Dr. Margot Hartmann has spent her career healing patients in hospitals. Now, she fifinds herself improving the health of a hospital itself. In just two years of being president and CEO of Nantucket Cottage Hospital, Dr. Hartmann has not only helped fifinancially resuscitate NCH, but she is now overseeing the delivery of a brand new medical facility for the island.

Transitioning from emergency room to boardroom, Dr. Hartmann has managed the hospital with surgical precision and today, through increased services, improved
finances and a dynamic partnership with Mas- sachusetts General Hospital, NCH is on the path to becoming stronger than ever. One only needs to listen to her vision of the hospital’s future to realize that the health and wellbeing of the Nantucket community is indeed in very good hands. “We have an op- portunity to create something for this community that will be a beacon of wellness long after we’re here,” Dr. Hartmann says. “I would like to be a hospital that is not only where people bring their illness, but where people bring their hopes for wellness.”

Two years ago, this vision might have sounded a bit lofty amidst the hospital’s $7.5 million losses. Certainly the very idea of build- ing a new facility at the time would have been unrealistic. Upon taking office, Dr. Hartmann faced a “perfect storm” of decreased patient volume, decreased reimbursements, and an outdated building. Over the last two years, she and her board have remedied the first of these challenges by reaching out to the community, learning what its specifific needs are and increasing the hospital’s services precisely to meet those needs. The hospital has since grown in primary care and specialty clinics, and is offering new services ranging from podiatry to neurology. Not only have the services increased, but also the quality of care meets a “gold standard” through the NCH’s partnership with Mass General Hospital. “We have a lot of local expertise and a lot of local knowledge about how to deliver care,” Dr. Hartmann says, “but we now also have all the clinical power and breadth of the number one hospital in the country.” As a result, more and more patients have been checking back into NCH rather than going off island for their care.

On the revenue front, Dr. Hartmann has streamlined the hospital’s infrastructure, both fiscally and technologically. “For decreased reimbursement, we’ve worked with Partner’s Healthcare and our board to redefine certain contracts for insurance payers,” she explains, “and we’ve been able to reduce charges in our lab by forty percent.” The hospital’s billing system has also been improved. By leveraging federal dollars, all medical records are being digitized and soon every room in the hospital will be equipped with a computer. These measures have helped tourniquet NCH’s financial bleeding and put it on a road to recovery.

With patient volume and reimbursements on the mend, Dr. Hartmann now turns to treating the failing building. While the specifics of its design are still being determined, her vision for a new hospital is clear: “This hospital should not be more hospital than it can sustain. It’s not going to be a little Mass General. It has to be the customized hospital that this island and this community needs for all its constituents.” In particular, the new hospital’s infrastructure will support both evolving medical technology and a patient population that fluctuates five-fold from winter to summer. Every room will be equipped with telemedicine, thus connecting Nantucket patients with leading physicians in Boston and beyond. “The ability to see a top quality neurologist without leaving the island is the way of the future for here,” she explains. “We’ve always struggled to bring specialists out to serve the community. We now have a modality that allows us to access the best quality specialists that we can with a flat screen TV and a nurse practitioner at your side.” And this is only the beginning. Ultimately, Dr. Hartmann wants to build a hospital that meets the unique challenges of an island thirty miles out at sea while also setting a new standard for community hospitals nationally.

Beyond the building’s functionality, Dr. Hartmann envisions the new hospital as offering more than just treatment and care. She wants it to become a community focal point where islanders go to discover ways of living better. “I would like to be a hospital where we can have meeting spaces to educate the community in wellness,” she says. “This hospital wants to be the hospital for our community. It wants to be in relationship with it in an active, alive way.” This will require not only a change in the building, but also a change in the public’s perception of NCH. As she explains, “I think there are some people who drive by this building and don’t see a building where they feel confident to bring their vulnerability, because I don’t think this building reflects the quality of the medicine delivered within it.” Thanks to Dr. Hartmann and her board, that perception will change dramatically in the next several years.

Considering where Nantucket Cottage Hospital has come in the last two years and where it’s poised to go in the years to come, the fact that Dr. Hartmann had no prior experience in business or hospital management is remarkable. Perhaps it was her time as head of the emergency room that prepared her best for the job. “You’re constantly having to triage to your larger vision of health,” she explains, “how to keep the greatest number of people safe and do the best amount of good.” Yet she also thinks on the micro level, drawing from her own personal experiences with the hospital: “I know what it means to have this hospital here because my mother needed cancer treatment and was able to receive it here on the island in her eighties… Nothing matters if we don’t have a great hospital for life on this island. Period.”

While she has delivered change quickly, there is nothing breathless in her approach. As with many physicians, there is a calm about Dr. Margot Hartmann that fills the room, and she speaks with the measure of someone who has faced dire situations before and found solutions. So as she leads the charge to break ground on a new hospital, Nantucketers can take comfort in knowing that the project is in the steady hands of a doctor, an astute manager and a visionary.

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