A Florida system's care coordination strategy, version 2.0

In launching its own care coordination center, Memorial Healthcare System set out to go beyond capacity management and centralized bed placement. Specifically, it combines human capital, data and IT, Chief Medical Officer Aharon Sareli, MD, told Becker's.

The Hollywood, Fla.-based health system's $1.7 million, 3,000-square-foot facility coordinates interfacility transfers, manage bed capacity and float pool staffing needs in real time, and implement virtual care models. It incorporates Epic EHR technology for patient flow and technology company Artsight's artificial intelligence-driven virtual nursing, among other features.

Dr. Sareli, an executive vice president at the health system and chief physician executive at Memorial Physician Group, told Becker's he expects the center to yield positive results for patients and families, as well as for Memorial's clinical staff.

"We were interested in marrying technology and AI, leveraging real-time data through the Epic dashboard, and co-locating the right people under one roof to optimize and build a care coordination center," he said.

"This isn't just about replicating what's done in other systems but also innovating and adding unique components to our care coordination center and integrating future ideas."

Discussions regarding the center began between Memorial's clinical and executive teams late in 2021. The project began in earnest early in 2022, and the center officially opened Oct. 22. 

During the process, Dr. Sareli said Memorial explored various technologies and visited other care coordination centers in Florida. 

"Our IT teams have many connections around the country, so we're aware that other systems are pursuing similar models, but we aimed to use best practices and innovate from our leadership's perspective," he said.

Like many care coordination centers, Memorial's facility focuses on optimizing a transfer center model, capacity management and centralized bed placement. Dr. Sareli noted that it also focuses on capacity balancing across the system. Memorial is one of the nation's largest public health systems, with approximately 1,800 staffed beds across the enterprise, which includes its flagship facility, Memorial Regional Hospital.

"Ultimately, the main goal is always patient safety and quality," Dr. Sareli said. "By reducing variability, locking in standardized processes and leveraging real-time data with Epic dashboards from a central location, we're able to enhance safety.

"A second goal is optimizing the patient experience. All patients want to be in the right place at the right time, and anytime they're not — for example, an admitted patient in the ED instead of an ICU or telemetry unit — it impacts their experience."

A specific element of the center that is of note: virtual patient observation. Under this model, a team assigned to designated adult patient rooms virtually monitors patients who are at high risk for falls.

"There's audiovisual communication from the center to patients' rooms through fixed or mobile devices," Dr. Sareli added. "A virtual patient observer monitors 12 screens and uses AI to detect increased movement, prompting attention to specific screens. They can communicate with patients and call in bedside staff if necessary. It adds safety and ensures quicker responses."

He said the center also has virtual patient observation for cases with aggressive behavior or potential abuse cases. 

Additionally, Memorial has integrated its centralized staffing pool leadership into the center. Dr. Sareli said this enables real-time deployment of workers based on predictive models from Epic, and it allows the health system to be proactive in areas with high patient acuity or ICU needs.

Moving forward, Memorial is considering hospital at home to monitor discharged patients at home with wearables and virtual nursing follow-up, Dr. Sareli said. The health system also seeks to implement a clinical command center to streamline response times for events such as stroke alerts. 

"Co-locating the right people, using real-time data and integrating innovative technology," Dr. Sareli said. "This helps maximize efficiency, improve patient quality and safety, and reduce variability. Combining human capital, data and IT is the way forward, not replacing humans but complementing them with technology to enhance efficiency and patient experience."




 

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