As the healthcare landscape changes, some of the key qualities and initiatives that community hospitals have been working on for years are now essential for larger organizations as well.
At the Becker's Healthcare Community Hospitals Virtual Forum on Oct. 12, a panel of healthcare leaders gathered to discuss what large health systems can learn from community hospitals.
The panel included:
Aaron Herbel, CEO of Mercy Hospital in Moundridge, Kan.
Harsha Upadhyay, regional CEO at Prime Healthcare
William Rhoades, DO, chief medical officer of Advocate Good Samaritan Hospital in Downers Grove, Ill.
Mark Pratt, MD, director of solutions management at Allscripts
Below is an excerpt from the panel. Click here to view the panel recording on demand. Note: the responses are lightly edited for clarity and length.
Question: Aaron, could you tell us about Mercy's telehealth strategy and infrastructure. How did the lessons you learned prior to the pandemic give you an advantage when making virtual care more widespread?
Aaron Herbel: Our approach, like across all of the services that we offer, is to meet the patient where they are and provide them the service in a format that meets their needs. That care delivery method applies to telehealth just the same as it does to any other way of providing care. Obviously, we added technology, we added devices in our facility since this pandemic started that have enabled us to have more capacity. Before we had one or two designated workstations in the hospital that were somewhat mobile but were primarily centered on the ED delivery location. Most of our telehealth prior to COVID-19 was tele-psychiatry in our emergency room.
That was kind of our biggest experience with the telehealth prior to [the pandemic], but I think we saw advantages for both our medical staff and for the patients by being able to take a mobile device, a tablet, into the patient's room and they could have a visit with the provider. It saved the provider having to put on PPE and risk exposure even if it was not necessarily a COVID positive patient. We were using telehealth for all in-patient interactions basically based on provider preference.
Q: Dr. Rhoades, what are the unique aspects of medical teams at community hospitals? How do they constantly improve patient care and experience?
Dr. William Rhoades: I would echo a lot of what Aaron said about telehealth. I think we are going to see it continue. We certainly had goals to get telehealth off and running in 2020; we had no idea that we'd be breaking through those goals. What seems like a decades' worth of work in telehealth happened in six months, which is wonderful. One particular aspect we've seen at our hospital is our ability to make a psychiatrist to the bedside of a patient in the acute care hospital a lot more readily available than we had previously [through telehealth].
The second half of your question as far as the medical teams, we have two large groups [for cardiology services]; one's a hospital-operated group and the other is an independent group and then we have a series of independent cardiologists. We want to reach out into the stratosphere with cardiology programs and structural heart programs, really doing cutting edge things along the aspects of electrophysiology or heart failure. We can't do that with just one medical group or with one cardiologist; we need them to be able to partner with one another and when they see this as a program that we can bring to our hospital, it's a lot more cooperative and collaborative. We're able to leverage our collaboration in specialties like cardiology with our infectious disease teams, with our ICU teams and others in the pandemic and really use that to our advantage.
Q: Mark, what are the most interesting initiatives you've seen at community hospitals that could apply to larger organizations as well?
Dr. Mark Pratt: I think Bill just said it. Whoever thought that a horrible pandemic would actually improve healthcare delivery via telehealth and virtual health I think it's 10 years of trying to convince adoption of that technology is crunched into six months. We just took a huge leap from a technology standpoint to serve patients better. Hospitals are also now able to use data that wasn't present before EHRs. Being able to use analytics tools to look at your patient data across populations and make decisions. I heard from a hospital that has to report COVID data to 18 different agencies on a daily basis and so being able to help from a technology standpoint, whether it's mining your data or being able to provide that electronically without having to burden humans with it is certainly something that technology has allowed us to do as well. Data analytics has taken a big jump as well as telehealth.
Q: Next I would like to discuss 2021 priorities and strategy for your organization. Harsha, given the current healthcare climate, what are your top priorities for the next year?
Harsha Upadhyay: With everything going on I would want to continue to push for virtual care platforms within my hospitals and in my region and in general in Prime Healthcare because this is something which I truly believe in is to give care to the patients in a comfortable setting and at a convenient the time that they choose. I think we will continue to push for about care outside of the four walls of the hospital, which is more in demand right now. We need to continue to push for permanent telehealth reimbursement as well. Once we have the reimbursement, we already have the technology and I think the rest is going to follow. Virtual care is the wave of the future; I definitely believe in it.
We've seen a decline by 40 to 42 percent of the elective volume and ED volume coming in and not everything is related to patients actually all of a sudden feeling better, they are just reluctant to come into a setting where they think that their care could be compromised. We are seeing a lot of these things going unnoticed and when patients do come in, we see the acuity of those patients is fairly high. So, I want to reassure that they can come back in a setting which is safe for them and reliable in terms of not contracting COVID-19 and passing it on to their family members. The total message is those patients that can get a virtual visit should get it and those patients who have a serious medical condition should come back to a hospital and receive care safely. That is my priority for 2020.