg include a general pediatric outpatient clinic, a pediatric subspecialty center, and a pediatric ambulatory surgery unit. Virtual care programs (telemedicine):lvhn has remained a leader in the development and implementation of innovative virtual care programs that have expanded our capacity to provide high quality healthcare services throughout our growing network and beyond. Virtual care programs allow our team to offer specialty care to sites and patients that would otherwise not have access to these services. Through the c19 pandemic, as noted, our virtual care programs offerings have expanded exponentially to include video, phone, and e-visits. The video visits include not just clinician and patient encounters, but also include multiparty video conferences.

The Lehigh Valley heart and vascular institute currently offers 18 cardiovascular access sites throughout the lvpg-l service area to enable patients to receive premier cardiovascular care close to home. Office locations include: berks county:- lvpg cardiology-hamburg - lvpg cardiology-moselem springs bucks county:- lvpg cardiology-richland township carbon county:- lvpg cardiology-carbon- lvpg vascular surgery-carbonlehigh county: - lvh cardiology-1250 cedar crest- lvh cardiac and thoracic surgery-1250 cedar crest- lvpg cardiac and thoracic surgery-muhlenberg- lvpg cardiology-laurys station- lvpg cardiology-muhlenberg- lvpg vascular surgery-cedar crest- lvpg vascular surgery-muhlenbergnorthampton county:- lvpg cardiology-bangor - lvpg cardiology-easton - lvpg cardiology-fairview avenue - lvpg cardiology-hecktown oaks - lvpg cardiology-highland avenue to improve the cardiovascular care in the communities we serve, the heart and vascular institute has developed an array of subspeciality programs. For example, our hispanic heart program, centro del corazon, breaks down language and cultural barriers experienced by some of the spanish-speaking members of the community. This program pairs spanish speaking cardiologists with support staff that are equipped to help meet the needs of this part of our community with the goal of improving their overall cardiovascular health. Additionally, our cardiovascular disease identification and intervention program uses electronic health records to identify patients that are at-risk for specific diseases. This program not only helps identify at-risk patients, but it also partners with primary care providers to education the patients about their risk and encourages appointments with lvpg providers to help prevent or care for the identified disease. The heart and vascular institute and its lvpg colleagues also participate in a great deal of community outreach and education. In fiscal year ending june 30, 2022, the heart and vascular institute participated in over twenty educational programs for the community that raised awareness about cardiovascular disease and prevention. Additionally, a partnership with the city of allentown has been formed for their million clicks for million hearts walking program that encourages walking and physical fitness improvement in the city's parks. This partnership also features a "walk with a doc" program that brings lvhn colleagues in front of members of the community to educate them about various health topics as they walk. Pediatric services:lehigh Valley Physician Group (lvpg) maintains pediatric services at all our regional campuses encompassing approximately 20 outpatient sites and providing care for over 60,000 pediatric patients annually. Introduced in may 2012, Lehigh Valley reilly children's hospital (lvrch) offers the most wide-ranging, specialized health care services for children of any facility in the region. Staffed by lvpg pediatricians and advanced practice clinicians (apcs), Lehigh Valley reilly children's hospital (lvrch) has the region's only children's emergency department, level iv nicu, children's ambulatory surgery center, and children's cancer and infusion center. We also have the region's only child advocacy center at lvh-17th street. Lvrch of lvhn has been a full institutional member of the children's hospital association for 9 years and has had a pediatric residency training program for 10 years. We have a pediatric sleep center, and a pediatric cystic fibrosis center. We also provide services to children with bleeding disorders through the lvh hemophilia treatment center. We have two school-based clinics in partnership with the allentown school district at the sheridan and hays schools. Through our school-based behavioral health services we provide mental health care to students in 13 school districts across the region. Our clinic for children with medical complexity is at the vhp children's clinic at 17th & chew. We have the region's only children's express care at 2 sites. We have developed 30 clinical pathways, which drive high-quality, efficient care. The lvrch family advisory council continues to assist us in shaping family-centered programs, processes, and places. Lvpg's board-certified physicians provide children's care in greater than 30 pediatric specialties including pediatric surgery, pediatric urology, pediatric ent, pediatric plastic surgery, pediatric orthopedics, pediatric neurosurgery, pediatric anesthesia, pediatric radiology, pediatric hematology-oncology, pediatric pulmonology, pediatric neurology, pediatric endocrinology, pediatric infectious disease, pediatric rheumatology, pediatric gastroenterology, pediatric hospital medicine, neonatology, pediatric critical care medicine, pediatric emergency medicine, adolescent medicine, developmental pediatrics, pediatric neuropsychology, child protection medicine, and child and adolescent psychiatry. Lvrch child protection team evaluates children who may have been abused or neglected. This team includes a board-certified child abuse specialist. Lvrch in partnership with Valley health partners is continuing the allentown children's health improvement project (achip), which is a community-based needs assessment, resource connection, and family empowerment services for families with children under 5 years old. Lvrch provides and supports educational services. Our weller education services provide highly regarded programs administered by professional educator in schools across the region. Lvrch promotes safety and healthy living in various forums throughout the year. The most notable is our community canvas program, which in partnership with the kellyn foundation provides programs in over 15 elementary schools that promote good nutrition and healthy living.palliative medicine and hospice:lvpg physicians and providers provide services across the care continuum to improve patient, family, and provider satisfaction, decreased hospital readmissions and emergency room visits for patients with advanced illnesses. The palliative care team is called oacis optimizing advanced complex illness support and consists of multidisciplinary teams that travel to patients' homes for care. We also care for patients at the end of life in coordination with hospice home services. The team spends time ensuring patients are supported with care that aligns with their medical and personal goals, promoting the highest quality experience and life possible.over the past fy, efforts were also focused on advanced care planning (acp) and serious illness conversation. Over 4,100 patients had acp documentation added to their medical record over the past year. Additionally, the focus on training clinicians on goals of care conversations with their seriously ill patients continued.internal medicine and family medicine primary care:lvpg physicians and providers provide high quality, comprehensive, coordinated care to adults and children in the setting of patient-centered medical homes. We strive to provide access to care at the time of need, focus on prevention and chronic illness management and provide coordination between specialist and service. Using discretionary funds, the department of family medicine continues to support practices participating in the reach out and read program. Reach out and read is a physician-led literacy program that promotes early reading in children up to age 5. Children who visit participating practices receive an age-appropriate book from their clinical provider at their annual well-child visit.in collaboration with the cancer institute, family medicine leadership has supported efforts to develop workflow and processes to improve lung cancer screening rates. Work on lung cancer screening has been a focus of our practice based research network team, as it was recently awarded a 5 year national cancer institute grant for a multi-institutional collaboration with jefferson, penn state and christiana care to improve lung cancer disparities and continue building from our previous Pennsylvania department of health cure grant in collaboration with the american college of radiology, american cancer society and thomas jefferson university to test the feasibility of a centralized lung cancer screening program. Diabetes management: through ongoing collaboration and network support, lvpg has implemented a diabetes pathway across all ambulatory adult primary care practices. This pathway has helped our clinicians' partner with patients better to improve testing and management of their diabetes. Our most recent fy22 data has demonstrated ongoing improvements in diabetes care over the past four years, with current performance the best regarding patient management and outcomes.