In the face of a protracted pandemic, no one and nothing has been more front-and-center than the region’s health care providers and facilities.
Amid the challenges arising from that early meteoric rise in demand—burned-out employees’ industry exits giving way to staffing shortages that further overworked an overwhelmed and diminishing pool of skilled professionals, limited patient space, ongoing financial pressure, and the harrowing uncertainty of dealing with a virus when neither it nor its long-term effects are fully understood, just to name a few novel difficulties—are organizational leaders tirelessly working to satisfy their obligations to the community while remaining solvent enough to keep their facilities’ doors open.
But medical science does have things like technological innovation and treatment breakthroughs on its side, both of which mitigate some of the new hardships that have besieged hospitals and other care providers in the recent past.
As South Jersey’s health care industry moves beyond the worst of COVID’s wildfire spread and heartbreaking body count with cautious optimism and unflagging hope, it’s internalizing lessons learned while forging ahead to break new ground and meet modern challenges head on.
“We’re seeing less and less COVID hospitalizations, thank goodness, so we’re treating it now more like it’s an outpatient or ambulatory disease,” says David Johnson, SVP and chief innovations and information officer at Inspira. “[COVID-19] is something we’re going to be living with long-term and, although we reference it still, we’re trying not to make it the focal point of every meeting, every discussion. We’ve adapted to living with it, in terms of our workforce, how we manage our business, and how we treat and handle and manage our customers and patients.”
A Lingering Influence
While Virtua Health President and CEO Dennis W. Pullin, FACHE, notes that “we’re all suffering from COVID fatigue,” he adds there is no doubt that the pandemic’s ripple effects will be felt for quite some time.
“Helping people through the initial COVID treatment was just the beginning: I have very real concerns that, honestly, we’re going to be treating long COVID for a long time,” he says. “There’s still so much that we are learning and have to learn about the virus and its lasting impact. … But we have a strong sense of purpose, and that has allowed us to continue moving forward despite the many obstacles that COVID has put in front of us.”
The pandemic age has ushered in an era of sweeping transformation for medical providers. Part of that is how conversations about the unmet need for more mental health support and resources have been thrust into the spotlight.
“There’s just been a huge demand for [addressing] anxiety, depression, suicide, trauma,” notes Brian Sweeney, president and chief operating officer of Jefferson Health – New Jersey. “But it’s a supply-and-demand problem where there’s not enough resources to provide care because there’s not enough counselors or social workers out there.”
Beyond adopting services and practices that balance the new necessity of providing what long-COVID patients need while still meeting the broader community’s everyday demands, the health care industry is still reeling from how the pandemic has profoundly diminished its talent pool. From the waves of frontline workers’ deaths to the ensuing burnout that even the most impassioned staff is susceptible to—especially after bearing the brunt of a global health crisis—there are tangible voids at every level of health care.
“Early on, everybody was full and staff was getting pretty burned out trying to keep up with the pace of that,” observes Joseph Chirichella, president and CEO of Deborah Heart and Lung Center. “While we’re not facing that so much today, I think our biggest challenge right now is there’s just not enough employees. It’s not just nurses: It’s in the kitchen, it’s in environmental services, it’s in plant operations, it’s in respiratory therapy, it’s in the lab. There’s not a single discipline that we rely on that hasn’t been affected.”
It’s not all bad, though. Pullin cautiously concedes that “if there was one silver lining of COVID-19,” it’s how rapidly its advent advanced and legitimized telehealth options, which aren’t new but certainly are more readily accessible and resoundingly embraced than they’ve ever been.
“It accelerated our capacity and abilities when it comes to remote care,” he says. “We were forced to look at delivering care differently as a result of COVID. … So we really stepped up at the beginning of this year and launched a hospital-at-home program, which basically empowers certain hospital patients to recover in the comfort of their own home while receiving hospital-level care.”
“As difficult as it was for the community, there have been a lot of innovations because of COVID,” Sweeney adds, citing telehealth’s explosion as chief among them. “There’s been a shift in many different procedures in the hospital environment. A lot of our focus has been looking at transformation of care delivery and how to innovate, whether it’s providing more telehealth services or providing care in the home environment, like a hospital-at-home type of model.”
Where Innovation Meets Health Care
Whether it’s providing the most current scope of in-home medical care, the latest in surgical technology, the newest breakthroughs in previously little-understood diagnoses, or healthy food and dietary education to chronically underserved communities, the region’s health care providers are determined to find modern solutions to all manners of stubbornly persistent health concerns.
“One of the things that helps with quality of care is staying up to date on the latest practices in evidence-based medicine and making sure you’re up to date with cutting-edge procedures and the latest technology,” Chirichella says. “Hardly a week goes by without us investigating something that involves robots or AI or some new device.”
Just as important as investing in top tech, though, is ensuring that any new device, treatment or procedure is properly implemented.
“Anytime there’s innovation, there’s also a need for professional development,” Sweeney explains. “We’re making sure we’re arming our workforce with the skills and competencies that they need to be successful in transforming health care delivery so we can be much more effective in the future.”
Embracing and understanding today’s tech is helping South Jersey’s health care facilities combat their own worker shortage by reliably automating menial, repetitive back-office tasks so talented medical professionals spend their time and energy on face time with patients. It can also foster a sense of community among remote staff, which helps retain top talent.
“Probably 80% of our back-office business side are working from home right now,” says Johnson. “But if you can work from home for a South Jersey health care hospital, you can be working from home for a hospital in California or Illinois or Nebraska, which creates a level of competition. We have to ensure our remote workers are still able to stay in touch and collaborate and feel like they’re part of a team, just like they did while they were here.”
Johnson adds that a COVID-initiated project—Inspira’s predictive modeling “that very accurately modeled the path of this pandemic” with at least 90% accuracy—is still very much in play. “It allowed us to respond very well to potential surges within our hospitals and develop plans to react to them. … We don’t stop running that AI predictive model, it runs every single day. We’re always looking at new variants and what the impact of those variants might be.”
Minimally Invasive, Maximally Individualized
Part of implementing cutting-edge medical technology is embracing laser treatments, scans and other nonsurgical options that offer the most optimistic patient outlooks. After all, reduced invasiveness can be the difference between an inpatient and outpatient procedure, and largely equates to a reduced recovery time and a decreased risk for post-surgical infections.
Of course, nothing becomes a newly adopted solution, treatment or approach without the likes of rigorous testing, peer reviews and evidence validating its place in the medical community’s toolkit.
“I think medicine will continue to be less and less invasive,” ventures Chirichella, who’s looking forward to the FDA’s approval of a small mitral valve device that treats the most common heart-valve defect in patients for whom surgery isn’t a viable option. “Right now, you can get your aortic valve replaced and be home in a day or two—that used to be a major surgery. That progress is just going to continue for heart and other surgeries.”
There is also an ongoing movement to treat patients like people, rather than their diagnoses. Everything from taking into account all the unique factors influencing the way a disease or disorder manifests in each patient to laser treatments that can eradicate a cluster of cancer cells without damaging the healthy tissue surrounding it is yielding what every health care professional says they prioritize: optimal patient results, including faster recovery and shorter hospital stays.
“It’s about treating the whole patient,” Pullin says. “It’s about providing the patient with the care they need when they need it, where they need it and how they need it.”
Balancing Business with Wellness
Being a business and providing a service is, admittedly, a difficult line to walk. But it’s a crucial balance to strike, since managing the business side of a hospital and health care means those facilities have the financial resources to treat the region for another day—and the funding to keep delivering high-quality health care right in our backyard.
“We need to be good financial stewards of the organization, but that’s not what gets us out of bed in the morning—that’s patient outcomes, a quality patient experience, a safe patient experience. I feel like if you’re good at those things, you’ll figure the financial piece out,” says Chirichella. “A lot of things keep CEOs awake at night, but I never worry about the quality of our patient care.”
Like so many other organizations, community involvement is a significant part of the health care industry’s business model. In addition to proactively serving their patients by meeting them where they are, getting to know their community through direct interaction is how health care leaders identify exactly what issues and risks necessitate intervention.
“We just did our Community Health Needs Assessment, which is where we go out into the community, we ask what’s important to them, we look at data, we collaborate with other health care organizations, including our competitors,” says Sweeney.
For Virtua, that meant getting to the root cause of so many health issues: a poor diet, often born of living in a food desert or never being properly educated about how to make good nutritional choices. Its Eat Well mobile grocery store, a decommissioned city bus stocked with healthy food options, is among its suite of health-services-on-wheels options, which include a pediatric mobile services program for children in underserved communities and mobile mammography for women whose health insurance, or lack thereof, presents a barrier to diagnostic treatments.
“The role of the grocery store is to reduce things such as hypertension, diabetes and other diet-related illnesses by hopefully establishing healthy eating habits that people can keep for life,” Pullin says. “It also empowers what we consider low-income families, especially those with children, to learn how to eat well and take care of themselves.”
A continued focus on harnessing the revolutionizing care that technology can offer is most certainly where medicine is heading. That includes streamlining patients’ ability to view their medical information.
“A part of the future of health care is giving patients control,” says Johnson. “The patient’s record is theirs. We make sure they have access to their personal health information in a convenient way, and we do that through the My Inspira app. We give them access to their own patient portal with their data, their information, and it’s our job to make it as easy as possible for them to use and manage their care with that.”
Telehealth is also poised to enjoy a bright future. Its natural progression—hospital-at-home treatments—is the inevitable continuation of an approach that capitalizes on how the comfort of home and limited exposure to a hospital environment holistically benefits the patient’s healing process and mental state.
For those organizations affiliated with an educational program, mentoring and retaining future health care providers not only is a paramount priority, but also promises a mutual benefit for students and teachers which, in turn, ultimately is to patients’ advantage.
“Our intention is to attract the best talent to South Jersey and create rewarding careers in health care,” Pullin says of Virtua’s affiliation with Rowan University.
“Because of our legacy of teaching physicians, there’s a halo effect that results in us teaching nurses, respiratory therapists, perfusionists, it just goes on and on,” Chirichella says. “When you’re an academic medical center with a teaching culture and a medical staff engaged at all these different levels, I think there’s a different sort of culture that comes with that. … There’s a synergy that comes along with having students here that really raises everybody’s game.”
Some anticipate that mergers and consolidations are on the horizon, but South Jersey’s health care community is already well acquainted with sharing services, resources and practices.
“There’s a lot of fragmentation still in health care so, given the economic situation that everybody’s facing across the industry, there’s going to be a consolidation,” Sweeney. “The health systems have worked well together through the pandemic. Despite the fact that we’re competitors, when it comes to community commitment and working together through the pandemic, we have been lockstep in terms of teamwork and collaboration.”
It all is barreling toward a future of increased inclusivity and accessibility, whether that means addressing the onerous financial burdens that often accompany life-saving or -changing procedures, or eliminating stubbornly unrelenting societal barriers to care.
“It doesn’t apply to Deborah patients because we don’t bill them, but we routinely hear stories and statistics about patients crippled with medical debt,” Chirichella says. “One thing I hope happens is that this country gets its arms around that. There’s no reason why, in my opinion, patients should have to consider whether they eat tonight or pay for their medication.”
“We find ways of making care more accessible and more affordable through innovation,” adds Pullin. “I think the health care industry will look to South Jersey as a region that’s driving conversations about safety, outcomes and strategy.”